The Dr. Hyman Show - Treating The Underlying Causes Of High Blood Pressure with Dr. George Papanicolaou

Episode Date: June 22, 2020

Treating The Underlying Causes Of High Blood Pressure with Dr. George Papanicolaou | This episode is brought to you by AirDoctor Almost a quarter of the worldwide adult population has high blood pressure or hypertension. An additional third of American adults have what is called a pre-hypertensive condition. Hypertension is a leading cause of heart disease and can lead to kidney failure, stroke, dementia, and more. Conventional medicine typically treats hypertension with medications which is generally effective in reducing risk of these complications. However, these medications frequently come with unintended side effects. Functional Medicine, on the other hand, seeks to get to and treat the root cause of whatever is causing hypertension. In this episode, Dr. Hyman sits down with Dr. George Papanicolaou to discuss the Functional Medicine approach to treating high blood pressure. They discuss how things like diet, sleep apnea, insulin resistance, and more are often the driving forces of hypertension. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. He is also an Institute for Functional Medicine Practitioner. Upon graduation from his residency he joined the Indian Health Service. He worked on the Navajo reservation for 4 years at the Chinle Comprehensive Medical Facility where he served as the Outpatient Department Coordinator. In 2000, he founded Cornerstone Family Practice in Rowley, MA. He practiced with a philosophy centered on personal relationships and treating the whole person, not just not the disease. He called that philosophy “Whole Life Wellness”. Over time as the healthcare system made it harder for patients to receive this kind of 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. Dr. Papanicolaou to join The UltraWellness Center in 2017. In this conversation, Dr. Hyman and Dr. Papanicolaou discuss: What’s is considered normal blood pressure and why this metric is constantly changing Why high blood pressure is so dangerous The traditional medicine vs Functional Medicine approach to treating high blood pressure Why blood pressure needs to be treated How to get an effective blood pressure measurement Major causes of hypertension including insulin resistance, sleep apnea, low magnesium, low Omega-3 fats, and environmental causes Is salt an issue for high blood pressure? The connection between gut issues and high blood pressure For more information visit drhyman.com/uwc  This episode is sponsored by AirDoctor. We need clean air not only to live but to create vibrant health and protect ourselves and loved ones from toxin exposure and disease. Learn more about the AirDoctor Professional Air Purifier system at a special price at www.drhyman.com/filter Additional resources: Natural Remedies for Healthy Blood Pressure https://www.ultrawellnesscenter.com/2018/04/12/natural-remedies-for-healthy-blood-pressure/ 5 Strategies for Better Sleep https://www.ultrawellnesscenter.com/2020/03/19/5-strategies-for-better-sleep-2/ Magical Magnesium https://www.ultrawellnesscenter.com/2020/03/11/magic-magnesium/ A Functional Medicine Approach to Obesity: 10 Ways to Lose Weight & Keep It Off https://www.ultrawellnesscenter.com/2018/04/03/a-functional-medicine-approach-to-obesity-10-ways-to-lose-weight-keep-it-off/ 10-Day Rest GetFarmacy.com Should We All Avoid Gluten https://drhyman.com/blog/2018/09/26/podcast-ep20/ 8 Simple Hacks for a Better Night’s Sleep https://drhyman.com/blog/2016/04/13/8-simple-hacks-for-a-better-nights-sleep/ Magnesium: Meet the Most Powerful Relaxation Mineral Available https://drhyman.com/blog/2010/05/20/magnesium-the-most-powerful-relaxation-mineral-available/

Coming up on this episode of The Doctor's Pharmacy. There are so many other ways to treat hypertension besides just using pharmaceutical agents. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and this is Pharmacy with an F, F-A-R-M-A-C-Y, a place for conversation that matter. And if you're one of the millions and millions of people who have high blood pressure,

or you know someone with high blood pressure, this conversation's gonna matter to you because it's with my friend and colleague at the ultra wellness center in lenox massachusetts dr george papanikolaou he's one of our leading physicians here he's incredible guy who is doing great work here treating patients and they love him i can just tell you they love him uh and i love him so it's all good now we're going to talk about uh in this special episode of house call in the doctor's pharmacy we're going to talk about high blood pressure or hypertension so george tell us how big of a deal is this and and what

is the general approach of traditional medicine to dealing with high blood pressure and why should we care well we should care because you know in in the in the worldwide scheme of things there is about 1 billion adults which is about 25 of the adult population in the world that has hypertension. 1 billion people have high blood pressure. Yeah, it's 25%. Holy cow. By 2025, they think it's going to be closer to almost 30% of the world adult population. And it's also considered one of the leading causes of mortality to mankind.

So it's a big deal in in our country uh it's about 75 million americans that have hypertension that's a one in three and an additional one in three have what we call pre-hypertensive condition so they're like pre-high blood pressure pre-high blood pressure so that they the way it's staged you you can you know there's a category that's pre hypertension what was interesting george is like we constantly change the goalposts when i graduated medical school the blood pressure we wanted was anything under 140 over 90 then i was 120 over 80 now we're down to like 115 over 75 as being normal right so why are we do why are we changing the goalposts constantly well that's that's interesting that's interesting and I'm

quite honestly I'm not sure why we changed why we change it George is this reason because we keep doing the research that's finding that even at lower blood pressures people are experiencing the consequences of high blood pressure right so what are the consequences of high blood pressure why should we care yeah blood pressure side because it's a silent killer yeah yeah that's that's the key it's a silent you don't know you have it people won't know they have it uh and and what it causes it's one of the leading causes of heart disease that's considered like heart attacks congestive heart failure arrhythmias which is abnormal um uh the way the abnormal electrical activity in your heart that can lead to critical events.

So big cause of all kinds of heart disease. Yeah, heart disease. It causes end-stage renal disease. Kidney failure. Yep, kidney failure and stroke. Stroke. And stroke creates a great deal of mortality and morbidity for adult population. Even blindness.

Yep. Right? Hypertensive. Microvascular disease and blindness. Can lead to dementia because of its effects on the vascular system in the brain? Yeah. Right? Hypertensive. Microvascular disease and blindness. Can lead to dementia because of its effects on the vascular system in the brain. Yeah. And also affects things lower down, right? Yeah.

Like sexual function. Oh, yeah. Right. Oh, yeah. If your blood vessels get problematic in your sexual organs, you're not doing things normally. Microvascular disease in the penis can definitely result in erectile dysfunction, and that's not a good state. Nobody likes that. It also causes stiffening and hardening of your arteries, and you get vascular problems in your legs and blood flow issues. Peripheral artery disease is a major issue, and particularly if you

have diabetes, then you have two things that you have to deal with. The diabetic changes that create the peripheral vascular disease, and also the hypertension. And you can get literally blood flow issues. You need amputations. So this is a serious problem. Yeah, very serious. And a billion people have it. In America, a lot of people have it.

Yeah. Right? Yeah. 50 to 75 million Americans. Absolutely. And growing. And how many people are actually treated well? It's probably like 14 million out of those 50.

As we talk about that, treatment is primarily medication. It's not always effective. It has lots of side effects. And there's so many other ways to treat hypertension besides just using pharmaceutical agents. And we have determined that by treating people's blood pressure with medications that people do reduce their risk of these complications. So it's important to understand that if you have high blood pressure, you need to treat it. Absolutely. And whether it's with the things we're going to talk about or medication, you can't let it go.

And it's something you should do as a preventive strategy. You can go to the drugstore, they have blood pressure machines, you can stick your arm in or you can buy one for next to nothing in the drugstore 29 bucks and you can monitor your blood pressure now part of the problem with diagnosing blood pressure is that it's often hard to know if you have high blood pressure because one uh it fluctuates all day long two um just getting one blood pressure reading the doctor's office may not really tell you what's going on you might have coat hypertension, meaning you get nervous and stressed. It goes up. I mean, when you exercise, your blood pressure goes up. When you're stressed, your blood pressure.

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 effective because you can see what is 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 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. Yeah, it's true. And sometimes you can just get a cuff at home and have people monitor their blood pressure out the day. 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 monitor 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. 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 I got a virus right something happened and diabetes 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 in two Americans are pre-diabetes or type 2 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. 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 your belly fat is an immune organ and it drives inflammation throughout your body that causes oxidative stress which is really what causes rusting so it's like your arteries and your pipes are rusting and stiffening called hardening 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 is very powerful and you know i call it you know you you mentioned the the adiposity we have around our waist. I call that the toxic waist dump of the body. 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 one important cause of high blood pressure. Yeah.

And the other big thing is often misdiagnosed. And 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 it's a fasting glucose tolerance test that I do on 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 Cokesokes 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 on 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 uh agree. And then we have this other issue, which is sleep apnea, which is so underdiagnosed. Yeah, so sleep apnea,

there are about 25 million Americans that have sleep apnea. It is underdiagnosed. It's not just a disease of people that are overweight. 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 you have sleep apnea, that means you're just not getting enough oxygen to your body, particularly your brain, also 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 to hardening of the arteries. And when you're not getting oxygen to those blood vessels, then they actually can't perform the work they need to do and create the energy they need to have and so they they can't contract and expand the way they should and that can result in high blood pressure yeah and and then it also drives insulin

resistance so if you have sleep apnea it also causes you to be pre-diabetic yeah it causes independent of what you're eating weight gain weight gain that 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 was like he said look i i need to lose the 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 is what's your life like as well i mean 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 was before standing desk right and and 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 tired during the day if your wife says you're snoring and now there's apps you can get that actually record your you're on your phone they record your snoring so you can see because people don't believe it i don't snore and then i love that and then it's one called sleep cycle that i like it's record your story and and and uh it it's something that is easy to treat i mean there's different methods just c-pap and you know but 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 want to talk about a few other causes

that I think are really important and worth noting because those are the two biggest ones, but there's a lot of other ones. People who are nutritionally deficient in certain things can cause high blood pressure. Like magnesium. Right. So, and magnesium, you know, studies show that, you know, there's a very large percentage of people in our country have low magnesium. 45% of people have low magnesium, which is... And 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 sleep better. We see muscle twitching and cramping go away. 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 deliver 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. I mean, 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 oil

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 on your high blood pressure visit, your doctor's not checking your mercury and mercury are really common they're under diagnosed and when you're going 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 I think 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 the nutritional deficiencies. We're going to work on your stress levels. We're going to find the sleep apnea we're going to find the nutritional deficiencies we're going to work on your stress levels we're going to help you lose weight you know when you lose weight i mean you actually are going to drop your blood pressure i think i think the number is um per pound i think

uh for every two pounds you lose you drop your blood pressure by a millimeter mercury so if you lose 20 pounds you can drop your blood pressure by close to 10 million per week. A diet is so key. We created a program called the 10-Day Reset, which you can find in GetPharmacy.com. We put 1,000 people through it, tracked their blood pressures. It was incredible. Their blood pressures dropped an average of 20 points in 10 days. If you think about it, most Americans are at least 25 pounds overweight, or, you know, so let's say-

It's better than medication results. Exactly. If you get them to drop that 25 pounds, they're going to drop their blood pressure by, you know, near 15 millimeters of mercury. Yeah. Hi, podcast listeners. It's Dr. Hyman.

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You have heavy metals, environmental toxins, and we now are learning that that the gut microbiota the microbiome in the gut if it's altered through our bad processed diet and all the nasty drugs we take it actually causes inflammation throughout the body that drives high blood pressure anything that causes inflammation or oxidative stress will cause high blood pressure and the thing that struck me as I and this is stuff you know that's in the traditional medical literature is that high blood pressure is an inflammatory disease and we treat it like a plumbing problem. We do. And, and, you know, going back to the nutritional piece, a little potassium can be another reason why you can have high blood pressure. And that speaks to where do you get potassium? You get it from green leafy

vegetables. So having a, youbased diet is very, very important. I love my green smoothie in the morning. Absolutely. Yeah, more kale. More kale. Yeah. So this is very important. I think people also think about salt.

So people think high blood pressure, salt. But what's the deal with salt and high blood pressure? Is it something we should worry about? Is it as big a deal as we thought? It's not something everybody needs to worry about. There's certain populations that are going to be more salt sensitive than others. And so we can actually do genetic tests, and we do them here at the Ultra Wellness Center, that lets us know if you have those genes that make you more sensitive to salt, more likely to have high blood pressure.

So we do need to be concerned about it in certain populations and limit it. Salt, actually, it's the salt we add to our food that is the problem because it's processed. All the natural nutrients are taken out of it. It can be iodized, and iodine can cause problems. So it's not the salt that we personally add in our kitchen. It's the salt that's added in factories to process food. Yeah, exactly.

It allows huge amounts of intake of salt because how do they make junk ingredients taste edible salt fat salt yeah and sugar and processed fats right yeah so we know that and but if you get really good salt um you know sea salt um that you've purchased that's you know that actually has nutrients in it that can be valuable to you minerals anderals and so forth. Yeah, exactly. So these are some of the common causes we see, and they're often things that aren't looked at.

When you go to your doctor with high blood pressure, they're not checking your heavy metals, they're not checking your insulin resistance, they're not checking necessarily sleep apnea, although some might be thinking of that. That's just good medicine. You know, it's interesting. They're not checking your magnesium or anything. The reality is that, and just because when I was practicing private medicine before I started functional medicine years ago,

I was being graded on, if I had a high blood pressure patient, if I had them on certain medications to lower their blood pressure. So my reimbursement was based on whether or not I was using medication, not whether or not I was finding the root cause of the problem not whether or not I was helping somebody lose weight

not whether I was counseling them on you know how to lower their stress with meditation that didn't drive it and so you know in contrast to what we do in functional medicine you know we focus on making those changes that really get to the root of the problems and the causes we just talked about. It's absolutely true.

I think, you know, the traditional approach in medicine is you diagnose and then you treat. Yeah. When we diagnose, you say you have high blood pressure, that's the first step in our thinking. Yeah. Then we start to ask why, why, why, and everybody gets treated differently, right? In some patients, the treatment for high blood pressure is getting off the sugar and starch. Another person might be treating their sleep apnea. Another person might be detoxifying from heavy metals. Another person that might be giving them extra magnesium. And then we have a lot of techniques that we can use to help mitigate this. Sleep, stress management, exercise.

Exercise lowers blood pressure. So it's often frustrating to me understanding how the body really works when I see this knee-jerk response in medicine. It just feels like we're missing the boat. And this is not stuff that we're making up. This is all in the science. It's all in the literature. you just have to listen to the patient because the clues are always going to be there i can't tell you how many of my patients that come here to the ultra wellness center i i asked them so they're fatigued we have a lot of patients that come with chronic fatigue

or fatigue is part of their their complex of complaints and i asked them if they snore. Yeah, my wife tells me that I snore all the time. I said, so how long has that been going on? And I said, has anybody asked you whether you snore before? Has anybody asked you if you wake up refreshed? Has anybody asked you if you have daytime fatigue? And no, they've gone years and nobody has really explored it. So you have to listen to the patient and ask why and ask it again and keep asking questions so you make sure you have the whole terrain mapped out. Yeah. That's beautiful about functional medicines. We really do a very detailed history.

So people say, how do you diagnose? Mostly history. I mean, we do a 32-page questionnaire, which is annoying for patients, but it allows us to get a really deep sense of what's going on. So, Mark, how many times have you had a patient come in who has, let's say, high blood pressure? And maybe they're having headaches, they're having migraines. But they have the high blood pressure, they may be a little bit overweight, they have high cholesterol, but they have heartburn. Or they have, I get occasional heartburn, I take a PPI, I take an H2 blocker.

These are acid blocking medications. And they don't connect it to their high blood pressure. Right. Why is PPI or acid blocking medications a problem? Because it inhibits acid production, which you need to absorb magnesium. Exactly. And so you're all, wait a minute. And calcium and vitamin D, right you need to absorb magnesium. Exactly. And so you're all, wait a minute. And calcium and vitamin D, which can be impacted.

And they have, oh yeah, I also have difficulties with constipation or I get loose stools. You know what? There's a connection between the gut and the blood pressure. So tell us about this patient you had who you treated with high blood pressure. Well, I'm glad because it's a perfect segue because he had gut issues. And that sort of is what really was leading to his high blood pressure. So here's the gentleman that came in.

Because gut issues leads to inflammation. It leads to inflammation. And it's not just inflammation in the blood vessels, it's inflammation in the gut lining. So you can get this nonspecific lymphocytic infiltration. It's basically inflammation. That means a lot of white blood cells show up in the gut lining so you can get this non-specific lymphocytic infiltration it's basically inflammation that that means a lot of white blood cells show up in the gut and makes it inflame exactly so um and so what happens though is then you get a malabsorption of minerals and nutrients that's when you don't absorb vitamin d that's when you don't absorb potassium that's when you don't

absorb your calcium that's when you don't absorb potassium, that's when you don't absorb your calcium, that's when you don't absorb your magnesium. Those are the things that can help regulate blood pressure. So with this particular patient that came in, he was a 52-year-old gentleman, and he had been diagnosed with blood pressure, high blood pressure, about almost a year prior to coming. And they had tried multiple blood pressure medications, and he had different side effects, which is one of the issues with blood pressure medicine. Oh yeah, there's that. We forgot to talk about it. Exactly. So, you know, that's a big problem. Lots of people have side effects. They get dizzy, they get tired, they get erectile dysfunction, they get lower libido. They've been hair loss associated with their high blood pressure medicine. So he had been put on different medications that resulted in loss of libido, fatigue, brain fog.

One of the medications actually caused dehydration that resulted in him being in the emergency room where they found his potassium to be really, really low and it had to be replaced. So he was like, I'm coming here because I want a different approach to my blood pressure. So as we go through our new patient packet that's very long, some things that started to stick out were that he did have fatigue,

and he also had irritable bowel syndrome. And I asked him to explain that to me. And when I hear irritable bowel, I don't hear this, again, we talk about... It's just a syndrome. Yeah, like essential hypertension. We essentially don't know what's causing it. It's like we say irritable bowel. It's like, you know what?

Your diarrhea is irritating me. I don't want to talk about it. We don't want to get to the bottom line. Well, it's not even that. They don't know. In other words, when we say people have irritable bowel, like, oh, the reason you have bloating and gas and diarrhea and constipation is because you have irritable bowel syndrome right no that's just the name we give to people who have those

symptoms it doesn't tell you about the cause and that is what's unique about functional medicine is we have a methodology right an operating system to navigate to the root cause and we treat that and we don't have to treat the hypertension we treat the cause and the disease goes away as a side effect right so in this particular case we do we do testing for the gut microbiome and we can also do testing that tells us some things about the gut so we can find out if there is inflammation in the endothelial lining and that's basically if you look down a really big stainless steel tube and it's really shiny, imagine that shiny layer is basically a very thin membrane that protects the rest of the tube from anything that's going in the tube. So that's the endothelial lining, that very shiny stainless steel membrane.

It's like a one-cell layer between you and the sewer, right? You got it. Your immune system and the poop inside of you. That's a great way to put it so um so when that membrane gets inflamed it cannot function to absorb nutrients the way it should and that can lead to all of the things i just spoke about earlier in regards to low magnesium low vitamin d low calcium um and and so we know that people who have irritable bowel, there's a good percentage of them have non-celiac gluten sensitivity. And so that triggered my thinking. And that's why I

ordered that test that will look at whether you have leaky gut, whether you have gluten sensitivity, and whether you have crossover to other foods like gluten that can create gluten-light impact on the gut and so with this particular gentleman i also did a whole host of metabolic tests that included you know a glucose tolerance test i also looked at his magnesium levels i looked at inflammatory markers that omega-3 fat omega-3 fats that we look at so it did a comprehensive metabolic evaluation. I looked at a very expansive profile that looks at macronutrients, micronutrients, organic acids, amino acids, that gives us a really good clear picture of what his nutritional status is, whether the very important energy-making systems in his body are actually working the way they should. Are they

getting the nutrients that they need? Are they being blocked from doing their work by toxins? We do this panel that gives us all that information. And this is a very unusual panel in traditional medicine, but we're looking not for disease. We're looking for imbalances or dysfunction that we can correct that will help the body do what it's supposed to do. Exactly. So I gather all that information with the lab test, but the most interesting thing about this gentleman is that he had one gene positive. It's a gene that would express for celiac disease. But the tests that we do to see if he actually had celiac disease were negative. And what we know about people who have at least one or both of the celiac genes that do not have active celiac disease is they're more likely to be sensitive to gluten. And indeed he was. He had two things going on on that panel that we do to evaluate inflammation

and antibody interaction or the immune system creating antibodies against gluten in the body so he did have leaky gut meaning that that that endothelial lining that one thing saving you from the poop in the center of your intestine from the rest of your body was leaking and so um the immune system was creating antibodies so we knew there was inflammation and the second thing was he had enormous numbers that showed that he was sensitive to gluten. And so that gluten sensitivity... It's not celiac. People understand that there's celiac.

And most traditional medicine is like, yeah, they're celiac or you're fine. But now there's an increasing body of research, particularly by Dr. Alessio Fasano from Harvard, that shows that a lot of people have non-celiac gluten sensitivity, which you can tell through antibody testing a little bit. But it's a milder case, but it still causes leaky gut, inflammation, and many, many problems. And then there's a whole other category which you can't measure on lab tests called the innate immune system response or cell-mediated response to gluten, which means you can't measure it because it's just a generalized irritation of your immune system yeah so that can be a case even if these other things

are normal so gluten is often driving leaky gut and it's and it's often overlooked yeah very overlooked and particularly in a case like this so and the normal doctor will check your levels and if they're normal quote normal like it's zero to 20, right? Is 19 the same as one? No. Not at all. Is five the same as zero? No. So I think we have to understand that if there's any level of antibody,

it means there's some irritation of your immune system that's causing potential symptoms. Yeah. So in his particular case, I put him on a gluten-free diet. And I also, and the great thing the honestly I didn't put him on gluten-free diet identified that the gluten sensitivity and here at the ultra wellness center we have amazing nutritionists and when I discuss these types of cases then they develop a

program for a patient that is going to be customized to what their need are their needs are so in this particular case he was on a Mediterranean diet that was gluten free and that that made all the difference and when he tried to reintroduce gluten back into his diet his blood pressure went back up yeah so it was driving the inflammation that was driving his blood pressure and he was also low in vitamin D which was impacted by his gluten because gluten will keep you from absorbing iron and magnesium and potassium and calcium and it can have impacts on lowering vitamin D and vitamin D regulates inflammation

interactive dynamic biology where everything is connected and that's really what we do yeah and there's a lot of observational studies that show that vitamin D in people that have low vitamin d and you replace it you can lower their blood pressure particularly in people over 50 so i replaced his vitamin d put him on a gluten-free diet and gave him things that we know that work i make a fit he wasn't eating a lot of fish so he gave him omega-3s i I also added in some CoQ10 and magnesium. Yeah. And he did phenomenally well.

He never went back. Well, I shouldn't say never. He's been my patient for about eight months now, but his blood pressures have been normal. Yeah. So this is a really incredible story, which is... No medication, no side effects. And here's the view in traditional medicine.

Essential hypertension is a one-way street. Once you got it, you got it. You got high blood pressure, you can't get rid of it. You just got to treat it. And that just is not true. If you address the root causes, which is what we do with functional medicine and what we do with the Ultra Wellness Center,

we can often get to the bottom of this. Now, there are some people who have more genetic factors or there's more difficult to treat. But for the most part, we can have huge impacts on people's lives and health and well-being using this approach of functional medicine. And it's so refreshing and it's so invigorating as a provider because we're not just managing these diseases, we're getting rid of them. And we're not treating them, we're treating the factors that are causing them, and the diseases go away as a side effect.

Yeah, and that's, I can't say it any better than that, Mark. We do it, and you've been doing it here at the Ultra Wellness Center for almost 20 years, and we continue to do it, and we work as a team to do it, and we just have built you know we have worked on the things that you know if you've written about for years and we established um some really uh great ways to approach our patients and so this patient has benefited from that i actually had read another case in a functional medicine journal journal that clued me into this so it was in my mind to think about it

so he was really excited that by changing his diet not only is improving his blood pressure but he was also going to improve his health span in those years of health without disease. Yeah. And also health without side effect from medication. Yeah, that's it. So the side effects of this approach are all good ones, right? Excellent. I mean, getting your omega-3 levels is better hair, skin, and nails,

and overall well-being and mood. You know, vitamin D helps your immune system. Magnesium helps you more relaxed and less anxious and sleep better and have better bowel movements. So you basically get all these nice side effects by fixing these problems it's great so george thank you for sharing this incredible case and talking about high blood pressure which affects a billion people and which is really something we we have really been poorly treating with traditional medicines i'm so excited that we get to have this conversation and be here at the ultra wellness center and i encourage everybody who's concerned about high blood pressure, who has it, or has someone in their family they love,

or someone they know, to share this information with them. We at the Ultra Wellness Center here are now doing virtual visits. We can do patients from anywhere in the world through Zoom and do great jobs with getting you tests where you are. You can certainly come in if you want, and we'd love to see you. So just go to UltraWellnessCenter.com to learn more about our practice. And I would love you to share this podcast if you liked it with your friends and family on social media, leave a comment. We'd love to hear from you, share your story about how you may have tackled your high blood pressure and subscribe wherever you get your podcasts. And we'll see you next time 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 your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays.

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