The Dr. Hyman Show - Exclusive Dr. Hyman+ Ask Mark Anything: Creatine, Lymphedema, And More

Episode Date: August 29, 2023

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Hey podcast community, Dr. Mark here. I'm so excited to offer you a seven-day free trial of my revolutionary new platform called Dr. Hyman Plus. For seven days you get special access to all the private content included in Dr. Hyman Plus entirely free. It's so easy to sign up. Just go to Apple Podcast on your phone and click try free button on the Doctors Pharmacy podcast. You'll get exclusive access to ad-free Doctors Pharmacy podcast episodes and functional medicine deep dives where a practitioner dives into topics like heart health, muscle health, insulin resistance, and more to help you understand the root cause of specific ailments and walk you through the steps to improve your health today. You'll also get access to all my Ask Mark Anything Q&As where

I answer the community's biggest health and wellness questions. Because I'm so sure you're going to love this platform, I am offering you free access to all of this content for seven days and a teaser of my brand new Ask Mark Anything episode. Head on over to the Doctors Pharmacy podcast on Apple podcast and sign up for your free trial. Okay, here we go. Hi, everyone. Welcome to another episode of Ask Mark Anything. My name is Herschel Perth. I'm the Dr. Hyman Plus community manager. And of course, we're here with our expert Dr. Hyman. Hi, Dr. Hyman. Hi, Herschel Perth. I'm the Dr. Hyman Plus community manager. And of course, we're here with our expert, Dr. Hyman. Hi, Dr. Hyman.

Hi, Herschel. How are you doing? Doing well. And so we are here and ready to ask Mark anything. So let's go ahead and get started with our first question. So our first question is, is it okay to use creatine in your smoothies every day or only on workout days? Should it be cycled? And this question comes from a community member who has friends that are professional athletes who cycle on and off of it. And they want to know, is this something that everyone should do?

Oh, I think that's a great question. I think the key here is how do we build and maintain muscle? Muscle is the most important thing we need to focus on as we age. There's nobody anytime in their life goes, I need less muscle. I want to be less strong. And as you get older, it's critical to build and maintain muscle. And you need to do that throughout your life.

So the more muscle you build early, the easier it is to keep it and maintain it as you get older. And I think creatine is one of the compounds that can be used to help increase the building of muscle, particularly after exercise, after strength training for example this morning i did my resistance band workout and then i actually took a protein shake with goat whey pecan protein powder which sadly is not available anymore i have some leftover and uh and then actually put in uh five grams of creatine which i do when i work out and i probably work out like that four times a week i'll probably do the shake four times a week. So I don't, I'm not on it all the time,

but it's really good to do, particularly after resistance training. So what bodybuilders do is they use huge amounts of it. And I don't think it's essential to use huge amounts, five grams, 10 grams, if you want to kind of bulk up, you can do that for a little while, but I probably wouldn't do these huge amounts, like 20 grams or more that they're doing

for long periods of time. The one danger is if you have any kidney issues or have any problems with your kidneys, you have to be more careful about protein and particularly about creatine. So I think that's really an important adjunct. So I find like the regeneratively raised goat weight and the creatine together are a fabulous way

to help build and maintain muscle. And I found it really helped for me over the last few years as I began to do more resistance training. Okay, awesome. Thank you for that information. All right, so we're on to our next question. So what is estradiol and how do you elevate it naturally? Estradiol is one of the main female hormones and estradiol is one of three main estrogens that are produced by the body. Estradiol, estrone, and estriol. And estradiol is one of three main estrogens that are produced by the body, estradiol, estrone, and estriol. And there are different phases of life that we produce more or less than. For example, estradiol is more produced in the menstruating phase of life as, for example, estrone is produced more in the postmenopausal phase of life. And these are all metabolized.

So there's no such thing as estrogen. There's estrogens, and estradiol is the main estrogen. It's often produced in way too much amounts because of our current environment and our diet and environmental toxins. So what I often treat in my practice is what I refer to as estrogen toxicity, not truly toxicity, but it's a relative or an absolute increase in the level of estradiol. And why is this a problem? The problem because when you have constantly high stimulation of estrogen, you increase various estrogen-dependent cancers like breast cancer, uterine cancer, ovarian cancer. And these are really common cancers that kill many, many women.

So I think it's really important to actually balance your estrogen now i don't know why you'd want to increase your estradiol unless you're a post-menopausal woman um there are ways to increase it but it involves basically eating a lot of crap alcohol sugar and and those are the things that cause it to go up so too much sugar and insulin resistance leads to fat deposition your fat cells in your belly actually increase their production of estrogen, estradiol in your body. Men will actually get the same thing. They'll get high levels of estrogen if they're not careful with their diet.

If they eat too much sugar and starch or alcohol, they get, you know, beer bellies, they get man boobs, they lose the hair on their bodies. That's because of high estradiol levels. So excess fat on the body makes more estradiol. And that's why we used to sort of have this horrible way. We used to talk about women who were at risk for uterine cancer. In medical school, in the 40s, women often have high levels of estrogen because they're not ovulating all the time.

They get higher relative estrogen levels. They get more estrogen stimulation in the uterus. They're seeing moreulating all the time. They get higher relative estrogen levels. They get more estrogen stimulation in the uterus. They're sticking more uterine cancer. But basically, if you're overweight, you're at higher risk because your tissue makes estrogen. So the things that tend to increase estrogen levels are excess alcohol, excess sugar, excess starch, lack of exercise, stress, and also environmental toxins. And there's a whole class of compounds called xenoestrogens, which are environmental estrogens. Very, very small doses will stimulate

estrogen receptors and increase the risk of cancer. And this is pesticides or besides all the plastics, bisphenol A, every kind of petrochemical compound out there, and there's bazillions of them are all in our environment our food our water everything uh and so those actually are things we can reduce our exposure to and help actually to reduce our risk of estrogen dependent cancer so and women often get extra estrogen not just cancer but they get heavy periods clotting bleeding uh they get you know, problems with polyps, all kinds of stuff. So it's really important to balance your estrogen levels. And I've written a lot about how to do this, but it's a, it's a key part of, for women to stay healthy is understanding how to balance

their hormone levels. So if someone was a post-menopausal woman and, and would there be a need to elevate it? Well, sometimes, you know, I think if women are having estrogen symptoms that are perimenopausal, then, you know, that can be, estrogen can be helpful. For example, most of the symptoms that women get around perimenopause are hot flashes, mood swings, sleep disturbance, heavy bleeding, irregular bleeding. And that often is because of a relative estrogen progesterone imbalance, because you don't ovulate every time. And so you end up with more estrogen than progesterone. And so the treatment is often actually helping to reduce the excess estrogen by

the things that I talked about, eating healthy whole foods, flax seeds, you know, whole soy foods, fiber, stopping alcohol, sugar, starch, you know, whole soy foods, fiber, sopping alcohol, sugar, starch, you know, environmental chemicals, and also maybe adding progesterone, sometimes adding a little bit of topical progesterone can be helpful. Often herbal therapies can be helpful. And so we kind of, you know, kind of help them balance their estrogen hormones. But if they get into a period where they're having vaginal dryness, or, you know, other symptoms that may indicate low estrogen states, we test estrogen and we can use estrogen and hormone replacement therapy or hormone optimization therapy for postmenopausal women. And that really requires, you know, I think three main things to think about. One of them should be bioidentical hormones.

So they should be the human hormones that are not horse hormones or some synthetic version. Two, they should be isotopically, not orally when possible. And three, because it misses the liver and some of the toxicity. And three, it should be for as low a dose as possible and just for the time needed. So those are sort of the metrics we use to determine it. But I often use, for example, vaginal estrogen, or maybe a little bit of topical estrogen drops combined with progesterone and or testosterone to help balance out the hormones. But it's very individualized and depends on woman's symptoms and their hormone levels. And we kind of tweak it to be exactly

right. Okay, super helpful. Thanks for all that. So our next question is about emphysema. What can someone do to stop the progression of emphysema and is heavy exercise good for it or bad for it? Great question. Emphysema is usually caused by smoking. It can be caused by pollution. I remember being in Nepal when I was a medical student and visiting some of the hospitals there. And I saw women in their thirties with full-blown emphysema,-stage emphysema we call core pulmonality which is right side of heart failure and big veins all over the body it was really horrible and it was because they were cooking inside without a chimney and so they were exposed to smoke on inside a lot of developing countries they have a lot of problems with this with women because they don't have proper ventilation

um with that said emphyse you know, can also be caused by pollution. There are some genetic conditions that cause emphysema, but primarily it's from smoking. So obviously stopping smoking is the key. If you've already damaged your lungs, there's something called pulmonary rehabilitation or pulmonary rehab. And this really involves making the rest of your body fit as possible so that you can actually be very efficient with your oxygen. So it means increasing your cardiovascular fitness, your muscle fitness, your oxygen uptake, your VO2 max, and that can be done through exercise. But what's often difficult with emphysema patients is they drop their oxygen levels when they

exercise. So the key to partner rehab is exercising with oxygen. So my mother had this because she was a smoker when she was younger. So I put her on the exercise bike and I'd stick oxygen on her, and then she could actually exercise without dropping her oxygen and get fitter and fitter and improve her overall health. At this point, there's no way to really fix pulmonary damage. There may be some way in the future with stem cells or other regenerative therapies, but we're not quite there yet. Okay. Super, super helpful making sure that you have the oxygen while doing the exercise.

All right. So on to our next question, and it's basically if a lab report shows that the sex hormone binding globulin is high, what does that mean? And how can you lower it? Well, sex hormone binding globulin is sort of the regulator of your free hormones. So basically you have free and bound hormone. And free hormones are the ones that do the most activity. They bind to the receptors and the rest of it is bound.

So most of the hormones that you have floating in your blood are bound to sex hormone binding globulin. If it's high, it can be caused by liver disease, hyperthyroidism, by eating disorders, by hormone replacement therapy, by birth control pills. In men, it can be caused because you have lower sex hormones. So there's different reasons for it. But the key to lowering it is really fixing those problems. So, you know, fixing the liver issues or fixing the thyroid, hyperthyroidism or eating disorders, and actually, you know, looking at hormone replacement therapy, but the body kind of regulates, it's almost like the thermostat on

your hormones. So if you have too much hormones, you'll have more sex hormone binding globulin. If you don't have enough, you'll have lower amounts. So it's not, it's not so much of a really, you know, thing, but, but if you, if you increase a dietary protein that may reduce sex hormone binding globulin, if you, you know, drink wine, although red wine seemed to lower it i wouldn't recommend that um so i don't i don't think it's it's really critical high fiber high fiber diet the diets can actually lower it um and and uh you know it really it depends i don't think it's so essential to do this i think we can actually modulate the uh hormones just through lifestyle and diet mostly and not

have to actually treat a specific there's no specific cause other than treating the underlying causes um high cortisol also stress can do it so high cortisol can do it so meditation and those kinds of things can help okay super helpful uh the next question, what is the functional medicine approach to treating non-heart related? Is it lymphedema? Lymphedema. Lymphedema of the legs? Yeah. So there's a lymphedema can be caused by heart failure when you have what we call back pressure.

So if your heart can't pump the blood, then you get edema in the legs and the fluid, the sort of blood backs up and the fluid leaks out of the veins and into the tissues. That's called lipidema. And you get what we call pitting edema. This is not that uncommon with heart failure. And it's often we see when people are poorly controlled. However, if you don't have heart failure, what else can cause it? It can be cancer, different lymph diseases. And so lymph, there's also sort of hereditary lymphedema. It's tough. You need

to use compression stockings. You need to elevate your legs regularly. You need to exercise, which helps to pump the blood out of, I mean, sort of lymph back into the circulation because of it, you know, your heart actually pumps blood around your vascular system, but on your blood vessels, but your lymph vessels, you need muscles to pump the lymph fluid back into the heart and clear it out. Also there's special lymphatic massage that can help. So there's a bunch of different techniques, but it's kind of a bummer condition. Okay. So our next question is about something that the Heart Association put out a while ago. And basically, they said that they felt that broccoli sprouts were an excellent thing that everyone could add to their diet because of high concentrations of sulforaphane

and other key nutrients. Do you agree? And do you feel like they're beneficial? Should everyone start adding them into their diet? I mean, honestly, if I, if, you know, if I had my, you know, wish and I could stamp my fingers, I'd have broccoli sprouts made for me every day. And I actually had some recently, a friend of mine brought them on this boat trip I was on. And I just like munched them down for dinner. And broccoli sprouts are probably one of the most powerful superfoods on the planet. Why? Because the sprouts actually are far more powerful than broccoli or the broccoli family

vegetables, which are already amazingly powerful. Kale, collards, Brussels sprouts, arugula, all that stuff. And when you have high levels of these in your diet, and when you have high levels of broccoli sprouts, which are like the kind of like the Olympic champion, champion let's say of the cruciferous vegetables they have really high concentrations of sulforaphane which reduces the risk of cancer it helps to improve some of the aging processes like so i wrote my book young forever and a lot of the you know a lot of the research points to uh lucifarnan which is one of the compounds in broccoli that helps to regulate some of the aging longevity pathways and instant life. It also, uh, increases glucosinolates and also fluorophanes,

which help with liver detoxification, help with reducing risk of breast cancer, many other cancers helps boost glutathione, which is one of the most important detox anti-inflammatory and antioxidant systems in the body. So it's So it's really quite amazing. And I think, you know, the friend of mine, Doug Evans, who's actually trying to make it really easier to make your own sprouts. And he's going to come out with a sort of automated sprouting system where you don't have to do anything. You just put the things in there and you just, it grows. It's like a garden in your kitchen. And I can't wait till I get that. But I forget the name of it, but it's, it's really, it's pretty great stuff. So you can buy them, you can grow them yourself. It's not that hard to grow. Actually. You can

get a little sprout bread kit and, and you know, they also have high levels of C and B vitamins and other antioxidants. And, you know, it's like, you know, basically it's like if you have 50 cups of broccoli or like a big, you know, bunch of broccoli sprouts, you're getting about the same. So it's hard to eat that much broccoli, but I think they're one of the most important foods you can potentially eat for longevity, cancer reduction, glutathione production, and many other things. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode and get access to ad free podcast episodes, plus Ask Mark Anything episodes, plus monthly functional deep dive

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