The Dr. Hyman Show - How To Treat And Prevent Colon Polyps Using Functional Medicine with Dr. Elizabeth Boham

Episode Date: May 10, 2021

How To Treat And Prevent Colon Polyps Using Functional Medicine | This episode is sponsored by ButcherBox and Paleovalley Colon cancer is one of the most prevalent types of cancer in the United States.... While traditionally a disease of older adults, we are sadly seeing an increase in colon cancer incidence and mortality in young people. Screening for colon polyps with regular colonoscopies is an important way to access your risk of developing colorectal cancer. But what are colon polyps, why do we develop them, and how can we prevent them from forming in the first place? In this episode, Dr. Hyman sits down with Dr. Elizabeth Boham to discuss the Functional Medicine approach to preventing and treating colon polyps. They dive into the importance of eating an anti-inflammatory diet and optimizing gut health to create a terrain in the body where cancer is less likely to grow.  Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing, she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Boham has contributed to many articles and wrote the latest chapter on Obesity for the Rankel Textbook of Family Medicine. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the Functional Medicine approach to keeping your breasts and whole body well. This episode is sponsored by ButcherBox and Paleovalley. New members to ButcherBox can get two New York Strip steaks and two pounds of wild-caught Alaskan salmon for free in your first box when you sign up at Butcherbox.com/farmacy.  Paleovalley is offering 15% off your entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal. In this conversation, Dr. Hyman and Dr. Boham discuss: What are colon polyps and are they all dangerous? How a high fiber diet can lower risk of colorectal cancer and other factors that increase risk of polyp production  How insulin resistance and diabetes can drive cancer development Does eating meat increase risk of colorectal cancer? Is there a difference between processed and grass-fed meat? The importance of good gut health and healthy bowel movements in preventing polyp production and colorectal cancer Screening for colon cancer and polyps Making your body inhospitable to cancer Patients Dr. Hyman and Dr. Boham have treated to reduce risk of colon polyp production Additional Resources: The Functional Medicine Approach To Cancer and Cancer Recurrence with Dr. Elizabeth Boham https://drhyman.com/blog/2020/04/03/podcast-hc4/ What Is Your Constipation Telling You About Your Overall Health And How To Fix It https://drhyman.com/blog/2021/03/29/podcast-hc49/ Is Cancer Caused By Sugar https://drhyman.com/blog/2020/12/02/podcast-ep147/ Is Meat As Bad As We Think: Breaking Down Nutrition Myths https://drhyman.com/blog/2019/08/14/podcast-ep67/ How to Feed Your Gut https://drhyman.com/blog/2018/04/13/how-to-feed-your-gut/

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Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. I say that the most important colonoscopy is to get your first one because that really lays the groundwork. And if you're, you know, unfortunately, some people do have a higher rate risk of making lots of polyps or making these concerning polyps. And you want to know that at a younger age. Hey, everyone, it's Dr dr hyman here now so many of my patients ask me how i manage to work multiple jobs travel frequently well not so much anymore and spend time with my family and still focus on my health i know it can seem hard to eat well when you got a lot going on but the trick is to never let yourself get into a food emergency and to stay stocked up with the right things to support your
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Starting point is 00:02:05 of this deal. That's paleovalley.com forward slash hyman. I definitely recommend stocking up on the grass-fed beef sticks to keep in your house, in your car, and in your office. It's one of my favorite tricks to staying healthy while on the go. I'm always being asked how to source high quality meat and seafood, so I want to share one of my favorite resources with you that I use to get quality protein in my own diet. Unfortunately, most meat and seafood at the grocery store is not really serving our health. Conventional-based animals have higher levels of inflammatory fats, not to mention antibiotics, hormones, and other harmful compounds we just should not eat. And the seafood can be full of heavy metals and other toxins or just lacking
Starting point is 00:02:41 nutrients in general. Don't even get me started on the environmental and inhumane aspects of conventional meat and seafood production either. That's another huge issue that we can improve by shopping more consciously. And that is why I love ButcherBox. They make it super easy to get humanely raised meat that you can trust by delivering it right to your doorstep. ButcherBox has everything you could want, like 100% grass-fed and grass-finished beef and wild Alaskan salmon, and shipping is always free. ButcherBox is committed to humanely raised animals that are never given antibiotics or added hormones since they take out the middleman, you get extra savings. There is a major stipulation I always tell my patients about when it comes to animal protein. Quality needs to be a priority. And with ButcherBox,
Starting point is 00:03:24 you can feel good knowing you're getting the highest quality meat and seafood that will help you thrive. Right now, ButcherBox has a special offer. New members can get two New York strip steaks and two pounds of wild-caught Alaskan salmon free in your first box when you sign up at butcherbox.com forward slash pharmacy. That's butcherbox.com forward slash pharmacy with an F, F-A-R-M-A-C-Y. Now let's dive back into this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's Pharmacy on F, a place for conversations that matter. And today we're having a special house call episode with
Starting point is 00:04:00 Dr. Elizabeth Bohan, my colleague at the Ultra Wellness Center, where we do functional medicine better than anybody, I think. Of course, I shouldn't say that, but it's kind of what I think. And she's just an incredible doctor. We're going to talk about colon polyps today. She's a physician, an MD, an RD, an exercise physiologist. She teaches all over the world and trains other doctors around functional medicine. And it's just an all-around great human being. And today we're going to talk about something really fun, which is colon polyps and colon cancer, which is unfortunately really common and takes people's lives.
Starting point is 00:04:34 In fact, one of my closest friends died because she didn't have a colonoscopy, and it was just a horrible thing. And we now know so much about what causes them and what to do about them. But it's far more than just getting your colonoscopy. And that's what's so exciting. We're going to talk about why we get polyps, who gets them, what to do about them to prevent them, and what do you do if you get them? So welcome, Liz. Thank you, Mark. Thanks so much for having me. It's great to be with you all. So first of all, before you start, what's the big deal with polyps? Because we're told
Starting point is 00:05:08 to get colonoscopies every two years, five years, 10 years, depending on who you are. We're told that these are big deals, but we're really never talked to about how to really think about them from a functional medicine perspective in terms of prevention or treatment. It's just about going to the colonoscopy, cutting it out, or if you have colon cancer, cutting that out and taking chemo and radiation. But there's a whole other world of thinking around this that allows us to be much more targeted in our approach to preventing and treating these things. So talk about what are polyps? Why do we get them? How common are they? And like, you know, what's sort of the general thinking about them? How common are they? And what's sort of the general thinking about them? Yeah, absolutely. So polyps are these growths that occur in the inside of your intestine. So in your colon, you can get these growths that are polyps. And there's all sorts of different
Starting point is 00:05:59 shapes and types of polyps, from adenomas to hyperplastic polyps. And, you know, all of that really influences how risky the polyp is in terms of it turning into colon cancer. So a percentage of these polyps can become cancerous and cause colorectal cancer. And as you mentioned, unfortunately, you know, there's a there's an increased rate of colorectal cancer. It's the second leading cause of cancer death in the United States. And unfortunately, we're seeing real precipitous increase in young people getting colon cancer. And, you know, it's hit home for me, unfortunately, a few times with some really close friends of mine. And so it's something that we want to think about. How do we prevent these abnormal growths from occurring, especially the ones that can become dysplastic or cause cancer in the body.
Starting point is 00:07:07 And there are things that are so common, right? We see such a high percentage of the population having this. And, you know, I've had my colonoscopy and thank God I didn't have any polyps. But it's really common to have these be expressed in our population and i sort of remember medical school learning about this guy named dennis burkett who was a scientist from the uk who went to africa and he studied the fact that there was such a difference in the populations of those hunter-gatherers versus the ones who were still afric, but who'd migrated to the city and were having an urban life and adopted a lot of Western habits. And what he found was that there was like no
Starting point is 00:07:51 colon cancer and no chronic disease in this group of indigenous, basically hunting, gathering populations who were eating their traditional diet. And when they looked at the people in the cities who were adopting a Western lifestyle and diet, they had way more cancers and way more chronic disease. And the thing that he found was fascinating was that the main difference was that the stool weight, in other words, how much did your poo weigh essentially, he didn't want a job to do that, was for the hunter-gatherers, two pounds a day. Whereas for the people who are living in the Western society, it was basically a few ounces. It was like four ounces. So that's pretty funny. And I think that speaks to the importance of diet in regulating what happens in the gut and how
Starting point is 00:08:43 we're beginning to understand the role of our current Western diet in driving so many diseases. And I think, you know, the thing about polyps is that they basically can get converted into cancer. They're like pre-cancerous things. It's almost like getting a pap test. It's like a pre-cancer by doing a colonoscopy. But they grow very slowly. They often are incidental. You don't necessarily know you have them until often it's too late. Like my friend who had colon cancer, she basically had no clue until she started having really bad symptoms and this giant cancer was blocking her rectum. But you don't want to wait until that stage.
Starting point is 00:09:30 You want to think about how do you proactively prevent it. So talk about some of the risk factors that we know for colon polyps and colon cancer. Well, one of the things you were just talking about in terms of the size and the weight of the stool, it really is fiber, right? We know that what are those people doing that have the larger stools? They're eating lots more fiber and high, high, high fiber diet is great because it's, it's helping to pull toxins out of this, out of the gut so that those, that those carcinogens can't spend as much time touching the wall of the intestine and causing those shifts or changes in the cells that can go on to cause cancer. That's just one of the things the fiber is doing. And so a high fiber diet has been associated with a decreased risk of colorectal cancer. So more and more and more fiber. So fiber, we get from our beans and legumes, nuts and seeds, ground flaxseed, vegetables,
Starting point is 00:10:34 those are all high fiber foods. We know as we get older, our risk increases for polyps and colorectal cancer. We know that as we gain weight, as our BMI increases, especially that belly fat, that belly fat that increases inflammation in the body, that causes an increased risk of colorectal cancer. We know that lack of physical exercise increases our risk. And it may be because when we exercise, that helps improve the transit time. It helps the food move more quickly through the bowels. So when people have less exercise, they don't have as regular bowel movements, essentially. So lack of physical exercise, there's probably more to it than that in terms of improvement in insulin sensitivity and all sorts of things. But we know smoking increases risk of colorectal cancer,
Starting point is 00:11:30 excess alcohol intake, eating too many processed foods, eating too many processed foods that have been treated with antibiotics or meats grown with antibiotics, a diet that's low in vitamin C, low in antioxidants. And if you have a family history of polyp production or a family history, or you yourself have had previous polyps, that increases your risk as well. And inflammatory bowel disease, because that creates more inflammation in the intestines. So there's many things we know that increase our risk of polyp production and increase our risk of, of colorectal cancer. And then there's a lot of exciting things we're going to talk about during this podcast in terms of the microbiome and how we can shift it. And that that's going to, that's going to, we're going to just learn more and more about that as well.
Starting point is 00:12:23 Yeah, so true. You know, you mentioned obviously the obvious things, right? The, the, the insulin resistance and prediabetes, which is a huge driver of cancer. And people aren't realizing that it's not just heart disease or diabetes, but then when you eat sugar and starch, it drives cancer, particularly colon cancer, breast cancer, prostate cancer, pancreatic cancer, you know, a lot of the common cancers. And the fact that, you know, we, you know, we look at this whole issue of diet and cancer. One of the things I want to sort of dive into, aside from the thing you talked about needing, you know, more vitamin C and more fiber and getting off of processed foods and all that and getting more active and increasing fruits and veggies. I want to talk about the issue of meat and colon cancer for a minute, because the big reason that we're told to not eat meat, one of the big reasons is because
Starting point is 00:13:17 it's association with colon cancer. And so I sort of want to dig into that a little bit, because when you look at the research, it's a little more nuanced. And so I sort of want to dig into that a little bit, because when you look at the research, it's a little more nuanced. And I've looked carefully at this because, you know, I don't want to eat meat if it's going to give me colon cancer. But I also sort of want to understand what the science is. And what's your perspective on the issue of meat and slash processed meat? And is there a difference? And what should we be thinking about? And how does this all work? I think there's absolutely a difference with types of meat. You know, and I think we need to, there needs to be more research to explore this area further. But what we do know is that when people have a higher rate of processed meats in their diet. So, you know, hot dogs and deli meats and that at high
Starting point is 00:14:10 rates that there is some association with colorectal cancer. But what I think is important, and as you've spoken about before, is that teasing out, you know, how is that associated with other lifestyle factors is important. And what does the rest of the diet look like? And how much vegetables is that person getting? And how is that meat produced and then processed that really influences things? So I think what's important, and unfortunately, a lot of our meats are given high doses of antibiotics to cause that meat to those animals to grow faster and get bigger faster. So there's, you know, it makes sense that that antibiotic fed, those antibiotic fed
Starting point is 00:14:59 animals are going to influence our microbiome and our risk for cancer. But I don't think it's so simple. Like you said, I think it's way more nuanced than that. And it's not just that you can't eat meat, because there's a lot of good things in meat. There's a lot of good nutrients and iron that are harder for people to absorb, to get when they totally avoid those foods. So I think it's really critical that people are focused on the grass-fed, the healthier forms, and to balance their proteins, not just get all animal protein. I think vegetable proteins are a wonderful thing to have in your diet as well because of all the fiber they provide. Yeah, absolutely. And I think that one of the things I want to sort of highlight is that there's a distinction
Starting point is 00:15:48 between meat and sort of grass-fed meat, and there's also a difference between meat and processed meat. And I think this is really important for people to know. When you look at the data, this was data from the IPCC, I think, which was the group that looks at the risks of cancer, an international research group in the UN, that is independent scientists. And when they looked at the data, and they're looking mostly at observational data, right? So you have to understand this data has improved cause and effect. They found that there was about a 20% increase in your risk of colon cancer if you basically ate, you know, bacon every day.
Starting point is 00:16:28 And so the... Yeah, I think it was like five strips, right? If you eat five strips of bacon every day your whole life, your risk... I think it was five strips a day. Yeah, it was like five strips every day. Your risk goes up by 20%. Now, that seems like a lot. First of all, if you're looking at an observational study, unless the risk goes up by 200%, you're probably not seeing a cause and effect relationship, although there are theoretical
Starting point is 00:16:50 mechanisms for it. However, when you look at the absolute risk, you know, the background risk in the population of getting colon cancer is 5%. What they saw with the processed meat, mainly five strips of bacon a day for the rest of your life, which nobody's going to do, I think. I'm certainly not. The risk goes up to six percent, which is a 20 percent increase. So this is where the statistics get super confusing for people. And there's a difference between relative risk, which is the relative increase is 20 percent from five to six percent. But if you look at the absolute increased risk it's six percent so if you want to eat a piece of bacon or meat that's processed once in a while is that going to cause
Starting point is 00:17:34 colon cancer i don't think so and there's another caveat here is that it's not only what you're eating it's what you're eating it with and if you're eating it with. And if you look at the data, for example, from Maasai warriors and from Morocco's population that eats a lot of meat, and the Maasai live on basically milk and meat, one of the distinguishing features is they cook the meat or they drink the milk with tons of spices. And the spices and the marinades actually change the quality of the interaction with your biology of the meat and actually mitigate a lot of the potential risks. So I'm not, you know, one of those guys that, you know, meat is terrible, is going to cause cancer because I think the data is really weak. And I think we have to put it in perspective. And, like, I'm certainly not going to eat five pieces of bacon a day.
Starting point is 00:18:20 I might have, you know, some, you know, pasture-raised pork bacon, you know, once a month, or I don't remember the last time I had it, actually. It was like maybe once every, you know, six months. But it's something that we should be really focused on. It's not just what we're eating as one isolated nutrient, which is this whole nutritionism, reductionism view, but what is the overall context of our diet? And I want to get into that with you next, because changing the composition of your microbiome is key to actually reducing your risk of colon cancer. Absolutely. And I don't think people recognize how critical it is to feed the good bacteria with certain foods, right? So we know that phytonutrients, those are the components of our plant foods, really feed the good, healthy bacteria in the gut. We know that things like
Starting point is 00:19:13 pomegranate has substances in it like elagitanins, which feed the good, healthy bacteria in the gut. One bacteria called acromantia, which can lower inflammation. We know that we can feed it with things like pomegranate. We know that things like green tea, green tea is phenomenal in its anti-angiogenic antioxidant capacity, but it also has the ability to epigenetically suppress or epigenetically increase tumor suppressor genes. And that can therefore increase glutathione production, decrease risk of cancer. And so what other things we're eating with the meat and the beans and the chicken and all those phytonutrients are critical. Getting eight to 12 servings of phytonutrients a day is critical. And you mentioned spices.
Starting point is 00:20:10 They've done studies with mice and shown that curcumin, that spice, which is the phytonutrient in turmeric, right? That that can cause less polyp production in mice. So having a diet rich in spices, rich in these polyphenols, rich in these phytonutrients really can influence our overall health, but because of how it feeds the microbiome. Yeah, it's incredible. You know, what's really fascinating too, Liz, is that there's a particular compound in the gut that's so important for overall gut health, and it's called butyrate. And it's produced by the bacteria in your gut when they consume things they like to eat, like fiber. And certain kinds of fiber increase butyrate, which is what we call a short-chain fatty acid. Now, that's a big mouthful, but essentially this is the fuel for the intestinal tract. And essentially you're in
Starting point is 00:21:12 this symbiotic relation with bacteria where you're feeding them and then they're producing fuel for you. The key finding though, was that this butyrate when it's in high concentrations turns on the tumor suppressor gene. So it literally shuts off the genes that cause cancer, which is kind of staggering. So eating fiber, people, oh, eating fiber, that's great, whatever, whatever. But the truth is that, honestly, we can modify our microbiome and increase these short-chain fatty acids by simply providing the raw materials we need, which is kind of exciting. And we're going to go more into how do we create a healthy microbiome and how do we
Starting point is 00:21:47 create a better environment there and some other factors that relate to it, such as B vitamins and so forth. But before we get into that, I want to kind of just loop back and talk about how people can evaluate this, because it's more than just a colonoscopy. There's a lot of interesting new tests and diagnostics that we haven't really talked about that I'd love you to share about how we screen for colon cancer and polyps. Because polyps might not be able to be detected from tests that look at colon cancer, for example, like a stool blood test or a DNA test, because those might not really detect
Starting point is 00:22:21 just mild polyps, pre-cancerous polyps. But let's talk about what the tests are that we should be looking at. Well, you know, one of the things I wanted to mention first, and it's one of the tests we do all the time, is we can measure that butyrate level, which is phenomenal. Like you were mentioning how butyrate has been associated with a lower risk of colorectal cancer. So when you have more butyrate, which is a postbiotic, which gets produced when our probiotics, our good bacteria consume prebiotics fiber, we make these, we make this butyrate and we can measure butyrate. We can measure it in the stool and then we can,
Starting point is 00:22:59 we can, we can watch it improve when we improve the milieu in the digestive system. We know that butyrate, as you were mentioning, is so critical for healing the lining of the epithelium, the lining of the intestines, so that cancer is less likely to grow. We know that butyrate can lower inflammation in the intestines, and it can really help improve that barrier function and improve the immune system within the intestines. So that may be some of the reasons that butyrate has been associated with, you know, high levels of butyrate or good levels of butyrate have been associated with lower risk of colorectal cancer. And so I think it's something that we test all the time. And I think it's really a helpful thing to evaluate. I think you were also speaking about the tests that we do to screen for
Starting point is 00:23:52 colorectal cancer, right? So, you know, the general recommendation is to do colorectal screening testing, like a colonoscopy, between the ages of 50 and 75. Now, some organizations have really lowered that to 45, because we are seeing, unfortunately, this increased rate of colorectal cancer in younger populations. So some people are recommending that we start screening at 45, all the way to 75. And a colonoscopy is a good screening test. And when you do a colonoscopy, you can look for polyps, and if they're there, remove them, which is great because if that polyp was going to go on to become a colon cancer, you can remove it and prevent that from happening. So it's a good test that
Starting point is 00:24:43 I always encourage people to do. And people don't, a lot of times people are hesitant to do it, but it really is good. And I say that the most important colonoscopy is to get your first one, because that really lays the groundwork. And if you're, you know, unfortunately, some people do have a higher rate risk of making lots of polyps or making these concerning polyps. And you want to know that at a younger age. Absolutely. So, so getting those tests, and there's a DNA testing you can do for some of the markers of colon cancer that are available now, there's Cologuard. So there's, there's some interesting tests that are available,
Starting point is 00:25:22 but at the bottom line, you do need a colonoscopy. I think if you have a family history, if you're at risk, there may be even earlier indications for it. It's super important. Now, what is our approach from a functional medicine perspective? Typically, from a traditional medicine perspective, you do a colonoscopy. You go in. You cut the thing out. You go, okay, I'll see you later. Come back in two years.
Starting point is 00:25:44 I'll do another one. Hopefully, you go in, you cut the thing out and you go, okay, I'll see you later, come back in two years, I'll do another one, hopefully you don't get another polyp. And that's, we call that, you know, active surveillance. And to me, it's, I think it's inactive. It's doing nothing and waiting and hoping instead of going, gee, why did I get the polyp in the first place? And how do I prevent that from happening? And that is the difference between functional medicine and traditional care. We're always thinking about the why, not just the what, not just do you have a colon palp, but why do you have it? And how do we understand the biology underneath it? How do we test for what's going on that's causing it? Like, would your doctor, who's a gastroenterologist, look at your butyrate levels? No, they're not going to do that stool
Starting point is 00:26:20 test. At the Ultra Wellness Center, we do do those tests and we do see these factors in much more refined relief and can actually figure out what to do in a personalized way to help people really improve their overall health and get this better. So let's talk about how do we make the body completely inhospitable to cancer and particularly colon cancer and colon polyps in general. Yeah. How do we create a terrain where cancer is less likely to grow? And the first thing I always focus on is lowering inflammation. You want to lower inflammation locally within the intestine and lower inflammation systemically within somebody's body. And so you can measure inflammation by looking at things like C-reactive protein, by looking at somebody's body. And so you can measure inflammation by looking at things like C
Starting point is 00:27:05 reactive protein, by looking at somebody's waist to hip ratio, because that abdominal fat creates inflammation. You can measure if there's inflammatory markers in the stool. And you can get a sense of somebody's level of inflammation by their diet that they have, because some diets are more pro-inflammatory. And that's one of the first places we work to shift is creating, you know, shifting a patient's diet to one that's more anti-inflammatory, more rich in phytonutrients, rich in plant foods, rich in fiber, rich in omega-3 fats, and lower in sugars and refined carbohydrates. And so inflammation is one of the things I really look at testing-wise and when you're looking at somebody's situation. We also work to lower
Starting point is 00:27:56 insulin levels. We work to lower toxin levels in their body. We pay attention to their microbiome and what kind of, are we seeing an inflammatory bugs in their gut? Are we seeing the bugs that are associated with lower levels of inflammation in their digestive system? So we evaluate their microbiome and of course we pay attention to those lifestyle factors that really impact somebody's risk of developing cancer. Yeah. And those things you mentioned are really key. Getting insulin down, getting your toxic load down, improving the health of microbiome, dealing with the things that drive inflammation. We talked about how to build up certain good bacteria by providing the different kinds of fibers. There's insoluble fibers. There's prebiotic fibers. There's probiotics. You can
Starting point is 00:28:43 take butyrate. There's all the phytochemicals in food we're talking about that help all the spices we can include in it. I love making spicy foods. I make tons of things. I use all kinds of spices. And I think that is a great way to increase the phytonutrient content and reduce inflammation. You mentioned green tea and pomegranate curcumin. The broccoli family is fascinating.
Starting point is 00:29:03 The broccoli family is one where, you know, they've actually literally measured broccoli in the urine, you know, the byproducts of broccoli in the urine in large populations, particularly in China, and find that those who have the highest levels of these chemicals from broccoli in their urine have the lowest levels of cancer. And that's because it helps us to activate the genes that suppress cancer. It activates our detoxification system. It helps reduce inflammation. And it's powerful. Flax seeds are also great, as you mentioned, and they have lots of benefits in terms of doing things, fermented foods, probiotics. All these things are things that we can include in our general well-being and lifestyle program that help to
Starting point is 00:29:41 reduce our overall risk. And, you know, we might even be able to be soon in a much more targeted way with the microbiome, able to treat people with specific compounds, whether it's adding more butyrate or whether it's particular bacteria like bifidobacterium animalis, which is low in people who have colorectal cancer, to basically targeted probiotic therapies for various things. So I'm sort of excited about what's happening in this world of the microbiome, because what's going on is people really can upgrade their microbiome through all these things we just discussed. One of the challenges, though, for people is constipation. And that is something we're not really talking about, but it is associated with increased
Starting point is 00:30:27 risk of colon cancer. And of course, it makes sense because there's all this junk in there, these toxins and crap, literally, that is causing all these adverse biochemical reactions and activation of cancer genes if we don't really get rid of the poop that's in there on a regular basis. And that's really, really important. I was just going to mention, like if the stool, the longer it is in contact with the cells in the colon, the more likely those toxins within the stool are able to damage the cell lining of the colon and trigger the, the inflammation or the start
Starting point is 00:31:09 of cancer production. So having good regular bowel movements is really critical. And we can improve that with, you know, butyrate actually as a supplement can help people have better bowel movements, more fiber, absolutely. Ground flax seed, chia seeds, more fiber in their diet, more water in their diet, as well as probiotics. I'm sure you've found this too. When you give certain blends of probiotics to people, the healthy bacteria, whether it's because it's lowering inflammation, that helps with them having better regularity as well. So there's so many things we can do to be helpful there. Absolutely.
Starting point is 00:31:49 And so let's go through a case because maybe I'll illustrate a little bit better. And the reason I want to share this case with everybody is because it explains how in functional medicine, we do different diagnostic tests, we're able to do different therapies and be much more deliberate, personalized, and proactive about optimizing function. And it really goes back to this idea of traditional medicine being very much like the old model of a single pill for a single disease. And in functional medicine, we don't focus so much on that. We focus on the underlying terrain. So how do you make your body inhospitable to disease or cancer? And this is really what you've done with this guy, which is pretty amazing.
Starting point is 00:32:30 Yeah. So like you said, you don't want to just wait for your next colonoscopy. We want to be proactive to do whatever we can do to prevent the production of polyps or colon cancer. So this was a 40-year-old gentleman who came in because he wanted to be proactive. He wanted to prevent colon cancer. And the reason he was so interested in preventing it is, unfortunately, he had a strong family history of colon cancer. His father had colon cancer and his uncle had colon cancer in their 60s. And so he wanted to
Starting point is 00:33:03 do, he was like, I want to be proactive. I want to do whatever I can to decrease my risk. And so that's exactly what we worked on. We got a really detailed history and worked on where for him, we needed to make improvements. And, you know, one of the things we found out when we got his detailed history is he was only having a bowel movement every third day. And so that made me concerned because of what we just spoke about, how if the stool just sits there longer, then it has a higher risk of causing inflammation or damage in the cells inside the intestine. And so we want to have people having at least one bowel movement a day. And so we did a stool analysis on him. And his stool analysis showed
Starting point is 00:33:53 that he was low in that short chain fatty acid butyrate. And we know, as we talked about, that low levels of butyrate have been associated with an increased risk of colorectal cancer. So I said, okay, this is where we want to focus because a lot of his other risk factors were in good control. He had good insulin levels. His blood sugar was good. His weight was good. He was active. He was exercising. He had a pretty good healthy diet, but I knew we needed to focus on bumping up this butyrate level. So we focused on increasing his fiber intake and giving him that fiber, that food, to feed the probiotics so they would make more butyrate, that short-chain fatty acid butyrate, that short chain acid, short chain fatty acid butyrate. So we really worked to shift his diet to get get in those eight to 12 servings of phytonutrients a day, and gave him some ground flaxseed and and really increased his fiber intake. And that was really what made a difference. I also did give him some probiotics. I gave him a good general probiotic blend. And I also gave him some actual butyrate because his levels were low and
Starting point is 00:35:15 we wanted to be more proactive. And so, you know, after six months or so, we rechecked his stool. He started to have regular bowel movements every day and we rechecked his stool. He started to have regular bowel movements every day and we rechecked his stool and we could see his butyrate level improve and the level of good bacteria improve in his stool test. So that was really satisfying and he's doing really well. This is a few years later now and he's doing well and we hope to keep him doing well for many, many more years. You know, one of the things that was interesting was that sort of reading about the case, you were able to give targeted probiotics that are studied. So we think, oh, we'll just take yogurt or just take fermented food.
Starting point is 00:35:56 But there are specific varieties of bugs that have been shown to do really different things. For example, Lactobacillus KCIBLBL23 or lactobacillus alphidopsis and CFM have anti-tumor properties. So they modulate immunity, they lower inflammation, they inhibit the bad bugs from growing, they help the gut barrier function. And there are other bacteria like lactobacillus rhamnosus, plantarum, and various E. coli, which sounds like a bad bug, but it's actually there's one that's actually okay, make a huge difference. So in addition to doing those probiotics, you also give him prebiotics, fibers, and fermented foods.
Starting point is 00:36:34 But you also advise him on how to cut down some of the toxins, right? The nitrates in his diet, the processed meats, getting rid of pesticides by eating organic, getting rid of antibiotics in his diet. And also the other thing that's really important for people in real life, and I'm a bad guy for this because I love to grill, but it's not good for you. And the heterocyclic amines in the charred meat is a big cause of cancer. But the biohack here is if you sort of marinate your meat in a vinegar or lemon or lime or some type of acidic solution and add a lot of spices, it really seems to mitigate that. But you
Starting point is 00:37:13 don't want to eat blackened stuff, basically. Not too often, right? Yeah. Yeah. So Liz, this has been a great conversation about a very common condition that affects millions of people that causes so much unnecessary death. And the truth is, this is one of the cancers that nobody should die of. This is a totally preventable cancer in terms of death. I mean, maybe we'll still get polyps or early cancer, but by proper screening, by looking at some of the other things that are setting your risk up that we look at in functional medicine, such as your microbiome or your nutritional status or toxin exposures or
Starting point is 00:37:50 insulin resistance, we really take a holistic 360 view of this. And we work on the biological terrain. You know, we don't want to create a container in which our bodies, in which disease grows or cancer grows. So that's the beauty of functional medicine. It's the beauty of what we do at the Ultra Wellness Center. And now we're doing a lot of virtual consults because of COVID, which has allowed us to see a lot more people and we're building our staff. So, you know, we'd love to help you if you have any concerns about cancer, family history, whether it's prevention or whether it's you've already had cancer, you want to prevent it from coming back, or you actually have it and want to get a supportive approach. We really can be guides
Starting point is 00:38:22 on that process. And we'd love to see you. It's pretty exciting field now, functional medicine, because we have so many more tools than we used to. And we have so much more insight than we used to. And even since we've been doing this in the microbiome in the last 30 years, it's just the research has exploded. And now we're able to be so much more sophisticated about our targeted approaches. And it goes way deeper than what you'll get from traditional medicine. And I'm just so honored to be able to work with you, Liz, and other team members at the Ultra Wellness Center to be able to offer these kinds of services to the population. And it's really gratifying because you just see people change and get better and improve. And I just feel sort of grateful. Yeah, it is fun. Thank you so much, Mark.
Starting point is 00:39:05 Well, thanks for this great conversation about colon polyps. Probably not everybody's favorite topic. If you love this podcast, please share with your friends and family. Leave a comment. Maybe you've suffered from colon polyps or figured out a way to figure it out. We didn't talk even about some of the things related to methylation, B vitamins, but there's a lot of things we can do in addition for this. Maybe you've discovered what works for you.
Starting point is 00:39:24 Subscribe wherever you get your podcasts. things we can do in addition for this. Maybe you've discovered what works for you. Subscribe wherever you get your podcasts and also check out my new Dr. Hyman Plus, which is a subscription service for exclusive content for me and my team about everything you can imagine. And it's super exciting. So check it out and we'll see you next time for another episode of House Call and The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love
Starting point is 00:39:57 and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements, to gadgets, to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up.
Starting point is 00:40:28 That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. and live younger, longer. services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

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