The Dr. Hyman Show - Stop Blaming Salt: Fixing High Blood Pressure by Treating the Root Cause

Episode Date: November 24, 2025

Most people think high blood pressure is just about “bad pipes,” but it’s really a whole–body problem driven by inflammation, insulin resistance, and years of eating sugary, processed foods. Hidden problems like sleep apnea, belly fat, toxins, and not getting enough key nutrients slowly damage your blood vessels and raise the risk of heart attacks, strokes, kidney failure, and memory loss. Instead of simply pushing the numbers down with medication, the Functional Medicine approach looks for the real “why” behind high blood pressure in each person—food choices, sleep, stress, genetics, environment, and more. By rebuilding health with real food and targeted nutrients, better sleep, movement, and stress relief, many of these root causes can be reversed or improved. The message is clear: high blood pressure isn’t destiny, and with the right changes, the body often has a powerful ability to heal. In this episode, I speak about, along with Dr. George Papanicolaou and Dr. Cindy Geyer, how high blood pressure is largely driven by inflammation and lifestyle factors, but with some foundational changes it can be reversed. Dr. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. Over time as the healthcare system made it harder for patients to receive personal care, Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health—a practice dedicated entirely to Functional Medicine. In August 2017, Dr. Papanicolaou joined The UltraWellness Center. Dr. Cindy Geyer received her bachelor of science and her doctor of medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N.Y. and is triple board certified in internal medicine, integrative medicine and lifestyle medicine. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN to save 15%. Full-length episodes can be found here:What Causes High Blood Pressure And How To Fix It Treating The Underlying Causes Of High Blood Pressure Treating High Blood Pressure at the UltraWellness Center How To Do The 10-Day Detox

Coming up on this episode of the Dr. Hyman Show. You know, I was sort of a really shocked to learn, you know, when I sort of got into functional medicine that high blood pressure wasn't just like a plumbing problem, that it was an inflammation problem and that the inflammation has many, many causes. Do you ever wonder why you still feel stressed, wired, or wake up tired, even when you're doing everything right? There's one nutrient deficiency I see over and over again in my community and in my patients, magnesium.

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Go right now to bioptimizers.com slash hymen. Use code hymen and grab your favorites before this deal disappears. After December 3rd, it's gone. Don't miss it. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one-on-one, there just isn't enough time in the day, so I've built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the Hyman Hive, for live Q&A's exclusive content and direct connection.

For real-time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor-trusted supplements and health products at Dr. Hyman.com. And if you prefer to listen without any breaks, don't forget, you can enjoy every episode of this podcast, Add Free with Hyman Plus. Just open Apple Podcasts and tap Try Free to start your seven-day free trial. That 93% of Americans have either high blood pressure, high cholesterol, high blood sugar, have had a heart attack or stroke or overweight. That means that about 6.8% of Americans are actually healthy and don't have any of these

problems. That's scary. That's adult Americans over 18. so why is this going on it's because our diet is so bad we have a very inflammatory diet creates a lot of oxidative stress and high blood pressure is a problem of inflammation and oxidative stress and what's triggering that often is the insulin resistance which is triggered by the mountains of sugar and flour we have every day I mean the average American has about 152 pounds of sugar and 133 pounds of flour a day a year that's almost a

almost a pound a day. And that is driving lots of metabolic issues, insulin resistance, organ fat. And that creates a whole cascade that drives up blood pressure and causes weight gain. And it's really, really important to address those causes. So there are other factors. You know, the heavy metals can be a big factor, often undiagnosed heavy metals lead. Mercury can drive a lot of issues. Sleep apnea, another big factor. If you have sleep apnea, you snore night, it may be driving high blood pressure. Lots of nutritional deficiencies can be a factor. Omega-3, magnesium deficiency, very common. Magnesium deficiency about half the population. Omega-3 is over 90% of the population. So these are really treatable causes. And obviously stress, lack of exercise,

certain environmental toxins, all can drive these problems of high blood pressure. And according to the population who are adults worldwide have high blood pressure or hypertension. And a lot of people have pre-hypertension, which is sort of early hypertension. We know the levels we say of like 140 over 90, even when you're down 120 over 80, you're still have risk. Below 110 over 70, you're doing good. So most of us don't have broad pressure like that because of our lifestyles, because of our diet, because of the stresses of our environment, because of lack of exercise, because of all

the inflammatory things. And then high blood pressure is a real killer. It's the silent killer. You often don't know you have it, but it's a huge driver of kidney. failure, strokes, heart attacks, dementia. It's a big deal. Now, normally it's treated with medications and often combinations of medications, which can help reduce the risk of these complications, but it doesn't address the root cause. So we've got to figure out the root cause. These medications are not risk-free. Often they have side effects. In functional medicine, we really focus on dealing

with the root cause, whatever it is. What's the cause of high blood pressure? So what's really wrong with our current approach. We are just using whack-a-mole medicine. We treat the symptoms to suppress them with medication without ever really digging into why. So what about salt? Because that's a big question, right? Is salt the cause of high blood pressure? Well, no, we need salt. But the problem is since we were hunter-gatherers, our ratio of salt and potassium is completely flipped. We used to be 10 times as much sodium. Potassium is sodium or potassium is salt. But now we have 10 times as much sodium. as potassium. And potassium helps you lower your blood pressure. Potassium actually is a very important mineral that we are not getting enough of, but it comes primarily from plant foods. So when you're

eating a lot of plant foods, you're getting a lot of potassium. If you're eating a lot of processed foods, you're getting a lot of salt. How do they make basically refined oils, flour and sugar taste edible? They often will add a lot of salt to the product. So it's really a problem with added salt in this country and lack of the right amounts of fruits and vegetables that can help to provide the right amount of potassium. So we need salt. It's not bad. And there are certain patients that are salt sensitive genetically, often African Americans that have to really restrict salt or watch their salt intake. But most of us don't really have to worry so much about salt if we're not eating processed food. It's not the salt that you add to your diet. It's a salt that's

added by corporations in processed food. So if you want to add a little salt on your food, don't worry about it. If you are using salt is actually tricks, you can actually put on after you cook and just put it on top of the food and you'll get the same kind of salt flavor without having even as much sodium. But the key is to actually increase dramatically your plant foods to include and a potassium. And that's really the issue. So a lot of unprocessed plant foods that have a lot of potassium or spinach, broccoli, squash, avocados, papayas, bananas. Also, you can make make broth, if you make a lot of root vegetable broth, greens, mushrooms, boil them up. You know, you don't have to eat the mushy vegetables, but strain it and drink the broth

full of potassium. I call it the ultra broth, and there's an ultra broth recipe on our website. We'll link it in the show notes. Now, if you have high blood pressure, you know, you'll be told to cut your salt, but that may not be great idea. And there's some studies that kind of say that maybe we shouldn't be so aggressive about lowering salt for everybody if we're having them eating a whole unprocessed diet. So in fact, in one study on heart failure patients, those who were salt restricted were 85% more likely to die

or be hospitalized than those who did not limit their salt intake. Now, again, there are people who are salt sensitive, so be careful. So where are you going to get your salt? We'll get it from foods which is naturally occurring in there. Basically, it's, it's, it's, high in things like meat and carrots and beans and beans. But you can add a little bit of salt, like Himalayan pink sea salt is great. Redmond salt is great from Utah. I like those. You want to make sure though you're kind of adding salt towards the end of cooking because it'll actually help bring out the flavor without having to eat as much. So you definitely can eat too much salt for sure. So it's not really unlimited. But be careful when you have

high blood pressure. And watch what happens. Check your blood pressure, check your diet. Also, iodide salt's really common. They add iodine into the salt because of deficiencies that we were had in a population. And you do need iodine and it can cause problems if you don't have it. But often you can get it from fish and from seaweed and other sources. So I think, you know, it depends on your diet, but we might need a little extra iodine. Now, what can you do to actually fix high blood pressure? Well, the first is to reduce inflammation, to get rid of oxidative stress in your diet, and how do you do that? Well, you've got to get off of the junk, right? So eat, get rid of all the processed foods, eat a whole foods, plant-rich diet that's high in potassium-rich foods.

And I created something called the 10-day detox diet, which is a very simple 10-day approach to cutting all the inflammatory process foods. And we found people's blood pressure drops up to 20 points when they do that in a week. or seven days or 10 days. So it's very impressive when you see the results. You want to eat a lot of potassium-rich foods, like I said, the broths are great, fruits, vegetables, nuts seeds, high fiber, good fats, calcium, magnesium. magnesium is a relaxation mineral. It's really important for regulating blood pressure. In fact, when women come in with preeclampsia, which is a pregnancy-induced high blood pressure condition that can cause seizures and high blood pressure, what's the treatment? We give them intravenous magnesium. Now, I don't know why we start with all the

drugs with blood pressure, why don't we start with magnesium? And you can get a lot of, I can get a lot of magnesium for your diet, greens, beans, nuts seeds, a little chocolate, too. Carbohydrates are a big factor, starch and sugar. So make sure you're cutting those down or cutting those out and eating good carbohydrates, which are all the fruits and vegetables. Sugar is really the big problem. It's driving insulin resistance that drives the high blood pressure. Eat the right fats. So omega-3 fats are really important, help reduce inflammation, but also can help lower blood pressure. Those can come from wild fatty fish. I like the smash fish, which are small, low in toxins, sardines, mackerel, herring, anchovies, salmon. Those are all

really good, good quality fat. So you can get also grass-fed meats often have omega-3s like bison, grass-fed lamb, chickens depending what they're eating. All great. Get real food. Just eat real food, get rid of all the processed food, like I said, make sure you try to avoid inflammatory foods that maybe triggers for you, like gluten and dairy. Those can be driving problems with blood pressure as well. That's why the 10-day detox is a great way to start, reset. Also liquid sugar really bad, sodas, juices, all that affects you. Hydrogen and fat, actually, we shouldn't be any of that anymore, but that also can be very inflammatory. Get protein and fat for breakfast, not starch and sugar. Most of our breakfast in America is cereal, bagels,

muffins, croissons, blah, bloody, blah, all that stuff, pancakes, French toast. That's all dangerous to eat for breakfast. You want fat and protein. I usually have a protein shake. You can have eggs, avocados. Those are great. Flax seeds are great. Also, lots of fiber can help improve insulin resistance.

And alcohol, alcohol can be a big factor. So I would really minimize or eliminate alcohol for a little while. Stay hydrated, really important, keeping your blood pressure normal. and don't need before bed, that worsensensensensal resistance, weight gain. So you do all these dietary things. You're still maybe need a little help. What do you do? Well, there's some supplements that can really be helpful.

I like magnesium, and you can take magnesium citrate or glycinate. If you're a little constipated, use magnesium citrate. If you're not, you can use magnesium glycinate. Kukuten has been shown to help with blood pressure. You can take potassium, omega-3 fats, B vitamins, extra fiber. good multi. All those are great strategies. What about exercise? Exercise actually can increase your blood pressure when you're exercising, but overall it helps your cardiovascular system and lowers your blood pressure. You'll help you lose weight. I mean, even if you lose five to ten pounds,

we've seen that really have a big impact on blood pressure. Exercise is not a luxury. I mean, one cartoon I often use my lecture says, would you rather exercise an hour a day or be dead 24 hours a day? So it's definitely not a luxury. It's an essential. part of living, just like eating and breathing and brushing your teeth. So what about stress? Well, stress is a big factor. And we know that stress drives blood pressure up. We know that it increases adrenaline, which increases blood pressure, cortisol. So practices like yoga, Tai Chi, meditation, guided imagery, breath work, all engage your parasympathetic nervous system and help lower your blood pressure and inflammation and help your metabolism and just basically healthy

overall. Sleep also super important. A lot of us don't get enough sleep. And, you know, in fact, sleep can deprivation can be a factor in high blood pressure as well. So I encourage people to get good sleep. And there's a lot of tricks for that. I mean, try to go to bed and wake up at the same time every day. You're in bedroom for sex and sleep only instead of working or, you know, doing a lot of stuff that we do in bed. I'm watching TV. Make sure it's dark and quiet and cold in your room. Have you been feeling stressed or tired lately? You might be low in one powerful mineral. That mineral is magnesium.

Most people are, and most supplements don't fix it because they only include one or two forms. I use magnesium breakthrough from bioptimizers because it has all seven forms of magnesium your body needs for sleep, stress, and recovery. It actually works. You can feel the difference. From November 23 through December the 3rd, you get 25% off. This is the once a year sale you do not want to miss. Go right now to bioptimizers.com slash hymen and use code hymen.

Part of the problem with diagnosing blood pressure is that it's often hard to know if you have blood pressure because one, it fluctuates all day long. Two, just getting one blood pressure reading in the doctor's office may not really tell you what's going on. You might have white coat hypertension meaning you get nervous and stressed. It goes up. I mean, when you exercise your blood pressure When you're stressed or blood, but what's your average blood pressure? So one of the diagnostics we do is a 24-hour blood pressure test, which I found really affected because you can see what it's happening when they're sleeping, when they're active, when they're inactive, and you get a really good sense of what their pattern is day, night and

average, and that'll tell you what your real risks are. Right. So doing 24-hour ambulatory monitoring is something that is really important to do, particularly if you're, you have any concern that the readings you're getting in your office are inappropriate. And you mentioned white coat hypertension, and that is not uncommon. It actually is fairly common. And so we will oftentimes recommend ambulatory blood pressure readings. And that gives us the clearest picture possible.

Yes, true. As long as you can just get a cuff at home and have people monitor their blood pressure out today, and that'll help too. You know, I want to just dig into a little bit before we get talking about the difference with functional medicine and traditional medicine, right? Traditional medicine is you check your blood pressure, it's high, you get medication, you're moderate. it. We call it essential hypertension. Now, there are other causes of hypertension that we

know of that are kidney diseases and other problems. But for the most part, people call it essential hypertension, which I joke and I say it means essentially we have no idea what's causing it. But we know that's not true. We know that's not true. So everything has a cause. Nothing is just random. Right. Right. If you have diabetes, there's not a random event. It's not like, oh, I got a virus. Something happened. And now, we know some of the major causes of high blood pressure are never addressed. Right. And the two biggest ones that I see treating patients is insulin resistance and sleep apnea. So one of the biggest factors is insulin resistance, which is an epidemic in this country. We have one and two

Americans that have pre-diabetes or type two diabetes, 75% are overweight, 42% are obese, and they all have some degree of trouble regulating their blood sugar, which just causes them to get belly fat. And that belly fat is such a big factor in driving all sorts of diseases. Everything from high blood pressure to cancer to heart disease to diabetes to dementia to depression and so on. But the insulin resistance drives inflammation. Yeah.

And it drives inflammation throughout the body because those belly fat cells aren't just sitting there holding up your pants. They're dynamic hormonal and immune organs. Right. belly fat is an immune organ and it drives inflammation throughout your body and that causes oxidative stress which is really what causes rusting so it's like your arteries and your pipes are rusting and stiffening called harding the arteries and that happens as a result of this inflammation and oxidative stress and so insulin resistance is probably the biggest cause of that today in america and it's it's really

driven by diet so i think people don't understand how powerful that is diet is very powerful and And, you know, I call it, you mentioned the adiposity we have around our waist. I call that the toxic waste dump of the body. Yeah. And that fat just does have a metabolic effect that is toxic to the body. As you said, it creates the hardening of the arteries, which is, you know, one important cause of high blood pressure. Yeah. And the other big thing is often misdiagnosed.

And by the way, by the way, insulin resistance affects so many people, 90% are not diagnosed. Absolutely. So the way you diagnose it is you do a test. for insulin and blood sugar and he's a fasting glucose tolerance test that we do I do in almost every patient yeah and this is the other test it's a little more advanced where you take a sugar drink basically drink the equivalent of two coax check your blood sugar and insulin fasting and then every one in two hours after but most doctors just check blood sugar but that's a very late finding you want to check insulin early and even doing a fasting insulin isn't going to give you an answer

and some you know it'll help yeah but by the time your insulin goes up fasting it's already down the road pretty far right so i agree And then we have this other issue, which is sleep apnea, which is so underdiagnosed. Yeah, so sleep apnea, through about 25 million Americans that have sleep apnea, it is underdiagnosed. It's not just a disease of people that are overweight. You know, most people think about obstructive sleep apnea being related to just being overweight, but you also can have upper respiratory anatomy and muscular relaxation that even if you're thin, you can have obstructive sleep apnea. Yeah, you have a narrow palate, a small airway, you have sinus issues.

And when, right, and when you have sleep apnea, that means you're just not getting enough oxygen to your body, particularly your brain, also to your, you know, to all your blood vessels. And your cortisol levels rise. And then you get into that whole cycle you talked about before, which is an inflammatory cycle, which is an oxidative stress cycle, which can lead the hardening of the arteries. And when you're not getting oxygen to those blood vessels, then they're actually can't. perform the work they need to do and create the energy they need to have. And so they can't contract and expand the way they should. And that can result in high blood pressure. Yeah. And then it also drives insulin resistance. So if you have sleep apnea, it also causes you to be prediabetic. Yeah, it causes weight gain. Independent of what you're eating, weight gain. It

leads insulin resistance. It leads to diabetes, which complicates everything. I mean, I had this guy who couldn't lose 50 pounds. He was a, he was a lawyer. And he told me the story. It's like he said, look, I need to lose a weight. I don't know what to do. I'm trying to eat right. It's not working. I'm trying to exercise. I said, what does your life like?

Well, I'm a lawyer and I work really hard. And, you know, but every day I have to stand up at my desk. I can't sit down. And this is before standing desk. Right. And I'm like, why? He says, well, if I sit down, I fall asleep. Right.

And I'm like, gee, maybe you have sleep apnea. So if you're falling asleep at work, if you fall asleep in front of the TV, if you feel it's hard during the day, if your wife says you're snoring, now there's apps you can get that actually record your phone, they record your snoring so you can see because people don't believe it. Oh, I don't snore. And then I love that app, by the way. And then it's one called sleep cycle that I like.

It's record their story. And it's something that is easy to treat. I mean, there's different methods of CPAP and, you know, but it is a treatable condition and the weight loss then will happen and you'll feel better. So that's really important. I just don't talk about a few other causes that I think are really important and worth noting because those are the two big.

biggest ones, but there's a lot of other ones. People who are nutritionally deficient in certain things can cause high blood pressure. Yeah. Like magnesium. Right. So in magnesium, you know, studies show that, you know, there's a very large percentage of people in our country have low magnesium. Forty-five percent of people have low magnesium, which is you know, magnesium, it's not magic, but you know, when we replace magnesium in patients, we see amazing things happen. We see blood pressure come down. We see them being able to able to sleep better. We see muscle twitching and cramping go away. We see mood improve. Magnesium has a very important role in the body and certainly plays a big role in lowering

blood pressure. Yeah, but I call it the relaxation mineral. And you know, it's funny how in medicine we have these blind spots. But when I was training in obstetrics and gynecology, I was a family doctor. I delivered lots of babies. There's this common condition that women get called preeclampsia, which is high blood pressure in pregnancy. And when they come in and their blood pressure is high, which can cause seizures. The treatment isn't high blood pressure pills because they don't tend to work. We give them intravenous magnesium

to relax their blood vessels and save their life. So we serve it's just a strange thing to me we don't think about it that way. The other thing that is important is omega-3 fats and fish show up because it helps relax your blood vessels, make them more pliable.

But there's other causes that we also see. For example, environmental toxins, heavy metals in particular, lead and mercury are really common they're underdiagnosed and when you go in your high blood pressure visit your doctor's not checking your mercury and lead levels not even your blood and probably not on the most important test which we do with the ultra wellness center which is a challenge test where we give people a drug to pull out the metals the key later and then we check their urine and see how much dumps in there and if they have high levels that's often a big factor as well and i think you're

you know you're you're really hitting on all the things that i think about and i tell people when they come to me and hypertension is part of what they want me to work with, I said, we're going to get your hypertension better by not treating your hypertension. We're not going to treat your hypertension. We're going to treat everything else that's causing your hypertension. We're going to find the sleep apnea. We're going to find your nutritional deficiencies. We're going to work on your stress levels. We're going to help you lose weight. When you lose weight, I mean, you actually are going to drop your blood pressure. I mean, we do know the genetics play a role. So somebody who has strong family history of high blood pressure, we might want to be paying more

attention. But as you've said so many times, our genes aren't our destiny. Those genes that we come into the world with are going to be influenced by so many other factors, many of which can unmask that potential and manifest as high blood pressure. So some of the root causes of high blood pressure, we know that weight gain and insulin resistance is a huge one. We know that diet plays a big role because of its effects on oxidative stress and endothelial dysfunction. insufficient sleep, whether that sleep quality, quantity, or timing can play a role with high blood pressure, loss of artery elasticity. So our endothelium is a target for a lot of the negative effects of lifestyle. We know that artery elasticity can be adversely affected by stress,

by certain foods, and there's even emerging evidence that food sensitivities, disruptions in the gut microbiome and toxic exposures can all have negative impacts on our arteries leading to or contributing to high blood pressure. So basically you're talking about modifiable factors that are treatable and fixable that cause the siffening of our arteries and that lead to high blood pressure. When you say endothelium, you mean the lining of the blood vessels and that becomes dysfunctional because of inflammation and oxidative stress, which has many causes, right? So, you know, I was sort of a really shocked to learn, you know, when I sort of got into functional medicine that high blood pressure wasn't just like plumbing problem, that it was an inflammation problem. And that the inflammation has many,

many causes. And you outline some of them, genetic predispositions, environmental toxins, changes in the microbiome or crappy high sugar processed diet, nutritional deficiencies, all these things impact the function of our blood vessels. And they're all treatable. So you're kind of treating patients. And I want you to sort of present this case here of your patient who had who had high blood pressure and what you kind of thought of what you did diagnostically and to kind of unpack some of the things we do at the ultra wellness center which is doing a deeper dive on your biology not just taking it face value oh your blood pressure is high here's a pill but we go into why like what's going on underneath the hood how do we find

things and search for things and hunt for things that may be treatable and modifiable factors that are driving you touched on a bunch of them you know whether it's pre-diabetes and insulin resistance, whether it's sleep apnea, whether it's nutritional deficiencies like magnesium or omega-3s or whether it's environmental toxins, some of which we can measure, some which we can't, but heavy metals have been linked to high blood pressure. So we kind of have to look for all these things. And that's what you did with your patient that I'd love you to sort of share her story. Actually, Mark, I think I love this idea of personalizing the story and the recommendations because you can have 20 different people with high blood pressure, and there may be

different combinations of those variables that are playing a role for any individual patient. So we have to go back and understand who the person is sitting across the table from us. If you see one person with hypertension, you've seen one person with hypertension or any condition, whether it's autism or depression. And that's one of one of the fundamental principles of functional medicine. You know, one disease can have many causes and one cause can create many diseases. We call end of one medicine. What is that person in front of me doing? What are the risk factors? What are their risk factors? What are the other factors that may not even know about? And how do we dig into those? And that's what we've been doing for decades at the Ultra

Wellness Center. By the way, if anybody wants to learn more about what we're doing, go to ultrawealth center.com. You can learn more about how to become a patient. But now let's sort of dive into that in that case. And how did you think about this case? Sure. So this was a 56-year-old woman. And she had a long history of so-called white coat hypertension. We'll unpack that in a few minutes. She also had a strong family history of high blood pressure and late onset memory concerns. Her mother had recently been diagnosed with cognitive impairment at the age of 80, who also had a long history of white coat hypertension and then sustained hypertension. And she was starting to get concerned about, you know, what is this white coat variable telling her about her vascular system? How can she do everything she can to try to optimize vascular health and prevent disease down the road?

For years, she'd been told with her blood pressure, don't worry about it. She'd go into the doctor, it would run 120s, 1 30s, maybe as high as 140, and she was told not to worry about it. So what do we do in conventional medicine? Either tell them not to worry about it, or you think about it, you think about the case of, oh, your blood sugar's borderline. Come back and we'll check it in a year. Well, no, we wanted you better than that.

Or decide, okay, now we need to put you on a blood pressure medicine. medication. So what's different in functional medicine, as you already talked about, Mark, we really want to go upstream. We want to see what the variables are that played a role with this particular patient. Why she's showing up with this reactive blood pressure. What are the things we can do to modify those risk factors and hopefully delay or prevent her from ever needing medication? And at the same time, keeping her heart and her brain healthy. And it starts by gathering the story. It's important to get into the story because, you know, like I think of my my parents, My mom and dad just obviously didn't listen to me and they ate crappy and they both run high blood

pressure pills and I'm 65 and my blood pressure is like 110 over 70, which is really highly unusual for someone my age, but it's not an anomaly. It's just because I understand what to do to regulate my biology and stay healthy as they get older. And most people don't do that. And our default in our society is basically leading us all to have these problems. That's why one and two Americans have high blood pressure and pre-diabetes. And by the way, I don't think it's an accident that.

one of two people in America have diabetes or prediabetes, and also one and two people have high blood pressure because they're very related. Going back to her story, I mean, she had a pretty uneventful early life. She was born vaginally. She was breastfed back at a time when it wasn't a common thing to do. She didn't have a lot of infections, not a lot of situational stress, all of those early life exposures that we know can prime the vascular system to be more potentially more reactive. She did have a history of allergies, but kind of unremarkable other than that.

started birth control pills at 19, and interestingly, I've developed hypertension on the birth control pills. Why is that? Well, the blood pressures, that can be genetically determined. It may be that it unmasks a potential for oxidative stress. I don't actually have the answer to that one, but I think there's some clues later. Yeah, I mean, the birth control pill is interesting because, you know, estrogen does make you retain a little more fluid, and that may be part of it. The progestone can also make you, you know, gain weight.

sometimes, that may be part of it. So there are things that, you know, medications that may also, like the birth control may actually drive increased risk of hypertension. That's true, especially through the ren and aldosterone system that we know plays a big role. And they're much higher doses in the birth control pills and what a woman would have made with her own natural cycling hormones. Other than that, pretty healthy until she had her first pregnancy at 35. It was a twin pregnancy and it was complicated by low amniotic fluid, preterm labor, and pregnancy-induced hypertension. She went on to carry her babies to term. She had a vaginal delivery.

She nursed them for a year and a half. And that was when she started having the white coat periodic elevations in her blood pressure. Again, she was told, don't worry about it. It was attributed to the stress of being a young mom with two kids and maybe some sleep deprivation and working as an emergency room. Fast forward, she in her early 40s, because she was snoring probably related to her allergies and she had some daytime fatigue, she was set for a sleep study that did not show sleep apnea. It showed a pattern that's called upper airway resistance syndrome. More common in women, that is a pattern we'll talk about in a few minutes, but it's where

the airway becomes a little bit more collapsible or there's a restriction in the ability to get air into your body maybe because you've got nasal allergies or you've got a small jaw, but you're not actually stopping breathing and you're not really dropping your oxygen level. So back then, there was no treatment recommended other than to work on her allergy symptoms. Just to double down on that, a lot of people who have high blood pressure have undiagnosed sleep apnea. Yes. You know, if you're snoring or your partner says you're snoring or you gasper breath or other symptoms of sleep apnea, meaning you fall asleep easily watching TV or when you're driving, you feel tired. I mean, these are clues. And it's important

that people get this diagnosed because it's treatable. I'm often with weight loss and other things, but sometimes you need to take a breathing machine at night. And that can often resolve high blood pressure. So when I sleep someone, the first two things I think of are pre-diabetes and insulin resistance and sleep apnea as both causes of- Absolutely, Mark. And I'm so glad you said that because I think what's emerged is upper airway resistance syndrome isn't just benign. I mean, that's another area where it's like, don't worry about it. It's not sleep apnea. There's really nothing to do except treat your allergies. But what do we know about even that pattern? If you're having these subtle disruptions and the continuity of your sleep, even if you're not stopping

breathing, you wake up tired, you have trouble with daytime fatigue, and it's associated with high blood pressure. This is also a more common pattern for women, and it gets overlooked all the time because we have a stereotype about who's the more likely person to present with sleep apnea. And it's usually an overweight man with a big neck circumference whose nords really loudly. It gets missed and lean women in particular. And then what else did you find on her? So, well, the next piece was she had gone. She went through a pretty significant menopause, lots of heavy periods.

Last period was finally around 49, tons of hot flashes and night sweats. Why is that important? Well, guess what? There's now been a recognized association between women who have more of those vasomotor symptoms, also being associated with more vascular reactivity and higher risk of cardiovascular disease. But at the time, again, nobody was thinking along those lines. She had a conversation with her OBGYN and decided to go on an estradiol patch and progesterone. She had good relief in her symptoms. Another really important thing, though, about the menopause transition is the changes in estrogen that happened can also unmask more effects of stress on the vascular system. We also know that insulin resistance tends to get worse in the menopause transition. So it's a potential window of opportunity to think beyond just should you take hormones or not. Because, again, fitting into her story, looking way upstream and trying to put things into place that are going to keep her hard.

heart and her brain healthy. She's always been physically active. Another piece of her story that I think is going to be relevant down the road, she's always been physically active. In fact, one of the main things that she sort of hung her hat on in terms of trying to keep her heart and brain healthy was to stay physically active. And she periodically would be plagued by multiple soft tissue injuries. She'd had planar fasciitis. She'd had posterior tibialisthenitis. She'd had epicondylitis. So she'd had a lot of these soft tissue injuries, which would periodically take her out of commission from her exercise. So that's sort of her backdrop. And it leads us to some interesting clues of some other things we might want to think about related to her blood pressure

beyond just medications or not. And think back to her original goal. She's really concerned about future risks for cognitive decline. What's the connection between blood pressure and cognitive decline? We know that the blood brain barrier, that critical interface between the body and the brain, it is really vulnerable to the effects of any kind of masculine risk factor, whether that's prediabetes, insulin resistance, high blood pressure, oxidative stress, inflammation, that blood brain barrier can become more permeable or leaky. And it plays such an important role at selectively letting in the nutrients to the brain that we want getting in, keeping out toxins and microbes that we don't want getting in, and then also supporting the brain's waste removal

system, the lymphatic system that removes waste from the brain. Any vascular insults are potentially going to contribute to that leaky blood brain barrier. So optimizing your blood pressure, looking at those upstream factors, is going to be really, really important for her to meet her goals. One of the things that's interesting with your diagnostics is that you look at genetics related to high blood pressure, which we can now do. So these are tests that we do at the ultrawana center. It's a cheek swab. You can look at your full sort of panel of risk genes. And we don't look at your entire genome because it's like too many things, 20,000 genes. We look at the ones that are common that we can do something about that are probably affecting your health in an immediate

way and we can actually modify. And so you found a number of things there. And I think there are a lot of variations and we can use the science of genomics and our understanding of the biology of what happens when you have certain variations to modify your risk factor. So the genes, like you said, you know, load the gun, the environment pulls a trigger. And there are certain people have salt sensitivity, which we can pick up through genetic testing. But But not everybody with high blood pressure has a salt issue. You know, I think there's a real issue there with like how many people are salt-sensitive. And it's probably maybe, you know, 40% of people who have high blood pressure are salt-sensitive.

But a lot of people aren't. And there's, you know, a real controversy about salt, whether it's the issue or not the issue. And there's been large population studies that kind of show that there's maybe a slight risk. There's an intersalt study, for example, in 1988. it was just a tiny, tiny little risk. And the question is, you know, is it the salt or is it, and this is just a question I have, is it the salt or is it the salt in connection with certain genetics or the salt in connection with pre-diabetes or insulin resistance, which makes you retain more

water, hence you'll get high water pressure because you have bigger fluid, fluid in your system. So what are your thoughts about that? You know, it's a great question mark, and I think it's not simple, right? So we know that that subset genetically of people who are sensitive to salt, it's less than 50%. But there was an older mouse study that found that high sodium intake actually increased oxidative stress. So there may be another mechanism that it's not just about the sodium's effects on the renin, aldosterone angiotensin system and fluid retention, but it also creates more opportunity to produce these free radicals that directly impact vascular health. So also, like, nobody talks about the fact that, you know, historically, we had 10 times

as much potassium as sodium in our diet as hunter-gatherers. Now we have 10 times as much sodium. So it's not just the excess sodium, it's the lack of potassium. And where does potassium come from? It comes from all our vegetables and fruits and stuff. So we're not eating enough plant foods. And those have really high, high levels of potassium. And magnesium.

And magnesium. Yeah, magnesium is the other nutrient where probably 45% of us are deficient. And so is it the salt or is it the balance of all these other electrolytes like magnesium and potassium and calcium that we can't ignore, but that we do look at in functional medicine. The traditional doctors won't look for that and they won't modify that. But it can be really a huge factor. And you can give people potassium supplements. You can increase their potassium in their diet.

You can do the same with magnesium and in terms of dietary magnesium as well as supplements and same thing with calcium. So we have to be really aware. It's not just such a simple reductionist view that, oh, salt caused high blood pressure, and so you should eat less salt. I find that most people have never connected the dust between how they feel and what they eat. They walk around with what I call SLSD syndrome. That's when you feel like crap.

And that is a big problem for people. What do I mean by that? Well, you might be tired, sluggish. You might have brain slog. Maybe I have digestive issues, reflux, heartburn, earl bowel, maybe have nasal congestion, sinus issues, muscle aches, joint pains, headaches, insomnia. Should I go on? Rashes, acne. I mean, it goes on and on and on it goes on and many of these things are caused by food.

And the only way to know is to do a total body reset, like hitting the reset button on your commuter when all the systems are jammed. It's a complete reboot. So how do you do a reboot? It's very powerful. And those people have narrow experiences. And this is why I love to do with people. And I actually then tell them all around that we're angry if people can come and actually experiences.

We do programs where we have people do this just in five days, not even 10 days. People have a 70% reduction in all symptoms of all diseases. Now, I'm going to put in the show notes the medical symptom questionnaire that I use in my practice, which essentially gives you a score based on the degree and frequency, severity of symptoms. So if you have a headache, is it at zero, meaning never, or four, you get it all the time, it's really bad, or some version in between. And then you get a score at the end, and, you know, people have a score of 60, 70, 100.

It should be less than 10, maybe even zero. Ideally, I should have a symptom. It's not normal for human beings to suffer this much. And that's really why I created this book and the program, the 10-day detox side, because I was doing this with my patients and seeing such incredible results. So I do this personally regularly. I do it at least two or three times a year, four times a year to really resexie. my system to kind of get my body back on track, to get all the bad stuff, put it all the good

stuff. Now I want to walk you through how to do this. I'm going to teach you how to hit the reset button, reboot your system, and to optimize your biology to help your gut, you help your detox system, help your immune system, help reset your nervous system, and it's powerful. So if you want to really see how your body can feel and get rid of what we call FLC's in your I would do this. Most people are like a frog that's in cool water where you turn the heat up slowly and it starts to boil to death. We just kind of get used to it and think it's normal.

These symptoms are not normal. My fan. I want to do this with a junior eye school once and the teachers are like, well, we might have to get permission from the paris to see if it's safe. You know, maybe they don't want their children doing this. I'm like, what, is it safe to eat fruits and vegetables and nuts and seeds and protein and cut out sugar and starch and processed food. I mean, they should get a note that it's permission to eat the junk food that they just the opposite. So, anyway, yes, it's very saying anybody can do this.

And some people, by the way, you know, need more certain things or other things. But basically, this is a very universal approach to resetting your system. A second pillar, aside from which you eat, the food is really important. And by the need to be approaching the morning, you need to make sure you get rid of sugar and starch in the morning. It's super important. when people start their diet, their day with carbs, which is the worst thing you can do, sugar sweet, coffee, teas, cereals, muffins, bagels, breads, done.

Second pillar are your daily habits. Essentially, you love a pattern of eating and living that puts your body back in rhythm. It helps you resale your nervous system. And there's two really important habits as part of the 1080 time. One is when you eat and also when you sleep. So let's talk about when you eat. Now, when you eat might be as important as what you eat. So many of us don't eat in the right pattern.

We tend to, you know, eat all day long. We tend to snack. We tend to eat before bed. We snack late at night. It's kind of bad. So basically, when you eat, it's very important. Research shows that doing that can really be bad for your health. I don't know if you eat at night.

So the first is make sure you give yourself at least 12 to 14 hours between dinner and breakfast. So dinner is six. breakfast at eight, that's a 14-hour fat. Okay. If you eat at six and then you keep snacking all night, that doesn't count, right? And it's the most simple form of what we're called time- restricted eating. And it's basically giving your body a rest and getting the body to reset. And I wrote a lot about this in my book, The Young Forever, but basically there's a whole process at night that happens about autophagy and clean up and repair. You want to eat your body the ability to do that. The next is food.

Now, you can do a breakfast if you're eating, you know, for example, dinner at six and breakfast at eight or so. That's important to have protein in the morning or not carbs and sugar. Also, not eating three hours before bed is really important. So most people eat and snack after dinner, don't do that. Have at least three hours the time you eat and you go to sleep. That way you will lose weight. Your body can repair and yield instead of trying to digest and store the food.

What about sleep? Sleep is one of the most underrated pillars of help. It's probably even before exercise, meditation, maybe even before nutrition. Because when you don't sleep well, you're going to eat sugar in arms. You're going to claim more. So you want to focus on sleep and restore to rest. We know that getting in a routine of waking and sleeping can help them deeper and restful sleep. So try to pick the same bedtime every night, try to get off your screens for an hour two before bed,

keep your room, or use blue block your glasses, keep your room dark and cold. that probably 55 to 68, really important because your body does much better with sleep at night, try to relax at night with meditation, do it got imagery, do breath work, stretching, journaling, gratitude practice, whatever you like, do something, very important. So your evening or 18 should be like, set of bedtime and stick it over in 10 days, turn your phone off and get out of your bedroom, turn the TV off for at least an hour before you go to bed, and then use the time at night to read, to journal, to meditate, to connect with people you love,

and just kind of wind out. Well, the third pillar is extra support we need on the journey, right? Now, we all need nutrients. They're called vitamins because they were vital amines, vital to life, right? And so we've seen a dramatic reduction in the nutrient density of our food.

Our organic matter has gone out of our soil. Nutrients can't be extracted. foods travel long differences. We have commodity crops, which are bred to actually breed out the nutrients and in the starch and yield. And so foods aren't as nutrition as they once were. And probably 90% of Americans, according to the government-owned surveys, are deficient in one or more nutrients at the minimum level to prevent deficiencies. How much vitamin need or do you need to not get rickets? Not very much, like 30 minutes. How much need for optimal health? Probably three to five thousand so we need to really probably focus on nutrients and even with a

perfect diet you know because none of us are hunter-gatherers anymore or you know all kinds of food that we never ate and I mean nutrient depleted we need we need the basic supplements so we need a basic set it's a multivitamin mineral foundational magnesium a lot of us are deficient magnesium involved in more 300 different enzymatic reactions super important helps you relax your nervous system at night help you calm down also people get constipated. Sometimes they change her diet. So taking magnesium citric can help. And lastly, vitamin D. It's also sick fish oil, but vitamin D is really important. Vitamin B over 80% is lower deficient in vitamin B. It's involved in so many different things in the body. So really important.

And it helps your mood, helps your muscle function, helps your brain, your energy, helps inflammation, autoimmunity. It's just super important. And most of us show out. Fish oil is also important. And I recommend fish oil to people or omega-3 fats. So one of the, program steps in the 10-day detox? What should be the tips? And then we're going to go to the first step is to eat from the 10-day detox approved list for 10 days. So eat what the hell you eat is, right? Whole foods, you know, whole food-based shake in the morning. You could add, you know, protein powder, protein if you want to have aggressive protein called super simple protein, but you really need to make sure you have good breakfast. Second is commit to daily

habits, right? Pick your designated eating window, right? You want a 12 to 14 hour or night fast, which means eating without a 10 or 12 hour window. Don't snack before bed, try to have the same bedtime, get off your technology an hour or 2 before, practice some active relaxation, huge impact on your health. Step 3 is adding the supplements. That you don't have to do this, but I really encourage you to have a multivitamin, magnesium, vitamin D, and potentially fish oil. And we're going to list which the products you should take in the show notes. You have it all listed there. Also, what you should eat and what you should avoid during your 1080 talk. Let's go through that. So here's the full food list. We're going to have it

in the show notes. You can take it with you in store. It's in the book, the 1080 talks. It's in the 1080 cookbook. But essentially, here's what you should eat and what you should actually get rid of. What you should eat is protein. You need right protein, right? So grass fed or regenerally raised Meats is great. You can have a pasture-raised lamb, beef, bison, venison, elth, grass-fed beef, pasturrace chicken, turkey, duck, all that's fine. What you should avoid is conventionally raised chicken, poultry, and eggs and so forth. And by the way, you can also have eggs, they're pasturized eggs, meat, get rid of all processed meats, deli meats, all conventionally raised, feedlot meats, get rid of all that stuff. But about fish and seafood.

Lots of small fish are good, big fish are bad, right? Big fish like swordfish, tuna, sea bass, halibate, most farmish fish are pretty bad for you. What you should be consuming are things like the, I call this matchfish, small wild salmon, sardines, anchovies, herring, a macrol, you can have black cod, shrimp, scala, trout, those are fine. Eggs, as I said, pastures eggs are fine, not organic, regular eggs are not fine. What about nuts and seeds? It's very important. And almonds, Brazil nuts, cashew nuts, hazelnuts, macanamia, pecas, pistachios, walnuts, all that's great. You have cacao nids, chocolate, not actually chocolate, but where chocolate comes from. Seeds are great, chia seeds, flax seeds, hemp seeds, pumpkin seeds, sesame seeds, sunflower seeds, pumpkin seeds, all great.

Nut butter is also great. Unsweetened nut butter, so almond, cashew, pcan, macademia, I love mechamia, walnut. All that's great. You also eat beans if you're a vegan and you want to do this, you can use GMO-free or non-GMO tofu or tempe as your protein. What you should avoid are nuts there with sugar, they have cooked in oils that are basically candied stuff. A lot of nut butters have sugar, hydrogate your fats. Peanut butter, peanuts can be okay, but I wouldn't say mostly avoid peanuts because there has. have aphotoxin, they often are rants, and so you want to be careful with that.

You about oils and fats, well, the ones you want to use are organic avocado oil. You can use organic coconut oil for cooking, grass-fed and ghee. If you want to use tallow, lard, duck fat, chicken fat, that's okay, as long as they're path to raise or regenerative raised for salads. And you can use some fragrance of oils like almond oil, flax oil, hemp oil, macadamia oil, and can work with olive oil. And you can cook with olive oil, but only like tomato sauces and things like that. Things are not high heat.

Sesame oil, tahini is great as well, great fat, sesame seeds kind of paste walnut oil. Other flavorful oils, they're not main oils. But you want to avoid the traditional oils, all the seed oils, canola oil, partially hydrogenated oils, margarine, peanut oils, soybean oils, sunflower oil, saffler oil, trans fats, vegetable oil, vegetable oil, vegetable shortening, all that stuff bad. What about veggies? What should you eat? Well, you want to stick with lots of non-sardiches or orange chokes.

Organic, if you can. I use the Dirty Dozen Guide from Environmental Working Group, www.org. I'll tell you which of the Clean 15, meaning you can eat when they're not organic, or the Dirty Dousin, which you definitely not eat if they're not organic. But I love asparagus, arnichokes, avocado, bean sprouts, broccoli, brussels, cabbage, cabbage, cauliflower, cauliflower, celery, cucumber, eggplant, garling, ginger, hearts of palm, Corabi, leaky greens, mushrooms of all kinds, onion peppers, radicular, radish, rootabegas, all the kind of stuff.

Seaweed is great, lots of minerals, shallots, summer squash, tomatoes, turnips, zucchini. The list goes on. We have all in there. You can have some things like sweet potatoes. I like the Japanese purple sweet potatoes, winter squash, carrots, pumpkin. All that's fine. I mean, carrots are fine because unless you're doing carrot juice, that's a problem. But basically try to limit into like one serving, which is like half a cup a day.

What you should be avoiding is corn and red potatoes, mostly. A little, you know, some of the little fingling potatoes or the Peruvian potatoes, primal potatoes, and it can be fine. What about dairy? You can eat pasture-raised butter or ghee, but I encourage you to get up all dairy, including sheep and goat, which are mostly fine for people, but I encourage them to get all other dairy. And if you're having, he encouraged you to have, make sure it's breastfed or we're generally raised. And what about bees?

Well, you can have green beans. you can have green peas you can have a non-GMO organic soy that's just tofu or tempe you can have sap beans you can have snow peas

but otherwise definitely no beans what about grains no grains at all so even healthy grains quinoa buckwheat things like that I can't really have off all of that

why because it just shuts down the insulin response helps you lose weight reduce inflammation not that these are this are all bad, but eventually you can add them back, but basically get rid of all the other all grains, wheat, barley, rye, rice, emerald millet, oats, oh, it's everything, get rid of it. Fruit, fruit can be okay, but small amounts of non-hyglycemic rates. So, regantic blackberries, blueberries, blueberries, cranberries, kiwi, lemons, limes, raspberries, all that's fine.

Not too much, right? You don't mean, like, you know, two pounds of blueberries, but you can have a top half a comp a day. One and get rid of all the other fruit. all the high glycemic fruit, like bananas, pineapple, melons, peck, cherries, grapes, is the worst. Even foods that you think, you know, may be good for you, are actually good for you, right? Whether it's, you know, peaches, pears, acturines, cherries, for example.

But you don't want to eat them while you're on the tend to detox. You want to really shut down the blood sugar and some risk points. What about sugar sweeteners? Sorry, the tip. You can sometimes have a little bunk food or stevia. You have in the shake, we have, but generally it can, avoid all that stuff. Also, just get all the other artificial sweeteners, sugar, all that stuff. If you have to ask, the answer is no, basically. Then what should you be drinking?

Well, lots of water, herbal tea, green tea, all this, like caffeine, that's okay. A little green tea is fine. You'll help you get a coffee, sparkling water, mineral water, all this noise you avoid, alcohol, coffee, bottled water, some potpick, soda, obviously sugar. beverages. Basically, that's the program. So if you eat that way for 10 days, if you use those simple habits, your body is going to totally transform and you're going to see just how food is impacting your health, which I think most people don't have a clue about. And that's why I love this so much. Now, after the program, it's really important if you do it for 10 days or 21 days or 10 weeks or 10 months, you have to be small.

about getting off of it or you can get into big trouble. Because when you go off with the things that are inflammatory, foods they're learning to, and then you reintroduce them, you can get a lot worse symptoms. So let's say you had migraines before and then they're gone. Wow, you're going to get a duty of a migraine. Let's see, had gut issues before, you had a real problem. Unless you had sinus congestion from eating dairy and then eat it. Again, you might get a science of infection.

So you really have to be smart. So if you're feeling great, you want to continue and you let's see have a lot of weight to lose, let's say you have an immune disease, let's say you're feeling great, You want to continue. No problem. You continue it. Continue to do it. You can do it for another 10 days. You can do it for another 10 months. It's totally safe to eat. It's pretty much how I eat most of the time or the occasion grains and meat. Also prior to sleep and obviously your fasting window, not eating before bed. And then eventually people can transition slowly to the Pagan diet, which incorporates a lot of the principles of the 10-need detox diet, but it gets you more flexibility in your diet. Do you have a question about my favorite books, supplements, or recipes? Then sign up for my free Marks Picks newsletter at Dr.heimen.com slash markspicks, where I'll share all of this information with you and so much more. You'll get emails from me every Friday with recommendations on things that have helped me on my health journey,

and I hope they can help you too. Thank you so much again for tuning in. We'll see you next week on the Dr. Hyman Show. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show

wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am chief medical officer. This podcast represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests.

This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the ultra-wellness center at ultra-wellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed health care

practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public, so I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.