The Dr. Hyman Show - 3 Things That Destroy Your Gut Health

Episode Date: April 11, 2022

This episode is brought to you by Rupa Health, Thrive Market, and Pendulum.   The number-one reason people visit the doctor is problems with the gut. Not only do gut issues impair gut function, makin...g life miserable, but they also are a contributing factor to many serious conditions such as cancer, heart disease, autoimmune disease, diabetes, and more.   In this episode of my Masterclass series, I am interviewed by my good friend and podcast host, Dhru Purohit, about the three biggest contributing factors to compromised gut health. We discuss the importance of looking at gut function, the top foods that typically cause gut problems, and the top substances that support healing the gut.   Dhru Purohit is a podcast host, serial entrepreneur, and investor in the health and wellness industry. His podcast, The Dhru Purohit Podcast, is a top 50 global health podcast with over 30 million unique downloads. His interviews focus on the inner workings of the brain and the body and feature the brightest minds in wellness, medicine, and mindset.   This episode is brought to you by Rupa Health, Thrive Market, and Pendulum.   Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com.   Join Thrive Market today to receive an extra 40% off your first order and a free gift worth over $50 at thrivemarket.com/hyman.   Pendulum is the first company to figure out how to harness the amazing benefits of Akkermansia in a probiotic capsule. To receive 20% off your first purchase of Pendulum’s Akkermansia probiotic supplement, go to Pendulumlife.com and use code MARK20.   In this episode, we discuss (audio version / Apple Subscriber version): Three main things that destroy your gut health (4:11 / 1:00)  Diving into dysbiosis (8:18 / 5:00)  Microbiome testing and gut-health evaluation (13:12 / 10:00)  Toxins that harm the gut (16:48 / 13:34)  How and why stress is bad for your gut (21:45 / 17:18)  My personal gut-health story (26:16 / 21:44)  Best and worst things for your gut (29:15 / 24:45)  Questions from our community, including constipation and heartburn (31:57 / 27:44)   Mentioned in this episode: An Epidemic of Absence by Moises Velasquez-Manoff Missing Microbes by Martin J. Blaser, MD Breaking the Vicious Cycle by Elaine Gottschall

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Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. A third to half of all the molecules and thousands and thousands of molecules floating around your blood come from the bugs in your gut. And if they're bad bugs, they're going to create havoc. And if they're good bugs, they're going to keep you healthy. Hey everyone, it's Dr. Mark. One of the most important tools I have for helping my patients optimize their health is testing. And that is why I love what Rupa Health is doing.
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Starting point is 00:01:05 Genova, Great Plains, and more. It's 90% faster, letting you simplify the process of getting you the functional tests that you need and giving you more time to focus on your patients. This is really a much needed option in the functional medicine space, and it means better service for you and your patients. You can check it out with a free live demo, with a Q&A, or create an account at rupahealth.com. That's R-U-P-A health.com. Time and again, I've had my patients tell me they're too busy to eat healthy as they'd like. And that's when I ask them how much time they spend on email or social media. I like to tell them that if they have that time to scroll,
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Starting point is 00:03:05 Just in case you missed that, it's thrivemarket.com slash hyman. Welcome to the doctor's pharmacy. I'm Dr. Mark Hyman and we are here with a new episode for our masterclass, a new way we can dive into popular health topics, including inflammation, autoimmune disease, brain health, sleep, and more. And today I'm joined by my guest host, my good friend, my business partner, Drew Pruitt, the host of the Drew Pruitt Podcast,
Starting point is 00:03:34 and we're gonna be talking about the top things that are not food-related that destroy your gut health. Welcome, Drew. Mark, we've done so many episodes on gut health, and we've talked a lot about food and how food plays a major role, both foods to eat and to avoid. And we might hint at some of those today, but we want to talk about the other categories. And we have three that we've identified here. I'm sure we'll break down more. Give us the top three things that you see in your practice and through your own experiences over the years of being a functional medicine doctor, three categories that are major contributors
Starting point is 00:04:08 to poor gut health function. Well, I mean, the first one is what we call dysbiosis, which essentially means an imbalance in the microbiome in the gut. You've got maybe 100 trillion cells in there, maybe 10 times as much your own cells, 100 times as much your own DNA. And they're not just hanging out. They're doing stuff. They're producing all kinds of proteins and molecules. And if you have bad bugs, it creates bad downstream effects.
Starting point is 00:04:40 And if you have good bugs, it creates beneficial effects. Your microbiome produces vitamins and it produces all sorts of beneficial molecules like butyrate that can prevent cancer and so forth. But if you're feeding the wrong things that are in your gut, it can actually end up causing more havoc. We call this dysbiosis. So it's not necessarily an infection, but also infections can be a problem. So you have a worm or parasite or overgrowth of yeast or small bowel overgrowth of bacteria.
Starting point is 00:05:05 Those are forms of dysbiosis that are more extreme. But those all are related to disturbances in the equilibrium in the garden that you have inside your gut. It's like any garden. You don't want too many weeds. You want the right plants and so forth. So that's a huge area that I think has not even been on the radar of medicine, which is how do we
Starting point is 00:05:25 optimize our microbiome now there's companies out there that are have my kids at home there's people talking about the gut but but in day-to-day medical practice your doctor if he's not trained in functional medicine does not understand how to optimize the microbiome doesn't even know what to do to look at it and test it properly they'll do look for parasites look for worms they'll look for infections they'll look for sometimes they'll look for inflammation so they'll look for digestive enzymes if they're super fancy but it's really not a comprehensive view of the gut the second is toxins and i think this is something we don't really appreciate very well and i i think I'm going to share a story later about how toxins have impacted
Starting point is 00:06:06 a particular patient in a very profound way that disrupts the normal equilibrium in the gut. So if you have heavy metals, if you have pesticides, toxins, they create all kinds of problems. There's even things in food that are not food, that are chemicals like emulsifiers for example carrageenan and other thickeners that are hidden in food that actually cause leaky gut and all kinds of gut damage one of them is called microbial transglutaminase and that is basically manufactured gluten by bacteria in a lab that they put in food to make it stick together because gluten is glue that's what i call gluten because it's sticky and it's a way to hold food together that otherwise would fall apart because it's full of processed nasty ingredients. And the third is stress. So any kind of physical, psychological
Starting point is 00:06:52 stress will cause a leaky gut. If you go in the ICU, if you're healthy, you get a leaky gut. It just happens because of the level of stress. If you take soldiers on a forced march overnight, in the morning, you'll have a leaky gut. So stress has a huge impact. And by the way, your microbiome is listening to your thoughts, okay? So it's involved in constantly dynamically changing depending on your relationships, your experiences, your feelings, and even the profound nature of how the microbiome influences our health.
Starting point is 00:07:28 And this was shocking to me. I was on a panel at Cleveland Clinic with a colleague named Stan Hazen, who's one of the top cardiologists there, but who's studied the microbiome in heart disease. And I said, Stan, how many of the metabolites in our blood do you think come from the microbiome? And I thought he would say like 5%, 10%. He's like, I don't know, maybe a third to half. So think about a third to half of all the molecules and thousands and thousands of molecules floating around your blood come from the bugs in your gut. And if they're bad bugs, they're going to create havoc. And if they're good bugs,
Starting point is 00:07:56 they're going to keep you healthy. Well, let's dive into each one of those a little bit more. And let's start off with dysbiosis. You know, you mentioned one in particular. You talked about overgrowth of the wrong type of bacteria or even like fungal overgrowth, candida. Just give us a little bit of a big picture of how does that come up in the first place? Yeah, so why are we having a pandemic of dysbiosis? That's basically the question. And the reasons are multitude.
Starting point is 00:08:26 One is we've over sanitized our world. So we're really not living in relationship to nature in the way we were. And the microbiome of the earth helps our microbiome. We're in the symbiotic relationship. So when we're over sterilized, sanitized world, we end up creating imbalances in our gut flora. There's books written about this called
Starting point is 00:08:44 "'Missing Microbes, The Epidemic of Absence. Those are great books talking about how our modern life has really taken us out of an intimate relationship with nature. If you grew up on a farm, if you're living in a developing country, you're much less likely to have an autoimmune disease or allergies or any inflammation because of how those microbes have helped you regulate and normalize your immune system and then there's there's all the gut-busting drugs that we take the antibiotic you know it's just massive amounts of antibiotics we use in this country and overuse in animals as well acid blocking drugs that people are taking like candy it's the third leading class of drugs after statins and psychiatric drugs. Basically, Prolocec, Prevacid, Asifex, Nexium, all those
Starting point is 00:09:31 drugs that you can buy over the counter now and people are taking, horrible for your gut. They prevent you from producing stomach acid, which you need to digest food. And so you get all these imbalances and the pH goes up, which means you grow different bugs and you get overgrowth of different bugs. And one of the side effects of these drugs is irritable bowel syndrome. So you fix your reflux and your heartburn, but you get irritable bowel. Which one do you want? And then there's obviously drugs like the non-steroidals, aspirin, which is irritating to the gut, Advil, Aleve,
Starting point is 00:10:03 all those drugs that we take for inflammation, also damage the gut. The birth control pill also changes the gut flora, steroids that people take. There's a whole bunch of gut-busting drugs that are really common that we use. And of course, C-sections, lack of breastfeeding, early introduction of the wrong foods, the hybridization of our food supply, the extra antigens, all these weird things we're eating chemicals toxins all the stuff pesticides in our food additives all those go to destroying our microbiome and ends up causing this epidemic of gut issues the number one reason for doctor visits is gut problems it's huge irritable bowel we think oh it's a little bowel it's not serious disease but it accounts for 10 of of the healthcare costs of major corporations
Starting point is 00:10:45 for insurance. It's a big deal. So I think we have to understand that we live in a gut-busting culture and a gut-busting world, and that's why we're seeing such challenging issues around gut health and all the downstream consequences of poor gut health, which leads to so many other chronic diseases. We know that the microbiome now is involved in heart disease, cancer, diabetes, obesity, autoimmune diseases, allergies, dementia, Parkinson's, autism, I could go on and on. Pretty much every disease in some way can be linked back to the microbiome. And if you don't
Starting point is 00:11:17 believe me, just go on PubMed, just Google PubMed, and it'll send you a link to the National Library of Medicine. Just put in microbiome and whatever disease you have or whatever thing you want to learn. And you'll see there's amazing amounts of data emerging. And this is all new stuff. Like when I was starting out in functional medicine, we knew the gut was a big deal. And we knew it made a huge difference when we worked with the gut.
Starting point is 00:11:36 But all the data wasn't there. And now it's just mountains and mountains of data. We're learning so fast about how the microbiome works and all the different species and what they do. But we've ended up with most people having pretty messed up guts in modern world and i mean there was one study where they looked at the stool from um from kids in uh um burkina basa which is an african country and america and they found that their stool was so different the microbiomes are so different based on what they ate. Dennis Burkett was a famous scientist from the UK decades ago
Starting point is 00:12:12 who studied the differences between the hunter-gatherer societies and their cousins, basically, who moved to the city in African cities and the differences in their diseases. And he found that the hunter-gatherers didn't have all the chronic diseases of Western civilization, but the city dwellers did. And he found that the city dwellers, their stool weight was four ounces. The hunter-gatherer's stool weight was two pounds. Why?
Starting point is 00:12:36 Because they were eating tubers and roots and roughage and all this fiber, and so they had giant poops, whereas the city dwellers were eating processed food and not a lot of vegetables and who knows what they're eating and they had these tiny little poops and it had a huge impact on chronic disease and their health on the topic of gut dysbiosis before we get to toxins and stress and unpack those what do you want to say about a lot of the microbiome testing labs that are out there? What can we know from them? What are their limitations? And are there any ones that you feel are more superior?
Starting point is 00:13:11 Yeah. So here's the deal. As a functional medicine doctor, the microbiome typically means what bacteria or viruses or yeast or parasites are in there, right? What's in there? So it's basically like taking a population survey and seeing what you got.
Starting point is 00:13:29 And it's helpful. And there's certain keystone species we need like Arcomantia and others that make mucus layers for our gut to prevent leaky gut and the biofilm layer. And there's really, really importance in knowing what the balance of overall flora are. Do you have more firmicutes, more bacteroides? So you kind of get a sense of what's the overall ecosystem and that's helpful. And there are a lot of companies that are testing that,
Starting point is 00:13:55 but correlating that with particular conditions or diseases, you know, there's some degree that that's happening, but it's still in its infancy. And I think there's a lot of over-interpretation of tests. And, you know, I think we have to be really careful. As a functional medicine doctor, I look at the actual microbes, but I'm also interested in the function of the gut. Not just who's living there, but what are they doing? And often the indirect measurements are way more relevant to me. For example, I look at digestive enzymes and absorption of food
Starting point is 00:14:25 and see if you're having fat malabsorption because I know maybe you have other issues. I look at the immune system in the gut, things like calprotectin, eosinophil, protein X, the antibody levels of IgA. I look at is there some kind of irritation or inflammation. I look at something called short-chain fatty acids, which are the downstream byproducts of bacteria consuming the food that we feed them. And there are certain of these short-chain fatty acids that are extremely beneficial, like butyrate. And if you're low on them, it's a problem. It means you don't have a healthy ecosystem. Or maybe you have high levels of
Starting point is 00:14:59 propionic acid, which is another short-chain fat, but it's a bad one that can cause autism and cognitive issues. Or maybe you have high levels of an enzyme that's produced by bad bacteria called Clostridia, called beta-glucuronidase, that actually is linked to increases in estrogen and estrogenic diseases like cancer or fibroids. Or maybe you have problems with various kinds of commensal bacteria that are a little bit pathogenic. So you're not looking for a true infection, but you see, oh, this is a little bit too much of this nasty bug called Klebsiella. It's been linked to arthritis.
Starting point is 00:15:35 I know I need to deal with that. I'll change my patient's treatment based on that. And then, of course, we look at parasites, and we look at things like lactoferrin, and we look at all kinds of things that we can look at yeast. So we start to look at the whole environment. And that to me is way more relevant. And the test that I use is called GIFX from Genova. I don't really have any relationship with them. We've just been using them for decades in functional medicine. And I think it's a really important way to look at the gestalt of what's going on. Because just looking at little bits here and there, I think we'll be missing a lot of what's actually happening and more clinically relevant things to do now.
Starting point is 00:16:08 Yeah. The reason I wanted to bring it up is that people always write in from your community are like, great. I always hear Dr. Hyman talking about going and test your stool. And there's no shortage of companies that are out there that are offering to test people's stool and send them information. But it's a little bit art. It's a little bit science is what I'm hearing from you when it comes to the interpretation of how to do it. That's where a good functional medicine practitioner could be helpful in helping people navigate that journey. Okay, let's go into the next categories. We have toxins and we have stress. So let's talk a little bit more about toxins and unpack exactly how toxins, how can toxins contribute to an overall unbalanced microbiome?
Starting point is 00:16:47 Yeah, so toxins interrupt normal biology. They poison mitochondria. They jam up enzyme systems. They create inflammation. They create oxidative stress. They directly affect the microbiome. For example, glyphosate. I was shocked because I eat pretty healthy.
Starting point is 00:17:08 I try to eat organic. I never eat GMO that I'm aware of when I buy food. But I go out to eat. I'm traveling. And you never know what you're getting. I could be getting canola oil that's a GMO thing, sprayed with glyphosate that's on my salad dressing, or they made my vegetables in salad dressing or it's made they
Starting point is 00:17:26 made my vegetables in or whatever so i don't always know what i'm eating and i check my urinary glyphosate levels and they were like pretty high like they were the 50th percentile i thought it'd be like really good but they weren't and i was like oh boy this stuff's everywhere and that is a microbiome destroying chemical for example uh heavy metals or another let's just pause on glyphosate because I think some people hear that and they're like, shit, this guy watches everything that he eats and is like paying attention
Starting point is 00:17:50 and is like the guy that's teaching people. So it was a little bit of like, I just didn't want to leave it hanging there. Is it like, kind of like we're all doomed or is it like, how are you mitigating that? Well, now I'm a little more careful when I go out and I'm a little more cautious about what I eat and I'm just more cautious about what i eat and i i'm
Starting point is 00:18:05 just more smart about it um but you know if unless you're you know buying all the food yourself and cooking all yourself you always don't know what's in stuff and it's also a reminder that all these other things that you do regularly uh you know working out sauna etc taking the right supplements those things are helpful to get rid of that buildup in your body. Hey, everyone, it's Dr. Mark. Now, a few years ago, I went through the worst health crisis of my life. And as a key part of my recovery, I had to revitalize my gut, which meant encouraging the growth of a specific good bacteria called Ackermansia mucinophilia. Yep, that's a mouthful, but it's essentially the bacteria that keeps the mucus layer in your gut and protects from leaky gut. Now, back when I went
Starting point is 00:18:51 through my healing journey, I kind of had to be creative and then use lots of different ingredients to support the right kind of growth in my gut of Ackermansia. But now it's easier than ever to up your Ackermansia thanks to Pendulum Therapeutics. They've done something nobody else could do because of the first and only company to offer products that directly contain acromantia mucinophilia. Now, acromantia is the bacterial strain known for strengthening and regulating the gut lining and is also one of the most important determinants of maintaining your long-term health, your weight, your metabolism, and so many other factors. Increasing the acromancy in my gut has such a big payoff for my health and I've become a real super fan. If you want to try it
Starting point is 00:19:31 for yourself, Pendulum is offering my listeners 20% off their first month of acromancy subscription with the code HYMAN. Just head over to PendulumLife.com to check it out. That's P-E-N-D-U-L-U-M life dot com with the code hymen for 20% off. Now let's get back to this week's episode of The Doctor's Pharmacy. And so the toxins just disrupt systems and they disrupt enzyme systems, they cause leaky gut, and they're pretty ubiquitous and they can be quite profound. I mentioned, you know, another podcast about a guy who had mercury poisoning. This was my story. I didn't know what was wrong with me, but I had lived in China for a year and was exposed to a lot of mercury through the air filter that I was cleaning out. In my life, I've always eaten fish.
Starting point is 00:20:17 I grew up on tuna fish sandwiches. I liked swordfish. I had fillings. I just was exposed to a lot of mercury. I was fine for a little bit when I got back. But then I was up in Maine and I was at some, you know, summer camp thing that I was at and ended up getting really a bad stomach, but I don't know what it was, but my stomach just blew up like a balloon, extreme bloating and really severe discomfort. And then my whole system just cascaded down. And that's when the chronic fatigue started
Starting point is 00:20:45 that's when i started having severe you know cognitive issues muscle injury issues and but my biggest symptom was my gut all of a sudden i couldn't eat anything i was get bloated i didn't know at the time but i had small bowel overgrowth i had a parasite but I also had terrible dysbiosis. And I just didn't know why. And I couldn't figure it out. And it took me a couple of years till I figured out it was mercury. And I had diarrhea and bloating and irritable bowel
Starting point is 00:21:17 for like five years till I actually was able to get my mercury levels down to normal and then my gut normalized. So often it's kind of weird things that can sometimes be causing it. And I think it's important that people have gut issues to start with the basics, but then you start thinking if you see that you're really not getting better. Okay, let's go into stress next. What do you want to talk about when it comes to stress and what do you want people to know when it comes to how stress can significantly destroy our gut health?
Starting point is 00:21:47 You know, stress is one of those things that is ubiquitous. We all experience it and learning how to deal with it is an important life skill, whether it's through meditation, yoga, hot and cold plunges, sleeps, whether it's massage, whether it's deep relational connection with somebody else, whatever it is that resets your nervous system. But many of us are just bombarded with chronic stress and it leads to changes in our health and one of the ways it alters our health is through change in our microbiome and the microbiome literally is listening to your thoughts the bacteria know what you're thinking and they they actually change and when you are under chronic stress it changes the bacteria to
Starting point is 00:22:22 be more toxic the bad ones, the good ones die, and you end up with more and more dysbiosis, which has all these downstream consequences. So we know that people, they get gut feelings, right? This is a real thing, that my stomach's in butterflies or my stomach's in knots or my whatever whatever the metaphors we use because the gut is directly connected to your nervous system and there's more neurotransmitters in your gut than there is in your brain right which is crazy when you think about it and there's a whole separate nervous system called the enteric nervous system which is the basically means the gut nervous system and it communicates with your brain but it's bi-directional. So stress here will cause stress in your gut. So stress in your brain causes stress in your gut. Stress in your gut will cause
Starting point is 00:23:10 stress in your brain. So we used to think irritable bowel syndrome was because people were neurotic and that was what was causing the problem. But actually we found out that the inflammation from the irritable bowel because of dysbiosis in the gut creates inflammation in the brain which makes you anxious and depressed so it's it's kind of a bi-directional system so stress will mess up your gut but your gut can mess up your stress if you know what i mean yeah it makes me uh you know it just reminds us that like there's so many things that can all build upon each other and lead to a whole host of gut challenges. There was recently a friend of mine that was on my podcast. Her name is Nishita Patel.
Starting point is 00:23:51 She's a nutritionist that's based out of London. And she had shared that her daughter, who suffered with irritable bowel disease and had a situation where it sort of showed up out of nowhere for her daughter. And in unpacking it, and that led to a path of learning about functional medicine and becoming a fan of yours and your podcast and everything. For her daughter, what had happened is that they were on a trip. I think it was in the Mediterranean and they were jet skiing and they were around this area where there was some either algae buildup or oil spill that was there. And her daughter fell off the jet ski, ingested a bunch of water, swallowed some sort of items, and pretty much her symptoms started
Starting point is 00:24:41 to show up after that process, which naturally, especially when you didn't know where this came from, leads to more stress. That stress builds on top of the dysbiosis that's there and it all cascades. Yeah, it's true. It's true. So, you know, I think you kind of have to deal with all the things that disturb the gut, right?
Starting point is 00:24:58 It's your diet, it's stress, it's sleep, it's exercise, it's the right environments, you're not exposed to toxins at an excess level all that is so important and i think we're so bad in medicine and dealing with gut issues it's just it's just embarrassing given what we now know and actually what we were doing and unfortunately conventional medicine you're either told to eat more fiber or do a FODMAP diet if you have irritable bowel now they're treating they're treating bacterial overgrowth but they just give you an antibiotic and they don't deal with anything else to restore the gut or they give you acid blocking drugs for heartburn which makes more problems downstream and it's really it's
Starting point is 00:25:41 really a crime because we know so much about how to deal with these issues. I've written many, many blogs about irritable bowel and reflux and heartburn. Check them out. We'll link to them in the show notes. But the reality is that we now know so much about how to handle these problems in a much more effective way through diet and lifestyle and through looking for root causes and diagnostic tests that we just don't get at a traditional doctor so mark you talked about your first sort of bout with gut issues when you had mercury there's a second time that you had gut issues that came up more recently
Starting point is 00:26:14 can you share about that absolutely you know i i basically have had the privilege or the curse or the blessing i don't know it depends how you look at it, of getting pretty much everything and having to figure it out. And I've heard about this before, but about five years ago, I had chipped a tooth, it broke, I needed a crown, it didn't work, I needed a root canal, and the root canal went bad, and I had to take the tooth out. And a doctor who was a friend of mine, the dentist, said, look,
Starting point is 00:26:42 and he was an integrative dentist, he says, look, I think it's pretty infected, you should take an antibiotic. And he gave me clindamycin, which I know is a regular antibiotic, it's been around forever, but it is associated with a particular super infection called C. diff or Clostridium difficile,
Starting point is 00:26:58 which kills about 30,000 people a year and is pretty nasty. And it's very hard to treat. Many of the traditional medicines, which you give other antibiotics to kill, it's like you take an antibiotic, cause a problem, you take another antibiotic to kill that and it causes more problems. And then one of the best treatments
Starting point is 00:27:14 is actually fecal transplant, believe it or not. It's actually 98% effective, where you take the poop out of a healthy person and give it to someone with this infection. But that same time I had that, I also a few weeks later broke my arm and I was in pain. And so I was taking, uh, like a non-steroidal anti-inflammatory cause I didn't want to take narcotics like morphine or whatever they were.
Starting point is 00:27:38 I mean, maybe I should have taken the morphine. I don't know. And I ended up, ended up having terrible gastritis, which messed up my gut so my stomach was awful i was in pain nauseous it was awful like and then i developed colitis so some people get cdf and they just get the infection and then it causes diarrhea stuff and they get an antibiotic it goes away other times it develops into colitis so the walls of my comb were thick they were red they were plain my markers of inflammation called calprotectin were through the roof i mean normal is like 20 30 less mine was like a thousand and it was bad i developed ulcer of colitis as a consequence of taking this antibiotic which was for a dental procedure that i you know in retrospect i probably wouldn't have
Starting point is 00:28:22 taken it i would have used other things i may have been nasal rinses or ozone or something else, but it was kind of bad. And I think we have to be very careful when we take these medications because they can create untoward side effects that have long-term consequences. And so it took me a while to rebuild back my gut, but now I've been doing that and I feel much better. And I developed the, we're actually launching a product that I developed out of suffering from that called Gut Food Soon, which is basically designed to rebuild your gut, like a multivitamin for your gut. Yeah. And it wouldn't be a Dr. Hyman or Doctors Pharmacy podcast episode if we didn't at least touch on a little bit of food. So we covered a lot of non-food contributors, again, stress, toxins, dysbiosis. But when it comes to healing the gut,
Starting point is 00:29:07 let's give people a top three. So top three things that you think that support gut health and top three things food-wise that you think take away from gut health. Yeah, I mean, the top three things that are likely to cause problems for the gut are gluten, dairy, and refined starch and sugar. Like one, two, three, those those are big if you have gut issues get
Starting point is 00:29:26 rid of those and see what happens if you want to go a step a little further try getting off fermentable starches greens and beans are a huge issue uh and and certain certain certain vegetables can be problematic uh there was a very amazing book called um breaking the vicious cycle by elaine gotchall years ago written that talked about how to treat ulcerative colitis by using what he she called a specific carbohydrate diet so it took out all sugars that needed to be digested so you didn't get this fermentation and this bloating and tension and inflammation. So those are the things you want to go to. The things you want to add are three key things that are in foods that are not specific foods, but they're in specific foods, which are prebiotics, probiotics, and polyphenols.
Starting point is 00:30:18 Prebiotics and prebiotic foods are things that provide fiber to the bacteria that they like that we can't eat. I mean that we can't digest. So they're just food for them. And they're in all sorts of plant foods. Jerusalem artichokes, regular artichokes, plantains, asparagus, a lot of foods have chicory root, a lot of foods have these prebiotic fibers that can be consumed as part of our diet. And just fiber in general, high fiber diets in general are good for the bugs in your gut. Then there's prebiotic foods, which we just talked about. And there's probiotic foods. So those would be sauerkraut, miso, natto, tempeh, you know, just things that are fermented that
Starting point is 00:31:01 have been around for a long time and been used to preserve food that end up actually having probiotics in them. And we barely eat any of those anymore. Pickles and pickled vegetables. Even pickles, I grew up on pickles, but pickles count. And then the third are polyphenols, which has set up a new discovery that good bacteria like to eat these colorful compounds in plant foods. The reds, yellows, greens, purples, oranges. And the more you can include these polyphenols from a colorful rainbow-colored diet, actually helps to fertilize the good bugs. Things like cranberry, pomegranate, green tea, turmeric,
Starting point is 00:31:33 various kinds of compounds that we can get as just part of our diet help fertilize and help gut. So yes, it's cutting out the bad stuff and it's actually eating gut-supporting foods. All right, Mark, this is the part of the episode where we go into community questions. And the first question that we have here from our audience is I struggle with chronic constipation.
Starting point is 00:31:53 What are some things that I could be keeping in mind to alleviate my symptoms? Well, constipation is very common and it's often, we call it irritable bowel syndrome C or constipation, there's irritable bowel syndrome C or constipation. There's irritable bowel syndrome D, which is diarrhea. But constipation is very common. And it can be many reasons for it that are not food related.
Starting point is 00:32:13 Hydration is a big one. People not drinking enough water. Magnesium deficiency is a huge one. Now, magnesium deficiency is sort of food related, but not necessarily. It's really because, one, our diet is so deficient in magnesium, which comes from greens and beans and nuts, which we eat very little of. And two, we do a lot of things
Starting point is 00:32:30 that cause us to lose magnesium. Caffeine, sugar, alcohol, stress, all cause you to leak magnesium. So getting enough magnesium is important and magnesium citrate can be very, very helpful. And then there's other factors that can cause constipation that are based on dysbiosis like yeast overgrowth is a big cause of constipation. Dairy is a big cause of constipation. Even though for some people it can cause lactose intolerance and diarrhea, it can cause constipation for many
Starting point is 00:33:00 people. In fact, it's the number one cause of constipation in little kids and it's also the number one cause of anemia which is kind of striking why because it's an irritating protein in a set of proteins in dairy that irritate the gut and cause bleeding in the intestines of little kids wow don't think about that um i'm not making this stuff up. This is in National Library of Medicine PubMed major journals. So constipation is really common, and it can be also caused by parasites or other issues. So in one case I had was really fascinating. She had a tick infection, Babesia,
Starting point is 00:33:38 which caused a nerve paralysis in her gut, which is really unusual. So there's some of these unusual causes, but it's usually constipation is really easy to fix by upping the fiber, upping magnesium, upping vitamin C, upping hydration. And for most people, that'll work. I had a patient once who was a radiation oncologist. She was a resident actually at the time and she had severe headaches migraines and she had been treated she was a resident at the mayo clinic right she was a doctor at the mayo clinic which is where everybody goes to figure out problems that no one can fix
Starting point is 00:34:18 and she saw everybody and no one could fix her and she was taking all the preventive drugs and all these different drugs and and it was just stuck she was on narcotics and zofran and chemo drug like chemotherapy um anti-nausea drugs that would be used for chemotherapy i mean it wasn't working and and she came to see me so okay you have migraines but what else do you have let's talk and so we went through a list and she had constipation that was severe. She had palpitation. She had anxiety. She had insomnia. She had muscle cramps.
Starting point is 00:34:48 These are all magnesium deficiency symptoms. I said to her, so how often do you go to the bathroom? She said, well, I'm pretty regular. I said, well, how often do you go? Well, she's like, I go every week. I'm like, that's not regular. Well, she says, regular for me. I go every week.
Starting point is 00:35:03 I'm like, you should go every day or twice a day she's like really it's amazing people don't even know what's normal and so i gave her enormous doses of magnesium because it was what it took to get her to go to the bathroom and her headaches went away her muscle cramps went away her constipation went away palpitations went away all this insomnia went away and so it really shed a magnesium deficiency problem all right mark this is the next question from the community member. Is there a connection between our gut health and reflux?
Starting point is 00:35:30 Well, clearly reflux is a gut problem. So it means that you essentially have acid coming up into your esophagus or in your back of your throat, and it can cause all kinds of problems. It can cause cancer in your esophagus, cause vocal cord issues. It can be uncomfortable. And people, you know, people had a heartburn call it heartburn right and you see those commercials oh don't worry you can eat your sausage and your peppers and onions and don't
Starting point is 00:35:56 worry you just have to pop this purple pill and everything's gonna be fine right and you remember remember you know those those uh that this commercial i can't believe I ate the whole thing, and it was this guy eating Alka-Seltzer or whatever. So these are really common problems. And often they're treated very simply with traditional medicine using acid-blocking drugs. They're problematic because they actually cause you to block stomach acid, which is needed to digest your food. It's needed to actually keep the pH of your lower part
Starting point is 00:36:25 of your intestine normal and you end up with all these secondary problems. And the causes are often the medications we're taking which can actually be an issue. It can also be a bacteria called H. pylori, it can be because of our diet is too processed and junky. If I eat fried foods, if I eat junky foods, I can get heartburn. So it's not that my stomach's a problem, it's what I'm eating is a problem. So I've written a textbook chapter on this. I've written many articles about this and provided a guide on how you can get rid of reflux. But essentially, a lot of it's common sense. It's getting rid of the trigger foods. So it's often fried foods,
Starting point is 00:37:02 processed foods, spicy foods for some people, citrus food, tomato foods can be an issue for some people, smoking, alcohol, caffeine. All those things are worth taking off the table for a short period of time. And then seeing how that works, checking for H. pylori is really important and also treating imbalances in your gut.
Starting point is 00:37:19 Magnesium deficiency can be also caused because the sphincter in the lower part of the stomach has to relax in order for you to actually let the food go down. So there's a lot of things you can do to help calm the stomach down. We use glutamine, zinc, carnosine, another form of zinc that can be very helpful, and licorice, deglycerized licorice, DGL, which is also very helpful. So there's a lot of ways to treat this. And almost all of my patients with reflux get better pretty quickly by following a functional medicine approach.
Starting point is 00:37:46 All right, Mark. So those are the questions that we had for today's episode. So this is a great opportunity to do a little bit of a recap on the top things non-food related that contribute to dysbiosis inside of the gut and just overall poor gut health. Well, thank you, Drew, for asking that. But people think, oh, my gut is only problematic because of food, but it's so many other things that we don't think about. It's the imbalances in the gut flora that come from our gut-busting lifestyle and medications. It's environmental toxins and
Starting point is 00:38:12 it's stress. And sometimes it's latent infections or things that we haven't even thought about. So I encourage people to just not take at face value that they have X or Y disease. I have reflux, I have irritable bowel, have you know inflammatory bowel these these are just names that we give to people who share certain symptoms they don't tell you anything about what to do about it what the cause is and that's why in functional medicine we focus so much on the gut and we're so good at addressing gut dysfunction so if you've been listening to this podcast and you know someone with gut issues or you have them please share this with your friends or family we'd love to hear from you about how you've helped yourself with gut issues or you have them, please share this with your friends or family. We'd love to hear from you about how you've helped yourself with gut issues that maybe weren't related to food.
Starting point is 00:38:48 Subscribe wherever you get your podcasts and we'll see you next time on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health.
Starting point is 00:39:19 It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter. And I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer.
Starting point is 00:39:50 Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding
Starting point is 00:40:04 that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner
Starting point is 00:40:20 who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

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