The Dr. Hyman Show - Daily Steps To Boost Energy & Never Be Tired Again

Episode Date: February 14, 2022

This episode is brought to you by Rupa Health and Mitopure.   Between 20 and 30 percent of all doctor visits are initiated due to lack of energy, or chronic fatigue. It is a common problem that plagues so many of us. Often we don’t realize that the last thing we want to do—exercise—could be an easy solution to increasing our energy levels. When we create stress in the body from exercise or other stressors, also called hormesis, we can actually build back stronger as the body heals and repairs.   In this episode of my new Masterclass series, I am interviewed by my good friend and podcast host, Dhru Purohit, about all the things we can do to improve our energy levels. We also talk about how caffeine and sugar in your diet impact energy, as well as answer questions from our community about the value of napping, if MCT oil increases energy, and why fruit juice is not a great choice. 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 and Mitopure.   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.   Mitopure is the first and only clinically tested, pure form of a natural gut metabolite called urolithin A that clears damaged mitochondria away from our cells and supports the growth of new, healthy mitochondria. Get 10% off at timelinenutrition.com/drhyman with code DRHYMAN10.   In this episode, we discuss (audio version / Apple Subscriber version):   Three things we can do to improve our energy levels (4:37 / 00:50) Three things that zap your energy (8:17 / 4:29)  Steps to evaluate chronic fatigue (12:34 / 7:02)  How to reduce fatigue and increase energy (15:37 /11:43) Evaluating caffeine consumption and if it works for you (18:24 / 14:17)  Why blood sugar management is important for optimal energy (20:42 / 16:49)  What I do to support my energy level (27:22 / 23:25) Questions from our community (39:26 / 35:37)    Mentioned in this episode: Try This: Why You Need a Coffee Break and How to Do It New Barn Organics Almond Milk OmegaQuant Levels

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in a capsule powder or protein blend at TimelineNutrition.com. That's TimelineNutrition.com, T-I-M-E-L-I-N-E.com, forward slash DrHyman, D-R-H-Y-M-A-N. And use the code DrHyman10 to get the discount. I've been using it for almost a year now, and at 61, I feel stronger and more energized than ever. And now let's get back to this week's episode of The Doctor's Pharmacy. Hey everyone, it's Dr. Mark Hyman. How y'all doing? Welcome to another episode of The Doctor's Pharmacy, a special episode called Masterclass, where we dive deep into popular health topics like inflammation, sleep, brain health, autoimmune disease, lots more. And today I'm joined by my good friend, my partner, my CEO, Drew Pro at the host of the Drew Pro podcast. And we're going to

talk about all things energy. How do we get more energy? Okay. Welcome Drew. Mark, let's jump right in. This is a huge topic. A lot of people with questions about it. So first question that we have here is what are three things? If you had to name three, I'm sure there's a bunch. What are three things that people can do today to improve their energy levels? Can you give us a list of three things that help us improve energy? Of course. Well, you know, the good news and the bad news is that I've become an expert on this, not by desire or by will, but by the situation I found myself in, which was having severe chronic fatigue syndrome at 36 years old. And we're going to talk more

about that in a little bit. But in terms of energy, I found some amazing hacks that are so amazingly easy and good and effective. And they're what we call adversity memetics, also known as hormesis, which means you stress your body a little and it bounces back stronger. And the first are hot and cold treatments. So sauna, steam bath, hot bath, followed by an ice shower, an ice bath, cold plunge, whatever. That resets your nervous system, your autonomic nervous system. It flushes out all the toxins from your lymph system, increases your blood circulation, increases blood flow to your brain, and has the amazing ability to boost your immune system. And it releases something called heat shock proteins, which are part of your body's healing and repair mechanisms. So it's a really cool way to do it. I love to do like a 10 minute steam, jump in my bathtub full of cold water.

You can use a sauna, hot tub, whatever works for you, but hot and cold is super effective. You can even use a shower. There's protocols that are out there where you don't have access to steam. You don't have access to stuff. You go in the shower for a little bit. Wim Hof, who you've interviewed before, he has a whole protocol that's there. So you don't need fancy equipment. You can even do it with just your basic plumbing that you have at home. Exactly. Exactly. But I think, honestly, what we're learning about hot and cold therapy is so profound as a therapeutic longevity strategy that I'd encourage everybody to invest in some type of unit, whether it's just a bathtub in your house so you can fill with cold water or a

sauna that you can use at home. There's portable saunas or small ones. Get a steam shower installed. I know it's an expense, but I'm telling you, as far as a health hack, it's one of the best. And that's why we see longevity in countries like Finland where they, I think there's enough saunas in Finland for every single Finnish person to do a sauna every day. So that's the kind of thing we want to see. The second thing is movement. And often, you know, when you're tired, you feel like just laying on the couch and doing nothing. It turns out, though, if you do something, if you

walk, if you run, if you jump up and down, if you dance, if you do some pushups, whatever it is, burpees, it will immediately give you energy. And I think one of the most important things people realize when they're tired is actually a time to exercise. I mean, not if you're exhausted and burnt out, obviously, but if you just kind of feel sluggish and out of it and a little down, it's a powerful booster of all of your healing and repair systems. It's what we call an adversity mimetic. It puts the stress on your system, but your body kind of likes that and bounces back stronger. And the third thing is what you might not expect is the timing of your eating. You know, when you eat all the time, your body has to do all that work and metabolize the food. But you often hear when people say,

well, I fasted or I fast for a long time and I get huge mental clarity. Well, that is because you get an increase in the production of ATP and energy and repair and your mitochondrial function improve. And the best way to do that in an easy to do way every day is time-restricted eating. You can do a 16-hour fast, eight-hour eating window. You can do a 20-hour fast, a four-hour eating window. That's a little more challenging. You can also just do a 12 to 14-hour window. So anything that works for you, try it. But that's another quick way to reset your system. Again, it's another adversity where you're depriving yourself of food, but it's kicking in all these healing and repair mechanisms in the body. Mark, let's go through a few things that people often associate with energy,

but actually they might be zapping our energy instead. So just like we said, three things that will give people energy. Let's talk about three things that might be zapping our energy. Let's start with a big one, caffeine. Yeah. Okay. Caffeine. So what are you talking about, Dr. Hyman? Caffeine gives me energy. Yes, it does. It's short-term. It raises adrenaline, cortisol. It's basically a stress response in the body, which then crashes. And it depletes something called the denosine in the mitochondria, in the brain, in the cells, which is really an important part of the source of energy because your body makes what we call ATP or denosine triphosphate. It's the molecule of

energy in the body that's produced from oxygen and food. But when you actually are consuming caffeine on a regular basis, you get a short-term high, and then you crash. And I remember this from medical school. I never was a coffee drinker. And then I'm like, everybody's drinking coffee. I'm like, oh, I'll try coffee. I'm in medical school now. And I would try coffee.

And every afternoon, I would just go, ugh. I would plump down. I would just feel wiped out, tired. I'd have a crash of low energy. And I realized it's the coffee. So when I stopped drinking coffee, I would just feel wiped out, tired. I'd have a crash of low energy. And I realized it's the coffee. So when I stopped drinking coffee, I have even energy all day. The second thing that people think about is sleep. And of course, people know that if you don't sleep, you're tired. But people undervalue sleep. They don't prioritize sleep. They don't learn how

to practice good sleep hygiene. We've done a bunch of podcasts on sleep. But having deep sleep, quality sleep is super important to repair and restore your system. And if you are just a few hours sleep deprived, it's equivalent to being drunk. So I would highly encourage people to prioritize sleep in terms of timing, the time you go to bed, the time you wake up, all sleep habits and hygiene. Keep your room dark, room cold, quiet.

I mean, really focus on sleep. It is one of the most important reparative healing systems in the body and will give you a lack of energy if you don't get quality sleep. And the last is something people understand is sugar. Same thing with caffeine. You get the short, immediate burst of energy and then you crash. Everybody's experienced that. And so sugar is another no-no if you want to keep your energy even all day. If you want to be swinging on a roller coaster, then you should have sugar for breakfast, sugar for lunch, sugar for dinner, which is pretty much what Americans do.

Cereal, sandwiches, pasta, dinner, it's bad news. It doesn't even have to be actual sugar. It just be starch. So I encourage people to really focus on cutting back on sugar, caffeine, and getting up to sleep, and then moving, hot and cold therapies, and time-restricted eating. And that'll get people a lot of the ways towards feeling good. Mark, let's do a little bit of a compare and contrast. So prior to being a functional medicine physician, you were practicing traditional, what we would call maybe conventional medicine or allopathic medicine. Now, the stats are that about 20% to 30% of all patient visits for primary care are related

to fatigue, the chief complaint being fatigue. When you saw patients, again, in your other life prior to being a functional medicine doctor, and they would come in with the complaint of fatigue, what were you trained to look at and ask them? And what were you looking for as the source of what the fatigue was? Yeah, well, fatigue is a catch-all basket of symptoms that doesn't really specifically denote a particular disease, but it depends on the fatigue. So we'd look for thyroid issues, we'd look for certain vitamin efficiencies like B12. We would look for chronic illnesses like cancer. We would look for heart disease. We would look for common things that we find in medical practice. But most of the time, doctors wouldn't

find anything. They'd say, you're depressed. Take some Prozac. That's basically what we would do. You'd be looking for, just to clarify, you're looking for things that are blatantly wrong that would show up on a lab report or had a diagnosis. Is that what I'm hearing? Exactly. Exactly. Exactly. So it would be, it would be like stuff that you typically see like thyroid or B12 or, you know, things that are common in medicine, but that we don't really, we don't really have a system of thinking about fatigue very well when we're looking at what I tend to look at now when I'm looking at fatigue. So then contrast that. When somebody comes into your office now and you still are a practicing doctor, you're not taking on new patients, but there's still patients that are under your care and they come to you and they

say, Dr. Hyman, I'm suffering with fatigue. What kind of questions are you asking yourself and them? And what type of tests are you running to help get to the actual root cause of what could be contributing to their fatigue? You got a few hours? I mean, yeah. So I think, you know, fatigue is a rabbit hole. And I obviously became an expert in fatigue

when I had chronic fatigue syndrome. And, you know, there's layers. There's obviously the superficial layers of things we look at. But in functional medicine, we only need to ask two questions to learn everything we need to know about somebody. One is, what is it that is bothering your system? What is it that you have that you need to get rid of so your body can function properly? What's causing an imbalance? Second is, what does your body need to thrive that you need more of, whether it's sleep or vitamins, whatever? So what's the list that I go through in my mind when I'm thinking about diagnosing? I think about the five things

that are the cause of most, almost all imbalances in the body, that combined with their genetics. One is our diet. So very poor nutrition has a huge role in energy. Stress, and that can be physical or psychological stress. Toxins, and those are all sorts of toxins from environmental toxins, pesticides, heavy metals, internal toxins, metabolic toxins. Next is allergens. So something that is inflaming your body could be a food allergen or sensitivity or an environmental allergen. And the last is toxins. That could be heavy metals, mold.

And then the last thing we look at are microbes. So microbes are not only what's in your gut, but also Lyme disease, viruses, ticks. So COVID, you know, right now everybody's got COVID. That's a huge thing that causes fatigue. Epstein-Barr virus can cause a chronic fatigue syndrome, chronic Lyme disease, tick infections, mold toxins, all these things we tend to look at very carefully. Of course, there's physical things like lack of sleep, which is I can put under the stress

category. It's a physical stress. And that can also be caused by sleep apnea. So we look for all those things. We test for all those things based on a person's story. So if someone says, you know, I don't eat fillings and I don't ever eat fish in my life, I'm not going to check their mercury, but they go, yeah, I've had sushi five times a week for the last 10 years. I'm like, oh, we better check your mercury. So, uh, you know, I live in an endemic area for ticks. Well, which is pretty much the whole world.

I like check for ticks. So it's really about looking at their overall picture, their overall symptoms, looking for clues about what's really driving it. Is it their gut? Is it an infection? Is it mold? Is it hormonal imbalance? Is it, you know, some kind of stress? What's going on? So I really am very careful about drilling down into all those. And we'll look at diagnostic tests that can look at all that. We'll look at full nutritional evaluation, hormonal evaluation, gut evaluation, look for mold, look for and and allergens and much more and we'll see often what the cause is and we'll be able to fix it you know not everybody has access to all the tools in the toolbox of what a functional medicine doctor might use as diagnostics

that are out there what percentage of generalized fatigue i know i know I'm using an umbrella term, but what percentage of generalized fatigue can be improved? And this is your estimate, right? Just asking you for your best estimate from simple things that people can do at home that they're in control over. I mean, a lot. I mean, most people do not understand that all their habits and their lifestyle drive their energy and how they feel. And so I basically teach people through an experiment on them, right? So let's try this for 10 days, two weeks, see how you feel. So you take out the bad stuff, you put in the good stuff. That's actually all functional medicine's about. So what's the bad stuff? Processed food, junk, you know, lack of sleep, you know, excess stress, lack of movement. I pick all those

things out and I take out caffeine, alcohol, sugar, and make sure people are really eating a clean diet, which is super important, a vegan diet, let's say. Sometimes even like the 10-day detox, which is more of an elimination diet to get rid of all the inflammatory foods and add in all the good foods and so forth. So that's the first step. The second thing would be, you know, to try simple things like a good multi-fish oil and vitamin D. Often that can help replete any deficiencies that can cause a problem. I'll often, you know, with regular conventional doctors, you can do a lot of blood tests. You can look at thyroid. You can look at nutritional levels.

You can look at vitamin D and many, many other things. So I would look at all that stuff as a conventional doctor. And then I would look at what are the things that they can do, like just gentle exercise to start with. Look at their sleep habits. How do we fix those? What's wrong with their sleep apnea? Can we fix that? What else can they do?

They can do hot and cold treatments. Really simple things can make a huge difference. So between cleaning up your diet, exercise, stress reduction, slash meditation, yoga, and sleep, and then some of these hormetic therapies that we talked about, like hot and cold treatments, those are all basically free or what you're already paying with your food. So I encourage people to try those things first. And then usually if there's a lifestyle reason, it'll get better. And if not, then they'll need to go on and start digging. And depending on what your symptom complex is, we dig in different places. But it is a solvable problem. All right. I want to talk about blood sugar and how blood

sugar can be related to energy levels and blood sugar management and being on the rollercoaster ride of blood sugar. But before we do that, you've talked about caffeine a couple of times. Now, people get scared anytime you talk about caffeine, especially I have a lot of friends that are new parents and it's kind of like caffeine is part of the thing that's helping them just get through the day. You do drink caffeine. And so give us the context around caffeine. When is it that it falls into the category of zapping your energy? And when is it beneficial and you can take advantage of some of the healthy properties that have been discovered through research around caffeine and specifically coffee?

You know, I go on and off it. And I'm always curious what happens when I come off it. I always have more energy, which is just paradoxical. I obviously don't get the kick in the morning. And recently, I went off coffee for a couple of months. And my alternative was to wake up and go in an ice cold shower. And I can tell you, that'll wake you right up. Or I would in a cold dip. They had a cold dip where I was over the holidays. And that was amazing. It was just like woke me right up and I didn't need coffee. So if you're looking for that initial morning buzz, there's other ways to get it, which is as close as your shower or about them. So just to clarify, just to jump in, because I want to make sure I parse it out. So it's not that you're poo-pooing caffeine. I'm kind of hearing from you and knowing you a

little bit is that you're talking about the importance of getting off of it every so often so that you understand what your baseline is because caffeine can hide a lot of challenges that people have that are brewing in their system. Yeah. I mean, there's a lot of variation in how people metabolize caffeine. So there's fast and slow metabolizers. There's people that can have a cup of espresso and go to sleep and be fine. Other people have one cup of coffee in the morning and they're bouncing off the walls and have palpitations and panic attacks and anxiety. So it really depends on the individual and what your metabolic pathways are. And we measure those through genetics. So we can actually look at that. But the truth is that it's worth an experiment for

yourself to see how you feel. Now, if most people can tolerate a cup of coffee or two in the morning, and that's fine. I probably wouldn't have one after the morning cup. I certainly wouldn't have one in the afternoon and definitely not in the evening. Now, you may be one of those super fast metabolizers. It doesn't bother you. You're fine. You like to have an espresso after dinner. Go ahead.

But know your body because it ultimately can catch up with you. So I encourage people to try to just limit their caffeine a cup a day, but also to go on a caffeine holiday and see how they feel because it might actually give them way more energy. It's great. We actually have a protocol that we put together based on some advice that you have on how you can do a coffee fast. We'll link it in the show notes and people can follow that. And also why, why you would want to do that. Okay, let's go to blood sugar management. So give us the big picture overview on blood sugar management. Your first big number one bestseller was all on this

topic. And tell us why blood sugar is so connected to what we perceive internally as our energy going up and down throughout the day. Well, we recently partnered with a company called Levels, which is a fascinating company that measures continuous glucose throughout the day. So you're measuring your glucose all the time. And you can see, depending on what you're eating, it's going up and down. And we recently did a podcast with Casey Means, who founded it. And it was fascinating to see the foods that just jack your sugar up and down. And when your sugar is going up and down, you're on a roller coaster of energy and crash and refuel. And that's where people end up with this tremendous amounts of weight gain and fatigue and, and, you know, buzzes and mood issues and all kinds of other health complications. So sugar is really nasty.

And if, if you understand it's a drug, if you understand it's very powerful, if you understand that if you use it, it has to be used as a drug. Like you wouldn't drink a bottle of tequila at a sitting. You might have one little shot or two in the context of a meal. And I think, you know, you can have sugar. It's not saying I don't ever have sugar, but I think it's when you have it, how you have it, with what you have it, and how much you have. So I think for most people trying to sort of reset their energy levels, cutting out sugar and starch and eating protein and vegetables for a week during the 10 day detox diet essentially

is an amazing way to actually recalibrate their metabolism, their brain chemistry and their energy. Yeah. And we have a podcast and you've done one as well. I've done one where we actually talk about like the top 10 most popular foods that will spike your blood sugar and put you on this roller coaster that you have a super high high, and then you end up having a crash afterwards. And for a lot of people who go through the standard 3pm, 2pm, 4pm, midday crash, it's often because of what they're eating early in the day. So doing something like levels could give you insight on what you're eating and how that's throwing your blood sugar off. So we'll link to that inside of the show notes. Yeah, we had an interesting conversation about that with Casey, where she

said that a Clif Bar, which we all think is a healthy snack, had a worse glycemic index load than Snickers. So you don't really always know. You think something's healthy and it's like, could be just jacking up in sugar and down. So I'm very careful about that. Somebody sent me a promotion for a new kind of ice cream and I, that's my Achilles heel. I love ice cream. It's supposed to be the best ice cream, but it's still got like, you know, five teaspoons of sugar in a serving. So it's like, you gotta be careful. Right. And a lot of this is not, you don't ever have those foods ever. It's about being smart about it, making sure that it's not part of your

regular baseline. That's what sets us up for chronic disease. And more importantly, how to eat and exercise and move and sleep in a way that allows you to, um, uh, enjoy certain things. For instance, uh, in your podcast with Casey Mark, I remember you guys talking about how eating a little bit of fat, fiber, and protein, for example, like instead of eating berries on an empty stomach, right? Fruit has so many amazing phytonutrients and other properties and polyphenols inside of it. But if you eat a ton of fruit on an empty stomach, that'll do one thing to your blood sugar versus if you have it at the end of a meal where you had a lot of healthy fat, fiber, and protein that was there. Yeah. It's called the glycemic

load. It's basically, you know, what the total composition of your meal will do to your blood sugar. So if you add in fat and protein, sorry, if you add in fat and protein and fiber, it basically acts like a sponge and slows the absorption of the sugar. So you don't get the spikes, then you don't get the insulin surges, which then means you don't get the blood sugar crashes. And so it all evens out. So as a functional medicine doctor, you also know that not everything is what we eat and movement and sleep, although that's a huge part of it. There's other aspects, which is call it like emotional debt, things that we have in our mind, stuff that's unresolved, that we're just kind of kicking the can down the road. How have you seen that that

can zap people's energy, both in your own life, your personal life, but also conversations with your patients who are struggling with fatigue? Yeah. I mean, often it's, I remember this one patient, she was early 50s, still living with her mother, who was incredibly critical of her still, and the mother was like in her 80s or something. And she was struggling with her weight and metabolism and her health and energy. And I said, listen, you need a motherectomy, like you need to move out. And I said, listen, you need a mother ectomy. Like you need to move out. And I think, I think sometimes the stress that people are under how it just causes huge amounts of, of changes in their brain chemistry and their metabolism and, and leads to a lot of fatigue. I mean, depression, one of the key symptoms of depression is, is fatigue. So I think it's

really important for people to look at their lives and go, where are things not right? Where are things out of alignment? Where am I out of integrity with myself, with my family, with my work, with my life dreams and goals, and start to correct those problems and figure out what it is. Because those are big energy zappers. Is there something that you notice in your body, whether it's shortness of breath or a little pit in your stomach or tightness in your neck, everybody has something that's usually an indication that there's something weighing on me emotionally, even if I'm not fully present to what it is. And I got to do a little bit of an inventory to see like, man, why do I feel so

run down right now? Yeah. Yeah. I think there is a different process. Journaling is a great way every morning for people to journal. I think focusing on things like gratitude is a huge way to sort of reset your framework and your mindset. You know, our, our beliefs and our attitudes and our perceptions really determine our quality of life. And so if we're kind of in a negative loop, it's really important to figure out how to get out of that. There's a lot of ways to do that through therapy, through self-practices that people can do, through meditation, but it's really looking to become a master of your mind. Because if you're not a master of your mind, your mind's running you, you're not running your life. And I think Drew, you really are very good at this. You're one of

the people I know who's best at this, at really looking at how do you have integrity in your thoughts, your feelings, and your actions. Because that's how life works. You've got a thought, it creates a feeling, it's an action. And if you don't straighten out your thoughts, your feelings, and your actions. Because that's how life works. You get a thought, it creates a feeling, it's an action. And if you don't straighten out your thoughts, your feelings and actions are going to be messy and they're going to lead to all kinds of problems, including disease and fatigue and many other issues. Okay. So what does Mark Hyman do? What does Dr. Mark Hyman do when he feels a little stuck, a little bit in the rut? And it could be emotional, it could be physical, it could be a blend of the two. But what's your go-to, like actual go-to? You feel a little fatigued, you feel a little bit in the rut.

You know it's not your baseline, but you feel off. Could have been after a bunch of travel. Could have been you spread yourself too thin. What do you actually do in your life to bring back that energy? Well, I know there's a list of things that give me energy and there's the things that deplete my energy. So I get rid of the things that deplete my energy and add in all the things that give me energy. So things that deplete my energy, not sleeping enough, running around too much, not eating well, not exercising, all that stuff, not meditating. I just lean back on the things that I know work. So

meditation is a huge thing for me for energy. It gives me so much energy. Getting up to sleep, hot and cold therapy, huge for me. Like if I do a sauna or steam and an ice bath, it's amazing. I get my energy back. Exercise, whether it's working out with weights or going for a bike ride or doing yoga, always gives me energy. I can go into an energy. I mean, I remember when I had chronic fatigue, actually, it was really quite interesting. I would, I was so exhausted and always had pain and fatigue and brain fog and just not able to do life very well at all. And the only time I would feel really good were the only two times I could really reset myself or hot and cold. That would give me like an hour of feeling a little more energy and clarity. And also like

a yoga class, I would do a very intense yoga class. It wasn't even a hot yoga, but if I do hot yoga, which is hard to do now because of COVID, but it's such a powerful reset. So I could walk in there dragging, feeling tired, wanting to take a nap. I come out of yoga after an hour and I just feel rejuvenated and alive and clear and energetic. And I was sort of shocked when I had chronic fatigue that that was one of the few things that actually would reset my nervous system. So Mark, let's give a case study and I can't think of a better one than your own case study. You've written a lot about it. You've talked a lot about it, but we're going to go in more detail in today's podcast. So as you mentioned, you had chronic fatigue. Walk us through what you actually did and maybe even who helped you down the process

of getting to the root of what your particular contributions were that were ending in this result of chronic fatigue. Well, you know, it was ultimately a blessing and a curse, right? It felt like a curse at the time because I could barely function. I couldn't get out of bed. I was unable to have any really clear thinking. I was barely able to work. I had a job, thank God, where I could work from nine to four, three days a week. And at lunch, I could go get a massage or do a steamer, a sauna, and an ice dip so I could literally function in the afternoon. And it was one of the most difficult periods of my life. And I didn't know what to do. And just to interject on your story, right?

Just because I think this is really just, I'm curious for myself. You were also a single parent at the time. Is that correct? Yeah. Yeah. Going through divorce, a single father, alcoholic ex-wife was kind of a messy time as well. So there was this psychological stress as well. Huge.

And that underscored it all. But what really my own illness did was teach me functional medicine from the inside out and how to unpack what's wrong with somebody and how many layers there can be to actually getting better. So I didn't know what was wrong. Just felt like crap. My immune system wasn't working. I was exhausted. This is not just like, oh, I'm tired. Let me take a sleep and I'll get better. You never feel better. So you can sleep 10 hours. You don't wake up feeling like you haven't slept at all. It's one of the worst things you can

imagine suffering from. And I feel so much compassion for those who do because it's real. And most doctors have no clue how to deal with it. And now, thank God, you know, when I had it, it was like, oh, you know, take Prozac, you know. Now, there's a lot of literature and science about the biology and the inflammatory cytokines and all the things that we actually can measure in people who are chronically fatigued. So for me, I didn't know what it was and my gut was a mess. Everything was a mess. So I started just sort of learning about functional medicine and i discovered that i had mercury poisoning that was the first thing and that was huge for me to get rid of the mercury and it took me a long time took me probably five years or more to get rid of the mercury through chelation and iv therapy and avoiding fish and doing all the foods

that upregulated my detox pathways and And I really learned about the science of detoxification of heavy metal treatment. And that was big, but it didn't get me all the way better. And can I ask one quick question about mercury, Mark? How is it, connect the dots, how is it that something like having excess mercury in your body could invoke something like chronic fatigue or make it worse? What is actually happening? Well, so fatigue is coming from your mitochondria damage. So mitochondria are energy factories, and they produce energy that runs everything in your body. That's your energy. It's called ATP or adenosine triphosphate, and it's made when you breathe oxygen and you eat food,

and that gets metabolized in your little mitochondria, which are little engines inside your cell. They are critical for everything in your body to function and for aging and longevity and everything else. And I ended up having really bad functioning mitochondria based on my testing. I had elevated muscle enzymes, meaning my, my muscle cells and my cells were just being damaged because of something. And I didn't know what.

And it was really painful and really, really difficult. And the chelation test showed me I had a super high level of mercury that was damaging my mitochondria. And mercury and any toxin damage mitochondria. They're very sensitive, but they also damage your metabolism. They damage your immune system. They damage your brain. They damage your hormones. They have wide-reaching effects across the body that screw everything up. The main symptoms are fatigue, cognitive impairment, autoimmune disease, gut issues, insomnia, anxiety, depression. I mean, these are the symptoms of heavy metal poisoning. And again, it's missed most of the time because most traditional doctors have no clue on how

to diagnose it and certainly not how to treat it. I mean, I literally got an email from a patient the other week. I don't know if it was a patient. I think some guy randomly found me online, whatever. And he's like, Dr. Hyman, I know you've had mercury issues. I went to my doctor. I heard your stuff. And I've been eating sushi like three times a week for like a bazillion years.

And I know it's probably affecting me. And I have all these symptoms. I went to my doctor. And they're like, oh, not worth testing. Nothing you're going to do about it. Just stop eating fish. And that was the end of the story. And I'm like, oh my goodness, that is just such a sad thing because he has all this mercury stored in his body. You need to get it out. So that's really important. And functional medicine is really good at helping design a safe way to remove heavy metals and other toxins from your system. So toxins is number one.

But then I wasn't all the way better. And then I realized, oh, it was just kind of stupid and kind of shows how doctors are the worst patients. But I was like, oh, I'm going to check. I'm feeling a little tired. Let me check my Lyme test. And I live I, I, you know, I live up in the woods in the Northeast and there's a lot of Lyme and, and I checked Lyme and all these co-infections and ticks. And then I know so busy working and running around saving the world and being Dr. Hyman, I forgot to look at my result because I was, did my own test and I, I opened it up and one day I was like, what happened to that test? And like, I was like, Oh no. Cause I had a PCR positive Lyme, which means was like, what happened to that test? I was like, oh, no, because I had a PCR positive Lyme, which means not like, oh, I might have Lyme or it's maybe Lyme. It's like I'm actively replicating in my blood, which is not good.

And I also had Babesia. And so then I went down that whole rabbit hole of treating my own tick infections, which was very challenging. You have to use antibiotics and herbs and this and that. And it was still really hard. And then I found out a number of years later that. And it was still really hard. And then, and then I found out a number of years later that I lived in a moldy house. I lived in a 1825 post office that was converted to a house in a small New England town. And, and the basement was just

full of mold and I knew it, but I didn't, I didn't like at the time, I didn't really know that much about mold and didn't connect the dots. And that was also contributing. And so I literally have had to deal with all these things. You know, normally it's like, oh yeah, you eat bad and you don't exercise and you're stressed. Well, I got, I had all that down. It was all this stuff that, you know, happened in my environment, like toxins and mold and ticks and infections. And so for me, it's been a, it's been a multi-decade long process of unraveling the root causes of my own dysfunction. And, uh, and I just keep learning more and more about it. And, and now I'm going the other direction. I'm like, how do I not just have energy, but how do I

sort of unpack the science of longevity, which is the topic of my next book, which is all about how we create and heal and repair our energy systems in our body, our mitochondria, because most of the regulatory systems that control aging are in the mitochondria. And so I really like, you know, taking NAD and I'm looking at working on mTOR and we'll talk all about this stuff in the coming months. It's going to, I'm very excited to kind of dive deep into the whole aging space for the all soon, but it's, it's pretty exciting stuff. And I'm like, you know, going to start a new, um, a new aging medication soon. And I'm going to try this. I'm going to try that. And so I'm kind of experimenting. I'm pushing the other side of the envelope is how do I get

stronger, bigger, faster, better, you know, like, you know, like Superman I'm training, I'm training for the centenary olympics which my friend peter atia talks about so yeah well i want to say you know i don't think it's intentional at all mark but you're always taking one for the team you're getting some infection you're getting some disease you're getting something that happens but i always appreciate how you bounce back up and then you share everything that you've learned with your community. So, but yeah, now I got COVID, so I got, I got to deal with that too. So I'm working on that. Yeah. And actually speaking of COVID and energy and other stuff, again, you're, you're a new variant, everything, your symptoms have been pretty mild, knock on wood, everything

like that. You've done plenty of episodes on COVID, but actually you were feeling really low energy and you texted me a little bit ahead of time. You were like, you know what? I need to take my own advice and I need to do hot cold therapy. So tell people, what did you do right before we hopped on the podcast here to record today's show? Yeah, well, I had a steam shower installed 20 years ago in my house and it's the best thing I ever did. And I have a claw tub, six foot bathtub, and I just turned the cold water on and it's winter. So it's, and I got a will, so it's really darn cold. And, and I turned the steam on and I let it get really hot to 120 and I go in there and

I steam for 10, 15 minutes. And then I jump in that cold and I'm like reset. And, you know, it usually lasts me depending on what's going on a few hours or more, or even the rest of the day. That's great. Yeah. And I know even when we record sometimes podcasts in LA where I'm located in that morning of, you're like, okay, we have a

bunch of recording to do this day. Me and you need to go do like a yoga class or we need to go do a workout or something. You find these tools and these tips that you can step into. And even though there's that initial willpower of just making the decision, right? You have to make that decision to say, I'm going to do it. It gets better and better because you know, a temporary little moment of pain, like a burst of cold, a temporary moment of pain, like, you know, that first little workout that you're going to do like squats or whatever. It's a temporary moment, but on the other end of it, you get this massive flood of energy that makes everything else in the day a lot easier and more fun. So I just always

appreciate that about you because I've integrated a lot of that into my life before when I was tired and I'd never think like, let me go for a run. Let me go outside. Let me go do some pushups. And now that's kind of like my first go-to. Yeah. I mean, in fact, today I also was like, I'm getting over COVID and my energy is not back completely. And I decided it was a sunny, beautiful day. And I just went for a light walk for half an hour by the river and by my house. So normally I would go for a bike ride or I'd do intense workout or whatever, but I just decided to take a walk and just doing that alone and getting out in the fresh air, little things like that make a huge difference.

All right, Mark, let's take some questions from our community that hit us up on this topic of fatigue and energy. So the first question from the community is, does taking a midday siesta really increase your energy levels for the rest of the day? And what does Dr. Hyman think about napping? I think napping can be fine. I actually, I think some people can go down for a power nap for 20 minutes, wake up and feel fine. If you over nap, you can feel more groggy and you might affect your sleep at night, which can be a problem. For me, I prefer meditation. You know, 20 minutes of a deep meditation, which you can do anywhere on the

subway, in the back of a car, on a plane. It's like a magic trick. And I talked about it on many podcasts. Ziva Meditation is what I do, zivameditation.com. My friend, Emily Fletcher, started that. And it's just, it's a simple mantra-based meditation once a day, twice a day. It's really remarkable. I literally could be, you know, on a plane, tired, not able to actually even read a book or an article. And I just close my eyes, I meditate, 20 minutes later, I wake up and I'm like, oh, wow, I feel like I got a brainwash. You know, I literally got all the cobwebs out and sharp and alert and focused. So that's fine. I think whatever works for you, but sometimes it's hard to take a nap. Meditation,

you can take with you anywhere. I mean, and bring to your office, you can do it anywhere, really. You don't want to do all your driving, but you can pretty much do it anywhere. Yeah. And one of the best parts about meditation is that if you end up falling asleep, this is a little hack. A lot of people actually are bad nappers. They feel like their mind is very active. They can't fall asleep, but they're overtired. And when you practice meditation, if you end up falling asleep, that's okay. They say that's actually one of the best ways, the best, it's almost like a sign of respect to the meditation because you actually need sleep more than you needed the meditation, but the meditation was able to ease you into that sleep. I get that a lot. It's called napitating. I often can't nap if I lay down, but if I lay down, I'm like, well, where am I? I think I didn't fall over. Was I asleep or was I just

in nirvana? I don't really know. Yeah, it's like at the end of a yoga class, falling asleep in Shavasana. It actually feels very restful. It's a very restful sleep to end up having. Okay. This is one that's interesting, especially with your history around lipids and you talking about that category. There's a question on MCT oil. And can MCT oil be something that people can include in their daily routine that could help them with energy levels. Thoughts on that? Absolutely.

Absolutely. So, you know, how do your body produce energy? It's like a Toyota Prius, electric and gas. It's basically a hybrid. You can run on carbs, you can run on fat. And carbs are more of a dirty fuel. They're like the gas and the fat is like the electric fuel or the battery. And the amazing thing about MCT oil is that it's absorbed not through the typical fat absorption system in the body, but it's basically

goes directly into your system and is the preferred fuel for your mitochondria. And your mitochondria love it. And I'll use it, for example, I'm going for like a long bike ride and I want to make sure I have enough fuel, but I don't want to eat all those sugary, gummy, gooey things that people have. I just load up on a couple of tablespoons of MCT oil. I'm like the Energizer Bunny. I can go for 50 miles. It's really an incredibly clean burning fuel. It also improves cognitive function, focus, attention. So I encourage people to use it. The only downside is there are a subset of people, and I think I'm one of them, where if I do too much, it causes my cholesterol to go wacky because we're what we call lean mass hyper responders, meaning we have a lot of lean body mass, not a lot of fat. And for some reason, there's some genetic variation that causes certain people like me to have abnormal cholesterol. But for most

people, it's fine. It actually can help raise HDL and improves particle size, especially if you're overweight and if you're insulin resistant, it's great, which is about 88% of the American population that's metabolically unhealthy. So for those people, mostly it's good. Yeah, I'm definitely one of those individuals. After learning through you, I went deep down the rabbit hole of lipids, particle size, and I found out that MCT oil and grass fed beef for me with my genetic history, background lineage was throwing off my lipids. And even my NMR test came back like completely

wonky. My small dense cholesterol was super high, even though my diet was cleaned up. I got off MCT oil, which I would put in my coffee every single day. I love the taste. It would make me feel great, right? I'd have a lot of energy from it. And my lipids are not fully back to normal. It's only been since basically last summer, but they've improved significantly and almost back to what I consider to be the optimal numbers. But again, it just goes back to what you're saying that it's all about that personalization of finding the things that work for you. All right. Next question from our community. What about natural sugars found in fruits and vegetables after juicing? Do you think that these natural sugars have the same effect on brain mitochondria as highly processed sugar,

such as high fructose corn syrup or white flour? I'll often use a fruit juice to give me a burst of energy when I need it throughout the day. Thoughts on that? Eat the fruit, skip the juice. I mean, you know, the truth is that when you take, you know, 10 oranges and you squeeze them, or 10 apples and you squeeze them in one glass, you're getting a huge concentration of sugar, and not just any sugar, you're getting fructose. And fructose on its own, not in the wrapper of the fruit that it came in, is the worst thing for your body. It drives all sorts of changes in your liver, including high triglycerides, insulin resistance, inflammation. It's just nasty. So, you know, orange juice, can of Coke, you know, flip of a coin. I would, I would stay

away from all juices. If you want to have a juice once in a while for fun or flavor, you know, have a small amount and have it as part of a meal, not just on an empty stomach. Fine. You know, that's okay. But it's like, you know, just don't think fruit juice is a healthy snack or an energy boost. Terrible. Right. I think that's great advice. Skip the juice, have the fruit with the fiber. And again, can you explain that? Why is the fruit with the fiber going to be better? Aren't people end up going to get the same molecules? What is it about the fiber that relates to energy and just overall health? Yeah. So what really is key, we talked about it for years, but essentially it's the rate of rise of your blood sugar or the rate of rise of fructose. Because fructose will not raise your blood sugar, but the rate of rise is key. And when you have a spike from a quickly absorbed source,

it's what creates the problem. Then you get spikes in insulin, you get all these downstream consequences. When you have a fruit in the matrix of the whole fruit with fiber and all the other molecules in there and in all the other phytochemicals, it creates a kind of a buffer so that you don't get the quickly absorbed problem. Better if you eat fruit to eat it with something. Like for example, an apple is okay, but an apple with a tablespoon of peanut butter on it is way better because it slows the absorption. And we're seeing this now with levels. So if you're, you know, what's really fascinating, and we've known this in functional medicine for every year, but everybody's different. We call it biochemical individuality.

So two people eat an apple, it's a different experience in their body once they eat it. And some people are creating huge spikes in insulin, others aren't. And even in the same food, you expect in people who are seemingly the same, they can have very different responses based on their microbiome, based on all sorts of things. So I encourage people to check out their blood sugar, even if you're not going to use a monitor for your whole life. Do it for a month or a few months and track what you're doing, see how it affects you. I was shocked to learn that, you know, one of my friends gave me one of those and I put it on my arm and I was with one of my really best friends in Martha's Vineyard and it was a summer and he

ordered this incredible feast from this local organic regenerative farm and it was all super healthy food. But it was so much food and it was so good. And I just ate and ate and ate. And we both ate a lot of food. I'm exercising around, I'm like, whatever, I can pick out one night. It was so good. And then we both got to bed that night and we checked our sugar and it was like 150, 160. And we're like, ah, I'm already diabetic. What's happening? And it was like, yeah. And even a big meal, even if it's a healthy food will cause a problem. Right. And the good thing is that that's not how you eat on a regular basis, but if people do, then it's this, you know, a CGM, a continuous glucose monitor. Patrick,

we'll put the link up to levels over here. You can sign up right now. It's in beta under Mark's link, which it'll be in the show notes too. We're big fans of the company. As Mark mentioned, we're both investors and partners with them, but they didn't pay us for that mention. So the good thing about that is that for people who do regularly have things, I have a friend, Mark, who is starting every morning with two oat milk lattes. And even though they're plant-based vegan and they think that they're making a lot of really great decisions they saw that those two oat milks uh basically throw their blood sugar off the the whole rest of the day um because of uh the glycemic spike and the blood sugar spike that comes from oat milk

and they ended up switching to an unsweetened regenerativeative. Actually, Whole Foods now carries this company called New Barn, regenerative, dry farming almond milk. And that's unsweetened. And they make their lattes at home. And now they don't have that crazy spike and they don't have that crash that comes later on in the day. So this is all about digging in and figuring out even within healthy products that people are choosing on a regular basis to see if they're actually serving your body in the best way. Yeah, for sure. All right, Mark, last couple of questions that we have here. This is an important one. It goes back to emotional health, mental health. How can you make healthy energy boosting decisions when you're depressed? What would you suggest for somebody that's on the depression spectrum?

It's tough because the very things you need to do are the things you don't feel like doing, right? Eating better, exercising, you know, getting enough sleep. I think the data is so compelling that you almost, I know it's hard because I've been there, but you almost have to push yourself past that self-limitation. For example, the SMILES trial showed that swapping out healthy food instead of junk food was more effective than drugs for depression or that bigger exercise, you know, 30 minutes, four or five times a week, like running, velocity, is better than Prozac. So, you know, getting sleep is important. So getting off your screens at night and going to bed early and making priority of sleep also very important. So even though it may seem hard, it's really important to try to double down on those things that really we know work and to get a buddy. If you can't do it yourself, get a buddy, do it, do it with somebody. Because I always say

getting healthy is a team sport. And if you really are struggling, you know, get an ally. But don't just kind of accept that this is the way you feel. It's not normal. And maybe there's other factors too. Like if you're depressed, maybe another thing, maybe a vitamin D deficiency or B12, or maybe you have some other inflammatory issue or something's going on. So we know that depression can be inflammation. So you got to look at all the factors. Like I remember when I got COVID, I never get depressed. I mean, I get emotionally affected by things. I'm sad. I'm happy. I have normal range of human emotions, but I'm just, I don't wake up like, uh, you know, ER, you know, like I just, I just was so depressed and I was like, wow, this is terrible. Like what's the

point of living? Like this is awful. And I, and I, but I knew that it was this COVID, you know, but it's so hard when you feel like that to kind of overcome it. And I get it, but it's possible. And we know so much about how to treat depression. That's why I wrote my book, The Ultra Mind Solution. We created the Broken Brain series. You've got your Broken Brain podcast. So I think, I think there's a lot we can do to fix our brains. And as soon as we have to fix our brain before we can fix our, our health and the way to fix our brain often is through the body first. So the body is a great doorway to fix your mind and your brain. And that's what I think people don't often realize. Well said, you know, Mark, my dad was an administrator for a psychiatric hospital. And growing up, I grew up in the system was very well aware of depression,

the symptoms of it, you know, the importance of getting the importance of getting help. But we didn't know that much about sort of how diet influenced things. Even though I grew up, my parents were pretty health aware. And in college, I became a vegan on top of being a lifelong vegetarian. And then later on, when I learned about the world of functional medicine through you, I did a test that completely changed my life. And that was the omega quant test. And I looked at my ratio of healthy omega three fatty acids in my body and my ratio of omega three to six, which is directly connected to feelings of, of depression amongst many other aspects. And I saw that I was so deficient in omega three fatty acids, which you get from a lot of really great quality animal protein and fish in particular. And when I fixed that, this regular sort of depressive

episodes that I had, I was never on medication. They had stopped for me. Now that doesn't mean that it's going to happen for everybody else, but that test, which is like a hundred bucks and anybody could do it at home, you get a really great report that then you can discuss with your doctor was a huge role in my experience, just connecting depression and energy levels back to diet. Huge, huge. All right, Mark, we covered a lot of topics over here. I think this is a good opportunity for a little bit of a recap on the topic of fatigue and energy levels. What do you want people to know? And can you recap some of the things that we talked about in today's podcast? Well, I think the fundamental thing for

people to understand is that fatigue is a symptom of something else. And so you have to be a detective to figure out what your fatigue is from. Is it just from eating crappy, not exercising, not sleeping enough, being too stressed? Is it from a vitamin deficiency like B12 or vitamin D or omega-3 fats? Is it because you have some deeper issue? Is it because you have Lyme disease or mold or heavy metals or toxins? Is it because your microbiome is off? Is it because there's something else going on that's driving the fatigue? So it's important to be a detective to figure out what your fatigue is. And then it's important, you know, as the first step to double down on those things we know make a huge difference. And it's nothing surprising here. It's a clean diet. It's exercise. It's

getting up to sleep. It's things like meditation, yoga, getting on a good multi, fish oil, vitamin D. That alone will make a huge difference. Then try some of these other therapies like adversity memetics or we call hermetic therapies like the hot and cold therapy or interval training or all kinds of things we can do to actually help our bodies to reset and renew and repair. So we've talked about time-restricted eating. We talked about movement. We talked about hot and cold therapies. We talked about diet. And we talked about things to avoid, all the things which are energy suckers. Obviously, caffeine can be an energy sucker. Sugar is an energy sucker. Stress is an energy sucker. Lack of sleep obviously is an energy sucker.

Poor diet is an energy sucker. So just get rid of those things. Take out the bad stuff. Put in the good stuff. And most of the time people will feel better. And if you don't, like me, if I didn't, I didn't because I did all those things, you got to start digging and you need the help of a functional medicine doctor. Fantastic recap, Mark.

And as also I'll add to that is that all the links that we mentioned in the podcast, some of the articles on how to take a caffeine fast, signing up if you want to check out a CGM from the company Levels that we love, and the mega quant and other things, you can find those in the show notes. And I'll pass it back to you, Mark, to go ahead and conclude us out for today's episode. Well, Drew, thank you. That was a really great conversation. My favorite topic, fatigue. I'm sadly an expert, but I hope you learned something.

And if you love this podcast, please share with your friends and family. I'm sure some of them are tired or fatigued and life is so difficult now. We all need to figure out ways we can hack our energy. And this is a great podcast to tell them how to do that. Subscribe wherever you get your podcasts. Leave a comment. Tell us how you've managed your fatigue. We'd love to know.

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.

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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 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 who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.