The Dr. Hyman Show - 3 Steps To Fix Your Gut Health

Episode Date: October 29, 2021

This episode is brought to you by Rupa Health and Athletic Greens. Our gut bacteria regulate many of our bodily functions, from creating vitamins to controlling our immune system, our brain function, and of course, our metabolism and weight. They are critical to our long-term health. This is why Functional Medicine almost always starts helping people treat chronic health problems by fixing their gut.  In this episode, I’m joined by Dr. Steven Gundry, Dr. Todd LePine, and Dr. George Papanicolaou to talk about fixing your mitochondrial function, what foods to avoid, food sensitivities, and incorporating a whole foods diet that’s rich in polyphenols.  Dr. Steven Gundry is one of the world’s top cardiothoracic surgeons and a pioneer in nutrition, as well as medical director at The International Heart and Lung Institute Center for Restorative Medicine. He is the author of many New York Times bestselling books and is the founder of GundryMD, a line of wellness products and supplements, and host of The Dr. Gundry Podcast. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine, and is an Institute for Functional Medicine Certified Practitioner.  He has been practicing Functional Medicine for over 15 years focusing on optimal aging, bio-detoxification, gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital, Abington, Pennsylvania. He is also an Institute for Functional Medicine Certified Practitioner. He specializes in treating the root causes of many conditions including neurodegenerative disorders, ADHD, PANDAS/PANS, and gut and hormone health. This episode is brought to you by Rupa Health and Athletic Greens. Rupa Health is a place for Functional Medicine practitioners to access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, Great Plains, and more. You can check out a free live demo with a Q&A or create an account at RupaHealth.com.  Right now, Athletic Greens is offering my listeners 10 free travel packs of AG1 when you make your first purchase. Just go to athleticgreens.com/hyman to take advantage of this great offer.

Coming up on this episode of The Doctor's Pharmacy. The more you stay away from processed foods, from ultra-processed foods, that's really the fundamental starting point. The more you actually use whole foods, and literally foods in their whole state, the better off you're going to be. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me helping patients heal using real food and functional medicine as your framework

for getting to the root cause. What's critical to understanding what each individual person and body needs is testing, which is why I'm excited to tell you about Rupa Health. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to optimize health and reverse disease. But up till now, that meant you were usually ordering tests for one patient from multiple labs. And I'm sure many of you can relate how time-consuming this process was, and then it could all feel like a lot of work to keep track of. Now there's Rupa Health, a place for functional medicine practitioners to access more than 2,000 specialty labs from over 20 labs like Dutch, Fibrin America, Genova, Great Plains, and

more. Rupa Health helps provide a significantly better patient experience, and it's 90% faster, letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. This is really a much-needed option in functional medicine space, and I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at rupahealth.com. That's R-U-P-A health.com. So many of my patients wait until they're sick to finally take care of their health.

I've even had doctors as patients, well, many actually, who just wait for their problems to get worse and worse and receive a diagnosis of disease before taking any kind of action. This is not the path to health. We can live longer, healthier, happier lives if we just prevent imbalances in our

bodies in the first place. And nutrition is a key part of this. Many of us don't get the optimal amounts of key nutrients through diet alone, even with a whole foods diet. And then when you add in all the stressors we're up against, like work demands, toxins, lack of sleep, we're even more likely to have a nutrient deficiency. So one of the things I use every day to optimize my intake of vitamins, minerals, phytonutrients, pre and probiotics is AG1 from Athletic Greens. It's a comprehensive superfood powder with a special blend of high quality whole food ingredients that work together to fill the nutritional gaps in your diet. It's specifically designed to support energy and focus, aid with gut health and digestion,

and support a healthy immune system, which we all need right now. I've made AG1 part of my daily ritual because I feel better knowing I have a little extra nutritional insurance to complement my healthy diet. It also gives me a nice energy boost without feeling overstimulated. I like to think of it as a huge leafy green salad shrunk down into a simple glass of water I could take anywhere. Right now, you can get 10 free travel packs of AG1 when you make your first purchase. Just go to athleticgreens.com forward slash hyman. That's A-T-H-L-E-T-I-C-G-R-E-E-N-S dot com slash hyman. Now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Feehan, one of the producers of The Doctor's Pharmacy podcast.

The gut is an integral part of our health, yet it is so often overlooked or ignored. Our gut microbiome plays a key role in supporting our body's immune function, energy production, and much more. In today's compilation episode, Dr. Hyman talks to doctors Stephen Gundry, Todd Lapine, and George Papanikolaou about how to remove toxins, improve energy, and feed your gut. Let's dive in. The microbiome talks to the mitochondria. And my eyes went up and I said, well, how do they do that? And he says, well, we don't know yet, but I'm telling you, we're going to find out that the microbiome talks to the mitochondria because they're

literally sisters. And I said, well, you know, that's interesting. He says, yeah, they send text messages. Well, lo and behold, Marvin was right, because the language, what's called the trans-kingdom communication system of how the microbiome talks to mitochondria and to our DNA was discovered. And it's as big a discovery as the Enigma code discovery in World War II, the German code. So what that discovery was, is the discovery of postbiotics. And postbiotics, everybody knows probiotics, friendly bacteria. Most people are learning prebiotics, which are the fibers that friendly bacteria need to eat. But when those bacteria eat those fibers, they produce either short-chain fatty acids like acetate and butyrate, but more importantly, they produce gases, and they're called gasomessengers or gasotransmitters. And it's these messaging system that's now been discovered that actually talks, actually tells

mitochondria what to do, whether to make more energy when things are good, or whether to throttle back because things are bad down in the engine room. And it's it, you know, the whole discovery is just like, holy cow, we are this incredible symbiotic organism. I mean, for instance, the Nobel Prize for discovering how nitric oxide works and where it came from, you know, was awarded in 1998. And, you know, for years in cardiac surgery and cardiology, we knew what nitric oxide did, but we didn't know how it did it. But nitric oxide is a gaso-messenger. But here's something really wild. So hydrogen gas is a gaso-messenger. But here's something really wild. So hydrogen gas is a

gaso-messenger. And part of the fermentation process of bacteria eating fiber is to produce hydrogen gas. And hydrogen gas is the world's smallest molecule, and it diffuses right across our gut wall. And one of the shocking things as I was researching this is if you look at patients with Parkinson's disease, they have a microbiome that does not make hydrogen gas. Whereas people who don't have Parkinson's disease have a microbiome that produce hydrogen gas. And you can give patients with Parkinson's disease hydrogen water, and that's water that has hydrogen dissolved in it. And they will symptomically improve once they consistently start taking hydrogen water. And so, as I joke in the book, in Boy Scouts, what we used to do,

you know, we'd eat beans on the camping trip, and we'd have Bic lighters, and we'd actually literally light our farts with this blue flame. I've seen that happen at a campfire a couple of times. Exactly. That's hydrogen gas. And little did we know, so... Methane too, maybe, I don't know. Exactly. Well, it turns out is actually a gas, a messenger as well, as well as hydrogen sulfide, that rotten eggs smell. And for years, you and I were taught that hydrogen sulfide is a toxic gas. But we now know that the effect of hydrogen sulfide is that of a hormetic agent. And a hormetic agent is basically

that which doesn't kill me makes me stronger. So that no hydrogen sulfide is not good. A little hydrogen sulfide is good. A lot of hydrogen sulfide will kill you. So a little dab will do you of these things. And so getting back to your original question, the more we feed our microbiome, the foods that they can make these literally text messages that tell your mitochondria to produce energy, the better off we are. And again, you look at, oh, a tribe like the Hansas, who they eat, oh, about 165 grams of fiber a day. If we're lucky, the average American may eat 20, probably not. But they're a watch. I think it's eight is the average american lucky and half of the fire weed is actually insoluble fiber which is actually really bad for you in a lot of ways so the long story short we are so deprived of the energycing compounds that are available to all of us if we'll just feed the microbiome what they need. And that's a big part of the book.

So a lot of the key is fixing your gut to get your energy back. Yeah. The second key is we are overfed and underpowered. And what the heck does that mean? We, in general, Americans eat nearly 16 hours a day, almost continuously, from sunup until well after sundown. And we have what's called mitochondrial rush hour, which living in L.A. is easy to understand. But simplistically, our mitochondria can handle sugars, fats, and proteins. And we use a slightly different system for making energy from sugar, from fat, and from protein. And in the good old days when we ate whole food, like you advocate and I advocate, these different components, sugars would arrive

first in the mitochondria. They'd be followed by protein sometimes later. And a long time later, they'd be followed by fats. And mitochondria have, if you will, basically a freeway, an energy-producing freeway. Now, when these things arrive in a staggered fashion, the freeway moves great. But what happens is with our modern diet, with processed foods, with ultra-processed foods, we have combined simple sugars, simple proteins, and easily absorbed fats that hit our mitochondria simultaneously. And the mitochondria actually can't handle all these. So we actually have stagnation in the energy-producing highways. And we have systems on freeways. Okay, we're going to have traffic lights that's going to control the onslaught of all this. But we get mitochondrial

gridlock. And I use the example. So, okay, let's have breakfast at 7 o'clock in the morning. All of a sudden, you're slamming with all three of these components, and your mitochondria literally go into gridlock for two or three hours. You begin to get sleepy at 10 o'clock, and you say, oh, I need a little pick-me-up. I'll have a donut and a cup of coffee. And once again, traffic gets slammed. By that time, it's lunch. We slam it again. And so this process of gridlock really never stops until we go to sleep. And even after we go to sleep, there's still two to three hours

of backup, if you will, on the mitochondrial freeways. So our mitochondria really never have a chance. And in researching this book and trying this out on my patients, one of the things that was dramatic was that if I could lessen the period of time that you're asking mitochondria to handle food, the better off you're going to be because they have a chance to recover and heal themselves, if you will. And that gets into part two of the book. How do you put this into practice? Dr. So, your book is quite extensive and it really goes into detail about a lot of these unusual compounds that come from a disturbed gut microbiome that have broad spectrum challenges in the body. And this is what we've been doing in functional medicine for decades. It's really the foundation of my practice. It's really the key to getting people healthy. And I sort of agree with you that a lot of the beginning and the end of health starts in the gut.

And it's really always the first place we start with food and gut repair and functional medicine. But you talk about the plan of how do you do this? What are the do's and don'ts of the energy paradox when it comes to eating? Well, first of all, the more, and you and I, I think, would agree complete with this, the more you stay away from processed foods, from ultra-processed foods, that's really the fundamental starting point. The more you actually use whole foods and literally foods in their whole state, the better off you're going to be. Number two, I can't resist telling people to get lectin-containing foods out of their diet. Lectins are part of the plant defense system against being eaten or having their seeds being eaten. And these are proteins that Dr. Fasano and others have shown disrupt

the gut wall. And they in themselves are antigens that in my original line of work, heart disease attract inflammation to the wall of blood vessels. And so, they're a nasty bunch of compounds, and they're in so many of our favorite foods, such as whole grains. The nice thing about beans is beans are loaded with lectins, but pressure cooking and soaking beans and fermenting beans actually eliminates the lectin problem. Would the pressure cooking grains do break the gluten in wheat, barley, or rye. Gluten resists pressure cooking. There is a gluten-like protein in oats that also resists pressure cooking. And I can't tell you the number of people who have gone on a gluten-free diet with autoimmune diseases, with celiac, who are not cured. They still have celiac because the foods that they're eating, like oats, like corn,

are loaded with lectins. And just recently, I had a gentleman who we, I don't like to use the word cured of rheumatoid arthritis, but his markers vanished by following our program. And then he was a snowbird and he came back this winter and his rheumatoid, one of his RA markers was elevated for the first time in like four years. And he said, you've been cheating. He said, no, no, no. Are you kidding? I wouldn't do that. And I said, well, something's getting into your diet. I said, what've been cheating. He said, no, no, no. Are you kidding? I wouldn't do that. And I said, well, something's getting into your diet. I said, what do you have for breakfast? He says, oh, glad you asked. I've been on a pressure cooked oatmeal kick.

Every morning I have a bowl of pressure cooked oats. And I said, wait a minute, you can't do that. It's on your list. You can't pressure cook oats. And he would pull out the list. He said, oh, oh, no,'s that's the change and so we took it out a month later his ra was back to normal yeah absolutely i see that so often yeah i see that so often so um so getting out lectins eating whole foods um any other any other sort of key key dietary do's and don'ts? Yeah. So one of the, I think the shocking benefit of time-controlled

eating, and that is limiting the amount of time during the day that you consume food, is probably one of the number one fixes in our current energy crisis. And it seems almost contradictory, paradoxical, if you will. The more you kind of snack throughout the day, the actual harder it is for your mitochondria to make energy. And the more you limit- You have to eat to get energy, but what you're saying is if you stop eating, you actually are better at, at the end of the day, making more energy. Yeah, that's exactly right.

I'll give you an example. We're actually supposed to have significant downtime for repair work, for repair work for our brains, repair work for our mitochondria. And that would normally have happened because we were sunlight creatures and we were controlled by sun. And we'd get up when the sun came out and we'd basically go to bed when the sun went down. And even the advent of fire 150,000 years ago, we were still exposed to orange light, red light, and we certainly weren't exposed to blue light. So we still had a limited period of eating. And the evidence is if we have a 12-hour window of no eating, which is really easy if you think about it, that's 7 a.m. to 7 p.m. That's a 12-hour

eating window, and you'd have from 7 p.m. to 7 a.m. of not eating. We begin to shift into mitochondrial repair. And what's really exciting is the more you go beyond 12 hours, the better the repair work goes. Let me give you an example. There's not a lot of repair work done on LA freeways during the day because the traffic is so bad. I drive into LA very early in the morning or to Palm Springs very early in the morning from Santa Barbara, and that's when the repair work's going on because there is much traffic on the road. Well, our mitochondria do the same thing. If they're doing work, they have no time to repair. And it's the repair of mitochondria, undoing the damage of our eating that actually allows mitochondria to get back to full power. So the more we can limit the time period that people eat, the better.

I always tell patients that when you're eating food, you want to be choosing your food, not just for you, what you like, the things that are pleasurable for you, but you also want to be feeding the good bacteria. And we talked earlier about this acromantia mucinophilia. That's a specific bacteria that is in the body and that you want to have on high levels. And when we do the testing, we can actually determine, do you have high levels of it or do you have low levels or do you have no levels or very low levels? And there are certain foods which you can incorporate into your diet, things like pomegranate and maca and acacia fiber, cranberries and things like that. These are foods which are basically prebiotics. And when you incorporate them into your diet, it's like putting Miracle-Gro on that garden. They

start to flourish. They start to take over. And they help balance out the whole ecosystem. Yeah, I think it's one of the biggest advances in our thinking about gut. We just didn't give probiotics and that'll fix it. But you're giving like 50 billion is a lot, right? But you have 100 trillion trillion bacteria. So it's like a drop in the ocean. And one of the big insights I had was actually from an experience I had last year where I developed colitis. It's a long story, but I had been sick from mold and I've told that story and I had a

recurrence of my gut because I had the C. diff and that was kind of really messed me up. And I checked my stool and I had really low levels of this acromantia, which has been linked to autoimmune disease, been linked to poor response to immunotherapy for cancer. It's been linked to cardiometabolic disease and diabetes. And I'm like, whoa, this is not good. So I started to research it and created this cocktail of cranberry, pomegranate, green tea, acacia fiber, some probiotics, other prebiotics. And I took it and it literally within three weeks, I went from full-blown colitis to completely normal, perfect. And it was sort of a wake-up

call for me, which was, you can't just get probiotics. You've got to feed the whole inner garden. And what it likes is certain foods and it likes all the polyphenols and the colorful, dark rainbow color of chemicals that are in plant foods. There are certain plant foods have more of them, like the berries and so forth. Absolutely. Yeah. The polyphenols are gold. And to me, I think that's actually probably one of the things that plays a role with the French paradox is the polyphenols that are found in red wine. I think that's definitely what you're doing is you're actually feeding, you know, patients love me because the two things that I always prescribe to my patients is chocolate and red wine.

Depends. And they're high. I would say people like wine drinking, but I wouldn't give it as an extra thing. No, right, right. But I'm just, I'm just, I'm just, yeah, razzing. But the polyphenols are the miracle food prebiotics for the gut absolutely so tell us a story about a patient who had a screwed up microbiome and what you did and how they got better oh i've had i mean multiple patients i mean like as for example i just had a

patient this uh i followed up today 18 year old with fatty liver disease disease and sort of pre-diabetes picture. And lo and behold, I did the testing for him and his acromantus immunosynophilia was almost undetectable. And now fatty liver, typically, like you said, we used to see that in some patients who were drinking alcohol. What we're now finding out is that fatty liver is the thing that is being driven by disruption of the gut microbiome. So what's happening is when you destroy the mucus, the protective mucus lining of the gut, some of those bad bacteria get into the body, get into the circulation. They go into the liver and causes systemic inflammation, which in turn causes fatty liver. And it was just, I don't know

if you saw the recent paper about this, about what is termed non-alcoholic fatty liver. And it was just, I don't know if you saw the recent paper about this, about what is termed non-alcoholic fatty liver is actually from alcohol produced by gut bacteria. So some bacteria will actually produce alcohol, which in turn poisons the liver. It ferments, right? It ferments, exactly. It's just like, you know, you get this bloating food baby. That's actually your bacteria fermenting the food you're eating. And certain foods are more fermentable like starches and sugars exactly yeah we we uh we actually have seen cases of patients who literally

had elevated blood alcohol levels yeah auto brewery syndrome from the bacteria in their gut yeah and they literally got pulled over and found you know they had like for drunk driving exactly it actually the auto brewery syndrome is and I've had a couple of patients with that and they, typically that's usually been attributed to yeast overgrowth. But there also are cases specifically with bacteria that can also produce alcohol. I mean, you're basically, it's like a, it's a brewery in your body. Yeah. You don't need a Budweiser.

No. This Bud's for you. So the, so what happened when you This Bud's for you. So what happened? You have this patient and you – Yeah. So, I mean, basically you work on doing dietary interventions. Do you get better when you fix this or you just – Well, this was just – I was just offhand because I just had this patient this morning.

And it was a very interesting case because the thing that really stood out is that his protective anchorman's immunosynophilia was quite low. He was also a vegan, which we could discuss what is the best diet. I don't believe that veganism is actually the best thing. I think we're omnivores. And I come from a family of dentists. So I always talk to my patients. You see that thing right there?

That's a canine tooth. And a canine tooth is designed to chew meat and to chew fish. And we have specific enzymes in the body, which are pancreatic elastase and proteases, which are designed to digest protein. So we are, you know, like Michael Pollan said it best, eat plants, eat food, real food, mostly plants, not too much. So a plant-based diet with healthy amounts of fish and lean meat on occasion is really probably the best type of diet and i think some of my

most difficult patients are the ones who are sort of strict vegans for whatever reason ethical or spiritual or whatever religious um can oftentimes get into really difficult situations because it's like a cat chasing their tail. They don't have the specific nutrients to patch up and heal the body. Doesn't all that plant stuff help the microbiome? It does. Absolutely. It's going to help the microbiome, but he had almost no omega-3s. It was really nutritionally deficient. Unless people are supplementing, they get super nutritional. Well, exactly. You can have a person like, it was just in the news recently, it was a 22-year-old, I think it was over in England, who was living on potato chips,

white bread, and French fries, and went blind. There's no vitamin A. Yeah, went blind. So you can be walking and talking, and you can be severely malnourished. Because there's about 40 nutrients that your body needs on a regular basis. And I like to also make the analogy to my patients is like your body is like a house that's being built and broken down 24-7. You need all those building materials to make that house. You need carpeting. You need wood. You need glass.

You need all these materials. And if those materials aren't there, then the structure may still be standing. But if you don't have glass, the wind comes in, the rain comes in, the snow comes in, and then you're going to have problems with your body. The problem with traditional medicine is they don't look for those building blocks. They don't test for them. And that's what's different here at the Ultra Wellness Center. We actually look for these things. We find them. I mean, when was the last time a doctor looked for acromancy in someone with fatty liver? Probably never, right? Other than us here or some functional medicine. Or check their omega-3s or check their vitamin D. Exactly, yeah, right. And so those kinds of diagnostics are available and help us really think differently about treating

disease. I mean, most doctors understand hepatic encephalopathy, but most doctors who are treating fatty liver don't actually think about what's going on in the gut microbiome or how to treat it. They don't even know how to fix it. Well, you know, the thing that one of my pet peeves, Mark, and I'm sure you've heard this too, is that patients will go see the expert endocrinologist for their diabetes and the expert gastroenterologist, and they tell the patients to eat anything they want. That is absolutely- Wait, you mean food has something to do with our health?

It does. Oh my God. What a radical idea. My favorite was once I was at Canyon Ranch. I was playing basketball at lunch because they had these basketball pickup games. And there was one of these people there was playing and he was a gastroenterologist. And I said to him, you know, have you ever thought of like how, you know, food might impact what's happening in the gut? Because you're putting literally pounds of this stuff through that tube every day.

You think it might have something to do with why people have digestive symptoms? He was like, gee, you know, I never thought of that. That seems so interesting. Yeah, that makes a lot of sense. And I'm like, holy crap. You know. But yeah, I mean, your microbiome is dependent on what you feed it. How you grow your inner garden depends on what you're eating. And you can create a nasty garden with weeds and

toxins and bad stuff and poisonous plants, or you can create a really flourishing, rich garden that actually takes care of you. Yeah, absolutely. And then also the other thing that a lot of even physicians aren't even aware of is that most of your immune system is in your gut. Yeah. So when you disrupt that ecosystem, that rainforest inside of you, you are disrupting the immune system. And we're talking about fecal transplants. There's a recent study that showed that children with autism who got stool transplants had a marked improvement up to two years out from just replacing the gut microbiome. I mean, that's pretty powerful. So there is no pharmacological-

Because autism is like an encephalopathy. It's a metabolic encephalopathy. To some degree, absolutely. It's like a hepatic encephalopathy. Yeah. I mean, to me, that's sort of the canary in the coal mine in our environment today. We have one in 68 kids having autism now, depending on where you are living in America and around the world, that is a big, big issue. And what we're finding out is there's more and more connection to the microbiome. Yeah. I mean, so 60% of our immune system is in the gut. And essentially, there's a sewers

that's on the other side of the lining of your gut which is only one cell thick and on the other side is your immune system and there's a breakdown which can come from having c-sections antibiotics acid blocking drugs stress poor diet yeah all that stuff damages the gut creates a sleaky gut gluten dairy, dairy, all those things. Then you get this inflammation. So we treat a lot of people with autoimmune disease here at the Ultra Wanda Center. And often the place we start is the gut. So tell us how that works and about some patients you might have had with autoimmune disease and how working on their gut helped them.

Yeah, so I had one patient in particular who I saw who came in, it was a great story. She came in and she was having MS as her diagnosis. She also had auto immune disease, multiple sclerosis, and she also had infertility. And I did a complete workup on her. She had dysbiosis, had bacterial and yeast overgrowth, also had sensitivity to gluten and had also some, not a heavy, not a big level, but some level of mercury in the body. So I worked on a diet, worked on, you know, both prebiotics and probiotics to clean up the gut, got her completely off of gluten. And lo and behold, guess what? Her multiple sclerosis went away. Amazing.

Disappeared. All right, not to say that all- And you got her metals out too. Yeah, not to say that all cases of multiple sclerosis are due to that, but there are many pathways to multiple sclerosis, just that there are many pathways to Alzheimer's disease. Or any disease.

Or any disease, exactly. Because the body will manifest it in only certain inflammatory pathways. So ultimately, she got off of her medications. Her MS to this day is in complete remission. She has no symptoms, on no meds. And as a side effect, she got pregnant. Wow. That's a good side effect. Yeah. And she was happy. So that's an amazing story. And I think for people who are listening,

functional medicine is a new way of thinking about disease. It's not based on the label MS. It's based on the cause. And you can have one disease that has many causes, like MS, which can be caused by heavy metals, by Lyme disease, by Epstein-Barr, by the gut microbiome, by gluten, you know, like B12 deficiency, right? You can have so many things that are driving this same syndrome.

Right. And the personalization of medicine is what functional medicine is all about. And that's really what's different here about how we practice medicine at the Ultra Wellness Center because we're looking at each person as an individual. We're creating a personalized medicine and personalized health, which is a radically new way of thinking. And we just lump everybody with the same symptoms in the same categories, but it doesn't tell you anything about the cause.

And I always say, just because you know the name of your disease doesn't mean you know what's wrong with you, right? And that's what we do through very detailed histories here, through very advanced diagnostic testing, the look, some of these things. Absolutely. And I think the enjoyable thing, I'm sure that you experience yourself, is that every patient is unique. Yeah.

You know, I've never treated two patients the same way from a functional approach. No. Completely different. Even in the same family. And that's actually the fun part about it is the, I call it, you know, the person comes in with their own genetic uniqueness, their own, you know, personality makeup, their own story, all of these, you know, things that you can paint the picture of, you know, where were they when they got sick? Where are they now?

And what are the things that, you know, that we can remove, you know, like the four R, what do we need to replace? It's sort of like being Dr. House, right? It's like medical detectives. Yeah, like medical detective, exactly. And, you know, I think, you know, one of the most important things that I always tell people who are training in medicine is to listen to the patient. Yeah.

They'll tell you what's wrong. Absolutely. And when. And what. Exactly. And sometimes I just have to sort of bite my mouth because you want to always interrupt patients and say, oh, what about this? And what about that?

I just sort of let patients talk more. And I just sort of listen. And then I'll ask the questions later. And when you really do that and let the patients tell their story in their own way, in their own terms and get that out, you really find out all the little details and you can play house and play detect and try to, you know, piece the piece of the puzzle together. Yeah. You know, we, we in regular medicine, we are trained to create an exclusive history. In other words, someone comes in with a symptom, let's say they have heartburn or reflux or chest pain we don't want to know

anything else about them except about that right we want all the details about that we don't know do they have a rash are their fingernails cracked uh do they have eczema is their butt itch like don't talk to me about any of that because that's not relevant and in functional medicine all of it's relevant because it's a clue that could give you a clue to what's actually happening for that patient and that's what's so beautiful about this process you know i i think i used to work in the emergency room i think you did too it's boring it's boring because someone comes in and he's like okay it's the heart attack treatment it's the asthma treatment it's a kidney stone protocol it's like it's like you just look at the nurse you go heart attack okay they don't they know what the orders are they know what to do you treatment. It's like, it's like, you just look at the nurse, you go up heart attack. Okay. And they don't, they know what

the orders are. They know what to do. You just barely write it down. And it's like, it's like rote and boring. It's, it's, it's a, it's a formula, like a recipe. Right. In functional medicine, there is no recipe. There's actually having to think every time you see a patient. Right. Right. And, and, and, you know, and, you know, being trained in traditional medicine and also in a functional medicine approach, there's definitely, if you're having a heart attack, I want a thrombolytic. Absolutely. Now you blew out your knee.

You need a knee surgery. I want you to follow the protocol that has been shown to work. But for chronic conditions, acute care medicine, which is basically the scalpel or the prescription pad, are probably some of the more toxic things that you can have. A lot of what I see in my patients here is iatrogenica imperfecta. All right, which basically means the doctor did it, right? So the patient comes in and they're on a whole laundry list of medications and these are interacting, you know, they're on proton pump inhibitors, they're causing acid blockers they're they're causing uh uh calcium deficiency

mineral deficiency b12 deficiency so there's you know there's these these drugs have their their their risk benefit and the the less drugs you use in medicine the better off the patient is yeah it's hard because that's what we know how to do it's what we're trained to do it's like we don't know how to treat people with food as medicine we don't know how to restore a gut from a messed up gut to a healthy gut and that's really what we're trained to do. It's like, we don't know how to treat people with food as medicine. We don't know how to restore a gut from a messed up gut to a healthy gut. And that's really what we do in functional medicine. Yeah. And I also, another important thing that it's important for physicians out there who are new to functional medicine and also for patients is to realize these things don't happen overnight. It can take time, but usually sometimes you can see a

difference in, in, you know, days to weeks. Sometimes it could take months and sometimes it takes years. It depends, depends on what's going on. So weeks. Sometimes it takes months and sometimes it takes years. It depends on what's going on. So true. I mean, sometimes it's like, it's almost miraculous and you go like, it's hard to believe. I remember when I first started practicing, I would like go, okay, do these things, take this, eat this. And then they'd call back a few weeks later or a month later. I'm like, how are you doing?

Well, I'm all better. I'm like, what? You're better from that? Because it was such a contradiction to everything I learned. But then I started to trust it and I started to expect it. And I just remember this one patient, she had psoriatic arthritis, which is a horrible condition where you've got psoriasis, but your joints are being deformed and destroyed. You're in pain all the time. But she had a bunch of other stuff, which quote was unrelated. She had depression. She had insomnia. She was overweight. She had terrible reflux and heartburn and she was having bloating and SIBO and irritable

bowel. And I'm like, okay, well, let's see. She's inflamed. Everything that she's got is inflamed. The weight is inflamed. Depression's an inflammation in the brain. Her gut symptoms are about inflammation in the gut. You know, everything's related to inflammation. So why don't we sort of just start simple and clear out things that are causing potential inflammation. So we got rid of gluten and dairy in your diet and sugar and starch and all processed food. We got her gut cleaned up. I gave her an antibiotic and antifungal and a little gut program and a couple of nutrients to help her fight some inflammation that she was suffering from. And six weeks later, she came back, her psoriasis was gone, her arthritis was gone, her reflux and irritable bowel was gone,

her depression was gone, she lost 20 pounds. And she got off of her medications, even the one that was costing 50 grand a year to suppress her immune system from the psoriasis. And it seems like a miracle, but it really isn't when you follow this methodology. And that's what we've been doing here for decades, practicing functional medicine up in Berkshire in the middle of nowhere. It's pretty amazing. Well, it's really interesting because most of the patients who have psoriasis are going to see a dermatologist. And most dermatologists do not have a clue about the gut microbiome, nor are they testing or thinking about it. And then if they get psoriasis and they develop psoriatic arthritis, which is arthritis in addition to the skin condition, because I always tell patients is the skin is contiguous with the gut. So if I draw a line on the skin and I keep drawing a line and go down my tongue and I go into my esophagus, down to my stomach, into my intestine, I'm still on the same surface.

Yeah. So oftentimes, and you know this, Mark. That's true. I never thought of that. Yeah. It's kind of a cool thought. That's how I explain it to patients. So the skin is contiguous with the gut. It's an ectodermal tissue. And when there's skin issues, think gut. It's really a tube that's outside your body. Here's your gut. Yeah. It's

true. I mean, when I'm a patient with psoriasis, eczema, acne, rosacea. I treat their gut. And I don't put stuff all over their face or on their body. Exactly. To suppress the inflammation, I get rid of that. And it's like really a miracle. It is. I mean, dermatology is not something that I'm an expert in, although I was trained as a family doctor in dermatology.

But I feel like we get the most amazing results just for something as simple as fixing the gut and changing the diet. Absolutely. Yeah, exactly. Yeah. I mean, the body's this interconnected, complex, self-healing organism. I mean, that's the big thing is I often ask patients, I mean, do you think you're going to get better? And if I have a patient who thinks they're going to get better, then together we're going to get better. But if I have a patient who doesn't think they're going to get better, then I try to get them to change their mindset.

Because even though somebody comes to me, they really almost believe I'm not going to get better. Well, that's what they've been taught. Exactly. You have to live with this. Exactly. You have to manage your disease. Right.

I don't want to manage it. I want to get rid of it. And the body's ability to self-heal is amazing, as you know, as you mark. It's really amazing. There's an intelligence in the body that we, you know, as much as we know about the body, there's a lot more that we don't know. And the more I practice medicine, I think the more humble I become because I realize how little I know.

It's how complex it is. It's really, really complex. But there's so much that we can do for patients that, you know, they've gone to, you know, the Mayo Clinic. They've gone to Mass General. They've gone to, you know, X, Y, and Z everywhere else. And they, you know, as you say, the resort medicine, we come here for last resort.

I mean, that's... Yeah, I literally just walked from my office to here after seeing a patient who went to the Mayo Clinic who had chronic dizziness, chronic constipation, fatigue, insomnia, all these different symptoms that they couldn't find, quote, anything wrong with him. And I'm like, well, I know what's wrong with you. You've got this, this, and this, and this based on looking at it through the functional medicine lens. Yeah. Well, and the other thing is, is, you know, I think, I think it was a Sid Baker, I think who made the analogy or it was in, or maybe it was Sid Baker, I think, who made the analogy, or maybe

it was Jeff Glenn, is that if you have a dime and you're on a dark street and you lose your dime over there and the streetlight's over here and you're looking under the streetlight, which is where you're testing. So most of the testing is basically looking where the dime isn't. All right. So the type of testing that we do here, which is nutritional, metabolic, toxic genomic testing is, is spreading out the searchlight to find that. Absolutely. That's such a key point because, you know, you go to the doctor and they say, well, we've tested everything and all your results are normal. And the implication is it's

all in your head. But I would say, I don't agree with that because, you know, either two things are true. One, the patient's crazy or the doctor's missing something. And I'm going to bet on the doctor's missing something. Because when we start to look, we find all sorts of stuff in places that nobody's looked before because they're looking under the street lamp instead of actually where the problem really is. Exactly. That's exactly right. And I think, you know, what you alluded to before was really important, which is that functional medicine is about getting rid of the things that impair health and putting in the things that help the body thrive. And then the body can take over and with this amazing intelligence can repair and heal from all sorts of things. In our food, yes. But in that food are toxins and in our environment,

and we have medications and we have you know we have xeno we have endocrine disrupting hormones all of which end up in our gut in our in our gut microbiome and are very disruptive and if a person has a genetic predisposition to ulcerative colitis or Crohn's inflammatory bowel disease in general then they're going to be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment, it's the stress. All of those can trigger your genetic predisposition. Absolutely. Absolutely. Because you have to ask yourself the question, like, why have we had, you know, such a rapid increase over the last several years?

Yeah, what's going on? And, you know, and this is, you know, this is your area that you just, you know, you're you are the leading edge of the medical voice and understanding agriculture and food production in our country and how it is. It is toxic and why it's toxic. You know, we don't have healthy soil, and that's where it begins. Because if we don't have healthy soil, we're not going to get the nutrients in our gut soil to grow good bacteria and have a healthy microbiome so that our intestines can stay healthy and do their job for us. Yeah, it's such a big deal. And, you know, from a conventional perspective, the treatments are

really to shut down your immune system, right? Oh, yeah. Prednisone, steroids, chemo drugs, TNF alpha blockers, things that increase risk of cancer and infection. They're pretty extreme drugs, and they can be very helpful, and they can be life-saving, and they can work for people but the question is is there an alternative yeah and do you know do we have to deal with this the same old way we've been doing with it and then of course for a lot of patients who have it sometimes they need surgery appear they total colectomies for ulcerative colitis where they remove your entire colon or resect whole sections of your bowel with crohn's disease which doesn't really even cure the problem it's just a rough rough disease it is rough And I think you and I can bring people some really

good news today that using functional medicine and what we understand about the gut microbiome, what we understand that food is medicine, you can get better and stay better without having to use the kind of drugs that you just mentioned that can lead to cancers down the road. People on immunosuppressive drugs, you know, followed for 20 years or, you know, they're already at very high risk. They're already at increased risk with inflammatory bowel disease for, you know, colon cancer. And then if you put them on an immunosuppressive drug and follow them for 20 years, you know, they have an increased rate of skin cancers by about 40%. And so, you know, and during

that period of time, they have increased rates of infection. They have side effects to the medications. They have to come on and off them. They have to try new medications. And by and large, you know, they're moderately effective and sometimes not effective at all for some people. For sure. And I, you know, I think that people suffer a lot from this and they can manage the disease, but it often doesn't go away or it's not curable. But from a functional medicine perspective, it can be really curable. And I can tell you so many patients that i've had i mean i just actually how i got the job and probably how i got the job job at uh at cleveland clinic was because i met someone to the ceo who whose niece had severe colitis was tried all the medications wasn't working was about to have her total entire colon removed at

32 years old and i said look just have her come to me no promises but no it's worth trying before she rips out her entire colon which is irreversible right and i think she was skeptical uh she was from new orleans and probably wasn't the healthiest you know lifestyle down there and she agreed to do what i told her but she was quite skeptical but i changed her diet i reset her gut microbiome you know did simple things simple things and six weeks i talked to her she said um i'm perfect i'm fine I'm on no medication. And I'm like, what? Literally six weeks, and they were going to take her colon out, and she's symptom-free and off her medication. And I can tell you story after story like that. Another young kid was 25 years old.

Same thing, about to take his colon out. Just some simple dietary lifestyle changes and getting the gut microbiome straight and resetting the gut with the functional medicine for our five-hour program was so key. So I think it's it's we we had talked earlier as we were preparing for this and one of the one of the i think were the first things that happened and you can correct if i'm wrong but you met with dr ruggiero who's a gi doc clinical clinic and he got to put up a collaborative you know to you know work with functional medicine and traditional and conventional forms to treat ulcerative colitis, inflammatory bowel diseases.

And that sounds like a phenomenal partnership. Absolutely. It really is. And I think there's a real openness to understanding there's really room for this, including with everything. It's not either or. Yes. How do we how do we create the best conditions for a patient to get to health? And I think, you know, I just, in terms of causes, let's sort of dive into that. Because from a functional medicine perspective, you know, we really look at root causes. And today I was, you know,

going through my medical research that I do every day and just sort of looking at what's new and was sort of shocked to see this. Well, not really shocked. I kind of expected it, but I was shocked to see it sort of published so prominently in in a medical journal really really discussing the uh way in which food sensitivities i mean that's right food additives and ultra processed food will drive changes in in people's um gut so when you look at this data it was quite interesting they looked at uh mice and people and they basically show that high sugar processed food diet

affects the gut in a harmful way we also know that there's a lot of emulsifiers and additives in food like that they're thickeners even things like microbial transglutaminase which is a like a gluten product that's put on purpose in food to make it stick together because gluten makes it glue, makes it stick together. And so we have to sort of think about when we take care of these patients, what their causes are. And I've seen all sorts of cases of Crohn's and colitis. And I just share another story of a guy who I saw years ago who had severe colitis, was really losing weight, struggling. I tried all the normal functional medicine stuff, reset his gut microbiome, 5R, elimination diet, tried everything, the right supplements, and he just wasn't getting better.

And so I went back to the principles, first principles that I learned from Sid Baker, which is what could be bugging this person that needs to be gotten rid of? Is there something else that I'm missing? And what am I missing? Is there something I'm missing? Yeah. So I went back to the drawing board as my medical detective had on and found out this guy had really high levels of mercury. And it wasn't until I chelate his mercury that he was able to correct his colitis and is now symptom free. I personally had a different cause. You know, I was, I was somebody who mostly had a healthy gut most of my life. And then I developed mercury poisoning and that messed up my gut. I didn't get colitis, but I had really bad irritable bowel and bacterial overgrowth and all sorts of issues that I cured.

But then a few years ago, about five years ago, I got a confluence of events where I ended up having to take an antibiotic for a bad tooth and root canal, and it was clindamycin. And this antibiotic is known to cause C. difficile, which is a really common intestinal infection that causes death in about 30,000 people a year. And all of a sudden I started getting not just diarrhea and this and that from it, I started getting really severe pain, nausea, going to the bathroom 20 times a sudden, I started getting not just diarrhea and this and that from it. I started getting really severe pain, nausea. I'm going to the bathroom 20 times a day, bloody bowel movements. It was miserable.

I literally was in bed five months running back and forth to the bathroom. And it turned out I had developed colitis from the C. difficile. And then it continued even after we cured the infection. The colitis continued. And so I had to really go back to the drawing board to think about what do I do? Because I also had mold exposures and I had all these imbalances, I had low ecromancia. So I learned a lot about on a personal level, which I really didn't want to learn that way, but I learned about what the symptoms are, what it does and how to actually start to think about fixing it differently. And for me, I did a number of things. I used a cocktail of, I call it gut

food, which is a cocktail of components that are, I think, have not really been put together too often, including prebiotics, probiotics, polyphenols, and immunoglobulins, and things that really help the body to reset the gut. And I also dealt with the mold that I had in my house. And I also used ozone to help boost my immune system and kill infections. And it was really amazing. Within a very short time, I was able to really recover. And I think a lot of us sort of struggle without really knowing what to do. And even sometimes when you do an elimination diet, if you have colitis, you don't necessarily always get cured because there may be something else going on. And maybe like what I had,

maybe there was, you know, C. diff or maybe there was mercury or maybe, you know, there was something else going on. But you can really help these patients so much. Crohn's is often a little more challenging, but we do a lot of different approaches. So traditional medicine, it's pretty cut and dried. So what are the kinds of things we find that work the best? And talk about from a dietary approach, and then sort of drill down into the other aspects of our treatment for colitis and Crohn's disease. Right. So the, you know, neck and neck, it's diet and gut microbiome. Right. So it's really neck and neck. intriguing because there's more and more research being done into the differences between a healthy

gut microbiome and the gut microbiome of a person that has inflammatory bowel disease, and there are significant differences. And in a person that has inflammatory bowel disease, one of the key bacteria, as you mentioned earlier, is acromantia. Yeah. Acromantia plays a role in keeping the mucosa, the gut lining, the goblet cells really healthy. It breaks down the mucin, and then when it breaks that down, it turns it into short chain fatty acids. And we know that short chain fatty acids are the, you know, that's the honey of the, you know, the colonocyte. It just loves, you know, it's short chain fatty acids and that keeps it really healthy. People who have inflammatory bowel disease tend to have really low levels of acromantia. And it's not uncommon for me to find that they're not even detected

when I do the complete diagnostic stool analysis on patients. So replacing acromantia, you know, has been shown to have, you know, an important role in helping the gut mucosa heal. There is a study that I had come across in preparing for this. It was in the European Journal of Inflammation 2020. And basically, in this study, they took bifidobacterium, another strain of bacteria that is found to be really low in patients with inflammatory bowel disease. And they took a specific strain of bifidobacterium lactis, and they combined it with xyloglucan, which is a non-digestible fiber source. So they had a prebiotic and probiotic together in a patient with ulcerative colitis. And they followed, you know, all of the patients in the study and control groups. And they found

that there was at six weeks, the study group had significantly more healing and resolution of their symptom, more healing of the gut mucosa and healing and resolution of their symptoms, more healing of the gut mucosa and healing and resolution of their symptoms. And this is just, they had no other therapy. This is just a prebiotic and a probiotic that they used. And so using probiotics, you know, to control and to resolve an exacerbation can be really critical, and I think we're learning more and more about how they work. There are other probiotics or other bacterial species that are missing

or are in low concentration in patients with inflammatory bowel disease, including lactobacillus GG, sarcomyces boulardii. And when you replace these, you find huge benefits. So I use probiotics pretty quickly in a patient. I also will use, there's a probiotic called VSL number three. A lot of people know about that because it's frequently used. And it's really powerful. It has all the strains of lacto, bacillus, and bifidobacterium that are low and are also very helpful in healing that gut lining and gut mucosa. And just by using that, I've been able to help people start to feel better and see the symptoms resolve. So as you can tell, the gut microbiome, using probiotics are really a big part of how I'll treat my patients. But there has to be balance about what they can tolerate and where they are

in their disease because the diet then becomes really important. Sometimes I can't give probiotics right away. Sometimes I've got to get this person eating. I've got to get them feeling better before they can actually tolerate the addition of the probiotics. What are the kinds of diagnostics you'd see us using with these patients to figure out what's going on with them? Well, traditionally, you're, you know, first you're going to get to set us. I always like to go back to the basics. You know, we've got to remember that we're, doctors are cognitive beings. We are medical detectives. We like to think. So I think you need to make sure that you're listening to the patient's story, hearing all of the symptoms,

doing a really good examination, and making sure you do that part. Because that's where you get, you find those predispositions, you find those triggers, and you find those mediators that are so important. Because that begins to, those are the categories of thinking to solve the mystery. Okay. So once we've – I've done that piece and I have a really good idea of what the predispositions are. I have a really good idea of what the potential triggers are because those triggers can give me an idea of how I'm going to help them get better and control it down the road.

And some of the mediators and perpetuators um you know that could be you know stress or that could be their diet once i have those pieces then i say okay you know what i'm pretty sure you have ulcerative colitis you know how do we how do we know for sure um we can check inflammatory markers like something called calprotectin uh which will be very elevated in people with um inflammatory bowel disease. And then we can also visualize, and it's the gold standard, is to visualize with the colonoscopy the intestines. And you can probably do both in upper and lower.

And you'll see that with Crohn's disease, it can involve the entire intestinal tract, whereas with colitis, it typically just involves the very end or the distal part of the large intestine, the rectus sigmoid and the first third or the last third of the colon. And that will visualize it through colonoscopy. So that's the conventional way. And then once they land in my lap after being frustrated by just not getting better or finding that their diets are really

restrictive and they're constantly having symptoms and they're not finding any answers in the places they're looking in the conventional medical world. Then I immediately go into action and I'll look at the complete diagnostic stool analysis where we will get a full complete picture of your digestive processes. Are you making enough gastric acid, pancreatic acids? Do you have markers of inflammation? Is your detox system in your gut working correctly? Is your immune system responding, over-responding, under-responding? And it will also tell us very specifically the diversity and abundance of your gut microbiome. And so it's one of the, it is the first test that I'll get, but I'll also look for other things. And we should have mentioned this earlier, but

I'll look for SIBO, which is small intestinal bacterial overgrowth. I will look for food sensitivities, particularly to gluten. I'll look for leaky gut. And I'll also look for those cross-reactive foods, foods that act like gluten that can create inflammation if you're sensitive to gluten and then be a trigger for your ulcerative colitis. So those are some of the tests. I'll do an ion profile or a micronutrient. It's a functional evaluation of all the most important biologic processes that your body does. And it allows us to determine which systems are or aren't working. And if they're not, what nutrients are you missing?

Do you have, particularly when it comes to the mitochondria, do you have compounds or toxins that might be impairing those functions? Like with you, you had mercury elevations that know, tipped you over and made you more susceptible to the adverse outcome with a antibiotic. So we're looking at all those things and those are the tests that I look at. And I, you know, I may do, you know, some, well, yeah, I usually will stop there in my first year. I usually get most of all the information I need with those tests. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving

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