The Dr. Hyman Show - Sick And Tired Of Being Sick And Tired? How To Reclaim Your Energy with Dr. Steven Gundry

Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. We are so deprived of the energy-producing compounds that are available to all of us if we'll just feed the microbiome what they need. Hey, it's Dr. Mark. One of today's episode's sponsors is ButcherBox, and I'm always being asked how I get enough high quality protein into my diet and where to find it. With all the convention raised animal products flooding the supermarket, it can be hard to find meat that actually supports your health goals instead of taking you farther

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Starting point is 00:04:06 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. All right, now let's get back to this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman.'s Pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. And today's conversation is going to matter to you if you're tired or you're sick and tired of being tired, because it's with none other than my friend and one of the leading thinkers in health and wellness today, Dr. Stephen Gundry, about his new book, The Energy Paradox, What to Do When Your Get Up and Go Has Got Up and Gone. I know we've all felt tired from time to time, but it seems like we have a pandemic of fatigue.

Starting point is 00:04:56 And I'm so happy to be able to talk to my friend, Steve. He's one of the world's top cardiothoracic surgeons. He's a pioneer in nutrition. He's the medical director of the International Heart and Lung Center for Restorative Medicine. And he spent the last two decades studying the microbiome and now helps patients using diet and nutrition as a key form of treatment. He's written so many New York Times bestsellers you've probably heard about, including The Plant Paradox, The Plant Paradox Cookbook, The Longevity Paradox, and now The Energy Paradox.

Starting point is 00:05:22 And he's also got a great podcast called the Dr. Gundry Podcast. So welcome, Steve, to the doctor's pharmacy. All right. Thanks for having me on. It's good to see you again. You're looking well. Thank you, sir. Okay. So here we go. We have this pandemic of fatigue. And personally, I've had chronic fatigue syndrome. So sadly, unfortunately, I've had to become an expert in fatigue, both from the inside out and the outside in. And it's really been a journey to understand what causes people to be tired, because it's one of the most common symptoms that people go to the doctor for.

Starting point is 00:05:57 Now, sometimes it's silly and simple. Like one guy years ago gave a lecture, and I said, I'm tired all the time. I said, well, how many hours do you sleep? He said, I sleep five and a half, six hours. I'm like, sleep eight. He said, that'll be $500, please. But it's more complicated than that for most people. So we just sort of internalized and accepted the idea that, oh, we should be tired.

Starting point is 00:06:20 But it's not normal. So what's causing this energy crisis? It's not an energy crisis of oil. It's energy crisis of ATP, which is our body's own energy system. So what is the driver of all this? Well, I think there's multiple drivers, and I certainly get into that in the energy paradox. But if I was going to break it down into two really actionable items. Number one, we talk about chronic inflammation and that most of us somehow think that chronic inflammation in one way or another is driving most of our chronic disease processes in one way or another. And people go, well, where does chronic inflammation

Starting point is 00:07:05 come from? I think, and many others now think that chronic inflammation is actually coming from leaky gut. And if you had asked me, I think, 15 years ago, what I thought about leaky gut, I probably would have called it pseudoscience and said, oh, come on, really? There's very little evidence. But I think thanks to Alessio Fasano and others, we now know that leaky gut probably confirms what Hippocrates said 2,500 years ago, that all disease begins in the gut. In fact, Dr. Pisano from Harvard now has a new paper out saying all disease begins in a leaky gut. And I think he's absolutely right. And certainly in our practice, I see that really as one of the major driving forces in chronic inflammation. Now, why does that reduce energy? Because 70 to 80% of our immune system, as you know,

Starting point is 00:08:15 lives in our gut, lives along the lining of the gut. And the immune system is a big time energy hog, an energy burner. And we devote a huge amount of our resources to powering our immune system. An example I use in the book, which I use with my patients constantly, before COVID, there was obviously the flu. And the flu is a virus like COVID. And the flu in and of itself is just a protein that our immune system looks at and says, oh my gosh, this is a bad actor. And we've got to mobilize our forces. And we've got to be ready to, you know, get this guy. So what we do, the flu does not cause you to be aching and have ache and pain and just want to lay in bed. The flu does not give you brain fog.

Starting point is 00:09:13 The flu does not make you channel surf and not think. Your immune system actually needs all that energy. So what we do is we ration energy, we make ourselves hurt, our immune system makes ourselves hurt, so we don't move. If our muscles hurt, we don't move. And we make our brain go into standby mode, because our brain is the biggest energy hog at all, of all. And if you're using 20% of your energy to think, you're taking away from your immune system. And so imagine the same thing happens in our gut, when we have leaky gut, a huge amount of the energy that we would normally have goes to our immune system in our gut. That's number one. So what you've been saying is quite incredible, which is that

Starting point is 00:10:04 a lot of the fatigue that we think may have other causes might start in the gut. That's number one. You've been saying this quite incredible, which is that a lot of the fatigue that we think may have other causes might start in the gut because when your gut is damaged or injured, it literally, quote, leaks the bad toxic crap literally into your immune system and your immune system goes, ah, what's this? And I better do something about it. It gets very busy and sucks a lot of energy. But it also creates inflammation. And inflammation and fatigue just are neck and neck. That's what the body actually does when you have inflammation.

Starting point is 00:10:36 It creates a lot of fatigue. You kind of repair. I guess it's sort of a natural thing. You want to stop and not do anything and let your body heal. Like animals, they'll lay down until they get better. So you talk about the warning signs. stop and not do anything and let your body heal, like animals, they'll lay down until they get better. So you talk about, you know, the warning signs. How do people know if they're just like a normal tired or if they have something more severe kind of fatigue?

Starting point is 00:10:53 Like, what are the warning signs? Well, I think certainly we're seeing, even in a younger and younger and younger patient population, brain fog. And I think if you had asked me about brain fog 20 years ago when I first started this area, this was a common complaint in 70-year-olds, 80-year-olds. But now we see it in 20-year-olds and 30-year-olds. Millennials come in with, you know, complaining of brain fog and malaise. And it's like, I'm really getting old. You know, I thought I was just 30. I just don't have my get

Starting point is 00:11:34 up and go that I used to have. And this is a warning sign. We're not supposed to have that. We're not supposed to have to be powered by double espressos three times a day and 12 Red Bulls to get through the day. And I think part of the problem is we've thought that our modern lifestyle, particularly social media, we see everybody happy, happy, happy, doing everything wonderfully. And we somehow go, oh, my gosh, that's what I should be like, too. And we have to power through our day or I'm a mom with two young kids. And, you know, I've got to be there to get them to their 27 events every day. And that's normal to be, you know, fatigued to be not knowing what to do. But it's not normal. And surveys actually show that at least 50% of the population is fatigued or tired at

Starting point is 00:12:34 any particular time. And we've accepted that as normal, and it's absolutely not normal. No, for sure. In the book, you talk about the seven deadly energy disruptors. And as a functional medicine doctor, I noticed a few missing, but we can talk about those. But I mean, things that I see regularly in my practice, but these are really a great starting list. So tell us about these seven deadly energy disruptors. Yeah, you know, I had seven disruptors in the Plant Paradox book. And I've book, and I tweet that list in terms of energy

Starting point is 00:13:08 because I think there's some real mischief makers that deserve our attention. First of all, antibiotics. We still not only overuse antibiotics to treat things that have no business being treated with antibiotics, such as viral illnesses. We still, unfortunately, practitioners, anytime someone comes in with a sore throat or a cough, the gut sense is to give them broad-spectrum antibiotics. And what none of us realized until recently is that broad-spectrum antibiotics kill off not only a bug that we thought we were going to kill, but also our entire gut microbiome. And it may actually take two years to re-establish

Starting point is 00:13:55 an entire healthy microbiome after a single round of antibiotics. We had no idea of this dense tropical rainforest that we had in our gut that drove so much of our energy. And we'll talk about that in a little bit. Plus, the antibiotics, as you and I know, are in our food supply, particularly in animals from factory farms. It is still legal for veterinarians to dose entire flocks of chickens or entire herds of animals with the claim that they're treating one sick animal. And still, as long as the veterinarian says that they need it, they still legally can do it. And as you and I know, some of these organic or natural chickens have been tested for antibiotics from certain farms, and they may have a 60% antibiotic pickup rate in normal, natural chickens that aren't supposed to get any antibiotics.

Starting point is 00:15:03 Really? I didn't know that. That's frightening. Yeah, it is actually really frightening. Is that because they use them anyway? If one animal is sick, they give it to everybody? Yeah. Yeah. There's always loopholes, as you and I, unfortunately, have learned in laws. And the loophole was if the veterinarian thinks there's a sick chicken and there's a flock of 100,000 chickens in a warehouse, then he is allowed to treat the entire flock to treat that one sick chicken. And the vet, there's great vets and great doctors, and there's bad vets and bad doctors.

Starting point is 00:15:44 If the vet is on the payroll of the big corporation, you see where I'm going. Absolutely. So what are the other seven, the six disruptors? So I think glyphosate has rapidly rose to kind of my number two mischief maker of all time. It is a, it's an antibiotic against the earth, in my opinion. It was actually patented by Monsanto as an antibiotic initially. And what we didn't know, what you and I didn't know is that, yes, it works with this crazy, it works against the shikimate pathway, how plants make protein synthesis. And Monsanto said, don't worry, humans don't use the shikimate pathway, so you're safe. It can't hurt you. What they didn't bother to tell us was that bacteria and fungi use the shikimate pathway

Starting point is 00:16:40 so that when you swallow glyphosate, it actually kills off your microbiome rather effectively. Plus, recent evidence is that it in itself, without any other effect, is a gut wall disruptor. It breaks tight junctions. And in one paper, I show that glyphosate actually interferes with mitochondrial function. And that's actually not too hard to believe, because mitochondria, as your listeners know, are actually engulfed ancient bacteria, and they actually carry a bacteria signature, and they work as a functioning bacteria within all of our cells. So it's actually was not surprising as I was researching this to find out that in fact, glyphosate affects mitochondrial function.

Starting point is 00:17:36 So it's, and it's everywhere. I mean, it's on 70% of our agricultural crops. It's the most abundant agrochemical in use today. It's on over 90% of our corn, soy, and cotton. It's kind of scary. It's out there, and it's really being looked at from the legal point of view. There's over 14,000 lawsuits pending against the herbicide. And I think, and that's for its human effect, but I think what you're speaking to is something really more important, which is its effects on the microbiome of the soil and also the microbiome of humans. And they're interconnected. And I think

Starting point is 00:18:15 we literally are destroying the microbiome of the soil, which kills the organic matter and leads to increased greenhouse gas emissions from loss of soil carbon. And then you've got the microbiome effects on humans, which has all the consequences that you just talked about. Yeah, you know, you're right. We talk about you are what you eat, but you are what the things you're eating ate. Well, the same thing is true with plants. And plants, as you and I know, have this incredible rich soil microbiome that would normally assist in feeding the plant and allowing the plant to absorb nutrients. we could have a plant that looks like bok choy or spinach, but it does not have the nutrients that it used to have. In fact, our soil is so depleted of the common nutrients that we need,

Starting point is 00:19:16 like magnesium, for instance, that we don't have a chance. No, it's huge. I mean, and the data on glyphosate is, people understand. No, it's huge. I mean, and the data on glyphosate is, people don't understand, oh, it's just Roundup, it's just on Roundup-ready soybeans. It's not. It's used on 70% of crops

Starting point is 00:19:34 and it's 220 million pounds a year that's used in the United States. I think since 1974, it's 1.6 billion kilograms have been used on crops in the United States alone. And it's on 70 different food crops, including corn, soy, canola. If you have a slice of bread, a bowl of Cheerios, a sushi roll, a plate of pasta, a slice of pizza, a chicken nugget, it's probably got Roundup on it. And it's scary when you look at the work from the environmental working group.

Starting point is 00:20:02 Your Cheerios has more glyphosate per serving than vitamin D or B12, which actually have to be added to the cereal to enrich it. It's a big problem. And I think you're right. This understanding of its role in the microbiome is really quite important. So you've got antibiotics, glyphosate, and there's more chemicals that are a problem, right? Yeah. I mean, we're surrounded with environmental toxins. You know, one of the favorite old ones was BPA in plastics, and most of BPA has now been

Starting point is 00:20:34 banned, but BPS looks to be even more mischievous than BPA. And these are endocrine disruptors, they're hormone disruptors. And one of the things people should realize is that estrogen, for instance, is one of the best fat storage hormones that's ever been invented. As any young woman in her teenage years knows that estrogen is designed to make you store fat. And we now have chemicals that mimic estrogen. And we're awash in these things. For instance, phthalates, another very important plasticizer, is present in our food wraps, any plastic food wraps. So you may get your organic pastured chicken breast. And if it comes in a shrink-wrapped plastic, you'll actually pick up phthalates off of that plastic. And one of the really scary things is that there's really scary

Starting point is 00:21:40 correlation between boys' penis sizes and the amount of chicken their mother ate during pregnancy. And it's a inverse relationship. Yeah, that's interesting. So you mentioned environmental chemicals. And the couple that you haven't mentioned, these are the sort of, we call persistent organic pollutants that are really petrochemical driven from, you know, oil derivative things, plastics and so forth. But there's another class, which is heavy metals. And for me, that was the massive driver of fatigue and for many patients. So mercury, lead are the two biggest. And how do you think about those? That's a great question. I look at mercury and lead and cadmium in a great number of my patients. I can tell you that the vast majority of people with high mercury levels in my practice are dentists and sushi eaters.

Starting point is 00:22:37 Dentists for obvious reasons, sushi eaters hopefully for obvious reasons. Mercury in this case. Yeah, mercury. One of the interesting things, at least I see, is that heavy metals in general are contained in our fat cells. And it's like a tuna, maybe have toxic levels of mercury, but that tuna is doing perfectly fine because the heavy metals are actually in the fat. It's when people have weight loss that we release those heavy metals from fat. And this was actually demonstrated by Ray Walford in Biosphere 2. You and I are probably old enough to remember Biosphere 2, the experiment in the Arizona desert where they locked everybody in a geodesic dome for a year to stimulate a mission on Mars. And everybody had to grow their own food and produce their own food.

Starting point is 00:23:33 And long story short, it was a horrible failure. People lost about 30% of their weight in six months. And one of the findings was that heavy metals and organopesticides went up precipitously, very rapidly, and stayed elevated for over a year before they went down. And it was because those heavy metals were there in these participants' fat cells. And we, as you know, have a horrible system for detoxifying heavy metals. Our liver does a horrible job of it. And they're excreted by our liver into our bile, thinking that we'll get rid of it through our stool, except we're really good at absorbing heavy metals out of our gut.

Starting point is 00:24:19 So we actually set up a vicious cycle. So we excrete it and then pick it up. And as I talk about in the book, anyone who's actually on a weight loss program really should be supplementing with chlorella and activated charcoal during that time period, because they will complex with heavy metals. And knock on wood, we've been very effective with those two treatments in bringing down people's heavy metals without the need for chelation. Yeah. I mean, chelation is a bigger term, but it's basically there's ways to upregulate your body's detox system and reduce the inputs. And I think it's so key.

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Starting point is 00:27:09 throughout the whole day. Now let's get back to this week's episode. And you also mentioned drugs that disrupt your energy. Yeah. You know, the big driver that I saw in Lamp plant paradox was NSAIDs, non-steroidal anti-inflammatories. These drugs are actually one of the best ways to create leaky gut that anybody ever came up with. And this was known about by the drug companies when they were introduced in the 1970s. In fact, it was so well known that by law, you couldn't take these drugs for over two weeks period of time, because they were so dangerous with that effect. Now, of course, we eat them like candy. And so anytime we produce leaky gut, we produce inflammation. And that inflammation, in turn, actually produces more pain.

Starting point is 00:28:05 And if you have more pain, you'll take more of these drugs, and the cycle continues. So one of the things that I really urge people to do is get these seemingly harmless NSAIDs, ibuprofen, Aleve, Naproxen, out of their medicine cabinets. The second group in the same box are the PPIs, the proton pump inhibitors. Yeah, yeah. Now, to take people back to high school biology class, we actually make energy in mitochondria by pumping protons across the mitochondrial membranes. When proton pump inhibitors like Nexium, like Prilosec, like Protonix came out, they were a miracle in terms of the treatment of ulcers because we had something to stop

Starting point is 00:29:06 stomach acid production. But like any good idea, when we then make them easy to obtain for the treatment of heartburn, what we didn't know was that these things were not specific for the proton pumps in the stomach. They affect all proton pumps, and proton pumps are what drive mitochondrial function. And when we poison the mitochondria in our heart, and specifically poison the mitochondria in our brain with proton pump inhibitors, it's no wonder that congestive heart failure strongly correlates with proton pump inhibitors. Yeah. Densha strongly correlates with proton pump inhibitors, all for the sake of relieving heart

Starting point is 00:29:56 burn. So if you want to poison mitochondria, take a proton pump inhibitor. That's an interesting framework. And we know it inhibits absorption of nutrients and it can affect your GI function and cause irritable bowel and leaky gut, all kinds of problems. But the mitochondrial story is an interesting one that hasn't really been told. And I think it all comes down to mitochondria, which is really what we're talking about in terms of energy, right? All these things affect the mitochondria, which are these little energy factories that take food and oxygen and burn them in your cells for this energy. And all the things you're talking about will have adverse effects, all those chemicals, not only by affecting your microbiome, but also just directly affects on the mitochondria.

Starting point is 00:30:36 And the key to really figuring out your energy is healing your mitochondria. And I think some of the shocking data about the microbiome, and I'd love if you could sort of draw this connection a little more, is how the microbiome affects the mitochondria. Because it's really the subject of your book. I'd love you to sort of maybe tease that a little bit. It's really all about how does the damage to the microbiome and the adverse metabolic gut compounds influence everything, including hormones or appetite, mood, brain function, weight, energy. But start with the mitochondria, because the idea is that the gut has all these bacteria, and they get out of balance, and then that stuff happens. So, and what happens? So, again, mitochondria are ancient and false bacteria. And they actually talk to their sisters, the gut microbiome, which for the most part are bacteria as well. In fact, we inherit our mitochondria from our mother. Our dad doesn't give us any. And we inherit, if things work out okay, our initial microbiome from our mother via birth and also by being

Starting point is 00:31:48 breastfed. Believe it or not, one of the huge benefits of breastfeeding is that a woman's breast milk has huge amounts of bacteria and fungi that are also populating the baby. Okay, so years ago, one of my first times presenting at the World Congress of Microbiota in Paris, I met the director, Marvin Endres, and he and I were talking. I had a paper on, and he says, you know, I'm going to tell you something. He said, the microbiome talks to the mitochondria, and my eyes went up, and I said, well, how do they do that? And he says, well, we don't know yet, but I'm telling you, we're going to find out that the microbiome talks to the mitochondria because they're literally sisters. And I said, well, you know, that's

Starting point is 00:32:35 interesting. He says, yeah, they send text messages. Well, lo and behold, Marvin was right because the language, what's called the trans-kingdom communication system of how the microbiome talks to mitochondria and to our DNA was discovered. And it's as big a discovery as the Enigma code discovery in World War II, the German code. So what that discovery was is the discovery of postbiotics. And postbiotics, everybody knows probiotics, friendly bacteria. Most people are learning prebiotics, which are the fibers that friendly bacteria need to eat. But when those bacteria eat those fibers, they produce either short-chain fatty acids like acetate and butyrate, but more importantly, they produce gases, and they're called gasomessengers or gaso transmitters and it's these messaging system that's now been discovered that actually talks actually tells mitochondria what to do whether to make more energy when things

Starting point is 00:33:58 are good or whether to throttle back because things are bad down in the engine room. And it's, you know, the whole discovery is just like, holy cow, we are this incredible symbiotic organism. I mean, for instance, the Nobel Prize for discovering how nitric oxide works and where it came from, you know, was awarded in 1998. And, you know, for years in cardiac surgery and cardiology, we knew what nitric nitric oxide did, but we didn't know how it did it. But nitric oxide is a gaso messenger. But here's something really wild. So hydrogen gas is a gaso-messenger. And part of the fermentation process of bacteria eating fiber is to produce hydrogen gas. And hydrogen gas is the world's smallest molecule, and it diffuses right across our gut wall.

Starting point is 00:34:57 And one of the shocking things as I was researching this is if you look at patients with Parkinson's disease, they have a microbiome that does not make hydrogen gas, whereas people who don't have Parkinson's disease have a microbiome that produce hydrogen gas. And you can give patients with Parkinson's disease hydrogen water, and that's water that has hydrogen dissolved in it. And they will symptomatically improve once they consistently start taking hydrogen water. And so, as I joke in the book, in Boy Scouts, what we used to do, you know, we'd eat beans on the camping trip, and we'd have Bic lighters, and we'd actually literally light our farts with this blue flame. I've seen that happen at a campfire a couple of times.

Starting point is 00:35:52 Exactly. And that's hydrogen gas. And little did we know. Methane too, maybe. I don't know. Well, it turns out that is actually a gas omo messenger as well, as well as hydrogen sulfide, that rotten egg smell. And for years, you and I were taught that hydrogen sulfide is a toxic gas. But we now know that the effect of hydrogen sulfide is that of a hormetic agent. And a hormetic agent is basically that which doesn't kill me makes me stronger so yeah so that no hydrogen sulfide is not good a little hydrogen sulfide is good a lot of hydrogen sulfide will kill you so a little dab will do you of these things and so getting back to your original question, the more we feed our microbiome, the foods that they can make,

Starting point is 00:36:48 these literally text messages that tell your mitochondria to produce energy, the better off we are. And again, you look at, oh, a tribe like the Hansas, who they eat about 165 grams of fiber a day. If we're lucky, the average American may eat 20, probably not. But they're a watch. I think it's eight is the average American. If we're lucky. And half of the fiber we eat is actually insoluble fiber, which is actually really bad for you in a lot of ways. So long story short, we are so deprived of the energy-producing compounds that are available to all of us if we'll just feed the microbiome what they need. And that's a big part

Starting point is 00:37:46 of the book. So a lot of the key is fixing your gut to get your energy back. Yeah. The second key is we are overfed and underpowered. And what the heck does that mean? We, in general, Americans eat nearly 16 hours a day, almost continuously, from sunup until well after sundown. And we have what's called mitochondrial rush hour, which living in L.A. is easy to understand, but simplistically, our mitochondria can handle sugars, fats, and proteins. And we use a slightly different system for making energy from sugar, from fat, and from protein. And in the good old days when we ate whole food, like you advocate and I advocate, these different components, sugars would arrive first in the mitochondria. They'd be followed by protein sometimes later. And a long time later, they'd be followed by fats.

Starting point is 00:38:59 And mitochondria have, if you will, basically a freeway, an energy-producing freeway. Now, when these things arrive in a staggered fashion, the freeway moves great. But what happens is with our modern diet, with processed foods, with ultra-processed foods, we have combined simple sugars, simple proteins, and easily absorbed fats that hit our mitochondria simultaneously. And the mitochondria actually can't handle all these. So we actually have stagnation in the energy-producing highways. And we have systems on freeways, okay, we're going to have traffic lights that's going

Starting point is 00:39:43 to control the onslaught of all this. But we get mitochondrial gridlock. And I use the example. So okay, let's have breakfast at seven o'clock in the morning. All of a sudden, you're slamming with all three of these components. And your mitochondria literally go into gridlock for two or three hours. You begin to get sleepy at 10 o'clock and you say, oh, I need a little pick-me-up. I'll have a donut and a cup of coffee. And once again, traffic gets slammed. By that time, it's lunch. We slam it again. And so this process of gridlock really never stops until we go to sleep. And even after we go to sleep, there's still two to three hours of backup, if you will, on the mitochondrial freeways.

Starting point is 00:40:35 So our mitochondria really never have a chance. And in researching this book and trying this out on my patients, one of the things that was dramatic was that if I could lessen the period of time that you're asking mitochondria to handle food, the better off you're going to be because they have a chance to recover and heal themselves, if you will. And that gets into part two of the book. How do you put this into practice? So your book is quite extensive and really goes into detail about a lot of these unusual compounds that come from a disturbed gut microbiome that have broad spectrum challenges in the body. And this is what we've been doing in functional medicine for decades.

Starting point is 00:41:24 It's really the foundation of my practice. It's really the key to getting people healthy. And I sort of agree with you that a lot of the beginning and the end of health starts in the gut. And it's really always the first place we start with food and gut repair and functional medicine. But you talk about the plan of how do you do this? What are the do's and don'ts of the energy paradox when it comes to eating?

Starting point is 00:41:50 Well, first of all, the more, and you and I, I think, would agree complete with this, the more you stay away from processed foods, from ultra-processed foods, that's really the fundamental starting point. The more you actually use whole foods and literally foods in their whole state, the better off you're going to be. Number two, I can't resist telling people to get lectin-containing foods out of their diet. Lectins are part of the plant defense system against being eaten or having their seeds being eaten. And these are proteins that Dr. Fasano and others have shown disrupt the gut wall. And they in themselves are antigens that, in my original line of work, heart disease attract inflammation to the wall of blood vessels. And so there are a nasty bunch of compounds and they're in so many of our favorite foods,

Starting point is 00:42:55 such as whole grains. The nice thing about beans is beans are loaded with lectins, but pressure cooking and soaking beans and fermenting beans actually eliminates the lectin problem. Would the pressure cooking grains do the same thing? Great question. Pressure cooking will not break the gluten in wheat, barley, or rye. Gluten resists pressure cooking. There is a gluten-like protein in oats that also resists pressure cooking. And I can't tell you the number of people who have gone on a gluten-free diet with autoimmune diseases, with celiac, who are not cured. They still have celiac because the foods that they're eating, like oats, like corn, are loaded with lectins. And just recently I had a gentleman who we, I don't like to use the word cured of rheumatoid arthritis,

Starting point is 00:44:00 but his markers vanished by following our program. And then he was a snowbird and he came back this winter and his rheumatoid, one of his RA markers was elevated for the first time in like four years. And he said, you've been cheating. He said, no, no, no. Are you kidding? I wouldn't do that. And I said, well, something's getting into your diet. I said, what do you have for breakfast? He says, oh, glad you asked. I've been on a pressure-cooked oatmeal kick. Every morning I have a bowl of pressure-cooked oats.

Starting point is 00:44:31 And I said, wait a minute, you can't do that. It's on your list. You can't pressure-cook oats. And we pulled out the list. He said, oh, oh, no, that's the change. And so we took it out. A month later, his RA was back to normal. Yeah, absolutely. I see that so often. Yeah, I see that so often. So getting out lectins, eating whole foods,

Starting point is 00:44:53 any other sort of key dietary do's and don'ts? Yeah. So one of the, I think the shocking benefit of time-controlled eating, and that is limiting the amount of time during the day that you consume food, is probably one of the number one fixes in our current energy crisis. And it seems almost contradictory, paradoxical, if you will. The more you kind of snack throughout the day, the actual harder it is for your mitochondria to make energy. And the more you limit... You have to eat to get energy, but what you're saying is if you stop eating, you actually are better at, at the end of the day, making more energy. And you have to eat to get energy. But what you're saying is if you stop eating, you actually are better at, at the end of the day, making more energy. Yeah, that's exactly right. I'll give you an example. We're actually supposed to have

Starting point is 00:45:55 significant downtime for repair work, for repair work for our brains, repair work for our mitochondria. And that would normally have happened because we were sunlight creatures and we were controlled by sun. And we'd get up when the sun came out and we'd basically go to bed when the sun went down. And even the advent of fire 150,000 years ago, we were still exposed to orange light, red light, and we certainly weren't exposed to blue light. So we still had a limited period of eating. And the evidence is, if we have a 12-hour window of no eating, which is really easy if you think about it, that's 7 a.m. to 7 p.m., that's a 12-hour eating window, and you'd have from 7 p.m. to 7 a.m. of not eating, we begin to shift into mitochondrial repair. And what's really exciting is the more you go

Starting point is 00:46:54 beyond 12 hours, the better the repair work goes. Let me give you an example. There's not a lot of repair work done on LA freeways during the day because the traffic is so bad. I drive into LA very early in the morning or to Palm Springs very early in the morning from Santa Barbara. And that's when the repair work's going on because there is much traffic on the road. Well, our mitochondria do the same thing. If they're doing work, they have no time to repair. And it's the repair of mitochondria, undoing the damage of our eating that actually allows mitochondria to get back to full power. So the more we can limit the time period that people eat, the better. Now, the first thing

Starting point is 00:47:43 we don't want to have people do is, okay, what Dr. Gundry says tomorrow morning, my first break fast is going to be at noon. I'm going to hold off break fast until noon. And I can tell you that 80% of your listeners and my listeners will fall flat on their faces because 80% of Americans are insulin resistant. And with insulin resistance, that's in the book too, you can't use free fatty acids, fat as a fuel. You can't, you can't get to them. And so you got to build up slowly in tolerance. And we have a six week program of holding people by the hand and changing when they eat breakfast one hour at a time so that we're going to stepwise because people fall flat on their faces with

Starting point is 00:48:36 attempting intermittent fasting because they don't have the availability to mitochondrial flexibility of changing fat metabolism. So you talk about a lot of other things that are really important parts of energy, including exercise, packing, sun exposure, avoiding blue light, which ruins our circadian rhythms, and even getting a dog. And can you talk a little bit about those things before we have to wrap up the podcast? Yeah. You know, I mentioned that blue light from our devices, from our lights, we are constantly being exposed to blue light. And blue light is really detrimental to almost all of our functioning, including our mitochondria.

Starting point is 00:49:29 And it really, we are awash in what I call junk light. And I think one of the most important things people can do is two things. Be exposed to red light at sunrise or sunset. If you're going to take walks, that's the time to do it. If you can't get exposed to red light, get yourself a red light box. There's a number of red light and near infrared light makers. I particularly use a Juve device, but there's plenty of other ones. And expose yourself to red light. Interesting. One of the things I learned, which I found hard to believe, but we actually produce ATP from melanin exposure from natural sunlight.

Starting point is 00:50:19 And so we do photosynthesis exactly like a plant. It may be why, fundamentally, we want to be outdoors. We want to be at the beach. We want to be exposed to sunlight. It may be that we're far more attuned to what sunlight is actually doing for us at a basic level than we thought. Plus, there's really cool evidence that sunlight actually activates mitochondria. And it changes the way water moves in mitochondria. But that's a whole other subject.

Starting point is 00:51:01 So why get a dog? Two reasons. I'm a big fan in the book of exercise snacking. And there's really good evidence that walking upstairs for a minute, up and downstairs for a minute, may have the same effect on your mitochondrial function through the production of myokines from our muscle cells as 20, 30 minutes of walking on a treadmill. And the effect of five minutes is even more. So why get a dog? Dogs are going to have to go out at least twice a day. And dogs will take you for a walk. The other thing about dogs is the evidence is overwhelming that people who have dogs have a much healthier and diverse microbiome than people who don't have dogs. Because the dogs… Get licked in the face.

Starting point is 00:51:56 Let your dog lick your face, and they bring in all these amazing dirt microbes into your house that you will mix with. Amazing. So a take-home from the energy book you've written, this really extraordinary sort of breakdown of a lot of the reasons why we're all struggling with fatigue, what you do when you get up and go has got up and gone. You know, what are the most important things people can do on day one to really look at what the causes are of their energy deficit and how to reboot it? Like you were just sort of summarize the take home from the book.

Starting point is 00:52:35 What would they be? I think the take home of the book is the more you get processed foods, simple ultra processed foods. And quite frankly, early on, the more you get modern fruit out of your diet, the better. And that always gets people riled up and my Twitter lights up. Modern fruit has nothing to do with healthy fruit. Believe it or not, a cup of grapes has more sugar than a full-sized Hershey's chocolate bar. And I could tell you which I'd rather have, but neither. And these things have been bred for sugar content. And we have to also remember that it's actually the fructose that's the troublemaker in stopping energy

Starting point is 00:53:27 production. Fructose goes directly to your liver and regular table sugars have fructose, folks, goes directly to your liver and actually stops ATP production. And it was one of the most enlightening findings of my research through the last few years. And the more I research how fructose works, the more scared I am of how much fructose is in a typical American diet. So that's number one. Number two, the less you snack, the better. The farther you stop eating before you go to bed, the better. And if you can get a three-hour window between the last thing that went in your mouth and going to sleep, it'll make a huge difference in your energy levels and your sleep patterns. That's so great. So it really is quite extraordinary. When you look at how do we get healthy, whether it's energy or whether it's autoimmune disease

Starting point is 00:54:28 or microbiome or brain issues, and we all come to the same conclusions. It's a very simple principle of eat whole food. Don't eat before bed. Give yourself a break between eating. Get rid of all the junk and eat real food. I mean, it's so simple. And yet it's just so hard for people to think about,

Starting point is 00:54:45 because there always should be some other thing that we're being drawn to that might be a thing, but it's actually what we're putting in our mouth most of the time. Yeah, I mean, we spend so much time talking about, well, we need to eat anti inflammatory foods, or we need to take antiatory supplements. Well, that's like trying here in Southern California to put out a forest fire that's coming to your house with a garden hose. And, you know, the forest fire is this massive leaky gut that most of us suffer from. And I can tell you that you can have a turmeric smoothie and that's a garden hose compared. Yeah. Right. Yeah. Well, Steve, thank you so much for being

Starting point is 00:55:33 on the podcast and for your incredible work to bring these principles of health and healing and wellness to so many people. Your book is called The Energy Paradox. What to do when you're get up and go is got up and done maybe show a copy uh so everybody can see what it looks like it's out um could you go get it wherever you get your books amazon barnes and nobles wherever harborwave.com and you uh i think will will not be sorry because it's just a treasure trove of wonderful tidbits and guidance on how to actually reset your energy balance because we are all in an energy deficit and we need to be thinking about

Starting point is 00:56:08 how we can get our energy back because that's what we need to do to live and love and be. So everybody, thank you so much for being a part of the Doctors Pharmacy audience. We'd love to hear from you. Leave a comment, how have you struggled with energy and what have you done to improve your energy? And also subscribe wherever you get your podcasts,

Starting point is 00:56:26 share with your friends and family who probably are tired too. And we'll see you next week on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements, to gadgets, to tools to enhance

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Starting point is 00:57:49 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.

The Dr. Hyman Show - Sick And Tired Of Being Sick And Tired? How To Reclaim Your Energy with Dr. Steven Gundry

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