The Dr. Hyman Show - What To Eat For Balanced Blood Sugar

Episode Date: July 1, 2022

This episode is brought to you by Gut Food, Vuori, and Paleovalley.   Have you ever wondered what the worst candy or cereal for your blood sugar is, or what the best thing to order at your favorite restaurant might be? Thanks to continuous glucose monitors, this is knowledge we’ll all be able to take advantage of in the near future. With insulin resistance playing a key role in the majority of the chronic diseases of our time, monitoring how our blood sugar responds to different foods is a huge step towards health.   In today's episode, I talk with Dr. Casey Means, Jessie Inchauspé, and Dhru Purohit about the best and the worst foods to eat for glucose management, as well as tips and tricks for combining food for optimal blood sugar balance.   Dr. Casey Means is a Stanford-trained physician, Chief Medical Officer and Cofounder of the metabolic health company Levels, an associate editor of the International Journal of Disease Reversal and Prevention, and a guest lecturer at Stanford University. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tools that can facilitate a deep understanding of our bodies and inform personalized and sustainable dietary and lifestyle choices.     Jessie holds a bachelor’s degree in mathematics from King's College London and a master’s degree in biochemistry from Georgetown University. Her work at a genetic analysis start-up in Silicon Valley made her realize that, as the key to good health, food habits beat genetics. In her first book, Glucose Revolution, Jessie shares her startling discovery about the essential role of blood sugar in every aspect of our lives, from cravings to fertility, and the surprising hacks to optimize it while still eating the foods we love.   Dhru Purohit is a podcast host, serial entrepreneur, and investor in the health and wellness industry. His podcast, The Dhru Purohit Podcast, is a top 50 global health podcast with over 30 million unique downloads. His interviews focus on the inner workings of the brain and the body and feature the brightest minds in wellness, medicine, and mindset.   This episode is brought to you by Gut Food, Vuori, and Paleovalley.   Check out Gut Food at gutfood.com.   Vuori is offering my community 20% off your first purchase. Just head over to vuori.com/farmacy to claim this deal.   Paleovalley is offering my listeners 15% off their entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal.   Full-length episodes of these interviews can be found here: Dr. Casey Means Jessie Inchauspé Dhru Purohit

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is offering my listeners 15% off your entire first order. Just go to paleovalley.com forward slash hymen to check out all their clean paleo products and take advantage of this deal. That's paleovalley.com forward slash Hyman. I definitely recommend stocking up on the grass fed beef sticks to keep in your house and your car and in your office. It's one of my favorite tricks to staying healthy while on the go. All right, now let's get back to this week's episode of the doctor's pharmacy. Hi, this is Lauren Feehan, one of the producers of the Doctors Pharmacy podcast. Blood sugar is an aspect of our biology that has major implications for how we feel and function on a daily basis.

And the good news is balancing your blood sugar doesn't have to be difficult, and you'll start to notice the benefits right away. In today's episode, we feature three conversations from the Doctors Pharmacy on what to eat to manage your blood sugar, as well as tips on how to combine foods to minimize blood sugar spikes. Dr. Hyman speaks with Dr. Casey Means on the best and worst foods for blood sugar, with Jesse and Chowsby on tips and tricks to minimize spikes, and with Drew Prowitt on the benefits of adding fat and protein to starchy foods. Let's dive in. We have 51 million glucose data points, and this is just amongst our closed beta program,

16,000 people who have gone through our closed beta program. We have almost 200,000 people on our wait list. So you can imagine that 51 million data points is going to get a lot larger when we start opening to more people. We have those 51 million glucose data points paired with 1.3 million food logs. So we can start to see for the first time ever how specific foods across a population are affecting glucose and creating this population data of a closed loop biofeedback. You mentioned the individualized aspect of this. That is so true. And that paper that you referenced, Personalized Nutrition by Prediction of Glycemic Responses, that was done about five years ago in Israel, showed how variable it is person to person. We could both,

of course, eat the exact same cookie, and you and I could have a very different glucose response based on several factors like our microbiome, our underlying insulin resistance, et cetera. So that's a really important aspect is for the individual, what kind of data they can get to really, truly personalize their own data based on glucose response. Because of course, and we talked about this a lot in our last episode, a more stable glucose level with more gentle rolling hills after meals, avoiding the huge spikes and valleys that we see after eating large amounts of carbohydrates and sugar. That's what we want.

We want the gentle rolling hills, the low glucose response. So you can start to see that in yourself and shape your diet very quickly. On the population level, then we get to see something interesting as well that actually can benefit anyone, not just the people who have a sensor on. Because this becomes a database that really informs the nutrition industry like we've never been able to before, where we start to see radical transparency about what food is actually doing to people's bodies.

And I personally think in five years, it's gonna seem incredibly outdated, incredibly quaint to walk into the grocery store and choose foods based on what the box says, based on interests that are not aligned with your thriving and wellbeing. They're aligned with taking you to your bliss point, making you dependent for it, making your dopaminergic reward systems want to keep coming back, but it's not aligned necessarily with your health. And so we're going to start to see this huge new way of choosing

foods. I can imagine, you know, like a person with polycystic ovarian syndrome, for instance, a condition that we know is directly related to insulin resistance. And studies have shown that low carb diets, a healthy Mediterranean ketogenic diet for just 12 weeks can actually reverse PCOS. This was a study done just a couple of years ago. So there's people and women are very savvy with their research and they're going out and they're reading the books, they're reading these papers and they know they need to keep their glucose and insulin under control. They know that just being prescribed a birth control pill and metformin is not the answer to their long-term health. And you can imagine that woman, her doctor says to her, you know, oh, you don't have diabetes. You don't need to worry about blood sugar. You have PCOS.

It's very different. They know, though. They've read. They do their research. We're not, you know, people are very smart, very informed. They know they're going to work to keep their blood sugar down because they know that in the research that shows that it will help. So they go to the grocery store now with this app, with something that they can actually look up every food they're buying and see exactly across tens of thousands of people what it's doing to people's blood sugar. So you go into the non-dairy milk aisle and you've got 15 different options. You've got oat milk,

you've got almond milk, you've got cashew milk, blah, blah, blah. And it's like, what the heck are you supposed to get? And you think you're making a good choice because you're buying an unsweetened non-dairy milk. But the reality is from our data set that there are some of those that give you a monumental spike, even if they're unsweetened oat milk, you know, and then there's others that actually have virtually no glucose response. So that person now can take their health into their own hand, make a consumer decision, not based on marketing, that's going to serve their goals. And I am so excited for that world because people are going to start, I think, demanding from food companies to actually create products that are not creating a huge amount of glycemic variability or these ups and down spikes.

And you can't hide from that data. And so I'm really thrilled that of what that's going to do. So circling back to your, your main question of kind of like some of the themes that we've seen. Yeah. What do we see? I think one of the first things that's really interesting is our demographics, actually. So aside from glucose data, actually 52% of our beta members are women. And this is so different than what you hear in the mainstream media. There's a New York Times article about levels that talks about how this is for the worried well, and the biohacker guys, and the longevity crazy. And it's like, that is not the reality. The

reality is this is mostly women in their ages of 30 to 40. So very similar to the demographic I was talking about with people who are at high risk for things like PCOS. And their primary reason for wanting to use a CGM, what they report to us is weight loss, followed by finding their optimal diet. Of men, in the 48% who are men, their number one goal is optimal diet as well. So people are clearly interested in finding what actually works for them. You know, if you go back to what you're talking about with COVID, you know, the CDC just announced yesterday finally admitted that 75% of the people dying of COVID have four or more of these largely preventable cardiometabolic, you know, comorbidities. People know, they know now, and now it's finally coming out in the

mainstream media that we've got to get the blood sugar under control. So that's one thing we're seeing is really interesting demographics. This is not the worried well, this is not the, you know, like for the celebrity rich and famous, this is for people who want to just figure out their diet and lose weight, which is great. The second thing we've seen a lot of is that foods that are commonly touted as healthy or that we perceive to be healthy may actually be generating shockingly high glucose spikes. And I think we particularly see this around breakfast foods. We certainly see snacks, common snacks, drinks, common takeout foods. And we can certainly dive into the details on those.

But it's amazing how some of these things that we just think are totally normal to just eat on a Friday night or whatever, they're actually – or grab for breakfast or serve in school lunches at schools are actually causing these huge, huge glucose spikes. And then I think another thing that's been really interesting is showing people combinations and alternatives of foods that they can do that will do better. So for instance, combinations, we see a lot of people log something like an apple, and then they'll log an apple with like peanut butter and yogurt. And that peanut butter and yogurt is adding, of course, fat and protein. Sometimes they'll put some chia seeds on that. That's some fiber. And we've definitely seen that when carbohydrates, sort of naked carbohydrates, like a fruit, are paired with fat, protein, and fiber, people do better. In terms of alternatives, we've seen some really interesting things. We just published

an article on Chipotle. We see people logging all sorts of things at Chipotle. Some of them, disaster for glucose. Some of them, virtually no glucose response, like an average of seven milligrams per deciliter, very low. So the really minimal glucose spiking things is the keto bowl. This is a salad that has protein, you know, fajita veggies, guacamole, salsa, virtually no glucose spike, tons of nutrients. Burritos, on the other hand, with that gigantic tortilla, send people on average through the roof. So people start learning, if I'm going to go to McDonald's, if I'm going to go to Chipotle, if I'm going to go to Sweetgreen, what should I order that's going to give me the best, you know, bang for my buck in terms of blood sugar? And then I

think the last thing I would just- And everybody's different, right? Everybody's different, right? So, you know, it doesn't mean that, you know, what works for you. Like you say, oh, I found that this screwed up my blood sugar. It doesn't mean it's going to screw up your friend's blood sugar, right? That's definitely true. So these are more of the population-based sort of things that we're seeing that can kind of give you, I think, a general gestalt of where you should start. And then, of course, it's about actually trying it for yourself and seeing what actually works for you. There may be that person out there that doesn't spike to a huge flour tortilla. But for most people, knowing that getting the keto bowl is going to have totally stable blood sugar on average for the population, they can at least go in there and get that

and see what it does to them. So it kind of, I think, nudges people in the right direction. And then the last big insight that I think we're seeing is around, this is so simple, but it's profound, is walking. We have seen that a simple walk after eating significantly reduces glucose responses. And we actually did an experiment with our members where we sent people a 12-ounce can of Coke, two of them, and we said, hey, if you want to do this, drink this Coke on one day. And then on the next day, drink the Coke and take a walk right after you drink it. Yeah, yeah, yeah. And we actually saw across this population that of the people who completed both aspects of the experiment, the median delta of the glucose rise was 33%

lower if you just took a walk. So that was going from an average of 162 milligram per deciliter peak to 132. Over the course of your lifetime, if you're doing this every day, that's a huge difference. So how soon do you have to walk after you eat? Well, there's a lot of research that looks into this and it really comes down to the sooner the better. Anytime you walk after a meal, even if it's an hour to the sooner the better. Anytime you walk after a meal, even if it's an hour or two, do it. That's fantastic. But because our glucose tends to peak within an hour after a meal, I would say what I would recommend to people is after a meal, finish the conversation, 15, 20 minutes, get up with the family, take a spin around the block,

put the dishes in the sink, go take a nice stroll around the block, and then come back. And if you don't want to walk outside because it's cold, put on some great music and have a dance party in the kitchen, or do a few squats. It's really just about moving, but these are significant effects. So that's kind of the general layout of some of the things that have been so interesting to me, just from looking at this huge, huge data set. That's just so fascinating. It's like, you know, we just sort of have this one size fits all approach in traditional medicine. And it's just so far from that, right? You know, you also learned about, for example,

what would be things we should never eat? Like one of those things we should just never eat. Well, I'll go off of just what we're learning in our data set. Like, because we could obviously, you and I could talk about this forever about general principles, but. Yeah. I think getting the specific data is just so fascinating. That's why I want to get into it. Absolutely. Of the categories of things that at this point, based on what we've learned, I would not really eat anymore would be certain candies, which I'll go into each of these in more detail, cereals, certain cereals, soda for sure, fast food, and lots of common takeout. So when we look at candy, this is actually really interesting. The worst food in our entire data set of 51 million glucose data points is...

I want to hear this drum roll, please. Skittles. Skittles. Skittles, wow. Not surprising because it's a refined carbohydrate. Obviously, there's refined sugar in there, but it's also kind of a naked carb, right? It doesn't actually have fat, protein, and fiber. A Snickers bar at least has some fat and some protein. The Skittles are just like naked carbs. So the Skittles have an- Naked carbs. I love that term. I never heard that. I love that. They're just on their own. And you can think of fat, protein, and fiber as kind of clothing the carbs.

So Skittles have an average glucose rise in our data set of 83 milligrams per deciliter. So that's certainly going to take you up. Wow, that's huge. It's way more than a Coca-Cola. And you are going to almost inevitably crash after that type of spike. Because of course, when you spike that high, you release all this insulin to soak up that glucose out of the bloodstream. And that huge surge of insulin can overshoot. The body responds sort of in an exaggerated way. You take up all that glucose. And then people often dip to below their baseline and have that reactive hypoglycemia after the spike, which is when they feel shaky, tired, lethargic.

Yeah, exactly. The beauty of achieving more of the gentle rolling hills is that you don't end up having that reactive hypoglycemia that can make you feel really crappy, that post-meal slump that people are often like, oh, I just need a cup of coffee or something. It's like, no, it's the Skittles. And so Skittles have a huge, the other candies that are in the worst part of our data set are Sour Patch Kids, Caramel Corn, Twizzlers, and Jelly Beans. So you notice they all are similar. They're all these kind of, um, not chocolatey, not, no protein, no fat, just like straight, you know, congealed sugar basically. Um, so those are the candies. We used to have those things when I was a kid. It was like this powdered stuff,

Lick-A-Mate or something. Like I forget what it's called. Lick-A-Mate. You put a stick in, you lick it, it's just pure sugar. Yes. And the stick was made out of sugar too. Wasn't it like a, like a candy stick? I don't remember seeing that anymore. I mean, I don't really look for it, but I was like, that was my main go-to thing. It's like when I was six, seven years old, I wanted to lick a maid. It was like a fentanyl lollipop, you know? I mean, we use sugar as a pain management tool in hospitals. You know, this is abhorrent, but when children undergo circumcision in the hospital in their first days of life,

what do they give them for pain medication? This little dropper called a Sweeties, which is just sugar water. That is the analgesic. So it's like exactly like you said. It literally is like a functional lollipop. So that's candy. So get rid of the Skittles. A Snickers bar literally has half the glucose spike of Skittles.

So it's pretty amazing. Then it's cereals. Oh my gosh. Get the cereal out of the house. We should eat those. You mentioned takeout and other things too, right? Well, just to tell about the cereals, Cinnamon Toast Crunch, Honey Nut Cheerios, Lucky Charms, about 60 or above on glucose responses. Wait, wait, wait. Honey nut Cheerios. So we think honey is good, nut is good, and Cheerios are good. So it's like actually just a wolf in sheep's clothing, it sounds like. After Cinnamon Toast Crunch, it's the worst. Yeah. Oh my God. Worse than Froot Loops or Pebbles or Cocoa Puffs or any of that? Those, you know, I haven't checked those precisely in our data set, but when you look at just like the top 50 worst foods that people log, all three of those, I mean, these kids are going to school after having these spikes and crashes. And, you know,

a lot of them are probably eating a glass of OJ on the side, which, you know, these are isolated food logs. So. I mean, you know Casey, I'll just break in for a minute. I remember when I was filming the movie Fed Up and one of the scenes was where the mother was trying to get her kids to lose weight and her family to lose weight. And she's like, well, what I really focused on is healthy breakfast cereals. And she pulls out these cereals that are marketed as quote health foods. I mean, Kellogg, who invented breakfast cereal as a breakfast food, which wasn't a thing, right? These are basically dessert for breakfast. It's 75% sugar and that is having a soda with breakfast.

So I think people need to get that cereal and starch for breakfast is a huge no-no. And if you can do one thing to change your biology quickly, it's get rid of any starch or sugar for breakfast. Yes. Yes. You said that it's like eating sugar for breakfast. I will up the ante here. It's much worse than eating dessert for breakfast. Peach pie has an average glucose spike of 46 milligrams per deciliter. Cinnamon toast crunch is 59. And they both have, of course, the refined seed oils and the flour. It's worse.

Okay. Give me the peach pie. I love peach pie. I know. Exactly. Exactly. So you mentioned getting rid of the breakfast foods that have the refined starches. This has been one of the most fascinating things we've seen because all the common American breakfast foods are in the worst hundred foods that score. And these, just to run through them really quick, we're talking about, this is in our worst 50 foods, egg McMuffin, bagel with cream cheese, French toast, Pop-Tarts, cereal, English muffin, blueberry scones, cinnamon roll, Cheerios, croissant, toast with jam. Those are all above a 40 milligram per deciliter spike. So that's a big spike.

Which is a lot. It's a lot. If you look at then the best foods in our data set, like very little glucose spike, you also see a handful of breakfast foods. And so these are the ones we want to eat. Like what? We see frittata. We see avocado and egg, avocado and greens, chia pudding, Greek yogurt and berries. And we actually see this. A lot of people log this. I think because Kelly Levesque is sort of close in our network, but we get a lot of logs for the Fab Four smoothie, which is a smoothie that she has popularized, which is really balanced. It has very minimal fruit, a lot of protein, fiber, fat, and greens. And all of those that I just mentioned

all score below 20 milligrams per deciliter. So you want to get it. I mean, it's basically, Mark, it's the Pagan diet. People can read your book. But, but it's the beautiful sort of like nutrient dense foods that none of those have refined carbs. And I think people sometimes assume that, oh, if I'm going to have a keto breakfast or a low carb breakfast, I need to eat the animal products. That's not true. Half of those things I just mentioned don't have animal products, the fab four smoothie, the chia pudding.

You could do non-dairy yogurt with some berries uh some avocado uh with you know and so so that's just something important to remember that breakfast is this one's straightforward don't eat those first things eat those things so fat and protein for breakfast get rid of the starch and sugar yes very important and i you know i think it's super important i mean i used to in my uh sugar detox book i create a smoothie which essentially nuts and seeds so it's raw nuts almonds walnuts pecans whatever hemp seeds chia seeds flax seeds um putting in like cranberries which is actually very low glycemic the lemon uh maybe some berries unsweetened macadamia milk or whatever and it's it's like basically and greens you can put in there an avocado and it's basically a protein and fat smoothie that or whatever. And it's basically in greens, you can put in there an avocado.

And it's basically a protein and fat smoothie that tastes delicious. And it's not all the typical, I mean, oh my God, like things like Ensure, Boost, all these sort of meal replacement things. Most traditional smoothies are full of sugar, artificial sweeteners are processed, highly processed protein powders. I mean, it's so good to get just real food. So I love that, a real food smoothie. I want to ask a couple more questions. are there are a bunch of things you learn just because this is such a new area we're just learning about in real time what happens to real people in in a continuous glucose mounting setting which if people have to realize this is not a this is not a technology that's been around for a long time it's relatively recent and it's even more recent that it's being used at scale by non-diabetics. So that's a huge thing. We're just learning stuff that we've

just never had insight into before. And Levels is capturing that data and making sense of it. It has so many beautiful lessons. And for you, I mean, for anybody listening, Levels is going to be launching. It's a great technology to actually see what's going on with your own biology. And I was super surprised too and shocked. And I'll just give you a little anecdote of what happened to me. But the first night we got it, I used it. I was at my friends and we had this big dinner. We ordered all the healthiest food from this like regenerative farm and like lamb and all these veggies.

And it was like so healthy and non-sugar. There was no starch. It was like amazing. And we like ate so much food. Like we just ate a huge volume of food, of healthy food. And we both were like going to bed, checking our sugar and texting each other. Like, what happened? Our sugar is like 160.

This is freaking me out. What's up? Like any big meal also can cause a spike. But there's a few things you learn. One is, what are the surprising things you learned that we should really never eat? I mean, sorry, that actually spike your blood sugar that are surprising to you? And what foods might not actually spike your blood sugar but you still should get kind of rid of? This is such a great question.

You asked for some surprising foods that spike blood sugar. I want to preface this answer by saying that some of these foods, it's not necessarily that you should avoid them completely because they're actually nutrient-dense whole foods. It's that it's good to be aware of how they're affecting you so that you can figure out how to eat the food in some different way. Maybe eat a smaller portion, maybe pair it more with fat, protein, and fiber, maybe take a walk afterwards. But the intention is not to hear these foods and then say, oh, I can't eat that again. It's not a good food. So this is what brings me to one of the first ones, which is certain fruits. There are

certain fruits that spike people on average a lot more than others. The ones that we see in the data set are banana, which is maybe not that surprising. But grapes, grapes have an average glucose spike of over 40 milligrams per deciliter. Whereas like a mandarin orange, for instance, is like 20. So it's a very big difference. We also see even within fruits, like different types of oranges, a mandarin orange has a low spike. A sumo orange is almost double that. And I mean, those sumo oranges are like so unbelievably delicious. And, you know, it also could be kind of a size thing, but, you know, chop up those oranges, put them in some yogurt and have add some Zen basil, you know, seeds or chia seeds or something with tons of

fiber. It's going to potentially blunt that spike. So fruit juice is not a huge surprise, but like orange juice, huge spike, average of 40 milligrams per deciliter. So I would say, of course, avoid liquid sugar, which I would consider juices to be liquid sugar, but certain fruits do have more of a spike than others for sure. The next one, corn on the cob.

Average glucose spike of 46 milligrams per deciliter, which is the same. What if you lather it in butter? Well, maybe doing some grass-fed. And what do you have it with you? Yeah. I think it's a good point. Grass-fed beef with it as before? Or grass-fed butter.

You know, some really nice butter, some ghee. I actually put corn now. I only use corn really now within recipes because I know that if I eat corn alone, it's going to spike me. So, for instance, I make these really great hearts of palm crab cakes. So they're crabless crab cakes, and they have some corn in there. They don't spike me. I eat it with an avocado relish. There's lots of other stuff going on.

So I just have figured out how to balance it to not spike me. We also see big spikes to some foods that are totally marketed as low carb. Like I hate to throw, you know, some, some certain brands under the bus, but smart sweets, you know, they market themselves as having significantly less sugar than other candy. but they have a higher glucose spike on average than a cinnamon roll. So that that's where marketing, you know, people are like, Oh, eat the low carb candy. You got to test it on yourself. Um, and then this one was interesting. So the fasting mimic, mimic, mimic, mimicking diet has become really popular. And actually, yes. Oh, this one in our top 10 worst scoring foods.

So right next to Skittles is. You mean the fasting mimicking diet, the Prolon diet? Wow. The tomato soup has an average glucose spike of 53 milligrams per deciliter. I don't quite know. So it wasn't the whole program. Nope. It wasn't the whole program.

This is an individual food. Yeah. One of the soups. So I need to talk to Walter Longo and tell him to swap out that soup. You should just send it to him. I will. I'm going to. I'll send him the episode.

You know, we have not met personally. But the thing is, their results of the data of that program are profound. And it is clearly evidence-based that it is extremely effective for improving cardiometabolic biomarkers. What I would say though, is that there's probably a way to even more tweak that program if the ingredients were slightly modified. I don't think that glucose spike in the context of basically eating like 500 calories a day for five days is really going to hurt people, but we want to reduce glycemic variability, you know, and it's probably pretty simple to swap out some ingredients there. So, so that's good information to have, you know, and, and the last thing I'd mentioned that has really blown me away is the energy bars. We probably have over 50 different types of energy bars logged in the data set, ranging from Quest bars, Bulletproof bars, Cliff bars, Luna bars, all of these. And the spectrum

is profound. We see that- Yeah, somebody's like, what bar should I eat? It's such a big question. What protein bar? What bar do I have? What's good? And people are eating stuff and I'm like, I wonder about it. has high protein, et cetera, et cetera. This one's organic. How the heck do you know what to choose? Well, in the future, we can look it up like this and figure it out. So for instance, like Cliff bars have a spike around 42 milligrams per deciliter. That's almost 10 points higher than a Snickers bar. I used to eat those. I used to live on those things. Yeah. Go macro bars have a spike of around 44 milligrams per liter. And then you look at some of these others like bulletproof bars are very low, perfect keto bars. And so this'm just, you know, this is all just sort of your kind of, you know, anecdotal data. This is obviously not controlled trials. But what I get excited about is that that person in that aisle who has made the commitment to try to lose weight, to try to be healthier is not at the mercy of the food marketing of what the box says. They actually have some agency now

in the face of, unfortunately, industries that are not necessarily aligned with our long-term health. So those are some of the surprising ones that we've seen. What I've developed are these 10 principles, these food principles that allow you to keep your glucose levels steady without giving up all the foods you love. Because personally, Mark,

I need a chocolate cake for my birthday. I'm not going to have a Brussels sprout, low carb, no sugar cake. Like I need chocolate cake. This is a non-negotiable part. You're a better human than I am, but like I love sugar. And so when I first discovered the world of glucose,

my fasting glucose levels was 95. I was 23 years old and that was high. And through my hacks, I've lowered it to 79 without giving up all the stuff I love. And that's two hacks. So we've got the timing of what you eat when, right? Vegetables, protein, and starch. And then the vinegar before you eat. What else?

So if anybody is still having a sweet breakfast, this is a very important hack. Have a savory breakfast. And of course, nobody listening to this podcast ever eats a sweet breakfast because they've been listening to this podcast and they know that we should not have dessert for breakfast. But just in case you haven't heard many of the podcasts, listen up. Just in case this is the first podcast you listen to. Have a savory breakfast. So in the studies, what they've done is they've taken two groups of people and they've given them two

breakfasts, one of two breakfasts, same number of calories. We know calories don't count, but still it's important to mention this. One group had a breakfast that spiked their glucose levels. The other group had a breakfast that kept their glucose levels steady what happened was in the group that had the spiky breakfast they got hungry again after two hours whereas the group that had the steady glucose breakfast didn't get hungry for five hours so course curve yeah of course the curve of your breakfast really determines how you're gonna feel for the rest of the day and whether you're gonna feel in control and connected to your body or whether walking by that bakery is going to give you an irresistible urge to buy all the cookies like it used to be for me. I used to have a Nutella

crepe for breakfast every morning growing up, Mark. And by 1030, I was starving. I mean, Nutella crepe. Yeah, that'll do it. But I'm recovered now. I'm recovered. And if I really want Nutella crepe, what I do is I have it after lunch or dinner as a dessert, and I have some vinegar before. So that's another hack. If you want something sweet- So put vinegar on your cookies? Is that the thing? Yeah, just pour vinegar all over my cookies. I'm not sure that's going to go over very well. My friends love me when I come to parties. No, so it's having the vinegar in the water before you eat the sweet thing, having the sweet thing after a meal, and also then using your muscles for 10 minutes.

So your muscles are really your biggest ally in reducing your glucose spikes. And so what I recommend, it's another hack. After your meals, use your muscles for 10 minutes. Top favorites include dancing to your three favorite songs really loud in your living room, going for a walk with your dog, doing the dishes, the laundry, whatever. Use your muscles. That way you'll curb the spike and you'll feel better. That's a really important point. I think people don't realize this, but the data is so compelling on what you're saying, which is if you just take a walk after dinner for 15, 20 minutes, half an hour, you will see a dramatic change in your metabolism

and your blood sugar. Absolutely. Absolutely. It's really incredible. And this works particularly well to combat the post-meal sleepiness that a lot of us feel. If you just use your muscles afterwards, you have all this energy again because you're not experiencing such a big crash. And if you can't go outside and you're just home and you're watching, for example, a TV show after dinner or a movie, people can get really creative.

So you could do like, you could hold a plank in front of your couch while you're watching the movie. You could get some kettlebells and do some bicep curls, whatever works, whatever floats your boat, but that'll really help your body deal with the glucose coming through.

Amazing. What else? You've said 10 things. There's a lot more. I know. I'll give you one more, but then the rest are in my book, Glucose Revolution. One more is putting clothes on your carbs. So what do I mean? Do not let your carbs- Clothes on your carbs. Don't let your carbs-huh don't let your naked carbs no naked carbs no naked carbs so anytime you're eating uh-huh so a naked carb is sugar or starch that you're eating on its own naked you just eat it naked and it lands naked and it creates a big glucose spike so to put clothes on your cards what you do is

anytime you eat something sweet or something starchy you make sure to put some protein fat or fiber on it you put some clothes on that so example I'm gonna take the chocolate cake example I put Greek yogurt on it if I ever want it in the middle of the day. If you want a piece of sourdough bread, put some avocado on it. Put some butter on it. If you ever want to eat some rice, have some eggs with it, some smoked salmon, some greens that you saute. That's brilliant. I think the idea that we need to not be eating any of this stuff in a way that spikes our blood sugar is key. And what we're learning, what you learned through measuring your blood sugar for years and tracking everything is how different foods affect you. But the interesting thing is that what might affect you might not

affect somebody else and what affects somebody else might not affect you. So can you talk about the differences in glucose metabolism from person to person, depending on their genetics and even their microbiome. Absolutely. So when I started discovering the world of glucose monitoring, I set a few of my friends up with one as well, and we tested the same foods. So for example, you know, we would eat the same cookie and then compare our glucose spikes. Turns out mine was bigger than other people's. I was like, darn it, I really love cookies. And so I started thinking, you know, what does this mean? Why is my spike so much bigger than my friend Luna's spike?

What's going on here? Well, many things could be going on. So as you mentioned, microbiome could be a factor, hydration level, tiredness, how well we had slept the night before, muscle mass, obviously, because your muscles soak up glucose, insulin sensitivity, so you know how metabolically healthy we are, and just many, many more things, the phase of your menstrual cycle, your stress levels, there's a lot of stuff going on there. So it was really interesting to notice what choices might be better for my glucose levels compared to other people. But I kept coming back to the fact that the science shows that the hacks work in all of

us. So if me and my friend who both ate the cookie had both put some clothes on the cookie, let's say 10 almonds, both of our spikes would have been proportionately smaller than the naked cookie spike. So you have to keep that in mind. These principles work for all of us. But then if you have the opportunity to use a glucose monitor, you might discover much more personalized and in-depth preferences that your body has.

Yeah. You know, Jessie, I remember reading that Israeli study where they looked at the microbiome and how that uniqueness of each of our ecological community that we live in, which is our gut. That lives in us. Yeah. How that actually is so determinant of what happens with our metabolism. And we know from animal studies, if you take the poop out of a skinny mouse and you put it in a fat mouse, the mouse will get skinny yeah or in a diabetic diabetic to non-diabetic yeah if you take a healthy metabolically healthy person which there's not that many of us around anymore there's about only 12 of us in America that are metabolically healthy but if you find a person good luck and you transmit their poop into a diabetic their blood sugar gets better and I

remember I remember a case, which I had years ago, I think I might've mentioned on the podcast once, of a gentleman who had type 2 diabetes. We really poorly controlled, sugars were well over 200 all the time. And we got him down to like 150, but we couldn't just get him all the way normal, even on a ketogenic diet. And one day he called me up and he said, Dr. Hyman, I'm having a lot of digestive symptoms. I'm bloated. I'm distended. I'm all these issues. And I said, okay, well, let's do some diagnostic workup, a stool test or anything. But in the meantime, while you're suffering, just try some charcoal to see if that can absorb some of these sort of bloating and the gas and the toxins, which can cause these symptoms. And he did. And then he called me back and says, Dr. Hammond, I don't

know what happened, but my blood sugar went to normal. I don't even understand. And I did understand because the microbiome plays a huge role in our metabolic health and something called metabolic endotoxemia, which means that the toxins produced by bad bugs in the gut when we eat the wrong things get absorbed and they cause inflammation. The inflammation causes us to be insulin resistant and that makes us more diabetic. mean it's just a whole cascade of vicious cycle and and so simply by absorbing the metabolic toxins in his gut from bad bugs we were able to actually correct his blood sugar so it's quite fascinating it's not as simple as we think it's just oh just eat this or don't eat that or exercise don't exercise it's really

it's kind of a personalized story and and I think there are universal principles like you mentioned. I think I just want to loop back on something you said before as well, because you talked about these sort of toast that happens when proteins and sugars in your blood and you become toast and you're literally toast. I mean, it's actually true. You're toasting your system. And there's a phenomenon that's called advanced glycation end products. And we measure this when we measure our average blood sugar through hemoglobin A1C, which is just measuring the proteins in hemoglobin getting glommed onto by sugar and forming this like crusty creme brulee, like chicken skin, that kind of, that phenomenon, it's called the maillard reaction,

happens inside your body, not just when you're cooking. And that is one of the hallmarks of aging, is the abnormal proteins that form in the body that gum everything up. And this happens in your brain, it's called type 3 diabetes, it happens in your heart, your organs. It really is the phenomena that leads to rapid aging and death. And then what's even funnier is that these things are called ages, advanced glycation end products, and they bind to receptors on your cell called rages. So the ages make you rage, literally, and turn on all the inflammatory downstream phenomena that we see as inflammation. So it's such an important thing to understand.

And regulating your blood sugar is probably the single most important you can do i remember being at kenya ranch years ago and there was a cardiologist that came from harvard and he gave a lecture and he said you know if you could take a group of 100 year old people and you could find a group with clean arteries they'd have one thing in common what would that be they're insulin sensitive meaning they're very good at keeping their blood sugar even without a lot of insulin. That's a key to longevity and healthy aging. And not just that, but all these other conditions that you mentioned from acne to infertility

to depression to panic attacks to fatigue, energy, insomnia. I mean, night sweats are even a common symptom. You know, men get night sweats too. And often it's because they have these hypoglycemic spikes and they can wake up with soaked sheets. So really important to get your sugar dialed in. So that's one of the things that happens when we have a glucose spike. It's the toasting. And maybe I can mention something else that happens when our glucose levels spike.

So every cell in your body needs energy to function. You know, your brain cells need energy to think, your eye cells to see, your toe cells to dance all night long. Like every cell in your body is really hungry for energy. And the most easy place they get this energy is through glucose that we eat. And so as you digest a meal and glucose goes into your bloodstream, it heads to your cells to be converted to energy. And the little organelles that do this work are mitochondria. They take glucose, turn it into ATP,

which is energy. And so you might think, okay, well, if I need energy, then the more glucose I eat, the more energy I have, right? There must be a correlation just like that. It turns out that's not the case. If you overwhelm your mitochondria with too much glucose, which is the case when a glucose spike happens, your mitochondria don't get excited. They actually shut down. They're like, whoa, can't deal with all this stuff. Don't know what to do. I'm stressing out. I can't work anymore. Your mitochondria shut down and they get stressed and they release these things called free radicals into your cells. And free radicals, they harm everything that they touch. So if they touch your DNA, they might harm it and create a mutation that could

lead to cancer later on. If they touch a cell membrane, they can break the cell membrane and damage the integrity of the cell. And so your body's response to these free radicals is inflammation. And that's one of the ways that glucose spikes increase inflammation. The problem is, in this case, if it becomes chronic inflammation, it's not good. And that is another thing that creates a terrain for chronic diseases. I mean, three out of five people are going to die of an inflammation-based disease. I mean, I don't know if it's three. It's probably 100%. You think?

Actually, sure. I mean, unless you get hit by a truck or fall off out of a train or something, I think most of the people die from inflammatory-related conditions because all aging itself leads to more inflammation through a whole series of mechanisms, including your blood sugar, including environmental toxins, including your microbiome, including latent infections, including our unprocessed inflammatory diet, including chronic stress. I mean, all the things that we see around us all the time are all driving this inflammatory process. But sugar is sort of the king, queen, and prince of driving inflammation in your body.

And so it's such an important thing. That's why I've been talking about this for decades because, you know, as a doctor seeing patients and testing this stuff, when no one else was looking at it, it was like, wow, people are messed up. Like I would do glucose tolerance tests, not on diabetics, but on almost everybody who came in as a screening test for their metabolic health. Because your blood sugar can be perfectly normal and you can still be a mess, right?

Absolutely. And I think that's an important lesson. We've had Dr. Casey Means talk about this on the podcast talking about how there's patients who literally have perfectly normal blood sugars but their insulins are so high that they're keeping their blood sugar normal and that causes a whole other cascade of problems yeah cuz I think insulin increases for 10 years before glucose fasting glucose levels increase yeah no you know last no yeah I mean the last thing that happens that your is your fasting glucose going up, right?

Yeah. And the second thing that, you know, second to last thing is your fasting glucose goes up and then your insulin, I mean, your glucose after you eat goes up. But that's, again,

a late stage phenomena. Earlier stages are high insulin after two hours, then high insulin fasting. And then it's like, so we're getting on the train so late in medicine we need to think about how to go upstream to get to the cause yeah for a long time we only thought diabetics should worry about this you know only

if you have diabetes should you then think about managing your glucose levels and by the way to manage it just eat better and exercise more i mean come on we need to give people the hacks mark we need everybody to be using this because it's so easy. Yeah. They eat better. People have no clue what that means. The other thing I wanted to sort of jump into was hormones, right? We talked about aging. We talked about heart disease, but you know, one of the real problems with sugar is, is screwing up our hormones, both for men and women. And can you take us down how that works and what goes wrong and why it's so common to see such hormonal chaos in this country absolutely i think one of the conditions that is becoming more and more prevalent especially in my community i'm noticing that the

numbers are increasing so much is polycystic ovarian syndrome. And this is a condition where women stop getting their period, their ovaries become burdened with cysts. They start displaying masculine traits like hair on the chin, balding, et cetera. And this is something that often we're told to just medicate, oh, just take the pill and it'll fix it. It turns out actually that polycystic ovarian syndrome is a disease of too much insulin. And we know, yeah. And the way it works is fascinating. So when your body has too much insulin in it, it's not as good as it was before at converting male hormones into female hormones. So you end up with people who have uteruses who have this excess of testosterone in their body yeah so their female hormones are just not working anymore yeah and you get they grow beards yes and they get acne period anymore yes and and they lose the hair

on their head so the women get bald you ever see this kind of women with the big round middle and their hair is all thin and like looks like they're going bald on top? Yeah, so many, so many. They got the little whiskers going. It's heartbreaking. It's really from sugar. Mark, yeah, because they don't know that the reason this is happening is because of too much insulin.

And the reason there's too much insulin is because their glucose levels are out of whack. And so what's really empowering, I think, is when women started applying the principles, the science-backed stuff that I share, because they're able to get their period back within months. A few women even got pregnant, even though they had been told they were infertile. And this is so empowering because we have power. We have power. It starts in our plate. And this is really a message of hope. So anybody listening, this can really benefit you. And I hope you'll find a lot of relief in this information yeah it's not your dna it's your dinner i love that so here's the deal in men the opposite sort of thing happens so what happens to men right what happens to men when they eat too

much sugar and starch is they actually produce because they produce way more fat cells and the fat cells have a compound called aromatase which converts testosterone into estrogen and so the men get man boobs and they get soft skin and they lose the hair on their bodies so they become more like women so basically men become more like women. So basically, men become more like women, women become more like men. It creates this massive chaos in the hormones. And I just want to reinforce what you're saying because you say glucose. And most people, when they think of glucose, they think of sugar. But you should think of bread or sugar or corn flakes in exactly the same way. In fact, bread is the gold standard

for measuring glycemic index. And it's worse than sugar. The score for bread is 100. The score for sugar is 80. So actually, you're better off having the sugar than the bread. I would disagree, Mark, because in the sugar, there's also fructose.

And all the things we talked about you know the aging the inflammation fructose does it at an even a higher rate than glucose alone that's true I would argue that if you have a choice between something starchy and something sweet I would go for the starchy thing but better even have some vegetables first then some protein and fat and then have the starchy thing and maybe you won't even want to have the sugary thing in the end. Yeah, I think that's fair. But I also say, if you're going to have starch, have starch that's in forms that are coming in a good package. So for example, I have a Japanese purple sweet potato at night. I love that, which is starch, but it's got full of phytochemicals and fiber and vitamins and minerals, and I eat the

skin. So it's really actually a very healthy food. And it's quite different than eating white bread, which is also a starch. So starch is a starch is a starch. It really depends on where it's coming from and how it's metabolized. Even oatmeal versus steel cut oats, profoundly different. Absolutely. And this is, so what I've been doing in my work is testing all these things on my own body and using a continuous glucose monitor, showing people the different spikes that happen. So I tested steel cut oats versus regular oatmeal and the steel cut has a smaller spike and same for bread. So white bread is far worse than something like sourdough, for example, which is worse than something like very dark pumpernickel bread that's all gooey and feels almost like a cake because it's so rich of fiber.

Yeah, from Germany. So it's always a spectrum, right? You have to think within a category. There's different types of bread, different types of potatoes, different types of starch, and you can always make a choice that's a bit better. And you can always add some fiber to it and some vinegar and go for a walk after so basically throw some Metamucil and some vinegar on your food and you're good right so tell us some of the surprising things Jesse that you learned about your own body and in researching this about what you thought was okay to eat but actually wasn't or what you thought wasn't okay to eat but actually maybe it was okay well as i mentioned you know i used to have donuts for

breakfast so i really got a cold shower in terms of nothing sweet first thing in the morning because first thing in the morning when your body is completely fasted your glucose levels will respond incredibly fast to anything that you ingest so i realized that if i wanted to eat something sweet for example a donut i should never ever ever eat it on an empty stomach i should always eat it after a meal yeah then in terms of other surprising things i mean oatmeal was a big one because they even say oatmeal is for diabetics i mean there's all this information that's very confusing. Yeah. Rice cakes.

Oh my God, Mark. Oatmeal is not a health food. No, it's not. Rice cakes. This is crazy, crazy. Brown rice cakes. How could they be bad? I tested brown rice versus white rice.

Literally no difference. Well, what if you put like a nut butter on top? Then it's perfect. That sounds really gross, but it probably works. I love it. That's my favorite thing. I get the rice cakes and I put like a macadamia butter. Oh, on the rice cake. I thought you meant put the nut butter on actual rice, like warm rice. No, no, no. You get a rice cake and you put on the nut butter and it's kind of good.

Then that works. Yeah. So all the breakfast things are really, in this country, so geared toward extremely high levels of starch and sugar. And in fact- Fruit juice? Yeah. Fruit juice is terrible, right? And I think people need to realize that the most important thing they need to do when they eat in the morning, eat plenty of protein, fat, and fiber. Yes. Because those are the magic tricks to actually keep your blood sugar normal. Protein, fat, and fiber. And you have to learn what foods have protein, fat, and fiber. It's a little bit of an education because as most people may not know, but it actually is the key to success. And you're

basically saying eat protein, fat, and fiber before you eat any starch or sugar. And that will mitigate all the results. Give us the big picture overview on blood sugar management. Your first big number one bestseller was all on this topic. And tell us why blood sugar is so connected to what we perceive internally as our energy going up and down throughout the day. Well, you know, we recently partnered with a company called Levels, which is a fascinating company that measures continuous glucose throughout the day. So you're measuring your glucose all the time. And you can see, depending on what you're eating,

it's going up and down. And we recently did a podcast with Casey Means, who founded it, and it was fascinating to see the foods that just jack your sugar up and down. And when your sugar is going up and down, you're on a roller coaster of energy and crash and refuel. And that's where people end up with these tremendous amounts of weight gain and fatigue and, you know, buzzes and mood issues and all kinds of other health complications. So sugar is really nasty. And if you understand it's a drug, if you understand it's very powerful, if you understand that if you use it, it has to be used as a drug. Like you wouldn't drink a bottle of tequila at a sitting. You might have one little shot or two in the context of a meal.

And I think, you know, you can have sugar. It's not saying I don't ever have sugar, but I think it's when you have it, how you have it, with what you have it, and how much you have. So I think for most people trying to sort of reset their energy levels, cutting out sugar and starch and eating protein and vegetables for a week, doing the 10 day detox diet essentially is an amazing way to actually recalibrate their metabolism, their brain chemistry and their energy. Yeah. And we have a podcast and you've done one as well. I've done one where we actually talk about like the top 10 most popular foods that will spike your blood sugar and put you on this rollercoaster that you have super high high, and then you end up having a crash afterwards. And for a lot of people who go through the standard 3pm, 2pm, 4pm, midday crash, it's often because of what they're eating early in the day. So doing

something like levels could give you insight on what you're eating and how that's throwing your blood sugar off. So we'll link to that inside of the show notes. Yeah, we had an interesting conversation about that with Casey where she said that a Clif Bar, which we all think is a healthy snack, had a worse glycemic index load than Snickers. So you don't really always know. You think something's healthy and it could be just jacking up in sugar and down. So I'm very careful about that uh somebody sent me a promotion for a new kind of ice cream and i that's my achilles heel i love ice cream it's supposed to be the best ice cream but it's still got like you know five teaspoons of sugar in in a serving so it's like you got to be careful right and a lot of this is not you don't ever have those foods ever. It's about being smart about it, making sure that it's not part of your regular baseline. That's what sets us up for chronic

disease. And more importantly, how to eat and exercise and move and sleep in a way that allows you to, um, uh, enjoy certain things. For instance, uh, in your podcast with Casey Mark, I remember you guys talking about how eating a little bit of fat, fiber, and protein, for example, like instead of eating berries on an empty stomach, right? Fruit has so many amazing phytonutrients and other properties and polyphenols inside of it. But if you eat a ton of fruit on an empty stomach, that'll do one thing to your blood sugar versus if you have it at the end of a meal where you had a lot of healthy fat, fiber, and protein that was there. Yeah. It's called the glycemic load. It's basically what the total composition of your

meal will do to your blood sugar. So if you add in fat and protein and fiber, it basically acts like a sponge and slows the absorption of the sugar. So you don't get the spikes and you don't get the insulin surges, which then means you don't get the blood sugar crashes. And so it all evens out. things that we have in our mind, stuff that's unresolved, that we're just kind of kicking the can down the road. How have you seen that that can zap people's energy, both in your own life, your personal life, but also conversations with your patients who are struggling with fatigue? Yeah. I mean, often it's, I remember this one patient, she was early 50s, still living with her mother, who was incredibly critical of her still. And the mother was like in her 80s or something. And she was struggling with her weight and metabolism and her health and energy.

And I said, listen, you need a motherectomy. Like, you need to move out. And I think sometimes the stress that people are under just causes huge amounts of changes in their brain chemistry, in their metabolism, and leads to a lot of fatigue. I mean, depression, one of the key symptoms of depression is fatigue. So I think it's really important for people to look at their lives and go, where are things not right? Where are things out of alignment? Where am I out of integrity with myself, with my family, with my work, with my life dreams and goals, and start to correct those problems and figure out what it is. Because those are big

energy zappers. Is there something that you notice in your body, whether it's shortness of breath or a little pit in your stomach or tightness in your neck. Everybody has something that's usually an indication that there's something weighing on me emotionally, even if I'm not fully present to what it is. And I got to do a little bit of an inventory to see like, man, why do I feel so run down right now? Yeah. Yeah. I think there is a different process. Journaling is a great way every morning for people to journal. I think focusing on things like gratitude is a huge way to sort of reset your framework and your mindset. You know, our beliefs and our attitudes and our perceptions really determine our quality of life. And so if we're kind of in a negative loop, it's really important to figure out how to get out of that. And there's

a lot of ways to do that through therapy, through self-practices that people can do, through meditation. But it's really looking to become a master of your mind. Because if you're not a master of your mind, your mind's running you, you're not running your life. And I think Drew, you really are very good at this. You're one of the people I know who's best at this, at really looking at how do you have integrity in your thoughts, your feelings, and your actions. Because that's how life works. You get a thought, it creates a feeling, it's an action. And if you don't straighten out your thoughts, your feelings and actions are going to be messy and they're going to lead to all kinds of problems, including disease and fatigue and many other issues. Okay. So what does Mark Hyman do? What does Dr. Mark Hyman do when he feels a little stuck,

a little bit in the rut? And it could be emotional, it could be physical, it could be a blend of the two, but what's your go-to, like actual go-to? You feel a little fatigued. You feel a little bit in the rut. You know it's not your baseline, but you feel off. Could have been after a bunch of travel. Could have been you spread yourself too thin. What do you actually do in your life to bring back that energy?

Well, I know there's a list of things that give me energy, and there's the things that deplete my energy. So I get rid of the things that deplete my energy and add in all the things that give me energy and there's the things that deplete my energy. So I get rid of the things that deplete my energy and add in all the things that give me energy. So things that deplete my energy, not sleeping enough, running around too much, not eating well, not exercising, all that stuff, not meditating. I just lean back on the things that I know work. So meditation is a huge thing for me for energy. It gives me so much energy. Getting up to sleep, hot and cold therapy, huge for me. Like if I do a sauna or steam and an ice bath, it's amazing. I get my energy back. Exercise, whether it's working out with weights or going for a bike ride or doing yoga, always gives me energy.

I can go into an energy. I remember when I had chronic fatigue, actually. It was really quite interesting. I was so exhausted and always had pain and fatigue and brain fog and just not able to do life very well at all. And the only time I would feel really good, or the only two times I could really reset myself were hot and cold. That would give me like an hour of feeling a little more energy and clarity. And also like a yoga class. I would do a very intense yoga class. It wasn't even a hot yoga, but if I do hot yoga, which is harder to do now because of COVID, but it's such a powerful reset. So I could walk in

there dragging, feeling tired, wanting to take a nap. I come out of the yoga after an hour and I just feel rejuvenated and alive and clear and energetic. And I was sort of shocked when I had chronic fatigue that that was one of the few things that actually would reset my nervous system. So Mark, let's give a case study. And I can't think of a better one than your own case study. You've written a lot about it. You've talked a lot about it, but we're going to go in more detail in today's podcast. So as you mentioned, you had chronic fatigue. Walk us through what you actually did and maybe even who helped you down the process of getting to the root of what your particular contributions were that were ending in this

result of chronic fatigue. Well, you know, it was ultimately a blessing and a curse, right? It felt like a curse at the time because I could barely function. I couldn't get out of bed. I was unable to have any really clear thinking. I was barely able to work. I had a job, thank God, where I could work from nine to four, three days a week. And at lunch, I could go get a massage or do a steamer, a sauna, and an ice dip so I could literally function in the afternoon. And it was one of the most difficult periods of my life. And I didn't know what to do. And just to interject in your story, right? Just because I think this is really just, I'm curious for myself.

You were also a single parent at the time. Is that correct? Yeah. Yeah. Going through divorce, a single father, alcoholic ex-wife was kind of a messy time as well. So there was this psychological stress as well. Huge. And that underscored it all. But what really my own illness did was teach me functional medicine from the inside out and how to unpack what's wrong with somebody and how many layers there can be to actually getting better. So I didn't know what was wrong, just felt like crap. My immune system wasn't working. I was exhausted. And this is not just like, oh, I'm tired. Let me take a sleep and I'll get better. You never feel better. So you can sleep 10 hours. You don't, you wake up feeling like you haven't slept at all. It's one of the worst

things you can imagine suffering from. And I feel so much compassion for those who do because it's real and most doctors have no clue how to deal with it. And now, thank God, you know, when I went, when I had it, it was like, oh, you know, take Prozac. You know, now there's a lot of literature and science about the biology and the inflammatory cytokines and all the things that we actually can measure in people who are chronically fatigued. So for me, I didn't know what it was. And my gut was a mess. Everything was a mess. So I started just sort of learning about functional medicine. And I discovered that I had mercury poisoning.

That was the first thing. And that was huge for me to get rid of the mercury. And it took me a long time. It took me probably five years or more to get rid of the mercury through chelation and IV therapy and avoiding fish and doing all the foods that are regulated by detox pathways. And I really learned about the science of detoxification of heavy metal treatment. and that was big, but it didn't get me all the way better. And can I ask one quick question about mercury, Mark? How is it, connect the dots, how is it that something like having excess mercury in your body could invoke something like chronic fatigue or make it worse?

What is actually happening? Well, so fatigue is coming from your mitochondria damage. So mitochondria are energy factories, and they produce energy that runs everything in your body. That's your energy. It's called ATP or adenosine triphosphate, and it's made when you breathe oxygen and you eat food, and that gets metabolized in your little mitochondria, which are little engines inside your cell. They are critical for everything in your body to function and for aging and longevity and everything else. And I ended up having really bad functioning mitochondria

based on my testing. I had elevated muscle enzymes, meaning my muscle cells and my cells were just being damaged because of something, and I didn't know what. And it was really painful and really, really difficult. And the chelation test showed me I had a super high level of mercury that was damaging my mitochondria. And mercury and any toxin damage

mitochondria. They're very sensitive. But they also damage your metabolism. They damage your immune system. They damage your brain. They damage your hormones. They have wide-reaching effects across the body that screw everything up. The main symptoms are fatigue, cognitive impairment, autoimmune disease, gut issues, insomnia, anxiety, depression. I mean, these are the symptoms of heavy metal poisoning. And again, it's missed most of the time because most traditional doctors have no clue on how to diagnose it and certainly not how to treat it. I mean, I literally got an email from a patient the other week. I don't know if it was a patient. I think some guy randomly found me online, whatever.

And he's like, Dr. Hyman, I know you've had mercury issues. I went to my doctor. I heard your stuff. And I've been eating sushi like three times a week for like a bazillion years. And I know it's probably affecting me. And I have all these symptoms. I went to my doctor and they're like, oh, not worth testing. Nothing you're going to do about it. Just stop eating fish. And that was the end of the story. And I'm like, oh my goodness worth testing. Nothing you're going to do about it. Just stop eating fish. And that was the end of the story. And I'm like, oh my goodness, that is just such a sad thing because he has all this mercury stored in his body. You need to get it out.

So that's really important. And functional medicine is really good at helping design a safe way to remove heavy metals and other toxins from your system. So toxins is number one. But then I wasn't all the way better. And then I realized, oh, it was just kind of stupid and kind of shows how doctors are the worst patients. But I was like, oh, I'm going to check. I'm feeling a little tired. Let me check my Lyme test. And I, you know, I live up in the woods in

the Northeast and there's a lot of Lyme. And I checked Lyme and all these co co-infections and ticks and then i know so busy working and running around saving the world and being dr hyman i forgot to look at my result because i was did my own test and i i opened it up and one day i was like what happened i tested like i was like oh no because i had a pcr positive lime which means not like oh i might I might have Lyme or it's maybe Lyme. It's like actively replicating in my blood, which is not good. And I also had Babesia. And so then I went down that whole rabbit hole of treating my own tick infections, which was very challenging. You have to use antibiotics and herbs and this and that. And it was still really hard. And then I found out a number of years later that I lived in a moldy house. I lived in a 1825 post office that was converted to a house in a small New England town.

And the basement was just full of mold. And I knew it. But at the time, I didn't really know that much about mold and didn't connect the dots. And that was also contributing. And so I literally have had to deal with all these things. Normally it's like, oh yeah, you eat bad and you don't exercise and you're stressful. I had all that down. It was all this stuff that happened in my environment, like toxins and mold and ticks and infections. And so for me, it's been a multi-decade long process of unraveling

the root causes of my own dysfunction. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. I hope you enjoyed this episode of The Doctor's Pharmacy. Make sure to check out Gut Food and learn more at gutfood.com. 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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If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.