The Dr. Hyman Show - 3 Heart Experts Reveal What Really Prevents Heart Disease

Episode Date: July 1, 2026

As part of our summer series, we're revisiting some of the most important conversations we've had on the topics that matter most to our health. And few are more important than heart disease. Heart disease remains the number one cause of death worldwide. Yet despite decades of research, millions of prescriptions, and billions of dollars spent on treatment, many people are still confused about what actually causes it—and what we can do to prevent it. For years, the conversation around heart disease has focused almost entirely on cholesterol. But what if that's only part of the story? In this special compilation episode, you'll hear from Dr. Cindy Geyer of The UltraWellness Center, Dr. Eric Topol, and Dr. Aseem Malhotra as they explore a different perspective on heart disease—one that goes beyond cholesterol and looks at the deeper drivers of cardiovascular risk, including inflammation, insulin resistance, metabolic dysfunction, lifestyle, and early detection. You'll hear why many experts now believe heart disease often begins decades before symptoms appear, why traditional testing can miss important warning signs, and how emerging science is giving us new tools to identify risk earlier than ever before. Most importantly, you'll hear a message that is both practical and hopeful: that many of the factors driving heart disease are within our control, and that prevention remains one of the most powerful tools we have. Let's dive in. View Show Notes From This Episode Sign up for Dr. Hyman’s Brainshaping Academy to learn how to nourish the biological systems that support your mental, emotional, and cognitive health https://drhyman.com/products/brainshaping?utm_source=dr_hyman_show&utm_medium=newsletter&utm_campaign=may_27&utm_content=link Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by BON CHARGE, BIOptimizers, Rho, Made In, Seatopia, and Cozy Earth. Explore red light products at boncharge.com/hyman and enjoy 15% off with code HYMAN. Go to bioptimizers.com/hyman and use code HYMAN to save 15% off your order, plus get a free gift.  Explore science-backed products at rhonutrition.com and use code HYMAN for 20% off the entire site. Upgrade your cookware at madeincookware.com and save 10% off your first order with code HYMAN-HIVE. Find a cleaner source of seafood. Check out seatopia.fish/hyman and receive free shipping on your first order. Head to cozyearth.com to save 20% and upgrade all of your daily essentials today. (0:00) The persistence of heart disease and the low-fat diet hypothesis (0:32) Preventing heart disease through diet, lifestyle, and simple behaviors (2:19) Revisiting key conversations on heart disease (3:44) Beyond cholesterol: deeper drivers and risk factors (7:18) Typical workup, treatments, and advances in cholesterol testing (17:48) Metabolic health, hormonal, and inflammatory factors in heart disease (29:37) Advances in cardiovascular diagnostics and AI (31:31) Impact of lifestyle and new pharmacological treatments (36:55) Statins, side effects, and lipoprotein fractionation (40:13) The role of AI, new diagnostics, and Dr. Topol's journey (43:19) Rethinking treatment: diet, industry influence, and the low-fat craze (45:28) Saturated fat, cholesterol, and revisiting the evidence (48:00) Cholesterol in heart disease risk and systematic drug review (52:31) Insulin resistance, cholesterol’s role, and mortality (58:31) Challenges in changing medical dogma (1:00:31) Closing remarks and call to action

Why are we still seeing so many people with heart disease? Yeah, it's still the number one killer around the world, not just here. And it's still the number one killer in women who, you know, they think it's breast cancer. No, no, this is it. I concluded that one of the root causes, Mark, was this flawed hypothesis that we should have low-fat diets to prevent heart disease. Cardiovascular disease is an inflammatory process, that it's not just about cholesterol, but there's ongoing inflammation. Ammonic stress, loneliness, isolation, bad sleep. Those things are huge in heart disease.

But we know that 80% of cases of heart disease and diabetes may actually be preventable with diet and lifestyle. Most of us are walking around in a state of chronic stimulation. Your cortisol is elevated. Your nervous system is stuck in go mode. We wonder why we can't sleep or focus. Now one thing I've been using that I generally look forward to at the end of the day is the infrared PMF wrap from Bon Charge. PEMF, otherwise known as post-electromagnetic field therapy, He delivers gentle, electric magnetic frequencies into the body that mimic what you naturally absorb spending time on the earth.

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Heart disease remains the number one cause of death worldwide. And despite decades of research, millions of prescriptions and billions of dollars spent on treatment, many people still are confused about what actually causes it and what we can do to prevent it. For years, the conversation around heart disease has focused almost entirely on cholesterol. But what if that's only part in the story? In this compilation episode, you'll hear from Dr. Cindy Geyer of the Ultra Wellness Center, Dr. Eric Topol, and Dr. Sima Hotra, as they explore a different perspective on heart disease, one that goes beyond cholesterol and looks at the deeper drivers of cardiovascular risk, including inflammation, insulin, insulin, insulin, and early detection.

You'll hear why many experts who now believe that heart disease often begins decades before symptoms appear, why traditional testing can miss important signs and bitter warning signs and how emerging science. is giving us new tools to identify risk earlier than ever before. And more importantly, you'll hear a message that is both factable and hopeful. And that many of the factors driving heart disease are within our control. And that prevention remains one of the most powerful tools we have. So let's dive in. So let's talk about heart disease because we think we know all about heart disease. Oh, it's cholesterol and statins are the cure.

And if that doesn't work, you get a bypass and angioplasty. And, you know, if that doesn't work, you get a red transplant. That's sort of. And then, you know, of course, there's all the normal causes we know, like diabetes and high blood pressure and high cholesterol. But diabetes is a symptom, high cholesterol is a symptom, smoking is a habit. And yet we're kind of missing the boat, I think, on a lot of the reasons we have heart disease and what we can do about it from a more assistance perspective. So let's talk about just what a big deal this is and how few people actually are meeting the, simple behaviors that will prevent heart disease. Yeah, again, this is another one of those conditions

that the debate is, well, it's in my family, so I'm doomed to get it. But we know that 80% of cases of heart disease and diabetes may actually be preventable with diet and lifestyle. And despite that really powerful message, fewer than 3% of the U.S. population is meeting the core for basic characteristics that predict low risk. And it's a pretty low bar mark. And what are those? One of those four things. It's not smoking. Okay. Getting the minimum recommended 150 minutes of exercise a week,

eating in the top two quintiles of what's considered a whole food's diet, and having a healthy body fat percentage. Fewer than 3%. I still find that shocking. So not too much body fat, eating pretty healthy, little exercise, and don't smoke. Yeah, that's good. Simple things to do, but like... We're not even there yet.

3%. Yeah. And what's really staggering is that, Yeah, not only do the people not meet those habits, but that there are some really other big factors that we are just so bad at in America. Our whole society is set up to actually cause heart disease. Absolutely. One of those things that really are these risk factors besides cholesterol. Well, of course, it's inflammation.

I mean, you and I were working together back at Canyon Ranch when that pivotal study came out. I think it's been 21 years now. I remember that, New England Journal of Medicine review paper. Peter Libby and Paul Ritker showing that cardiovascular disease is an inflammatory process, that it's not just about cholesterol, but there's ongoing inflammation. And as you've talked about many times on this podcast, inflammation is not, it's also a symptom that it can come from a lot of different places. Because in our paper, our local paper when that article came back out, I don't know if you remember this. It said President Bush's doctors measured as CRP, which is the common marker of inflammation. And they don't know what to do about it.

Right, right. So it's one thing to say, well, we know inflammation matters. It's another one entirely. Take aspirin. Take aspirin and a statin, right? But it's another to say, well, what are the root causes of inflammation? Well, that's true. And there's a lot of them.

And some of the things that we don't typically think of as causing inflammation. We know infections and allergens and things like that, even toxins and bugs in your gut. But stress causes inflammation. Absolutely. Lack of exercise causes inflammation. Yeah. Bad sleep cause inflammation. Loneliness and isolation cause inflammation.

And those are pandemics in America. Chronic stress, loneliness, isolation, bad sleep. I mean, those things are huge in heart disease, and we often miss the boat on helping our patients really deal with those. So, okay, so the typical person comes in, he's, you know, got a high cholesterol, he or she is a high risk for heart disease, maybe family history. Typical doctor does sort of what work up and what kind of treatments? So a typical doctor might measure a glucose and an A1C to look at their blood sugar status,

and they would do a standard cholesterol profile, which, interestingly enough, calculates your LDL cholesterol, the one we usually think of as being the lousy cholesterol, from a formula, doesn't even really measure it, and base most of the decisions on that. If they have symptoms, they might send them to a cardiologist for a stress test. If they have chest pain. Or shortness of breath on exercise. It's already kind of down the road.

Right. But most doctors don't measure a C reactive protein because, as I mentioned before, it's like, well, what do we do with it? What do I do with it? Oh, statin and aspirin. And then they're probably going to treat them with if they are pre-diabetic or diabetic, they're going to give them metformin or medications to lower blood sugar and probably a statin to control the cholesterol. How often do they actually talk to them about those root causes such as diet and stress

and sleep? Maybe not. Yeah. They're talking about this polypill as a treatment, which is this combo pill of an aspirin, a statin, and a blood pressure drug. Yes. Put it in the water. Just like give it to everybody.

It'll prevent heart disease. I'm like, yeah, okay. Well, why do we have my blood pressure? Why do we have a need for aspirin inflammation? Why is our cholesterol all screwed up? And you know, it's really interesting. There's, believe it or not, there's a potential behavioral component for patients who go on a statin and their cholesterol is now normal. It's good.

Oh, yeah. I can eat my cheeseburger. I can eat my cheeseburger. Isn't that interesting that people change their diet in an unhealthy way when their numbers better? One of the worst things I ever read was there was a bunch of cardiologists advocating for selling statins over the counter at McDonald's and fast food. restaurants. And I think they do sell even statins over the counter and like, you know, it's like, it's like those commercials for the acid blockers like, take some pepsid because don't worry, Daddy, you can eat your peppers and sausage. Just take the pepsons. And I'm like, no, don't eat the

peppers and sausage. So, you know, you kind of mentioned they do it sort of a cholesterol profile, but there was a hint of a subtext in that sentence where they really weren't. measuring the right thing. So we tend to look at things that we're used to looking at that are easy to test and measure. But, you know, one of the things that I think people forget, and I think doctors honestly forget, is we get trained in this panel of tests. And it's your blood cow and your metabolic profile and your cholesterol. And we measure, like, a few things.

Maybe it's 30, 40 things. Maybe if, like, it's a super fancy doctor, they'll measure 100 things. Like, and they think that. kind of checking everything. Oh, your tests are fine. Everything's great. You look good. And the truth is that they're missing a huge amount. There are literally tens of thousands of different molecules in your body all doing things all the time, every minute, every second, and we ignore most of them. And they, in fact, we may ignore some of the most important ones. And when it comes to cholesterol, we covered this on the podcast with Dr. Baum, and we went really deep into this. We just

should just do a quick refresher because the tests that most people get, not the one we get here at the ultra-balness number, the test that most people get is like an antiquated cholesterol test that doesn't really tell you a whole lot. And I have a patient yesterday who's a classic example of that, right? So tell us about, and I'll tell you about his test in a minute, but tell us about, you know, the new kind of testing that we're doing. It's not so new because we've been doing it for 20 years.

But and the discovery that allowed for the testing was 50 years ago. Yeah. So the focus has been on amount of cholesterol, but we want to know the quality of the cholesterol. So we know, for example, LDL that's typically labeled the lousy cholesterol. There's big, fluffy, puffy pattern A, LDL cholesterol, which is less easily made into a plaque in the artery, less prone to inflammation and oxidative stress and rupture. So it's a less risky LDL. whereas somebody could have small, dense pattern B LDL, and that's the really risky LDL. So quality matters.

And if you have two people with a calculated LDL of 130, one of them could all have pattern A, low-risk LDL, and they're actually fine. Somebody else could have lots of those dense particles that's not captured by the calculated LDL of 130. So the quality matters. The same is true for HDL. We've historically thought of HDL as being the good healthy cholesterol. But size matters there too.

Small HDL doesn't seem to be as able to cart out the bad LDL and get rid of it. So we want to know the quality and the size of both the HDL and the LDL. And we want to know what other remnant particles are floating around like very low density lipoprotein and intermediate density lipoprotein and those don't show up on a typical panel. Yeah. So practically what you see is people come in when it looks like a normal cholesterol. Like this guy yesterday has early dementia. His cholesterol, I think, was 160 something.

Sounds good. Yeah, his LBL was, I think, under 100. Straglalal wasn't bad. His HDL was 39, which is kind of low. But we looked at this particle number, even though his LVL, like if you're regular dog, oh, that's a great, 160, that's a great cholesterol. They missed the boat because his particle number was like 1,500.

it should be under 1,000. Wow. And his small particles, which should be like zero or less than 300 is, you know, you can live with, but anything over that is high. His was 900. Wow. So he was like, and he was a skinny older guy, was 84 years old and had, you know, lost muscle, belly fat, you know, underweight over fat.

And he was pre-diabetic, and that was driving some of his dementia. But there were all your cholesterol. fine, not an issue. And we also look at a lot of other things besides that. And by the way, you know, in 2021, no one should get the regular cholesterol panel. I mean, you got to insist from your doctor. You can get it from Lab Corps quests called NMR, Cardio IQ. It's so important to do. And I guess, you know, the problem is most doctors want to do with it once they find it. There's no drug for it. Like, oh, your LDL's high, we'll give you a statin. It's like, it's like we treat what we can easily test and find, not necessarily what the right thing is.

And so with heart disease, you know, it really is a metabolic issue. It's, it's, you know, you could, they shouldn't be called cardiologists. It should be called cardio-endo-immunologists, right? Because it's all about the hormones, including insulin, and all about the inflammation, the immune system. And you mentioned earlier that study by Paul Ritker and Libby, in which was sort of the beginning of the conversation, a lot of the follow-up studies like the Jupiter trial, they found that if patients had a high LDL,

but they didn't have a high CRP, their risk of heart disease was negligible. But if they had a high LDL and a high CRP, that was the problem. So independent of inflammation may not be an issue. This episode is brought to you by Rose Nutrition Liposomal NAD. Here's a real question. Why did two people, the same age,

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is that it makes cooking real food at home easier and more enjoyable, which is one of the foundations of long-term health. If you're looking to upgrade your cookware, go to maidenware.com and use the code hymen-dash-5 for 10% off your first order. And also, you can get falsely confused by cholesterol tests. You've seen these patients who were, and I don't mean to stereotype people, but like it was this kind of cohort of women who were probably in their 70s and 80s, who were thin, who are fit. The ladies we see at Kenya ranch who like exercise, eat well, don't smoke, normal blood pressure, no diabetes. And their cholesterol is 300. And there are HDLs 100.

And there are LDLs like, I don't know, maybe 150 or something. And they have no small particles. And they have all these large, fluffy things. And they're in really no risk for heart disease. And they don't need a statin, right? I even ask Peter Libby, who's the chair of cardiology at Harvard, like, do these women need a statin? Like, no, they don't. We don't have any data to say that they do.

And I'm like, oh, that's interesting. So we kind of have to be really personalized in our approach. And that's the other feature of functional medicine. and not like one size fits. Everybody gets the polypil. Everybody gets a static aspirin and blood pressure pill. Like, no, we have to start to think about what's the cause. And the heart to these is a symptom.

It's a syndrome. It doesn't, there are many, many causes. So let's talk about this whole idea of metabolic health. Because, you know, we were chatting a little earlier. And it's staggering to me as a physician, just how poor our metabolic health is. So how healthy are Americans metabolically? Yeah, not very. So a recent study was looking at the Nahan's data from 2009 to 2016. To government surveys. Government survey.

Our blood tests and health records and everything, right? And trying to say, well, how many people are what we would call metabolically healthy? And if you're not familiar with it, for people who may not be familiar with that term, sort of meeting the optimal numbers for a blood pressure less than 120 over 80, HDL levels being in the high range, a good range, greater than 40 for men and 50 for women, having triglycerides that are low, having a glucose that's less than 100, and they found that 12.12% of Americans... 12.2%.

12.2%? Thank you. 12.2% of Americans were metabolically healthy. Which kind of means that almost 88% of Americans are metabolically unhealthy. And since 75% of people are overweight, there's another 13% there. It's like, what's going on with the skinny people? Well, and that's the interesting piece. Fewer than one third of so-called normal weight people were metabolically healthy. So that's another really important message. Oh, wait, wait, wait.

Did you just say that two-thirds of skinny people are metabolically unhealthy and have pre-diabetes-like syndrome? Yes. Two-thirds. That's mind-boggling to me. Okay, so that means that what? like 95% of Americans are metabolic. No, no, no, it's still the 88%. But that we're looking at how strongly it correlated with weight.

That's so terrible. So just having a body mass index that's less than 25 is not a guarantee that you're metabolically healthy. So if you're a skinny sugar and bagel eater, don't think it's fine because you're skinny. Exactly. It's basically the bottom one. Exactly. Because foods have other impacts besides just what they do with cholesterol anyway. foods directly impact the elasticity of the arteries, for example, which is another key player.

You mean food is more than calories, Cindy? Food is information, Mark. You said that for years. It talks to our genes. It talks to our systems. Yeah. Wow. So you're talking about how the food impacts are in metabolic health.

And we're not really good at diagnosing metabolic dysfunction. Right. I mean, 90% – I mean, okay, one out of two Americans has pre-diabetes or type 2 diabetes. And if you look at this new study, I would argue that nine out of ten Americans have some degree of pre-diabetes or type 2 diabetes, like 90% of Americans. So when you look at that data

and you also look at the parallel data that 90% of Americans with prediabetes are not diagnosed by their doctor. Right. That's terrifying, especially because this is a 100% reversible, preventable, treatable condition. And it gets worse and worse over time and people just don't even know they have it.

and doctors miss it because there's no pill to take. O-Tec-Metformin, well, that's not going to help, right? It's like, and so what are the kinds of ways that we look at these patients differently? What are the tests that we do? What are the things that we really focus on? When someone comes in with a risk of heart disease or the concern about heart disease, you know, what's our approach? It's not just looking at the typical cholesterol and even CRP.

Yeah, so we would look at those, of course. We would also want to know what is somebody's insulin. Most doctors measure glucose but not insulin. I personally like to look at somebody's glucose trends over time, because if you think about something that's preventable, you don't want to wait until they cross that threshold to pre-diabetes or diabetes. So even in the range of so-called normal glucose mark, you know this. Somebody who's fasting glucose runs less than 85 is in a very different metabolic place

than somebody who's fasting glucose is 95 to 99, even though they're both technically normal. that it's a spectrum of risk, and the farther along you marks that spectrum, the higher the risk of heart disease and diabetes. So if somebody's glucose used to be 85 and then it was 91 and now it's 98, we're going to talk to that person right off the bat about all the things they need to put into place to prevent it from progressing because they're already on that spectrum. We also want to know insulin levels, not just a fasting insulin, but sometimes the insulin response to food, because the other thing that's emerged is insulin is a player. And way before somebody's blood glucose goes up, they might be pumping out tons of insulin to try to keep it in a good place.

And insulin by itself contributes to inflammation and more weight gain around the middle, that visceral adipase tissue. So we want to know they're insulin, both fasting and in response to a challenge. So wait, wait, wait. Are you saying that's sugar, not fat, that's causing heart disease? And sugar, the thing that's driving the insulin, because fat doesn't cause insulin spikes. well there is some I mean fat is a player fat by itself

fat by itself is a player right if you eat fat with the food it will but yeah yeah and I would say that quality of fat does matter and we can talk some more about that but I think fat plays a role with artery elasticity

which is another component of vascular risk yeah so fried foods trans fats refined oils those are nasty absolutely but fat itself if it's made from whole food sources

and nuts and seeds and avocados and olive oil Beneficial. Actually beneficial, yeah. So what you're talking about is a set of diagnostic tests that are so important, but mostly ignored. So the particle size and number, which nobody's doing. And the second is not just measuring your blood sugar A1C, which may be perfect.

And you may be in really bad trouble, but measuring also insulin in response to drinking like a couple of coax, right? I have a patient, Cindy, that I remember, who was a super high risk for heart disease. and she had, I mean, she looked like the Tasmanian devil. I mean, she was just like a round apple ball like this. And her belly was like, this big thing. And I'm like, this woman is in big trouble. And she's inflamed.

She's a high school heart disease, high blood pressure, diabetes. And I'm like, less check her glucose tolerance test with insulin. And this is, you know, this is like 20 plus years ago. And no one was like looking at this. Even today, no one's looking at this. It's like, so hard. I mean, it took 50 years from the time that. the guy said, hey, we should wash our hands before surgery for us to wash our hands.

You know, McKinley died, President McKinley because he got shot in the belly, and the doctor McBurney stuck us finger in the wound to check it out without washing his hands. You know, that's like crazy. It took 50 years from the time the guy said, let's do a stethoscope so we don't get lice jumping into the doctor's hair to start using the stethoscope because the doctor used to put their head on inpatient. So it takes forever, and we've been doing this. Anyway, this woman, I did this test.

I gave her this drink. And it was the most shocking thing I'd ever seen. And it taught me so much about what we miss in medicine. Her blood sugar was perfect, like 80. And she took the sugar drink and it was like perfect. Like it never went over 110 after taking like the equivalent of two Coca-Cola's. Oh, she's fine. Her A1C was perfect.

Her insulin normally should be under five fasting and under like 25 or 30 after a drink. Her insulin was like 50 fasting. Wow. And like 250 after a drink. So her body was just pumping out insulin, which was making her hungry, slowing her tablets, putting fat in her belly cells,

which were basically inflammation factories, and leading to this perpetual cycle. And she was able to lose 50 pounds like that when we cut out starch and sugar. And I just feel like, you know, that showed me so much because you can even do a normal glucose tolerance test. If you're not measuring insulin.

Perfect. And if you were super hyper-insulinemic, you're going to miss that patient's real problem. And you know, it's interesting, Mark, because that scenario is also associated with that cholesterol profile we talked about with the small, dense LDL and low HDL and the sequela that we usually link to diabetes. Fatty liver, peripheral neuropathy, all these other organs that are affected, and it can happen with the high insulins alone before the sugars go up. Yeah. It's a metabolic imbalance. Yeah. So that's really the take home here is that heart disease is really a hormonal issue around insulin and insulin resistance and an inflammation issue. So let's talk about the heart disease because people say, well, that story's been told. You know, we've got statins. We've got this piece of SK9 inhibitors. We're all good. Like, what's the big deal? What should we worry about? It's just all about all the L.D. cholesterol. What's new? What should we be looking at? What should we be thinking about? And why are we still seeing so many people with heart disease? Yeah, it's still the number one killer around the world, not just here.

And it's still the number one killer in women who, you know, they think that it's breast cancer. No, no, it's, this is it. This is exciting because we do know the things that we've been reviewing for risk factors, but we have a way to now establish the risk, are they really high risk without, before they ever have heart disease, 20 years plus. And the way we do that is we can get a simple lipid panel. add the LP.L.A. APO B. So a little more than what is the standard lipid panel, the LPLA will be part of a lipid panel on the next year or two. But anyway, when we get that

lipid panel, which is, again, very inexpensive. And we can also get a polygionate risk score, very inexpensive. We can also get a heart clock, right? And we can get inflammation markers. Anyway, now you have the full stack with their records and, you know, and you have somebody who is well before they've ever manifest heart disease. And you say, oh, wow, this person is really high risk for heart disease. What do we do? Well, you get their LDL down, you know, not just to low 70. We go down to 20 or, you know, less than 30, right?

We have so many ways to do that now. We have these injectables that are against this PCSK-9. We've got new drugs, five new LP little A drugs that are going to be out within the next year or so that are really potent. And we've had none of them. None until now. Yeah, we never had one. We always saw, well, too bad, your LPLA's over 100, you know, nothing we can do.

We're going to be able to change that, and that's going to have a big impact. We can get all the inflammation, get all over it, right? In terms of bringing the inflammation down, we've already seen how GLP1 drugs do that before any weight loss. So that should work well in people who aren't even obese. And we've seen how that can prevent heart, preserve ejection fraction, heart failure, which is half of all heart failure, right? GLP-1s prevent that.

So for heart disease, we're seeing some really breakthroughs for the treatment, particularly the new target of LDL, that we have five different drug classes, statins you've mentioned. But the PCSK-9, we have three different ways to do that now. We've got other new drugs that are coming. Just recently, the CETP inhibitor worked really well on top of, so we got, we can, we can stamp out inflammation. The other thing is we have a metric we never had before, which is AI. And by the way, that also goes with Alzheimer's. You can do a retina AI exam. So I have a picture of the retina and you do AI on it and it tells you when you're going to have Alzheimer's, if you're going to

have Alzheimer's, five to seven years in advance. The retina also tells if you're going to have heart disease or stroke in advance. It will even tell if you're going to, you know, your calcium score of your heart arteries through your retina. It's remarkable. And that should be widely available. It isn't yet, but it will be. We'll be doing smartphone retina check someday, right? But here's where we get a real kick on, a jump on this, because if you are concerned about high risk and somebody, you'll say 40, 50, they have significant risk doctors, you can do a CT angio, which is, you know, now becoming very inexpensive. And you can look at inflammation in the artery.

I go through this in the book. Inflammations in the artery without a narrowing. Okay, so it basically does AI of the fat around the artery. And this is something that was developed in the UK. And it's now getting ready for FDA approval. This is a big jump because we always were working. So this isn't the clearly scan. This is something else?

No, no. Clearly, and the other ones in the U.S. don't do this. But this is a Oxford University of Oxford spinout. I think it's called Carista. They're going to have that available soon. And I went through the data in the book. I mean, they've had multiple papers, but it's striking, if you have inflammation without a narrowing,

you could have 15-fold risk of a heart attack. So that's when you use that as a metric, just like we were talking about the Petow 217 for Alzheimer's. We've got all these new things for car. cardiovascular, we are going to get a grip on this and we got to, you know, ideally start early, but, you know, the lifestyle factors work really well. This is the most preventable known of the three big age-related diseases through lifestyle. Because even without a lot of the drugs, like the lifestyle plays a big role. Like, you know, I've seen data up to 90% by healthy diet,

exercise, stress mitigation, sleep, right? Yeah, I mean, is that, is that, in the book, I found all these studies that I was really struck by that are, recent that showed that if we practice the lifestyle factors that we've been reviewing with the details that we discussed, that gets us seven to ten years of healthy aging without one of these age-related diseases. I mean, who wouldn't want seven to ten years of healthy aging just from the stuff we've been discussing without any magic potion or pill? So that's, I think, people don't know about that. I didn't know about that. It's really impressed. That's powerful. So, so what you're saying is some of the advanced in cardiology are more

pharmacological that you're thinking are coming, like the drugs that lower this genetically determined lipoprotein called LP little A, which I've been checking for 30 years, APOB, which I've been checking for 30 years. I read some article the other day that was like, there's this great new test that can be more predictive of your risk of heart attack than any of their tests is just discovered. I'm like, what is that? I'm like, look like there the article. It's like, apeo B. I'm like, oh, God. I mean, you know, you know, you're a lot. I mean, you know, You only need to get it once, and then you can tell if you need to check it further. But you're getting at a key point here is it isn't just that we have better, you know,

more armamentarium of drugs, but we didn't know how to get the risk down. You know, we didn't know how to say this person's really high risk for atherosclerosis because we didn't really have, we didn't use the polygienic risk or we didn't have, as we do now, we're going to have a heart clock. So there's a big debate out there, as you probably know, how low should we go on LBO? Should we pull out all the stops? Well, if you look at all the data, the lower you go, the more protection. But you don't want to necessarily give people, you know, acetamide and statin and an injectable and all these things.

Unless they really are at high risk, then you go for broke and you also get the LPA and you get the inflammation down. We have ways that we can do that, and we're going to keep having better ways. So this is a striking. It's a combination of who's at risk, partitioning the risk, and having a better ways to work on that risk. Just to play devil's advocate, because this conversation comes up all the time. You're a cardiologist, so your favorite organ is the heart. And so your idea is get the LDL as low as you can.

But your brain is made up a lot of... Only in people who are at high risk. And people are at high risk. Okay, so if you're really high risk, but what about the effects, for example, on the brain and cognitive function because the, you know, cholesterol is a big part of your brain and sex hormones, which is what your testosterone is made from is cholesterol. So how do you kind of navigate that? And what's the truth? And what do we know? Yeah, I mean, the statins are probably the most studied drug class in history, really. Some of the data that comes out of these big meta-analys

which say, oh, people don't get any leg cramps. That's not true. you and I know that's not true. People do get severe leg cramps where they can't even sleep at night, you know, and all sorts of other leg and muscle-related symptoms. Now, with respect to cognitive and sexual dysfunction, the data really don't show a hit there at all. And in fact, you know, I think that we have some data to suggest the chances of having dementia in people, and Alzheimer's, as you know, accounts for 70% of dementia, that if you don't

have the LDL lowered to, let's say, less than 100, less than 70, you're going to be at higher risk for dementia. So if anything, the data support statins and, you know, the data for sexual dysfunction, it's, again, some of that's vascular. And if it's vascular, we're talking about atherosclerot, and other. again, is going to be ameliorated with. And of course, we don't have to just rely on statins. A lot of people do have side effects from statins,

no matter what the group at Oxford keeps saying that everyone can take a statin, and it's just, you know, it's mental if they can't. When I wrote an op-ed in the New York Times like a decade ago, and I called out the diabetes from statins, okay? Because if you take a very potent statin, you have a higher risk of developing type two diabetes. B. Right?

Oh, did I get slammed by my cardiology colleagues for that? I think, well, wait a minute, that's the data, folks.

I'm sorry. And over the years, we've seen many more reports about, you know, the potent statins, high doses where you get a higher risk.

Yeah. And you know what? Most physicians are not keeping up with this. They're not watching their patients to see if their glucose, like, oh,

hemoglobin, you know, A1C or fasting glucose. And this is bothersome to me because that is a side effect of statin. particularly potent statins. So again, this is important because if we're going to lower LDL and pull out all the stops and, you know, high doses of resuvostatin crestor or a tourerstatum,

limit, that could also raise the risk of that person developing type 2 diabetes. We don't want to do that. And we have cardiologists, my colleague, they are, you know, really sold on statins and they basically ignore this diabetes issue. And did I ever take grief? No. I agree with you. And I think there's a concern I have around its effect on mitochondrial function and some of the data I've seen that even in people without muscle pain, even without elevated muscle enzymes, that there's mitochondrial damage on muscle biopsies. And for me, mitochondria are so key to healthy aging in the brain,

in everything, from Parkinson's to heart disease, diabetes. Diabetics have poorly functioning mitochondria. that may be part of why it causes it. And so I'm wondering, you know, some of these other drugs that are coming down the pike, even though some of them are expensive, may be a better solution. Well, people that have clear-cut adverse effects, you know, the PCSK-9 injectable drugs are a winner because they're potent.

And they have not been associated with diabetes, which is really interesting. They have not been associated with cognitive or other side effects. So most insurers cover that now. We went through years where it was a, because they were so expensive, the costs has come down. So as long as people have the right indication where they have significant side effects or they need to have their LDL substantially lowered, it's usually not a financial stress

for most people. So heart disease is still its lifestyle, but then there's a cocktail of other drugs in very high-risk patients that you can detect early that figure out. And what about lipoprotein fractionation, which is at least. test that we include as part of function health, as well as APOB and LPA, something I've been testing for 30 years, but you think that's as important? Because to me, the particle number and particle size story is important, and it's sort of a clue that there's insulin resistance, which is one of the biggest drivers of heart disease and all the other age-related disease. Yeah, I mean, I think

it's mild, potentially mild incremental information. I just don't see that it has nearly the impact of just zeroing in on LDL and LP little A. And I do recommend everybody get an APOB at least once. And then you can figure out whether that needs to be further assessed. These other things, you know, it's an additional expense. I just haven't seen the value. But, you know, I have colleagues that are lipidologists that test every known particle of the mankind, right?

I just haven't. I haven't really seen the benefit because it doesn't change usually. To me, I got to know the person's risk. And then I'm going to go after inflammation. I'm going to work on their lifestyle and if necessary, you know, get their LDL down as low as possible. So the other things just don't have, for me, an added value. But I do know there are people that are, you know, wild and crazy on every particle,

small, large, dense, you know, you name it out there. Yeah. Yeah, so I hear you on that. I think, you know, sometimes more information isn't always better. But, you know, what is the most important information? I think you cover that in your book. And I think, you know, we're going down the kind of the horsemen of the apocalypse, you know, the heart disease, the cancer, the dementia.

I think diabetes is sort of all in there related. But you're talking about how there's kind of a newer, with the advances in our diagnostics, whether it's imaging or retinal scans or new ways we can measure dementia biomarkers we never had before cancer, we'll get into an sec, that these diseases can become more optional. Like, they're not inevitable. They don't have more agency than we ever had before, given what we know now.

And when you layer up, what we're learning with AI and using multimodal treatments, we're really able to actually make a big dent if people really understood how to navigate this. And the sad part is that, you know, you spend your time thinking about what's coming. Most physicians are just trying to deal with the onslaught of what is and don't have the bandwidth

with to actually apply this stuff until it kind of is way often decades later. And so I really appreciate your sort of paying attention to, you know, what's happening and keeping your nose to the scent of where things are emerging because otherwise people just don't know. And doctors, like you said, don't know. And the average person doesn't know, but this is such a hopeful message. And I'd let me sort of unpack how you came to go from being a trained cardiologist who, basically swallowed the gospel,

to one who understands and has looked at the literature and has come to a different conclusion. Because it's not just that you're anti-drug or your anti-medical care, anti-the-system, you're for the truth and for science and for an objective look at the facts. So the question I have is, how did you go from being a trained cardiologist

who believed in statins to one who started to question statins, to one who's come to understand that our approach to cardiovascular least might be a little bit misguided and we'll talk about what the right approach should be later, but I kind of want to start with unpack, unpack the science for us because everybody listening has no is heard if their cholesterol is high to take a statin. So statins cause side effects, which they do for a lot of people, probably 20% get some muscle damage or some symptoms or increase the risk of diabetes. You know, we'll talk about that data. There's still a huge drive in our society

for prescribing these and globally. Yeah, absolutely. So, my interest in this came from really looking at the initially the obesity epidemic. So 2004, WHO announced it as an epidemic. You know, by 2010, I was in nine years qualified as a doctor. I was a specialist registrar in my cardiology training. I was seeing more people viscerally. I'm very sensitive to, how to put it, suffering around me, if you like, but also seeing my colleagues under more stress in the system. I was like, hold on a minute. If we carry on down the trajectory, the whole healthcare system is going to collapse. We want to even manage people acutely if they are ill, right? I never thought that would happen. And ultimately, that, one of my,

two of my own parents basically died because of the failure's in the system because the system's under so much stress, right? Never predicted that would happen. But that's where I started from. And when I looked into the issue of obesity, you know, I concluded that one of the root causes, mark, if not the main root cause, was this flawed hypothesis that we should have low-fat diets to prevent heart disease. Food industry exploited that, increasing sugar intake, increasing refined carbohydrate intake. It became quite clear. There was a clear correlation between that changing guidance in the late 70s in the US and early 80s in the UK when the obesity epidemic started to then, you know, take its trajectory down the wrong way. In 2011, I visited a farm in

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looking to upgrade your daily essentials, head to cozierr.com slash hymen. I received 20% off. Yeah, and I covered a lot of this in my book, Eat Fat, Get Thin, which we sort of unpacked the whole history of how we got this low-fat craze. Yeah. It led to this high sugar-starch craze that then led to this dramatic rise in obesity, which now, of course, we're treating with another drug, the GOP-1 agonist, and, you know, just appetite and some glutide or Zempic and Majaro. It's kind of crazy, right? Yeah. It's kind of flipped it upside. Oh, absolutely. So when I looked at that, it's like looking at the data in spending years and months in is looking at it and looking at different bits of data. I was able to put it all together,

and I wrote a piece in the BMJ in 2013 called saturated fat is not the major issue. I read it. That's how I first came across. Yeah, and that got a lot of attention, right? It was international news and British news and CNN international and whatever. You know, because obviously, suddenly you've got a cardiologist busting this myth that we think butter has been bad for our cholesterol. But when I did that, okay, so I looked at the data, and it was very clear, there was no clear association with saturated fat consumption and heart disease. So if that's true, then, and we know saturated fat raises LDL cholesterol, that means LDL cholesterol can't be that important. So, and if LDL cholesterol, the total cholesterol isn't that important as a risk factor,

how does statins work? But I knew statins had a separate effect to low in cholesterol, which is their anti-inflammatory and they're anti-clotting. And I knew this even, it's well known within cardiology circles. You know, I trained as an interventional cardiologist, and that means keel heart surgery, stents, for example. Patient comes in. We didn't even check their cholesterol. Maybe some of the thinking was a lower, the better, which we'll come on to as well. So it doesn't matter what their cholesterol starting from, the lower your cholesterol, the better. In fact, 2011, 2011, our cardiologist, one of the editors, I think, of the American Journal of Cardiology, wrote an article, which I mentioned in my book of Staten Free Life, which was entitled,

It's the cholesterol stupid, right? And what did he say in that? He said, you can be an obese diabetic smoker that doesn't exercise. That sounds crazy. But as long as your cholesterol is low enough, you're not going to get heartache. You're not going to get heart disease. That's crazy. Like, really? So, okay, I had to unpick that. And what I also then did moving forward from 2003. So that's how I got down this track, realizing that our obsession with LDL lowering has been a problem. So you looked at the saturated fat literature and you weren't impressed and data showed that it didn't seem to be. Both observational data and randomized control trials. No benefit, like in lowering it, no association, nothing. Right. Right. And when you look at all the data, so that was the first sort of bit, that was okay. And some might even have been protective, like some of the dairy fat. Well, we know now, yes, there is some suggestion that dairy fat could be protective, absolutely. So there's all that. And then coming back to the LDL hypersis...

By the way, you're not alone on this. I mean, there was a major paper published by Dairishma Zafarian from Tufts and others looking at butter and actually showing that there really wasn't evidence that it was... So Mark, this is what's interesting. That article I wrote, because creates such a, you know, a lot of headlines and then backlash or whatever else. That's when people like Darius started looking at this again. So it was all really from the back of that BMJ piece. It all came together. So then everybody's like, you know, and at the time, I was writing just a commentary, which was peer-reviewed, but I could have got it wrong. I could have. But I was like, you know what, there's enough here that for me needs to provoke the thoughts. And then it all got proven that, you know, what I'd written had validity, right? Which is good. But the other aspect of this, if we go back and you mentioned cholesterol, so is cholesterol, so is high cholesterol a risk factor of heart disease? And is LDL cholesterol risk factor? Yeah. So you have to go back to square one, right?

So these are the Framingham studies that, you know, started in Massachusetts in 9,48 and went over decades looking at thousands of people where a lot of risk factors emerge for heart disease, whether it's diabetes, high blood pressure, smoking, for example. And high cholesterol, right? So you go and look back at the Framingham studies. And just to summarize it, without complicating the situation too much, William Castelli is a cardiologist, and he published, he was a co-director of Framingham. And in 1996, he published in one of the cardiology, major cardiology journey, is a summary of Framingham, specifically looking at LDL cholesterol. Let's just look at LDL because that is the so-called bad cholesterol.

And he said, from Framingham, unless your LDL was above 7.8 millimoles, which by the way, I think in your units is probably 250 or 300, 250 probably, I think. Maybe we can look it up and calculate it. But let's just say for argument's sake, around 250, which is very, very high, by the way, it absolutely had no, it was useless as a predictor for coronary artery. LDL. LDL. Now, why is that? When you correct for triglycerides and HDL, okay, which by the way is a more important predictor of heart disease,

LDL loses its significance completely. So then if that's true, and I'm saying that means that LDL isn't really a risk factor of heart disease, and I believe with everything I know now that to be the case, okay, let's unpick every part of it. Does lowering LDL cholesterol from diet or drugs, but more specifically drugs, because they're the most potent ways of lowering LDR cluster,

whether it's PCK9 inhibitors, whether it's statins, whatever, is there a clear correlation? Is this dogma true that the lower the better? So myself and two cardiologists did a systematic review of the totality of drug industry sponsored trials, by the way, and some diet trials, but many drug industry sponsored trials, all of the randomized control trials on cholesterol lowering drugs, statins, PCK9, blah, blah, was there a clear relationship as you lowered LDL in low risk and high risk patients, mark? Okay? Over 30 studies. Yeah. Was there relationship with lowering LDL and preventing cardiovascular events?

No. Even at high risk patients? Even in high risk. It's nonsense. It's nonsense. So the question then is... Why do we all so... No. So does that mean...

But then I said, well, of course, statins have a role. They do have a benefit from the RCT data, which is small, because I knew already they're anti-inflammatory and anti-clotting. So it's nothing... In my view, listen, I could be proven wrong here, but the evidence at the moment looks very clear that there is no consistent relationship, right? It's definitely not a clear relationship. So even if it's a weak relationship, Mark, let's just argument's sake.

Let's say there is a weak benefit. LDL. What else is going on and what else are you ignoring, right? Yeah. What else is statins do? They cause insulin. Say one in a hundred people get type two diabetes because of statins. One in two. One in a hundred. One in a hundred. Yeah. One in hundred. So about one to two percent, but one in hundred. Some studies say one in 50, right? We'll get type two diabetes because of the statin. Probably reversible still, but not ideal, right, if you're on a stent drug. The second thing is, look at the whole patient coming in. We have the illusion of protection. We have patients I used to see coming in and they thought, my cholesterol is low, I can go and eat McDonald's. It's fine. And they're

getting more and more of a weight, more insurisistant. They're increasing their cardiovascular risk. They're not told the statin is going to give them a 1% benefit, i.e. more likely than not, they're not going to benefit. So you could imagine that concept that the overall net effect of the way that statins are prescribed and the dogma around them, in my view, has been negative and has actually been one of the main reasons why we have got this pandemic of chronic disease. Because we overemphasized an index on LDL cholesterol and forgotten everything else.

Absolutely, right. Because there's a drug for it. It was interesting to me, if there was a drug for insulin resistance that worked really well, and we have mid-formin, but it's, eh. And it fixed insulin resistance, you know, everybody would be prescribing it.

But we don't even diagnose it in most people because we don't have a drug for it. Exactly. And it's stunning to me that, you know, I was talking to the live director at Quest, laboratories. I said, what percent of your test you get to come in are measuring insulin, which is, I think, one of the most important things you need to know about your biomarkers. And he was like less than 1%.

And it's part of why I co-founded this company Function Health to really look at a deep biomarker set around cardiomatabolic risk factors, including insulin, including L-P-L-A, including something called APOB, which I want to talk to you about, not just. your total LDL, HDL, and triglyceride levels, but also particle number, particle size, inflammation markers,

all the things that are often missed, but that are much better at giving you a holistic picture of your cardiovascular risk, and then you know where to intervene. And in one of the studies that it was so interesting to me was, actually from, I think, Scotland or Ireland,

was where they looked basically at a series of patients who came into an emergency room with a heart attack, and they did glucose tolerance tests on everybody who came in with a heart attack. And they found that two-thirds either had diabetes or prediabetes who had a heart attack.

Yeah. That was really the big driver. Yeah. Now, there's a subset of people have familial lipid disorders, you know, inherited genetic lipid disorders. And those people probably need to be treated more directly. But for the majority of people out there who are obese or have pre-diabetes or metabolic dysfunction, which is basically in America, 93% of Americans, that's what's driving probably most of the heart disease, not butter or saturated fat or...

No. LDL elevations. Well, something else to throw into the picture, right? So you can make the argument, okay, Dr. Mahhotra, you're saying there's no consistent relationship. There may be a benefit. Why not just lower your LDL? Okay. So, 2016, and the reason we did this, me and a number of international scientists looked at,

we decided to a systematic review of observational data looking at people over 60. Was there a relationship with LDL cholesterol and heart disease? And the reason we did this, by the way, is another thing that was interesting from framing in which wasn't well publicized, is that when after people hit 50, years old, as their cholesterol dropped, their mortality increased. So we thought, okay, is there something, you know, because for it to be a risk factor for heart disease, it should be consistent, really, across all age groups and both sexes, right?

For mortality. For mortality, yeah. But even for heart disease as well, right? That's a good point. So we looked at, was there, first of all, any association, if you're over 60, with LDL cholesterol and heart disease? Right? We found none.

Okay. Interesting. But what was surprising was there was it. inverse association with LDL cholesterol and all cause mortality. In other way, statistically, if you're over 60, the higher LDL, the less likely you are to die. So what's the reasoning for that well? Something that's been forgotten or missed or not discussed. Chlestrel has a very vital role in many functions in the body, including the brain, hormone production, but also the immune system. And it's likely that that's where the protective benefit comes because older people are more

vulnerable to dying from infections. And we also know there is an association. I'll use this word an association, right? Can't say it's definitely causal between low cholesterol and cancer. Again, it's probably related to the immune system. Yeah, I mean, I think the problem with this data, though, is, I'll just push back a little bit, is it's observational data. And the data, like, from the Hawaii study, you show that, you know, you're older and you had higher cholesterol, you know, you're more likely to live longer than if your cholesterol is lower. But it may be because the people have low cholesterol are malnourished, have cancer and other reasons. So let me push back on that. we counted for that and we found actually no when you count like time lag you go back five or ten years

no it's not it's not that does happen but it no it's independently it does seem to be an issue okay so you sort of look at all the data and you came up with this very kind of contrary opinion which is that ldl isn't all it's cracked up to me that statins work a little yeah but not for the reasons we think meaning they lower inflammation and they may have other properties that may beneficial. We don't even know what called this pleatropic effects. So they, for example, they induce nitric oxide synthase, which dilates your blood vessels and reduces inflammation and helps your lining of your blood vessels, all that's protective. And so it may be a stabilizes plaque, it may help in those ways, but it may not be the LDL lowering effect. In fact,

Paul Richter from Harvard, I remember he published a trial, I think it was the Jupiter trial, where they show that if you had a high LDL but didn't have any inflammation, you didn't have that significant risk of having heart disease. But if you had a- Interesting. a high level of inflammation, high LDL, you had a much higher risk. So it was the inflammation that was really driving the heart disease. And that was really the seminal paper was in the New England Journal of Medicine over 20 years ago. I remember reading it by Paul Ritker and his crew that really laid out how heart disease is not a plumbing problem.

It's an immune problem. It's a chronic inflammatory process exacerbated by metabolic risk factors or insurisance. And I wrote a metabolic risk factors. By that you mean problems of your blood, sugar, and insulin. Interresistance. And pre-diabetes. 100%. And actually, you published an editorial with two cardiologists.

in British Jones Sports Medicine in 2017, which was a very long title, but it got a lot of publicity and more than a million downloads, which was saturated fact does not clog the arteries. Chrony artery disease is a chronic inflammatory condition, which can be effectively managed with lifestyle changes. That was the title of this thing.

But it's all there. It's free access. People look it up and read it. But we've overdone the thing, and just Dr. Mahatra, his opinion being controversial. My two co-authors were both editors of medical journals and cardiologists. Louis Redberg, editor of Jammettole Medicine, and Pascal Meyer,

editor of BMJ Open Art. So why is this not getting more play? Why is still the dogma and the orthodoxy that if you have a high LDL, you take a statin? Do you want my honest answer, Mark? Yeah. I mean, not all, I mean, I know doctors are usually very good-hearted, sure, very smart, well-intentioned, don't want to hurt their patients,

try to do what's in the best interest of their patients and follow the science. so why are they not hearing about this? Okay, so let's go to the root cause of the problem, even in society today. What's the big issue in health? We have commercial distortions of the scientific evidence. Who is behind that and who has more power and control over medical education, medical training, the media than ever before, big corporations. In this case, big pharma. And the level of this control and power mark has got to a level where it can be very easily and rationally, not in an inflammatory way.

or overplaying it as being tyrannical. What also happens with these big corporations in the way they exert their power is that they want to avoid conflict, right? They want to avoid the truth coming out. So there's a debate and discussion because ultimately people like myself, like you, who are obsessed with the truth, who want to get it out to help patients, when we speak and act from a place of integrity and truth, it has a very powerful resonance with people.

And it can very quickly destroy all these other dogmas that people have created because of that power that the truth has. They want that conflict to remain latent, to remain hidden. So that, you know, Noam Chomsky says the general public doesn't know what's happening and they don't even know that they don't know. That's right. Right. So a lot of these doctors, and I agree are well intentioned, but they don't, they're living, you know, in many ways, they're living, they're climbing up the wrong wall to success when it comes to helping patients. because it's a drug companies that are really calling the shots. So we are under a situation of tyranny.

And the reason I call it tyrannical is because there are doctors that know this, Mark. There are a few doctors that kind of know this, but then they're afraid to speak out. And only a minority of the doctors that know what's going on will then speak out. 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 Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show.

wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. 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 Dr. 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 guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests.

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Thanks so much again for listening.