The Gut-Brain Connection: Why Your Mental Health Starts in the Microbiome

The connection between mental health and metabolic health is far deeper than once believed, with growing evidence showing a powerful, bidirectional relationship. Inflammation, poor diet, and gut dysfunction are now recognized as key drivers of both physical and psychological illness—often hiding in plain sight. By addressing root causes such as blood sugar imbalances, nutritional deficiencies, and microbiome disruption, many chronic mental health conditions can improve or even resolve. This emerging science challenges the traditional separation of mind and body, pointing instead to an integrated approach where healing the body becomes essential for healing the brain. Recognizing this link is crucial in shifting the future of mental health care. In this episode, I discuss, along with Dr. Chris Palmer and Dr. Shebani Sethi, why our diet is so closely related to the state of our mental health. Dr. Chris Palmer is a psychiatrist and researcher working at the interface of metabolism and mental health. He is the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School. For over 25 years, he has held leadership roles in psychiatric education, conducted research, and worked with people who have treatment-resistant mental illnesses. He has been pioneering the use of the medical ketogenic diet in the treatment of psychiatric disorders - conducting research in this area, treating patients, writing, and speaking around the world on this topic. More broadly, he is interested in the roles of metabolism and metabolic interventions on brain health. Dr. Shebani Sethi is a double board-certified physician in Obesity Medicine and Psychiatry. She is the Founding Director of Stanford University’s Metabolic Psychiatry program and Silicon Valley Metabolic Psychiatry, a new center in the San Francisco Bay Area focused on optimizing brain health by integrating low carb nutrition, comprehensive psychiatric care, and treatment of obesity with associated metabolic disease. 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: The Hidden Connection Between Gut Health & Mental Health That Therapy and Drugs Cannot Fix A Harvard Psychiatrist Rethinks Mental Health As A Metabolic Disease How Does Ultra-Processed Food Affect Our Mental Health?

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

  The relationship between mental health and metabolic disease is bidirectional, which means if you have a mental illness, you're more likely to have metabolic disease and vice versa. And if you have a metabolic disease, you're more likely to develop a mental illness. You're more likely to have a heart attack, for example, if you have depression. And you're more likely to develop depression after you have a heart attack.

• 0:28Dr. Mark Hyman?

  Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at scale. That's why I've been busy building several passion projects to help 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 a summary of my favorite and thoroughly tested products. We have a mental health crisis. Globally, 300 million people are suffering from anxiety. 280 million people are suffering from depression. Now, from treating thousands of patients over the last 30 years,

• 1:10Dr. Mark Hyman?

  I've learned that depression is mostly not in your head, it's in your body. When I treat patients' gut issues, and this is something I just discovered almost by accident, their mental health would magically get better. But it wasn't magic, it was science. I just didn't understand at the time. It's not magic. Gut dysfunction is not the only cause of our mental health crisis. There's a lot of things that are driving it, but it's a major factor that's often unaddressed. And when your gut is unhealthy, when it's inflamed, your brain is unhealthy and also inflamed. When we fix the gut, then brain health, mood, memory, focus, and mental health all improve. Now, why is this important? Inflammation is a huge driver of most of our mental health issues from depression, anxiety, autism, ADD, even things like Alzheimer's, schizophrenia, bipolar disease, all linked to inflammation in the brain.

• 1:55Dr. Mark Hyman?

  And where's this inflammation coming from? Obviously, our diet, but also from our microbiome. And I learned this early in my medical practice. In fact, one of my early books, called The Ultra Mind Solution, a deep dive into the way the body affects the brain, including the gut and the microbiome. Now, conventional medicine views these two things as Completely separate and unrelated. And typically, if you have GI symptoms, you go to the GI doctor, a gastroenterologist. And if you have mental health issues, you go to a psychiatrist to help with balancing your mood. They prescribe different drugs for each condition instead of understanding the root cause and treating that. And then we're going to talk about how this works, why it's important, what the science is, and some of my clinical case studies, which are quite compelling. Now, in functional medicine, we know the gut and the brain are intimately connected, and that the health of one directly impacts the other.

• 2:38Dr. Mark Hyman?

  So you can't fix the brain without fixing the gut, and you can't fix the gut without fixing the brain. So it's bidirectional. It's not mind-body, body-mind, body-mind, mind-body. It's both, right? When we do that, and I've done this in thousands of patients, and the studies back this up, and more and more data is coming out, Chris Palmer, Umanidu, a psychiatrist from Stanford, and integrative psychiatrists, functional psychiatrists are all seeing this. The data is really exploding on this. When I wrote the book 15 years ago, there was data, but it was limited. But I saw it, and I saw the whispers in the wind, let's say, the tea leaves. And I was like, okay, this is really something. And when I started to do this with my patients, and when we do this now, we see profound improvements in mood and obviously digestive health and all other areas of health. So gut is just linked to everything. So fix the gut, fix the body, fix the gut, fix the brain.

• 3:22Dr. Mark Hyman?

  I know how powerful this is and how powerful functional medicine is for fixing depression, because I also had it myself. And it wasn't because of something that had to do with my psychoemotional health, but my physical health. My brain literally broke one day in 1996. I felt like I had ADD, depression, and dementia all at once. I saw lots of doctors, psychiatrists. No one could find the cause, although they wanted me to take Prozac for my symptoms, and no one could agree on the diagnosis. Some said I had depression, others said I had chronic fatigue. And in fact, I did have chronic fatigue. And I started to dive into the literature. And I consulted with other doctors and scientists, people on the leading edge of medicine, and I started to do some experimentation. And when I came to understand that it wasn't just one thing. That caused my brain to break. It was accumulation of a lot of things. Diet stuff, stress, environmental toxins like mercury was a big factor.

• 4:07Dr. Mark Hyman?

  My gut was just a mess. In fact, that's what happened. I had mercury underlying all this. And then one day I got some kind of gut infection up in Maine at a camp and then boom, my gut was off and it didn't get back on track for many years until I figured out how to fix it. And all that leads to inflammation, rebalancing my gut microbiome, getting rid of the mercury. It was messing up my gut because mercury interferes with gut function. It was the key to getting my brain and health back. I also saw this with so many of my patients. I had a woman who had severe OCD. She wouldn't clean up her house for years because she didn't want to move things around on the floor. Looked at her health and her biology and tried to see what was going on. And in functional medicine, we just take out the bad stuff, put in the good stuff. So I saw she had a lot of bad bugs in her gut, a lot of overgrowth of yeast. And I gave her basically an antibiotic, an antifungal that was designed to kill those particular bugs.

• 4:51Dr. Mark Hyman?

  And literally overnight, her OCD went away and she was able to clean up her whole house after decades. I also had a little girl who was a sweet little girl, nine years old, was a terror. She would get kicked out of school all day on the bus ride home. They'd have to stop the bus 10 times. She was terrorizing her little sister, tearing up pictures of the family, just kind of little nuts. I did testing and she didn't have any gut symptoms, but we found really high levels of bacterial overgrowth and bad bugs in her gut and yeast overgrowth. And again, I gave her an antibiotic, an antifungal, and literally overnight, she turned into this beautiful, sweet little girl. So that made me think, oh my God, there's a whole untapped world here that we're missing of how to help people who not only have physical health issues, but also have mental health issues. So today we're going to dive deep into the gut-brain connection. We're going to share some functional medicine tools that will help support your gut health

• 5:36Dr. Mark Hyman?

  and obviously your mood and mental health too. So what is this gut-brain connection exactly? Well, let's go into the science. The human brain contains approximately 100 billion neurons, brain cells, nerve cells, right? The gut also has a nervous system. It's called the second brain, also known as the enteric nervous system. Enteric just means gut, fancy medical word. And this contains, get this, 500 million neurons. So there's five times as many neurons in your gut as in your brain. Now, there's a bidirectional highway between the brain-brain and the gut-brain. And this is called the vagus nerve. And it links our enteric nervous system with our brain and their central nervous system. And it's sending and receiving. Receiving signals all the time. So whatever's happening in your brain, mood, stress, emotions, impacts your gut function. And what's ever happening in your gut impacts your brain function, right? Mind, body, body, mind. We talk about this.

• 6:21Dr. Mark Hyman?

  I felt sick to my stomach. I have gut feelings. Maybe you're so nervous you had to run to the bathroom, right? This is the gut-brain connection at work. There was a study that looked at more than 1.2 million hospitalizations for irritable bowel in 4,000 hospitals. And people with IBS or Irritable Bowel Syndrome had three times higher risk of anxiety, two times greater risk of depression, and had two times greater risk of suicide ideation, meaning they were thinking of suicide versus the general population. Now, we used to think that anxiety caused IBS. But now we know it's the other way around and a little bidirectional. So think about that. It's not really the stress or anxiety or mental health issues that's causing irritable bowel. It's the change in the microbiome and the irritation, inflammation to the gut lining and the enteric nervous system that feeds back to the brain.

• 7:06Dr. Mark Hyman?

  It creates an irritable brain. So irritable bowel leads to an irritable brain. So before we dive any deeper, let's define the features of this gut-brain axis. The gut, which basically we talked about, is the GI tract. It starts at your mouth and it goes to your anus. It includes esophagus, stomach, small intestine, large intestine, all the way down to the bottom. The vagus nerve is the longest nerve that comes from your brain called the cranial nerve. It travels through the brain stem to the gut and it connects the gut to the central nervous system. And it goes through the entire GI tract. Think about it, you've got huge amounts of gut. If you laid out your small intestine flat, it would be the surface area of a tennis court. And then there's your large intestine and then your esophagus. So all that is really important. The vagus nerve connects to other things like your heart and lungs and so forth. But this vagus nerve is a really important part of your nervous system called the parasympathetic nervous system.

• 7:50Dr. Mark Hyman?

  This is the relaxation nervous system. It also is called the autonomic nervous system or automatic nervous system. So it's not usually under our willful control, although we can regulate it through various practices. And the yogis have been doing this for centuries. It regulates involuntary sensory and motor functions. You say, I'm going to move my arms. So you move your arm and you'll go, oh, I want to digest my food. Can you please digest the food in there? Can you please regulate my heart rate? Can you control my blood pressure? You don't really think about it. These things happen automatically. A lot of this happens. Through this automatic system, there's a lot of signaling that happens through this nervous system. For example, it helps control appetite. And how does it do that? Through peptide hormone called GLP-1, right? You might have heard about this.

• 8:33Dr. Mark Hyman?

  This is Ozempic, Wegovy, and so forth. Unjaral, these are, these are drugs now, quote drugs, but they're not really drugs. They're just mimicking your body's own GLP-1 at a much higher concentration. This is also known as the satiety hormone. I mean, it makes you feel full, which is why people don't eat because they take this shot and they don't feel full. And this is also why people lose weight because they take this shot, they feel full, they don't want to eat as much, and they lose weight. This is typically secreted in the lower part of the intestine, but it basically reduces your appetite and promotes satiety. And it sends a signal via the vagus nerve. So this is really important, this drug, right? It's Ozempic. So this is, this is something your body makes. Also, there's other hormones that are regulated called CCK or cholesterokinin peptide YY, really important. And other compounds called short chain fatty acids, we're going to talk about why they're important. But these

• 9:18Dr. Mark Hyman?

  are made by your gut. It suppress appetite by making you feel full by activating the vagus nerve. And these are things that you can regulate. Leptin is another hormone produced in fat cells and in the gut. And it's also the feel full hormone. There's many of these redundant pathways in your body, and it exerts its effects through the vagus nerve. This network, this gut brain, this second brain or enteric nervous system is a vast network of, like I said, almost 500 million neurons that's embedded in the lining of the GI tract. What's in them not only is nerve cells, but also hormonal cells, right? Enteroendocrine cells, and they're throughout the entire GI tract. And they're involved in sensing all sorts of signals, right? What nutrients you're taking in, taste, mechanical stimuli, fiber, they detect the microbes, what's going on in there,

• 10:01Dr. Mark Hyman?

  they help sense toxic compounds. So it's really a critical system. And as I mentioned, this is called the second brain. It operates independently, but also with the brain brain, right? The central nervous system via the vagus nerve, and it controls everything, right? Gut motility, right? Whether you're constipated or have diarrhea, enzyme secretion, digesting your food, hormone release that regulates appetite, and then mention the feel full hormones or the hungry hormones like Graylin. And it also affects blood flow that aids in digestion and absorbing nutrients. So it's super important. And the microbiome consists of about 100 trillion microbes, maybe about 5,000 different species, and you got about two pounds of poop in there of microbes in your GI tract. So what do these microbes do? Well, they help you digest your food, they produce vitamins, they regulate hormones, and they help you get rid of toxins. It interacts with your whole

• 10:46Dr. Mark Hyman?

  Enteric nervous system and central nervous system. So the microbiome is a whole nother thing that's involved, right? You don't just have your brain, brain and your second brain. You have your microbiome brain, let's call it, right? It's really important and it helps regulate everything in your body and it regulates mood particularly a lot. Now, the composition of your gut microbiome, and I'm going into this because it's important to understand if you're going to understand what to do about fixing your gut and how this all works, because I want you to understand this, the importance of understanding your gut as it regulates, regulating your, your mood and brain health and, and pretty much everything else. So the composition of your gut flora, it varies from person to person. It depends on their diet, right? So if you're a hunter gatherer and eating meat or bison all the time, or if you're a vegan, all it changes based on what you're eating. It changes based on your lifestyle, stress, toxins, genetics, all regulate the microbiome. Now,

• 11:30Dr. Mark Hyman?

  there's a large research project going on called the Human Microbiome Project. It helps map, map out the gut microbiome of individuals who are healthy and who are sick to understand better their gut bacteria species. So what defines a healthy gut? What defines a sick gut? And how does that relate to different diseases? Now, what's amazing also to me, this blew my mind when I learned about it, is that a third to a half of all the metabolites in your blood, all the thousands of molecules floating around your blood that regulate everything in your body are not human. They're from your gut microbiome. In other words, these molecules produced from bacteria in the gut are absorbed and then impact your whole biology, including your brain and your mood. There's still a lot we don't know about what makes a healthy gut or a sick gut, but we know a lot. Now, your gut microbiome can

• 12:12Dr. Mark Hyman?

  produce healing metabolites that keep your gut immune system healthy, things like short chain fatty acids, we'll talk about those soon, vitamins like B12, for example, riboflavin made in your gut, enzymes, or it can produce harmful metabolites. So bad bugs produce bad stuff, good bugs produce good stuff. And the bad metabolites from bad bugs can be things like cytokines. We've learned about from COVID, the cytokine storm, these are inflammatory messenger molecules of your immune system. Endotoxins, literally poisons, we call these lipopolysaccharides, these are endotoxins, things that are toxic produced by bacteria that can be absorbed across the leaky gut, cause you to be inflamed and create disease, including obesity and mental health issues and much more. So bad bugs make you inflamed and almost all issues related to mental health, this is really important to understand, almost all mental health issues and brain issues, whether it's

• 12:55Dr. Mark Hyman?

  Parkinson's, Alzheimer's, autism, ADD, depression, anxiety, bipolar disease, schizophrenia are all caused by inflammation in the brain. So if we fix the inflammation, we can fix many of these things. And we'll talk about how to do that soon. Now, what is this gut mood connection? We talked about, so what is the gut? And what is the gut brain and the second brain and the first brain and the hormones? Okay, we talked about all that. So the gut microbiome actually influences brain health and function. And it impacts your mood, impacts your stress level. So literally you could have stress molecules produced in your gut that are not because of something happening outside, but something happening inside. And it increases the risk of depression, mental illness via a complex network of things. Nerve cells, endocrine cells, or hormone cells, immune pathways. It's the psychoneuroendocrine immune system, right? We talked about this a lot.

• 13:37Dr. Mark Hyman?

  It involves all sorts of activities like the transport of neurotransmitters, metabolites, cytokines, and certain species of gut bacteria are directly involved in the production of neurotransmitters affecting both the gut and the brain. Let's talk about some of them. So dopamine, for example, is best known for its role in reward pathways, pleasure, motivation. For example, we know about Adderall or these ADD drugs. They all stimulate dopamine pathways, sugar does, all the addictive compounds we like to. So does alprazim, by the way. By the way, there are certain bacteria that help increase dopamine. Things like lactobacillus plantarum, bacillus subtilis, bacillus cereus, and certain strains of E. coli that are beneficial. Pretty cool. What about serotonin? Another important neurotransmitter involved in mood. It's involved in regulating various physiological processes, including the secretions of your intestinal

• 14:22Dr. Mark Hyman?

  tract, peristalsis, motility, respiration, blood vessel regulation, behavior, mood. We know all about Prozac. That's how it works through inhibiting serotonin reuptake in the nerve cells in the brain, which makes you have more serotonin. Now, certain bacteria that are good can actually help improve the concentration of serotonin. And by the way, 90 to 95% of serotonin in the body is produced in the gut. But bacteria like lactobacillus plantarum or streptococcus thermophilus, which are healthy bacteria you can get through supplements or you can help grow their diet, actually help with improving serotonin. What about GABA? This is the relaxation neurotransmitter. It's sort of the receptor upon which volume and the benzos work. So GABA is a sort of a relaxation neurotransmitter and it helps reduce.

• 15:06Dr. Mark Hyman?

  Neural excitability helps reduce anxiety and stress, sleep. And a lot of bacteria can help produce this in your gut like bifidobacterium, lactobacillus plantarium, lactobacillus ruderi, lactobacillus rhamnosus, even things like acromancia. We talked about this a little with Valene from Pendulum Therapeutics. She basically was growing acromancia in this big vat to be a probiotic. And they started to analyze what was in, what were the metabolites that the acromancia was producing? And they actually found a big spike and it turned out to be GABA. So this acromancia bacteria, which is so important for so many reasons and can have many podcasts and things we've written about it, I'll share in the show notes. The acromancia actually produces GABA. So it's like a natural valium. Other bacteria can influence the levels of neurotransmitters by encoding genes for enzymes

• 15:49Dr. Mark Hyman?

  that produce neurotransmitters or directly impacting the synthesis of neurotransmitters or the breakdown of neurotransmitters. So the microbiome plays a huge role in all sorts of neurotransmitter function. For example, the conversion of neurotransmitter precursors like tryptophan you get from your diet into serotonin, which is the happy mood chemical. They're also involved in the production of a really important compound in the body called BDNF. BDNF means brain derived neurotrophic factor. This is like miracle growth for your brain cells, increases neuroplasticity, neurogenesis, meaning the making of new brain cells and the connections between brain cells. Also bacteria can produce really important compound called short chain fatty acids. These are called postbiotics. A lot of these things are postbiotics, right? Prebiotics fertilize good bacteria, probiotics are the bacteria and postbiotics are the compounds

• 16:31Dr. Mark Hyman?

  produced by the bacteria that are bioactive molecules or metabolites that are produced by healthy gut bacteria and impact our bodies and brains. Now, short chain fatty acids are one of the most important of these. Why? Because they affect every level of our health, regulating cancer, metabolism, inflammation and gut health, but they also cross the blood brain barrier and they affect brain health by regulating neurotransmitter levels and they reduce inflammation, which again is at the root of all this mental health stuff.

• 17:02Speaker 02

  Depression is the leading cause of disability. So this, you know, most people think of depression as a fairly straightforward illness. And we have tons of antidepressants and we've got psychotherapy and we've even got shock treatments and we've got so many treatments available, they have to be effective, right? Well, actually, wrong. The majority of people with depression, bread and butter depression, are not getting better with our current treatments. And it's not because they're not getting treatment, it's because our treatments fail to work for far too many of them.

• 17:44Speaker 02

  And so I think that, you know, it was really interesting because the way that I went about unpacking all of this was, you know, I started with the neurology literature and because this is an anti-seizure treatment and we use anti-seizure treatments in psychiatry every day in tens of millions of people. And so that was really low-hanging fruit and it was a great resource to tap into because we've got 100 years of clinical and neuroscience evidence on the ketogenic diet and what is it doing to the brain? And so I could tap into that and low and behold, sure enough, the ketogenic diet rebalances

• 18:25Speaker 02

  neurotransmitter imbalances, it decreases brain inflammation, it changes the gut microbiome in beneficial ways. It, you know... Gets people off gluten. Yes, it gets people off gluten. It gets people off lots of other toxic foods, probably. It improves insulin signaling and insulin resistance in most people. And so it has a wide range of effects. But still, this is where the field of psychiatry is. It's like all of these different things. And so I went on a deeper search for how do these connect?

• 19:07Speaker 02

  Because at first, I started off with a mission to how am I going to convince other mental health clinicians to use the ketogenic diet for serious mental disorders? Because nobody's going to believe this. They're just not going to believe it. Unless I can present a clear and plausible mechanism of action based on science, nobody's going to buy this. And this miraculous treatment that I am seeing in front of my eyes is going to go wasted. And so I kind of felt like I'm an academic.

• 19:39Dr. Mark Hyman?

  No, you might lose your job.

• 19:42Speaker 02

  Yeah, that's I did worry about that many times.

• 19:45Dr. Mark Hyman?

  You probably wouldn't go to jail like Galileo, but you might lose your job.

• 19:48Speaker 02

  I worried about that. The good news now is that I have the full support and endorsement of McLean Hospital, actually.

• 19:59Dr. Mark Hyman?

  Amazing.

• 19:59Speaker 02

  They are very enthusiastic and supportive of this.

• 20:04Dr. Mark Hyman?

  See, when I heard about what you're doing, I just did the happy dance. I was like, and I've been telling everybody, I'm like, wow, finally, somebody's getting it where it counts.

• 20:12Speaker 02

  That's awesome. So the way that I ended up coming to the science is I ended up focusing on mitochondria and mitochondrial function and more broadly, what we call metabolism. And so I came at the science from that perspective and ultimately viewing mental disorders as metabolic disorders of the brain. And that in order to understand metabolism, you have to understand mitochondria. But in fact, you have to understand everything that you have known about for decades, functional medicine, how it's all interconnected, how diet, toxins, hormones, the gut, stress,

• 20:55Speaker 02

  all of that come together to result in illness. So functional medicine has been doing this for decades. And yet I was holed up in my, you know, Harvard position and evidence-based medicine. And so we didn't learn a lot about functional medicine. And certainly, functional medicine protocols are not being used in psychiatric hospitals.

• 21:24Speaker 02

  For the most part around the world, most psychiatric hospitals are not using these protocols or this paradigm. And so, but, but at the end of the day, even looking at mental disorders as metabolic disorders, which revolve quite a bit around mitochondria and mitochondrial function, I ended up coming to the same conclusions that you did.

• 21:46Dr. Mark Hyman?

  Mm hmm. It's, it's quite extraordinary and, and you know, I don't know if you're aware of this, but right at Harvard, there is Umanadu, who has a whole department of nutritional psychiatry talking about the microbiome and the brain. And there's another physician who's been on my podcast at Stanford, they have a department of metabolic psychiatry. So it's starting to happen and more and more psychiatrists are becoming aware of the data because there is data, there's a lot of literature now that supports this notion. So when I, when I look at sort of the mitochondria, it's really about, you know, metabolism and energy and, and, and it's sort of, I'd like you to sort of unpack how that actually connects to psychiatric diseases because, you know, I first heard this concept when I talked to

• 22:29Dr. Mark Hyman?

  Martha Herbert, who is a psychiatrist, sort of neurologist, sorry, neurologist, and I think she's also, what's her name in psychiatry, I might be wrong, who, who was treating autism. And she was doing brain scans on these autistic kids. She saw their brains were swollen and inflamed on biopsies with these kids got killed on a crack or something and see these brains are just full of inflammatory cells and the immune cells, the white blood cells called the glia. And she also called what they have a metabolic encephalopathy. She said that, that autism is just not a brain disorder, it's a systemic disorder that affects the brain. And, and it's what I hear you saying, that psychiatric illness, for the most part, is a systemic disorder that affects the brain.

• 23:12Dr. Mark Hyman?

  Now, and now, and the causes can be many, like it could be what your diet, it could be your microbiome. But I was with a gentleman this weekend whose family was a Hungarian Jew, whose family was killed in the Holocaust. He says, I know 150 members of my family were killed in the Holocaust and everybody's name. And I've lived in a constant state of trauma and stress my whole life. And, you know, I was like, wow, this is the epigenetics of this. And Scientific American just came out with a paper, not a paper, but an article to documenting some of the research in New York after nine 11, where they saw women who were pregnant, or when nine 11 happened, their children were incredibly affected by the stress and trauma that happened to the mothers when they were pregnant and was registered in gene

• 23:53Dr. Mark Hyman?

  expression patterns and epigenetics and in cortisol levels and cortisol receptor function. And I was like, wow, this is, the data is really coming along in this. So there's, there's a lot of things that can affect it. But, but often the psychiatric problems are so misdiagnosed and, and mistreated, honestly. And it's, and it creates so much suffering. And so, you know, what you're talking about is, is really a revolution.

• 24:15Speaker 02

  It is. It, um, it certainly was for me and it certainly is for psychiatrists that I speak with.

• 24:25Speaker 02

  I don't think they've really considered this. The, the reason that I am so passionate about mitochondria in particular is because they actually, they actually are responsible for much more than just energy production. So most people know mitochondria as the powerhouse of the cell. And so they create ATP, which is our energy source. But it's, and there's no doubt they do that and they are instrumental in that role. And without that, we would not live. But they actually do so much more than that. So they are primary regulators of hormones, for instance, key hormones like cortisol,

• 25:09Speaker 02

  estrogen, testosterone, progesterone and others, um, that the production of those hormones actually begins inside mitochondria.

• 25:21Speaker 02

  And as those hormones travel through the body and influence cells throughout your body, the primary influence ends up converging on mitochondria.

• 25:32Dr. Mark Hyman?

  Yeah.

• 25:32Speaker 02

  And so, um, and so in many ways, the reason that I became like ridiculously excited about this theory is because it is a way to connect all of the dots, the bio psychosocial models of mental illness. It is a way to connect all of them. So mitochondria are instrumental in neurotransmitter function, neurotransmitter production, the release of neurotransmitters, the influence of neurotransmitters. They play a significant and powerful role in inflammation, but inflammation in turn affects mitochondria.

• 26:14Speaker 02

  And so it all, at least in my mind, once I started diving deeper, I was kind of flooded with all of these questions, but wait, this can't, it can't be this simple.

• 26:28Dr. Mark Hyman?

  Right.

• 26:28Speaker 02

  Like this, this is too, this is too simple. There's no way that this complex issue and the complexity of psychiatry and the brain, there's no way it can end up being this simple. And, you know, for the last five years, I have tormented myself in some ways with questions, like if this is really true, then this should be true, or that should be true, or this.

• 26:54Dr. Mark Hyman?

  Yeah, yeah.

• 26:54Speaker 02

  And, um, and at the end of the day, everything in my mind seems to converge on these issues.

• 27:02Dr. Mark Hyman?

  Yeah, well, it's so true because, you know, I was reflecting on a, I guess we had on a previous podcast, who's a pediatric neurologist, trained at Harvard, Oxford, she works at University of San Diego now. And she, she did brain imaging, functional MRI imaging of the brain in autistic kids and found they had energy problems, that mitochondrial energy deficits were evident in the brain of autistic kids. And then by giving them mitochondrial nutrients, basically the cofactors and helpers that actually help you turn food and oxygen and energy, like CoQ10, for example. Or in B vitamins and just some really simple things that are very inexpensive that these kids would literally get better from autism. That's not to say that all autism

• 27:44Dr. Mark Hyman?

  is just caused by these nutrition deficiencies or mitochondrial issues, but it's one of the things that we see. So there's a lot of people coming at this from a lot of different areas. You're in the psychiatric lane, but you know, the neurological lane is seeing this too. And so is pretty much every other, the other issue. I mean, whether it's your weight, or whether it's heart disease, or diabetes, or Alzheimer's, or Parkinson's, so many diseases are really related to mitochondrial dysfunction. So it's great. It's really amazing. And I think that, that this is such a breakthrough. And, and I think, you know, there's, how besides the, the Kitty Drake diet, are you approaching addressing mitochondrial function? Cause for example, in autism, they're using these mitochondrial cocktails and, and supplements to help.

• 28:28Speaker 02

  So, and that, that's, that's where, when I read your book, I was a little embarrassed. Because, because if you want the roadmap to, if you want the, the self-help version of how can I fix my mitochondria, I feel like your book Ultra Mind Solution is that roadmap. It, it involves improving your diet, exercise plays a role, stress reduction plays a role, toxins can play a role, hormonal dysregulation can play a role. And these can be wildly different in different people. And I think that's, you know, it's, it's a point that you made in your book. It's a point that you make frequently. And so it's

• 29:12Speaker 02

  not that there is a one size fix, you know, fits all solution for people. So one person could have an autoimmune thyroid disorder and have, you know, a horrible, horribly low thyroid hormone. And that person will suffer from both metabolic and mental symptoms. And fixing that problem is replacing thyroid hormone, or somehow addressing the autoimmune disorder and correcting that. Another person could have an autoimmune disorder, you know, related to intrinsic factor, and they could have malabsorption of vitamin B12. Regardless of what they're eating, that person too could have both metabolic and mental

• 29:54Speaker 02

  symptoms or disorders as a result of vitamin B12 deficiency. And the treatment for that might be vitamin B12 injections because they can't absorb B12. So very different treatments. But you're, but you're addressing the same root problem or the same root cause, which is metabolic, in my mind, metabolic dysfunction or mitochondrial dysfunction. But lots of different things can cause mitochondrial dysfunction. And so that's the way I'm thinking about it is I, in my mind, mitochondria are front and center. And, but there are hundreds of different inputs.

• 30:37Dr. Mark Hyman?

  That's right.

• 30:38Speaker 02

  That, that can influence how well mitochondria function and how they're doing. And then the consequences of mitochondrial dysfunction are widespread and they have numerous effects on the brain, resulting in very different symptoms. Some people might have ADHD, other people might have depression. Others might have seizures and others might have schizophrenia. And, and that probably depends on a variety of factors. What, what are the different, you know, components or environmental factors that are contributing to your disorder?

• 31:12Dr. Mark Hyman?

  Genetics or, you know, other things we may not even understand.

• 31:15Speaker 02

  Yes.

• 31:16Dr. Mark Hyman?

  Right? Yeah, it's, it's so true. And I, I just remember being in my clinic, you know, looking at the patients I saw and not really treating their psychiatric problems, but they would come in with autoimmune disease or digestive problems or arthritis or whatever, migraine. And I would just do what I did and they would get better from other stuff. Like you're saying, you were treating this guy's weight loss and schizophrenia got better. And, and I was like, wow, I call myself the accidental psychiatrist. You know, I never intended to figure this stuff out, but I could not ignore what was in front of me. Whether, and I had, I had a patient with ADD once who was so severe and he had, you know, really terrible inflammatory symptoms as well, asthma and allergies and gut issues and migraines.

• 32:01Dr. Mark Hyman?

  And, you know, of course, the doctor who was treating him, the psychiatrist just treated ADD with a stimulant and ignored the other things because of course they're not related. But I treated it. I just cleaned up his diet. I gave him some vitamins, like cleaned up his gut. I, you know, very simple things. And the mother brought his homework and we'll post it in the show notes because it's pretty impressive. Bought us homework before and after two months, just of changing these few things. And these kids often have what we call dysgraphia, their handwriting, you can't read it. He's 12 years old. It looks like a, somebody, you know, who's got some kind of severe disorder with writing or something. I don't know. And it went from like severe dysgraphia to perfect penmanship in two months. And I'm like,

• 32:42Dr. Mark Hyman?

  holy crap, what is going on in the brain? How does it go from being chaotic and disorganized and asynchronous, dis synchronous to being completely coherent? And I, I, and it was really a mind blowing concept for me. And that's where it gave me the idea of the book. I don't know if you know this, Chris, but the origin of functional medicine was in psychiatry from Abraham Hoffer. I did not know that. Yes. So I'm going to tell you this quick story. I don't want to dive into some more of your work. I don't want to take too much of a sidetrack, but it's fascinating. Abraham Hoffer was a Canadian psychiatrist who treated schizophrenia. And he sort of somehow got the idea that there was some abnormal molecules going on in the brain and that it was related to some kind of nutrient problem. So he gave high doses of niacin and zinc and B6 and magnesium.

• 33:27Dr. Mark Hyman?

  And many of these patients would improve or get better. And, and so he began to write about this, talk about this. And, and then he was friends with Linus Pauling. And they, Linus Pauling is a two time Nobel Prize winner. He discovered the structure of proteins and he almost discovered that, well, he kind of did discover the double helix of the DNA and he told his son about it, but then they went, his son went to London and hang out with Watson and Crick and they kind of took it. That's a whole other story. And then he wrote an article in Science Magazine, which, I mean, which, Science, which is a very prominent medical journal, which I don't know if you've actually seen, it's called Orthomolecular Psychiatry, written by Linus Pauling. Have you seen that? I have actually, yes. Yeah. Well, that, that was the genesis of that. And essentially the idea was that we could correct orthomethy to straighten

• 34:11Dr. Mark Hyman?

  and molecules, molecular means molecules to straighten the molecules of the brain by using high doses of nutrients to move chemical reactions to their completion. Now, it was a very simple idea and it was super complicated paper, very scientific, but it sort of started this process. And then Jeffrey Bland, who was really the father of functional medicine, was a student of Linus Pauling's. And, and Linus Pauling was kind of thought of as a crackpot later in his life. I mean, I don't know if you're gonna call anybody who won two Nobel Prize a crackpot, but he was kind of dismissed for his ideas about vitamin C and everything, but he was on to something. And this is what we're seeing now. So I think your work is so important and your ability to actually communicate this, to look at the science is so important.

• 34:52Dr. Mark Hyman?

  So talk about how we can think about some of the inflammation process in mental health and metabolic health and what we need to do to fix that. People listening, well, I hear this, my mitochondria aren't working, inflammation is connected. How do I start to address that in myself?

• 35:11Speaker 02

  It's a great question. And you know, inflammation is, as you know, is a complicated topic because so there are some clear causes of inflammation. You can get an infection, for instance, and that causes an inflammatory reaction in your body. And low and behold, we have an abundance of evidence that if when a woman is pregnant, if she experiences a serious infection, sometimes even a mild infection, like with the influenza virus, her baby will be at increased risk for mental disorders later in life. If young children

• 35:52Speaker 02

  experience serious infections, especially if it's serious enough to be hospitalized, they are about twice as likely to develop a mental disorder, oftentimes within three months of that hospitalization. And the mental disorders are not trivial disorders. It's not anxiety because you are hospitalized. It's the disorders include things like autism, schizophrenia, mental retardation, obsessive compulsive disorder and others. And these can become lifelong disorders. And so we know in those cases, the inflammation appears

• 36:30Speaker 02

  to be doing something that takes a toll or that changes neurobiology or changes kind of whole body. Function and you know, my hypothesis right now is that inflammation takes a toll on your metabolism, plain and simple.

• 36:50Dr. Mark Hyman?

  For sure.

• 36:51Speaker 02

  And that it dramatically, we have very good direct evidence that inflammation takes a toll on mitochondrial function. It actually inhibits the function of mitochondria in some brain cells. We have direct evidence for that.

• 37:06Dr. Mark Hyman?

  And by the way, the brain has got the most mitochondria per cell of any organ in the body. So it's really important.

• 37:12Speaker 02

  It, yeah, it is. And, and the brain is exquisitely sensitive to even slight fluctuations in mitochondrial impairment. So whenever people have a metabolic problem, usually the brain is the first organ to suffer. And, and it might just be trivial symptoms. So, so clear causes of inflammation can result in metabolic or mitochondrial impairment and then result in mental symptoms or mental disorders. Even people with, you know, runny noses or hay fever are like 86% more likely to have chronic depression than people without that.

• 37:57Speaker 02

  So, um, so in some cases, these things are unavoidable and I just have to say that. I mean, you know, a woman getting an infection while she's pregnant, there aren't a lot of things that she can do to necessarily, I mean, there are some things she can do to avoid an infection, but it's not going to be a hundred percent. And I don't want to get into a situation where we're trying to blame pregnant women for getting an infection.

• 38:21Dr. Mark Hyman?

  But you can do something about it when the baby's born and you can fix the baby

• 38:25Speaker 02

  Yes.

• 38:25Dr. Mark Hyman?

  Afterwards.

• 38:26Speaker 02

  And you can even do something about it immediately after that infection. So there are lots of ways to improve metabolism and mitochondrial health.

• 38:35Speaker 02

  And most of them are lifestyle related and they include things like diet making removing, as you say, removing the bad stuff from your diet and putting in the good stuff.

• 38:47Dr. Mark Hyman?

  So easy.

• 38:49Speaker 02

  It's easy. It's probably more complicated than most people realize because then they question, well, what's the bad stuff? Is it just fat? You know, if I remove fat from my diet, am I going to be good? No, no, it's not that simple. And it's not as simple as carbohydrates, you know, as somebody who's, you know, using the ketogenic diet. Some will say if you just remove carbohydrates, that will solve all of the world's ills. I don't believe that at all.

• 39:14Dr. Mark Hyman?

  No.

• 39:16Speaker 02

  So it's about removing bad things from the diet, adding in good things.

• 39:23Speaker 02

  But it could also include exercise. It can include prioritizing sleep, getting more rest, allowing your body to recover from that process. So if you are usually a workaholic, if you are highly stressed and you have an infection, maybe it's time to, you know, to just prioritize self-care for, you know, even a month or so after that and, and really make sure you're getting good nutrition, you're exercising maybe more than you normally even do, getting good rest, trying to decrease stress levels, those types of things in order to allow your body to reset, in order to allow your body to recover from that assault on it.

• 40:04Dr. Mark Hyman?

  One of the best doorways to the mitochondria is exercise, right? It stimulates the growth of new mitochondria, improves the function of mitochondria. It's quite important and it also cuts down inflammation and activates free antioxidant enzymes. It has so many benefits and, and we know it's better, they quill into many drugs for depression if you just exercise regularly vigorously. All right. And we know the diet also plays a role. And you know, one of the challenges, I wonder, how do you address this with your colleagues? Because this is something I've, I've found even at, you know, Cleveland Clinic, working with some of the researchers are like, well, you know, we can't do everything at once. We can't do diet and exercise and supplements and sleep. And I'm like, we can only do one thing at once because you don't know what's going to work.

• 40:47Dr. Mark Hyman?

  And I'm like, wait a minute, if you want to grow a nice garden, you don't just go, I'm going to give the water, the plant water only, but no soil or sunlight. And then I'm going to give it sunlight, but no soil or water. It's just, it doesn't respect the laws of nature. So, so how do you kind of battle that within the medical paradigm? Because it's really tough. We're looking for the single drug, for the single disease, or the single outcome, which is a model based on infection, which can work. But even then, it's flawed because it depends on the biological terrain and why some people get sick and don't, or why some will die and don't. We see that with COVID. Not everybody gets sick, is sick or hospitalized or dies. People who are chronically ill or overweight or aged do because their systems don't work as well. So, how do you address this?

• 41:31Speaker 02

  I think it's a really-

• 41:32Dr. Mark Hyman?

  I don't want to get you in trouble with your-

• 41:34Speaker 02

  No, no, no. It's, I kind of chuckled as you were saying your garden analogy, because I've used that exact analogy with people as well. And, you know, I think, you know, most, most athletes and coaches know this as well, that if you want to become an Olympic champion, it's not only about exercise, it's about exercise and diet and sleep and get rid of any toxins. That means no drinking, no drugging, no anything, because you are trying to get your body in prime condition. And, and it requires a multifaceted approach.

• 42:19Speaker 02

  And they, those things are all interconnected and they're all going to relate to whether you can grow your muscles, whether you can get faster, improve your, you know, cardiac health, all of those things. And so I completely agree with you. And I think it's, it's a huge challenge in our field. To me, the lowest hanging fruit is with the chronic severe mental disorders. I think that if-

• 42:51Speaker 02

  Because right now, the prognosis is so abysmal for these disorders. And the likelihood that any intervention, whether it's a single intervention or a complex intervention, the likelihood that anything will change the course of these disorders is extremely low

• 43:13Dr. Mark Hyman?

  Yeah.

• 43:13Speaker 02

  in in most academic psychiatrists' minds.

• 43:16Dr. Mark Hyman?

  It's like autism, right?

• 43:18Speaker 02

  Yes. So I actually am hopeful that we can get funding for studies like this using a quote unquote treatment resistant population. And and maybe design a comprehensive treatment. You'll call it a functional medicine treatment. I'm trying to get mainstream medicine to buy into this. So I might just call it a comprehensive, effective treatment. And I might call it a metabolic treatment or a mitochondrial treatment. At the end of the day, it's gonna be the exact same thing as what you're doing. But sometimes language matters.

• 44:03Speaker 02

  And so I'm not sure, but I think that I think that we could probably get funding for such a study. I think we would want some of the best practitioners, maybe you included, to really be part of this protocol because we maybe get, you know, one or two shots. And we don't have to cure everybody. But if we can even get 30% of those people dramatically improved, I think that would get the attention of a lot of people in the mental health field. And again, these disorders are the most disabling disorders. They are some of the most costly disorders to society.

• 44:45Speaker 02

  So it won't only get the attention of those in the mental health field. It will get the attention of insurance companies.

• 44:52Dr. Mark Hyman?

  Of course.

• 44:52Speaker 02

  The government, because, you know, the government is providing disability. And so not only Is the government providing disability payments to these people? They are failing to get tax revenues from their employment. For sure. And I can be the first to say, working, having worked with these people for well over 25 years, these people are desperate to contribute to society. They want to work. There's this stereotype out there that, oh, depression is the leading cause of disability because everybody's lazy slackers and they're just looking for an excuse to be on disability. Let me just maybe disabuse some of, if any of your listeners are thinking that and thinking, yeah, that's right.

• 45:37Speaker 02

  Let me disabuse you of a few notions. Number one, they're not living the high life. You're, you're living essentially in poverty on that lifestyle. But this notion of self-respect and autonomy is huge. And I have had schizophrenic patients crying in my office because they just want to work and earn some money to be able to hold their head high and say, I earned some money. And I remember with one of these patients, I tried with her for six months to help her get a job bagging groceries at a grocery store. And at the end of the day, she couldn't do it. And she couldn't do it because her symptoms would get worse.

• 46:20Speaker 02

  She started thinking that the manager was stealing money. She got paranoid about the manager, started causing trouble, and it was a nightmare and she got fired. And, uh, and so, um, I think that if we can demonstrate that even if it requires a complex intervention like water, sunlight, and good soil, if it requires a complex intervention, that maybe we can get people to take this seriously.

• 46:51Speaker 01

  The relationship between mental health and metabolic disease is, is bidirectional, which means if you have a mental illness, you're more likely to have metabolic disease and vice versa. And if you have a metabolic disease, you're more likely to develop a mental illness. You're more likely to have a heart attack, for example, if you have depression. And you're more likely to develop depression after you have a heart attack. So these observations that I made really put questions in my mind as to there must be something more to what we're doing that needs further investigation. And I believe that there are metabolic issues that are not necessarily

• 47:34Speaker 01

  addressed within the field that I think needs to start occurring. I mean, we need to start including that in the way that we diagnose and treat and evaluate disease.

• 47:47Dr. Mark Hyman?

  Yeah, you know, as you were talking, you were talking earlier about this idea of comorbidities, which is a term we use in medicine to describe diseases that now occur in the same patients. So if you have high blood pressure, diabetes, depression, you know, reflux, we call these comorbidities. But we were talking earlier about how they may not really be unrelated, that in fact, they may be very connected. And it sounds like from your observations, you made the conclusion that maybe the, it wasn't a coincidence, that the fact that people who were overweight or unhealthy also had mental health issues. Maybe there was a relationship, nutritional deficiencies, metabolic issues. You talk a lot about insulin resistance. So how, how did you come to sort of understand that that was really going on?

• 48:29Dr. Mark Hyman?

  That, that, that the biology of that was, was something that was real?

• 48:36Speaker 01

  So I originally started off with an interest in learning about nutrition and metabolic issues and obesity. And I wanted to treat obesity. And then I saw that in a lot of the patients, there were psychiatric conditions in those patients. So I started to veer into the realm of psychiatry and got very interested in that. So what happened was that when I was treating metabolic dysfunction, not necessarily obesity, but metabolic dysfunction, which is problems with blood sugar or insulin resistance or high blood, you know, cholesterol.

• 49:18Speaker 01

  I saw improvements in quality of life, in mood, in anxiety symptoms, in psychiatric symptoms essentially.

• 49:28Dr. Mark Hyman?

  Yeah.

• 49:28Speaker 01

  And that really got me interested in what is this relationship? Why is this occurring?

• 49:33Dr. Mark Hyman?

  Yeah.

• 49:34Speaker 01

  And, and got me interested in treating these patients in, in a slightly different way than standard of care, really integrating the, the understanding of what metabolic dysfunction is. And I then started a clinic and I started to do research and that's how my, my path started. And I started early on developing this clinic and, and residency training.

• 50:00Dr. Mark Hyman?

  Which is incredible because when you, when you look at the, the level of mental illness in society, it's one of the biggest causes of disability and one of the biggest costs is depression and anxiety. And, and I remember when I was seeing patients early on, treating them for insulin resistance and pre-diabetes and other issues or gut issues or other factors that were going on related to autoimmune disease or inflammation and we would get them healthy, they would sort of say, wait, you know, my, my depression went away, my anxiety went away, my panic attacks are gone, my bipolar disease is better, my ADD is better. And I'm like, well, how did that happen? And then you begin to go down the rabbit hole, you begin to look at the biology of what's happening.

• 50:42Dr. Mark Hyman?

  And one of the, I think the greatest discoveries around mental health is that it's an inflammatory problem very often, that the brain is inflamed, but the brain can't say ouch, like you have a sore throat or, you know, a swollen ankle, it manifests as all these psychiatric symptoms. So I'd love if you sort of take us down the road of how inflammation is connected to mental illness and what the approaches that you're using to help correct that.

• 51:11Speaker 01

  Sure, so that's, you know, quite an important question and, you know, when we talk about how nutrition affects the brain and specifically focusing on reducing that sugar and processed foods and refined carbohydrates to improve mental and physical health, we know that consuming excessive amounts of sugar, processed foods and refined carbohydrates lead to obesity, metabolic problems, fatty liver, heart disease, even cancer. There is evidence for this and the body is really one whole system and what happens in the body also affects the brain. The brain has a delicate balance of neurotransmitters

• 51:56Speaker 01

  or chemical messengers with more sugar and processed foods, these levels really become unbalanced and they're significantly off. So I'm talking-

• 52:05Dr. Mark Hyman?

  So wait, so your brain chemistry gets screwed up when you eat processed food and sugar? Is that what you're saying?

• 52:10Speaker 01

  Yeah, and I'm talking about ultra-processed food also in particular because I do think that there's a difference between processed food and ultra-processed food. Ultra-processed food is like the real sugar, the, you know, the cookies, the cakes, the chips, the potato chips, it's kind of highly processed things versus minimally processed foods, maybe some oils, you know, vegetables that are frozen. That's a little bit different than ultra-processed food and so the research is showing differences between those things in the brain.

• 52:45Dr. Mark Hyman?

  Yeah.

• 52:46Speaker 01

  And you need the right raw ingredients for chemical reactions to occur in the brain and elsewhere, like vitamins and minerals and nutrients. You need proper functioning, you know, of the brain, you need proper speed of transmitting signals. Your brain is composed of electrical cells and it's a complicated web of signaling molecules. Those cells need fat to develop and to function properly, so you need those omega-3s in your diet and-

• 53:16Speaker 01

  If you eat sugar and ultra-processed foods, the chances are that you're likely not getting those important nutrients, those vitamins and minerals, for those important reactions that you need, nor are you absorbing them. The most people with metabolic dysfunction actually have nutritional deficiencies and are malnourished.

• 53:35Dr. Mark Hyman?

  So you're saying it's people who are overweight and obese often are very malnourished and vitamin and nutrient deficient?

• 53:43Speaker 01

  Yes, that's right.

• 53:44Dr. Mark Hyman?

  That's sort of a paradox, right?

• 53:46Speaker 01

  Right, right.

• 53:47Dr. Mark Hyman?

  They're eating all this food, why are they nutritionally deficient, but they're actually among the most malnourished?

• 53:52Speaker 01

  They are, unfortunately.

• 53:54Dr. Mark Hyman?

  They're looking in all the wrong places for the nutrients. They eat more and more food. And I think a study from Kevin Hall and others showed that if you let people eat as much as they want, and you give them ultra-processed food versus whole foods, they'll eat about 500 calories more a day of ultra-processed food because they'll keep eating and they're hungry and they keep driving. And you talk a lot about it in your work about the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you literally become addicted to these compounds and how that affects you.

• 54:26Speaker 01

  Right. So the rates of obesity and binge eating and addictive-like eating are rising alongside the increasing dominance of ultra-processed foods in the modern food environment. And there are several mechanisms as to how this works, some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body. And we used to learn in medical school that you have this blood-brain barrier that nothing can get across it, but that's not, it's like the Berlin Wall. But in reality, it does leak, right? And there are things that do cross and...

• 55:08Dr. Mark Hyman?

  It's more like a coffee filter, you know, it's a sip.

• 55:12Speaker 01

  Yeah, so ultra-processed food and sugar decrease our dopamine receptors and make us eat more compulsively. Much like addictive drugs, the highly-processed foods, they trigger dopamine reward pathways. And they invoke addictive-like behaviors, which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food, continuing to eat these things despite knowing the adverse consequences to it, and repeated attempts to try to quit. Right, I'm describing addiction here, basically.

• 55:51Dr. Mark Hyman?

  Yeah.

• 55:51Speaker 01

  And the consumption of larger quantities over time than intended.

• 55:56Dr. Mark Hyman?

  You know, people go all the way to it's like emotional eating, it's not really biological true addiction. What you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure, you down-regulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. And it's really this vicious cycle that people get into, and then they blame themselves and they feel guilty, you know, for doing it, and they think they just have no willpower, but you're saying it's much bigger than that.

• 56:29Speaker 01

  Yeah, that's exactly right. It's, so, sugar is an addictive substance. It's not just something we say, it has a straightforward neurochemical basis in the brain, just like any other drug. And I think of sugar as a, it's a recreational food. It's not a, it's not a food that's essential for survival. We make sugar, you know, through the process of gluconeogenesis, through other foods that we consume. And so, it's really about excess carbohydrates.

• 57:02Dr. Mark Hyman?

  I call, I call sugar recreational drug. I've never heard anybody say it, but I always write down in my book, sugar is a recreational drug. It's like, if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.

• 57:15Speaker 01

  Exactly, yeah. And we also, actually, I would like to share a story about this, just during the era of COVID, since we're in it.

• 57:26Dr. Mark Hyman?

  Yeah.

• 57:27Speaker 01

  You know, just to give context as to, you know, why I wrote about this and why I'm working on this as well and continuing to feel, you know, motivated to continue to do my work is. The shelter in place order had come, you know, a couple of months back for my county, and I'm in California. I live in Menlo Park. When it was announced, my husband, he's an infectious disease physician at Stanford, and I'm a psychiatrist and a U S D medicine physician, as you mentioned. We both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store, and we saw many people loading up their carts with Pop-Tarts, Hawaiian Punch, popcorn, anything ultra-processed, basically. And

• 58:10Speaker 01

  they weren't loading up their carts with fresh vegetables, or, you know, they were out of cookies at the grocery store.

• 58:17Dr. Mark Hyman?

  Yeah.

• 58:17Speaker 01

  There were still-

• 58:18Dr. Mark Hyman?

  Cookies and toilet paper.

• 58:19Speaker 01

  And toilet paper, exactly. And there were still, you know, produce left in the store. You know, it wasn't like they ran out of produce.

• 58:28Dr. Mark Hyman?

  No.

• 58:29Speaker 01

  So here I was-

• 58:30Dr. Mark Hyman?

  I was gonna run on broccoli.

• 58:31Speaker 01

  No. And here I was at the checkout counter, and I was thinking to myself, you know, staring at the person's cart in front of me, that it's full of the recreational food, as I mentioned, the food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic, or helping their immune system, and if anything, weakening it. And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to, to kind of get that public message out on this topic.

• 59:08Dr. 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 professional.

• 59:52Dr. Mark Hyman?

  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.

• 1:00:32Dr. 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.