The Mouth-Body Connection: How Oral Health Shapes Whole-Body Healing

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a fifteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Todd LePine
And there's a there's a lot of organisms that are in the mouth. In fact, the oral organisms, and we have hundreds of oral organisms, there's about a 45% concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract. And you can think of the whole body as being like a tube.

Dr. Mark Hyman
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Dr. Todd LePine
The gut is sort of where everything starts and, it can either lead you down the path of health or it can lead you down the path of disease. And the beginning of the gut is the mouth. So as you mentioned, you know, in medical school, we didn't learn anything about the mouth. That was like for the dentist, you know, we'll just ignore that. And the dentists just basically stay in the mouth and they don't really realize that there's a whole body connected to the mouth or some of the dentists don't.

And this is where I think a lot of both, you know, even functional medicine physicians and dentists really miss the connection. So unless you're working with a holistic smart dentist or a functional medicine doctor who's aware of the connection between the mouth and the gut and systemic immune system, you're going to be missing a lot of things. And as you mentioned before, there are a host of conditions, including premature birth, obesity, diabetes, cardiovascular disease, rheumatoid arthritis, inflammatory bowel disease, and even dementia that are directly connected to poor oral health.

Dr. Mark Hyman
It's incredible. Yeah. I mean, dementia. They're finding that the microbes in the mouth get absorbed and then go up into the brain and create inflammation in the brain. Pretty wild.

We know that your risk of having heart attacks is higher if you have gum disease. We know that even, you know, weight and metabolism are related to what's going on in your mouth. So, you know, what's so what's wrong with traditional dentistry and its overall approach? Because, you know, a dentist does your teeth cleaning. They might treat your gum disease, they'll fill your cavities, they'll thicken root canals.

So what, tell us what is the problem with traditional approaches to dentistry?

Dr. Todd LePine
You know, traditional dentistry, and dentistry has gone long way. You know, the original dentists were actually barbers. You remember that. The barbers used to, like, pull the teeth out. And dentists have come a long way since being barbers.

You know, a lot know, dentists are what we call drill and fill. And then you can do root canals, and then you can do implants and those kinds of things. A lot of that's related to structure function in cosmetics. People want to have white teeth and don't realize, okay, because you have white teeth doesn't mean you have a healthy oral microbiome. And you really have to look at the whole picture because, you know, the beginning of digestion starts with your mouth, starts with healthy saliva.

And all of those things are interrelated to being able to digest and absorb your nutrients from the get go. You need to have a proper salivary pH. You need to have sufficient amylase. So there's a lot of happening in the mouth that is the beginning of digestion.

Dr. Mark Hyman
All right. So, you know, one of the challenges is traditional dentistry is they use certain techniques that we find problematic. For example, putting in silver fillings or mercury fillings. And recently you sent me a link to the FDA's new ruling that fillings were not acceptable for pregnant women and babies and kids. So why is it good for the rest of us?

Dr. Todd LePine
It's not good. It's not good for the rest of us. And, you know, the thing is, is that interesting thing about that is that, you know, I think, you know, as you said before, there's no safe level of mercury. You know, mercury is a known neurotoxin. And some people are better able to detoxify it.

My father is an example of that. My father, he practiced dentistry up until his 80s. And he used to literally handle amalgam in his hands. And he'd be, you know, throwing it on the floor and I can remember going to his office and playing with the mercury in his office. And, lo and behold, you know, people, there are some people who are better at detoxifying mercury.

And there are others that don't detoxify mercury as well. But mercury is definitely, for some people, a real problematic issue. Fact, you experience that yourself. And there's testing that we do for mercury. You can check for mercury body burden and you can check for both organic and inorganic mercury.

One of the labs, Quicksilver that we use, test and it can tell you how you're excreting both organic and inorganic mercury. And the one from fillings is the inorganic mercury, which is the more toxic to the brain.

Dr. Mark Hyman
Right. And then, and so we've got the filling problem, which really nobody should ever have silver fillings. If you have them, you know, it's, it's tricky that, you know, you get them out, you not get them out. How do you determine when? Think you need to know that there are biological dentists who do it safely.

And there's a website called iaomt.org. I'll put in the show notes, iaomt.org, which is a resource of learning more about biological dentistry and finding a biological dentist in your area who knows how to practice safe removal and all, and other dental techniques that actually help to rejuvenate your mouth. One of the other challenges is root canals. I think, you know, people are getting a lot of root canals. I I certainly had one and I had to take it, had to take it out.

But tell me, what is the problem with root canals? Why should we be concerned? And, and should everybody with root canals have their teeth pulled or what do we do?

Dr. Todd LePine
All right. So, okay. So I'm not, I'm not an endodontist, who does root canals. I've spoken with my family members about this. And if somebody is really, really skilled at doing a root canal, you can do a root canal.

I think the key thing about doing a root canal is to make sure that you're dealing with a sterile environment, which is very, very difficult in the mouth. Because, you know, when you're doing a root canal, my sister, Gail, she made a comment that like a root canal is basically a dead tooth. And if you have a dead spleen, would you leave a dead spleen in your body? No. You just, you know, you want to remove a dead organ.

And a tooth that's devitalized doesn't have nerves. So if you get an infection, you oftentimes won't get pain unless it starts surrounding to the other area. You don't have a lymphatic system to drain infections. You don't have blood supply, arterial and venous supply. So you can really get these, you know, these stealth infections.

And by that, you know, we typically think of an infection as someone who's, you know, got a fever, there's swelling, etcetera. But you can have these smoldering infections. And I've seen, you know, just this past week, I've had two patients who had a history of, root canal issues that were manifesting as systemic issues, and they really didn't have a whole lot of oral issues. Were having peripheral issues.

Dr. Mark Hyman
Yeah, that's interesting.

Dr. Todd LePine
Exactly, yeah. And then when they open, open those, root canals up, if it's a bad root canal, root canal, gone bad, they often find these anaerobic infections and they are foul smelling. They're, know, the anaerobic bacteria produce things like putrescine and cadaverine. And you don't want a lot of cadaverine in your body unless you're cadaver. And putrescine is very,

Dr. Mark Hyman
Doesn't sound good either.

Dr. Todd LePine
And there's a lot of, yeah, you're right. And there's a lot of organisms that are in the mouth. In fact, the oral organisms, we have hundreds of oral organisms, there's about a 45% concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract. And you can think of the whole body as being like a tube. And the opening of the tube starts at the mouth and then it goes all the way down into the stomach, the small intestine, the large intestine, and then out the anus.

And those bacteria that are in the mouth get swallowed by the body. I mean, will swallow about 10,000,000,000 bacteria per day. And some of those bacteria, when you swallow them, can actually cause systemic inflammation. And those systemic inflammation can manifest in the joints, in the heart or the brain. It can also promote systemic inflammatory diabetes, as you well know.

So it's a real important issue. It's not just having, Okay, my teeth look white. Everything's fine. You can't see the types of bacteria that you have in your mouth. Not only that, but your individual immune response to the bacteria is really critical.

We know that in terms of, you know, with, say, for example, COVID. You know, COVID is a virus. And as a virus, you know, for the vast majority of people, it's not going to kill you. You get it and you may be totally asymptomatic. You may have a mild cold or you may die from it.

The same thing with certain types of bacteria. Everybody's immune system is unique. And when certain people are exposed to certain, organisms at critical levels, it provokes a low grade inflammatory, response, or in some cases, actually even more acute. And that can lead to a whole host of, systemic, issues.

Dr. Mark Hyman
Yeah, I think that's true. And I think both of us have seen patients who, when addressing their dental issues, often resolve other systemic issues. So maybe you can share a little bit about some of the patients you might have seen that have, links to their systemic health from their oral health?

Dr. Todd LePine
Oh, absolutely. I have three cases. Real briefly, the first case, is a patient, actually was a friend of mine. And, I remember we were talking over a beer and he was telling me, you know, some of his health issues. And, you know, he was bemoaning the fact that he was having all these symptoms and nobody could figure it out.

And I said, Well, why don't you come see me? I'll do a consult on you. We'll take a look at it. That's sort of what I do. And he told me, you know, in going over his history that he had a Cadillac in his mouth.

And I said, Well, even have a Cadillac in your mouth? Yeah, I got about 40,000 worth of dental work in my mouth. And he goes, You know, the dentist said I have weak enamel. And I said, Well, what do you mean weak enamel? And I said, You know, weak enamel is not normal.

I said, Did he tell you why you have weak enamel? And the first thing that popped into my head is that he probably had undiagnosed celiac disease, which we thought was enamel. Lo and behold, I tested him and sure enough, he had marked a response to gluten. And when he got off of I mean, all of the, a lot of his symptoms, they didn't affect his teeth because, you know, the horse was already out of the barn. But he also was having sort of unexplained fatigue and malaise and all that kind of stuff.

And, and actually just getting off of gluten cleared up those other, conditions. And we all, you know, you and, you and I well know that there are multiple autoimmune conditions that are associated with gluten sensitivity. But weak enamel is one of those things. And I also, I try to get my patients and the dentists who I see, the rest patients or dentists who I meet in social circles, to really be aware of that because I just think it's below everybody's radar. Yeah, was really, and it was very life changing for him.

Another case is a patient who I saw who was diagnosed as having rheumatoid arthritis. And this is a woman over from Europe, and she wasn't getting anywhere in the European system. Not that the European system is better or worse. It's just different than our system. But She was not getting any significant help over there.

They wanted to use the disease modifying anti rheumologic drugs, or the DMARDs. And when I did a workup on her, I did a deep dive in her, and she had a seropositive rheumatoid arthritis. And by seropositive, meaning that when you check for rheumatoid arthritis, you can have a positive rheumatoid factor or you can have a positive CCP antibody or both of them. One or the other or both of them. You can also have seronegative rheumatoid arthritis.

And as we talked about earlier, rheumatoid arthritis is just a label that we put on things and lots of different things can cause rheumatoid arthritis. The most virulent, aggressive type of rheumatoid arthritis is the one that has both RA positive and CCP antibody positive. Now, you go into the medical literature, CCP antibodies are associated with periodontal disease. So anytime I see a rheumatoid patient who's got a positive CCP, there are other things that can do that. Epstein Barr virus can do it also, but it's strongly associated with the periodontal disease.

And then they have to start doing a deep dive. So what I did with her is I did a deep dive, and lo and behold, she had a lot of dental issues. She had old root canals. She had silent infections. And I did as much as I could.

And then I also referred her to a very good colleague of mine, Doug Thompson, who runs the Wellness Dentistry Network out of Michigan. And he helps to teach other physicians about integrative dentistry. So I referred my patient to see him, and he did all the different things that he did. In addition to having rheumatoid arthritis, she also had undiagnosed Lyme disease. Wow.

Exactly. So she had two things going against that can affect the joints. So I basically treated her Lyme disease, did that successfully over a period of time, had her see an integrative dentist. We did testing on her oral microbiome. He did his thing.

And she had a dramatic improvement. She also really changed her diet. And all of those factors really, really made a huge difference in her life. She was basically not able to function. And when we treated, you know, the underlying causes, the root causes, she had a dramatic improvement in her health.

Then one other case, and this is a really anecdotal case. I really like this case. Mark, you probably have seen some patients or your career that you've seen a lot, is a patient who has, frontotemporal dementia.

Dr. Mark Hyman
Yeah.

Dr. Todd LePine
Right. That's a bad thing. And it's like Lewy Body, you know, we don't really understand, you know, these kinds of conditions. And I saw the, the lady and she was actually quite advanced with her, frontotemporal dementia when I saw her. And I did a big workup, did the ion test, nutritional metabolic testing, testing for leaky gut, testing for heavy metals.

And I did, actually, at the time, I did a relatively new test, which is the Myperiopath test, which is looking at the DNA of the oral microbiome. And she had one of the worst oral bacterial microbiologist analysis that I've ever seen. And my hypothesis was is that I think her frontotemporal dementia was really being driven by undiagnosed severe periodontal disease that was spreading up to her brain.

Dr. Mark Hyman
You just said a mouthful there because I just I just wanted to highlight a couple of things. One, there is an oral microbiome. Yes. And just like there's an intestinal microbiome, and that has implications for your health. And there's ways that now we can test this.

And this is not something you're get at your traditional doctor. It's what we do here at the Ultra Wellness Center that's so unique. We we do to dig down below the layers to see what's really going on. There's also genomic variations in our in our own DNA that affect our risk of periodontal disease. There's also tests we can look at to look at the heavy metals in the mouth and see if the mercury in your fillings is getting off gassed and if you're absorbing it and detoxifying it or not.

So there's a lot of tests that we do in functional medicine that can be very helpful to identify whether the issues you're having are oral. The, yeah. So the the other thing is, you know, what do we do to to change our diet, to keep our gums healthy and keep our teeth healthy? And and what do what do we know about food and nutrition and oral health? And then of course, basic lifestyle hygiene stuff that we should all be paying attention to.

Dr. Todd LePine
Yeah. So I actually, Mark, when I prepared for this, I made a couple of slides which should be available as an add on, for the podcast, for those who want to look at it. But the big thing is the introduction in the diet, in the modern day diet, the standard American modern day diet, is the introduction of acellular starchy fiber or foods. And when you think of this, it's very simple to think of it. These are the things like, you know, rice crackers and pretzels.

They basically have very little nutritional value. And then sugars. The modern American diet is very high in these types of foods. And these types of foods are basically instant sugar and they feed the oral bacteria. And those bacteria also will multiply in the body.

We obviously know that, you know, you can have bacteria that can cause dental caries and tooth decay, but it can also feed some of these other pathogenic bacteria. And you mentioned the role of the various types of bacteria. There's a couple of bacteria which I like to see on the Myperiopath test, which is Pusobacterium nucleatum, and then another one which is a real bad actor, which is the Porphyromonas gingivalis. And these organisms are in the mouth and you're swallowing them. So the diet that you eat will feed both the bacteria in the mouth and then also the bacteria in the gut.

So some simple things that you can do is avoid snacking, you know, drink water after you've had a meal, watch for, you know, processed carbs, sort of fake food, if you will, in your diet. Chewing xylitol gum is actually something that is a simple thing to do that can actually have an antidental caries type of an effect. And then using an electric toothbrush. That's another thing that is a simple thing to do. I pretty much recommend that for all my patients.

And you can, you know, use that right after you eat. And then also, having lots of fiber in your diet. When you eat or eating fiber, it basically is cleaning the teeth. And we all know, we've all woken up in the morning with that film over our mouth. Well, you know, that film is actually a biofilm.

And unless you're actually keeping your oral hygiene clean, you're gonna get, you know, some slime on your teeth. And that's really where the bacteria really sort of takes hold in the mouth. And, good integrative dentists will actually work on oral biofilms also.

Dr. Mark Hyman
That's great. And you know, it's often there's a lot of things we can do to improve our oral health through supplementation. Things like CoQ10 is very important. Proethosanitans from colorful plant foods, vitamin C for gum disease, even things like vitamin D to help the bone structure and prevent osteoporosis in the jaw, which can cause gum, know, weak teeth and so forth. So there's a lot of things you can do to actually help improve your overall oral health.

One of the things that I love was developed, by a friend of mine who was a dentist in Lenox years ago. It's called the Dental Tooth and Herb gum tonic, and essentially it's a series of herbs. It was amazing. He he basically showed me, would scrape my mouth and we'd put it on a slide and he'd show all the little bugs swimming around. Then I'd I'd do the the dental swish with this dental tooth and gum tonic, this herbal tooth and gum tonic, and it was just totally different.

And all the bad spirochetes and things that are causes of gum disease would improve. So there's a lot of simple things you can do from, you know, obviously electric toothbrush to water picks and flossing to, you know, using these different kinds of herbal tonics, it can really help to keep your teeth and gums healthy. It is really important because your oral health is so connected to your overall health.

Dr. Todd LePine
That's interesting that you mentioned that, Mark, because there's a-

Dr. Mark Hyman
You probably knew him, remember? He was in Lennox years ago.

Dr. Todd LePine
I don't remember, but you know what? There's a company, I believe it's up in New Hampshire. I don't know if it's the same company or are they, there's another company that uses, it's like a tooth tonic, if you will, which is an antimicrobial. So, that's actually quite interesting. The other thing is, which I'll mention because this is, it sounds sort of hokey, it's actually, it's in the medical literature.

In fact, preparing for the talk, actually looked on PubMed and there's an article from 2020 about oil pulling and the benefits of oil pulling on oral, the oral microbiome and oral hygiene. So you can do that with a variety of different oils. You can do it with coconut oil. I don't if you've ever done it, Mark, but it also leaves the mouth with a very clean taste, a very clean feeling in the body. And then that also comes out to the other aspect of the oral hygiene is halitosis.

So if somebody has really bad breath.

Dr. Mark Hyman
Bad breath.

Dr. Todd LePine
Exactly. So bad breath is not just, you know, an embarrassment. It's telling you that you've got some bugs in there that are producing chemicals that are not very good for your body. And these are usually some of the bacteria that can actually reside in the tongue and the tongue fissures, and they're what we call sulfide or sulfur reducing bacteria. And there's a dentist who came up with a product, which is a very effective one.

It's called TheraBreath, which I oftentimes will have patients use. And that's a very effective way of dealing with halitosis, but then also then looking at how can we actually improve the oral microbiome in addition. And there are some products that are out there, you know, with some Lactobacillus salivarius and such that are oral probiotics to also help balance out the microbiome.

Dr. Mark Hyman
Canker sores. What are canker sores? We've all probably had them one time or another. Why are they a problem? And what do they signify?

And how do we think about them differently in functional medicine than traditional medicine?

Dr. Elizabeth Boham
Absolutely. So canker sores are those ulcers, those sores that you get in your mouth. They're usually at the side of your mouth, you know, by your cheek, inside of your cheek that is, underneath your tongue. Those are some typical places for them. And and they are, about three to five millimeters in size, And they are a sword that comes if you look at them, they'll look like a round circle.

They're they're they're reddish. Sometimes they'll have like a yellow Coating. Coating on it. Yeah.

Dr. Mark Hyman
And they hurt like heck.

Dr. Elizabeth Boham
They hurt like heck. Yes. And like you said, most of us have had them at least once or twice. And having one once or twice is not a big deal, right? Or even more than that.

But what we get concerned about or what we wanna talk a little bit about are those people that are getting lots and lots of canker sores. And could that mean that there's something we need to be looking into and thinking about?

Dr. Mark Hyman
Yeah, I mean, I think that's right. I think, you know, in traditional medicine we go, Oh, well, canker sores is not a big deal. You know, swish your mouth with like tetracycline and Benadryl was the cocktail we used to use. And that'll help reduce the pain and inflammation. But it really wasn't ever a conversation about, well, what was the cause of these and how do we diagnose the root cause and make it so people don't get them anymore?

Dr. Elizabeth Boham
Absolutely. And you know

Dr. Mark Hyman
And what does a functional medicine doctor think when they see a canker sore?

Dr. Elizabeth Boham
You know, if if again, if it's been like if it's an isolated incident, it might not be a big deal at all. But if there if people are getting them all the time or even a couple times a month or even, you know, five or six times a year, it makes you wanna ask that question why. What could be going on? And there could be many things from celiac disease to an impact in the immune system not working properly, to eating a food that causes inflammation for your body. So celiac disease, it would be gluten, but there's other foods that for people can be inflammatory for them.

It's like a food sensitivity or food reaction. Definitely, we see it with some food additives. So some food coloring and some food additives, people will get canker sores. There are some more rare situations where people get lots and lots of canker sores, Behcet's. They'll get sores in their mouth and other areas of their body.

So, you know, that's an autoimmune process. Another autoimmune process, lupus can can cause some, recurrent sores in the mouth as well. And, of course, nutritional deficiencies. You know, it's something I think about all the time. We know b twelve deficiencies, b vitamin deficiencies.

So I'm thinking when somebody's coming in with recurrent, canker sores, those are things I'm thinking about.

Dr. Mark Hyman
Yeah. So it could be some of the foods that we're eating or chem the chemicals in our food. The average American eats three to five pounds of food additives a year. And we think, Oh, it's a little additive here. When you add it all up with all the crap we eat, it's three to five pounds.

A lot of these things are really immunoreactive. It can be very inflammatory, irritating and can cause these canker sores. But you mentioned also Behcet's and lupus. These are autoimmune diseases. But what's really striking to me and after doing functional medicine for decades is that so many people with canker sores really have gluten problems.

Absolutely. And I remember one of my friends was a Harvard trained doctor who started having really severe recurrent canker sores. We call it aphithystomatitis, but it's like a really nasty, nasty case of this. And I said, have you checked yourself for celiac disease? He's like, no.

And I'm like, well, check. And he had it and he stopped eating gluten and everything went away.

Dr. Elizabeth Boham
I see that all the time. I mean, that's probably one of the most common reasons when we have people who have a lot of canker sores, you know, whether they test positive for celiac or just we think it's gluten sensitivity or we don't have a full positive celiac test. But when they take away gluten, they often will clear up, which is phenomenal and a wonderful response. The other thing, you know, I was thinking when you were talking about the food additives and food coloring, you know, Halloween is a time where kids will get canker sores all the time right after Halloween, you know, all of those, all of that, you know, the candies that have, they're eating so much of it with a lot of additives and coloring and stuff. And so people will notice that that's a time where they get a lot

Dr. Mark Hyman
of it. That's true. And I remember when I was really sick with chronic fatigue and my immune system wasn't working right and my gut was a mess, I used to get tons of canker sores and it was terrible. I get them in my tongue, get them in my cheeks. It's horrible.

Once you start to get things back in balance and fix your gut and your nutritional status, really, really makes a huge difference. So tell us about this patient you had. It was a young woman who had really bad canker sores.

Dr. Elizabeth Boham
Yeah. I just wanna mention one thing about that and then we'll delve into this case. When things are out of balance in the digestive system, there's a lot of inflammation in there. And so the ability for the body to digest and absorb your nutrients is much less. And so and and the the oral mucosa, the the the cells in your mouth and the digestive system, you know, need a lot of regular nutrition.

So so many times, we see nutritional deficiencies show up first in the mouth and the gut area because they're just getting turned over so quickly. And so, you know, we you think a lot about those B vitamins that are necessary for healing and zinc that's necessary for healing. So when you mentioned when your body was depleted, you know, there may have been some just decreased absorption of some nutrients that are that are so necessary.

Dr. Mark Hyman
Yeah. Think you're right. And you get those cracking at the corners of your mouth. That's called keloidosis. That can be also from b vitamins

Dr. Elizabeth Boham
B vitamins.

Dr. Mark Hyman
Deficiencies. So, yeah, I have that. I mean, it's interesting to see what happens when you start looking at this stuff, you go, wow. Because you teach a whole course on the nutrition physical examination.

Dr. Elizabeth Boham
Yes.

Dr. Mark Hyman
Where through looking at various signs on your body, you can pick up nutritional deficiencies that may be related to some of these things.

Dr. Elizabeth Boham
Yeah. So with doctor Michael Stone. So that's fun. So yeah. So this this woman was a 25 year old woman who had regular canker sores her whole life.

She had them as a kid. She had them in her teenage years. She was getting them probably once a month, and sometimes she'd have multiple canker sores. And they were painful and no no fun, like, you know, you mentioned. And and she was always thin.

So she was always on the thin side. She had some digestive issues, some diarrhea, some bloating. But, otherwise, you know, she was she was healthy. Oh, she was told she had iron deficiency. So she was low in iron, but, otherwise, not really anything that would make you think she was ill or or, or sick in in any way.

But she just wasn't you know, she wanted to kind of deal with these canker sores and came in. And so we decided to test her for celiac disease because as we were mentioning, it's gluten and wheat can be a common cause of these canker sores for some people. And

Dr. Mark Hyman
It also cause irritable bowel and prevent you from absorbing iron and make you not be able to gain weight, all the things she was exhibiting.

Dr. Elizabeth Boham
Exactly. Exactly. And she tested positive conventionally with regular celiac testing. She was positive. Her tissue transglutaminase was elevated.

So we were like, Oh my goodness, you have celiac disease. So she stopped It was eating kind of, she stopped eating gluten and the canker sores went away.

Dr. Mark Hyman
Absorbed her irritable bowel and her iron deficiency. Exactly. She started gaining weight, I'm sure.

Dr. Elizabeth Boham
She did. I mean, the iron and the weight took a little bit more time, but the canker sores and the irritable bowel went away right away. It's pretty

Dr. Mark Hyman
amazing when you think about how common this is, because we've talked a lot about gluten on this podcast, but even people who don't have celiac, they can have non celiac gluten sensitivity. So they're on the full blown celiac numbers on the lab tests, they're in that continuum and they can still have all the same problems. And the thing that people don't realize is that, doctors don't realize is that they think, Oh, the problem you have is canker sores. That's the diagnosis. That's not the diagnosis, that's just the symptom.

What's the cause? And that's what's so different about functional medicine. It's what we do here at the Ultra Wellness Center that's so unique is we're really medical detectives that look at the cause. And it may be different for different people. Some people's canker sores might be caused by a food additive or maybe it's because of a food sensitivity or maybe it's gluten or maybe something else.

So I think that's really the beautiful thing about functional medicine is we can kind of drill down.

Dr. Elizabeth Boham
Yeah. You want to look for that underlying root cause. And then, you know, if it is more of an autoimmune if for somebody, it's more of an autoimmune condition, then you have to ask that question why. Right? Why do they have this autoimmune condition?

What is out of balance in their body? What's triggering it? And we can't always answer those questions, but they're really important questions to ask because that really influences how we treat them. So we're not just treating the the outward symptom of the canker sore, but looking for that underlying root cause.

Dr. Mark Hyman
Yeah. Amazing. And people don't have to suffer from it because it's so annoying. Yeah. People

James Nestor
are disconnected from their breathing when they're mouth breathing at night, when they're over breathing in the day, when they're hunched over and their posture is bad, they are perpetuating this feedback loop of constant stress. And breathing is the quickest way of breaking that stress feedback loop. So you can change your breathing and break your stress, and you can measure what happens to your body when you do that.

Dr. Mark Hyman
You know, as a doctor, you know, it's really clear when you look at the biology of breathing that that there I mean, there's a lot going on. And often people are shallow breathers or they're mouth breathers. There's all kinds of of challenges that happen biologically when you do that. But one of the things that people don't realize is that their their diaphragm, which is basically the muscle that moves when you breathe, expands and contracts in order to actually fill up and empty your lungs. The main nerve that relaxes your body goes through there.

And that's why when you take a deep breath, you relax, and it's called the vagus nerve. And and what's fascinating is there's all this incredible science around how we have to do, you know, injections around the vagus nerve, or we do sort of certain kinds of, you know, trans like magnetic therapies for the vagus nerve, all those different things. But we always have access to be able to activate the vagus nerve through our breath. So can you kinda explain how that all works and why why the diaphragm is so important and why we need to understand how to breathe differently and what it does to our biology?

James Nestor
Sure. That vagus nerve travels right along our throats as well. So this is one of the reasons why yoga practices have a lot of humming and singing and that allows for better vagal tone. It calms you down. But the vagus nerve is also I mean, it spreads throughout the whole abdomen.

It's it's the longest nerve in the body, vagus, like a vagrant. It's a wandering nerve. So when you are breathing in a shallow way, you are sending messages through the vagus nerve and the phrenic nerve to your brain that you are stressed. So 80% of the messages between the body and the brain are coming from the body. So you can send your brain, if you want to do this, constant stress signals by breathing too much and by breathing in a shallow way.

And the lungs don't inflate themselves, right? They need something to do that, and that's what the diaphragm does. So most people understand the role of the diaphragm in expanding the lungs and deflating the lungs. But what I didn't know, and I'm learning more recently, is that the diaphragm is also essential. That diaphragmatic movement is essential in the circulation of lymph fluid and in the circulation of blood.

This is a pump. This is like can think of your body as a there's a piston in your body. Okay? It's the diaphragm. And you need those fluids constantly moving in an efficient way.

You can get by by breathing in this very short and stilted way. A lot of people do, but compensation's different than being healthy.

Dr. Mark Hyman
Yeah. Well, that's a very important point because the, you know, the body, we think, you know, exhale exhales carbon dioxide as as a way of detoxifying something that can actually be harmful to us in excess. Right? And that's what the breath does. You breathe out carbon dioxide.

You breathe in oxygen. But also what you're saying is that it detoxifies us in way more complicated ways through the lymph system, which actually clears out all the waste and the metabolites from your tissues and your cells and brings it back to the heart to filter and do all that stuff that has to do with the liver and clean it up. So it's a if you don't have your lymph circulating, you're gonna get sick. And I actually had a podcast with doctor Mehmedaz and his father-in-law, Jerry Lamol, talking about the importance of lymph and and lymph function to health. And breath, like you said, is one of the most powerful doorways to actually activate lymph circulation.

So very, very important. Tell me tell me how you got into breath because I think you had a particular story that was quite interesting, and and it and it really kinda led you down this rabbit hole researching what actually, was causing some of your issues.

James Nestor
Yeah. As a science journalist, you don't think that you're gonna one day write a book about breathing, which seems like

Dr. Mark Hyman
such a

James Nestor
simple and and mundane and completely boring subject. But I had Yeah. This was a long time ago, about ten years ago, plus I had constant respiratory problems. I was eating the right food. I was exercising all the time.

I was sleeping eight hours a night. You know, I was tuned into my health, but I kept getting bronchitis. I kept getting mild pneumonia. I was wheezing when I was working out. Every time I went to my doctor, I was told it was normal.

And whenever I got mild pneumonia, you know, I'd get a Z Pak and be sent on my way. And, it worked, but but it didn't fix the core problem. Every year, I kept coming back. And they would just be like, oh, you're back. You have pneumonia.

Yeah. I I have pneumonia again. And so it just something seemed a little off. That went on for years until one doctor friend said, oh, you should explore a breathing class. I said, does breathing have to do with immune function or my chances of getting pneumonia or bronchitis?

She she said she had had experience with yoga. She said, you you'd be surprised. So in San Francisco, you know, it's it's hard to throw a a tennis ball and not hit four different breathing classes. So I I just sort of spun the roulette wheel, found one, and had an extremely powerful experience. But as a journalist, I'm not gonna write a memoir about breathing, so I didn't know what to do with this experience.

And years went by be before I found a way to tell a larger story. And and it was specifically learning from free divers, people who are doing things that are supposed to be medically impossible with their body. They do it every day.

Dr. Mark Hyman
10 underneath. Right. It's like a it's a whole doorway to health that we hadn't really thought about. And, you know, a lot of us, you know, we don't think about our breath, but we often don't breathe very well. My mother, you know, had a lung issues, and she was a mouth breather.

And she I was always trying to get her breathe through her nose, and she just couldn't do it. But tell us about the distinction between nose breathing and mouth breathing. You know, why why is mouth breathing not good for you, and why is nose breathing good for you?

James Nestor
Mhmm. So when we breathe through our mouths, we're exposing ourselves to everything in the environment. If you live in a city like me, that means pollen, that means pollutants, means smog, it means mold. And there's nothing filtering that air all day long. If you breathe through the nose, and I so happen to have a special guest here, is a cross section of a human head.

And if you see what happens when you breathe through the nose here, you're forcing this air through all of these very ornate structures. And as that air goes through these structures, it's heated up, it's moistened, it's filtered, and you get this huge perfusion of nitric oxide as well, which guess what? Nitric oxide helps kill viruses and bacteria. Yes. And it's a vasodilator.

So when you're when you're breathing through the mouth, you get none of those advantages. You can survive mouth breathing, but it's gonna wear you down and make you sick. And that's just how things work. And you can very clearly see this by just looking at our physiology and and looking at our anatomy.

Dr. Mark Hyman
It's quite amazing. Know, the way you just brought up is really important because we had Louis Signaro on the podcast who won the Nobel Prize for his discovery of nitric oxide. He's this cute little, like, 80 year old Italian guy who think he'd be like your uncle or something. And he's so sweet. And he just he just really explained how important it is to breathe through your nose and how nitric oxide is produced, which is, like you said, antimicrobial and also increases in your ability to fight inflammation as an antioxidant.

And, you know, it's the main main thing that happens when you take Viagra, which is you increase nitric oxide, which includes dilation of blood vessels and so forth. So it's fascinating. And he's he even said, and this was fascinating, they were doing some preliminary studies around COVID, where they were giving nitric oxide gas to COVID patients and seeing remarkable changes in their biology and improvement in their lung function and their overall health. So it's kind of interesting that our body knows what to do, but we often have have sort of lapped in these habits around mouth breathing. And and actually, there's this there's this kind of new trend out there.

I'd love to hear what you think about it. Are you using mouth tape at night for people to breathe through their nose at night instead of through their mouth? What do you think about

James Nestor
Well, what I learned about nitric oxide was from Ignaro. So he won the Nobel in in the nineties. And I think last time, last interview I heard with him, he said there were 11 clinical trials looking at patients who had severe COVID and giving them nitric oxide. Some of those trials have come out. They're official published studies.

And it works incredibly because of course it does. You know, it's just we're supplementing what our natural body in its natural form would be doing otherwise. It's important to note too, if you you increase that nitric oxide 15 fold. So I I think that this would be an interesting thing to explore. And there a lot of yoga practices have have you I wish someone would do this study.

Yeah. You know? It's never gonna get

Dr. Mark Hyman
funded, but

James Nestor
but, he's he's an amazing guy. I've learned so much from him.

Dr. Mark Hyman
That's so great. And you and you did an interesting study where you were at Stanford, when you were sort of researching the breath for your book, where your nose was completely plugged for ten days and you had to breathe just through your mouth. So what was that study, and what did you find out?

James Nestor
So I've been working with a chief of rhinology research at Stanford, a guy named doctor Jayakar Nayak, who probably knows more about the nose and nasal breathing than anyone on the planet. So we had had several interviews, and there had been animal studies looking at what happens when you make an animal, a monkey specifically, a mouth breather, and all the awful things that happen to their health and their facial structure. Don't read those studies. They're they're horrendous. But I asked Nayak.

I said, has there ever been a human study of this? And he said, no. And I said, well, why don't you do it? You're at Stanford. You you study this stuff all the time.

He said doing so would be unethical because he knew of all the damage it it could do. So I said, well, why don't I volunteer for an experiment? I'll try

Dr. Mark Hyman
to make informed consent. Alright.

James Nestor
Yeah. And two, you know, I wish it were a 100 people. We had to pay for the study ourselves, which at Stanford was was not cheap. And, the longest we were allowed to do this was for ten days. Ten days, just mouth breathing, ten days, nasal breathing.

And as advertised, it completely destroyed us. And, we have all the data to show that. There was extreme fatigue. My blood pressure went through the roof. I got home after about three hours of mouth breathing.

My blood pressure was one fifty eight over a 100, which was about Wow. Higher than I had ever seen it. And I said, oh, you know, I'm I'm stressed out. I need to go to sleep. For the first time that I'm aware of, I started snoring.

Then I started getting sleep apnea. It got worse and worse the longer we have this. The other subject in the study had the exact same thing at the same time. We had trouble focusing. Our mouths were completely dry.

We were miserable. Athletic performance plummeted. I mean, this to be clear, two people in an experiment means nothing. What I was doing was personally experiencing what science has known for for literally decades and Well, there

Dr. Mark Hyman
are n of one studies, so I don't think it's meaningless. You know, there are there is a whole science, and the NIH is actually advancing this, which is looking at changes in an individual and that being relevant. And if you measure changes before and after, it's actually not insignificant. So I wouldn't discount what you're saying as being more widely available to to to sort of think about. And I think I think that, you know, you you actually have a lot of different things that you talk about as a way of of fixing your breathing pattern.

Maybe you can share a little bit of what are the tips. How should we breathing? How do we get enough quality breath? How do we stop mouth breathing? What what do we have to do?

James Nestor
Luckily, in that Stanford study, we did ten days of mouth breathing followed by ten days of just nasal breathing. This is where the sleep tape comes in. So it's it's easy to nasal breathe in the day. You just shut your mouth. But at night, more than 60% of us breathe through our mouths.

And so how do you keep your mouth shut at night? About a hundred years ago, they used to have chin straps. So they knew how damaging mouth breathing was a hundred years ago. We've we've seemed to have But lost that nowadays we So have I learned from a breathing therapist at Stanford. She prescribes tape for her patients, for every one of her patients to tape their mouths at night.

This is not full on Yeah. Hostage situation stuff. This is the

Dr. Mark Hyman
team It's not duct tape.

James Nestor
It's a it's a No.

Dr. Mark Hyman
And there's a little hole in it. There's a little hole in it.

James Nestor
There's a specific tape. It's a surgical tape. It's called MicroPore tape, and it's very light adhesive. You wanna take this stuff off with your tongue. Never pull it off of your lips.

That's where people go wrong. But what this tape does is it's just a gentle reminder. At any time in the night, you can go if you're uncomfortable, and it pops off. But this has been all of that snoring that I was doing mouth breathing immediately went away by just with one hack closing my mouth. And this is the one thing I've I've literally heard this from thousands of people have written, and they said this was the most profound health hack that they've experienced.

It's for a lot of

Dr. Mark Hyman
people I've heard the same thing.

James Nestor
And I'm not saying it's gonna work for everyone, especially with advanced severe sleep apnea. You're gonna need more treatments. But it's free. Breathing through your nose is only gonna help you. So you may benefit a little or you may benefit a lot.

And I cannot sleep. I mean, technically I can sleep, but I can't sleep well without sleep tape now. It's a real That's amazing.

Dr. Mark Hyman
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So tell us what tape you use and what are the options out there for people? Because it sounds like I after this conversation, a lot of people are gonna around and wanna buy tape, but I don't want them to get, like, Scotch tape or some masking tape or something. It's not the right tape.

James Nestor
Well, there's there's so many different types of tape that work, and it really depends on the person and their preference. I went through about 30 different types of tape before I found one that I really liked and that worked for me. It's, I'm not getting paid to say this. It is a MicroPore tape, a surgical tape by three m. Has a really light adhesive for sensitive skin.

That's the best stuff I've found. Other people like different brands. There's specific brands now that are just sleep tape that you can buy on Amazon or wherever else. They work great. So I would say play around, find something you like.

You want something with a very light adhesive. And most importantly, as I mentioned, you don't need a very fat strip of this stuff. All you need is something about the size of a postage stamp. This is the whole technology here. That's sleep tape.

Okay? It's just keeping I can even talk to you when I have this stuff on. When I take it off, you take it off with your tongue. Don't rip it off. Take it off with your tongue and you won't get any irritation to your mouth that way.

Dr. Mark Hyman
Love that. That's amazing. Okay. That's a wonderful hack. Do you think everybody should do that?

Or how many people breathe through their mouth at night? Is it a common thing? Or why why why would we if it's not supposed to? Is it, like, just because we're unhealthy or because we're stressed or what?

James Nestor
I think that about 60%, this is the the percentage I heard, more than 60% of us breathe through our mouth at night. And if you were like me, you would go to sleep with a huge mug of water because you would wake up throughout the night and be hitting on this water because your mouth was so dry. Breathing through the mouth at night, especially for eight eight hours at a time will also change the pH in your make in your mouth and make you much more susceptible to having cavities in periodontal disease. So everyone should be breathing through their noses at night. You need to find a way of doing this.

Dr. Mark Hyman
If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Doctor.

Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Doctor Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Doctor Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.

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