Is Your Thyroid the Hidden Root Cause of Your Health Issues?

Is your thyroid the hidden culprit behind your fatigue, weight gain, or mood swings? In this episode, I uncover the vital role your thyroid health plays in energy, metabolism, and mood—and why its symptoms are often overlooked. Learn about comprehensive thyroid testing, the impact of toxins and stress, and practical diet and lifestyle tips to keep your thyroid in top shape. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Full-length episodes of these interviews can be found here: How To Treat The Root Cause Of Thyroid Problems Is An Underactive Thyroid To Blame For Your Mysterious Symptoms? with Dr. Elizabeth Boham A Root Cause Approach to Hyperthyroidism and Graves’ Disease Which diet really gives you the best shot at optimal health? On Wednesday December 4th, Mark Hyman, MD will answer that question during The Diet Wars, a LIVE digital experience. Joined by Dr. Gabrielle Lyon, they’ll break down the science, debunk the myths, and share their expert perspectives to help you make the best choices for your health. Find out more and get tickets now at https://www.moment.co/markhyman This episode is brought to you by Seed, Cozy Earth, and AG1. Seed is offering my community 25% off to try DS-01® for themselves. Visit Seed.com/Hyman and use code 25HYMAN for 25% off your first month of Seed's DS-01® Daily Synbiotic. Right now, you can save 40% when you upgrade to Cozy Earth sheets. Just head over to CozyEarth.com. Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year's worth of D3 and 10 Travel Packs for FREE with your first order.

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 Doctor's Pharmacy. But your thyroid gland is important to understand and take care of, to love and figure out. Often can be fixed. I had thyroid issues when I was really sick with chronic fatigue, but then it all corrected.

• 0:13Dr. 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 this 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. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite and tested products.

• 0:50Dr. Mark Hyman?

  Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to The Doctor's Pharmacy. Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just trump right in. What is a thyroid function? What is your thyroid gland? It's this little gland in your throat. And it's, think of it as your overall metabolic regulator. It really controls everything. It's like your motor. It's like, you know, in terms of the RPM on your engine. So you know, some, some things like a golf cart or something have a governor and you can only go so fast. It's a little like that. So if it's slow, your whole system slows

• 1:35Dr. Mark Hyman?

  down. If it's fast, your whole system speeds up. That's hyperthyroid. Not that common, but it can be a problem for some people. But low thyroid or hypothyroid function is really common. And it, and your thyroid gland produces hormones, T4, which is the inactive thyroid hormone. And your brain produces something called TSH, which tells your thyroid to make more thyroid hormone if it's low, or if you have too much thyroid hormone, your TSH goes down. So it's a way we sort of track things. Now, the inactive hormone is T4. That has to get converted in your body to the active hormone, which is T3. Now, T3 is only about 7% of your hormone, thyroid hormone, but it's really important. Because it does all the work.

• 2:19Dr. Mark Hyman?

  It actually binds to the nuclear receptors that then translates into gene expression and to all these downstream metabolic effects. And it sends these messages to your DNA to turn up your metabolism. There's not fat burning in your mitochondria to basically get all systems go. And if you have a good T3 level, your cholesterol's in check, your memory's good, your metabolism's good, you stay thin, it helps your hair grow, and it helps your muscles, prevents muscle aches, constipation, and even improves fertility. So if you have your T3 working, it's really great.

• 3:00Dr. Mark Hyman?

  But the inactive form often doesn't get converted. And there's a lot of reasons for that into T3. And it can be environmental toxins, it can be stress, it can be lack of certain nutrients. I will talk about that, like selenium, it can be overgrowth of yeast. So there's a lot of things that affect this conversion, and often we'll see people with inadequate levels of T3. So the main role of thyroid is to stimulate metabolism, and it really affects almost every single function of the body, and it can cause so many weird, vague symptoms that people don't even often identify it because it's like, oh, I'm a little this, a little that, and you don't really get it. And the main reason it's not diagnosed is that the symptoms aren't specific. You're a little achy, you're a little tired, you're gaining a little weight, your skin's

• 3:45Dr. Mark Hyman?

  a little dry, losing a little bit of hair, you may be sluggish, you have trouble concentrating, you're a little depressed, you're maybe a little cold when everybody else is warm, you get cold hands and feet, you get low libido, you might get a little flu retention, your cholesterol's a little high. These are really nonspecific symptoms that can be caused by many, many things, but when you add it all together... And you look at this list, it's feeling, oh, I have all that, you know, like, that's really a clue that you might have thyroid issues. So when we're taking a thyroid quiz, which is really important, we can link to it in the show notes, gives you a pretty good sense of if you're having a likelihood of having low thyroid. And then you need to do the right testing. Now, the problem is that it's often what we call subclinical.

• 4:29Dr. Mark Hyman?

  So it may not be full blown thyroid disease, but you know, with functional medicine, we like to think about how do we get to optimal function, not just what's normal. If you look at the normal lab tests, they're often misleading because they're based on a population that may not be healthy. So, you know, the range of, for example, TSH, which is what most doctors look at to check your thyroid, is 0.5 to 5. It's a tenfold range of what's considered normal. The American College of Endocrinology has lowered the top number to 3.5 or 3, but what's optimal might be 1 or 2, or you know, 0.5 to 1. So what's really optimal is very different than what's quote, "normal." And that's why it's often

• 5:14Dr. Mark Hyman?

  missed. And doctors will often miss it because they just check the TSH and not the whole panel of tests that gives you a really comprehensive view. If you just check TSH, it could be normal, but you could still be, for example, having an autoimmune thyroid condition, or you could still have a low T3. And doctors will not check that. They'll only check your other numbers if your TSH is abnormal, which is really a bad way to go about it. So I think it's really important to do a comprehensive thyroid panel, which includes TSH, free T3, free T4, and thyroid antibodies, thyroid proxides and antithyroglyblin antibodies.

• 5:55Dr. Mark Hyman?

  Now, a lot of doctors will check thyroid panel on a lab rec. And the old lab recs have very old thyroid panels that use all kinds of antiquated tests, which I still see unfortunately, like T3 uptake and all these weird things that are not really accurate, given how sensitive these current new tests are for free T3, free T4, and ultra sensitive THH. And also,

• 6:22Dr. Mark Hyman?

  You know, if you're really stuck and there's other things going on, there's more advanced tests like thyroid releasing hormone that we can use by using a stimulation test. So we won't get into that, but the key is the basic test should be TSH, free T3, free T4, thyroid antibodies, TPO, and anti-thyrogland, anti-thyrogland antibodies. If you get that whole panel, and you can see, for example, cases where there's high antibodies, but normal thyroid testing, those people still need to be treated, or you'll see a low T3 but normal TSH. So it's really, really important to do a whole panel. Now, let's talk about what causes thyroid problems, because, you know, why are we seeing so many people with thyroid issues? Is this a genetic defect in human beings? I don't

• 7:04Dr. Mark Hyman?

  think so. It's really because we are living in a toxic world in many ways. One, environmental toxins are really impactful on the thyroid function. Think of your thyroid as a yellow canary in your body. The yellow canaries were put in coal mines, and when the canaries died, the coal miners knew the air was bad, they had to get out of the coal mine. So the thyroid is like the yellow canary of the body. Very sensitive to pesticides, heavy metals, environmental toxins of all sorts, which are super abundant. And it's 80,000 is compounding environment, only 1% have been tested for safety. They're ubiquitous.

• 7:45Dr. Mark Hyman?

  The average person is basically a walking toxic waste dump, dioxin, PCBs, stalates, DDT, all this stuff is still in us, even though it's been banned. Some of this stuff has been banned. And most of us can handle it, but it's really important to focus on identifying these toxins. Heavy metals are a huge factor, particularly mercury, and a big factor. Also, stress, you know, there's a deep connection between your adrenals and your thyroid glands. So people who are overstressed, you know, by psychological stress, physical stresses, lack of sleep.

• 8:18Dr. Mark Hyman?

  Those stresses register in the body directly in terms of adrenal function. And when your adrenal function is low, you often will see a kind of this thyroid function go low. So you're, for example, if you put young soldiers on a forced march, you'll see their thyroid function decrease just because of the stress of an overnight march with carrying a 50 pound pack. And they'll look like they're hypothyroid, even though they're really not. So stresses are a big factor. The other one is gluten. Gluten is a huge factor. And about probably 20, 30% of, in my experiences, I don't, seeing, you know, thousands of patients and testing them. Everybody's got low thyroid or antibodies

• 9:02Dr. Mark Hyman?

  to thyroid. I check their gluten antibodies too. About 20% to 30% of people who have low thyroid function can be a result of gluten sensitivity, their celiac disease or non-celiac gluten sensitivity. And it's really important to track because if you keep eating gluten, like you, or you keep having mercury, your thyroid's just not going to work. And this can affect about 10 to 20% of the population. So it's really common in terms of the inflammation in the thyroid. Also nutrient deficiencies, you know, thyroid function needs, you know, iodine to make the thyroid hormone. You need selenium to convert T3 to 4. You need vitamin D and vitamin A to have it bind on the nucleus to work and do its thing. You need the right

• 9:43Dr. Mark Hyman?

  omega-3 fats and many other nutrients to help optimize thyroid function. So what, what do you do if you think you might have low thyroid? What steps should you take? Well, first, do the symptoms check. Look at the questionnaire, the link, the things that I just mentioned, you can kind of do a mental checklist, or you can fill out the thyroid questionnaire, we're going to link to in the show notes. That's the first thing. And if there's some suspicion, you need to get the right tests. And there's a lot of ways to do that. Right now, you have to ask your doctor. There are labs that are coming online like Function Health where you'll be able to do your own ordering of tests, which is important. But you want the full spectrum, like I said, TSH, free T3, free T4, thyroid antibodies,

• 10:28Dr. Mark Hyman?

  TPO, and anti thyroid antibodies. You also want to check for aciliac with gluten sensitivity, with deaminated glide, antiglycan antibodies, tissue transglutaminase antibodies. We'll write all this up in the show notes and keep a track of it. We might also want to do a heavy metal test, look for heavy metals with a DMSA challenge test to look for urine toxic metals after a six hour collection. There are tests to look at pesticides and chemicals in your body through urine testing. Sometimes they'll do that, but we're all pretty exposed. We just want to reduce our exposures and you can do that by going to ewg.org and learning about how to reduce your exposures across skincare products, household products, food

• 11:09Dr. Mark Hyman?

  products. Vitamin D plays a huge role. If you're vitamin D deficient, you want to see that for sure because by correcting that, it'll help your thyroid work better. You can check for selenium levels. Often there's selenium deficiencies, iodine deficiencies. We can measure that as well. So we do a really close inventory of nutritional status. That's how I kind of evaluate it. So what do I do to help fix thyroid function? Well, first you deal with all the causes, gluten, stress, the microbiome. We didn't really talk much about that, but that can play a role in generating inflammation that causes problems. And obviously environmental toxins. And then what do you do to optimize your thyroid

• 11:50Dr. Mark Hyman?

  function? Well, first thing is eat the right foods that support your thyroid function. My favorite is seaweed. Seaweed is full iodine, minerals. It's great for your thyroid. Fish also great. Sardines, wild salmon, mackerel, herring. Also, fish contains a lot of iodine. Omega 3 fats, which you also get from the same foods. Make sure you get vitamin D. Probably need to supplement. You know, herring, mackerel are a great source of vitamin D, mushrooms, like porcini mushrooms, but it's hard to get enough. So sunlight and obviously checking your vitamin D and taking vitamin D. So you can get your vitamin A, which is important for thyroid function from dandelion greens, mustard greens, dark green leafy vegetables, liver, organ meats. Also, if you like that, I do.

• 12:34Dr. Mark Hyman?

  Also, selenium is super important, and that can come from herrings, scallops, smelt, which are tiny little fish, Brazil nuts probably are the best source. You get 50 micrograms of per Brazil nut. So I would, I would, I would make sure you have plenty of those foods. And the things you want to avoid, if you're having thyroid function issues, well, I would get off of gluten dairy, which are inflammatory for most people, and processed soy. If people are eating a lot of processed soy, it can affect thyroid potentially. Also kale and some of the cruciferous vegetables. If you, if you juice a lot of kale, for example, it can cause a problem. I, I once read a report of someone who, who I thought of the broccoli family vegetables was

• 13:16Dr. Mark Hyman?

  good for them, and they ate two pounds of bok choy raw every day. Now, if it's raw, it's worse. So don't eat raw cruciferous vegetables that much. And, and she went into a hypothyroid coma. So that's an extreme case, but if you're juicing raw kale every day, you can get into trouble. And then what should you do in terms of supplements? A good multivitamin that contains selenium, iodine, zinc, vitamin A, and then you might want to add in vitamin D and omega-3 fats. If your adrenals are stressed out from chronic long-term stress, you want to deal with that through regular circadian rhythm, lifestyle management, getting sunlight exposure in the morning for 20 minutes, waking and sleeping at the same time every day, having meditation

• 13:57Dr. Mark Hyman?

  practice, yoga, deep breathing, all the lifestyle practices for resetting your adrenals. And then you can use herbs like rhodiola, Siberian ginseng, various adaptogenic mushrooms. This is really a way to kind of boost your, your adrenal function. And then if you're stuck, you know, you kind of might need to work with a doctor to optimize what you need in terms of thyroid treatment and adrenal treatment. So if you, let's say you need thyroid replacement, and a lot of people do, sometimes you can get away without it. But if you, if you've done all the things that I just said, and your thyroid is still not optimized, then you need to know what should you take. Now, the traditional approach is everybody should take Synthroid, which is libothroxine or T4. And that works for some people, but many people it doesn't. And they'll be partially

• 14:41Dr. Mark Hyman?

  treated. And if you check the T3, their T4 will be good because you're getting it, but their T3 will be low. And I think it's better to use a bio-identical form of thyroid, which is actually how all the hormones were first developed. And it may sound kind of weird or gross, but it comes from pig thyroid, porcine thyroid. And it's very similar or almost identical to ours. And it contains T4, T3, something called T2, which is really unusual if you might not know about, which actually helps metabolism and is very important. And so most doctors just assume that the synthroid will get converted, but it really doesn't because all the pesticides in the environment, the heavy metals, the stress, the food sensitivities,

• 15:25Dr. Mark Hyman?

  gluten, you know, deficiencies of nutrients, you know, 100% of us have toxins in our body. So it's better to just take a combination bio-identical thyroid replacement. And that usually is armor thyroid. In the old days, it wasn't well manufactured and so the dose was variable, but now it's really well controlled. And a lot of doctors don't like it, but I encourage you to think about trying it because it really can help. You need to check your thyroid if you change your thyroid or put yourself on thyroid or take thyroid, you need to check it probably about six weeks after you take your, whatever dose you're on, and then you can see how it's working and then adjust it. If you take too much, you want to be careful because you can take too much and that can cause bone loss.

• 16:08Dr. Mark Hyman?

  It can make you a little hyper, insomnia, palpitations. So you have to track it. But your thyroid gland is important to understand and take care of, to love and figure out. And it's, and it often can be fixed. I had thyroid issues when I was really sick with chronic fatigue, but then it all corrected.

• 16:30Dr. Mark Hyman?

  What are the problems with the traditional way we treat thyroid in America?

• 16:37Speaker 01

  Well, I think, I think the first thing that as functional medicine docs, we recognize is that we're not asking that question, why? Right? So we're not looking for that underlying root cause, which so often helps us when we're treating our patient, because it helps us figure out for them, for that individual person, what do we need to do to help their thyroid work better? So is it? Because of a nutritional deficiency.

• 17:01Dr. Mark Hyman?

  Yeah.

• 17:02Speaker 01

  We know that we need iodine and selenium and iron and all sorts of good amino acids.

• 17:07Dr. Mark Hyman?

  Vitamin D, just to get, just to get the thyroid to work on your cell. You need vitamin D to help it actually send a message to your DNA to do what it's supposed to do.

• 17:16Speaker 01

  Right.

• 17:16Dr. Mark Hyman?

  And eighty percent of us are deficient in vitamin D.

• 17:18Speaker 01

  Yes, yes. And so if people aren't eating enough of certain foods, we might see nutritional deficiencies. Or maybe if their digestive system is a mess, they're not absorbing their nutrients well. So, so we have to ask that question, why? Cause sometimes that will just help the thyroid work better when we help support it nutritionally. Or maybe it's an autoimmune condition, like you mentioned, Hashimoto's. And then it gets us thinking of a lot of different things, right? It gets us thinking about, well, why does this person have autoimmunity?

• 17:45Dr. Mark Hyman?

  Isn't it the most common autoimmune disease?

• 17:46Speaker 01

  Yeah, it really is.

• 17:48Dr. Mark Hyman?

  What causes it?

• 17:49Speaker 01

  Well, you know, the body, when in an autoimmune condition, the body starts to fight itself off, right? So it starts to, it looks at the thyroid gland and says, okay, I'm gonna fight you off, I'm gonna attack you. And when it attacks the thyroid gland, the thyroid gland doesn't work as well.

• 18:03Dr. Mark Hyman?

  Yeah.

• 18:03Speaker 01

  And so then you get low, well, in many cases, you get a low thyroid. So what causes the autoimmune disease is the big question we always ask in functional medicine.

• 18:13Dr. Mark Hyman?

  Why?

• 18:14Speaker 01

  Right. And, and everybody's different, right? For one person, it may be gluten. We know gluten is associated with a lot of Hashimoto's thyroiditis, not all, but some.

• 18:24Dr. Mark Hyman?

  But my experience, like you look at thyroid antibodies and you compare it with the gluten antibodies in that patient. And it's about thirty, my thing is about thirty percent of the time, it could be related to gluten. What do you think?

• 18:35Speaker 01

  Yeah, I think it could be, it could be. It might even be a little higher. But it depends, because the patients we're seeing, so we might be seeing more patients who have a lot of different digestive issues going on. And so I might see it even a little more frequently.

• 18:48Dr. Mark Hyman?

  Selection bias, people who are sick, select to come see us, so they have more stuff, for sure.

• 18:52Speaker 01

  But, but we always think about the digestive system, right? You've got autoimmunity, you've got to think about what's going on in the digestive system. But then you think about, could there be a, an overgrowth of bacteria? Certain bacteria in either the digestive system or other parts of the body have been shown. To trigger autoimmunity in some people.

• 19:11Dr. Mark Hyman?

  Yeah.

• 19:11Speaker 01

  We know that.

• 19:12Dr. Mark Hyman?

  We're going to talk about that on another podcast. So stay tuned. We're going to talk about the gut and leaky gut.

• 19:16Speaker 01

  Okay, we'll do that. We know that imbalances in iodine, actually excessive amounts of iodine.

• 19:22Dr. Mark Hyman?

  Can shut down the thyroid.

• 19:23Speaker 01

  Yeah, so you know, some Hashimoto's, because it's, it's, you know, it was found first in Japan, where they have lots of iodine. So, you know, we know iodine is important for the thyroid, but too little is not good, but too much is also not good. So we pay attention to that. And toxins, of course, right? Toxins can be triggers for autoimmune disease in some people.

• 19:44Dr. Mark Hyman?

  Yeah, so you'll say that the thyroid is a yellow canary. However, that the yellow canary was, the coal miners used to bring the yellow canary into the mine. And if it dropped dead, they knew the air was bad, they had to get out. Right? So it was an early warning sign. And the thyroid is like that. And it seems to be extremely sensitive to disruption from heavy metals, from pesticides, the plastics and everything.

• 20:07Speaker 01

  Yeah, fluoride.

• 20:08Dr. Mark Hyman?

  Fluoride.

• 20:09Speaker 01

  Yeah.

• 20:09Dr. Mark Hyman?

  So, yeah, fluoride in the water, all these things can disrupt our thyroid function. And often, your doctor never even looks for them.

• 20:15Speaker 01

  Absolutely, right? They say, okay, you know, we're just going to look at the TSH. And if it's, if it's in the normal range, you're fine. Or we're going to give you medication to get it in the normal range, but not really look a lot deeper.

• 20:28Dr. Mark Hyman?

  Yeah, so what, what is the difference in, in the testing that? Oh, there's one other thing I wanted to bring up, which I remember reading about in the New England Journal of Medicine, was a lady who thought that bok choy was healthy. And she ate like two pounds of raw bok choy a day. And she went into a hypothyroid coma. And people having kale juice.

• 20:50Speaker 01

  Talking about goitrogens.

• 20:51Dr. Mark Hyman?

  Yeah, there's a whole kale craze.

• 20:53Speaker 01

  It's a great point.

• 20:54Dr. Mark Hyman?

  And people are juicing it, and it's raw. And, you know, raw cruciferous vegetables can be a problem. If you're eating a lot of raw broccoli and cabbage. And if you're having raw Brussels sprouts or raw bok choy, kale.

• 21:08Speaker 01

  Eating it in a level that's beyond just like a normal food portion.

• 21:12Dr. Mark Hyman?

  Yeah.

• 21:12Speaker 01

  Right? But, but as you mentioned, if you cook it, if you cook it, you get rid of a lot of that goitrogenic potential, that the part that's going to dam or interfere with thyroid function.

• 21:22Dr. Mark Hyman?

  Yeah.

• 21:22Speaker 01

  So you don't have to be concerned when you have cooked cruciferous vegetables. But it's that, like you said.

• 21:27Dr. Mark Hyman?

  So should I worry about having a kale juice every day?

• 21:29Speaker 01

  Ah, it's a good question. Depends how much kale you put in it, right?

• 21:33Dr. Mark Hyman?

  Well, I'd like to drink green juices and most of them have kale.

• 21:36Speaker 01

  A little bit of kale is fine.

• 21:38Dr. Mark Hyman?

  I'm careful about it.

• 21:39Speaker 01

  And it depends on the person, of course, right?

• 21:41Dr. Mark Hyman?

  Yeah.

• 21:41Speaker 01

  Right?

• 21:42Dr. Mark Hyman?

  What about soy?

• 21:44Speaker 01

  So, you know, that's a good question, too. You know, I, I think that if, if.

• 21:49Dr. Mark Hyman?

  Cause a lot of people are like soy is really bad. It's interruption thyroid. It's dangerous. You shouldn't eat it.

• 21:54Speaker 01

  I think if we're going with, you know, non-GMO, organic soy as a whole food, like edamame and tofu, then I'm, and I'm not concerned. Yeah, tempeh, I'm not concerned.

• 22:05Dr. Mark Hyman?

  Yeah, traditional soy foods that have been used for centuries, right? Miso, tempeh, tofu, natto.

• 22:13Speaker 01

  Right, yep.

• 22:14Dr. Mark Hyman?

  You know, soy sauce. I mean, those are fine. It's, it's, uh, you know, when we're, you know, drinking a, you know, quart of soy milk a day, that's a problem. Or when you're having all these fake soy foods that are processed or soy burgers and you're eating

• 22:27Speaker 01

  Yep.

• 22:27Dr. Mark Hyman?

  Stuff that's sort of weird. Frankenfood.

• 22:30Speaker 01

  Or like the, the textured soy protein that they put in cereals and bars just to get that protein content up. We, you know, we don't.

• 22:37Dr. Mark Hyman?

  Yeah.

• 22:37Speaker 01

  That's, that's stuff I, yeah, I tell people to stay away from.

• 22:41Dr. Mark Hyman?

  Okay. So you're, you're, uh, someone who comes in, you feel tired, you're constipated, a little depressed, your skin's dry, your hair's falling out, you don't have a sex drive anymore, you can't concentrate. You know, and you go to a traditional doctor, they'll just test one thing. What do they test?

• 22:55Speaker 01

  Right. So they typically test your TSH.

• 22:57Dr. Mark Hyman?

  Okay. So what is that?

• 22:58Speaker 01

  Your TSH is your thyroid stimulating hormone and there's a feedback loop in the body. So if your thyroid level is low, then the body will get triggered to make more TSH.

• 23:09Dr. Mark Hyman?

  And that comes from your brain, from your pituitary gland.

• 23:11Speaker 01

  Yeah. And then that TSH will say, okay, make more thyroid. So if the TSH is high, then the doctor says, okay, your thyroid is underactive and we need to treat it. So.

• 23:21Dr. Mark Hyman?

  That's the only thing they test.

• 23:23Speaker 01

  Often.

• 23:24Dr. Mark Hyman?

  And, and I think if you're functional medicine doctor, it's a very different approach.

• 23:28Speaker 01

  Yeah.

• 23:29Dr. Mark Hyman?

  What kind of things would you look at?

• 23:30Speaker 01

  We always, we always start with a full thyroid panel where you look at TSH, but you look at free T3 and free T4. So, so free T4. Is one thyroid that hormone that's floating around in your body, but then the the T3 is the active form that you wanna that your body needs for all the thyroid functions to occur. So we look at both, we look at all three of those at least.

• 23:53Dr. Mark Hyman?

  Amen.

• 23:54Speaker 01

  Then we often look at thyroid antibodies.

• 23:55Dr. Mark Hyman?

  Yeah.

• 23:56Speaker 01

  And sometimes we'll even do things like reverse T3 and the the reverse T3, total T3 ratio. So there's

• 24:02Dr. Mark Hyman?

  What does reverse T3 tell you?

• 24:03Speaker 01

  So the reverse T3 is a thyroid hormone that the body, when the body is, it's, it's, I always think of it almost as the brake that the

• 24:13Dr. Mark Hyman?

  The brake.

• 24:13Speaker 01

  Yeah, that the the body puts on itself. So when the body is saying, okay, I've got to slow myself down, it takes some of its T3, which is your active thyroid hormone, and it converts it to reverse T3, almost in a way to slow down our metabolism. It's a protective mechanism, I think of, right?

• 24:29Dr. Mark Hyman?

  Yeah.

• 24:29Speaker 01

  Um, and and it makes sense that we have that in times of stress.

• 24:33Dr. Mark Hyman?

  A lot of things will actually trigger that that are not actually good, right?

• 24:35Speaker 01

  That's very true. So like if there's a, you know, if there was a major stress going on, you'd want to have that mechanism in place. So you didn't starve to death. But with a lot of chronic stress, which we see a lot these days, we can sometimes see high reverse T3. And the other thing we see a lot that causes that high reverse T3 is sometimes toxins.

• 24:54Dr. Mark Hyman?

  Yeah.

• 24:54Speaker 01

  So it can be a sign that we've got to look deeper and say, okay, is this person under a lot of chronic stress? How is their adrenal gland functioning? Um, how are they? Are they working to activate that parasympathetic nervous system, that calming nervous system, which helps the body heal? Um, and then we look for toxins.

• 25:12Dr. Mark Hyman?

  Yeah.

• 25:13Speaker 01

  Yeah.

• 25:13Dr. Mark Hyman?

  And the gluten issues. We look, we look for everything that is is imbalancing the thyroid. So we'll look for nutritional deficiencies. Do you have selenium deficiency, iodide deficiency? Are you low in zinc? Do you have low omega-3 fats? Do you have yeast in your gut? Do you have heavy metals? Do you have pesticide exposure, toxin exposure? So we take a very detailed history that your traditional doctor would not do.

• 25:32Speaker 01

  Right.

• 25:32Dr. Mark Hyman?

  To really look at the broad spectrum, what's causing it? Because we could just treat the symptoms of the thyroid, but maybe we may not need to do that. And I've seen many patients where you fix these other things and their thyroid gets better.

• 25:41Speaker 01

  Absolutely.

• 25:42Dr. Mark Hyman?

  And and it's so powerful. And you see that it's like, oh, I don't need to do thyroid. I can actually fix the upstream cause.

• 25:46Speaker 01

  Yeah.

• 25:47Dr. Mark Hyman?

  And

• 25:47Speaker 01

  It's pretty impressive when that happens.

• 25:49Dr. Mark Hyman?

  And the last thing you were talking about was antibodies. So

• 25:51Speaker 01

  Mm hmm.

• 25:52Dr. Mark Hyman?

  Tell us about what antibodies are and why we should look at them and why the traditional doctors don't look at them?

• 25:58Speaker 01

  I'm not sure why they don't look at them enough. But the antibodies are giving us a signal that the body is attacking its own thyroid. And it's a sign that there's autoimmune disease going on in the body. And we've got to figure out that question. You know, why is that? Why is that going on? And, and, you know, so I had a woman who came in to see me and she, she was 40. And she had been struggling with all those symptoms we talked about with low thyroid. You know, she was cold all the time. You know, her hands were cold. She was gaining weight. She was tired. She was constipated. She was losing hair. Her eyebrows were thinning.

• 26:37Dr. Mark Hyman?

  Sound familiar to anybody?

• 26:38Speaker 01

  I know, right? So I'm like, okay, but then her, her primary doctor did her TSH and it was normal. So we then went deeper.

• 26:47Dr. Mark Hyman?

  Can I stop you for a sec? So what I was trained, and I'm sure you were trained the same way, was you only check TSH. If that's normal, then you don't do anything else. And what's normal is a range of like point five to five.

• 27:00Speaker 01

  Often, yeah.

• 27:01Dr. Mark Hyman?

  Which is a massive range that actually doesn't reflect even our current understanding on most reference ranges on the lab test that even the American College of Endocrinologists says if it's over three and a half, we should be worried.

• 27:12Speaker 01

  Right, and many, many studies are saying people between one and two feel the best, right?

• 27:17Dr. Mark Hyman?

  Right, and I remember, you know, because I always do all the tests. I don't do reverse T3, but I do TSH, T3, T4, and the thyroid antibodies. Because what I've learned is that even if all of those are normal, TSH, T3, T4, you can have elevated antibodies.

• 27:33Speaker 01

  Yes.

• 27:33Dr. Mark Hyman?

  And people who have those feel better when they get on thyroid.

• 27:36Speaker 01

  Very true.

• 27:36Dr. Mark Hyman?

  And I went to a conference years ago at Harvard and I, you know, it was a traditional medicine conference and the endocrinologist was talking about thyroid. And he said, look, if your antibodies are elevated, they should be treated because they're probably symptomatic. And you treat the patient, not the lab test. But in traditional medicine, now we're more treating the lab test, not the patient. And I think that's really important.

• 27:53Speaker 01

  And, and, and the physician sometimes thinks, well, I'll just wait until these antibodies damage the thyroid enough and then I'll treat.

• 28:01Dr. Mark Hyman?

  Right.

• 28:01Speaker 01

  That's the way they, you know.

• 28:03Dr. Mark Hyman?

  It's like, once the TSH starts to go up.

• 28:05Speaker 01

  I'm gonna wait until, but we say, okay, no, there's so much we can do.

• 28:09Dr. Mark Hyman?

  A hundred percent.

• 28:09Speaker 01

  There's so much we can do right away.

• 28:11Dr. Mark Hyman?

  Yeah, I remember this patient came in once with blood sugar like 115 and 126 is diabetes, 100 is pre-diabetes. And I'm like, God, you know, your, did your doctor say anything about your high blood sugars? Oh, yeah, I checked it out. What did he say? He said, well, when it gets to like 126, we'll treat with medication.

• 28:26Speaker 01

  Yeah.

• 28:27Dr. Mark Hyman?

  And I'm like.

• 28:27Speaker 01

  No, this is the perfect time to treat you.

• 28:31Speaker 02

  We look at the gut microbiome and, and the function of the gut almost first and foremost, when it comes to autoimmune diseases, because that's where you're going to find the majority of the triggers.

• 28:41Dr. Mark Hyman?

  So the gut is always a key thing to think about because 70% of your immune system's in your gut. And if you have an autoimmune disease, you have to treat your gut.

• 28:49Speaker 02

  I don't think that there's one person with an autoimmune disease I've treated that hasn't had, hasn't had some gut issue that had to be dealt with, that, that was part of reducing their autoimmune process and getting them into remission.

• 29:01Dr. Mark Hyman?

  Okay, then. Wow. And, and what's really fascinating is that it just recalls this patient of mine who was about a 40 year old woman who had Graves' disease and was struggling and did not want to be on medication long-term, was willing to whatever it took. And she, she turned out she had real gluten issues, she had terrible gut issues, and we did a really, and she had parasites. I mean, we did a really aggressive gut repair program.

• 29:24Speaker 02

  Yeah.

• 29:25Dr. Mark Hyman?

  And we optimized her health and her vitamin D, and we improved her diet. And what was amazing was that her antibodies for Graves went to zero, her thyroid normalized, and she's completely fine now and off medication, which is just really striking to me because that's something I never learned was possible in medical school.

• 29:41Speaker 02

  Yeah. And, you know, you know, I've had a case where, again, you get to the root cause, and yeah, was gut a major issue? Sure. But in my particular case, it was a woman who's 55 years old. She came with a diagnosis of Graves', like I said, many do, and she just didn't want to, you know, do the traditional therapies. So when she came in, she was also menopausal within the last two years, and she, that was the main, the other main issue with her. So, and although she had gut issues, she had bloating and distension and constipation, some loose stools. So with her, you know, one of the things that works, and I, you

• 30:22Speaker 02

  know, when you want to treat somebody, you're, it is perfectly appropriate to try to understand that the mechanism, the pathway of the way the organ works, in this case thyroid, TPO, thyroid proxidase antibody, thyroid proxidase is an enzyme that's blocked with a pharmaceutical agent that is very harmful. Botanical agents can oftentimes, because we get many of our medicines from botanicals. So botanical agents can oftentimes be very effective. In this particular case, L. carnitine can act as a thyroid peroxidase inhibitor.

• 30:57Dr. Mark Hyman?

  Oh.

• 30:57Speaker 02

  And so using L. carnitine was one of the first things I did with this particular woman. And she, you know, before our next follow up, she was already beginning to have some relief from her symptoms just using L. carnitine. And then because she was menopausal, estrogen can have an impact on your autoimmune state. So balancing hormones is really important. You know, when you think about hormone replacement, you know, there's always been a concern, particularly with women, about the possible impact on the breast and breast cancer. What I will say is that there are now studies that are showing that early in menopause,

• 31:40Speaker 02

  using hormone replacement for a short period of time can have a very beneficial impact on brain aging. There's reduction in Alzheimer, development of Alzheimer's for women who have estrogen early in their menopausal state.

• 31:58Dr. Mark Hyman?

  Interesting.

• 31:58Speaker 02

  It also reduces the autoimmune state because estrogen does play a role in balancing the inflammatory and anti-inflammatory sides of the immune response. So I actually put on hormone replacement.

• 32:11Dr. Mark Hyman?

  I wonder if that's why you see most of the case of autoimmune disease in women.

• 32:14Speaker 02

  Yeah, in forty to fifty, you know, forty to sixty range. So I balanced her hormones and then, of course, you know, we worked on her gut microbiome, which is always a critical piece.

• 32:24Dr. Mark Hyman?

  Yeah, and you know, the other thing you did was you got her off gluten and you put on an anti-inflammatory diet.

• 32:29Speaker 02

  Yep.

• 32:30Dr. Mark Hyman?

  Right?

• 32:30Speaker 02

  Yep.

• 32:30Dr. Mark Hyman?

  And you gave her the raw materials for helping her thyroid function.

• 32:33Speaker 02

  Yeah, and I, you know, yeah, and I think it's really important when we say we work on the gut, you know, we have to remember that when we work on the gut, we have a very... Programmatic approach that can be adopted and adapted to the various conditions people have, but it's that five R approach. You know, it's basically, let's find out what may be a trigger. So there are triggers to, you know, there are some, you know, bacterial and parasitic triggers to thyroid autoimmunity. One of them happens to be blastocystis hominis, which is a parasite that, you know, has been implicated in triggering antibodies that will go after the thyroid.

• 33:14Dr. Mark Hyman?

  That's interesting because that patient that I mentioned, that's what she had. She had this parasite.

• 33:18Speaker 02

  Yeah.

• 33:18Dr. Mark Hyman?

  Which we're going to talk about on another podcast.

• 33:20Speaker 02

  Yeah, we are. So, um, so when we look at the gut, we're going to look at it. So we're going to need to, we know we need to look at the gut carefully.

• 33:28Dr. Mark Hyman?

  So talk about, you know, what is really driving this, this, this problem? And what, what is Graves? What is hyperthyroidism? And what does it do to people? How do they feel? And how do people know they have it?

• 33:39Speaker 02

  Right. So hyperthyroidism is when the thyroid gland is producing way too much thyroid hormone. That's T3 and T4 level. And so when they're being overproduced, then you're going to have symptoms that are going to cause you to lose weight, feel sweaty, have palpitations, be anxious, have thinning hair, lose your hair, have thinning nails. Graves' disease happens to be the most common. It's about 60 to 70% of people with hyperthyroidism are Graves. It happens to about 1 in 200 people, men more than, uh, women more than men, 10, uh, 10 to 1.

• 34:20Speaker 02

  And it usually peaks around in the ages of 40 to 60 years old, but it can happen younger. So that's like the, the overview of Graves' disease. Now, there are the most, as you said-

• 34:32Dr. Mark Hyman?

  What are the symptoms?

• 34:33Speaker 02

  The symptoms are some of the ones I just mentioned, which are going to be, uh, weight loss, sweating, thinning, uh, thinning nails, hair loss, um-

• 34:43Dr. Mark Hyman?

  Palpitations.

• 34:44Speaker 02

  Thinning skin, palpitations. When it gets really bad-

• 34:46Dr. Mark Hyman?

  Diarrhea, atrial fib-

• 34:47Speaker 02

  Yep. And when it gets really bad, you can have heart failure, you can have, um, hormone imbalance, and you can have anemia.

• 34:54Dr. Mark Hyman?

  And insomnia, people can't, I had a friend, I had a friend call me who was like, I can't sleep. I know what's wrong.

• 35:00Speaker 02

  Yeah.

• 35:00Dr. Mark Hyman?

  And we get to her history, she's like, and I lost 20 pounds and I wasn't trying. I'm like, oh, okay.

• 35:05Speaker 02

  Yeah, you know, and it can be, yeah, so most people, as you said, have hypothyroidism. It's less common, I think 1% of thyroid disease or 2% is, is hyperthyroidism. Graves is the most common, but when you have it, it can be really debilitating and it can be really hard to treat. And as you said earlier, in conventional medicine, the treatments haven't changed in 50 years. And they're quite harsh. And functional medicine really gives us a great opportunity to get to the root causes of what triggers Graves and allows us to then treat our patients in ways that make sense for the biology and their life environment.

• 35:46Dr. Mark Hyman?

  Yeah. So, so it's really, you know, the symptoms can be quite dramatic for people, right?

• 35:51Speaker 02

  Absolutely.

• 35:51Dr. Mark Hyman?

  And like, as you mentioned, some of the complications are serious. It's not just about having a racing heart or insomnia or diarrhea. You can get eye damage, your eyes can bug out of your head.

• 36:01Speaker 02

  Right.

• 36:01Dr. Mark Hyman?

  You can get heart failure, right?

• 36:04Speaker 02

  Yeah, yeah, that can happen. And, you know, the reason why that happens, and I think we're going to have to just jump right into this part of it, is the autoimmune process. Graves is an autoimmune disorder, just like Hashimoto's, which causes hypothyroidism. And so you can't get away from talking about thyroid disease without talking about the autoimmune, you know, our immune system, autoimmunity, why we have it, why it's getting worse and what some of the major triggers are. So the eye disease is actually antibodies that are being made against your thyroid. They're called thyroid, thyroid stimulating hormone receptor antibodies or TRABS. And they're made specifically against the receptors on the thyroid.

• 36:48Speaker 02

  So when those antibodies hit those receptors, it triggers, it doesn't destroy those receptors, it actually triggers them to make more thyroid hormone. But we have, it's a very nonspecific interaction and those antibodies can also trigger.

• 37:04Speaker 02

  Like antigens in other parts of the body, they happen to be in the eye, where there are thyroid stimulating receptors and also in the lower extremities. So you can get the deposition of all these antibodies in the eye that caused that the Graves up the Graves eye disease and also pre-tibial maxedema. And that's because

• 37:28Dr. Mark Hyman?

  That's like fluid retention in your legs.

• 37:30Speaker 02

  In your legs where you get a destruction of the tissue underneath the the skin of the tibia or your shin. And you can see it thickened and fluid filled and it's not nice looking and it's not nice feeling. So those are the things that are the hallmarks of Graves. And they're all related to that autoimmune antibody response.

• 37:53Dr. Mark Hyman?

  What's interesting also is that autoimmune diseases often come in clusters. And with Graves, you see people often with other autoimmune diseases, right?

• 38:01Speaker 02

  You do.

• 38:01Dr. Mark Hyman?

  Like what?

• 38:02Speaker 02

  So some of the other autoimmune diseases can be,

• 38:08Speaker 02

  you can actually get Hashimoto's. Hashimoto's is one of the other autoimmune diseases.

• 38:11Dr. Mark Hyman?

  You're gonna have low and high at the same time?

• 38:13Speaker 02

  You can, you can definitely have that. You can have diabetes, which is an autoimmune disease.

• 38:18Dr. Mark Hyman?

  Type one diabetes?

• 38:19Speaker 02

  Type one diabetes.

• 38:20Dr. Mark Hyman?

  Vitiligo, right?

• 38:21Speaker 02

  Vitiligo is a common one.

• 38:23Dr. Mark Hyman?

  In your skin.

• 38:24Speaker 02

  Yep.

• 38:25Dr. Mark Hyman?

  Anemia. And autoimmune things like arthritis, rheumatoid arthritis, lupus, right?

• 38:31Speaker 02

  Yep.

• 38:31Dr. Mark Hyman?

  And then, and then, and then what's interesting is also celiac disease. So.

• 38:35Speaker 02

  There's a, well, there's a link between celiac disease because gluten is a huge trigger for autoimmunity, particularly creating antibodies against the thyroid.

• 38:43Dr. Mark Hyman?

  Okay, so, so, so that's a kind of a good overview of the prevalence of it, what the symptoms are, what the complications are.

• 38:53Dr. Mark Hyman?

  And you sort of, it's not, it's often not that hard to diagnose. When people are that sick, you can kind of tell. But it's subtle sometimes. What tests do doctors do to find out traditionally whether you have it?

• 39:05Speaker 02

  Yeah, so.

• 39:07Dr. Mark Hyman?

  And we're going to get to what are the tests we do in functional medicine that are quite different.

• 39:10Speaker 02

  So yeah, so the traditional test that you how you find it is looking first at your thyroid function. So you're going to be looking at somebody. The key thing is is the clinical symptoms, right? It's not always tests is people come in and they have symptoms. Then you have to start to use your your medical, you know, cognition and everything you know about medicine to figure out. Okay, what do I think is going on? Well, once you realize what the symptoms are, then you start to understand, you know, this is the thyroid. So you're going to look at the thyroid and you're looking at what we call the TSH, which is a thyroid stimulating hormone. And if that's really, really low, that means that you're the thyroid is is producing way too much thyroid hormone. And it's and your your pituitary gland is being suppressed.

• 39:54Speaker 02

  So it doesn't make enough of this thyroid stimulating hormone. Just let me just back up for a second. Your pituitary gland drives your thyroid.

• 40:05Dr. Mark Hyman?

  Yeah.

• 40:06Speaker 02

  And it sends a signal to the thyroid. It's called a thyroid stimulating hormone. So your thyroid.

• 40:12Dr. Mark Hyman?

  TSH.

• 40:13Speaker 02

  Yeah, TSH. And so your thyroid is sort of lazy. And so it has to be reminded to work. So the pituitary's responsibility is to send out this signal all the time. So you're going to have this certain normal level of TSH reminding the thyroid to work. And as long as it's doing its job and nothing's impairing it from doing its job, then it's going to function great. And it's going to make thyroid hormone, T4 and T3. T4 and T3 go to the cells. Now, T3 is the active form of thyroid hormone. And inside the cell, T4 gets converted to T3. Then it goes into the nucleus where it causes the DNA to start to transcribe and make enzymes and proteins and upregulate metabolism.

• 40:57Speaker 02

  And that's exactly what it's supposed to do. Now, if you don't make enough thyroid hormone, then you're going to experience hypothyroidism and a slowdown of your metabolism. And if you make too much, you're going to have a uptick in your metabolism and everything that goes along with that, and that's called hyperthyroidism. So, what happens is

• 41:18Dr. Mark Hyman?

  And we have the test.

• 41:19Speaker 02

  So the test, so that when we go for the test, the TSH is going to be suppressed if the thyroid is making too much. The pituitary is going to

• 41:28Dr. Mark Hyman?

  So the feedback system tells your

• 41:29Speaker 02

  The FSA shut off, and then the other It's a negative feedback loop.

• 41:32Dr. Mark Hyman?

  The other hormones go up.

• 41:33Speaker 02

  Yep.

• 41:33Dr. Mark Hyman?

  But there's also antibodies we check, right?

• 41:35Speaker 02

  Right. So now we're going to, so once you realize they have hyperthyroidism, then you want to check for antibodies. And the, the main one you check for is thyroid-stimulating hormone receptor antibodies. And if those are positive, it's 99% sensitivity and specificity for Graves' disease. That's the main test.

• 41:53Dr. Mark Hyman?

  And there's also a radioactive iodine test, right?

• 41:55Speaker 02

  Yeah. So after, after you do that, you can do a radioactive uptake to see if the person has maybe some other reason for having that hyperthyroidism, which can be an adenoma or multi, multi-nodular toxic goiter.

• 42:09Dr. Mark Hyman?

  And so what, what are doctors, once people are diagnosed with this, what are the treatments? Because it seems like they haven't really changed much since

• 42:17Speaker 02

  No.

• 42:17Dr. Mark Hyman?

  40 years since I graduated medical school.

• 42:19Speaker 02

  Yeah, they haven't changed much, and they're pretty harsh. And, you know, one, you know, so there's, there's methimazole, which is basically a thyroid peroxidase enzyme inhibitor. Thyroid peroxidase is the enzyme that the thyroid uses to, to bind iodine together to make thyroid hormone. And so it blocks that. And so you just reduce the production. Methimazole can have some, you know, significant, and poly, polythyrosol, PTU, particularly can have some, you know, very impactful side effects.

• 42:53Dr. Mark Hyman?

  Side effects.

• 42:53Speaker 02

  Like, you know, hepatic toxicity. So, and you're going to be on them for 18 months, up to 18 months to get into remission. And so they're not, they're not really, they can be harsh and they can have lots of adverse reactions. And a lot of, the, the, most of the people that I see in your Ultra Wellness Center, they come to me with Graves. I don't have to make a diagnosis. They come. And the reason why they come is they don't want to be on methimazole. And they don't want to have, you know, iodine, the, the next therapy is

• 43:21Dr. Mark Hyman?

  Yeah.

• 43:21Speaker 02

  You know, radioactive iodine destruction of the thyroid.

• 43:24Dr. Mark Hyman?

  Basically nukes your thyroid gland.

• 43:26Speaker 02

  Yeah, basically nukes. So you're gonna get, you're gonna get, you know, I, I-131, which is iodine tagged with, you know, a radioactive molecule. And when that, it's iodine, so now this radioactive material gets absorbed into the thyroid that's gonna, wants to use it iodine. But then that radioactive material breaks down to xenon and xenon destroys the thyroid or parts of it and reduces the production of thyroid hormone. Again, pretty harsh. You're, you're radioactive. And you're, you know, you're, you're, you're not, you know, you can't breastfeed, you can't, you can't be around kids, you can't,

• 44:02Dr. Mark Hyman?

  For a while.

• 44:03Speaker 02

  You can't touch people, yeah, you know.

• 44:04Dr. Mark Hyman?

  Not your whole life.

• 44:04Speaker 02

  It can be up to two weeks, you know, of the treatment. And then finally they just take the thyroid out.

• 44:09Dr. Mark Hyman?

  So basically like nuke it, take it out or poison it?

• 44:13Speaker 02

  Yeah, poison it, nuke it or rip it out.

• 44:14Dr. Mark Hyman?

  Okay. Well, I mean, sometimes that's necessary just to deal with symptoms or people can use beta blockers if their heart's racing and so on.

• 44:20Speaker 02

  Which is perfectly fine.

• 44:22Dr. Mark Hyman?

  But, but the question is, how do we deal with this in functional medicine that's different? And at Ultra Wellness Center, how do we think about this condition?

• 44:28Speaker 02

  This gets into the testing we do in functional medicine. So one of the first tests I do is a stool analysis. And that stool analysis is not only gonna tell me about the balance of good bacteria, which are your commensals and your bad bacteria. I always say that those are the, those are the bacteria that realize that poop's a great party, great place to live, and they come and hang out, but. They may not do anything for you unless you have a really bad diet. You're under too much stress. You're not taking care of your gut microbiome. You're eating processed foods and sugars. You're eating lots of GMO foods that have lots of glyphosate on them and your microbiome is disordered.

• 45:08Speaker 02

  Now, all of a sudden, those hanger-oners are now gonna just, they're just gonna multiply and they're gonna push your good bacteria out. And when that happens, then the good bacteria can't modulate your immune system, can't help you, doesn't make the compounds that you need. As we know, 70 to 90% of your serotonin is actually made by bacteria in your gut. So you need to rebalance that. So we're really careful about doing that. We want to know not only that balance, but how's your digestive system working? One of the things that allows the gut microbiome to go into this disorder is you're not making enough gastric acids. You're under too much stress.

• 45:53Speaker 02

  When you're under stress, then your fight, flight response takes over and suddenly you don't want to have an appetite when you're running away from the bear. So your appetite goes down, you start making less gastric acid. And when you're under chronic stress, this chronic loss of gastric acid allows bacteria and parasites and viruses to get into your intestinal tract where they can wreak havoc.

• 46:18Dr. Mark Hyman?

  That's another reason to worry about stress is more parasites, right?

• 46:21Speaker 02

  More parasites. It's another, another.

• 46:23Dr. Mark Hyman?

  So.

• 46:23Speaker 02

  Yeah, well, stress brings it all on. So we really, we really work on the gut.

• 46:28Dr. Mark Hyman?

  Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts and follow me on all social media channels at Dr. Mark Hyman and we'll see you next time on The Doctor's Pharmacy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes and lots more. And now you can have access to all of this information by signing up for my free Mark's Picks newsletter at drhyman.com/marks picks. I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey and I hope they'll help you too. Again, that's drhyman.com/marks picks. Thank you again and we'll see you next time on The Doctor's Pharmacy.

• 47:16Dr. Mark Hyman?

  This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland Clinic and Function Health, where I'm the Chief Medical Officer. This podcast represents my opinions and my guests' opinions, and neither myself nor the podcast endorse the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com. If you're looking for a functional medicine practitioner near you, you can visit ifm.org and search "find a practitioner" database.

• 48:00Dr. Mark Hyman?

  It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible. 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

• 48:44Dr. Mark Hyman?

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