The Dr. Hyman Show - Encore: Exposing The Flaws In Our Broken Healthcare System | Dr. Marty Makary

Episode Date: January 22, 2025

Do you ever feel like the more meds you take, the worse you feel? The problem might lie in how our healthcare system operates. In this episode, I sit down with Dr. Marty Makary to tackle the alarming rise of colon cancer among young people, explore how our microbiome plays a crucial role in preventing chronic diseases, and discuss the unsettling influence of the pharmaceutical industry on medical practices. From the impact of antibiotics on children to the hidden dangers of over-medication, we unpack the urgent need for more transparency and a shift towards addressing the root causes of illness. In this episode, we discuss: The alarming increase in colon cancer among young people The microbiome's impact on overall health, from regulating the immune system to influencing mood and metabolism The deep influence of pharmaceutical companies on medical research, education, and policy, often at the expense of patient care The long-term health consequences of early antibiotic use in children The overmedication of Americans, particularly children, and the need for a shift towards addressing root causes of diseases View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal This episode is brought to you by Seed, PerfectAmino, Timeline Nutrition, and LMNT. Seed is offering my community 25% off to try DS-01® for themselves. Visit Seed.com/Hyman and use code 25HYMAN for 25% off your first month of Seed's DS-01® Daily Synbiotic. Get pure essential amino acids today. Go to bodyhealth.com and use HYMAN20 to get 20% off your first order. Receive 33% off your order of Mitopure while supplies last. Go to Timeline.com/HYMAN33 today. Your future self will thank you! Get a free LMNT Sample Pack with any order—just head to DrinkLMNT.com/Hyman.

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Coming up on this episode of the Doctors Pharmacy. We have yet to really understand what's going on here. The rise in colon cancer in young healthy people. Turns out that there's an association with the microbiome. Being born by C-section and going on to have colon cancer before age 50 was an association just published in JAMA surgery. Before we jump into today's episode I'd like to note that while I wish I could help everyone via my personal practice there's simply not enough time for me to do this at this

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Welcome to Doctors Pharmacy. I'm Dr. Mark Hyman and this is a place for conversations that matter. If you've ever wondered if there's corruption and dysfunction in the medical system, then you have to wonder no longer because our guest today, Marty Macary, is a professor at Johns Hopkins University School of Medicine and the author of two New York Times bestselling books that have kind of pulled the curtain back on a lot of the dark side of medicine that you're

going to hear about in this podcast. Uh, Dr. McCreary served in leadership at the World Health Organization. He's a member of the national accounting of medicine, one of the highest honors you can get in the field of science. He's published over 250 papers.

His newest book, Blind Spots, challenges the conventional medical dogma to educate people about their health. Clinically, he's the chief of islet transplant surgery. That's getting something in your pancreas when your pancreas isn't working at Johns Hopkins. He's the recipient of the Nobility in science award and the national from the national pancreas foundation. He's been a visiting professor at over 25 medical schools. And he's just a very courageous doctor because he has pushed the limits of what

we should be talking about medicine. Cause we are told to keep the secrets. He wrote a book called unaccountable, what hospitals won't tell you and how transparency can revolutionize healthcare. He also wrote another book, the priceountable, What Hospitals Won't Tell You and How Transparency Can Revolutionize Healthcare. He also wrote another book, The Price We Pay, What Broke American Healthcare, about the lack of transparency in pricing and how we can fix it. He's just an incredibly brilliant man who is just on a mission to tell us the truth that you have not been hearing.

And today we talked about all sorts of things from the concern about vaccines and should we actually be vaccinating certain people and groups of people with a COVID vaccine or not. Why is the microbiome been ignored in medicine? Why is our medical education system completely teaching the wrong things? Why is our National Institute of Health actually have nothing to do with health and is all about disease and is not even funding the things we should be funding? How has the range of roles of GLP-1 agonists been ignored and why are we concerned about that? We also deep get into the topic of healthcare financing, payments, how research is funded,

the corruption of evidence based medicine. I mean, we talk about it all. I think you're going to love this podcast. So let's dive right in with Dr. Marty Macri. Uh, welcome Marty, the doctors Farnsley podcast. It's so good to have you.

I followed your work and honestly, I'm kind of shocking because you're a Johns Hopkins professor and you're a heretic in the middle of the belly of the beast and you're kind of telling tales that we've traditionally kept secret in medicine. It's kind of like a guild, you know, or like, you know, it's a club and you don't, you don't tell your neighbors or your colleagues or your friends about what's really going on in medicine

and healthcare. And what's really struck me as I've been a doctor god for almost 40 years now is the, is the level of, um, co-optation and capture of medicine by industry. Uh, and it's less about healthcare. It's more about business, uh, whether it's private equity taking over healthcare practices and emergency rooms, or whether it's, you know, just

pharma controlling policy and influencing medical education, or whether it's lack you know, just pharma controlling policy and influencing medical education, or whether it's lack of, of real accountability and transparency in healthcare and medicine. You know, you, you've been really outspoken about these things that we kept quiet about for a long time as doctors, uh, and you have quite a pedigree and, uh, you know, it means a lot coming from you.

I mean, I'm just a heretic on the margins and a little fringe doctor, but you're on RD, a real doctor. Uh, I just play one on TV. And, uh, and I think that, uh, although I do see patients, but I'm kind of kidding. Yeah, you're big time. But I, I really, I'm so excited about your

work, about your new book, Blind Spots. It's a great book. Uh, when medicine gets it wrong and what it means for our health and your other books, which I think are also very compelling and in touch on areas that are also quite concerning for me, which is really the lack of accountability and transparency in medicine.

That's called an accountable hospitals won't tell you and how transparency can revolutionize healthcare. And another book you wrote called the price we pay, what broke American healthcare and how to fix it. I mean, why are we spending twice as much as any other nation getting half the results? So I'd love to kind of hear how you went from

being like a, you know, revered surgeon at Johns Hopkins where the sort of the birthplace of modern medicine with William Ulcer to, uh, kind of calling, calling out what's really wrong with the system. Well, it's great to see you, Mark. Uh, you know, I think I, it hit me at a certain point, I went as far as you can go in academic

medicine, all the regalia, all the societies and honors and promotion and tenure. And it hits you at a certain point. I don't know if it's after I wrote 200 scientific articles or 250, but you realize no one's reading these things. Yeah. The system is so broke.

And the problem is we have a lot of smart people in a system where they're just collecting their paycheck every two weeks, putting their head down, this shouldn't be, this should, you know, this isn't right. And we feel like we're cogs in the wheel and people are afraid to get off the hamster wheel, take risks and call things out.

So in the book, The Price We Pay, we, um, my research team brought attention to this issue of price gouging and predatory billing, which is the term we called these kind of crazy bills that get thrown at people. They want a price, they're not given a price and it ruins lives. And now we have this massive trust problem where some 62% of Americans say they have avoided care or delayed care for fear of the bill. Yeah. So you can have the cure for pancreas cancer

now, but if 62% of the population, it doesn't trust you, that pill is only 38% effective, not a hundred percent effective. No, it's true. I mean, I literally had this direct experience. I had a knee issue, so I needed an MRI and I went to Chinatown in New York city. I got one for 400 bucks, had to get one in, uh,

in Berkshires and where I live in the Massachusetts. And, and it was 2,500 bucks for the same MRI, same machine, I just went and had back surgery and had hyperbaric oxygen. I, I went to this hospital and I said, I wanted to get it. And they said, okay, but it's $5,000 a session. I'm like, geez. And I talked to the head of everything goes, well, if you do it this way, not through Medicare

and you do it through, you know, an off label use, it's $175. So we're talking 175, 5,000 exactly the same procedure. How does that happen in medicine? Yes, exactly. Right. So this is the game.

I call it the game in the book, the price we pay. And we found that the game is designed to maximize profits. It's not designed to be honest with patients. And so, uh, the book actually led to some real legislation and an executive order from the White House that was entirely bipartisan that

now requires hospitals to start posting cash prices for common shoppable services and the secret insurance discount, uh, that the insurance companies have with hospitals. Yeah. We'll all be public. All of that is going to start to happen this

year. And, um, that is because we felt firmly like we gotta do something. All the doctors lobbying organizations out there are just fighting for more money for doctors. And that's the common trade association thing. That's not bad, as I'm saying, we're not getting cut on Medicare,

but the healthcare system is more than just fighting for more money for your own special interest. And yet the average consumer is kind of just, you know, at the effect of all this and has no power and the costs are escalating. And, you know, we spend so much money in healthcare and we're getting less and less and the outcomes are worse and worse.

And we don't have in line incentives. And so it's kind of, kind of messed up. You know, I think you, you also, um, talk about in your book, blind spots, some really interesting things that, that, uh, we've screwed up in medicine or things that we're not looking at. And, uh, you know, when I remember I gave a

lecture at Cleveland clinic, um, once, and it was, it was, it was a whole audience of, you know, doctors and scientists and it was, it sort of gave some case presentations and I presented a case around autism that I treated where we really helped to reverse the case using very sort of aggressive lifestyle dietary changes, fixing the microbiome, which was

as an issue for 98% of these kids have really screwed up guts. And he says, well, you know, you know, this was just an anecdote and you know, where's the evidence? And I'm like, this, I said, look, you know, you know, this is just an anecdote and you know, where's the evidence? And I'm like, this, I said, look, you know, can you help me explain how the microbiome affects almost all known health conditions from heart disease to cancer, diabetes, to dementia, to autism, to allergies, to autoimmunity, to depression, to eczema,

to asthma, and the fibromyalgia, to chronic, I mean, I literally could go on forever, right? How can you explain that with your current set of facts and theories? Like, well, it can't. Like, so when you have a set of facts that present themselves to you, when the science changes, you have to change your thinking and your practice, yet we don't do that.

It's just so evident to me that despite knowing now that so many of our diet, our disease are diet related, or that so many are related to the microbiome, which is controlled by our diet, or that so many of our diet, our disease are diet related or that so many are related to the microbiome, which is controlled by our diet or that so many diseases are related to environmental toxins, doctors don't learn about this. They don't put it in their practice and it's sort

of this, this kind of blind spot. Uh, can you kind of talk about, you came up with this idea of blind spots and why the microbiome is such a blind spot and we'll get into some more of them. You know, maybe we need to be treating more diabetes with cooking classes instead of just throwing insulin at people.

We are the most over-medicated generation in the history of the world, right? And so we can keep treating high blood pressure with first line after second line, or we can start talking about sleep quality and stress management. And this is the new movement now in medicine. It's a real tension to address these giant blind

spots. The microbiome is one of them. Food is medicine, general body inflammation, all is the new movement now in medicine. It's a real tension to address these giant blind spots. The microbiome is one of them. Food is medicine, general body inflammation, all the stuff that you've been teaching the public and the medical community about for a long time now. The microbiome may be this central organ health,

but it has no center at the NIH. There's a little tiny unit and I talked to the person who runs it and they're massively underfunded, but the microbiome trains the immune system, digest food, produces vitamins. It's involved in mood because some of the bacteria produce serotonin. It even regulates estrogen, it deconjugates

estrogen into an active form. And so there's. Now you're sounding like a functional medicine doctor, Marty. I think at heart I want to be one, but, uh, you know, I don't have the expertise on which foods and vitamins, but what I'm interested in as almost a journalist within the medical

profession is we have new exciting research that relates to every disease process, every specialty, and it gets almost no attention. Yeah. And, um, this one study by the Mayo Clinic, I think maybe the most significant study of the last 10 years, in my opinion, that got almost no attention.

Yeah. They looked at 14,000 kids and compared kids who got antibiotics in the first couple of years of life compared to kids who did not. Yes. And the kids who got antibiotics in the first few years of life went on to have higher rates of chronic diseases.

They had a 20% higher rate of obesity, a 21% higher rate of learning disabilities, a 32% higher rate of attention deficit disorder. All these things are on the rise, 90% higher rate of asthma, almost a 300% increase in celiac disease. All these diseases are on the rise, 90% higher rate of asthma, almost a 300% increase in Celiac disease. All these diseases are going up. We're messing up the microbiome.

That was the mechanism believed to the, which, how the antibiotics worked to induce the increased risk of these diseases. And how can you look at that and say, yeah, no, let's ignore that. There's nothing there. We may have. Cause there's no pill,, let's ignore that. There's nothing there. We may have. Cause there's no pill, Marty, to fix it.

There's no. No statin for the microbiome. No pharma company CEO gets rich. Um, but it's amazing now the research on the microbiome is, is blowing me away. And they published this study in the Mayo Clinic proceedings, which is in our world of research, it's a little bit of a flag that no one else

would take it. Right. I think it's probably the most important significant study in the last 10 years. Wow. Okay. Tell us about it. So, I mean, I mean, the fact that you have all

these chronic diseases, I mean, we, all the stuff, all the stuff that is increasing attention deficit disorder, learning disabilities, we scratch our heads, people come in and we diagnose them with Celiac and they say, doc, how could this possibly happen? And we come up with some non-answer like, well, it's unknown or, you know, genetic and no, we have, I mean, there's a study here telling us

300% increased risk when you alter the microbiome with antibiotics early in life. And it's other things that C-sections, it's ultra processed foods, it's high refined carbohydrates. So we have yet to really understand what's going on here. The rise in colon cancer and young healthy people.

Yeah, right. Turns out that there's an association with the microbiome. There's a, an association with polyps and antibiotic use. There's an association with the microbiome. There's a, an association with polyps and antibiotic use. There's an association with C-section delivery, being born by C-section and going on to have colon cancer before age 50 was an association just

published in JAMA surgery. So you have this incredible body of literature emerging on this central organ system that is highly actionable, that we can talk about, that we can study. And it kind of lives in this corner because what specialty is it? And what NIH center is it?

Is it infectious diseases, GI, is it oncology, is it primary care, is it functional medicine? And it has no home because we've created these silos, right? Well, that's really the fundamental issue with medicine, right? Is this, is the subspecialization, the specialization, the dividing the body into

parts and geography and specialization based on that, but it has no scientific rationale. Like when you actually look at how the body is truly organized, organized as one integrated ecosystem. Yes. And it's not a bunch of separate different parts that have no relation to one another.

They're all doing. It's so connected. It's so connected. Yeah. And it's really connected. And the microbiome is, is, I always say the best example of that. And in the functional medicine world, it's

always been the place we start when anybody comes in with almost anything, we can optimize their nutrition and we fix their gut. Now, when I we fix their gut. Now, when I say fix the gut, most traditional doctors, well, I don't know what you mean, like take a laxative if you're constipated, take a modium if you have diarrhea, if you have a parasite, take a drug.

Like people don't know in the medical world, how to optimize the microbiome. That's why it's ignored. It's not taught. It's people don't understand how to regulate it and it's possible and it's doable. That's what we do every day in functional medicine. It's inherited taught, it's people don't understand how to regulate it and it's possible and it's doable and that's what we do every day in functional medicine.

It's inherited the microbiome. So you pass on the skeleton of the microbiome to offspring, antibiotics and C-sections save lives. We've, we've both seen that, but they're massively overused and they're messing up the microbiome in ways we don't even appreciate. And people are being given options without really knowing what is potentially happening

because of this. Now, I don't know what causes autism. Other smarter people may have ideas, but the researchers that did this study, and they're not no name researchers, uh, talking to Marty Blazer, who I think is the world expert on microbe, on the microbiome. Missing microbes.

Missing microbes. Great book. He told me that while they did not find an association with altering the microbiome and autism, they believe there is an association there. They think maybe they haven't sampled enough children or something.

Now, I don't know if he's right, but if he's right, that is a massive signal in the data that we should be following. Well, I know it's true. I mean, it's not, it's not surprising. You look at the data on autism, almost all the kids have some kind of gut issue. They have bloating, they have distention, they have sticky smelly poops.

Really? I did not know that. Yeah. It's, it's, it's really common. I mean, it's, it's really out there and, and it's in the literature. And I can tell you, if you talk to parents with kids with autism, they all have gut issues.

And it's not, it was sort of a, it's not a, it's sort of a, kind of a, a sort of a red herring finding, it's a core finding. And about 75% have altered immune systems and inflammation. If you look at the brain of kids with autism, they're bigger on MRI. This is work done by Martha Herbert at Harvard.

And, and there's also, uh, if you look at kids who've died from some accident or something who had autism, their brains are all full of inflammation. Their gluomicroclay are just, which is the immune system of the brain are all just on fire. And when you look at the history and I've treated many, many, many dozens of kids with

autism over the years, the stories are almost sort of universally similar. The kids, you know, have born by C-section, they're not breastfed, they get lots of colic, they get antibiotics, they got eczema, they get earaches, it's like, and then they get piled down with tons of vaccines, not saying vaccines cause autism, but like, it's just a

lot for these kids, immune systems. And then something flips. I'm chuckling a little bit. I mean, I love what you're autism, but like, it's just a lot for these kids' immune systems. And then something flips. I'm chuckling a little bit. I mean, I love what you're saying, but I'm chuckling because I had this kid come in, a teenager, who had the classic sort of irritable bowel, chronic abdominal pain, no one knows what it is, has had a million tests done,

it doesn't show anything definitive. And I decided to take a lot of time, something we're not incentivized to do. Take a million tests done. It doesn't show anything definitive. And I decided to take a lot of time. It was something we're not incentivized to do. We take a lot of time. I mean, you took more than eight minutes. It took more than eight minutes. I listened to the patient. I didn't look at the EHR and it turns out that

the kid had that same profile. Born by C-section, they had constant antibiotics, unnecessarily it sounded like throughout their early childhood, especially in the first three years when the microbiome is being formed and had eaten terrible food their whole life. And then the mom tells me this condition, which we just give this diagnosis of irritable bowel, how could this possibly happen to my son?

Well, you know, I wasn't there when you got all these choices, but you've also been feeding the kid shit for the last 12 years. And, and so we're shocked. And then we have this massive whack-a-mole medical industrial system that's going to order millions of tests and put the kid on some kind of IVIGG or some kind of K-TRUDA.

Yeah. It's like, can we talk about root causes? Root cause exactly. And the antibiotics are prevalent. I mean, I gave a lecture to about 500 people on Aspen Institute last week. And I asked, talking about something, I think similar to this, I said, how many of you in the audience have never had antibiotics

and not a single person raised their hand? Right. So, and if you look at, for example, uh, there's work done on bifidobacterium infantis, which is a really key, important keystone species that proliferates in an infant, it's supposed to be there, but if the mother's taken antibiotics, it will, it's very sensitive, it will get wiped out. And this is important for the development of

immune intolerance, for the prevention of allergy, autoimmunity, um, eczema, inflammation, asthma, all these conditions. And, and there's actually a company that's been funded, I think hundreds of millions of dollars called it. I think it's, uh, the name of the company that the product is Avivo, E-V-I-V-O.

It's basically a baby probiotic that you can give to the baby. And the thing that's unique about it is that it colonizes. Cause when you take any probiotics as an adult, they don't really stay, they kind of go through, they, they have an impact. Uh, but that's unique about it is that it colonizes. Cause when you take any probiotics as an adult, they don't really stay. They kind of go through, they have an impact. Uh, but it's like tourists going through an

economy. This is actually building a house. And it's quite amazing how it prevents a lot of these conditions. So that's what we need research on. There's a lot. The thing is that there's a lot. Like if you, if you, you know, this is, we won't practice any face medicine. Like, have you looked at the evidence?

There's like 10 million articles on PubMed. Have you actually read all of them and you actually know what you're talking about? Because this, this sort of veil of evidence based medicine often is a sort of a smoke screen for people not knowing all the data and saying it just cause they don't know it. It means it's not true.

And I think that's unfortunate because they're, like you said, when you start to look at the research of the microbiome, you found so much. I saw a trial in China where they're treating autism with a combination of bacterial therapy or basically probiotics. Fecal transplants.

Fecal transplants and, uh, shepherd Pratt affiliated with my hospital, Johns Hopkins is doing a trial with probiotics and bipolar to treat bipolar. So it's like, this is, you know, we, how much have we spent on cancer and we, what have we gotten for it? Almost nothing.

Yeah. The ROI is almost zero. I mean, the top paper at ASCO, the cancer meeting was like, oh, if we use Avastin for GBM of the brain, you can get another. Couple of months. Couple of months, no added cure, right? So anyway, I love what you're saying.

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And if you don't love it, no problem. Element will give you your money back. No questions asked. So, so I want to go into like a, a kind of related, but a little bit of a touchy subject, which is the subject of vaccines. And it's one of those subjects that is so confusing to me as a doctor, as a scientist, because science is about asking questions. They can't ask questions. It's a very complex subject. And it's a very complex subject. And I think that's the most important thing.

And I think that's the most important thing. And I think that's the most important thing. And I think that's the most important thing. And I think that's the most important thing. And I think that's the most important thing. And I think that's the most important thing. And I think that's the most important thing. And I think that's the a doctor, as a scientist, because science is about asking questions. They can't ask questions about vaccines. It's about having a hypothesis and proving it negative. Right?

That's kind of the basic scientific method. And if you question anything at all about any vaccine, you're immediately able to be an anti-vaxxer and you can't say, well, is this vaccine safe? Is that vaccine safe? What are the risks and benefits of each one individually? What about them combined?

And, and, and it's, it's just the weirdest thing. It's like heresy. Uh, and I experienced this personally, like at Cleveland clinic when I was there, somehow I, because I, I, people thought I was anti-vaxxer. They, they, the pediatric department, like got very upset.

Get that label. And, and, and, and I literally had to write a letter like, no, I'm not. I've been vaccinated. My kids are vaccinated, but it's important to actually ask questions about this because if there's signal somewhere that there's an issue, we should look at it.

And then you wrote a very, uh, very courageous paper that was published, uh, that you co-authored in, in, it was published in, uh, journal of medical ethics. Uh, and it was talking about whether or not we should be giving vaccine boosters to young adults going back to school. And you basically said that in a survey of all

the data, I don't let you unpack it, but the punchline was that the risk of getting it was worse than the risk of not getting it. And, and, uh, I wonder one, can you tell us about that study and two, what has been the reaction and have you been now labeled in any vaccine? Yeah, sure.

I can, I've gotten that label a little bit for, uh, questioning the booster vaccine in young healthy people, especially who have already had COVID. So the question is what the vaccine booster in young healthy people, is there a benefit? And there was so much controversy and I saw how at the FDA, it was pushed in with the political

might of, you know, a top down order that it, um, made me ask some questions to the two top vaccine experts that the FDA were fired directly fired, um, by their superior for questioning the COVID vaccine approval for young, healthy people. That is the booster, the booster, not the original. So the CDC never released the data and only data we had was observational. The clinical trial data was on the booster.

It was basically just reamed through. They didn't go through the normal process. So then when you look at the risk of myocarditis, not to mention the other claims that are out there of people being messed up or injured or not the same after the vaccine. Again, high risk people early in the pandemic, it was very clear the benefits outweigh the risks.

But when you get down to young, healthy, 12 year old girl, does she really need six COVID vaccine doses in three years? We basically said. Well, yes, because Moderna needs to make a profit. Well, they weren't too happy with me. Moderna constantly has people at their company trying to reach out to me.

And so what is the risk of myocarditis of the COVID vaccine in a young health, of the COVID booster in a young, healthy person? I asked that every time I'm engaged on this topic with someone who's like, how dare you not support the vaccination with the COVID booster in young, healthy people. Well, what is that risk of myocarditis?

It's one in 2200 to one in 2800 heart injury from myocarditis. One person in a study of about 2000 died in an ICU. A couple of two, two others were admitted to an ICU in the New England Journal. This is New England Journal, it's not like. Yeah, right. So on a societal level, is there a net benefit

or a net harm to giving the COVID booster to a young, healthy population? It would, it's a net harm. If we actually do the math, it's a net harm, very small harm, but to mandate it, to force, you're going to create never vaxxers by doing that. Right. I mean, in your study, you basically look at it

like over 40,000 people, young adults, and found to prevent one COVID hospitalization, you would have to trade that for 18.5 serious adverse events from the mRNA vaccines, including the, uh, myo and pericarditis. We don't even know if that hospitalization, that's based on data where we don't know if the hospitalization is for COVID

or with an incidental COVID positive test. Yeah, but you're talking about like you have to vaccinate 40,000 people to prevent one hospitalization, but you get 18 serious adverse events. You've got to burn the village to save it. That's a problem. And so what's been the reaction to this article that you published and to this view, because it's, it's like, you can't have this conversation. It's like, you're not allowed to

have this conversation in medicine. And so how, how, how have you been able to still have a position at Johns Hopkins? They've been great. Actually, Hopkins, the school of medicine has been terrific. My Dean asked me to present to all the other department leaders, along with one or two other, uh, of Medicine has been terrific. My dean asked me to present to all the other department leaders along with one or two other infectious diseases experts. And my dean said, I know you have a

slightly different perspective on COVID and the vaccine booster in young healthy people. So I'd like the department leaders at Johns Sopkos to hear both perspectives. And we had a wonderful dialogue. I've been, I've been active there as a surgeon and public health researcher for over 20 years before COVID. So they knew you were in a nut job. Yeah, they knew I'm a reasonable guy and I work hard and I mean well, and I love this country.

So I didn't get that kind of anonymity based accusations you see on Twitter. Did you convince them? Um, I don't know, you know, you have people privately come up all the time to me. I don't know if you had this happen. We're like, Marty, I love what you're saying. I love, keep going.

I can't say anything, but you keep, that's perfect. Right, right. I'm like, what are you afraid of? You know, too many people are afraid of speaking up. It's still happening in so many areas of medicine. So I was like, how many doctors, in an audience, how many doctors here take, uh, neg vitamins and like almost everybody raised their hand like, how many doctors, uh, in an audience, how many doctors here take, uh, dig vitamins and like almost everybody

raise their hand and how many doctors recommended their patients and like, you know, half the hands go down. Exactly. All right. Uh, you know, the other thing you're talking about, you know, this whole idea of, of, of, uh, the GLP-1 agonists and they've been around

for a while, some of them more than others. Um, and you know, we're, we're in this moment where we're in a metabolic crisis in America. 93% have poor metabolic health, which means they have some degree of insulin resistance, pre-diabetes on the spectrum, even if they're normal weight, because they eat too much crap and sugar and ultra-processed food. 42% are obese. These drugs seem like a panacea. Wow, this is a miracle drug.

Give this shot once a week and lose weight, and everything's going to be great. I'd love to hear your thoughts on this perspective of widespread use, Medicare coverage you're talking about, insurers covering it. There's new study after new study coming out. And I just want to give a little background on this, showing it. And here's my belief. And I don't, I don't really have any evidence to back it up, but it's like, I see a new study almost every day about the benefits of, of these GLP-1 agonists coming out in major

journals. It works for heart disease. It works for depression. It works for this. It works for that. You know, it seems like everything. Now in my head, I'm like thinking, is it the GLP-1 agonists or is the weight loss? Right.

And in, in, in, in a bariatric surgery study, they, I'm like thinking, is it the GLP-1 agonist or is the weight loss? Right. And in, in, in, in a bariatric surgery study, they, they looked at, for example, um, what the difference was because you know, bariatric surgery can cure diabetes in two weeks. And they basically did bariatric surgery on one group and then no bariatric surgery on the other

group, but they fed an exact same diet that bariatric surgery group ate. They also reversed their diabetes in two weeks. No difference. Yeah. Sometimes out of the operating room in the recovery room, we noticed the requirements go down.

Right. Right. But, but what I'm saying is even without the surgery, so, so is it the GLP one or is the weight loss? And, and there was a guy I met recently named Sammy who started a company called Virta health, which uses ketogenic diets to

reverse diabetes. And he said they've actually done the study where they've actually looked at this and they found it wasn't really the GLP-1, it was just the weight loss and the improvement in metabolic health as a result of it. So I'd love to hear your perspective on that because, you know, it's hard to, to learn how to eat right. And it's hard to, how to do it. And yes, everybody wants that easy fix.

Uh, and then it is appropriate for some patients. But I know people who want to lose 10 pounds for the bikini, and I'm like thinking, this is not a good idea. So can you tell us your perspective on that? Well, one thing that is a theme in Blind Spots and a theme in the research I learned was that if somebody puts something out there with such absolutism, when the scientific evidence is really inconclusive

or there's a lot of opinion, we just don't know what the long-term effects of GLP-1 are, for example, they just haven't been around long enough. How can you say with such absolutism that there's no long-term downside? We may see a benefit in the short term with some of these chronic diseases, but we may be accelerating frailty,

which is basically loss of muscle mass. And that is, as you know, the number one predictor of longevity is muscle mass. And that's why we want people to be active when they're older. So, um, we, we don't have that data and people are acting as if, doesn't matter. It'll go the way we want it to go. Um, there are bacteria in the microbiome

that produce GLP-1. And maybe we should be talking more about. Probiotics. Having a very healthy. Yeah, maybe we already make some. So it's like, how can we not crush that? Um, we're on a path of having every eight year old in America on three or four medications.

It's scary. Maybe their children or when they're adults, when they're children. Yeah. I mean, already half of America are taking chronic medications and the average number is four. Um, once you get over 65, it's like you got to

have these boxes to remember what to take. And look, medications save lives. You and I have seen that that's, that's part of the medicine we're trained in, but. it's like, you gotta have these boxes to remember what to take. And look, medication save lives. You and I have seen that that's, that's part of the medicine we're trained in, but we're going to convert America's children into a generation of patients. Maybe we need to talk more about school lunch

programs than putting every kid on no Zempik. And that is not a conversation that we're having, we're just sort of celebrating, Hey, high five, we found a way to, you know, create a GLP-1 agonist. We'll see about these new generation GLP-1 drugs that have a blocker on the muscle receptor, supposedly they're going to enter clinical trials soon. Yeah. Um, but I.

So to prevent the muscle loss. To, to, yeah, prevent it or reduce it. Um, maybe, I believe in impeccable objectivity, changing positions as the day to evolve. Right now I have serious concerns about just giving out GLP ones like candy. For side effects wise or just beyond the muscle loss? The acceleration of frailty, the muscle loss. Um, there, some people don't do well with the, uh, profound loss of muscle.

So, you know, there've been studies that have looked at weight and it turns out that fluctuating weight all the time is worse for you than staying overweight. That's right. That's right. So are people going to be, I'm doing better now and I don't need it.

I need, I'm going on this vacation. I'm coming back. It's like, that's not, that's not good medicine. No. And I, and I, I don't have, um, that many patients on these GOP1 agonists, but you know, I'm seeing side effects. Like one person had pancreatitis the other day.

Yeah, no side effects. I mean, this is a 900% increase in the risk of pancreatitis. I mean, I've never seen pancreatitis unless you have somebody with a serious problem. And I see from a drug addict, it's very concerning. That's just, you're of pancreas. I mean, I've never seen pancreatitis unless you have somebody with a serious problem. And I see from a drug addict, that's very concerning. That's just, you're a pancreas surgeon. So you get out and point the pancreas.

I love the pancreas. You love the pancreas. So this is, this is concerning to me. And I think, um, the perverse incentives in medicine are driving this kind of crazy trend. Um, and, and in your book, you also talk about sort of the blind spot around, around the way we do research and the profit motive in research.

And I, you know, when I entered medical school, I thought science was this sort of ethereal thing, which was pure and independent and, and completely objective and just like, you know, just had this kind of halo around it. And what I realized is that science is really freaking corrupt and that, uh, that, and what I was at a, as a, uh, Passover dinner, um, with my, with my, um, one of my cousins and their husband, I was like, what are you gonna do? And he's like, well, you know, I, I, I, I, I'm a,

I'm a contract research organization. Uh, I run contract. I'm like, oh, really? What's that? He says, well, that's where a farmer companies pay us to find experts in different domains and then fund the drug studies, do the studies, write the paper, and then we pay them to put their name on it.

Like a super pack. Yeah. And I'm like, really? This is not right. Corruption. It's so crooked. So can you speak to that in, and this, and the challenges around, around the, the sort of the

peer review process, the weaknesses in that, the, the, how do we address this whole phenomenon? Cause it's, you know, it's, it's, uh, there's so much conflict of interest in medicine and it leads to like the massive funding. So for example, if the amount of money that was now going into JLP one research, we're going into food is medicine research, right?

We would be showing phenomenal outcomes if we did the right kind of research, right? So how do we, how do we deal with this? I do think everyone that goes into medicine is going in it for amazing reasons. And one thing that unites everybody in medicine is everyone has a sense of compassion that drew us into this calling.

So we've got good people, but we walk into a bad system and it's not a system we designed, it's a system we inherited, but we shouldn't defend it. It's entirely broken. We have a bloated NIH that funds research worse than the government funds, the postal service. We have silos. That's pretty bad. There's a small group of people making all the decisions at the very top.

These are folks where we need term limits, the folks where they decide what's important or not important, and it's based on their understanding of the world. Medical school education at every school in the United States is controlled by 19 people that serve on the board of a private company that determines the curriculum of every medical school in the country. And if you want to do something creative, talk about food or inflammation, you got to

get back in line. Is this the company that creates the licensing exam or is this? AAMC, they run, yeah, the USMLE. Yeah. And so these, you know, I've talked to deans of medical schools that have said, Marty, I'd love to talk about this stuff.

All this stuff you talk about, all these stuff that are in the blind spots, modern medicine, and they say we can't because the students know exactly what their learning objectives are for the boards. And if we teach something else, they're going to skip that class and I'm going to focus on memorizing and regurgitating the 55 enzyme names they have to spit out on an exam.

Why are we forcing our youngest, brightest, creative, most altruistic minds to regurgitate the names of enzymes that you can look up on a smartphone? And so we have this system now where a small group of people are controlling medical education, a small group of people control where the NIH dollars go and who are funding the big questions central to health.

For example, there's a new practice that's taking off of cutting the tongue under. The frenulum. Yeah. The frenulum under the tongue. Sometimes they'll even do the side of the tongue or the frenulum under the inside of the upper lip.

Sounds, it's crazy to me. I have ENT docs that say there's a subset of kids that may benefit. Well, if you've got your tongue tied, like fully tongue tied. If it's truly a foreshortened tongue, they believe there's a subset of kids that may benefit from the. Well, if you've got your tongue tied, like fully tongue tied. If it's truly a foreshortened tongue, they believe there's, there could be a benefit. It's never been proven, but they do believe

there's clinical benefit. But then they say going to the upper lip and the side is crazy. They also say we need a good study on it. Well, there's a group of people out there that are calling every kid tongue tied, doing it routinely. Who's going to, this desperately needs a randomized it routinely. Who's going to, this desperately needs

a randomized control trial. Who's going to fund it? Pharma? No way. NIH not in one of their silos. American Academy of Pediatrics, unlikely. And so this practice will go on. Moms against frenulum cutting.

Maybe, maybe sometimes it is the advocacy groups, the philanthropists that fund research. Most of our research at Johns Hopkins on my team, which is, it's a, we call it the redesign of healthcare. It's on all the major topics in medicine that we are not talking about that we should be talking about. And we are a rapid response team. When the opioid epidemic hits, we go to work in days.

When COVID hits, we go to work in days. When COVID hits, we go to work in days. The old NIH, you know, take a couple of years, work on formatting a grant. They're funding these tiny incremental little, I don't even call them discoveries, like findings. Yeah. Like, is it interesting what the average size of stones are on the street? No.

Is it research? I guess. Yeah. But we're funding these little dumb things and then the big questions go unfunded. So we think the solution is philanthropic funding, reorganizing the NIH term limits at the NIH and a small. For the, for the director of the NIH or?

For all, uh, all people who are in decision making leadership power over grants at the NIH. And grants, my opinion, when I say we, these are my opinions, the grant should be funded when one reviewer loves the idea and then it goes into a pool and you could give out the grants randomly to when one person thinks that's a big idea, that could be interesting.

Why do you have to have a consensus among the old guard establishment that yes, we're going to find another study on stents. And there's unconscious bias, you know, like I was talking to Francis Collins, who's a wonderful man, a really kind, good hearted man, brilliant guy, you know, who was the director of NIH. And I said to him, and I think I've talked about this in the podcast before, really kind, good hearted man, brilliant guy, you know, who was the director of NIH. And I said to him, and I think I've talked about

this in the podcast before I said, France, why didn't you use COVID to educate the American public about the importance of nutrition in optimizing your health to prevent COVID? Because 63% of the hospitalizations and deaths from COVID were because of poor diet. And we know that we are 4% of the population in the world and 16% of the cases in deaths.

He's like, oh, well, we couldn't do that because it would basically blame the victim and we don't want to do that. And at another meeting, I was like, no, it's not their fault. It's, it's just because we have a toxic food system. Talk about that as the, and then at another

meeting, he got up and said, well, there's no, we don't really know that much about nutrition and there's no national institute of nutrition at the NIH and many other countries have this and nutrition is the biggest cause of all the diseases that we see today. Period. Like no argument. All the science says this.

And I, and, and, and he got up and said, we don't really know much and there's not much data. And at the same meeting, Dr. Darius Mazofarian was there, who's the, was the Dean of the Tuft School of Nutrition Science and Policy is now the head of the Food is Medicine Institute there. He said, well, for instance, Dr.

Collins, I beg to differ with you. And, and then he went into this long kind of scientific unpacking of the literature that we do know. I was like, wow, you know, it's, it's, it's not necessarily a malevolence. Sometimes it's just, oh, ignorance. Never. No, but I was like, wow, you know, it's, it's, it's not necessarily a malevolence. Sometimes it's just ignorance. Never. No, but I was like, wow.

Yeah. Uh, and, and also in terms of the, the medical school stuff, you're right about the licensing exam and I think it's one of the things we're working on in Washington, my nonprofit, a color food fix campaign is to change the licensing exams because that's what determines the curriculum. And my, my daughter's in med school now and I'm

like, have you learned by this? No. Have you learned about the micro, but I know if you learn about the inflammation, it's like all the things that matter. She's not learning about. And she's, I know as dad, I have to pass the test and I just have to study for the test.

And that's it. Right. And I have the practice tests and I have the questions and I have, and it's, it's like, if there was 5% of the questions on nutrition and chronic disease, that would force the change in the curriculum. If there was 5% of the questions on the microbiome

or on inflammation and health or in like any of these things on mitochondrial function and how to treat mitochondria, that's another black hole, right? Yes. Yes. I don't know what a blind spot, I don't know if you talk about.

Yeah, it's a big blind spot, energy and micro, mitochondria. I mean, it's essential connected, you know, sort of universal theory behind health is that there are these basic principles of mitochondrial health, inflammation, nutrients. We have such a nutrient poor diet, all the stuff you've been working on.

But next time you see Francis Collins, you can remind him that the H in NIH stands for health. I know. I said, that's what I say. We don't have national health, we have national institutes of diseases. It's amazing.

Uh, so how, how do you think that, that we can kind of reform the system besides just changing the term limits and besides, uh, you know, do we get pharma money out? Do we, do we try to sort of have special barriers that prevent them from manipulating the science and the papers? You know, I mean, it's like half the time, what it says in the abstract isn't actually what it says in the data. Most people just read the abstract. Like there's all kinds of monkey business going on. Yes. Right. It's a monkey business.

Yes. Well, first of all, I think we insist on rules of transparency for clinical trials. Number two, if you're going gonna opine about a topic, do a clinical trial. The amount of opining around topics that the NIH throws out there, oh, we don't have good data on this. Well, you control the $80 billion budget over there at NIH. We saw this all during COVID.

All the COVID controversies could have been settled immediately by them doing the proper clinical or randomized control trial on that question. All those questions, masking toddlers, natural immunity, the booster. Six feet.

Oh, do the trial. And you know, is it spread airborne from, or from touching surfaces in the summer of 2020, six months into COVID, the NIAID and Dr. Fauci, sorry, I said something I shouldn't have said there. I mentioned his name. He was telling teachers. You can say his name.

Is that okay? I know he's very, some people love him, some people hate him. No, you can say Dr. Fauci. I try to be objective, but so he was telling teachers to wear gloves and goggles in class. Do the freaking study. If you think it's spread by surface transmission

and you don't believe it's airborne, do the study. You got the $80 billion budget at the NIH. So one is increased. He actually admitted that. He says, I just made this stuff up. I just made up the six feet thing. I just made up the mass thing. Like I just made this stuff up.

I'm like, wow. Okay. Well, thanks for telling us. I think one of the biggest propagators of misinformation during the pandemic was the United States government itself. And it's not new, the food pyramid and. It wasn't just Trump saying put a bleach

in your veins. It was more than that. Yeah, like. It was the actual NIH. It was the actual CDC. And it's not new. Penile allergies, same thing. We give people the wrong guidance.

There's so many recommendations that, um, people should be able to ask questions. I'm not saying be cynical. I'm not saying don't trust your doctor, but people should be able to ask questions. So if pharma does a study, regardless if that study goes their way or not, we should get the results immediately. Okay, that is a basic new principle of transparency we need to adopt in the United States. When Paxlovid, just as an example, the antiviral used made by Pfizer to treat COVID. When that came out, the government

recommended that for everyone. They promoted it. It was one of the biggest public health campaigns of the last year and a half of the pandemic. A study came out in the New England Journal of Medicine just a number of months ago that showed zero benefit in people under 65, none. Zilch.

The study, now that's studies go different ways and that's studies go different ways and that's the way science is. But the study ended nearly two years prior. If you look at the actual tables, the results were the study was done. Why did the public not see it for nearly two years?

Cause it didn't go their way. When the COVID vaccine booster goes their way, they tell you before anything's even published, just a press release and it's a CDC. Yeah. So they got a full page either in the art times. Yes.

So this is the type of trial level transparency we need. Yeah. And we got to do it now because otherwise we need, we need better funding in academics. We need a more civil discourse in medicine. We need less cancel culture. Yeah.

And so. Yeah, it's so true. It's so true. You know, uh, just like we totally agree on everything here. One of the things that shocked me that I found out, you know, cause this is a doctor, you think, okay, well, the literature is

published, it's, it's, they're publishing all the data on particular drug or particular intervention that they're, that they're studying all the data on particular drug or particular intervention that they're, that they're studying. And it turns out that, that pharma has to present all their data to the FDA, but they don't have to publish all the data. And typically they only publish the positive data.

They don't publish any of the negative trial data. That's right. And so the public has no clue that there's all these other studies that contradict the one study that showed that it was positive. And the FDA is, is a captured agency because it's like a revolving door for pharma and pharma leadership.

And, and so, like, it was sort of shocking to me as I sort of, even as a doctor, that I found this sound like, what do you mean? They don't, they don't publish all the data. Like they just hide all the negative data. Yeah. You can do the negative data. Yeah. You can do that. Yeah.

Yeah. And that's how it is. So, so for people listening, it's, it's, you know, you've got to be smart on your own and you've got to be your own advocate and you've got to be proactive about your health and you've got to not just take things at face value and you got to do a little digging and now with AI, it's going to be easier and easier with Dr. Chad GPT, you should be Dr. Google, but not always right, but it's at

least a good start. You know, one of the things you always talk about in your book was this whole idea of, of blood tests that are not being ordered that everybody needs. And I thought that was really intriguing because I just co-founded a company called Function Health, which is a health platform

and allows you access to your own health data and lab testing without having to go through a doctor or insurance company. And you get, you know, for 499, you get over 110 biomarkers would be $15,000 retail. And there's been huge consumer interest. We're like 60,000 members in the first year. Uh, and we had 10 million biomarkers.

Fascinating. And, and it's, we're, we're doing a lot of tests productively. Now you and I know when we went to med school, we were like, only test to confirm a diagnosis that you've already made through history, right? Diagnosis history, history, history. And yet you're saying maybe we should be

reconsidering this because there may be things that we can do proactively and practice more proactive, preventive, predictive medicine than reactive medicine. Can you tell us about what you're thinking there and what these tests are? Yeah. So, um, a buddy of mine, Will Brun, uh, just

graduated from medical school at, uh, I don't know if I should say that school, but it's in the South and he basically, um, said he got two hours of, uh, teaching on all of nutrition and cholesterol and lipoproteins basically. And in those two hours, and he got eight hours on a bunch of nonsense that he can't, you know, the disparity is unbelievable.

The, um, two hours on nutrition, he said it would have been better not to have those two hours because there was so much misinformation in him. All that was was. He looked like that. HDL is good. Yeah, exactly.

Oh, go forth, preach to the world, you know, check their total triglycerides. Turns out lipoprotein A and apoprotein B are very good predictors, at least better than the current old crude predictors of people that have early heart disease, looking for general body inflammation. The tests aren't great, but I get a highly

selective C reactive protein, um, sed rate, not very good, but something. So trying to measure general body inflammation, the deposition of the types of lipoproteins that result in that plaque buildup. And when you put that together. The lipoprotein fractionation? Yeah.

Lipoprotein fractionation, the high density particles, LP little a. So looking at the quality and number of the particles, not just the weight, which is what you get on a regular cholesterol test, which in my view should be banned. It should, it's such little useful information. It's misleading. It is.

Yeah. And when somebody has an early heart attack in their forties or early fifties and it shocks everybody, sometimes we'll go back and get that test and it turns out their LP little A was up or the APO protein was up, even though the other numbers showed that things were okay. So next time somebody gets to set a lab test,

I usually tell them, make sure that you've got that tested for at least once, LP little A, at least once it's a lot genetically driven. Um, 99% of cholesterol is made by your own body. And so these are some basic things that people can test for. And then I, I'm really fascinated with the micronutrients and allergy testing. And I, and that's something where you've got more

expertise than I do. Yeah. Yeah. Right. True. You mean, you mean, uh, like true allergy IGE, or you mean like more food sensitivity testing, food sensitivity because. And nutritional testing.

Nutritional testing, because we've had this dogma from the American Academy of Pediatrics starting 24 years ago that don't feed young kids any peanut butter related stuff, milk, eggs. There was this one, two, three saying, have you heard of this? Like your kids should get milk at age one, you can introduce a little bit of eggs at age two and then peanut butter

at age three. Well, you got it so backwards. Yeah. Peanut butter should get introduced a little bit, not in place of breast milk, but a little bit at age at four months, five months, six months, as soon as the kid can eat. There's the studies have even shown that five

months prevents peanut allergies more than introducing it at six months, six months, as soon as the kid can eat. There's studies have even shown that five months prevents penile allergies more than introducing it at six months, four more than five. And so it, there's a strong association with what we call oral tolerance. And that's what the American Academy of Pediatrics got perfectly backwards when they told lactating and pregnant mothers, total penile abstinence for you and kids zero through three, they didn't prevent

penile allergies with that recommendation. They caused them. So we have evidence-based medicine for the things we want to say, we prove and we, for the things we have no evidence on, we say that we say them with such authority that they act like they have evidence, but they don't. Well, that's the thing.

If you're going to put out a strong recommendation, either say, you know, this is don't. Well, that's the thing. If you're going to put out a strong recommendation, others say, you know, this is based on just me shooting from the hip here. I don't know. Or reverse it once the study comes out, showing that it was wrong with the same vigor that you put it out when the study came out in the New England

journal, 2015, what's that? Nine years ago, showing peanut avoidance causes an eightfold increase in peanut allergies. Yeah. Say, gosh, we got this so wrong as an academy, we need to tell the world instead. They kind of fade out, you know, get the low fat diet wrong for 60 years.

It kind of fade out, you know, get hormone replacement therapy wrong. Just kind of fade out. Where's the humility? Yeah. Yeah. Right. Oh, shoot.

We got it wrong. Like let's, let's may a culpa like let's, let's set the record Yeah. Right. Oh, shoot. We got it wrong. Like let's, let's may a culpa, like let's, let's set the record straight. Right. It's crazy. And you know, the test you mentioned the, the APOB, which is a, only a measure of small dense particles and all the bad particles that cause

heart disease and LPA, which is a, a marker that's genetic, but also increases your risk. The particle size and the number of life approaching fractionation, the sense high sensitive CRP. These are all tests that are just part of the standard function health profile. And we also test all the nutritional stuff. We're finding that 51% have abnormal APO-B.

We find that 40, 89% have abnormal lipoprotein particle size and number. We find that 46% have elevated CRP. This is in a health board population and 67% have a deficiency in one or more nutrients. And this is not at the level that would be optimum for health, but the minimum to prevent a deficiency disease. So a ferritin of 16, not an optimal ferritin of

45, for example, or a vitamin D of 20, not an optimal vitamin D of 50. And, and so we've been fighting this in the population. And, and so I'm a big advocate of, of test, don't guess, and of knowing your numbers and of actually being proactive about optimizing them. Cause they may not cause an immediate issue, but, uh, there was a brilliant, um, scientist,

uh, Robert Heaney, who was now dead, there was a brilliant, um, a scientist, uh, Robert Heaney, who was now dead, who was a vitamin D researcher. And he wrote an article a long time ago called long latency deficiency diseases. And it was fascinating because he talked about, well, if you have like, you know, acute, um, you know, uh, folate deficiency, you'll get megalblastic anemia, which is for type anemia.

But if you have like low grade, like low folate, you might get dementia. Or if you have like, you know, a little bit low on an optimal vitamin D, very low, you'll get rickets if it's acute deficiency. But if it's a little over your lifetime, you'll get osteoporosis, long latency deficiency disease, and it goes over nutrient like this.

And it was fascinating to me and it really changed my thinking about being more proactive because you're optimizing the body's systems and they all have to be functioning and, and it's, it's amazing to me how many doctors don't even think about this, don't know about it, aren't educated about it. And I mean, even asking my daughter, you learn about lipoprotein fractionation in medical

school, which is like, should be the goal of standard. I mean, I mean, I shouldn't be telling you his tales, but I was at Cleveland clinic and there's a, there's a doctor there who wonderful man, but he, you know, he's older and he developed the executive health program. I don't think he's there anymore, but I met

with him and I said, listen, you should update the second health program to include the lipoprotein fractionation because it's a much better representation of cardiovascular. So you have some with a normal, perfectly normal cholesterol under 200, their LDL under a hundred, their triglycerides normal, HDL looking like 45, 50, everything looks great,

but they could have the worst particle and size and density that you could imagine and be at very high risk. And he's like, well, you know, we only like to introduce things after we have a lot of research. I said, well, this has been around for 40 years. I've been doing this test personally for 30 years. Ronald Krauss developed this at.

It's been around. Yeah. And he's one of the most brilliant limitologists in the world. I'm like, you know, this is so slow to adopt actually the science into what we know. And people are suffering because of it. And that's kind of why I think, you know,

some of these things can be solved from the inside, but like you said, some of this has to be solved from the outside. And we need, you know, some of these things can be solved from the inside, but like you said, some of this has to be solved from the outside. And we need, you know, we, we need philanthropy. We need, you know, better policy regulations. We need better, uh, you know, reimbursement around medicine that pays for the things that actually work like food is medicine.

You know, we, you know, we need to have companies from the outside changing things from the inside. So it's pretty, it's, it's, it's kind of an exciting moment, but like you're like, you know, like, you know, the wizard of Oz when the curtain gets pulled back, you're that guy, you're like, you're the guy pulling back the curtain. And it was

like this little old guy back there with no pants on. Yeah. And it's, it's, uh, it's quite amazing what you've done. Well, you know, I go around and I talk to so many experts and I ask them, is there dogma in your field that is wrong or has been proven wrong or you believe is wrong, but it's still heralded out there as science when it's really just the way we it's been done.

It's just sort of custom and they start unloading and they start telling you things. And actually the lipidology community has evolved entirely independent of the cardiology community. So the cardiologist kind of claimed lipid science at a certain point, but the lipidology community is like, Hey, wait a minute, we've been studying this for a long time with hyperlipidemia and they have very different views on things.

So for example, lipoprotein A testing was recognized in the lipidology community as saving lives, as you mentioned, but not in the cardiology community, because all their tests just use the crude LDL. Right. So I went to the, um, head of the cardiology lipid center at Hopkins and I asked them, I said, I've been reading about LP little A,

seems like it should be this subject of a massive universal public health campaign to get everyone to get it done. It'd be a lot better than trying to get a defibrillator in every bathroom in the mall, you know, which is actually a real campaign Hopkins champion. And so.

Saves lives for sure. But. Saves lives, but like, here's something that's so, RCC is the number one cause of death. So he acknowledged, yeah, there's some new research and we, we did put it in our new guidelines. I'm like, you know what it was, I read those guidelines, American Cosmeticology.

It was a footnote. Like where's the enthusiasm? Where's the vigor? Where's the, it's just like molasses sometimes. Yeah. Well, cause there's no good drug for it. Right. I mean, there's plagmapheresis, there's

certain supplements that work. Sometimes the PS, CSK9 inhibitors lowered a little bit, but it's, it's, uh, you know, it's, it's a harder to treat problem. And we're very, very excited about testing things for which we have great drugs because the pharmaceutical companies, you know, make it easy for us that they do all these studies, they have

their drug recs come, they, they have great commercials that tell the patients what to ask for. Yeah. There is a drug in phase three clinical trial that targets lipoprotein little A. So we'll see what the results of that show. Um, but I wonder if, you know, those are the people you want to just be more

aggressive on maybe. Yeah. And totally track. And maybe you get the cardiac, uh, CT angio on them instead of just a calcium score. Yeah. You know, those are the ones. Well, with function health, we had a young 35

year old who did the test and he had high APOB, he had high LPA, he had really horrible lipid particles, the rest of his cholesterol, normal cholesterol profile looked pretty good. And you know, he was 35 and we sent him for a CCTA, but corner your intracranial with a CT scan, but we added the AI interpretation with a test called clearly.

I don't know if you've heard of this test, have you? No. It's really amazing because you actually can see soft plaque, inflamed plaque, not just calcified plaque, and you get a much better read on every artery. And.

Found a plaque. But. You found a plaque. Yeah. And yeah, and this guy's 35 and he's headed for a heart attack and he had no clue cause he was thin, he's healthy, he's fit, he exercises, he eats great.

It's like some genetic thing going on. And, and so, you know, we're often kind of walking into our futures without any idea of what we're heading into because, you know, we're not taking advantage of the latest science. And, and I mean, I wrote a book like more than 20 years ago where I was talking about APOB and LPA and CRP and testing insulin.

I mean, insulin is another one of those tests. Insulin. You know, thank God quest now has a test. It's called the insulin resistance score, which uses mass spec to measure insulin C peptide, which is a, I mean, your pancreas guy, I don't tell you, but it's telling your audience it's, it's, it's the precursor

of the insulin molecule. And, and when you get this ratio, it's as good as what we call euglycemic clamp test, which is the gold standard, it's a very invasive test that you do in the hospital for insulin resistance, but it's as good as that test and it's cheap and it's something other than what you get because it is the biggest driver

of cancer, heart disease, diabetes, dementia, and even linked to depression and fertility, acne and a bunch of other stuff. Even low sex drive and erectile dysfunction. And I mean, you name it. And yet nobody's doing that test. So I asked Quest, like how many people are getting lipoprotein fractionation?

Like less than 1%. How many people are testing insulin when they are doctors order insulin? It has less than 1% of our tests. I'm like. Tell them we don't need AI. We just need AI. Just need some basic.

Well, I actually, I should talk about this. I don't know if it's not right, maybe in your wheelhouse, you can tell me, but, um, I've kind of come up with this new concept, uh, what I call MI and not am I like heart attack, but am I like medical intelligence? Well, it's just something we don't have, we have a single doctor that you rely on for his own experience, however smart they are,

whatever they've learned, whatever course they went to, whatever school they went to, whatever residency they went to, like that's what you're getting and, and they haven't certainly read all 10 million papers on PubMed. They certainly haven't read every textbook and article about every disease and, and you're, and they haven't certainly read all 10 million papers on PubMed. They certainly haven't read every textbook and article about every disease and, and you're, and you're kind of relying on their goodwill and

intelligence and kindness to figure out what's going on. And, and, you know, we do a pretty good job most of the time, I would say. But you know, it feels like we're entering this moment in healthcare where we're going to be able to draw through technology, all of the world's scientific literature that it consume, every single textbook, you know, up

to date, all the latest medical knowledge, patient reported data, all their lab data, all their omics, all their imaging, all their bios sensors and wearables, all their medical history to track it over time. You know, what Lee Royhood calls dense dynamic data clouds of information that give you personalized predictive models of where you're headed and what to do about it.

To me, you know, having that, being able to sort of inquire to that, that, that your own data set, uh, about what, what's really going on and see those patterns and the correlations that, you know, the average doctor is going to miss. I mean, would you rather have your dermatology exam by, uh, you know, an AI, uh, computer or by a dermatologist.

Like I went to a dermatologist and I'm a doctor. I know I had a pre-cancerous lesion and, and he completely missed it. And he was like the head of, you know, I don't know, dermatology at a major academic, uh, you know, medical school. And I was like, I want to go to the top guy and give him a down professor.

And he basically, you know, he looked at me, like, turn me around, looked with his eyeballs. I'm like, no magnifying glass, no lights. I'm like, God damn, I'm not, I want to go to the top guy and get my down professor. And he, you know, he looked at me, like turn me around and looked with his eyeballs. I'm like, no magnifying glass, no lights. I'm like, God damn, I'm not, I know better than this and I was like, and I was like, it's a walk out, so disappointed. And I'm like, you know, so what do you think of this idea and could this really change things?

Cause then all of a sudden all the things you're talking about will bubble up. Like the, the, the, the, the pharma, uh, and, and the medical industrial complex won't be in charge anymore because you've got, you know, free access to data and information that's been locked away. I tell all our Johns Hopkins students and residents that what will make you a great doctor

is knowing your limits. It's your humility. It's saying, I don't know when that's the right answer, and that was the right answer during COVID a lot of times we didn't hear it. And so when I talked to a pediatrician and ask them about, uh, peanut allergies, you'll have somebody who will just recite a catechism.

Well, according to the guideline of the American Academy, you know, somebody else will think independently and creatively and they'll say, you know, there's a guideline out there, but there's this study and I've heard doctors suggest this and this has been my experience and I'm not sure, or this is what one mentor thinks. This is what that is a creative, that's a doctor you want, doctor who thinks independently and isn't

just, you know, falling in line with some dictum that says everyone obey and get in place. When we, as a medical profession have used good scientific studies to make broad health recommendations, we shine. We help a lot of people. But when we wing it, when there's broad health recommendations made by a small group of people who are just ruling on it, on an opinion and making it sound absolute, like it's scientific data. We have a terrible track record.

We ignite epidemics. We ignited the opioid epidemic saying opioids were not addictive. The pain is the fifth vital sign. Pain is the fifth vital sign. And these are manufactured, the peanut allergy epidemic, you go down, down the, down the line, even you could argue the low fat

contributed to obesity rates. So I don't think you can argue that. I think that's pretty much a fact. You don't need AI, just die for that. Yeah, no, it's true. And then we get stuck and don't want to say that we made a mistake either. That's the key.

That's the key. And patients are very forgiving if you're honest in real time. Yeah. I have a side of a friend of mine that, you know, if you're a doctor and you tell the patient the truth and you say, I don't know, or I fucked up, like they're less likely to sue you than if you just try to hide, hide what's going on.

Right. And we're kind of trained to kind of circle ranks and hide and not telling each other. And I'm so impressed by you because you're actually out there saying stuff that I've been saying forever, but I'm like, kind of, you know, on the fringe, you're, you're in the center of the belly of the beast.

I've, um, I've ushered so many people to the afterlife in the ICU and, you know, I've done a lot of care and, you know, on the fringe, you're, you're in the center of the belly of the beast. I've, um, I've ushered so many people to the afterlife and the ICU and, you know, I've done a lot of cancer care that I'm constantly reminded how life is short. And these folks that are just afraid of what somebody's going to think, if you just speak and your honest opinion, I don't think that's healthy.

And that's what we need more of. And so, so in, in the policy realm, because you've mentioned how your book really helped shift some policy around cost transparency. Yeah. You know, what are the other big levers besides fixing the NIH and putting it in a national institute of nutrition and funding the right

research and getting rid of all the kind of old cronies in there that just kind of don't want to get the kind of new science out there. What, what actually can we do on a policy level? Cause I'm curious. I have a nonprofit that works on food policy. I mean, I actually going to be doing a hearing in front of the ways and means committee on September

18th, uh, in front of the health subcommittee that's in charge of all Medicare and reimbursement. Um, you know, and, and like you were talking about, like, for example, about diabetes and I had, and, uh, spent the afternoon with Sammy, who, who started Virta Health and they, they really deeply studied that they could save $6,000 per patient after costs by putting them on this

program to reverse diabetes and they reverse diabetes, which is not something the ADA even basically recognizes as something you can do. And if, if Medicare implemented this overnight, it would save a hundred billion dollars. Yeah. It was like that. Boom.

Because there's 16 and a half million people on Medicare, uh, who have diabetes. Sammy's the endocrinologist that started Virta? No, Sammy is a, is a, is an entrepreneur who is an elite athlete who found that he had metabolic syndrome because he was using all these sports

goose that are full of sugar to fuel his endurance athlete, uh, performances. And so he was like, what's going on here? And then he basically trained and did a cross, uh, the ocean row from California to Hawaii, doing a keto diet and show that you could, you could do it. Um, and he rode from California.

Roe boat with his wife. Wow. Like robo. I mean, I don't think it's not safe, but it was do it. Um, and he rode from California. Road like rowboat with his wife. Wow. Like rowboat guys. Safe. I mean, I don't think it's not safe, but it was hardcore. It's at like 20 foot seas. It was pretty rough.

But, but the point is that, you know, I'm having this hearing and, and I, I, I imagine it's going to be very tough to, to get Medicare reimbursement for a program like that, even though the data is so clear, even though they've shown that it proves all the lipid parameters, it's like, it's sort of the opposite of what you'd think by being, eating only fat, right?

It's, um, the policy world is tricky because there are so many things we can do without the government that we're not doing. For example, the Virta, um, company that you mentioned, and I had met with the endocrinologist who was one of the, I think, co-founders or something, and he showed me that data. It was super impressive who was one of the, I think, co-founders or something. And he showed me that data.

It was super impressive. See, the Phinney. I think that was him. Yeah. Super impressive data. Just like you said, this is clearly something we should be doing and it fits the whole, what we've known and seen on the ground as doctors

for many years, and that is the hard part of treating chronic disease is not telling people what to do, it's helping them do it. Behavior change. It's behavior changes, checking in with them. It's being their friend. It's going along the walk with them. If I tell, I see somebody smokes on their chart.

I don't do what I used to do and tell you, yeah, you should stop smoking. You're going to die. Now I ask them, you know, some people. Let's go outside and have a cigarette. I'll tell you, do a talk. Almost, I almost do that. I say, some people really don't want to quit.

They don't want to talk about it. And other people really want to. Where do you stand? And whatever answer you say is okay with me. Most people say, I don't want to talk about it. And you're not going to affect them no matter what. But then you meet somebody that says, I just had a granddaughter, I'm dying to quit.

We should put all of our energy in to help them with medication, behavior, all that. And that's what Virta's doing. It's saying if you want someone to help and go down this walk with you and help pick foods and manage your diabetes instead of just pumping insulin in, we're going to be there for you. And those are the solutions that in the private sector, employers that pay for healthcare, what we call ERISA plans, Employer Sponsored Healthcare plans,

they're saying, you know, I'm gonna make Virta available to my employees at this company. I'm gonna make Teladoc. I'm gonna make, and they're piecing together what we call these point solutions. So now you can be creative and come up with a fruit as medicine program.

You don't need to wait for Medicare and there are 50 bureaucratic red tape steps and you can go, go to work right away. And that's the exciting thing. That's why I'm so optimistic about some ray of hope in this broken healthcare system. Cause employers are, are standing up and they're, they're saying yes to the challenges.

So they're in the financial incentives are aligned. The, the payer, the, the, the privately insured large corporations who are footing the challenges. So they're in the financial incentives are in line, the private, the payer, the, the privately insured large corporations who are footing the bill. They are, but at the same time, they see the demand for this. And if there's demand, they want to make those employees happy because they want

to attract employees. Fertility services. Is there a ROI on it? No, but they know there's demand for those fertility services. Is there a ROI on it? No. But they know there's demand for those fertility services. So that is now enabling smart people to say, hey, this makes sense medically in terms of improving health. Let's do it. Let's try it. Let's do a pilot. And it's happening fast. Like we don't have to wait. These diabetes alternative, these companies now,

they're not anti dialysis. Sorry, I meant dialysis. So in dialysis, we have a system where we just kind of let people go into renal failure. Then we put them on the machine. Well, what about actively getting them to avoid dialysis before they become dependent on it? Yeah.

So there's a couple of companies now, they're not the big ones and they are actively working And if they can avert one patient becoming dependent, it pays for itself. So this is the exciting stuff right now in medicine. Yeah, that's true. I mean, I, I, you know, with aggressive lifestyle intervention, you can reverse phenol insufficiency. You can. And I, and I had a patient who was like, you know, typically insulin resistant, you know, you know,

you're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. You're not going to get any more. Yeah, that's true. I mean, I, I, I, you know, with aggressive lifestyle intervention, you can reverse phenol insufficiency.

You can. And I, and I had a patient was like, you know, typically insulin resistance and cardiovascular disease and hypertension and kidneys starting to fail as GFR, which is the measure of kidney function was going down and kidney level tests were going up and. You know, I put him on a program and he

lost weight, he did amazing, got on a program and he lost weight. He did amazing, got the inflammation down and his kidneys normalized. The protein went out of his urine and his nephrologist was like, what the hell did you do? I've never seen this before. This doesn't happen. It's not possible.

Like, well, what's going on? Like, and we don't see it cause we don't know to tell people what to do. Like we just don't have the knowledge or education and it goes back to your licensing exam. That's one of the things we're working on is also changing the licensing exams, getting

ACCME to change those requirements. Graduate medical education, we spent $17 billion a year from the federal government paying for these residency programs and fellowship programs. And we have no strings attached about how that money is used or what they're teaching or anything like, and so we can put some guardrails on that.

Yeah. Uh, you know, it's, it's amazing. You're, you're, your work is tremendous. Um, I'm, I'm super excited about it. Um, Marty Macri from Johns Hopkins written so many books, his latest one is Blind Spots, When Medicine Gets It Wrong and What It Means For Our Health. Uh, you will not be sorry to read these books.

You will educate yourself, you will become empowered. And I think what you're doing is speaking out, telling them through, speaking truth to power, and actually empowering patients to learn how to become, uh, agent, have agency over their own health and do what's right for themselves and not be just at the sort of whims of a paternalistic system that has immense, uh,

financial, uh, perverse, uh, incentives and immense corruption. And it's not giving us what we need to know. So thank you for speaking out. Thank God you're there and doing this work. immense financial, uh, perverse, uh, incentives and immense corruption. And it's not giving us what we need to know. So thank you for speaking out. Thank God you're there and doing this work. I've loved having you on the podcast. Any final words or thoughts and advice for

listeners about how to navigate all this? That was great to see you, Mark. Keep up the great work. So, um, you know, I felt like there's so much new research that is directly speaking to these blind spots in medicine that people should know about it, not just in the medical community, but if my colleagues are fascinated by some new research that I'm

presenting to them in a lecture, some of that research has direct implications for everyday folks out there. And so that's why I put this book together. So I hope people enjoy it. Well, thank you. You can find it everywhere you get books. It's out there. And so that's why I put this book together. So I hope people enjoy it. Well, thank you. You can find it everywhere you get books. It's out there now.

Uh, and you can go to Marty, um, uh, Macri and just check, check out his work. His website is MacriMD.com. Marty MD. Yep. Oh, Marty MD. Okay. MartyMD.com.

Sorry. I should let you say what do you have social media? What is that? I'm on Twitter. It's a bit of a nasty place, but I try to encourage people on it and LinkedIn a little bit. But great to be with you.

So thanks so much, Mark. Okay. I can't wait to have you back for your next book. And I think there were like 4,000 tops we didn't cover. So get the book, check it out and. Push the field. Yeah, let's go.

Thanks so much, Marty. Great. Thanks. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at Dr. Mark Hyman.

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