The 5R Protocol That’s Helping People Reverse Disease Naturally

Many chronic health conditions—such as IBS, asthma, and autoimmune disorders—can be traced back to imbalances in the gut. Disruptions to the microbiome caused by antibiotics, poor diet, food sensitivities, and environmental exposures can lead to inflammation, malabsorption, and increased intestinal permeability (leaky gut). Addressing gut health through a structured Functional Medicine approach called the 5R’s of gut repair—removing harmful triggers, replacing missing digestive factors, reinoculating with beneficial bacteria, repairing the gut lining, and rebalancing lifestyle factors—can restore balance and improve systemic health. In this episode, I discuss, along with Dr. Elizabeth Boham and Raja Dhir, the Functional Medicine approach to healing the gut and why the gut is at the center of imbalances in the body, including many health conditions. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Raja Dhir is the co-founder and co-CEO of Seed Health, a microbiome science company developing innovative probiotics and living medicines to advance human and planetary health. He specializes in translating cutting-edge microbial research into impactful products and leads Seed Health’s academic collaborations with institutions such as MIT, Harvard, Stanford, Caltech, and the NIH. Raja co-chairs Seed’s Scientific Board alongside Dr. Jacques Ravel, guiding research across microbiology, immunology, genetics, and ecology. He also directs LUCA Biologics, a company focused on the vaginal microbiome and women's health, and oversees SeedLabs, which drives environmental initiatives. Through this work, Raja plays a key role in accelerating microbiome-based solutions from discovery to market. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: What Is Leaky Gut And How Can You Treat It? How to Select a Probiotic and the Future of the MicrobiomeHow To Do The 10-Day Detox

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dr. Mark Hyman?

  Coming up on this episode of the Dr. Hyman Show.

• 0:02Speaker 01

  When you have the wrong bacteria and the wrong yeast levels, you can get a lot of bloating after you eat. You can get a lot of fatigue after you eat. You can get those symptoms of constipation and diarrhea. And that causes this inflammation in the digestive system. So all of your digestive enzymes don't work well.

• 0:22Dr. Mark Hyman?

  Now, before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real-time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, The Hyman Hive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at drhyman.com for my website store for a summary of my favorite and thoroughly tested products. You know, people don't understand how so many of our issues come from the gut and how easy it is to diagnose it and treat it. And we use tests that traditional doctors just don't do.

• 1:07Dr. Mark Hyman?

  Like, we have a different set of lenses, a different set of filters that we can sort through information and data and ask questions that traditional doctors can't. Like, how do you measure a leaky gut? How do you look at the microbiome in the gut? How do you look at the digestive function in the gut? How do you actually start to treat it in a different way? And I think your first case is just so rich with a story that is so common that I just love you to share this because I think everybody's going to resonate with this story. And by the way, I've never seen this patient as your patient, but I have literally seen the same story 100 times, or maybe 500 times, or 1,000 times in my bracket. It's the same frickin' story. So tell us about this person.

• 1:51Speaker 01

  So it was a 24-year-old gentleman who came in to see me and was really struggling over the last year with his digestive system. He was having a lot of bloating and gas, pain in his stomach. Every time he ate, he was having diarrhea. And sometimes he was getting constipated. And he went to his traditional GI doctor, and they told him he had irritable bowel. And, but he wasn't getting any better, right? And he was just really, because he was having so much stomach pain. He had lost some weight. So he wasn't, you know, he was on the thin side to begin with. But because he was having stomach pain when he ate, he wasn't able to eat as much.

• 2:33Speaker 01

  And he was even losing more weight. He was feeling really weak and tired and sad, depressed. Right? And so for him, the time, well, for everyone, the timeline is so important, right? That's what we are, we were learned, we learn in functional medicine is the gathering that information, learning about that individual patient's story, seeing their timeline.

• 2:54Dr. Mark Hyman?

  We start with a history with the mother and her pregnancy and the birth. And whether they breastfed and whether they took antibiotics, whether they were sick as a kid. What happened? When they were introduced to food, when they got gluten, when they got dairy? We ask all these questions. So when someone comes in with irritable bowel, the average GI guy is not asking all these questions.

• 3:11Speaker 01

  Right.

• 3:11Dr. Mark Hyman?

  So why do we ask all those questions?

• 3:12Speaker 01

  So, you know, because, because for this gentleman, for example, you know, he really didn't have stomach pain before a year ago. But what we found out is that when he was a kid, he had ear infections. So, and he had asthma. Probably, right? So it's such a common connection.

• 3:28Dr. Mark Hyman?

  I remember once being in the ER, Liz, and I, this, this patient came in and this little boy keeps coming back and like a toddler was coming back over and over to the ER with ear infections and just so inflamed. And I said, how was he like, like, did you breastfeed? Yeah. So when did he start getting the ear infections? Well, we started formula and dairy and milk. And I'm like, oh, okay. And this is even before I knew about functional medicine.

• 3:51Speaker 01

  I know.

• 3:52Dr. Mark Hyman?

  And I was like, well, maybe you shouldn't eat dairy.

• 3:54Speaker 01

  Yeah, yeah.

• 3:55Dr. Mark Hyman?

  And the kid was fine, you know?

• 3:56Speaker 01

  Right. It's, that's such a, such a common connection. I mean, even my son with, when he started dairy, he got asthma and eczema. It was, it's, it's unfortunately such a common connection. So for this child, he had a lot of ear infections and, and, and, and eczema. And so he was on antibiotics about once or twice a year in his childhood. And he really didn't think that was very much.

• 4:19Dr. Mark Hyman?

  Yeah.

• 4:19Speaker 01

  He's like, that's not, you know, that wasn't too much, but you know, it makes a huge impact on the microbiome as we're learning. And then he started to have acne as a teenager. Maybe because of dairy more, right? Um, or, or some of the im, the imbalances in the microbiome, right?

• 4:35Dr. Mark Hyman?

  When you, when you screw up the gut with antibiotics or a C-section or lack of breastfeeding. Then you get often more acne.

• 4:43Speaker 01

  Yes.

• 4:44Dr. Mark Hyman?

  You know, we treat acne on the, from the, from the top in as opposed to the inside out, which is actually where it works much better.

• 4:50Speaker 01

  And this, this gentleman was given low dose antibiotics for two years.

• 4:54Dr. Mark Hyman?

  Yeah.

• 4:55Speaker 01

  So then he took even more antibiotics. And so this history of antibiotics sort of set him up. And about a year ago, he had some sort of stomach bug. So some probably viral stomach infection. And then since that time, he started to have all of these digestive issues and was losing weight. And so

• 5:13Dr. Mark Hyman?

  Which is a common story. People are

• 5:14Speaker 01

  So common, like you said.

• 5:16Dr. Mark Hyman?

  This sort of smoldering, a bunch of insults over the course of their life. You know, maybe they're a C-section. They had antibiotics as a kid. They took acne antibiotics. They got, you know, they were eating a crappy diet, whatever. And then all of a sudden, something happens and then boom, the body

• 5:29Speaker 01

  Right.

• 5:30Dr. Mark Hyman?

  Can't take it anymore.

• 5:31Speaker 01

  Yeah.

• 5:31Dr. Mark Hyman?

  And it creates some kind of disease.

• 5:33Speaker 01

  Yeah.

• 5:33Dr. Mark Hyman?

  But if you look at the story, you can often map out exactly how this happened.

• 5:36Speaker 01

  That connection with his acne, with his asthma, with his digestive issues, with those antibiotics, that's that story we, we often see.

• 5:45Dr. Mark Hyman?

  And we're not making this up. There's so much science that shows that your gut microbiome plays a role in acne and eczema and asthma that it plays, I mean, we're, we're actually doing this at Cleveland Clinic now. We're studying asthma and looking at how the microbiome plays a role and how it affects inflammation, all these various factors that most doctors just don't pay attention to.

• 6:02Speaker 01

  Right. So with him, as we do with most of our patients, we do food first, right? So we said, okay, we've got to really focus on this person's diet and help him start feeling better right away. So he can start to eat more and regain some of his strength. So we pulled away inflammatory foods. We took them off of gluten and dairy while we were waiting for tests to come back. Um, you know, sometimes we will do some tests that look at, of course, we'll, we'll test for celiac disease or

• 6:30Dr. Mark Hyman?

  Which is a big cause of leaky gut.

• 6:31Speaker 01

  Yep, that's for sure.

• 6:33Dr. Mark Hyman?

  Probably the number one.

• 6:34Speaker 01

  And he didn't have that, but, but

• 6:35Dr. Mark Hyman?

  By the way, you don't have to have celiac disease to actually have a problem. Right, you can have, they call it non-celiac gluten sensitivity.

• 6:42Speaker 01

  Yep.

• 6:42Dr. Mark Hyman?

  I would estimate it probably affects 20% of the population. And I think if you look at the antibody levels, you can get a clue, which most doctors don't look at.

• 6:51Speaker 01

  Yep.

• 6:51Dr. Mark Hyman?

  I read a study that autistic kids and schizophrenic patients often have, 20% of them have antibodies to gluten.

• 6:58Speaker 01

  Yes.

• 6:59Dr. Mark Hyman?

  And it may not be full-blown celiac.

• 7:00Speaker 01

  Absolutely, and, and even, you know, regardless of, even if people are negative totally for celiac, if they have increased intestinal permeability, they start reacting to a lot of different foods.

• 7:14Dr. Mark Hyman?

  Yeah.

• 7:15Speaker 01

  So then you start to see with that, with that leaky gut, as we talked about before, right? The coffee filter and things are coming through, then the body's reacting to lots of foods that it maybe never reacted to before.

• 7:25Dr. Mark Hyman?

  So they're not true allergies, they're more like sensitivities.

• 7:27Speaker 01

  Sensitivities, and because of, and the real thing is it's because of this increased intestinal permeability.

• 7:32Dr. Mark Hyman?

  Yeah.

• 7:33Speaker 01

  So our job is we have to heal that increased intestinal permeability so that they don't have to be so restrictive with their foods. I mean, we still always want them to be on a healthy diet, but, but we wanna, we wanna relax those restrictions over time. We, most of the time we can.

• 7:48Dr. Mark Hyman?

  Yeah, and so, so as part of the approach of functional medicine, we start them on the elimination diet. So eliminating all the inflammatory foods, gluten dairy, processed foods, all that stuff.

• 7:59Speaker 01

  That's remove, right? That's the remove in the five R's.

• 8:02Dr. Mark Hyman?

  Right, the five R's, remove, replace, re-inoculate.

• 8:05Speaker 01

  Repair, rebalance.

• 8:07Dr. Mark Hyman?

  And, and we'll go into each of those because they're really important. But the, the, the, the next step is also there's other things we may need to remove. There's tests we need to do.

• 8:16Speaker 01

  Yes.

• 8:17Dr. Mark Hyman?

  So what kind of tests would you look at as a functional medicine doctor that you wouldn't see at a traditional doctor's office that give us a roadmap of how to treat these patients?

• 8:25Speaker 01

  Right, so we did a stool test that looked at his microbiome. And what we noticed is that there was an overgrowth of unhealthy bacteria and unhealthy yeast. So he had this, you know, probably because of years of antibiotics, he developed this dysbiosis, this imbalance in the bacteria and yeast. And so there was an overgrowth of the unhealthy things.

• 8:47Dr. Mark Hyman?

  It's like weeds, having a lot of weeds in your garden, right?

• 8:50Speaker 01

  Right, it's not, it's, it's not always like one of those, you think of a stomach infection and you're getting really, really sick, you're throwing up or having diarrhea. This is this, it's a, it's an imbalance, and it's called dysbiosis. But that imbalance causes a lot of symptoms in people. When you have the wrong bacteria and the wrong yeast levels, you know, you can get a lot of bloating after you eat. You can get a lot of fatigue after you eat. You can get those symptoms of constipation and diarrhea. And, um, and that causes this inflammation in the digestive system. So all of your digestive enzymes don't work well. So you're not breaking down your food well. You're not absorbing your nutrients well. And it becomes this vicious cycle that people are, are dealing with. And we see all the time.

• 9:34Dr. Mark Hyman?

  Yeah, it's so, it's so powerful. So, so, you know, you know, when I see this patient, I'm like, okay, you don't have to do all the tests. But sometimes when you get stuck, you look at, you know, various tests to look at, antibodies against things that, that are in the gut that determine a leaky gut.

• 9:49Speaker 01

  Right.

• 9:49Dr. Mark Hyman?

  And we call it Syrex two testing, which is a test you can get.

• 9:52Speaker 01

  Right, is there, you can test to see if there's leaky gut. I love that test too, because it's a great way for us to follow up and see how much we're ceiling, seeing improvement. Are we doing enough?

• 10:03Dr. Mark Hyman?

  Right.

• 10:03Speaker 01

  Um, are we seeing improvement in, in, in their leaky gut or increased intestinal permeability?

• 10:08Dr. Mark Hyman?

  And then we look at poop testing, like, you know, where we do thousands and thousands of these tests. And it's so helpful. And it doesn't just look at the microbiome. It actually looks at the function of the gut.

• 10:18Speaker 01

  Yes.

• 10:19Dr. Mark Hyman?

  Like, uh, whether there's malabsorption, whether you had no digestive enzymes, whether there's inflammation, whether there's overactive antibodies in there, whether you have, uh, imbalances and what we call the short chain fats, which are the, the, the food for the colon that are produced by bacteria eating the right kinds of fiber. And if they're low, it means there's an imbalance. Then we look at the microbiome. We look at what grows. We look at parasites. And then we, we target and micro target the things that are out of balance for that person. And it's different for everybody. And we might look at food sensitivity testing. We might look at, at, um, and even things like heavy metals or other things which can also cause it. I had a patient with ulcerative colitis once and I did everything right. I did the whole five R, it wasn't working. But I forgot the first part of the R, which is remove, and I thought, well, maybe, you know,

• 11:04Dr. Mark Hyman?

  heavy metals can cause autoimmunity, maybe it's a problem. And so I tested him, and he was like wasted away, and he was like, it was terrible. He actually had high levels of mercury. We treated his mercury and his colitis went away.

• 11:15Speaker 01

  Which is phenomenal, yeah.

• 11:17Dr. Mark Hyman?

  So I think it's so powerful, and this case is so important because it really describes how a patient, you know, goes to the doctor, is diagnosed with a disease, Irritable Bowel Syndrome. By the way, anytime you hear syndrome, it means doctors know what the heck's going on. It's just a collection of symptoms that we agree, we're gonna put in this bucket, and if you have those symptoms, you have this disease. But it's not really a disease. And, and so, that's what functional medicine is, it sort of looks upstream to figure out what the root causes are, and personalize the treatment for everybody. And there's common things that we do, like the five R, but it's maybe different Rs for each patient, right?

• 11:50Speaker 01

  Right, right. So for him, we removed, you know, the inflammatory foods, and we removed the bacteria and yeast. I actually treated him with an antibiotic, a non-absorbed antibiotic, and an antifungal. So I treated him with a prescription medication.

• 12:06Dr. Mark Hyman?

  Weed killer.

• 12:07Speaker 01

  Yeah, weed killer. So that was the remove, right? And then the replace, because he was underweight, and because of that inflammation in his digestive system, I gave him some digestive enzymes for a short period of time, just to help him, to help it so the food wasn't as inflammatory for him, and to help him absorb more nutrients. And then we, then we worked on re-inoculating, right? So after, we, we gave him some good probiotics.

• 12:32Dr. Mark Hyman?

  Put in the healthy bacteria.

• 12:33Speaker 01

  Put in the healthy bacteria, some good prebiotics, right? So we know that there's...

• 12:38Dr. Mark Hyman?

  What are prebiotics?

• 12:39Speaker 01

  Prebiotics are the, are the things that help feed the good bacteria. So they're the food for the probiotics.

• 12:45Dr. Mark Hyman?

  Which is usually what, like?

• 12:46Speaker 01

  Like fibers. Fibers are amazing prebiotics. We know a lot of phytonutrients are prebiotics. So this, I think, is really exciting research, when we're looking at our phytonutrients. You know, we know that...

• 12:58Dr. Mark Hyman?

  What are phytonutrients?

• 12:59Speaker 01

  Right, so, I know, it's amazing, right? So, so our food has, has minerals in it, it has vitamins, but it also has these things called phytonutrients, which are these components in our plant foods that have this amazing health benefits for us. So that can include things like elagic acid that we see in pomegranate, that can feed some of the good bacteria, that acromansia that we know can lower inflammation. We know that...

• 13:26Dr. Mark Hyman?

  Just, just to back up on that acromancia thing. So when we look at the poop, we can tell if there's like good levels of different bugs.

• 13:32Speaker 01

  Yep.

• 13:33Dr. Mark Hyman?

  And one of them we look at is acromancia. And it turns out that that is so important for protecting your gut. It helps you keep your biofilm or that little coating over the gut so you don't have a leaky gut. And it's involved in so many autoimmune diseases and response to cancer therapy and metabolic issues and weight. And it's such an overlooked thing and you can't take a probiotic of it, at least not yet.

• 13:55Speaker 01

  Right.

• 13:55Dr. Mark Hyman?

  But you can feed it to good guys.

• 13:56Speaker 01

  Right. We can feed it. We can feed it with all these amazing phytonutrients like the, what's in pomegranate, the elagic acid. And also, we know that sulforaphane from our cruciferous vegetables feeds the good bacteria.

• 14:10Dr. Mark Hyman?

  Yeah.

• 14:11Speaker 01

  You know?

• 14:11Dr. Mark Hyman?

  So broccoli, collards, kale, but not juicing it.

• 14:15Speaker 01

  Right. Brussels sprouts, all those good ones. We know that green tea, you know, that has good phytonutrients in it that's good for the digestive system. So we always say to people, you know, get something from every color of the rainbow every day. You know, you're, get some plant foods from every color of the rainbow every day. Get some good red foods like the pomegranate or cranberry.

• 14:35Dr. Mark Hyman?

  Yeah.

• 14:36Speaker 01

  Get something orange and yellow and green, blue, purple, white, tan. You know, those, all those good, healthy plant foods that we, you know, like our vegetables, our fruits, our spices, our teas, our coffees, really actually are impacting our microbiome, which is fascinating.

• 14:53Dr. Mark Hyman?

  It's so great. And you know, just a great anecdote from a colleague of mine, Dr. Lee, who was on our podcast, talking about E to B disease. His mother had stage four uterine cancer. And being the smart doc he is, he understood from the research that if you have low acromancia, patients don't respond to the immunotherapy, what they call the checkpoint inhibitors, which is this new form of cancer therapy that helps activate your immune system. So if your gut isn't healthy, you can't actually get the cancer cells to die with the immunotherapy.

• 15:23Speaker 01

  Right.

• 15:23Dr. Mark Hyman?

  So it's basically you die unless you have good bacteria in your gut. And so his mother was, had stage four uterine cancer and was gonna die and wasn't responding. And he gave her pomegranate, cranberry, green tea, all these phytochemicals, got her acromancia levels up, and she was cured of her stage four cancer within a month.

• 15:43Speaker 01

  That's a phenomenal story.

• 15:45Dr. Mark Hyman?

  It's an incredible story, and I think that just shows the power

• 15:48Speaker 01

  Of these plant foods.

• 15:49Dr. Mark Hyman?

  Of the plant foods and of getting focused on the gut.

• 15:52Speaker 01

  Yes, yes.

• 15:53Dr. Mark Hyman?

  I, you know, we call it the five R. I call it the weeding, seeding, and feeding program. So like you weed out the bad things, you seed it with the good things, and you feed it with good nutrients and all this stuff. So it's really, it's so, it's so powerful. I can't tell you, you know, as a functional medicine doctor for the last 30 years, and you, you know, been doing this almost as long, the, the results you get from focusing on the gut with so many conditions, whether it's autoimmune, or whether it's allergic, whether it's digestive, whether it's your skin issues like acne or eczema, whether it's your mood, whether it's weight metabolism, whether it's migraines, whether it's Alzheimer's, I mean, autism, ADD, it's just amazing when you start to focus on this. So let's break down the,

• 16:38Dr. Mark Hyman?

  the five R program for everybody. So we got the remove. So what are we looking at? We're removing?

• 16:41Speaker 01

  Removing unhealthy foods or, or inflammatory foods for that person.

• 16:45Dr. Mark Hyman?

  So they can be food sensitivities, things like gluten and dairy, the big ones.

• 16:48Speaker 01

  Food allergies, food sensitivities, yep. And then we're removing

• 16:51Dr. Mark Hyman?

  Processed food and junk food, right?

• 16:53Speaker 01

  Oh, yeah, that's for sure. And sugars and, you know, excess sugar, which is feeding the wrong bacteria. And then we're removing the unhealthy bugs on, or, or yeasts or viruses

• 17:04Dr. Mark Hyman?

  You might have bacterial overgrowth, yeast overgrowth, a parasite.

• 17:07Speaker 01

  Yep.

• 17:08Dr. Mark Hyman?

  You know, I was on the Red Table Talk, and Jada and her son both had parasites, and they both had gut issues for a long, long time.

• 17:17Speaker 01

  Right.

• 17:17Dr. Mark Hyman?

  And they thought it was just how they were. But with, you know, a short little course of treatment, they were both, I've never felt better, right? And all these other symptoms got better.

• 17:26Speaker 01

  Because now you're actually absorbing the nutrients you're eating, which just helps the body heal.

• 17:29Dr. Mark Hyman?

  Yeah. So, so then, so you, you remove?

• 17:32Speaker 01

  Then we replace.

• 17:32Dr. Mark Hyman?

  But you might also remove things like heavy metals or

• 17:35Speaker 01

  Right.

• 17:36Dr. Mark Hyman?

  Stress or

• 17:37Speaker 01

  Right.

• 17:38Dr. Mark Hyman?

  Toxic people in your life or whatever's giving you a stomach problem.

• 17:42Speaker 01

  Right, right, right. Replace means just to replace some of those digestive enzymes if needed, re-inoculate.

• 17:49Dr. Mark Hyman?

  So the replace also could be like prebiotics, right? So putting in the fibers to feed the gut and to, to actually maybe use hydrochloric acid sometimes for people who aren't digesting their food as they get older.

• 18:01Speaker 01

  Yeah, and to help get them off of the acid blockers, which, you know, we know are creating a lot of problems because we need that acid in our stomach to digest our food.

• 18:11Dr. Mark Hyman?

  Okay, let's take a little detour. So you just mentioned acid blockers.

• 18:14Speaker 01

  Uh huh.

• 18:14Dr. Mark Hyman?

  Okay, these are among the most prevalent drugs prescribed today in America, in statins, I think. When I was in medical school in the eighties, we, we just had those drugs come on the market. The drug reps used to come to us and say, these are very powerful drugs. Never use them for more than six weeks because they block stomach acid and they'll cause significant problems if you do that long-term.

• 18:35Speaker 01

  Right.

• 18:36Dr. Mark Hyman?

  You can cure an ulcer with it, you can fix an acute problem, but never use this. Now, people are on this for decades.

• 18:42Speaker 01

  Yes.

• 18:42Dr. Mark Hyman?

  And it, and, and the, the side effect, which is listed in the, you know, manuals that we get as doctors, is that it causes irritable bowel syndrome.

• 18:51Speaker 01

  Right.

• 18:51Dr. Mark Hyman?

  So you end up fixing the heartburn, but you get irritable bowel and bloating and bacterial overgrowth and all these problems.

• 18:58Speaker 01

  Right, because you need the acid in your stomach. And when you block that acid, then there can be an overgrowth of bacteria where there's not supposed to be, and that can cause all those slew of problems.

• 19:08Dr. Mark Hyman?

  Change the pH, you get more yeast issues and all this stuff.

• 19:11Speaker 01

  And then you're not, you're not absorbing your minerals, so you can get osteoporosis, and you're not absorbing your B12, so you can get fatigue and dementia, right? It just goes on and on and on.

• 19:20Dr. Mark Hyman?

  It absorbs zinc and magnesium, minerals, calcium, it causes osteoporosis, pneumonia, it causes, you know, irritable bowel.

• 19:28Speaker 01

  On and on, right? It's so, and it's, it takes some work sometimes. When people have been on an acid blocker for a long time. It takes some work for us to help wean them off because their body has gotten pretty used to it. They they start to get their bodies. Their body wants to make acid, so it's it's working against the medicine. So when you wean them down, sometimes they get more acid production.

• 19:48Dr. Mark Hyman?

  It's called rebound. So you actually, it's like, and it's sort of a trick, like you get off it, but it makes you worse. So you feel like you have to get back on it.

• 19:55Speaker 01

  I gotta back on it.

• 19:55Dr. Mark Hyman?

  But it's actually not true, and you can actually get off it.

• 19:58Speaker 01

  Absolutely.

• 19:58Dr. Mark Hyman?

  So we do that all the time.

• 19:59Speaker 01

  We do it all the time. So re-inoculate, giving all the good prebiotics and probiotics, the good bacteria and all the things that feed the good bacteria. And then the fourth R is repair.

• 20:10Dr. Mark Hyman?

  How do you know what probiotics to take?

• 20:11Speaker 01

  Oh, that's a great question.

• 20:12Dr. Mark Hyman?

  I want to know, what are you prescribing?

• 20:16Speaker 01

  Oh, my goodness, that's such a, that's, that goes on and on. We could talk about that for the next hour.

• 20:20Dr. Mark Hyman?

  Yes, it's true.

• 20:21Speaker 01

  Right?

• 20:21Dr. Mark Hyman?

  There's a lot, there's more and more probiotics on the market every day, and they all have different roles and different functions. And we're just sort of, honestly, I think, you know, we've been doing this forever, but it feels to me like we're at the infancy of this understanding of how to use these in medicine.

• 20:33Speaker 01

  Yep. I mean, there's some great brands that I trust and I use all the time. But when, when somebody is, you know, doesn't maybe know what to do, I'll say, you know, get one, get, go to a reputable place, reputable pharmacy, or, or a good wellness store pharmacy, and, and get a probiotic, you know, try it. If it makes you feel worse, then stop it, you know? Because there's some, there's some good bacteria that make people feel worse.

• 21:02Dr. Mark Hyman?

  Well, they have bacterial overgrowth.

• 21:03Speaker 01

  Exactly.

• 21:04Dr. Mark Hyman?

  You have bad bugs growing in there, and you put the good bugs in there, they have a fight.

• 21:07Speaker 01

  Yep.

• 21:07Dr. Mark Hyman?

  And they cause lots of bloating.

• 21:08Speaker 01

  And so that means we just have to do more work before we can start it.

• 21:11Dr. Mark Hyman?

  Yeah.

• 21:12Speaker 01

  So.

• 21:13Dr. Mark Hyman?

  So you got to re-inoculate, and then you got the.

• 21:15Speaker 01

  And then repair.

• 21:16Dr. Mark Hyman?

  Yeah.

• 21:17Speaker 01

  And that's the fourth R. So that's things like, that's like giving good protein, good amino acids, which are the building blocks of protein.

• 21:25Dr. Mark Hyman?

  To repair.

• 21:26Speaker 01

  Yeah, to help repair that barrier, that, that. That coffee filter, right, we have to repair it with good protein. And sometimes we'll use amino acids like glutamine that help repair it. We'll, we'll give more zinc, whether it's from food sources or as a supplement. Maybe we'll give some vitamin A, which also helps with healing that barrier. It's, it helps with healing the endothelium in the gut. So those are things we will do to repair. And then, and then rebalance, right? That's the fifth R, which is really focused on managing our stress and how we're reacting to the world. Because we know that when our parasympathetic nervous system is engaged, when that calming nervous system is engaged through meditation and yoga and breath work,

• 22:11Speaker 01

  that our body has, has the ability to heal. And it heals better when our body is, is, is at, at rest.

• 22:17Dr. Mark Hyman?

  I mean, yeah, I think, you know, you just touched on something very powerful, which is that our, our gut and our brain are connected. There's a whole hard wiring of nervous system. And, and our, and the gut even has this independent nervous system that actually is like a second brain.

• 22:33Speaker 01

  Yeah.

• 22:34Dr. Mark Hyman?

  And, and so, you know, it's, you know, we often say people with irritable bowel are emotional or anxious or have, you know, just maladaptive emotional coping mechanisms. But it turns out that, that the irritable bowel actually can cause an irritable brain and lead to anxiety and all these emotional issues. So it's, it's a bidirectional. And I think that's a great lever for helping people reset their gut.

• 22:57Speaker 01

  Absolutely.

• 22:58Dr. Mark Hyman?

  You know, I, I, I just want to share a story because I, you know, I, I've been doing this for a long time. And, and of course, my, my, um, I don't know what it is, curse or blessing, depending on how you look at it, is, is actually getting really sick and having to figure out what to do to fix myself.

• 23:12Speaker 01

  Yeah.

• 23:13Dr. Mark Hyman?

  And, and I've had a lot of gut issues over the years, uh, which is why I've really focused on this. The first was when I had mercury poisoning. And I tried everything. I did every functional medicine trick in the book back then, and it wasn't working.

• 23:24Speaker 01

  Right.

• 23:25Dr. Mark Hyman?

  And until I got the mercury out, which disrupts all your enzymes, it disrupts your gut, it causes leaky gut, it causes yeast overgrowth, it screws up the bacteria in your gut. Until I got rid of the mercury from my system, I couldn't get my gut straight.

• 23:36Speaker 01

  Yeah, impacting your immune system too, right?

• 23:39Dr. Mark Hyman?

  Right. And then, and then I, many years later, I, you know, kind of got an issue which was triggered by an antibiotic for a root canal that I had to take called clindamycin, which is known to cause C. diff, which is a terrible bacterial infection that kills like 30,000 people a year.

• 23:55Speaker 01

  Yeah.

• 23:55Dr. Mark Hyman?

  And I got that.

• 23:56Speaker 01

  Yeah.

• 23:56Dr. Mark Hyman?

  And I was so sick.

• 23:58Speaker 01

  I remember.

• 23:58Dr. Mark Hyman?

  And, you know, Liz would come over to my house and I was like, it was pretty bad. I'm like, we're all struggling to figure it out.

• 24:04Speaker 01

  Yeah.

• 24:05Dr. Mark Hyman?

  And I had mold in my house and all these other things, but I ended up having colitis and I had tremendous leaky gut. And I did my own stool test and my friend Patrick Hanaway, who worked for the stool test company for many years, my colleague at Cleveland Clinic, he and I looked at my stool test and we probably, between the two of us, seen like 20,000 stool tests. We're like, this is the worst one we've ever seen. And everything was screwed up. And I had no good bacteria. I had low butyrate. I was not digesting. I had tons of inflammation. It was terrible. And, um, and I couldn't really fix it using a lot of the traditional things. And then I started to sort of work on a, um, a gut shake, which included a lot of the sort of five R concepts, right?

• 24:49Dr. Mark Hyman?

  So I cleaned up my diet. Obviously I got rid of the bad bugs, but, um, I used a combination of these polyphenols from the plants, a pomegranate, cranberry, green tea, also added, you know, glutamine. I added prebiotics, probiotics, I even added colostrum.

• 25:05Speaker 01

  Yeah.

• 25:06Dr. Mark Hyman?

  You know, which is to help regulate the immune system. And it was like a miracle. I had went from full-blown colitis to like normal in three weeks.

• 25:21Dr. Mark Hyman?

  There's so many probiotics out there, you know, you go to the grocery store, you go to the health food store. There's ones in the fridge, there's ones not in the fridge, there's with this strain, there was that strain. Like, nobody knows what's going on. Even most doctors have no clue what's going on. So can you, can you define like, what's a probiotic? And, and, um, you know, whether we should actually be taking probiotic supplements? Cause you know, we've been taught, for example, that, you know, when you take probiotics, they don't really take up residence there. They just kind of pass through and do little things and they go on. Is do they colonize? Do they not? Does it matter? And, and, um, and should we be thinking about probiotics from a, uh, basic health maintenance perspective? Should we all be taking them?

• 26:01Dr. Mark Hyman?

  How do we pick the right probiotic? And, you know, should we just be eating sauerkraut and kimchi and forget about probiotics? Can you help us unpack some of that?

• 26:10Speaker 02

  I think probiotics are fascinating in the sense that anytime a piece of news or press comes out that says probiotics don't work, or they don't do this, it seems that probiotic usage goes up. And so I can't explain it, but it's, people love them, people use them, but the science and the understanding and the development of them is very confusing and varied. And so just to start with some definitions, probiotics are defined as live organisms that confer a health benefit to their host. It's a very simple definition. Gregor Reed chaired the panel at the UN that wrote it in 2001.

• 26:54Speaker 02

  At its core, probiotics are, you know, and not a new discovery, or not a new hypothesis. You know, typically, they were in the early 1900s organisms that were isolated that were found to be beneficial. And benefit has changed over the years dramatically. I mean, back then, it was just keeping your food sterile or safe from pathogens that could be considered a benefit and preventing you from getting sick from what you eat could be considered a benefit. Today, people look for a lot more complex things. So what is it intended to do? And what is the health benefit? That's the question that you have to ask. Anytime you hear the word probiotic, that's what you have to say right back. Say, okay, so it's a live organism. Yes or no? You'd be surprised.

• 27:38Speaker 02

  Many times, they're not live, or they're not guaranteed to be live, or they don't make it to your colon alive. And so there's a whole spectrum of even that live part. And part two is, okay, so beneficial, what are they beneficial for? What are they going to do? What is the basis for if they are beneficial or not?

• 27:57Speaker 02

  I think people confuse probiotics sometimes with fermented foods, which have a very different definition. Fermented foods are microbial metabolized food matter that carry a microbial load. And so that actually was just defined by, in a Nature Review this year for the first time. And they're both good. They both can be good, or they both could do nothing. It really depends on what you're looking at. So fermented foods are different from probiotics, but sometimes fermented foods can be probiotic, and sometimes probiotics can be fermented foods. But it depends on what they are and what you're trying to accomplish.

• 28:36Speaker 02

  Classically, probiotics have been lactobacillus and bifidobacterium. Two years ago, the scientific community convened and said, "Okay, this is way too generic." And so lactobacillus actually was broken into about 200 subclasses and was completely renamed. And so we don't really use lactobacillus anymore, but there's way more genus and species variation now from what was originally called lactobacillus. Bifidobacterium, at least lactobacillus and bifidobacterium, and streptococcus, I would add, is the third, are the three class of probiotics

• 29:20Speaker 02

  that have been used in food in Japan, in Europe, and predominantly in North America. And so almost every probiotic product that is a microbial product that's standardized will contain or derive some version of these, or it's going to come from soil. So that's kind of the landscape, right? When you hear probiotics. And we'll get to the cases at the edge a little bit after. I do not think that most people, in the absence of any gastrointestinal or gut microbiome related, you know, people that I call like your super- Healthy individuals that that exercise well, but not too much. They're not elite athletes because that creates carries its own risk or not over endurance athletes.

• 30:06Speaker 02

  People that eat virtually no processed foods and that have no environmental toxins in their environment. You've talked before where where you can even find that in ways that you wouldn't expect if you could talk about later. So if you're kind of living in the wild, if you're growing all of your own food, if you're regulating contaminants in in your water supply and in the soil of the food that you're eating and you're eating a very diverse plant and animal based diet. I think that that's that that that you're in more or less peak performance. And lastly is you didn't have heavy antibiotic usage either early in life or at any period throughout your life or periods of disruption and and re colonization from the built environment,

• 30:50Speaker 02

  which means you didn't move to a big city or an urban dwelling place and change your microbiome away from what you would get in the countryside or in a more agrarian or a more kind of wilded environment. So these people that meet those conditions, I would say you probably are doing just fine. You don't need to do too much and a simple microbiome test will tell you, you know, what you need, what you don't need.

• 31:17Speaker 02

  The converse of all of those are people that live in kind of more of the modern world. And so you're getting, you know.

• 31:26Speaker 02

  Yeah, you know, you're you're you're having you're you're bathing using modern and and eating modern foods or packaged or foods or foods bought from a grocery store. You're you're drinking beverages which are contained in some container. You're generally using.

• 31:50Speaker 02

  Urban infrastructure and you may or may not have gastrointestinal or related to gut microbiome maladies. This is kind of that area that I want to focus on where I say probiotic usage is the most impactful, it could be the strongest and it could be the most helpful. My hypothesis why is that people that are in this environment actually have a very low microbial inoculation. So I don't know if when you're in in medical school, you heard this theory that actually they were giving people with IBS or IBD helmets, they were giving them like like known, you know, worms, basically.

• 32:32Speaker 02

  And they found that actually it was it was very effective and I don't know if it was an urban tale or not, but the idea is that, remember what I said about being born inflamed, right? That an active immune system has to be active or has to be inactive and that's very context dependent. So for I I've actually even heard many in the field and on this podcast, talk about the indigenous microbiome or the hunter gather microbiome and kind of define it as this optimal state, but but optimal for who? If you took this microbiome and you transplanted it to an urban, an urbanite living in New York City, that person would probably get very sick. I remember when the Ameri Indian project was happening, it was Maria Gloria Dominguez

• 33:16Speaker 02

  Bella, it was Marty Blazer, a lot of the missing microbes, people that were involved in characterizing the northern Amazonian microbiome. And actually, they went for six weeks to go live, live like them and see how their microbiome shifted. This was an experiment from from the mid to late 2000s. And I remember Gloria telling me that she could do everything, she could follow all of their practices, except for she snuck a little toothbrush with her and and snuck away to brush her teeth every night because she that's the one thing she couldn't give up. But, you know, that's, that's what it means. That's what it means to live like that. It means that you're, you're, you're taking it all.

• 33:56Dr. Mark Hyman?

  So, so with with probiotics, I mean, you know, there, there, there's a lot out there and.

• 34:03Dr. Mark Hyman?

  You know, what what's important to think about if people are trying to choose a probiotic? How do they evaluate it? Now, for example, for when people are choosing a vitamin, I'm very clear with them. They need to make sure that the product is in the right form. So in other words, the right version of that nutrient. For example, if you're taking folic acid, maybe you need five methylfolate as opposed to just folic acid. Or if you need magnesium, maybe you need magnesium glycinate or magnesium threonate instead of magnesium oxide, which isn't well absorbed. Second, you need to make sure that what it says on the label is actually what's in the bottle, that things are third party tested to be therefore both purity and potency.

• 34:47Dr. Mark Hyman?

  In other words, there's no contaminants or toxins, and it actually is what it says on the bottle, that there's no weird stuff in it, like allergens, fillers, cypriots, colors, dyes, sugar, lactose, gluten, all that stuff can be in vitamins. And I, and I think, you know, it has to be bioavailable in terms of the form. It also has to be absorbable. So if it's in a crushed tablet, it's under tons of pressure, it might be the right everything, but you may not digest it. So tell us about, how do we think about probiotics? Because, you know, should we be taking hundreds of different strains? Do we just take one? How do we know what's good? How do we know? I mean, if you buy something in the store, it says 50 billion units on the bottle. Is it actually that? Like, how do we know?

• 35:32Dr. Mark Hyman?

  What should we be thinking about?

• 35:34Speaker 02

  It's a very simple rule of thumb for people is there's two major classes of probiotics. One is targeted for a specific indication. I want to lose weight. I want to improve my mood. I want to signal to improve my skin. You know, they're very different microbes that work on these different axes, and they're usually very specific. So it's not necessarily a bunch of bugs that will do that, but you could.

• 36:03Speaker 02

  Find ones that are very targeted that have that targeted effect. And so I think that this is bucket one. Bucket two, are you, is your?

• 36:11Dr. Mark Hyman?

  Well, that's why I just want to stop there for a second. That's an incredible statement you just said was that there are different strains of probiotics that have different effects for different diseases and conditions. Uh, and I, and some may be good for your skin. Some might be good for your brain. Some may be good for your immune system. Some might be good for your heart. Some might be good for your metabolism, regulating your blood sugar. I mean, it's quite interesting, you know, the differential uh, ability to determine which probiotic is good for which thing. And that is something that's pretty new. I mean, it's almost like, you know, personalized probiotics.

• 36:45Speaker 02

  Well, you're not going to get that from one or two bacteria. And so you have to either only take one benefit you're looking for, or you have to take a more complex consortia. And so it's not that uh, you need a hundred strains, but if you want to maximize the outputs, you generally want see, see more, more microbes adding up together to create broader spectrum effects. So there, there is a uh, kind of network effect, if you will, going on, on which, what, what, which probiotics you take. And uh, and, and for what purpose you are taking them. That second category of probiotics is, well, what is your,

• 37:27Speaker 02

  what is your basis, right? What is your, you know, you hear all the time, somebody say, oh, well, I take uh, I get my probiotics from kimchi, or I get my probiotics from uh, a nutritional shake, or well, you, you get back, you get one or two strains of bacteria, or you get kimchi organisms, but you can't say that that is going to therefore be equal to a strain which is proven to signal to you, to the gut barrier, or a strain that regulates cholesterol uptake, or a strain that uh, works on evacuation disorders to relieve constipation. I mean, all of these are different mechanisms,

• 38:12Speaker 02

  and they're coming from different strains. It's why, again, I think I want to emphasize consortias are so important, which bacteria?

• 38:19Dr. Mark Hyman?

  I mean, I mean, when you say consortia, you mean a lot of different strains that have

• 38:22Speaker 02

  A lot of strains, yeah, together, together.

• 38:26Dr. Mark Hyman?

  So, so keep going on, on how we know to pick the right one or the right strains then.

• 38:30Speaker 02

  So, so now you've kind of asked your first sequence of questions. Do I want a broad spectrum consortia for many different things? Or do I want something more targeted? From there, you need to assess if, if what you're picking is, is good. And there's three layers to it. There's purity, there's potency, and there's efficacy. Purity means that there's the bacteria which are, you list, and none others. It's very simple, and that's done by very good quality control. So you're sequencing at the end of level of individual genes, all the bacteria in your product. You know them, you get a fingerprint every time you do a fermentation, every time you do a production,

• 39:13Speaker 02

  you get a fingerprint, and you know that those organisms are there and nothing else is there. And so this is the, the most important question, question to ask from a sake of purity. Potency is not just what's written onto the label, because that can be very misleading. So there's products in, in Japan that say that we have one trillion organisms, or a yogurt starter culture from Australia that says we have one trillion bacteria. There's kind of your, you know, V S L three kind, your, your gastrointestinal, gastro, gastroenterologist recommended probiotics that are three hundred, four hundred billion, where you see these big, big numbers on them.

• 39:55Speaker 02

  But, you know, you have a very kind of high die-off, either very high die-off when it comes into your stomach right away, or it's typically only one strain or one species. Even if there's listed eight or nine different strains on the, on the label, it's predominantly one, like, you know, the, the number one gastroenterologist recommended probiotic has, has nine strains listed on its label, I believe, or eight. But it's ninety-six percent yogurt starter culture, and the rest are.

• 40:27Speaker 02

  Small like tiny byproducts, you know, so, so potency is very important. Potency is very, very important, but at the level of throughout the entire gastrointestinal tract is something that I take very seriously. There's model, there's, there's sequence.

• 40:42Dr. Mark Hyman?

  So in other words, in other words, you could take a probiotic, it looks good in the bottle, everything's in there, but you eat it, take it as a pill and it gets digested in your stomach and kills everything, right?

• 40:51Speaker 02

  Yeah, or, or it's never even, what's listed is never even alive by the time it makes it. And, you know, so maybe, maybe you see a hundred billion written on the label, but there's, uh, there's 99% die off and by what reaches the colon. So you're not going to get much organic acid production with, with 99% die off before it even gets where it needs to go.

• 41:13Dr. Mark Hyman?

  Hmm. So the bacteria, you have to make sure you know, you're taking a multi, multiple consortium, uh, what you call consortium of bacteria that all have different scientific evidence behind them because there's a lot of stuff out there that doesn't, but there's a lot of evidence around a number of bacteria that have very specific effects on the GI tract, on immune system, on heart health, on metabolic health, on immune health. So, so there, we can use that data to start to design probiotics that actually makes sense.

• 41:44Speaker 03

  I want to walk you through how to do this. Uh, I'm going to teach you how to hit the reset button, reboot your system and to optimize your biology to help your gut, help your detox system, help your immune system, help reset your nervous system and it's powerful. So, uh, if you want to really see how your body can feel and get rid of what we call FLC syndrome, I would do this. Most people are like a frog that's in cold water where you turn the heat up slowly and it starts to boil to death. We just kind of get used to it and think it's normal. These symptoms are not normal. But yeah, I, I wanted to do this with a junior high school once and, uh,

• 42:27Speaker 03

  The teachers are like, well, I, we might have to get permission from the parents to see if it's safe. You know, maybe they don't want their children doing this. I'm like, what is it safe to eat fruits and vegetables and nuts and seeds and protein and cut out sugar and starch and processed food? I mean, they should get a note that it's permission to eat the junk food that they just, the opposite. By the way, yes, very same, anybody could do this. Um, and some people, by the way, you know, need more certain things or other things, but, but basically it's a very universal approach to resetting your system. A second pillar, aside from what you're eating, the, the food is really important. And then by the need to approach in the morning, you need to make sure you get rid of sugar and starch in the morning. Super important. A lot of people start their diet, their day with carbs, which is the worst

• 43:10Speaker 03

  thing you can do with sugar sweetened coffees, teas, cereals, muffins, bagels, breads, diets. Second pillar are your daily habits. Essentially, it involves a pattern of eating and living that puts your body back in rhythm. It helps you reset your nervous system. And, and there's two really important habits, part of the ten things. One is when you eat and also when you sleep. So let's talk about when you eat. Now, when you eat might be as important as what you eat. So many of us don't eat in the right pattern. We tend to, um, you know, eat all day long, we snack, we can eat before bed, um, we stack late at night. It's kind of bad. So basically when you eat is very important. Research

• 43:53Speaker 03

  shows that doing that can really be bad for your health, uh, if you eat at night. So the first is make sure you give yourself at least 12 to 14 hours between dinner and so dinner at six, breakfast at eight, that's a 14 hour fast. Okay. If you eat at six and then you keep snacking all night, that doesn't help, right? And it's the most, um, simple formula we call timer chicken eating. And it's basically giving your body a rest and getting the body to reset. And I wrote a lot about this in my The young forever, but but basically there's all process at night that happens called autophagy, cleanup or repair. You want to eat your body, the ability to do that. The next is food. Now, you can do a breakfast if you're eating, you know, for example, there at six and breakfast at

• 44:38Speaker 03

  eight or so, that's a 14 hour fast. Really important to have protein in the morning or not carbs and sugar. Also, not eating three hours before bed is really important. So most people eating snack after dinner, don't do that. Have at least three hours of time you eat and you go to sleep. That way you will lose weight, your body can repair and heal instead of trying to digest and store the food. What about sleep? Sleep is one of the most underrated pillars of health. It's probably even before exercise, meditation, maybe even before nutrition, because when you don't sleep well, you're going to eat with sugar and carbs, you're going to crave more. So you want to focus on sleep and restorative rest. We know that getting in a routine of waking and sleeping can help with a deeper, more restful sleep. So try to stick the same med

• 45:22Speaker 03

  M every night. Try to get off your screens for an hour or two before bed. Keep your room or use blue block the glasses. Keep your room dark, cold, probably five to six eight. Be important because your body does much better with sleep at night. Try to relax at night with meditation, do a good imagery, do breath work, stretching, journaling, gratitude practice, whatever you like. Let's do something. Very important. So your eating routine should be like set a bedtime of six to over 10 days. Turn your phone off and get it out of your bedroom. Turn the TV off for at least an hour or two before you go to bed. And then use the time of night to read, to journal, meditate, to connect with people you love, and just kind of wind down.

• 46:04Speaker 03

  Oh, and the third is extra support we need on the journey, right? Now, we all need nutrients. They're called vitamins because they were vital amines, vital to life, right? And and so we've seen a dramatic reduction in the nutrient density of our food. Our organic matter's gone out of our soil. Nutrients can't be extracted. Foods travel long distances. We have commodity crops such as your bread to actually breed out the nutrients and in the starch and, and, and, you know, yield. And so foods aren't as nutritious as they once were. And probably ninety percent of Americans, according to the government owned surveys, are deficient in one or more nutrients at the minimum level prevent deficiencies.

• 46:49Speaker 03

  How much vitamin D or you need, you not get rickets, not very much, like thirty. How much need for optimal health, probably three to five thousand. So we need to really probably focus on nutrients. And even with a perfect diet, you know, because none of us are hunter gatherers anymore, or you know, kind of food that we never ate and nutrients depleted. We need, we need the basics. So we need a basic set. It's a multivitamin, mineral foundational magnesium. A lot of us are deficient, probably forty five percent are low or deficient magnesium. It involves over three hundred different enzymatic reactions. Super important helps your lax, your nervous system at night. It'll be calm down. Also, people get constipated. Sometimes they change their diet. So taking magnesium citrate can help. And lastly, vitamin D. And it's also fish oil, but vitamin D is really important.

• 47:33Speaker 03

  Vitamin D over eighty percent is low or deficient in vitamin D. That's it's involved in so many different things in the body. So really important and it's your mood, muscle function, helps your brain, your energy, inflammation, autoimmunity. It's just super important and most of us are low. Fish oil is also important and I, I often recommend fish oil to people or omega three fats. So one of the program steps in the ten day, what should be the tips? And then we're going to go through the first step is to eat from the ten day decoct approved list for ten days. So eat one of the daily eats, right? All foods, uh, you know, whole food, uh, base shake in the morning. You could add, you know, protein powder, grass protein. If you want, I have a best approach called super simple protein.

• 48:17Speaker 03

  But you really need to make sure you have good breakfast. Second is, um, commit to daily habits, right? Pick your designated eating window, right? Uh, you want a twelve to fourteen hour night fast, which means eating within a ten or twelve hour window.

• 48:34Speaker 03

  Don't snack before bed. Try to have the same bedtime. Get off your technology an hour or two before. Like just some active relaxation. Huge impact on your health. Step three is adding the supplements. Now, you don't have to do this, but I really encourage you to have a multivitamin, magnesium, vitamin D, and fish oil. And we're going to list which products you should take in the show notes. You have it all listed there. Also, what you should eat and what you should avoid during your 10 day detox. Let's go through that. So here's a full food list. You can, we're going to have it in the show notes. You can take it with you in the store. It's in the book, the 10 day detox. It's in the 10 day cookbook. Essentially, here's what you should eat and what you should actually get rid of.

• 49:14Speaker 03

  What you should eat is protein. You need right protein, right? So grass fed or originally raised meats is great. You can have a pasture raised lamb, beef, bison, venison, elk, grass fed beef, pasture raised chicken, turkey, duck, all that's fine. What you should avoid is conventionally raised chicken and poultry and eggs and so forth. And by the way, you can also have eggs that are pasture raised eggs. Meat, get rid of all processed meats, deli meats, all conventionally raised feedlot meats. Get rid of all of it. But by fish and seafood, lots of small fish are good. Big fish are bad, right? Big fish like swordfish, tuna, sea bass, halibut.

• 49:56Speaker 03

  Most farmed fish are pretty bad for you. What you should be consuming are things like the, I call it smudge fish, as small wild salmon, sardines, anchovies, herring, mackerel, you can have black cod, shrimp, scallop, trout, eggs. Eggs, as I said, pasture raised eggs are fine, not organic, regular eggs are fine. What about nuts and seeds? Very important. Almonds, Brazil nuts, cashew nuts, hazelnuts, macanemia, pecan, pine nuts, pistachios, walnuts. All that's great. You can have cacao nuts, chocolate, not chocolate, but where chocolate comes from. Seeds are great. Chia seeds, flax seeds, pumpkin seeds, sesame seeds, sunflower seeds, pumpkin seeds, all great.

• 50:38Speaker 03

  Nut butters also great. So unsweetened nut butter. So almond, cashew, pecan, macanemia, I love macanemia. A walnut. All that's great. You can also eat beans if they're, if you're a vegan and you want to do this, you can use GMO free or non-GMO tofu or tempeh as your protein. What you should avoid are nuts, they're with sugar, they are cooked in oils, uh, that are good, casey candy stuff, a lot of nut butters have sugar, hydrogenated fats, peanut butter, peanuts can be okay, but I would say mostly avoid peanuts because uh, they have aflatoxin, often a

• 51:21Speaker 03

  range and uh, and so you want to be careful with that. Um, about oils and fats, well, the ones you want to use are organic avocado oil, you can use organic coconut oil for cooking, grass fed ghee, if you want to use tallow, lard, uh, duck fat, chicken fat, that's okay, as long as they're, they're um, have to raise or originally raised for salads and you can use different kinds of oils like almond oil, black oil, hemp oil, damien oil, olive oil, um, and you can cook with olive oil, but only like tomato sauces and things like that, I think they're not high heat, sesame oil, tahini is great as well, great fat, uh, sesame seed kind of paste, almond oil, those are flavorful oils, they're not mean

• 52:02Speaker 03

  oils, but you want to avoid the traditional oils, all the seed oils like canola oil, partially hydrogenated oils, margarine, peanut oil, soybean oil, sunflower oil, safflower oil, trans fats, vegetable oil, vegetable shortening, all that stuff, bad. What about veggies? What should you eat? Well, you want to stick with lots of non-arty veggies or carrot chokes, organic if you can. I use the Dirty Dozen guide from a working group, BWG.org, tell you which are the clean 15, meaning you can eat things not organic or the Dirty Dozen, which you definitely not eat if they're not organic, but I love asparagus, carrot chokes, avocado, bean sprouts, broccoli, Brussels sprouts, cabbage, cauliflower, celery,

• 52:41Speaker 03

  cucumber, eggplant, garlic, ginger, hearts of palm, horabi, lickey greens, mushrooms of all kinds, onion peppers, radicchio, radish, frutobegas, all that kind of stuff. Seaweed is great, lots of minerals, shallots, some are squash, tomatoes, turnips, zucchini, list goes on, we have all in there. You can have some uh, things like sweet potatoes, I like the Japanese purple sweet potatoes, winter squash, carrots, pumpkin, all that's fine. I mean, carrots are fine because unless you're doing carrot juice or that, but basically try to limit to a, like one uh, serving, which is like half a cup a day. Uh, we should be avoiding is corn, potatoes mostly, a little, you know, some of the little uh, fingerling potatoes or the purging potatoes, purple potatoes. What about dairy?

• 53:25Speaker 03

  Um, you can eat pasture raised butter or ghee, but I encourage you to get all dairy, including sheep and goat, which are mostly fine for people, but I encourage people to just get all other, if you're having,

• 53:37Speaker 03

  I encourage you to have, make sure it's grass fed or regularly raised. What about beans? Well, uh, you can have green beans, you can have green peas, uh, you can have a non GMO organic soy, that's just tofu or tempeh, uh, you can have snap beans, you can have snow peas. Um, but otherwise definitely no, no beans. Uh, what about grains? No grains at all. So, uh, even healthy grains, quinoa, buckwheat, things like that. I encourage really opt off all of that. Why? Cause it just shuts down the insulin response, helps you lose weight, reduce inflammation. Not that these are necessarily all bad, but eventually you'll have them back. But basically get rid of all, all the other, all grains, wheat, barley, rye, rye, amber, millet, oh, it's everything. Uh, get rid of it.

• 54:23Speaker 03

  Uh, fruit, fruit can be okay, but, um, small amounts of non hyglicemic fruits. So organic blackberries, blueberries, cranberries, kiwi, lemons, lime, raspberries, all that's fine. Not too much, right? You know what I mean? Like, you know, two pounds of blueberries, but you gotta have, have, have a dip. Want to get rid of all the other fruit, all the hyglicemic fruit, like bananas, pineapple, melons, cherries, grapes, worst, even foods that, so you think, you know, maybe good for you are actually good for you, right? Whether it's, you know, peaches, pears, lecterines, uh, cherries, for example, but you don't want to eat them while you're on the 1080. Kind of really shut down the blood sugar and response. Uh, what about sugar sweeteners?

• 55:05Speaker 03

  Sorry, the tip, you can sometimes have a little bunk fruit or stevia you have in the shake. Uh, we have, but generally tend to avoid all that stuff.

• 55:15Speaker 03

  Also just get rid of all the other artificial sweeteners, sugar, all that stuff. If you have to ask, it's basic grains. Then what should you be drinking? Well, lots of water, herbal tea, green tea. Uh, this caffeine, that's okay. Love green tea is fine. It'll be gonna stop me. Sparkling water, mineral water, hydration void, alcohol, coffee, bottled water, pot mix soda, obviously sugary beverages. Um, basically that's the program. So if you eat that way for 10 days, you use simple habits, your body is going to totally transform and you're going to see just how food is impacting your health, which I think most people don't have a clue about.

• 55:59Speaker 03

  And that's why I love this so much. Now, after the program, it's really important. If you do it for 10 days or 21 days, 10 weeks or 10 months, you have to be smart about getting off it or you can get a big problem. Because when you go off of foods that are inflammatory, foods they're allergic to, and then you reintroduce them, you can get all worse symptoms. Let's say you had migraines before and they're gone. Wow, you're going to get a disease of a migraine. Unless you had gut issues before, you have a real problem. Unless you had sinus congestion from eating dairy and then eat it again, you might get a sinus infection. So you really have to be smart. So if you're feeling great and you want to continue and you, let's say you have a lot of weight to lose, so you have a immune disease, you just want to,

• 56:42Speaker 03

  you're feeling great, you want to continue, no problem, you continue it, continue to do it. You can do it for another 10 days, you can do it for another 10 months, it's totally safe to eat. It's pretty much how I eat most of the time, or the occasion, grains and meats.

• 56:54Dr. Mark Hyman?

  When it comes to supplements, you only want the best for your body, the kind with the highest quality, cleanest and most potent ingredients you can get. That's exactly what you'll find at my supplement store, where I've hand-selected each and every product to meet the most rigorous standards for safety, purity and effectiveness. These are the only supplements I recommend to my patients, and they're also what I use myself. Whether you want to optimize longevity or reduce your disease risk, or you're looking to improve your sleep, blood sugar, metabolism, gut health, you name it, DrHyman.com has the world's best selection of top-quality, premium supplements, all backed by science and expertly vetted by me, Dr. Mark Hyman. So check out drhyman.com because when it comes to your health, nothing less than the very best will do. That's drhyman.com, D R H Y M A N dot com.

• 57:37Dr. Mark Hyman?

  If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical

• 58:21Dr. Mark Hyman?

  professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.