The Dr. Hyman Show - Exclusive Dr. Hyman+ Ask Mark Anything: Stomach Acid, LDL Cholesterol, and More

Episode Date: June 27, 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 Harshal Porth. I'm the Dr. Hyman Plus community manager and I'm joined by Darcy Gross. Hi, Darcy. Hi. Darcy's one of the producers of the Longevity Roadmap docuseries. And of course, we're here with Dr. Mark Hyman. Hi, Dr. Hyman. Hi, how's it going? Going well. So we're here to ask Mark anything. So let's go ahead and get

started. So we have a fun one to start with. And we're going to need to know what is at the top of your playlist. What song do you have on repeat? And I'll tell you why, so that everybody can go to Spotify or Apple Music and download it immediately. So you got to let us know which one it is. Well, I would say, you know, my top of 2022 was as by stevie wonder one of my favorite songs ever which is um you know the one of the lines in there i'll be loving you always but it's got a great

little stanza in there about how you know we we are exactly where we're supposed to be and we can heal ourselves if we kind of pay attention to what's going on and how our troubles often are the answers to our problems. So it's really, it's actually a great song. Love it. Love it. And is that the one that you continue to have on your playlist or do you have a new one for 2023? You know, I kind of, I'm kind of just listening a lot to the dead and company actually dating myself, but I love eyes of the world. That's one of my favorite songs. And Franklin's tower probably would be right up there. It'd be the most listened to song. It's like that grateful dead song roll the way they do. You know, it's like, it's like really great. Awesome. So we, we know everyone's on their way right now to download.

So thank you for sharing that with us. And we'll go over to Darcy for the next one. All right. So jumping right in. The next question is all about stomach acid. So we've talked on previous Ask Me Anythings about having too little stomach acid, too much stomach acid, which sounds kind of crazy, but it happens. But how do you know? How do you know if you have too much, too little? And then of course, if you could just reiterate what the functional medicine approach to treating that would be. Well, there's, you know, it sort of goes into the whole topic of reflux, heartburn, digestion. As we get older, we tend to get less stomach acid, something called achlorhydria or low stomach acid.

And there are tests, Heidelberg test, which is a kind of a fancy test you have to do in a hospital to look at your stomach acid. And often when you have low stomach acid, you're not absorbing nutrients as well. You're not absorbing particularly vitamins like B12, minerals, and you can end up pretty nutrient deficient. So being aware of this as a problem in medicine is important. And most doctors don't really understand how to treat it. There are specific treatments. People will often notice that if they have low stomach acid, they might have bloating, they feel poor digestion, they might have undigested food in their stool. They might feel like they're just uncomfortable after they eat. And that's, that's a problem. There is a test you can do to kind of see whether or not there's a problem. And we, we can kind of treat you with this

compound. It's called beta, beta-ion hydrochloride or B-A-T-A-I-N-E, not like beta-dine, like the antiseptic, but the beta-ion hydrochloride. And that actually can be taken before you eat. And we often will do a loading challenge where you start with one pill, go to two, three, four, five, six, seven, eight, nine, 10, whatever, until you start to feel a little warmth or burning in your stomach, that's kind of your dose. So some people initially may need like three, four, five, six capsules. Sometimes you may need less. And then you can use that before meals and see how it affects your digestion. Often we combine that with digestive enzymes as well.

So it's a way for people to sort of see if that's a problem. There may be younger people who can get it as well, and it's often underdiagnosed. There's also too much stomach acid, which can often be from poor diet. And reflux is something I've written a lot about. You can go on my Dr. Hyman blog and you'll find probably a dozen articles about reflux. I've written a textbook chapter on it for, on a functional medicine approach to reflux. And it can be a very easily treatable problem if you remove the foods that tend to be an issue, which are the opposite of the things that conventional medicine recognizes like caffeine, alcohol, spicy foods, tomato-based foods, citrus foods, fatty foods, fried foods.

Those tend to sort of trigger things. And I know, for example, if I go and have a pizza or something off the street, which I almost never do, I'll get heartburn. It's not hard to get heartburn as soon as you eat the wrong stuff. So it's often fixing your diet. Then there's looking a little bit deeper. Could it be bacterial overgrowth, fungal overgrowth? Could it be a problem with low magnesium status? Could it be H. pylori bacteria? Could it be a food sensitivity like gluten or

dairy or other things? So there's other triggers for it. And then you have to treat the cause. And obviously removing the bad foods that are causing it and sometimes uh you know treating the underlying issues like h-pylori with a antibiotic or a series of herbs so there's there's many ways to actually address this i detail them a lot and we can you know kind of go through some of it but it's um you know i'll use glutamine which can be very helpful if you have stomach acid as a substance. I actually often use a cocktail for metagenics called the glutagenics, which is glutamine and aloe and licorice. And you can also take licorice, chewable licorice tablets called DGL or deglycerized licorice, which doesn't raise blood pressure. It takes out some of the things that can cause a problem with licorice, but it actually allows you to sort of soothe and coat your stomach like Tums. So you can take that before you eat as well.

So those are some of the suggestions that I have for people, but there's a lot more. Yeah, for sure. That's super helpful. Thank you, Dr. Hyman. And over to you, Herschel. So we know in previous episodes, you talked about what someone can take after surgery to sort of help them with the recovery. But do you have any specific nutritional recommendations that can help following an orthopedic surgery? So for example, this community member had a knee replacement surgery.

Is there anything they should have to promote, let's say, bone health versus like cartilage repair? Yeah, I mean, it's really mostly the same, which is providing your body with the raw materials to help it heal, which is particularly adequate protein because your body has much higher protein needs after surgery for tissue repair,

a high quality protein, often animal protein or whey protein. Want to make sure you're taking plenty of zinc, vitamin C, vitamin E, glutamine, which can be really helpful in tissue and healing repair. So those are sort of some of the most important things. Bone broth is a great substance. It has a lot of minerals and nutrients as well as lots of extra protein.

So there's some simple things you can do there. I think really dealing with some of the inflammatory stuff can be important. So a lot of herbal therapies I'll use like xyflamen, which is a cocktail of different anti-inflammatory herbs, or curcumin, boswellia, which is another herb also known as frankincense that can be very helpful for inflammation and joint issues. Actually, there's a product called Root. I think I have root. I think I have a friend of mine made it, which is kind of like a natural anti-inflammatory and it's got a ginger and ergothionine and turmeric and, um, berberine, which are all sort of natural anti-inflammatory compounds. So there's all sorts of stuff with one I like to call root. Can't really see it, but or we'll be sure to put the link in the show notes so that that's super helpful.

Thank you. Over to you, Darcy. Awesome. Similarly, the next question is, in a general way, which foods help repair cells and set cells up for regeneration? So like, for example, skin burns or skin issues, if you're trying to heal or help your cells repair, which foods or what, how would you approach that? Well, you know, your body is really intelligent and it has built-in systems for repair,

healing, renewal, regeneration, and they have to just be fed. And so, you know, one of the things, you know, we did see in medical school, I think I've talked about this before, when people really have poor diets, their tissue is really bad. When you sew them together, basically the sutures just kind of pull through the tissue. It doesn't hold. And we had a really kind of derogatory name for it in medical school.

But it basically is people who like really crappy diets. And it's amazing what happens on the inside, not just on the outside in terms of how you look. So having really high quality nutrition is important as we just talked about, like lots of protein if you're healing and repairing, good quality fats, omega-3 fatty acids are essential for tissue and wound repair, zinc, vitamin A, vitamin C, glutamine, we talked about all these things are really important for for the body to repair and heal so making sure you have adequate micronutrients macronutrients in the forms of protein fats and also um making sure you're you're uh um cutting out all the stuff

that's going to be inflammatory like all the ultra processed foods sugar starches are all really the things that tend to cause poor wound healing. Yeah. Thank you. That's helpful. Over to you, Herschel. So there's always different diets that are out there in the news. And of course, our community wants to know what you think about all of them. So this time they're asking about the MIND diet. Do you know what the MIND diet and how does it compare to the Mediterranean diet? Is there anyone who should consider this MIND diet? compare to the mediterranean diet is there anyone who should consider this mind diet yeah absolutely mind diet is based on some research that was done um and it basically it stands for mediterranean dash diet intervention for neurodegenerative delay

or mind and the mediterranean diet is essentially people are familiar with it. It's like fish and olive oil and nuts and seeds and lots of vegetables. All those are really, really important. And the DASH diet, it tends to be a lower sodium diet. It's designed for dietary approach to stop hypertension, D-A-S-H. And this is designed to sort of be combined with the Mediterranean diet as a way to help improve cognitive function. So there's been some interesting data on this. Looking at, there was a Rush Memory and Aging Project where they looked at people who are free of dementia, and they put them on checks and they followed their dietary questionnaires. And they could

see if their diets were either brain healthy or not healthy. And it wasn't an interventional trial, but the people who ate more toward the Mediterranean dash diet approach were actually better in their cognitive function. So it's, you know, whole grains, it's lots of veggies, it's six servings of green leafy vegetables a week, uh, lots of nuts, beans, berries, poultry, fish, olive oil, um, and getting off of the junk, which is obviously the sugar, the starch, processed food, fried foods, and all that. So, uh, I think, I think it's helpful. What I would say is, you know, I always joke and say, compared to what? So if we look at kind of the American Heart Association or Diabetic Association diet compared to the standard American diet, it's better.

But is it better than, for example, a well-designed food is medicine, functional medicine, anti-inflammatory diet? Probably not, right? And so when you look at, for example, data on Alzheimer's and cognitive dysfunction, using ketogenic diets might even actually be better. So yes, while this is an improvement and it certainly leads people towards better cognitive function, I don't think it's the be-all end-all for the best diet for your brain. It's certainly a better diet than the standard American diet but i i think um you know

and the data was impressive you know it was very helpful but and it's not a rigid diet it's just sort of some guidelines around what i just mentioned um so i think um i'm not super impressed with it to be honest with you and i wouldn't use it as a way to treat my patients who have neurodegenerative disease but but I think it's definitely an improvement on their traditional crappy American diet. Yeah, that's super helpful. And I think that's such an important point when you say compared to what, so I appreciate that input on that. Darcy, over to you. All right. Next question. What causes LDL cholesterol to oxidize? And of course the follow-up is, are there certain diets that promote more or less oxidation of LDL cholesterol to oxidize and of course the follow-up is are there certain

diets that promote more or less oxidation of LDL absolutely so basically what is oxidation on what is LDL let's just start there so LDL is your LDL cholesterol this is one of the types of cholesterol your body makes to and and it's one that seems to be associated with a higher risk of heart disease when it's high the problem you know but when you look at the data really carefully around LDL, it's not actually elevated LDL that's the problem. It's the overall pattern of cholesterol and it's the quality of the LDL. So if it's large, fluffy LDL particles, not so much a problem. If it's small, dense LDL, it's a problem. And that has to do with the fact that we're eating a diet high in starch and sugar that causes the small particles, and those are the dangerous particles. The other part that we need to remember is that the LDL only becomes a problem if it's oxidized.

What is oxidation? That's when your car rusts or your oil turns rancid or you've got, I don't know what's the other example of it, your skin wrinkles, right? Those are all signs of oxidation. And the oxidized LDL becomes damaged, essentially rancid cholesterol in your blood. And that's what tends to activate your inflammatory system. So there was a really interesting recent paper that showed that even if your cholesterol was high, if your inflammation levels were low, your risk of cardiovascular disease was really insignificant. So it's not just the LDL, it's the inflammation and oxidized LDL causes a lot of inflammation. And then that causes problems with plaque formation. So the key to preventing oxidation is to reduce things that cause oxidation, which is like a

broken record here, but it's our processed, ultra processed, high sugar and starch diet that's low in phytochemicals and healthy food. So it's when you're eating a diet that's highly inflammatory, that's high in sugar and starch and refined oils, you're going to get into trouble. And also, if you have a lot of omega-6s, they tend to oxidize and your cholesterol can be oxidized because of these. So that's a problem. So you want to make sure you eliminate all that junk, culture, processed foods, starch, sugar, junk food, and eat more high quality fats, have more fruits and vegetables, more nuts and seeds, some whole grains, beans, good stuff, basically real food. And you know the ldl

tend not to be oxidized you can actually measure this i just did my cholesterol panel and i have no oxidized ldl i have no myeloperoxidase i have low crp i have low il-6 all the inflammatory markers that you you want to be low minor low thank god so and i don't have any oxidized ldl which i always check so it's important to kind of check it and you can measure it. And even if your cholesterol seems normal, if it's oxidized, it means you need to pay attention to that. And taking antioxidants can be helpful, but it's not necessarily the only way to do this

because the antioxidants that your body makes are actually more powerful. So boosting the source of those through having, for example, things that boost glutathione in your diet, like the broccoli family and garlic and onions can be really helpful. So making sure you're upregulating your body's own antioxidant systems is key. 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 episodes, I guess that's why we call it Dr. Iman Plus, then head on over to the doctor's pharmacy on Apple Podcasts

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