The Dr. Hyman Show - Answering Your Questions About Fasting, Liver Cleansing, Allergies, And More

Episode Date: August 1, 2022

This episode is brought to you by Rupa Health, Paleovalley, and Vuori. Today, as part of my Masterclass series, I’m answering questions submitted by my community through the video app HiHo. I am joined by my good friend and podcast host, Dhru Purohit, to discuss a variety of topics including hair loss, supporting your liver, food and pet allergies, and so much more. Find the link below to follow me on HiHo and we may select your question for a future episode! 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, Paleovalley, and Vuori.   Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com.   Paleovalley is offering my listeners 15% off their entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal.   It’s the perfect time to upgrade your wardrobe! Vuori is offering my community 20% off your first purchase. Just head over to vuori.com/farmacy to claim this deal.   In this episode, we discuss (audio version / Apple Subscriber version): Hair loss and your diet (4:07 / 00:57) The best way to support the liver (8:51 / 5:42)  Heal alopecia areata by eliminating gluten (19:21 / 14:37)  Staying healthy while working long shifts (21:16 /  16:32)  The root cause of allergies (26:15 / 21:26)  Choosing the right type of fasting for you (32:23 / 27:38)  What’s the deal with cheese? (34:37 / 29:48)  Healing dry skin from the inside out (39:00 / 34:17)  Medication for high blood pressure (41:12 / 36:22)  Follow me on HiHo here! Mentioned in this episode: This American Life: As the Worm Turns Betty Body with Dr. Stephanie Estima

Coming up on this episode of The Doctor's Pharmacy. What is the worst toxin now affecting the liver? You might say pesticides, you might say industrial chemicals, you might say heavy metals, and you'd be wrong. The biggest problem affecting the liver is sugar. Hey everyone, it's Dr. Mark. Now I know a lot of the listeners of this podcast are functional medicine practitioners like I am,

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organic acids, nutrient levels, inflammatory factors, gut bacteria, and so much more can help us find the most effective path to optimize health and reverse disease. And that means we're usually ordering multiple tests for each patient from multiple labs. Now I'm sure many of you can relate to how time consuming this process is and how it all feels like a lot to keep track of for both you and your patients. But I want to tell you about a better way, which is why I'm so excited to share with you about Rupa Health today. 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. They've made functional

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Paleo Valley is offering my listeners 15% off your entire first order. Just go to paleovalley.com slash hymen to check out their clean paleo products and take advantage of this deal. That's paleovalley.com forward slash hymen. Hey everybody, it's Dr. Mark Hyman. Welcome to a new series on the doctor's pharmacy called Masterclass, where we dive deep into topics like inflammation, sleep, autoimmune disease, brain health, and lots more. And today I'm joined by my friend and podcast host, Drew Prowett, and we're doing something really special. We were answering community questions that you guys have submitted on a new video app called HiHo. You can follow me on HiHo and submit your questions.

Maybe next week, I'll answer your question. So welcome, Drew. Thanks, Mark. Great to be here. Excited to jump into the questions. We have our first one on the topic of fasting and hair loss from Tanya. Let's go ahead with the first question from our community. Hi, Mark. My name is Tanya Mandich. I am doing intermittent fasting and the ketogenic diet, and I've been losing some hair since August. So wondering what your thoughts are on that. Thanks.

Hi. Well, that's a great question. I think intermittent fasting is something that is in vogue. Ketogenic diets are in vogue. And they're not necessarily for everybody. When you have hair loss, there are many, many causes. And it may be related to what you're eating. It may be a coincidence.

It may be related to your gut, amino acid intake, whether you're doing enough protein on a ketogenic diet. Sometimes amino acids are critical for hair growth. So you kind of got to look at the whole picture of what you're doing. When someone has hair loss, I tend to look at a number of different things. One, I look at thyroid. That's a big one. First, easy one to do.

And often most doctors miss thyroid. It affects one in five women, one in 10 men. Most of them are poorly diagnosed or not diagnosed, about half of them. And the ones who are diagnosed often are not treated optimally. Doctors don't tend to check T3, which is really important, free T3, and that can be off even if you're on Synthroid or a level of thyroxine, which is the most common treatment. It may not be enough. You may need to add T3 and that can often be a miracle worker. It can be gluten. Gluten is a huge cause. I just ran into someone at a conference and they're like,

my daughter has alopecia, which is a more serious autoimmune hair loss, but that can be a huge cause of it. And she's like, well, my doctor says food has nothing to do with it. And I said, look, go on the National Library of Medicine. Don't listen to me. Look at the National Library of Medicine, all the research ever published, basically, which fit the print, that's been peer-reviewed, and have a look. Just put gluten and hair loss and see what you find. And it was like hundreds of articles on celiac disease and hair loss. So I think many doctors are not aware of the connection between food and hair loss. So it's important to look for leaky gut, for gluten issues. Biotin can play a big role. Biotin is made by the bacteria in your

gut. So if you have a bad microbiome, you might not be making enough biotin, which is necessary for hair loss. Amino acids are critical. You might make sure you're getting enough protein and the right amino acids. And if you're doing a ketogenic diet, there may be something going on with your microbiome or there might be something going on with different factors of what you're choosing to eat or not eat because you can be a healthy ketogenic diet, you can be on an unhealthy ketogenic diet. So I need more information to actually determine what your cause of your hair loss is, but it's important to look at all these factors as you begin to think about it. Also for women, it can often be a problem with their endocrine system hormones. For example,

PCOS, which we've covered on the podcast, polycystic ovarian syndrome, is a common symptom of hair, is a common cause of hair loss. Women will get high levels of androgens or male hormones. They'll get male pattern kind of hair loss on the top of their head. And that's very concerning for women. They might get hair growth on their face. If that's happening, it may be a hormonal issue. You don't always have to be overweight for that. It can be often caused by insulin resistance or prediabetes or sugar. So there's a lot of things to think about when hair loss, but you kind of got to go dig down the rabbit hole and really take a comprehensive view. That's great, Mark. And I know you've had

Dr. Sarah Gottfried on your podcast before. And in her last book, she talked about the challenges with women in particular being on the ketogenic diet for longer term. So I'm not sure how long the last questionnaire community member has been on it, but that could also be something to look into. And that's the whole interplay of hormones that you were just mentioning. For sure. I mean, your diet plays a huge role in your hormones. And I would say ketogenic diet is interesting. I mean, if you're 300 pounds, type 2 diabetes, for sure, go for it. It's going to take a year, you know, get yourself reset. But when you think about historically what happened to our body, and I just, you know, finished writing a book on longevity,

and I went deep into this subject. What's interesting is that historically we would have periods of starvation, you know, where there wasn't a lot of food around. So we would go into a ketogenic state, meaning we would use the fat on our bodies to use that for energy. Because you might have 2,500 calories of glycogen, which is carbohydrates stored in your muscle, that'll last you a day. Or you might have 40 or 50 or 100,000 calories of fat stored in your body, and that'll last you for a long time. So the body is very good at adapting

to starvation. But historically, we would go through periods of scarcity and then periods of abundance, you know, summer and winter. And the problem is when you're in a ketogenic state, it's not your body's long-term state. So people talk about cyclical keto going on and off it. It can be a therapeutic diet. I typically don't recommend it as a maintenance diet for people. All right, Mark. Our next question is from Camille and she wants to know about liver cleansing. Hi, Dr. Hyman. My name is Camille and your podcast has helped me immeasurably.

Can you please advise the best liver cleanse to use on a daily basis? Thank you. Thank you so much for that question, Camille. It's really important because we all need to learn how to love our livers. They do a lot of work for us. They clean our blood. They keep us healthy. And when they don't work, we get sick. And people think that unless you have liver failure, it's fine, which is not true. The liver needs a lot of support to do its work. And I know this personally because I had mercury poisoning and I had to take care of my liver if I wanted to get better. The liver requires a lot of support to do its job of detoxification. And also, unfortunately, we are in a sea of toxins. So what is the worst toxin now affecting the liver?

You might say pesticides. You might say industrial chemicals. You might say heavy metals, and you'd be wrong. The biggest problem affecting the liver is sugar. It's the number one cause of liver disease today in America. In fact, it's the number one cause of liver transplants. America. In fact, it's the number one cause of liver transplants. Drew, I don't know if I ever told you this story, but I went to a conference on childhood obesity. It was maybe eight years ago. And there was a doctor there who was chatting

with in the hall. I'm like, hey, what do you do? He says, well, I'm a pediatric gastroenterological surgeon. I'm like, what are you doing here? He said, oh, well, we do liver transplants. I'm like, what do you mean? Liver transplants for what? He said, we're now seeing teenagers with cirrhosis of the liver from fatty liver from eating sugar and soda. And I'm like, you're kidding. This is just horrific. We see kids as little as five years old with what we call non-alcoholic steatohepatosis, which basically means fatty liver, and eventually ends up with scarring the liver and cirrhosis. We think it's alcoholism. It's not. It's sugar and starch. So this is the biggest driver of a toxic liver. So the first thing you need to take care of your liver is

really dramatically cut down or cut out starch and sugar. Obviously, alcohol is a problem. You next want to make sure you're avoiding as many toxins as possible. So get rid of the toxins in your food. Obviously, processed food for sure, additives, preservatives, but also pesticides and chemicals in food. I am on the board of the Environmental Working Group, and it's important to check which vegetables you're eating that are contaminated. For example, strawberries, which I love. The worst, I would never eat a non-organic strawberry. It's number one on the Environmental Working Group's list of most contaminated fruits and vegetables. You can Google it, ewg.org. You can find the dirty dozen

list. Stay away from those. And then there's a clean 15. So if you don't eat organic avocados or bananas, it's okay, right? Save some money there. But for sure, if you're having celery, if you're having nectarines, if you're having strawberries, you do not want to eat those if they're not organic. Next is clean up your house. Your house is one of the biggest sources of toxins both indoor air pollution from off-gassing of vocs and chemicals whether it's paint or furniture carpets i mean there's so much plastics and chemicals out there so try to use natural materials in your house and also household cleaning products are and if you don't if you

can't make sure you redo everything in your house, get an air filter and clean your air with a HEPA filter. We use one called Air Doctor, which is really great. Next, I would say you want to make sure you are using household cleaning products that are not making you sick. I mean, think about it. When you read these products, if ingested, go immediately to the hospital. You don't want those in your house. So the Environmental Working Group has, what do they say, household cleaning products, skin care products. They have a wonderful database called Skin Deep where you can see what are you putting on your face.

Your lipstick has got lead in it. Well, don't use it. If your topical creams have parabens and plastics in them, don't use it. You're absorbing it. If you wouldn't eat it, you shouldn't put it on your skin. And next, you want to make sure, obviously, the fish and the meat you're eating has low mercury and toxins. And there's, again, guides on the EWG..org so it's a great resource to lower your exposures

the next thing i would do is make sure you're eating foods that upregulate all your detox pathways so the most important categories of foods are the brassica or cruciferous vegetable family which is broccoli collards kale cabbage brus sprouts, that whole family, and the garlic and onions in family. And so I would eat those on a regular basis. For tonight, I'm having broccolini with garlic. So I do it pretty much every day. I make sure I have these foods. Next, you can actually start to do kind of more fancy stuff. You can have green juices, celery juice, watercress juice, cilantro juice. I had a guy who had heavy metals and he just juiced cilantro and had a cup of cilantro juice every day. And cilantro is a great detoxifier that helped his liver flush out the

metals and he got rid of his metals. You also want to eat herbs and spices like rosemary, curcumin, which is like turmeric for curries. You want to make sure you have things like rosemary, lemon peel. We throw away the lemon peel, but if you get organic lemons, you can kind of, I like to kind of grate the lemon peel and put it in salads. It's great with like my kale, pine nuts, lemon peel, lemon juice, olive oil,

salt and pepper, it's delicious. That's why I like summer because we grow fresh kale. It's really good with the fresh kale. And then once you've kind of upgraded your diet, include all the phytochemicals, and I'm literally just like touching the surface. There's whole books written about this.

I just got picked from Ikaria, which is in Greece, one of the blue zones. And every morning, and all day actually, they had this stuff called wild sage tea. And I'm like, wow, what is this stuff? Why do they live to be 100 years old? Why do they have the longest lived population in the world? I'm like, is it anything to do with the tea? Well, I think it does because when I looked up the tea and the phytochemical content, it was full of something called epigallactic catechins, which are these incredible compounds Does it have anything to do with the tea? Well, I think it does because when I looked up the tea and the phytochemical content,

it was full of something called epiglactic catechins, which are these incredible compounds that are detoxifying, that are anti-inflammatory, that help your immune system, that activate longevity switches. In fact, there's some theory that, and in fact, there's data on this, that these catechins in green tea and also in this wild sage tea upregulate glutathione and help your body detoxify, which is the main detoxifier. Then after you've done all that, obviously exercise is important. Making sure your gut's healthy is important. Making sure you're sweating.

I call it the three P's, pee, poop, and perspire. You want to make sure you're flushing your system. Lots of water, lots of sweating, saunas. I mean, I did hot yoga. I was just in New York. I do. I love hot yoga. Kind of flush your system, lots of water, lots of sweating, saunas. I mean, I did hot yoga. I was just in New York. I do, I love hot yoga, kind of flushes your system out, moves your lymphatic circulation. All that's great for detox. And then lastly, you want to kind of beef up your supplement measurement. So a good multivitamin. The reason, and the reason is, oh, before I go to the supplements, I just want to kind of loop back to the food. You know, a lot of people don't realize how important amino acids are from proteins. So

protein is so important for detoxification because a lot of the pathways, and I'm not going to bore you with all the fancy chemical names, but a lot of the pathways in the liver to get rid of toxins require amino acids. So you have to have a good complement of amino acids. And if you're just eating plant foods, you might not get those. So important to make sure you're getting enough of the right amino acids. And then supplements. So what should you be taking? A good multi is important, but then there's a number of ones that are really key. Methylation, B12, folate, B6, very critical. Zinc, very critical. Selenium, important for the liver detoxification and boosting glutathione. Magnesium. So you want

to make sure you have adequate levels of these nutrients. Then there's all the herbs like milk thistle and other compounds that can really be helpful, curcumin, artichoke. There's a lot of these compounds, ellagic acid and pomegranate. So there's all these things that we can use as part of our diet to upregulate these pathways that are phytochemicals. And then there's the supercharged ones like glutathione boosting supplements, like N-acetylcysteine, which works so well the government wants to ban it, which makes me laugh. You know, anything works too good, they want to turn it into a drug. I'm like, no, it's just like, it's just a supplement.

And then lipoic acid also is very important. And there's a host of other things. But those are the main things I focus on. And I've learned to incorporate these. It sounds like a lot, but those are the main things I focus on, and I've learned to incorporate these. It sounds like a lot, but I learned to incorporate these into my life every day. This morning, I had a green juice. I make sure I took a sauna today. I have one in my house, a steam. I'm having broccolini and garlic tonight for dinner. I'm taking my supplements with N-acetyl cysteine, lipoic acid, and my methylating supplements. So I just sort of work it into my life.

It sounds like a lot, but once you kind of learn how your body works, you kind of just do it automatically. All right, Mark, super robust answer. Really great and thorough action items that you shared over there. Hey, everyone. It's Dr. Mark Hyman. When I get dressed in the morning, I want to feel comfortable and ready for the whole day, from my meditation and workout to grabbing lunch or going to a

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bioriclothing.com, phoets.pharmacy, and you'll see why my team and I love their stuff so much. Now let's get back to this week's episode of The Doctor's Pharmacy. Okay, let's go to the next question that we have here. And this is from Flora. Hey, Dr. Mark, I'm a big fan of your podcast and I'm looking to help my husband who had some life-changing events before we met. He suffers from alopecia, areata, and restless legs. Just wondering if there was a connection between those two. Oh, wow. Great question. Alopecia and restless legs. Alopecia, for those who are listening don't know what it is it means you lose all the hair on your body no eyebrows no eyelashes no pubic hair no hair obviously on your head you lose all the hair on your body that is an autoimmune disease and that is usually because

of gluten uh now it can be other reasons leaky gut other factors and there's other causes of of inflammation autoimmune disease but but we approach it the same way we approach autoimmune disease. I remember I had a patient come in once years ago. I'd read with it. I do a lot of virtual consults over the years. I would see people in person and then I would talk to them on the phone. This was before Zoom. And I would help them with their health over the year. Then after this year, this woman came back and she'd gotten off gluten, we'd fixed her gut, we'd done all the normal functional medicine things, and she was wearing a hat, you know, and she came in wearing a hat. And like halfway through the consult, she pulled off her hat and she had a full head of hair. And I was like, what happened here? It was pretty wild. And I've seen

this many, many times. And then restless leg syndrome is kind of inflammation of the brain. So it can be often caused by magnesium deficiency, but it's come kind of neurologic irritability. And it can be other things like heavy metals, mold, Lyme, other things. And it's very horrible for people who have it. And they can't get comfortable at night. They don't sleep well. You can detect it by sleep studies. Often I'd start out with magnesium as a sort of initial treatment. But there are many other things that can cause it that I would check with your functional medicine doctor about. But they may be related, but they may not. Okay, great.

Awesome, Mark. We have a next question here from Mary. I am a nurse who often works 12 or 16-hour shifts. Trying to stay hydrated and eat healthy is nearly impossible any tips tell me about it i get it uh i i definitely get it because i worked in the hospital for years i delivered babies worked in the er worked overnight shifts trying to stay healthy. And it's not easy, but now more than ever, it's easier. So honestly, you know, honestly, what I would do, it sounds goofy, is I would get a camelback, which are those little backpacks you could buy for, you know, 30, 40 bucks. And it's

got a bladder in it. You can fill it with water. You can put electrolytes in it. It's got little pockets. You can kind of throw stuff in zippers in it so you can store a little food in there. And I would carry around your little survival pack, literally your hydration pack on your back. You can kind of put it in your mouth, drink water. It clips in so it stays out of the way. And then I would invest in snacks.

So I would get things that are high in protein and high in fat. I like nut butter packets, macadamia nuts are great, they're super high in calories, almonds, walnuts, you can get certain kinds of jerkies, beef bars, grass-fed, a lot of grass-fed beef, regenerative beef now, jerky, that kind of stuff you can just carry with you and it's super nourishing, super satisfying, fat and protein lasts a long time. If you go for the sugar and the carb snacks, you're going to go, you're going to spike your energy and then you're going to crash and you're going to feel awful and you're going to be hungry and then you're going to gain weight and become diabetic. So it's not a good idea. And by the way, most nurses are not that healthy and it's because of the stress of the job,

it's because of what you're saying and it's because of the crappy food in hospitals and lack of access. So it takes a little bit of planning, but I do. I mean, I work in the hospital, Cleveland Clinic, and my drawer, people laugh at me, but in my drawer, in my office, I have a whole, like, I have a whole enough food for like a week in there. I have canned salmon, I have canned sardines. Nobody wants to come in there when I'm eating them. You know, I make sure I have all the nut butters i have jars later jars numbers and a spoon i can just take a bunch of spoons of it so there's a lot of ways to hack this uh if you want to laugh and have a good time go google on dr hyman.com find uh the dr hyman's food emergency pack and there's a whole video of me showing what i put in my pack uh but it's kind of fun. But it's not easy, but you have

to do a little planning and it's totally doable. Yeah, it seems Mark, another part of this that Mary's asking about what I'm reading between the lines is also your community and the people that you work with. You know, a lot of my brother-in-law is a nurse and often he'll say that there's always like cookies and there's cupcakes and there's candy. Sometimes, you know, again, it's all well-intentioned. Oftentimes it's even patients coming in and giving a little care package to the nurses saying, thank you for taking care of my family members.

So how do you think about the community component and wanting to eat healthy, but also not wanting to, you know, present yourself as somehow better than the people around you? You just want to do your own thing, but you don't necessarily want to poo-poo on their lifestyle if they would choose to eat those foods. I mean, I just lead by example. I don't criticize people. I don't make fun of them. I had lunch with some people I didn't really know very well. And we were at a

restaurant and it was like an Italian restaurant. There was tons of bread. They threw bread on the table. There was pasta, tons of bread. They threw bread on the table. There was pasta, tons of, it's like famous for its pasta. And I'm like, well, what do you guys have? It's like protein and vegetables. Oh, we got, you know, bronzino and we got broccoli rabe. We got some mushrooms. We got some zucchini.

I'm like, great, I'll have that. And so they all waited for me to order. And then they all, or they looked around and they ordered all that. And you could tell they wanted the pasta and the bread. They just didn't eat it. So I don't say anything. And I kind of laugh, you know, but it's around and they ordered all that. And you could tell they wanted the pasta and the bread. They just didn't eat it. So I don't say anything. And I kind of laugh, you know. But it's really the power of peer pressure.

And when you see someone who's, wow, how come he has energy? How come he's healthy? How come he's 62 and hasn't got a pot belly and, you know, look like crap? It's because I take care of myself. And I, you know, I probably run my engine too fast is the truth. I mean, I love life. I like to do things. I enjoy people. And so I often pack too much into a day and into a life, but I still maintain my health. And I, you know, I do it by just creating these habits that I've started to accumulate over

the years. And sometimes I go off the rails for sure, but I come right back. You know, like today I was like, okay, I'm going to get back on track. I had a green juice this morning. I, you know, I had some protein for lunch and I just, you know, I got my activity in and I worked out and I took a little steam. So I feel like I just, even though I'm busy, I can kind of fit in the things that help support me and not every day, but most days. Great, Mark. Love that. All right. Our next question is from Emmanuel in the community. And she has a question about pet allergies, as well as some food allergies that her kids have. I have allergies to dogs and cats and was wondering if there's anything I could

do to heal from them. My kids also have food allergies, which happen to be severe. Anything that could help them? Thank you. Thank you for that question. So I don't think I've ever been asked that question, but I've seen a lot of patients who have this problem of both having food and animal environmental allergies. And most people don't think they're connected. And just, I want to sort of define terms a little bit. Allergy typically in medicine means IgE type one hypersensitivity reaction. That means that's the kind of allergy you get when you eat a peanut and your tongue blows up, you can't breathe, then you get anaphylaxis or you get bee sting and you get a hives and swelling up that's what we call allergy food allergy can be that or

it can be what we call a delayed response or a delayed food sensitivity which is not the same part of your immune system that's not as severe it's not like threatening and you may you know let's say uh i don't know you might have dairy on monday but you might get a headache on tuesday so you can't often connect the dots if you eat peanut, you know within a few minutes you're going to die if you've got a peanut allergy. So I think we've just sort of defined terms. If it's a food sensitivity, it's a little bit different. But what I've found is that there's been a really dramatic increase in environmental allergies and true food allergies over the last number of decades, three or four decades. And why is that? It's not like we've changed our genes. It's because we've had a toxic environment because

we have a leaky gut, because our diet's bad. Stress, all these factors cause increased allergy. Now, one thing I discovered many years ago was that I had patients with really severe IGE food allergies, which are real allergies. And they also, we also had environmental allergies, you know, like dust or pollen or animals. But when I treated their leaky gut, when I got their immune system sorted, their overall allergies went down. So their environmental allergies went down and their overall reactivity went down. And so we were able to really sort that out. Now I'm going to tell you something else that's going to be a little shocking, but it's very fascinating.

And it's not actually that wacky because there's a lot of science behind this. In fact, there's a number of books called The Epidemic of Absence, which is about the idea that we co-evolve with bugs in our gut. And if you go to countries where kids grow up in the jungle or they're super, you know, indigenous tribes or underdeveloped countries or in Amazon, there's no allergies. There's no autoimmunity. It just doesn't exist. But there's, what they do have is a lot of worms. And in fact, IgE, which is the, what I was talking about before, that part of the immune system is designed not to make you allergic to peanuts, but to help you kill worms and manage worms in your belly because we didn't have anti-worm medicine, so our immune system kept them in check.

And so when we eliminated all these worms and stuff, we started getting autoimmune disease. In fact, in the part of your immune system, the white blood cell that fights these worms called eosinophils is one of your white blood cells is the same white blood cell that gets activated and causes allergy. And I saw this little kid with and you're going to kind of go, wow, Dr. Hyman, you've really gone off the deep end here. But I'm telling you, this is actually a legitimately research field of medicine, which is helminthic therapy, which basically means worm therapy. And this kid was like super allergic.

And I'm like, oh, I tried all this normal stuff. It's like, listen, I know about this treatment. I know how to get it. It's pretty easy to do. You just swallow this tasteless vial of fluid, which has worms in it every two weeks for six months or so. And it often can fix your IgE allergies. And the mother's like, okay, anything. And so he took it and his IgE level, which is the antibody that affects the immune system in this kind of allergy, in the hypersensitivity allergy, was like a thousand.

It should be like a hundred or less. And in a number of months, it went down from a thousand to like a hundred to normal. And I was like, holy crap, this stuff works. And I began to start using this on select patients. I don't use it for everybody, but for select patients, and these are actually, it sounds gross, but they're rat tapeworms. They don't actually stay in your system. So they kind of go through, they kind of talk to your immune system. They say, hey guys, you know, it's okay. Let's focus on me. Ignore the allergens. Like over here guys. So like, you know, kind of like somebody, you know, being, being kind of a deflector and, and it seems to

work. And, and there are actually studies on using it for Crohn's disease and, and other, other, other colitis diseases, allergies, asthma. And so if you're really interested in this topic, I'd read the book Epidemic of Absence. There's also, if you want to get a short version of it, the New York Times had an article at the time. You can kind of find it online about the epidemic of absence of these microbes that we grew up with historically, evolutionarily, and that have now been eliminated for the most part and what the consequences are, which is this increasing allergy.

So I think this is maybe a little crazy sounding, but actually, it's really not. Yeah. And actually, This American Life, one of the top podcasts on public radio, they did a whole episode on this as well that we'll link to inside of the show notes where they had people, because it's illegal for doctors to prescribe that up here and you can't really get it but there's places in mexico and i think like one of the world's leaders in it is from israel and he came to uh he's coming to america and giving some lectures on it as well and talked about in the uk you can buy them from the uk yeah wow so we'll link all those in the show notes. Fascinating.

Who knows? Maybe in the future we'll have clinics and have worm dispensaries. Maybe, maybe not. For sure. All right, Mark. We got another question here from Jessica. Goes back to kind of how we originally started that episode. And that's on the topic of fasting.

So let's play this question from Jessica. Hey, Dr. Hyman. What do you think? Is it more beneficial to fast for longer and work out maybe later in the day? So let's play this question from Jessica. Hey, Dr. Hyman, what do you think? Is it more beneficial to fast for longer and work out maybe later in the day or to get my morning workout in when I feel my best and have a shorter fast? I'd love to hear your thoughts. Well, that's a great question, Jessica. I don't think you have to choose. My view of life is when there's a fork in the road take it so i would say you know you can design your life so that you can work out in the morning

and still have a fortune hour fast uh for example i did that today i i had dinner last night i maybe finished around eight o'clock i got up early at six, went, did my workout. And then, you know, around eight, eight 30 had some, uh, some, some breakfast and a juice, like a green juice. So that was a 14 hour fast overnight. And I got my workout in, I didn't have to go through some gyrations to like figure out my workout day. So I wasn't, uh, messing up my fast. So I think, I think it's, it's good to work out in the morning. If you feel like it, If you work out late at night, it often can be activating, prevent you from sleeping, jack up your cortisol, blood sugar. So I think you have to feel what's good for you, but I think that it's fine to just 12, 14 hour fast. If you want to do 16 hour, you can do that. You can just shift your eating

schedule a little bit. But I think workout when you you know people say when should i take my supplements doctor i said when you remember when should you exercise whenever you can so i think that's kind of the bottom line yeah there may be some nuances there for women as you mentioned previously and it's good to find like a community of other women that are out there that are also experimenting and depends on your life stage and your goals. There's a friend of Mark's yours. It's in Toronto who has one of these communities where they talk about fasting and working out. Dr. Stephanie Estima.

She's a chiropractor up there. Really a sweet woman has a whole community called Betty body. And they specifically are thinking about a lot of aspects of working out. We'll link over there to the community as well. So hopefully that's helpful, Jessica. All right, Mark. The next question here is someone who has high LDL and is confused about cheese. Her name is Kathleen.

Hi, Dr. Hyman. I just finished your book, What the Heck Should I Eat? I'm 72 years old with high LDLs and I'm listening to the diabetic 2 range. I'm confused about cheese. Can you explain that again? Thank you. You know, fat is something that can raise your cholesterol. Saturated fat will raise LDL cholesterol. But what I'm more concerned about and the thing you said that was most important was that you have type two diabetes. So if you look at what matters, it's not the LDL cholesterol, it's the quality of the cholesterol.

Is it large, fluffy cholesterol or is it small, dense cholesterol? Small, dense cholesterol particles, and a lot of them are what causes heart disease. We call this atherogenic dyslipidemia or basically heart disease causing cholesterol problems. And saturated fat will raise LDL, but it typically also raises HDL. And if you look at the pattern of most people who have heart disease, it's they have high triglycerides, low HDL, small particles, and lots of particles, or an enzyme called ApoB. These are really the concerns that we should be focused on, not LDL as an isolated

number, but as a picture, as part of the overall picture. So I've seen people with a cholesterol 300, but their HDL is 100 and their triglycerides are 70, they're fine. And their LDL might be 160, but they have no small particles and their particle number is low. And they just have a lot of large fluffy particles. Because when you look at the cholesterol measurement you get with your doctor, it's the weight. It's like, is it a golf ball or is it a ping pong ball, right? They're different. Well, a ping pong ball doesn't weigh anything. A golf ball is heavy, same size. So you really need to kind of look at the quality of what you're talking about. And so there's a new test, not really, it's about 40 years old, but most doctors

haven't caught on yet. It looks at the lipid particle number and the particle size. From LabCorp, it's called NMR. From Quest, it's called CardioIQ. It's not that expensive. Your doctor can order it. The problem is they don't want to order it for the most part because they don't know how to interpret it. And they should figure it out because there's really no other cholesterol test that really is relevant at this point. So I think if you have type 2 diabetes, likely you have to look at these other particle numbers, the particle size, the triglycerides, the HGL. And actually saturated fat might be good for type 2 diabetics. In fact, work from Sarah Hallberg, who sadly just died, she was a friend of mine,

an amazing doctor who led up a lot of the work on ketogenic diets and diabetes and has published lots of research papers on it, showed through her data that not only were they able to reverse diabetes, type 2 diabetes, in 60% of the patients, get 100% off the main diabetes medication, get over 90 plus percent of people off insulin, and have an average weight loss of 12%, which is a dramatic amount. I mean, normally if you get a 5% in a weight loss study, that's like everybody's jumping up and down and thinking so exciting, great results. But it's really, it was a dramatic result. Found when they looked at over, I think 30 biomarkers for heart disease and cardiovascular

disease that none of them were bad, that they all got better by eating a lot of fat. Now, there are some people like me who are skinny. We call them lean mass hyper responders. I exercise a lot. I have low body fat, high muscle mass. I have some genetics and my cholesterol will go up. My LDL will go up and my profile will not be better if I eat more saturated fat. So you have to be careful. And when you say about cheese, saturated fat is what you get in cheese. Now, goat and sheep, sheep might be better, but I would not be worried about it. I would be worried about eating conventional dairy, though.

I would stay away from regular cow dairy. I would stay away from, for sure, if it's not a regeneratively raised A2 cow, for sure don't consume it or anything from it. Goat and sheep are easy to find. You know, sheep yogurt, goat yogurt, goat cheese, sheep cheese, easy to find. I would stick with that. But I would really look more carefully at the overall cholesterol profile. And I've written a lot about this. I wrote a book called Eat Fat, Get Thin. I wrote, you know, too many pages about it. So you can kind of learn more there. There's, again, more and more articles about this all the time. So I would not be too afraid of cheese, particularly organic, regenerative sheep and goat cheese.

All right, Mark. Our next question is from Rafi, and it's about dry skin. Hi, Dr. Hyman. It's a pleasure to talk to you. My question is I suffer from dry skin very badly, and I would like your advice in what I should do first. Thank you. Well, thanks, Rafi. Dry skin is not uncommon and is relatively easy to treat. And it's usually, you know, dermatology is so backwards. They treat you from the outside in instead of the inside out.

Now, it's not necessarily bad to put things on your skin, but you got to start with what's happening on the inside. One of the most common causes of dry skin is omega-3 fatty acid deficiency, which is where you get dry, patchy, flaky skin that comes from not having enough omega-3s, which come from wild fish. So if you're, for example, a vegan and you're not taking some kind of fish oil supplement, you're going to get omega-3 deficiency. If you don't eat fish because you don't like fish, or if you don't eat mushrooms because you don't like mushrooms, or you're not having certain compounds in your diet, if you're not having

wild herring or sardines, you're going to get omega-3 deficiency. So the first thing to do is look at that. And there's a test called omega-3 index. You can do it from your regular lab. Make sure you're not. And just take fish oil. That's the first thing to do. In fact, I remember I had a patient with terrible dry skin. And I told her to, instead of putting like cream on her skin, to put a combination of flax and borage oil on her skin. Borage is omega-6 oil that's actually very anti-inflammatory, great for your skin, like evening primrose oil. There's another version of it.

And flax oil is omega-3. And she literally, in the winter, she put on her skin, her skin like turned beautiful. Also, thyroid is a big factor. So I would make sure you check your thyroid gland and make sure your thyroid is good because if you're low in thyroid function, you can get significant dry skin. Those are the two most common reasons. Eczema is another reason. This can be from gut issues, from leaky gut, from food sensitivities, often dairy, gluten,

big ones. So I tend to think about all these things. And usually people's skin can get beautiful from the inside out, not only the outside in. Mark, let's do one more last question here. We have a question from Heath in the community who is asking about recommendations from her practitioners to want to put her on medication. Hi, Dr. Mark. I'm a young, healthy 26-year-old female

who has been told multiple times that I need medication for high blood pressure and high cholesterol. They keep attributing it to genetics since my lifestyle would not reflect that I need the medication. I'd love to know your thoughts. So you're talking about high blood pressure and high blood pressure, high cholesterol, high blood sugar. They often go together and they're often treated separately. And I was like, gee, maybe they're all connected. The truth is they're

all connected. And in fact, 88% of Americans have this problem, which is poor metabolic health, and it's manifested by high blood pressure, high blood sugar, and high cholesterol, or abnormal cholesterol, I should say. And it's almost always caused by too much starch and sugar. So they call it essential hypertension, which means essentially they don't know what causes it. But in fact, it has a very clear cause. It's an inflammatory oxidative stress disease of the blood vessels. And this is in the most of the times caused by insulin resistance. So I hate to sound like a broken record on these podcasts, but insulin resistance is one of the biggest problems we have today in the world because it's driven by starch and sugar.

And this is what people are eating. And it causes your blood vessels to be inflamed. So I would for sure make sure you cut out starch and sugar as number one, two, and three. I think some people are salt sensitive, so you have to watch for salt for some people. Often it's not the salt you're eating, it's the lack of potassium. Potassium and salt should be in better balance, and so you can increase your potassium intake by eating lots of fruits and vegetables and bone broth and lots of vegetable broths, which have lots of potassium. Magnesium deficiency also is a big cause of high blood pressure. It's the relaxation mineral. And we know this as doctors. I mean, when women come in who are pregnant,

who have malignant high blood pressure that can cause seizures and kill them and the baby, it's called preeclampsia. What do we do? We give them intravenous magnesium because it relaxes the blood vessels. So why don't we tell our patients with high blood pressure to take magnesium? I have no clue. So there are many things that cause high blood pressure. It can be heavy metals. It can be kidney disease. It can be a lot of things. So you kind of have to look at the spectrum. But most of the time, you can really get to the root cause and fix people's high blood pressure pretty quickly. Okay, Mark, that's it for today. So thank you for all your in-depth answers. And I'm going to pass back over to you to close this out. Thanks, Drew. It was always great doing this with you. And thanks for submitting your questions. I

really love to answer them. That's it for this week's masterclass. So if you love this podcast, share it with your friends and family on social media, leave a comment. We'd love to hear from you. How have you helped your health doing various things we've talked about? And if you've subscribed to podcasts, please subscribe to this one. And we'll see you next week 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 introducing 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

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