Brain-First or Gut-First? Rethinking Parkinson’s Disease w/ Drs. Ray Dorsey & Michael Okun

Today we tackle Parkinson’s as a preventable epidemic—not an inevitable fate. I’m joined on The Dr. Hyman Show by two of the field’s top neurologists, Drs. Ray Dorsey and Michael Okun, co-authors of The Parkinson’s Plan, to unpack why cases are exploding and what we can do about it right now. We look at how toxins drive disease, why Parkinson’s goes far beyond dopamine, and the early signs most people miss—plus what you can do today to protect your brain. And we connect the dots between environmental exposures—whether from food, water, or even recreational spaces—and the growing burden of neurological disease. Watch the full conversation here or listen wherever you get your podcasts. [YOUTUBE THUMBNAIL] We also explore: • How to spot early signs—like loss of smell—long before a diagnosis • Everyday ways to cut toxin exposures in your food, water, and home • Why Parkinson’s is a whole-body disease, and what that means for prevention • The kind of exercise that protects your brain and slows progression • Simple nutrient checks that can support medication and brain health Parkinson’s isn’t inevitable. Protecting brain health starts with small daily choices. These are steps you can take right now for yourself and your loved ones. With awareness and action, you can build resilience today and help shape a healthier future. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by BON CHARGE, PerfectAmino, Function Health, Timeline, Big Bold Health and Pique. Head to boncharge.com and use code DRMARK for 15% off your order. Go to bodyhealth.com and use code HYMAN20 for 20% off your first order. Join today at FunctionHealth.com/Mark and use code HYMAN100 to get $100 toward your membership. Support essential mitochondrial health and save 20% on Mitopure. Visit timeline.com/drhyman to get 20% off today. Get 20% off HTB Immune Energy Chews at bigboldhealth.com and use code DRMARK20. Receive 20% off FOR LIFE + a free Starter Kit with a rechargeable frother and glass beaker at Piquelife com/Hyman.

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

• 0:00Dr. Mark Hyman?

  Adjusted for age, the rise of Parkinson's disease is going up 60%, far faster than Alzheimer's disease.

• 0:04Speaker 01

  It turns out by 2035, we should have 12 million people with Parkinson's. There's a big myth about Parkinson's, and the myth is, is that it's just a brain disease. This is a whole body disease. We have to start thinking about Parkinson's in a different way.

• 0:18Dr. Mark Hyman?

  Ray Dorsey, M.D., M.B.A., is a leading neurologist and Parkinson's expert. He's the director of the Center for the Brain and the Environment at Atria Health and Research Institute. He's a professor of neurology at the University of Rochester. Michael Okun, M.D., is a distinguished professor of neurology at the University of Florida, and he's co-founder of the Norman Fixel Institute for Neurologic Diseases and medical advisor for the Parkinson's Foundation. Both have been recognized by the White House as champions for change for their dedication to advancing research, care, and advocacy for people living with Parkinson's disease.

• 0:50Speaker 01

  There are all these symptoms that are non-movement and actually appear early, and they call them prodromal features. Constipation, acting out your dreams, loss of smell in your nose, those olfactory nerves, gut dysfunction and changes, and even some of the neuropsychiatric things.

• 1:06Dr. Mark Hyman?

  For all those golfers out there, is it a risk for people? Should they be worried? Should they stop golfing? What do they do to protect themselves?

• 1:12Speaker 02

  Individuals who live within one mile of a golf course had a 126% increased risk of developing Parkinson's disease compared to individuals who lived six or more miles apart.

• 1:22Dr. Mark Hyman?

  Oh, my.

• 1:23Speaker 02

  Do you know where else they find these toxins? You find them in the breast milk of nursing women.

• 1:26Speaker 01

  And it's all preventable.

• 1:27Dr. Mark Hyman?

  Okay, you've got someone to walk in your office with Parkinson's disease. What do you do?

• 1:36Dr. Mark Hyman?

  All right, Ray, Michael, welcome to the Dr. Hyman Show. So good to have you.

• 1:40Speaker 02

  Thank you very much for having us, Mark. Great to be here.

• 1:42Speaker 01

  Amazing to be here.

• 1:43Dr. Mark Hyman?

  You both have come all the way from Florida and New York to Austin, Texas, to talk about your new book, The Parkinson's Plan: A New Path to Prevention and Treatment. As a functional medicine physician, doing this for over 30 years, I was like, finally, there's these straight-up neurologists from top academic centers who get it. They get that we are living in a sea of toxins, environmental toxins, everything from heavy metals to pesticides to plastics, and the list goes on, that are impacting our health in real ways, and that we have to confront and face as a society, and that the... Canary in the Coal Mine, which is another sort of the coal mine where they put the canary in it and if it dies, you know, the air is bad and the coal miners have to get out.

• 2:29Dr. Mark Hyman?

  The canary in the coal mine here is Parkinson's disease, which is what your book's about. For those of you don't know what Parkinson's disease is, I want to let you explain that. But essentially, it's a movement disorder where you get really slow and shuffly and you talk soft and it's just like a, it's a very debilitating disease that happens as people get older, but it's happening in younger and younger people because we're living in a increasingly toxic world that's impacting our health and not just across Parkinson's, but across everything from autism to Alzheimer's to cancer to diabetes to autoimmune diseases. I mean, the whole shebang, you guys are both neurologists, but as a, what I call myself is a, not a subspecialist or a super specialist, but as a super generalist, I know a lot about

• 3:12Dr. Mark Hyman?

  it, a lot of things and not like, not as much as I like on many things, but I go, I go pretty broad because I see the patterns and connections between things. And so what really got me excited was that, you know, finally there's, there's two neurologists who were talking about how to think about this particular disease, Parkinson's, in a different way and also pointing out that what, what a dramatic increase we've seen in the incidence of this disease. It's always been around, but you know, why all of a sudden is it skyrocketing? Most people think, oh, it's genetics and most diseases are genetic, but the truth is, and Eric Burden said this, who's been on the podcast, that 93% of disease, chronic illness is not genetic. It's, it's, it's basically the environment influencing our gene expression where we

• 3:56Dr. Mark Hyman?

  might have predispositions, but we're not predestined to the problem. Also, what was really interesting, literature to me and Parkinson's, it was one, it's one of the few diseases that I, I've always said, uh, you know, throughout my 30 years of talking, that even traditional healthcare and doctors and neurologists understand that, that toxins are a major risk factor for Parkinson's. If you're a farmer, that's the most dangerous occupation on the planet, not because of injury from factory farm equipment, but from the toxins that they are exposed to. So why, why don't? So do I. I guess start with Ray Michael, just sort of talking to me about, you know, Parkinson's.

• 4:36Dr. Mark Hyman?

  What is it? Give us a little background on the biology of it and then the increasing incidence of it. And what you think are the major reasons why we're seeing this is increasing, dramatic increasing incidents. It's like orders of magnitude. It's not just like a 10 or 20% increase.

• 4:53Speaker 02

  Parkinson's, the first major description of the disease was by Dr. James Parkinson in 1817 in London.

• 4:57Dr. Mark Hyman?

  Yeah. Why do these guys name diseases after Alzheimer, Mr. Alzheimer's, Dr. Alzheimer's?

• 5:01Speaker 02

  He didn't name it after himself. He called the shaking palsy. Other guy, the father of modern neurology named after him. He didn't have an ego. So he's 61. He's a surgeon, actually, and he's actually even a geologist. And he sees something new on the streets of London, something so new that at 61, he bothers to write a case series. He basically writes his case series on six people, five, at least five of whom are men. They're all older and they have tremor, which has long since been described, but they have this stoop posture, this hunched posture and this tendency to walk faster and faster and to fall forward. And he said in 1817, this has not been described in medical literature.

• 5:39Dr. Mark Hyman?

  Really?

• 5:39Speaker 02

  This is 1817. So in 1817, Dr. Parkinson says that Parkinson's, disease that became known as Parkinson's, has not been described in medical literature. Ergo, I'm describing something new.

• 5:49Dr. Mark Hyman?

  And this was the beginning of the industrial revolution.

• 5:50Speaker 02

  And it's the industrial revolution. And where is it? It's in London.

• 5:53Dr. Mark Hyman?

  Yeah.

• 5:54Speaker 02

  And air quality in 1800 London is equivalent to what is in Delhi, India today. It's equivalent to what was over in New York City with the Canadian wildfires. Remember two or three summers ago?

• 6:05Dr. Mark Hyman?

  Yeah.

• 6:05Speaker 02

  The skies turned orange. That was every day, 1800 London.

• 6:09Dr. Mark Hyman?

  Yeah.

• 6:10Speaker 02

  So I think Dr. Parkinson is describing the effects of chronic exposure to high levels of air pollution. And so Parkinson's, we think as a

• 6:19Dr. Mark Hyman?

  And by the way, it was coal.

• 6:20Speaker 02

  Coal.

• 6:21Dr. Mark Hyman?

  Because coal was what they used to heat and do industry with, and that's full of mercury and lead.

• 6:26Speaker 02

  Exactly. And so we look in the brains of people with Parkinson's, they have high levels of heavy metal. And so when you look at smog in LA, for example, you're seeing little pieces of dirt and soot that are suspended in the air. The fancy term is particulate matter. Most of them we cough out or sneeze out, but some are so small, less than one thirtieth the width of our hair, they penetrate the nerve that hangs down, the responsible for smell that hangs down in our nasal passages. And hitchhiking on those pieces of dirt and soot are toxic metals.

• 6:54Dr. Mark Hyman?

  Wow. So it's a superhighway from your nose to your brain.

• 6:57Speaker 02

  Exactly. It's the front door to your brain.

• 6:59Dr. Mark Hyman?

  Wow.

• 6:59Speaker 02

  And it's the blood brain barrier you remember from medical school, right? Doesn't let, let things in.

• 7:03Dr. Mark Hyman?

  Well, kinda it does.

• 7:04Speaker 02

  Well, but it kinda does, but this.

• 7:06Speaker 01

  It's a little leaky.

• 7:07Speaker 02

  But this, this is the front door. This is, doesn't go through the blood brain barrier. It's just going through the olfactory nerve, this nerve response or smell that's hanging it. And it's hitchhiking are these metals, lead from gasoline, iron from brakes, platinum from catalytic converters. And so people with Parkinson's and Alzheimer's both have high, high levels of metals in their brain. No one's really been able to explain why, but I think one of the reasons why is air pollution, which is one of the toxins that are inhaled that lead to Parkinson's.

• 7:33Dr. Mark Hyman?

  Yeah, we're exposed to, I mean, listen, we're exposed to mercury in the fish we eat, lettuce, you know, in their food. And, you know, if you eat a lot of kale, it's grown in urban environments, it just picks up all the lead. You know, what, what, what you said was so interesting to me about the leaky brain. Because, you know, when I was in, in sort of my early years of practicing, we were talking about a leaky gut. And I used to get laughed at all the time by traditional doctors because they're like, oh, that's nonsense. It's just, you know, you're quacking. For a long time, I've also basically been saying that there's a leaky brain. Well, you, Michael, you, you sort of just sort of brought this attention because I think people don't really understand what that is. I mean, leaky gut is when the barrier breaks down and food and poop leak in and affect

• 8:17Dr. Mark Hyman?

  your immune system and then start to cause all kinds of havoc. You know, and, and as you mentioned, Michael, Michael, that you basically have this barrier, this blood brain barrier, but it becomes permeable. And then all of a sudden, things get in from the outside. So it's not like a, like completely impenetrable barrier. And I think we're seeing increasingly things that cause a leaky brain, like stress and many other things like toxins. So maybe you could talk a little bit about this leaky brain phenomenon because it's really how the toxins get into the brain that are causing all these problems. When you do biopsies and you're finding toxins and heavy metals in the brains, like what's happening?

• 8:54Speaker 02

  Yeah. And you're absolutely, you know, spot on when you talk about leaky gut too. And it turns out the gut is also a, a pathway, you know, where you can hitchhike in and potentially cause Parkinson's as well. And we talk about now, brain first.

• 9:09Speaker 01

  Parkinson and gut first Parkinson and and so this leakiness, you know, this permeability to, you know, to stress and and other factors that can get across is really important. So if you think about the brain as having like a force field, if you're a Star Wars fan, you know, it's kind of got like a force field. And we've always kind of taught all the medical students, we've taught everybody in medicine that this is this impenetrable

• 9:33Dr. Mark Hyman?

  That's right.

• 9:34Speaker 01

  Nothing's gonna get through this force field area. It's actually not correct. Not only is it not right, but as we develop, you know, treatments and as we develop, you know, different, you know, therapies, we're actually able to defeat the blood brain barrier is what we call it, or the BBB. We're able to defeat that. And and it's so super important for us to remember that things can get through it. We can use that for therapeutics. We can also need to be thinking about that for cause and getting to the root cause of Parkinson. And one other thing I do

• 10:07Dr. Mark Hyman?

  And even treatment.

• 10:08Speaker 01

  And even treatment. But one other thing I just wanted to bring into the discussion and and I'm so glad that you mentioned the gut is there's a big myth about Parkinson. And the myth is, is that it's just a brain disease.

• 10:18Dr. Mark Hyman?

  Yeah.

• 10:19Speaker 01

  It's a whole body disease, Mark. And and and we see it in the gut, you know, we see the proteins in the gut. We see it in the skin. We see it in multiple systems. And so we

• 10:29Dr. Mark Hyman?

  Proteins that are expressed in the body in Parkinson.

• 10:32Speaker 01

  Absolutely. And so And misfolded. Yeah, and misfolded. I mean, we have twice the risk of malignant skin cancer, you know, melanoma and Parkinson disease, twice the risk of osteoporosis and Parkinson disease. This is a whole body disease. And as we think about it, and I love, you know, kind of how you describe yourself as someone that that, you know, thinks of everyone, thinks of the whole, we have to start thinking about Parkinson in a different way. It's not just a brain disease, and it's not just the disease of dopamine. There are certainly multiple circuits in the brain. And then, you know, this barrier that we, you know, have, you know, invested so much in and all of our textbooks, we've got to rewrite those.

• 11:10Dr. Mark Hyman?

  Essentially, what you're saying is the ankle bones connected to the shin bones connected, the knee bones, the hip bone, everything's connected. And we can't separate out the body into these organs and Or I mean, it's it's such an unfortunate problem we have now because as we're beginning to understand the body as a network or as a system, network biology, you know, traditional medicines organized according to parts like geography, whereas in your body is your head, is your stomach, is your joint, is your knee, like whatever. So you've got all these specialists that are specialized in their organ. But if you start to read across specialties, you see there's these common themes that are like inflammation, mitochondrial dysfunction, oxidative stress, the microbiome involvement, the misfolded proteins, things like all these things you're talking about aren't just about neurology, they're about everything. And so, so that's why, you know, you can start to really

• 11:55Dr. Mark Hyman?

  help people by understanding how these systems.

• 11:56Speaker 01

  And we miss it, Mark, like, so we miss the point and, and, and we miss the diagnosis and we miss the treatments and we miss the approaches because no one takes a step back. Everybody's doing their super, you know, specialists and Ray and I are completely guilty, you know, we're guilty of a lot of things, Mark, but we're definitely guilty of being super specialists, right? On top of, you know, neurology, which is already a specialty, then we have a subspecialty of Parkinson and basal ganglia and all these crazy brain circuits, right? And so we have to step back, create navigators for people that are, you know, suffering and, and, you know, dealing with these symptoms and help to think of this as a whole body disease.

• 12:35Dr. Mark Hyman?

  It really is. And, and, you know, we were chit chatting before, and I mentioned this paper I read, like, I don't know, 20 years ago, it was in Jem, I think. And I forget the exact title, but it was essentially explaining how Parkinson, the biology of Parkinson's disease and what happens. And, you know, one of the key things we talked about in functional medicine is the mitochondria, which is our energy system, how we take food and oxygen and combust it in our cells and through a very series of steps, we actually can produce ATP or energy that runs the body. And, and ultimately, and the end result of what's happening, and you can explain this probably better than I can, is there's mitochondrial damage, particularly in the area of the brain,

• 13:16Dr. Mark Hyman?

  we call the basal ganglia, that, that is responsible for movement. So this is a movement disorder. Tell us about the, the increasing incidence of this and why we're seeing so much more. It's not just the prevalence. Which will grow as the population grows, but the actual incidents of how many new cases per per population is actually happening and and why we're seeing this accelerate over the last 50 years.

• 13:39Speaker 02

  Yeah. So when Dr. Parkinson described, he described six people in 1817 with the disease. 2017, the global burden of disease study estimates 6 million people have the disease. How do you go from six to 6 million in 200 years? Aging alone doesn't explain it. Adjusted for age, the rise of Parkinson's disease is going up 60%. Far faster than Alzheimer's disease, 60% adjusted for.

• 14:00Speaker 01

  Which is shocking, right?

• 14:02Dr. Mark Hyman?

  Yeah.

• 14:02Speaker 01

  Did you just say faster than Alzheimer's?

• 14:03Dr. Mark Hyman?

  And Alzheimer's is very, very fast.

• 14:06Speaker 02

  It can't be genetics because our genes, you know, don't change, generally speaking, for just 200 years. So it has to be in our environment. And if you look at a map of the world, areas of the world that are most industrialized, like the US and Canada, have the highest rates of the disease. Areas of the world that are least industrialized, like Saharan Africa, adjusted for age, have the lowest rates of the disease and areas of the world undergoing the most rapid industrialization and pollution. India and China have the fastest increasing rates of the disease. And so these chemicals, the ones that are implicated in Parkinson's disease are all mitochondrial toxicants. Means that they damage the energy producing parts of cells. You know that the brain is only 2% of our body weight, but 30% of our energy consumption is going to the brain. And nerve cells are the chief drivers of that. 75% of energy demands are from nerve cells or neurons.

• 14:52Speaker 02

  And so these toxicants, whether it's air pollution, whether it's dry cleaning chemicals, if you can believe it, whether it's pesticides, they all damage the energy producing parts of the cell. Some of them we inhale, some we ingest, some Parkinson's disease begins in the nose. Some Parkinson's disease begins in the gut, right? So when Parkinson described the condition, he thought it began in the brain. So I'm describing a brain disease, it must begin in the brain. Actually, Parkinson's disease, Per Borgheim, one of our colleagues in Denmark, says that there are two forms of Parkinson's. One that's brain or nose first, pathology beginning in the nose. And one that's body or gut first, pathology beginning in the gut.

• 15:30Dr. Mark Hyman?

  Yeah, interesting.

• 15:32Speaker 02

  And so these toxikins, I said to him, I emailed him, I read all his papers, I print them out on my Sunday evening and Sunday afternoon, I just read them all.

• 15:39Dr. Mark Hyman?

  I thought I was in there.

• 15:41Speaker 02

  And I'm like, holy cow. And I emailed him, I said, well, how's this fit with like chemicals that we eat or swallow or ingest?

• 15:48Dr. Mark Hyman?

  Yeah.

• 15:49Speaker 02

  Leading to a gut first form of the disease and chemicals that we inhale. He was skeptical at first, but we wrote a paper called the body, the brain, the environment and Parkinson's disease, arguing that Parkinson's that begins in the gut is due to chemicals that you ingest, like well water that's contaminated with pesticides. Chemicals that you inhale leads to a nose first, chemicals that you breathe in, like if you live near a golf course, for example, might be breathing in the chemicals.

• 16:13Dr. Mark Hyman?

  Yeah.

• 16:13Speaker 02

  Or air pollution will lead to a nose first form of the disease.

• 16:25Dr. Mark Hyman?

  What you're talking about is, is, is just, is such an important concept here around the, the load of toxins in the gut. Yes, we eat toxins from pesticides and chemicals and ingesting all this stuff, but I think it's more than that. And I read a paper years ago where there was a 400%, a fourfold increase in Parkinson's and those people are constipated. And I don't want to scare you if you're constipated, you can fix that with magnesium and probiotics and I've written a lot about that, but like, that's a really interesting phenomenon. And the, and the, the, I don't know if you're aware of this phenomenon, but in the metabolic health, there's something called metabolic endotoxemia,

• 17:03Dr. Mark Hyman?

  which means in English that there's a bad bacteria in your gut that release toxins. We call them LPSs or lipopolysaccharides, which are like little endotoxins or little poisons produced by these bacteria that we absorb across a leaky gut that interact with their immune system and cause inflammation. Which then leads to insulin resistance, which leads to weight gain, lenses and diabetes. So I'm sure this metabolic endotoxemia also could be affecting the brain, not just because you're ingesting toxins, but the microbiome itself is so messed up because of our lack of fiber and polyphenols and probiotics and the use of antibiotics and so on.

• 17:45Speaker 01

  So this gets back, right, Mark, to this whole thesis of like Parkinson is a whole body disease. You're making the argument for us and, and you know, it's really, you know, interesting, you know, so for almost 20 years, I've been the medical director advisor for the Parkinson's Foundation in addition to being a professor at University of Florida. And, and when early on, when we started to look at websites and, you know, you and I and Ray were old enough to remember the early days where you get an analytic and you're like, oh my gosh, all these people are actually clicking, you know, on these things. Well, we actually used that, you know, in the early days to see what people were interested in searching on the, on the Parkinson's Foundation website. And guess what kept coming up? Number one?

• 18:27Dr. Mark Hyman?

  Constipation.

• 18:27Speaker 01

  Constipation. You got it, Mark. I mean, it's just sort of like, my gosh. And, and so fast forward now, you know, so, so, you know, a couple of decades ago, Ray and I, and I'm always the skeptic of the two. I work a lot in a, in a, in more of a, a science laboratory setting and developing devices and things. And so, so, you know, fast forward a couple of decades, you know, ago, if you said to somebody Parkinson's, you know, could be set off by a toxicant or an environment or whatever, people would say, you're crazy, right? And now as we've learned more and more, we learn about, hey, do you know what? Parkinson's actually sets up many years in advance of when you see, you mentioned

• 19:07Speaker 01

  movement disorder, but there are all these symptoms that are non-movement that actually, you know, appear early and they call them prodromal features.

• 19:16Dr. Mark Hyman?

  Just like pre-diabetes, but pre-Parkinson's.

• 19:18Speaker 01

  Ah, exactly. You know, it was spot on. And so, so these are things like, and what are they? Constipation.

• 19:25Speaker 01

  Acting out your dreams, loss of smell. You talk about the hitchhiker, you know, and the, you know, in your, in your nose, there was olfactory nerves, you know, gut dysfunction and changes and even some of the neuropsychiatric things. So when you see middle aged men now, there's a study in Parkinson's showing middle aged men in their 50s suddenly start to get anxious, right? They've not been anxious before. That's, you know, they may be the beginning of developing Parkinson's symptoms. This is a whole body issue that's, that's going on. And so, so I think it's important to, to keep those perspectives, but there's nothing crazy about constipation, Parkinson and how it ties in.

• 20:03Dr. Mark Hyman?

  Well, it may, it may be both a cause and an effect, right?

• 20:05Speaker 01

  Yeah.

• 20:05Dr. Mark Hyman?

  It's like, you know.

• 20:07Speaker 02

  So exactly. So I think it's actually an effect of the toxins. So we mentioned that the toxin can be ingested, right? And so you know, the enteric nervous system, which controls the gut motility.

• 20:18Dr. Mark Hyman?

  That's the gut brain.

• 20:19Speaker 02

  The gut brain. And then the highway that connects the gut to the brain is the

• 20:23Dr. Mark Hyman?

  vagus nerve.

• 20:23Speaker 02

  vagus nerve.

• 20:24Dr. Mark Hyman?

  How am I doing, doc?

• 20:25Speaker 01

  We're doing good. We're doing good.

• 20:27Speaker 02

  Fantastic. So in 2003, in 2003, a German pathologist, really smart guy, Heiko Brock, says Parkinson's disease, the pathology does not begin in the brain. He said Parkinson's, which you consider a brain disease, it does not begin in the brain. He says, I first see it, the pathology and the olfactory bulb smells in the brain or in the dorsal motor nucleus of the vagus nerve. So he says the pathology of Parkinson's begins in the gut and it a sends up like this misfolded protein, like a fall of dominoes. This misfolded protein spreads from one nerve cell to another and goes from the gut up the vagus nerve and then up from the vagus nerve to higher parts of the brain that are responsible for sleep, for controlling

• 21:08Speaker 02

  our blood pressure. And then only later to the part of the brain, the basal ganglia that you were talking about earlier, that constipation is actually probably one is a is a sign that the pathology is affecting, for example, the vagus nerve and we're getting reduced gut motility.

• 21:23Dr. Mark Hyman?

  Is it over, overactive sympathetic activity?

• 21:25Speaker 02

  Well, it's the damage to the, to the, to the parasympathetic thing.

• 21:29Dr. Mark Hyman?

  So the parasympathetic, so they got over inbound. So it's inbound.

• 21:32Speaker 02

  For those listening, you've got the, the fight or fight response and the real

• 21:35Dr. Mark Hyman?

  Relaxation response, the sympathetic nervous system, the parasympathetic nervous system. And what you're talking about here is the parasympathetic nerve that keeps you calm and relaxed. That's why anxiety increases actually stops working as well. And you get a relative increase in the sympathetic nervous system, which then when you're running from a tiger, you don't want to be pooping. So your gut shuts down and a whole bunch of other bad stuff happens, right?

• 21:56Speaker 02

  You got it.

• 21:57Dr. Mark Hyman?

  I personally am waiting till I'm like 90 or 100 to start golfing because it's kind of slow for me. But I play tennis and you know, they live seven years longer. But anyway, for all those golfers out there, no criticism. There's a tremendous amount of toxins sprayed to keep those golf courses looking so great. Is it a risk for people? Should they be worried? Should they stop golfing? What do they do to protect themselves? For sure. Don't lick your golf balls, which I know people do to clean them. Tell us, like, if you're a golfer, WTF?

• 22:26Speaker 02

  So Dr. Brittany Krisonowski is a geographer. She's at the Barrow Neurological Institute and she worked with her colleague, Dr. Rodolfo Savica, one of our colleagues at Parkinson's, especially at the Mayo Clinic in Rochester, Minnesota. And she was concerned about the effects of living near a golf course because golf courses use huge amounts of pesticides.

• 22:44Dr. Mark Hyman?

  And a lot of people live on these golf course communities.

• 22:46Speaker 02

  And a lot of people live on these golf course communities. So she looked at Rochester, Minnesota, which does a very good job of measuring new cases of Parkinson's disease. And she found that individuals who lived within one mile of a golf course had a 126% increased risk of developing Parkinson's disease compared to individuals who lived six or more miles apart.

• 23:05Dr. Mark Hyman?

  Oh my.

• 23:06Speaker 02

  So why? And so she spends a lot of time in her paper discussing water supply. And so we talked a little bit about how pesticides can get into the water. For example, people who drink well water, not really by the Safe Drinking Water Act, prone to contamination from nearby farms and rural areas.

• 23:22Dr. Mark Hyman?

  Run off, seeps into the ground, yeah.

• 23:23Speaker 02

  Have a higher risk of developing Parkinson's disease. So she's focused on that. I worry a little bit about the pesticides that are sprayed into the air. There was a small little report in the Annals of Neurology that two neurologists found that 18 of their patients lived near a golf course and 15 of the 18 lived downwind of the golf course. So I worry about pesticides being sprayed on golf courses or on fields and people living downwind and inhaling them. We talked about how many individuals, most individuals perhaps, Parkinson's disease begins in the nose. So I worry about nerve toxins being inhaled into the nose. So what to do? Um, one, well, listen.

• 24:06Speaker 01

  Pickleball, pickleball.

• 24:07Speaker 02

  Uh, you know, why can't we ask golf courses?

• 24:10Dr. Mark Hyman?

  Pickleball is one of those dangerous sports, you know, that so many people who are out of shape.

• 24:13Speaker 01

  Listen, that's a whole other discussion.

• 24:14Dr. Mark Hyman?

  Are filling the emergency rooms with pickleball.

• 24:16Speaker 01

  I have a whole pickleball for Parkinson talk so we can talk about to keep people safe on the.

• 24:21Dr. Mark Hyman?

  Okay, back to the golf, back to the golf.

• 24:23Speaker 02

  Golf, so, uh, ask the golf course what pesticides they use, see if they can use less toxic pesticides, right? Can they use less? Can they tell you when they're spraying, right? So you can take interventions, especially if you have Parkinson's, maybe, you know, get out of town when they're spraying. You can close your windows, you can get an air purifier, these are all things.

• 24:43Dr. Mark Hyman?

  Like an air-conditioned golf cart?

• 24:44Speaker 02

  Well, you know.

• 24:46Dr. Mark Hyman?

  And don't drink the water from the court.

• 24:47Speaker 02

  And it's, and it turns out not just living near, uh, a golf course has been an increased risk. Three different studies have found green space workers, including landscapers, to be at higher risk for Parkinson's. And one study, uh, found that green space workers are higher risk for ALS, Lou Gehrig's disease. So there are lots of clues of what's causing these brain diseases, whether it's Parkinson's, Alzheimer's, or ALS. Lots of clues telling us that this is a preventable disease and lots of clues saying that if we pay attention to our environment, like Rachel Carson said we should.

• 25:17Dr. Mark Hyman?

  But realistically, like, right, can, can people really, like, reduce their exposure if they're out on a golf course for 18 holes?

• 25:24Speaker 02

  Well.

• 25:25Dr. Mark Hyman?

  Like, i- isn't it just in there, they're gonna be walking on it, it's on their shoes, it's on their clothes, it's like.

• 25:31Speaker 02

  I'm like you, I'm not a golfer, but I can't imagine that golf courses couldn't be using 50% less pesticides. There are organic golf courses.

• 25:38Dr. Mark Hyman?

  There are, actually.

• 25:38Speaker 02

  In Martha's Vineyard, they have organic golf courses. If we have organic wine, we have organic produce, if we have organic cheese and dairy products and meats, why can't we have organic golf courses? Why can't we enjoy a nice sport without having to worry about getting a parking?

• 25:53Dr. Mark Hyman?

  Maybe we'll get President Trump on this, regenerative golf.

• 25:56Speaker 01

  But practically speaking, you, you have a right to know, so ask the course, when do they spray the pesticides, right? Maybe you don't want to play right after they've sprayed the pesticides, watch the water that's there, get a carbon filter, maybe bring your own water, and when you're smoking, for those of you that smoke, I'm not saying you should smoke. When you smoke your stogie and your cigar, don't put it on the ground, like, while you're, you're, you're gonna hit the ball and then pick it right back up, because you're gonna put pesticide in your mouth.

• 26:20Dr. Mark Hyman?

  Thank you, thank you. That was a good answer to a hard question, which. Still feels like a bit scary to think about golfing. But anyway, for those of you golfers out there, just take care of yourself, get your liver working and reduce as much exposure as you can. I mean, this is just such a great conversation because I think I I'm like honestly pinching myself because I feel like, you know, I wrote, I wrote this book, you know, how to fix your broken brain by fixing your body first. And here you guys are neurologists starting to talk about these things. And usually neurologists pay no attention to anything but a little neck, you know, which is just dumb. Guilty. It's just dumb.

• 26:56Dr. Mark Hyman?

  And and and now it's like, you know, you can't ignore the science anymore. And here you are, two of the most esteemed neurologists in the world, who've written collectively, I don't know, a thousand papers and many books and have led organizations and advised governments and done everything. And here you are going, holy crap, you know, maybe we're living in a stew of toxins. And that's a big factor. So let's talk a little bit about the biology. And then I want to go into the toxin story and how you kind of came up with this because that is important to understand that there's, there's fundamental biological processes that occur in the body that are common to most diseases. And where it hits you depends, I

• 27:37Dr. Mark Hyman?

  think, on your genetics and who knows what we still don't understand. But like the phenomena of, you know, mitochondria, and you mentioned, you know, the brain has a lot of them, every cell in the mitochondria has, has, sorry, in the brain has more mitochondria than any other cell. The heart cell is next. So even more than your heart, your brain has more mitochondria. And they're very sensitive little creatures. They're like little bacteria that we kind of co-evolved with. They kind of hitchhike in our cells, produce energy for us, and we can make them have a home and it all works out. And biotic, really? Yeah. And the problem is that they're very sensitive to insults. So from your microbiome, from toxins, from stress, from, you know, inflammation, from food, from infections, from, I mean, why do you feel like when you had the flu or COVID, like you can't move

• 28:20Dr. Mark Hyman?

  when you're tired and you have brain fog? Because your mitochondria are being poisoned, right? But this chronic low level toxicity is something that is not been really accepted by traditional medicine. It's like, oh, you got acute poisoning, you come to the ER. You know, we'll give you something to fix that. But most traditional physicians just dismiss the idea that that low level toxins are an issue or that there's anything you can do about those. Can you talk about how you kind of first discovered this? And a little bit about the sort of the insights that led you to realize that this is really the big problem.

• 28:54Speaker 02

  Michael, I were both very, very traditional academic neurologists. And you know, I went to the oldest medical school in the country and you know, we're not told a lot about toxins. We're told a little bit about lead, we're told a little bit about asbestos, we're told a little bit about mercury, we're told a little bit about smoking, which we'll get to in a second. But we weren't taught to generalize this beyond the specific disease.

• 29:14Dr. Mark Hyman?

  And only acute.

• 29:15Speaker 02

  And only acute.

• 29:16Dr. Mark Hyman?

  And not related to any chronic illness. So if you're poisoned, you're poisoned.

• 29:19Speaker 02

  Talk about asbestos and mess with the leoma and stuff like that. But you know, it was, it was, it was narrow.

• 29:23Dr. Mark Hyman?

  Yeah.

• 29:24Speaker 02

  Uh, so I had the gift of a sabbatical. I'm an academic, I was an academic. So I had the gift of a sabbatical about eight years ago, and I devoted it to reading the papers of one of my colleagues, Dr. Caroline Tanner, who's a neurologist and an epidemiologist, who's now at UC San Francisco. And for 40 years, she's been quietly diligently telling us that chemicals in our environment are fueling the rise of Parkinson's disease, whether that's air pollution, whether that's pesticides, whether it's a dry cleaning chemical called trichloroethylene. She's been telling us that these chemicals are causing it. So I'll give you an example of chronic exposure to a toxicant. Lung smoking and lung cancer. So in 1900 United States, there is almost no lung cancer.

• 30:06Speaker 02

  Lung cancer, the leading cause of cancer death in the United States and around the world simply just did not exist in 1909 States. It was, it was so odd, it was considered a once in a lifetime oddity. All the doctors and medical students would gather around when they saw a case, thinking they'd never see a case again.

• 30:20Dr. Mark Hyman?

  And heart attacks and diabetes.

• 30:23Speaker 02

  Right. These diseases just didn't exist. And it wasn't until cigarettes that 25 years after the introduction of cigarettes, you got a corresponding rise in lung cancer. United States, we stopped smoking, decreased smoking in 1970s, 25 years later corresponding. So the challenge with these diseases is that it's not an acute exposure and you get the disease, that's much easier to identify, right? You take too much acetaminophen and you get liver toxicity, you know, it's a lot easier to make that relationship with smoking lung cancer, which wasn't, connection really wasn't made until 1950s, because there was a 25 year lag between the exposure. And now we're seeing the same thing with Parkinson's. You don't get exposed to the pesticides as a farmer and develop Parkinson's the next day, next year, next decade. It could be 25

• 31:04Speaker 02

  years later, 30 years later. They did a study at Camp Lejeune, which is the marine base in North Carolina, containing with this dry cleaning chemical. The Marines were exposed at age 20 to the chemical in their drinking water.

• 31:17Dr. Mark Hyman?

  Dry cleaning like from their uniforms?

• 31:20Speaker 02

  Yeah, so there was a, there was a, Marines needed to dry clean their uniforms. There was a dry cleaning base, ABC Dry Cleaners on the base that inappropriately disposed of their dry cleaning chemicals got into the drinking water for the Marines at Camp Lejeune. The Marines even knew about it in the later years, but for 25 years, a million Marines, their family and civilians were exposed to a cancer-causing chemical in their water that's since been linked to Parkinson's. Dr. Tanner and her colleague, Dr. Goldman, looked at the Marines-

• 31:49Dr. Mark Hyman?

  What was that chemical?

• 31:50Speaker 02

  Trichloroethylene, TCE.

• 31:52Dr. Mark Hyman?

  Yeah, you wrote a paper about that.

• 31:53Speaker 02

  And they looked at the Marines who were 20 years old when they were exposed. They were only there for 25 months, right? If you're a Marine, you move from base to base. Yet 34 years later, 34 years later, they had a 70% higher rate of developing Parkinson's disease. So exposure to toxins when you're young, some of them were teenagers, when you're young, sets the stage for developing a neurodegenerative disease 34 years later.

• 32:19Dr. Mark Hyman?

  So true. I mean, I was sharing this story before. I had a patient early on, which sort of clued me into a lot of this stuff, who was about 50. And that's pretty young to get Parkinson's. And she came in with Parkinson's. And I took her history and, you know, in, in, in functional medicine, and we do, we start like with what did your mother eat? And what was her, like, in utero environment like? And like, what was your first year like? And we go through the whole thing. And she was like, yeah, I lived in the Bronx and we were very poor. And I, you know, we were, we lived in this cockroach-infested apartment and the cockroaches would crawl across me at night and freak me out. And so when I married and, you know, had a little more means, that we moved to Long Island and I just had the exterminator

• 32:59Dr. Mark Hyman?

  come every week, inside and outside. And by the way, I have a barrel of Lindane- Which is a banned pesticide. That is so bad. I was like, this is, this is a big deal. And then, you know, you start hearing of farmers are the most dangerous occupation, start to kind of start to dig in and you see what's going on. But I've also had patients who, who are exposed to other things that, that can like mold, which can be a toxin or, or even tick infections, you know, which you wouldn't think, but do contribute. So it's a whole host of things together. And I think, you know, we talked about the effect of, of toxins on your neurology, but I mean, Rachel Carson talked about it on, on fertility. There's a book called Our Stolen Future I read again,

• 33:45Dr. Mark Hyman?

  two or plus decades ago.

• 33:47Speaker 02

  Shawna Swan wrote a book Falling Down.

• 33:49Dr. Mark Hyman?

  You know, Colburn about, about the, the effect on our reproductive health and the change in fertility rates and, you know, I mean, it's, it's, I just did a, a whole,

• 34:00Dr. Mark Hyman?

  talk with a Stanford urology professor about the declining rates of male fertility and what are we doing about it? And then it's all, it's affecting everything. So tell us about the most common toxins that you've found or associated with them. Where do we get them? And how do we start to think about like avoiding them and dealing with this?

• 34:16Speaker 02

  There's a pesticide called chlorpyrifos that used to be found on over half of apples, the United States, widely used on golf courses, utility pools. Turned out that chlorpyrifos was used to, to kill insects in apartments in New York City. And this amazing scientist, Virginia Rau at Columbia University, uh, looked at the children of women born, uh, who were, were in the homes that were sprayed with this pesticide. She finds that pesticide in the umbilical cord blood of the children in whose moms were sprayed, the homes were sprayed with this chlorpyrifos. The higher the level of the pesticide in the umbilical cord blood, the lower the IQ at three, five and seven.

• 34:57Dr. Mark Hyman?

  Yeah.

• 34:58Speaker 02

  And then two weeks ago, she follows them out to six to 12 and she does MRIs. And they have structural brain abnormalities and they have slowed motor function. In the lab.

• 35:08Dr. Mark Hyman?

  And these are developmental issues that kids experience as a result of being exposed to these cockroach pesticides in, that are used commonly in the homes.

• 35:15Speaker 02

  In New York City. They're no longer allowed. And then she also found in addition to having structural brain abnormalities on their brains as early as six years old, they have slow motor function. In the lab, that pesticide damages the dopamine producing nerve cells that are lost in Parkinson's.

• 35:31Dr. Mark Hyman?

  Which is the basal ganglion cells, right?

• 35:33Speaker 02

  Yeah, so pesticides as a whole is one is the certain pesticides have the most robust evidence for their role in Parkinson's disease.

• 35:40Speaker 01

  One of the Parkinson 25, Mark, we talk about is don't poison yourself. It seems like a like a no brainer, no pun intended, but you know, don't poison yourself.

• 35:49Dr. Mark Hyman?

  Hard though, I mean, we, we, you know, I'm on the board of the Environmental Working Group, which is a great organization that has done a tremendous job to catalog, identify all of our exposures across food, across household cleaning products, skincare products, you know, meat, fish, vegetables, and it really provides a very good guide on it's evidence based on how to reduce your exposures, filter your water, air purifier, we can talk about all this stuff. You know, what's really sort of concerning is that these, these toxins, you know, are found everywhere. The average newborn has 287 toxins in their umbilical cord blood. This was a study done by the Environmental Working Group.

• 36:32Dr. Mark Hyman?

  They took 10 newborn babies and they were like, there was like stuff like DDT that's been banned or dioxin that's been banned, which is Agent Orange.

• 36:41Speaker 01

  Which is really bad for Parkinson, those two, by the way. Wow.

• 36:44Dr. Mark Hyman?

  So the toxic exposures are pretty ubiquitous and it's hard to get rid of. And there was a big study that was done of the children of farm workers in California and they collectively lost 41 million IQ points. This is just exactly what you're saying.

• 36:58Speaker 02

  Exactly. And some of these toxins are so small that they cross the placenta, right? And they go into the child and some are fat soluble. So you know, your brain's covered in fat. Do you know where else they find these toxins? They find them in the breast milk of nursing women.

• 37:11Dr. Mark Hyman?

  You know, I, I know that and it makes me so sad. And, you know, I'm not a designer and engineer, but if there's any geniuses out there and want to design a good breast milk filter, that would be a huge boon to humanity because breastfeeding is still the most important thing you do to keep your kid healthy and. You know, you're there. I mean, we're already born pre polluted, right? So the question is then, you know, it's the degree, the amount, and you can, if you take a good history, you can actually really find out what people's exposures are, right?

• 37:44Speaker 02

  And it's all preventable, right? This is all, this is what your book, right? Forever, this is all preventable. We need not have DDT. We no longer have DDT. We got rid of lead and gasoline. But we, we made progress. We lead levels today, right, are 95% lower in kids than when you and I were children. Kids are smarter because we got lead in gasoline and lead out of paint.

• 38:05Dr. Mark Hyman?

  Yeah.

• 38:05Speaker 02

  And the world did not spin off its axis, right? The air quality in Los Angeles today is 50% better than it was in the 1960s, when Governor Ronald Reagan said we should eliminate all unnecessary driving because you couldn't see across the street, just like you were talking about China. That was 1960s Los Angeles. We fixed our ozone hole because we got rid of CFCs. If we get rid of these chemicals, we get rid of a lot of autism. We get a lot, rid of a lot of ALS. We get rid of a lot of Alzheimer's disease and we get rid of a lot of Parkinson's disease. The central thrust of the book is that Parkinson's disease is largely a preventable disease, is a product of the industrial revolution and chemicals in our food, water and air. We get rid of these chemicals in our food, water and air. We get rid of Parkinson's. We create a world like 1817 or 1717,

• 38:48Speaker 02

  when there is no Parkinson's disease or it's extraordinarily rare.

• 38:51Dr. Mark Hyman?

  I only have one word to say to that. Amen. It is, it is a, a, a big lift because the, in the industrialization of the world and the amount of chemicals we use, we all benefit from. And, and it's really tough to start thinking about how, how do you re-industrialize to remove those? How do we reduce our exposures? I don't remember, um, it was a world fair. I was living in Queens in 1965 when they had the world's fair and I went to it actually, because I lived in Queens and, and, um, and they had DuPont up there and they were like, better living through chemistry and all these Teflon and all these things like the PFAS chemicals. I just did, I just did my function health testing, which is a company I co-founded.

• 39:33Dr. Mark Hyman?

  And one of the things we offer is PFAS for forever chemical testing and phenol A testing and heavy metal testing. And it's hard to test toxins because they're fat soluble. But it's amazing how polluted I am. And I'm like, I'm a guy who tries to be careful. You know, like in glyphosate levels and I mean, I eat out and what can you do? Like, it's just, it's, it's really tough. So. And there's a reason one in 31 children have autism. There's a reason that more young adults are getting colon cancer, right? When we were in medical school, I mean, no one got colon cancer unless you had a rare genetic cause. No one got colon cancer before 50, right? Uh, why do one in eight women get breast cancer? Why do one in eight, one in 10 men get prostate cancer?

• 40:12Speaker 01

  Diseases have causes. And why is it not uncommon to see young people with Parkinson's? You said, young people with Parkinson's, maybe that's rare when you were describing the person they met. Not so rare. You know, we're, we're seeing lots of young cases. And in fact, you know, it does increase as you age, you know, over time. But we see people in their teens, twenties, thirties, forties, certainly gets more common the longer you live. But, um, but this is something that another myth that should be busted for people that this isn't just a disease of, uh, of, I don't like to say older. I say more seasoned. This isn't just a disease of more seasoned people.

• 40:45Dr. Mark Hyman?

  What you're both saying is, is, is just so important. And Ray, what you just said, uh, I want to just double click on because you kind of went over really fast. Diseases have causes. Now you would think in medicine that that's what we pay attention to. But unfortunately it's not. What we pay attention to is what I call the name it blame it attainment game. We name the disease by saying, here's the symptoms, here's the science, here's the lab test, here's the imaging results that explain that you have this pathology. So we, we're focused on the symptoms and the pathology, we can see in the microscope, but not on the cause or the mechanism. And so by understanding the mechanisms and the causes, you can really do something.

• 41:28Dr. Mark Hyman?

  The other thing I was struck with Ray, you said, the, the brilliant thing you said was. Cancer, you know, autism, Alzheimer's, and the list could go on. Autoimmune diseases. Now these toxins are called autogens, obesogens. These are toxins that cause obesity, toxins that cause autoimmune disease, toxins that cause neurologic disease, toxins that cause cancer. So even heart disease. But unfortunately, if we're really being honest with ourselves, if this is true, and it's clearly increasingly true, the evidence is just mounting every day about the role of toxins across all diseases, what do we do about it? Other than reducing our exposure. So I'm going to talk about that. And I want to talk about like medically, what can we do? Therapeutically, what can we do? And again, it may not be your guys' expertise is what I've been doing for years,

• 42:10Dr. Mark Hyman?

  but we can kind of jam on it a little bit, but I'd love to hear your perspective on this.

• 42:14Speaker 01

  You know, I'll just say first, for people that are listening, they should know that we should be embarrassed that we spend just two cents out of every dollar on prevention, right? And so it shouldn't be a, a big surprise that we haven't done the trials. We haven't done the, the research and we haven't looked upstream. And so the L, so the P in the Parkinson's plan is about prevent. The L is learning why we got to look upstream, right? And I just want to go back just for a moment and something that you said that resonated. And we had done an interview in the book and we talked to Buzz Jena at Emory and Matt LaVoy at University of Florida. And, and, you know, talking about how, you know, one of the goals here should be the Zen-ness of the cells in your brain, right?

• 42:59Speaker 01

  And we call it Zen-ness.

• 43:01Dr. Mark Hyman?

  Like Z E N?

• 43:02Speaker 01

  Z E N. And we call it the Zen-ness.

• 43:03Dr. Mark Hyman?

  Like a Zen Buddhist.

• 43:04Speaker 01

  Yeah. Because, you know, again, you think about, okay, so it's in, in scientific terms, we say homeostasis, right? Right. But it, but it, you know, for, for purposes of talking to a population, we're talking about houses and our cells, right? And so you have, you know, a group of circuits and a group of cells that are in the brain and it's like a thermostat. And what happens in your house when your thermostat goes out, you know?

• 43:28Dr. Mark Hyman?

  It's too hot or too.

• 43:28Speaker 01

  Exactly. And then, and then you end up with, you know, real problems. And when you do that over prolonged periods of time, that's an issue. And so when we talk about both the prevention of Parkinson's, but also the treatment of Parkinson's. Zen is an important word. So we talk about, you know, you want to keep your cells zen. And we know that when it comes to to toxicants, we know that they tend to go to the mitochondria and other areas in the brain. We know that the brain has to get rid of things, right? It has, it's like a garbage disposal, right? And that's normal. It has, actually, there are cells that, that, you know, that have to eat themselves, right? You know, in order to stay healthy.

• 44:05Speaker 02

  Autophagy, right?

• 44:06Speaker 01

  Autophagy. So, you know, so it's really important. And then we discovered a system in the brain we didn't even know existed.

• 44:13Speaker 02

  The glymphatics.

• 44:13Speaker 01

  The glymphatics, man, you're, we're, we're like a mad lib. Now we understand how important these things are. And then you start to say, ask yourself, okay, we gotta know why, learn why. So we gotta look upstream, right? We gotta understand, why does a disease start? Why does it spread, right? Why does it progress, right? Those are key elements so that you're not looking downstream. You talked about the canary in the coal mine, everything. We, we need to understand those things. And actually, that's why prevention is so important.

• 44:42Speaker 02

  Yeah.

• 44:42Speaker 01

  And so important for us to think about, because we're thinking as far upstream as we can. And we also need to shift our science at the same time, to be thinking more upstream and to be thinking. So when we talk about a few pennies on every dollar, we're also, you know, need to shift our basic science, you know, to be thinking about these systems and the systems that are in place early on. When you look at a toxin and you say, okay, everybody's listening here, let's, we got the toxin. You know, I've been the medical director advisor for the Parkinson Foundation. Mark, just get rid of the toxin, right? Just get rid of it, right? Well, there's an acute exposure, right? Toxins, right? It's an acute exposure and a chronic exposure over time. And then you take something like Paraquat, which has been in the news a lot, like a pesticide that's sprayed.

• 45:26Speaker 01

  And, and by the way, you know, it doubled in use in the United States here.

• 45:30Speaker 02

  Weed killer that sprayed on corn, cotton, soybean fields and.

• 45:34Speaker 01

  Yeah. And it doubles in use. So, and, and it's banned in 32 countries or over 30 countries, you know? Yeah. And, and Great Britain ships it to us, but they won't give it to their own people, you know? I mean, so you look at known toxins like this, well, it's, it's a challenge, right? Because Paraquat gets into the system quickly. And it goes quickly to the mitochondria, it goes quickly to these systems and it clears quickly and it hits your lungs, it hits your brain, it hits all of these things, hard to measure, right, hard to get rid of. So we knew, we're gonna need primary prevention to just step up and get rid of that. Whereas when we

• 46:07Dr. Mark Hyman?

  Well, this is a political problem, right? This is an EPA problem.

• 46:10Speaker 01

  So the prevention isn't a, it isn't gonna be a pill, it's gonna be a policy. Prevention is gonna be policy, not a pill, right?

• 46:17Dr. Mark Hyman?

  I love that. Prevention is going to be policy, not a pill, a hundred percent.

• 46:29Dr. Mark Hyman?

  And sadly, and I was so involved in advising on some of the, the, the science around the Maha Commission report, which got very mangled unfortunately, but

• 46:40Speaker 01

  We're hoping you're gonna fix that.

• 46:41Dr. Mark Hyman?

  The lack of, of attention to detail and the speed at which it was done, I mean, a lot of the links were all messed up. But that, the, the basic framework and content was right. And one of the things that had produced was like forty or fifty pages on the role of toxins in health. And it got removed down to just a paragraph, basically saying, well, pesticides may be an issue, glyphosate may be an issue, but the science really doesn't show it yet. So we don't really know. So forget about it. And, and that was like so disappointing to me because there were a whole bunch of scientists that worked on this project that actually documented this.

• 47:18Speaker 01

  For generations, for their lives.

• 47:20Dr. Mark Hyman?

  So it, it's really, you know, we've got the, the agricultural industrial complex, which is a real thing, that even the government is actually supporting indirectly through crop insurance and subsidies, which then are used to buy the agrochemicals that then are used to spray, that then are used to, you know, help the crops and help the farmers, but ultimately hurt them. And I think hurt the farmers most and hurt their families and then the rest of us downstream. You know, we have, we have to kind of go from field of fork on this. We have to go from, you know, factory to our closet and to wherever we have to figure this out. And it's, it's not gonna be easy, but the problem is that there's, there's such a dearth of research, really on, on funding this. There's also, I think, a Real lack of research on what to do once you have the toxins.

• 48:05Dr. Mark Hyman?

  And this is, this is an area that's sort of been on the margins of medicine. I want to get into it in a minute with you because it's like you can go to the environmental working group and you can kind of read their stuff and get a pretty good sense of, okay, here's the vegetables I never want to eat if they're not organic. Here's the fish I never want to eat unless, you know, like unless it's ever like, I'm not going to eat shark. I'm not going to eat swordfish. We're all like cesspools and the question that becomes is you can do all these things and it will reduce your exposures. You don't drink out of plastic bottles, filter your water, have an air filter, eat organic when you can, you know? These are all things that you can do, have better skincare products, household products. That, that's, that's easy. The hard part is, okay, you've got someone to walk in your office with Parkinson's disease, who's been exposed to chemicals, exposed to heavy metals. What do you do?

• 48:49Speaker 02

  Um, so first of all, we're all cesspools and we're all victims, right?

• 48:53Dr. Mark Hyman?

  Yeah, I'm not saying you're wrong.

• 48:54Speaker 02

  Yeah, yeah. No, but some people take it, take it the wrong way. I know you don't, but like, we're all victims, right? These are unnecessary. These are involuntary.

• 49:02Dr. Mark Hyman?

  Yeah.

• 49:03Speaker 02

  Right? These are involuntary.

• 49:04Dr. Mark Hyman?

  If you're drinking like a six pack of soda every day, you know what you're doing.

• 49:07Speaker 02

  Yeah.

• 49:07Dr. Mark Hyman?

  But like here, we're just.

• 49:08Speaker 02

  The Marines at Camp Lejeune didn't know that they were drinking personagen and the burn pits and the, and Asian orange. And the list goes on and on. And people who work with these drying cleaning chemicals likely don't know, many of the farmers don't know that the pesticides are linked to Parkinson's. The vast majority don't. Um, so the first thing that you do is stop getting exposed. Um, so, uh, if you are a smoker and you get diagnosed with lung cancer, what's the first thing the doctor's going to tell you to do?

• 49:32Dr. Mark Hyman?

  Stop smoking.

• 49:33Speaker 02

  Stop smoking. But if you're a farmer and you're coming with Parkinson's.

• 49:36Dr. Mark Hyman?

  Farming.

• 49:37Speaker 02

  I mean, like, do we even?

• 49:39Dr. Mark Hyman?

  I have a patient with ALS who's a farmer and he, you know, it's, it's heartbreaking because it's one of those, again, one of those neurological diseases caused by toxins.

• 49:45Speaker 02

  Sometimes you find it early enough, you know, and we could maybe stop it.

• 49:48Dr. Mark Hyman?

  Yeah, no, I stopped it and reversed it with him.

• 49:50Speaker 02

  Um, so there are ways that we can do this. So if you're working with Parkinson, if you have Parkinson's, we give you in, in the book, the Parkinson's 25, 25 actions that can reduce your risk. If you don't have the disease, if you're one of 330 million Americans who don't have the disease, we give you 25 actions to reduce your risk of ever getting Parkinson's disease, ever getting it. If you're not exposed to these chemicals, you are highly unlikely to ever develop Parkinson's disease. And if you already have the disease, they might slow the rate of progression. So I'll give you an actual concrete example. They looked at people who already had Parkinson's disease and they looked at people who lived in highly polluted areas of the country and those who lived in low polluted areas. People who lived in highly polluted areas had an increased risk of being hospitalized due to their Parkinson's disease if they lived in areas of the, with high air pollution.

• 50:34Speaker 01

  Yeah.

• 50:34Speaker 02

  So you got an air purifier in the corner, we can get an air purifier when you're driving through.

• 50:38Speaker 01

  I brought that in there just for you guys.

• 50:39Speaker 02

  When you're, when you're driving through Lincoln Tunnel, you know, roll up your window.

• 50:43Speaker 01

  Yeah, put the recirculation on.

• 50:44Speaker 02

  Exactly, recirculate the air. If you happen to live near, uh, fields that are being sprayed with pesticides, you know, close your windows. I mean, there are lots and lots of things that we, we can.

• 50:53Speaker 01

  I hold my breath while I fill up my gas tank. I literally like hold my breath for, I like.

• 50:58Speaker 02

  And, and, but we need to create a world where we don't have to take all these actions. So what are things that we can do in our community? Can we stop spraying pesticides on kids, schools and playgrounds?

• 51:07Speaker 01

  That would be a good idea.

• 51:08Speaker 02

  Right? And we wonder why one in 31 children get autism, yet we spray nerve toxins on their schools and playgrounds.

• 51:14Speaker 01

  What did TX actually said when you heard of the theory of evolution? How stupid not to have thought of that.

• 51:19Speaker 02

  So there are lots of things in, in our communities that we can do. And what are some of these societal actions that we need to do? And I'll let you talk about additional ways to address it.

• 51:28Speaker 01

  Well, also the other thing is, is that if you.

• 51:30Speaker 02

  Awareness is important.

• 51:31Speaker 01

  Yeah, if you're a smoker, you know, what's the first thing you do? You know, if you got lung cancer or whatever? Stop smoking, right? So, so, so, you know, this idea that, you know, you, you, once you have the disease, okay? Or once you have the diagnosis that you stop, you know, with these things is sort of another myth that needs to be busted. You know, it is the way that you live. You even talked about some of the people that you see within the functional medicine, you know, um, you know, in that paradigm, you're thinking about how can we help people to live better, right?

• 52:04Speaker 02

  Yeah.

• 52:05Speaker 01

  So the global burden of disease study, you told us something.

• 52:08Speaker 02

  Just for those who don't know, that's like 195 countries, a study of chronic illnesses all across the world. It was a large epidemiological study, one of the best ever done. And it gave us a lot of information about who's suffering from what, where. So just so people, just so people know what it is.

• 52:21Speaker 01

  Yeah, so a hundred percent. And so back in 2012, I had written this book, 2013 or something. I can't remember now, but, but they, we wrote a book called 10 Secrets to Happier Life with Parkinson and it kind of became this runaway bestseller. But it was like 10 simple things that you do, right? And in the prologue of the book, I made either the unfortunate or the fortunate choice of two words called the Parkinson pandemic. And came under a lot of scrutiny from, from colleagues and everything, and rightly so, right? I'm a scientist. I should be able to take.

• 52:49Dr. Mark Hyman?

  Turns out you were prescient.

• 52:50Speaker 01

  Well, you know, so I, you, you like, you have to put it forward. You have to, you know, these things need data. So then we write the book, ending Parkinson's disease in 2020. We have the first cut of that global burden of disease data. And guess what? Ray is better at math than me. He, he crunches all the numbers and it turns out by 2035, we should have 12 million people with Parkinson's, which is like, wow, growing faster than Alzheimer's.

• 53:13Dr. Mark Hyman?

  So like percentage wise, how much of an increase in that is like in 50 years?

• 53:17Speaker 01

  Oh, and well, and just in 1990, it's estimated that 2.8 million people have the disease. And I'll see a little Michael's punchline in 2021, they estimated that 11.8 million, a quadrupling, a quadrupling.

• 53:30Dr. Mark Hyman?

  Adjusted for population.

• 53:31Speaker 01

  So, and if you adjust for population growth, right? Population growth hasn't quadrupled between 1990 and 2001.

• 53:37Dr. Mark Hyman?

  Still two or three or plus times the amount, which is in just the last 30 years.

• 53:42Speaker 01

  After, after I graduated from medical school. Yeah. Right? Since your medical school. 12 million, Mark, in 2035. How many do you have today? 2025, 11.8, according to. You already got to 12 million, 15 years before we thought it was going to happen. And when you went to medical school, you know, Parkinson's was there, but it wasn't like everywhere.

• 54:02Dr. Mark Hyman?

  Oh, no, no. I mean, I've seen so many people with it.

• 54:04Speaker 01

  But now like anyone over 50, if you're over 50, you have friends, you have family members, you know, our inboxes are like, it doesn't stop. I walked the streets of New York and I'm like Parkinson's and when I see him, I get pissed off.

• 54:16Dr. Mark Hyman?

  Why?

• 54:17Speaker 01

  I, cause it's a terrible disease and I think it's largely preventable.

• 54:20Dr. Mark Hyman?

  Yeah.

• 54:20Speaker 01

  Right? Suffering is part of the human condition, right? You write about this, but preventable, needless suffering? Really?

• 54:27Dr. Mark Hyman?

  Yeah, I agree. I think that's, that's our goal. I mean, for me, my life goal is to prevent needless suffering because you know, we can't change everything. So just for the audience, what are the air, food and water things that they can do to reduce their exposures?

• 54:40Speaker 02

  So we give you the 25 recommendations in the book. I'm going to read you number one. Wash your produce, even your organic ones. Marking this better than we do. Pesticides have contaminated our food supply. Remnants of pesticides are found in 20% of common foods. Organic produce, dairy products and meat can reduce exposure, but can still have unsafe residues of pesticides. So wash your produce at least with water and consider simple vegetable washes vinegar or salt solutions too. When the government measures the pesticide residues on a piece of fruit, they do that after they've held it under cold water for 15 to 20 seconds. If that's what the government's doing, think about what you should do. I'll do the second one. I'll give the last one to Michael. Number

• 55:24Speaker 02

  nine, use a water filter. A simple carbon filter, water filter widely available in supermarkets can reduce exposure to pesticides, volatile organic chemicals like trichloroethylene and other chemicals that may be in your water. These carbon filters can be installed for the whole house at the point of entry or at the point of use, such as faucets or even water pitcher. My colleague at Atria Health and Research Institute, Robert Kaczko will tell you, reverse osmosis is even better. And I'll let Michael maybe take number 10.

• 55:55Speaker 01

  Yeah. So, you know,

• 55:56Dr. Mark Hyman?

  Yeah, I do reverse osmosis.

• 55:58Speaker 01

  In terms of your air, you know, number 10 is consider air purifiers. They're an easy, effective way to lower your risk of disease from indoor air pollution. Air purifiers do a range in cost. They can be as little as $10, as high as $1,000. I'm sure the one Mark has us breathing here has got to be the $1,000 one.

• 56:16Dr. Mark Hyman?

  No, it's not actually. It's a few hundred bucks.

• 56:18Speaker 01

  All right. 300 bucks. And require periodic cleanings. And remember, they need filter changes and may need to be installed in multiple places, depending on the size of the home, school or workplace. Be sure to use air purifiers that have carbon filters. They're designed to remove the volatile organic chemicals, VOCs, like trichloroethylene, which you all know from dry cleaning story and everything is so important in Parkinson.

• 56:42Dr. Mark Hyman?

  This is great. So these are simple things that people do every day. I have an air filter in my bedroom and in the place I spend the most time, I have a reverse osmosis water filter. You know, you know, I think. Those are the two most simple things you could do at home. Plus, go to ewg.org and make sure you clean out all your crappy household cleaning products and your skincare products, and you'll get like 80% of the way there.

• 57:04Speaker 01

  And a shout out to Ken Cook, the outstanding leader of the Environmental Working Group. He and his team are helping us understand what the role of these chemicals in our environment, in our health, and how to get rid of them.

• 57:14Dr. Mark Hyman?

  You know, we could talk about, you know, the role of toxins for a long time, but you know, we kind of covered a lot of the sources. But I kind of want to spend a little time on, on people who actually have Parkinson's and who are struggling. You know, there's been really shitty drug development in this disease. There is some really exciting new surgical interventions, the deep brain stimulation, you know, Dr. Machado at Cleveland Clinic, who I worked with, was one of the pioneers in this, a neurosurgeon. And I

• 57:42Speaker 01

  This guy's one of the pioneers right here.

• 57:44Dr. Mark Hyman?

  Yeah. You obviously read your work has been, has been very involved in this. And that's a huge boon. It's a, it's a big win. But it doesn't address the, it's just like a downstream sort of better mousetrap to fix the problem. But it's actually, we still have the mice. I would love to hear from your perspective from like a diet, lifestyle, supplement, detoxification, what you guys know. I would love to unpack what people can do. And can, can, in the answering of that, can you actually reverse it or stop it? Because right now, there's like clinical trials, for example, in Alzheimer's, like the finger trial, the pointer trial, Richard Isaacson's work, where they're showing not just slowing down of the disease, but actually reversing it with intensive lifestyle therapy

• 58:29Dr. Mark Hyman?

  and risk factor management. So do we see that in Parkinson's? Have you seen that in Parkinson's? You've guys like Del Bredesen, who people think maybe a little bit off the, off the rails, but honestly, he's not reversing Alzheimer's. I just talked to one of my patients two days ago, who I've been treating for two years, and she was diagnosed with Alzheimer's, and now she's better and back to work.

• 58:51Speaker 01

  Let's, let's unpack a little bit. And let's just start with sort of, you know, a few P's. So we need to change the way that we practice when we interact with folks with Parkinson's, you know, it needs To be practical, proactive and preventative. Okay, we need to be thinking of those three Ps when we're we're interacting. And I know.

• 59:12Dr. Mark Hyman?

  You might forget one personalized.

• 59:13Speaker 01

  And well, personal, we can keep going with Ps too. And but but but absolutely, although I will say, just, you know, like in general, you know how people make things a little too cliche. Sometimes people say personalized and that's going to cure everything. I say, well, what does that mean?

• 59:27Dr. Mark Hyman?

  Well, the reason I say that is is because if you have a diagnosis of Parkinson's, it doesn't mean you know what's really wrong with you. Like I always say, if you know the name of the disease, it doesn't mean you know what's wrong with you. You don't know the cause, you know, the name of the symptoms, which can have many causes.

• 59:42Speaker 01

  So Parkinson's disease, here's another myth. It's not Parkinson's disease, it's Parkinson's disease is.

• 59:47Dr. Mark Hyman?

  Yeah.

• 59:47Speaker 01

  Right? There are multiple causes, there are multiple syndromes.

• 59:50Dr. Mark Hyman?

  Yeah.

• 59:50Speaker 01

  No two people look alike. And I remember sitting next to Davis Finney in the White House, having a nice discussion with him. And, you know, he said, when you have Parkinson's, you got to make every day your best day. That always stuck with me. And and then and then when I made my comments, you know, I said, you know, I think Parkinson's is probably the most complex disease in clinical medicine. And and I just, I don't mean to insult other people in different diseases, but think about it. You know, you know, dozens and dozens of motor, tremor, stiffness, slowness, non-motor symptoms, anxiety, depression, constipation, sleep, cognition, right? So you've got all of those things, right? Plus, you've got this miracle drug, dopamine. You give people dopamine, they wake up, right? And then, of course, there are fluctuations later.

• 1:00:35Speaker 01

  Then you've got, you know, as you mentioned, deep brain stimulation, you've got dozens of different medications. Oh, and by the way, it changes over time, people wear off, they get these dance-like movements. It is a super complex disease. Okay. So when you take all of that, we need a different paradigm to care. And so unpacking the first part of your question is, we're doing it wrong, Mark. Like, we're caring for people wrong. So when we have HIV, we're able to create navigators, we're able to check people's viral levels. We're able to get people, listen to this, mind blowing for people. We can get really expensive cocktails of drugs for people all over the world. Have HIV.

• 1:01:14Dr. Mark Hyman?

  Aldopa for.

• 1:01:15Speaker 01

  And you can't get Aldopa pennies on the dollar. So we call for that as a bold action in the book. A hundred percent of people on this earth, on planet, if anybody's listening, you know, we need.

• 1:01:25Dr. Mark Hyman?

  And Aldopa is the drug that's the main safe for Parkinson's treatment that increases dopamine, which is what gets depleted in the brain when you have Parkinson's.

• 1:01:32Speaker 01

  And it's a game changer, right? And, uh, and so, so super important to think about that. And, and cancer, we do better in the way that we bring together the right teams. So, so thinking about this, we proposed, we used to say the person with the disease or the patient is the sun. And we revolve around the patient. I'm like the, the, uh, the broken record of saying this for 25 years at the institute I work at called the Fixcel. And, um, and now we've expanded that to be the Parkinson universe. And let me just explain that for people listening a little bit. So of course the person with disease is the sun and we should all orbit around them. But what's the closest planet to the sun? Mercury. Mercury is your caregiver. Gets a little hot being the caregiver on both sides because you're in between that and then all the other planets, which are all these different specialists.

• 1:02:17Speaker 01

  You might need, you know, a neurosurgeon, a neurologist, a psychiatrist. Mental health is huge in this disease and a problem throughout the world, not just in the United States. All the rehabilitation specialists, PTOT, speech swallow, et cetera. So you need all of these people orbiting at different areas. And then you've got Mercury, the caregiver in the middle, got to take care of the caregiver. Okay. More men than women get Parkinson's, but guess what? When a woman gets Parkinson's, they don't do as well as men. And the reason is the caregiver and the care partner. So we always should, we should be challenging men. I'm sorry, men, all the men that come to my clinic. I challenge all of you care better for your, you need to step up. The data says you need to step up. Okay.

• 1:03:00Speaker 01

  And then Pluto is the almost planet, that stigma, 25% of people hide their diagnosis with Parkinson disease. Unacceptable. So, so, and then, and then what else, Mark? So the stars are all the support groups, right? And then, and then the, the, all the satellites are the sensors. We have all these great sensors. I got some of them on. I think you've got sensors too and watches and rings and all these things, right? That can help us with sleep and exercise and making sure. We're doing all those things, bringing telemedicine. Ray is an absolute pioneer in bringing care to the home for Parkinson.

• 1:03:30Dr. Mark Hyman?

  Well, that was an interesting thing you said in your book, because, you know, it just annoys me to no end that, that, you know, you know, the body doesn't change when you move from New Jersey to New York or from California to Nevada, but your license does, and you can't treat a patient in another state, which is the most stupid thing. In Europe, if you're a doctor in any country, you can treat a doctor anywhere else. We uplifted those restrictions during COVID, and then we put them back again, and it's crazy.

• 1:03:54Speaker 02

  And who, and who loses?

• 1:03:56Dr. Mark Hyman?

  The medical boards.

• 1:03:57Speaker 02

  Yeah, but the patients lose, right?

• 1:04:00Dr. Mark Hyman?

  Patients lose, yeah. It's just a money grab, because every, every state has a licensing board, and they're all making millions.

• 1:04:04Speaker 01

  We should make it so that any patient, and any Medicare beneficiary, any patient can receive care from any clinician that they need to.

• 1:04:09Dr. Mark Hyman?

  Absolutely.

• 1:04:10Speaker 01

  So, thank you for saying that out loud. Like, sometimes we think it, but we don't say it. So, thank you for saying it out loud.

• 1:04:15Dr. Mark Hyman?

  I'm working on a telehealth bill also in Congress, so we're on that.

• 1:04:18Speaker 01

  So, maybe for the last, you know, two decades with Parkinson Foundation, we may have spent a lot of hours advocating, so that your, your care is defined by where your physician or healthcare provider is, not where the person with disease is. It's a very simple concept that we just can't seem to get. And then we did a red card campaign in our last book, Ending Parkinson. We, we actually took over the, the White House and sent thousands and thousands, like 20,000 plus cards. One of the things we called for was, was just this, watch out, the COVID restrictions on telemedicine were lifted. It's going to go away. Pay attention, we need that. And so it was one of the three things that we asked for.

• 1:05:00Dr. Mark Hyman?

  So, is there more? Because what you're talking about are sort of structural changes in the care delivery model.

• 1:05:06Speaker 01

  Yeah.

• 1:05:06Dr. Mark Hyman?

  What I'm really trying to get at here is, like, doctor-patient, like, what are the therapeutic interventions, other than just the social support and the structure and the care coordination? All the things you're talking about, which are really important. But like, I'm trying to get to the granular level of like, If someone's listening with Parkinson's or someone in their family has Parkinson's like, what do I do? Is there a way to slow this, stop it, reverse it?

• 1:05:29Speaker 01

  Yeah. So the practical, now you're to the P of practical, right? Let's get practical, right? No, that's good. All right. So, so we think about practical, right? And the, the practical advice now that we should be giving that most people don't is guess what? When you take dopamine, dopamine, the most common drug for, you know, for Parkinson, very important, still the best drug we have. Ray likes to say, what a travesty that here we are 50 years after and it's still our best drug in the armamentarium, right? It's, it's, that should be unacceptable too. But, but having said that, dopamine depletes cofactors in your blood. And so your vitamin B6 may go down, your homocysteine may go up, you know, other things that might put you at risk for dementia and other things. So guess what? From a very practical standpoint, you need to be on at least a general multivitamin.

• 1:06:14Speaker 01

  I call it like a Centrum equivalent because most people, I, I don't favor Centrum over any other company.

• 1:06:19Dr. Mark Hyman?

  Yeah, don't take the blue pill.

• 1:06:20Speaker 01

  Right. I'm not, I'm not that, but.

• 1:06:22Dr. Mark Hyman?

  You don't want to take pills with dyes in them and titanium and.

• 1:06:24Speaker 01

  So no question about that, but, but, but, but.

• 1:06:28Dr. Mark Hyman?

  You're just adding more shit.

• 1:06:29Speaker 01

  But, but fundamentally, thank you for saying that. Again, you get to say the things.

• 1:06:33Dr. Mark Hyman?

  Talking to the expert here, man.

• 1:06:34Speaker 01

  I know, I know. Mark gets to say things out loud that we can't. But from a practical standpoint, you send people to the shelf.

• 1:06:40Dr. Mark Hyman?

  Just text me, I'll say it.

• 1:06:41Speaker 01

  And say you want to look for a good multivitamin because, because this is going to be super important. Right? And then when you're going to your general doctor, you want to have them check vitamin levels on you. Your regular thing, they're checking, you know, we're so preventative in cardiology, Mark. Why are we not in neurology, right? It's ridiculous, right? Vitamin E levels are low, you know, in, in Parkinson, right? Vitamin D levels are low, right? And then it's a double edged sword with vitamin D because we are, we should be telling folks, it's twice the risk. Did you know that twice the risk of melanoma and Parkinson's disease? You sweat different, you smell different, you know, you, Joy Milne was the, the famous UK person who could smell Parkinson's disease. And then they said, you know, you, you talked about quack. They said she's a quack. They put her to the test. Sure enough, there's a smell.

• 1:07:26Dr. Mark Hyman?

  Yeah.

• 1:07:26Speaker 01

  So you sweat differently. Remember it's a full body disease. It's in the skin and everything and, and you're not as well. Protected against the sun. And so we need to tell people about that. And of course, practically speaking, you can get subarachnoid and other things with skin. Twice the risk of osteoporosis. Are you getting regular bone scans? You know, like, I know this sounds like so, and we wrote the book 10 secrets. You know, you think everybody knows this, but they don't, you know, two times the risk of that. So we need to pay attention to those things. And then in addition, as we're seeing folks kind of along the way. I know, and Ray may want to talk about this. We need to shift our discussions with them to to sort of include the why, you know, figuring out what is your real history?

• 1:08:06Speaker 01

  And I was kind of jealous when you said in functional medicine, we always start the visit with the person. And Ray and I have taken care of thousands of people with Parkinson's. We didn't always do this. You always start the visit from the beginning. You know, it's like, um, you know, Mel Brooks in History of the World, no, no, no, the beginning of time, right? You start from the beginning and you want to know what that story is. And I don't know if you want to comment on that.

• 1:08:27Speaker 02

  So I want to go to slow, stop and reverse. So can we slow it? Yes. Can we stop it or reverse it? No evidence that we can do that today, but let's talk about slow.

• 1:08:36Speaker 01

  I'll, I'll jump in on that.

• 1:08:38Speaker 02

  I know, we're gonna, we're gonna.

• 1:08:38Speaker 01

  It's anecdotal, but I always say it's anecdota. Okay. Anecdota.

• 1:08:43Speaker 02

  And so we're gonna, uh, so slow, we told you to 25 things, stop getting exposure toxin. We got that. Next one is exercise. So exercise is probably this century, the biggest therapeutic advance. Sir William Gowers, when he described Parkinson's in the late 1800s. He said the life of someone with Parkinson's should be quiet and restful. He was wrong.

• 1:09:02Speaker 01

  A hundred percent.

• 1:09:02Speaker 02

  If you have Parkinson's, you cannot be quiet and restful.

• 1:09:05Speaker 01

  Boxing thing is a real thing that works for a lot of my patients.

• 1:09:08Speaker 02

  Boxing, you should be knocking out Dr. Hyman in the ring with Rocksteady boxing.

• 1:09:12Speaker 01

  7,000 steps a day.

• 1:09:14Speaker 02

  Um, so we increasingly know that vigorous exercise, amount of exercise to make you sweat. Has enormous health benefits. And it turns out it doesn't appear to be which exercise, whether you like to box, non-contact boxing, not hitting people in the head. Whether you like to swim, whether you like to jog, it all beneficial.

• 1:09:31Speaker 01

  The pugilistic Parkinson's that my family had.

• 1:09:34Speaker 02

  You don't want that.

• 1:09:34Speaker 01

  And we talk about that too.

• 1:09:36Speaker 02

  Um, and so it turns out that exercise, as you know, releases brain growth factors in the brain. And Likely protects the remaining nerve cells and protects them from dying off. Our colleague, Dr. Boss Bloom, has even shown that, you know, you can see these changes on imaging. So now with imaging, you can actually see beneficial therapeutic effects of, uh, of exercise. And then Michael and I both have had patients who have won either not taken medicine for many years because they were just so prominent exercising two, three, four hours a day, that they've delayed their need for medicine. And we have had patients who've been able to come, who've decided to come off medications and just, uh, treat their Parkinson's disease with exercise and other behavioral factors.

• 1:10:17Speaker 01

  Although we don't recommend that in general.

• 1:10:19Speaker 02

  In general.

• 1:10:19Speaker 01

  But, but it, but it's something we have to have an open mind to.

• 1:10:21Speaker 02

  And you said, you know, anecdotes, we see this. So now you want to say stop and reverse. So you know what gets measured gets managed. What gets measured gets managed. And so we.

• 1:10:30Dr. Mark Hyman?

  And you got an MBA, so you know that. That's, uh, um, what's his name? Drucker?

• 1:10:35Speaker 02

  Uh, Peter Drucker.

• 1:10:36Dr. Mark Hyman?

  Yeah, Peter Drucker.

• 1:10:37Speaker 02

  And so cholesterol, we came to the age where cholesterol was starting to be measured. We only got statins and everything like that because we started measuring cholesterol. Hemoglobin A1C, right after we did our training that we're going to measure the glycolization of hemoglobin as a measure of diabetes. And we do that. But are we measuring, I have never in my entire life, I'm a neurologist. Many pesticides are nerve toxins. I have never measured a pesticide level.

• 1:11:04Dr. Mark Hyman?

  Oh, I can help you with that.

• 1:11:05Speaker 02

  Okay.

• 1:11:07Speaker 02

  But if we're not measuring pesticide levels in, in people's bodies, how can we manage and see if we're taking steps to reduce it? When we did that with lead, we measured lead in children. We got really, really serious about getting lead out of paint, lead out of gasoline.

• 1:11:21Dr. Mark Hyman?

  Problem is you need a fat biopsy to properly assess.

• 1:11:23Speaker 02

  Exactly.

• 1:11:24Dr. Mark Hyman?

  But there's other ways.

• 1:11:25Speaker 02

  And so there are fat biopsies. So if we start to measure these chemicals in our bodies, whether that's in our blood, our urine, our fat, our hair. Or stool, we can take better actions to be more informed. And if we can start measuring these chemicals in our environment, in our water, in our household dust, in our soil, in our air, you know, we have a thermostat in this room.

• 1:11:44Dr. Mark Hyman?

  Well, actually, there's actually body things you can now wear. They will register the, the PPMs or particulate matter in the air.

• 1:11:51Speaker 02

  So why don't we, why don't we have a thing that's measuring particulate matter in, in our air? Right? That's a more greater determination of our.

• 1:11:57Dr. Mark Hyman?

  Indoor air pollution is a big thing. Yeah.

• 1:11:59Speaker 02

  Greater determination of our health than the temperature. What gets measured gets managed. We need to start measuring these chemicals in our bodies. We need to start measuring these chemicals in our environment. So we can figure out what interventions, which you're going to talk about in a second, can reduce these things in our bodies, in our environment. So we can all live longer, healthier lives and perhaps low, maybe get to the point that we can stop.

• 1:12:18Dr. Mark Hyman?

  So even at, you know, you just said something like, you know, I never measured a pesticide. So in academic medicine, other than maybe checking your blood, mercury or lead, maybe our stuff like, doctors don't know what to do, don't know what labs to send things to, don't know how to test them. Right?

• 1:12:33Speaker 02

  They're not widely commercially available. You can't just chuck them off generally speaking on a lab format.

• 1:12:38Dr. Mark Hyman?

  I mean, increasingly now they are like.

• 1:12:39Speaker 02

  They are. So, you know, when we were in training, this would be like.

• 1:12:42Dr. Mark Hyman?

  But we need to start measuring these things.

• 1:12:44Speaker 02

  A hundred percent.

• 1:12:45Dr. Mark Hyman?

  The body has a embedded system for removal of toxins. Your, you know, sweat, your breath, your poop, your pee, your liver detox systems. You have enzymes. And I think, you know, as we're beginning to understand genetics, I think in we're now, we went from a billion dollars, I think it's now 300 bucks to get your whole genome sequence.

• 1:13:03Speaker 02

  Yeah.

• 1:13:04Dr. Mark Hyman?

  You know, you can actually start to see, oh, I have these detox pathways that may need a little help or my methylation pathways that help also with detox also need a little help. Or, you know, I, I have certain increased needs for X, Y or Z nutrient. Or one third of your genes code for enzymes. Enzymes require a, a cofactors or coenzymes. All those are nutrients like so, and we have huge variations as Bruce Seame says, in, in our need for different nutrients at different doses. So we're all very soon going to be able to sort of create a roadmap of prevention and go, oh, here's your genetics, here's your potholes. Here's what you need to do to fix those and prevent it. And so, you know, one of the things I want to dive into is, is one, how do we detox?

• 1:13:49Dr. Mark Hyman?

  And two, how do we resuscitate our mitochondria? Because. You know, I don't know if you know Suzanne Goh, she's a pediatric neurologist, Harvard trained, Oxford trained, published in the journal, you know, JAMA, and has basically discovered in autistic kids using very sophisticated MRI imaging, functional MRI imaging, that their mitochondria aren't working. And she provides them mitochondrial cofactors, CoQ10, carnitine, things like that. And they actually get better. Now, I'm wondering, I remember a study years ago where there was, they were using like 1,200 milligrams of CoQ10, like normally when you take CoQ10, you take 15 milligrams or 100 milligrams, they're using 1,200 milligrams, and they found an improvement

• 1:14:31Dr. Mark Hyman?

  in their clinical outcomes. So is there any conversation among your colleagues and neurologists, like, how do we put together a comprehensive mitochondrial rejuvenation program? And what does that look like?

• 1:14:41Speaker 01

  Yeah, so, you know, it's a great question. And I think part of it to, you know, Tony Lang is one of the leading neurologists in our field in Parkinson's disease. And when we were talking about him and doing interviews, you know, with him about the book, you talk about when something is, has dysfunction, so it's not working properly, or something's kind of dead or degenerating, you know, and like, where is it on that spectrum, right? And so I think one of the challenges for us is understanding which segments of our cells, we talk about the zen-ness, trying to get ourselves more zen, which segments of the zen are still functioning and can we rescue them, which is

• 1:15:23Speaker 01

  what you're talking about. And could you rescue them with, let's say, higher dosages of CoQ10 or something else? And which are too far downstream, you know, like they're, they're, they're already gone, they're too far downstream, or we need to look more upstream in like for the answer, right? So is the answer going to be?

• 1:15:38Dr. Mark Hyman?

  Yeah, I mean, you're right. I'm going backwards. I'm going, how do you fix the mitochondria? I realize, how do you fix the toxins?

• 1:15:44Speaker 01

  Yeah.

• 1:15:44Dr. Mark Hyman?

  So let's go back to the toxin, but stay with the mitochondria.

• 1:15:46Speaker 01

  Yeah, so, so we know when it comes to toxins for Parkinson's, we know that when you take, you know, toxins, and we have a very good friend, he was a mentor of mine at Emory named Tim Greenemeyer. Tim Greenemeyer studied a toxin called Rotenome, common herbicide, it's in people's You know, it was in that they used it in the creature from the the dark lagoon. They put it into the water and make the fishes all die instantly come to the top. Great visual effect. Terrible if you're the creature parade who's in the in the water. But he actually now has Parkinson himself and and and he he wrote an article and was interviewed and went public with it in a in a very, I think, important magazine. I think it was in Science.

• 1:16:27Dr. Mark Hyman?

  Thank you.

• 1:16:28Speaker 01

  You know, which is, you know, very credible, reputable magazine, maybe on the top levels, I think, talking about this and talking about the lack of protection. But the thing about rotanone that he studies is it's like MPTP, which is the other toxin that came from the designer drug. You know, where they were trying to make a drug called MPP plus and they made MPTP instead.

• 1:16:48Dr. Mark Hyman?

  Yeah, that's right.

• 1:16:50Speaker 01

  The frozen addict, if you ever watched the old PBS special, you know, and read the book by Bill Langston. Amazing story. And it was because of recreational drugs that we actually got our best early animal model. So people say, oh, well, maybe recreational drugs are bad. Maybe not. It spurred decades of research in Parkinson and important research for my mentor, Malin DeLong and others. But what do those toxins do, Mark? What does that do? Yes, complex one of the mitochondrial system. And in fact, it's non selective for MPTP, which is what we worked with.

• 1:17:22Dr. Mark Hyman?

  What was the street name of that drug again? Like, Crystal something?

• 1:17:26Speaker 01

  Yeah, it's a it's a it's a form of heroin. Yeah, it's a methamphetamine. It's a methamphetamine and ecstasy, you know, sort of in that it's in that that category of drugs. But it was a designer drug maker trying to make a designer drug. He just got one little thing wrong on the end of that. So you take this complex one and the one that that Green and Meyer was working with, which was different than my mentor who worked with MPTP. That one go only does brain cells. It only hits complex one in those dopamine cells. Okay. And the brain, it's very specific toxin to that. And then Green and Meyer himself ended up with Parkinson disease and talked about how he probably should have been more protective. And he's very open, you know, about his his story. And I think that's a really, you know, great thing.

• 1:18:10Speaker 01

  And the question is, is, um, is Is access to. So let's say, um, somebody in functional medicine wants to address mitochondrial dysfunction. Awesome idea. Okay. And there are a lot of drugs out there that are addressing it. You gotta beat the, the leaky brain. So that's good, right? You gotta beat the leaky brain. You gotta get to, and there's mitochondria in other areas besides the brain too, that may be affected as well. And, uh, and then you've got to figure out, you know, how, how far down the system is it gone? What's the dose? You know, response on that. And here we are spending like two cents at every dollar on prevention. We're spending like zero on every dollar trying to figure out, you know, how we could actually try to resuscitate and improve the functioning, make them, make those cells more zen.

• 1:18:54Dr. Mark Hyman?

  Well, this is really important, what you're saying, cause you know, one of the failures of modern medicine came out of Louis Pasteur, which had a lot of benefits, discovered bacteria, but it was like, oh, there's a single cause for a single disease treated by a single drug. You've got pneumococcal bacteria, causing pneumococcal pneumonia, treat with penicillin, boom, end of story. And we've been chasing that false tiger for a hundred and plus years for chronic disease, which it doesn't apply. And these conditions are all multifactorial, meaning there's multiple causes. And you need multimodal treatments, meaning you need a lot of different things. You mentioned exercise. You mentioned reducing your exposures. You mentioned, you know, mitochondrial therapies. You mentioned L-dopamine. There's lots more things and you can't just do one thing.

• 1:19:38Dr. Mark Hyman?

  And people will say, well, you know, how do you do a randomized control trial? You don't know what works. Let's just try CoQ10. Or let's just try like podcasts, or let's just try blah, blah, blah. And I'm like, no. It's like, it's like saying, it's like saying, we're gonna create, uh, we want to win the NBA playoffs, but we're only gonna put Michael Jordan on the team and he's got no other players on the team. He's gonna lose every time.

• 1:19:59Speaker 01

  Yeah.

• 1:19:59Dr. Mark Hyman?

  Right?

• 1:19:59Speaker 01

  Yeah.

• 1:20:00Dr. Mark Hyman?

  So, hey, you know, I think, I think this is a fundamental flaw in, in research and I don't know how to answer that.

• 1:20:04Speaker 01

  Well, let me just add, like, just add on to that and just pile on a little bit and just say, we talk about in the book about combination therapies. Remember carbapril, levodopril is a combination therapy. You need the two to get it to the brain, right? And to reduce the nausea, get it out of the blood and up into the brain, past blood barrier, right? They, that leaky area, right? And HIV drugs, we talk about HIV drugs and heart therapy, which was, you know, where you take a bunch of these drugs together in combination and that was the winner, right? You talk about cancer chemotherapy, Malcolm Gladwell loves talking about this, telling the story. We tell a piece of that story again, the most disagreeable guy at NIH ever that you wouldn't want to be in the same room because he's, you know, such a curmudgeon. It takes a guy like that to challenge the system to cure these kids with leukemia, put

• 1:20:49Speaker 01

  these combinations together.

• 1:20:50Dr. Mark Hyman?

  Yeah.

• 1:20:51Speaker 01

  Now we're so far down the road and yet we're still not thinking in combinations. So I just wanted to add on to what you're saying, you know, like, what are we doing?

• 1:21:00Dr. Mark Hyman?

  Well, so I think I'm going to come back to the, how do you remove toxins? Because that's like going upstream. But, you know, often like you can intervene with mitochondrial therapies and you can get pretty, you know, I would say complex because there's a lot of different pathways, a lot of enzymes, a lot of steps. So CoQ10, we talked about. We didn't talk about this, but NAD or NMN, which is a common longevity now supplement. But that actually plays a big role in mitochondrial function. Creatine, which has been shown to help you have been in different neurological diseases.

• 1:21:31Speaker 01

  Helps your thinking in some of these recent studies.

• 1:21:33Dr. Mark Hyman?

  Yeah, that's why I'm so smart this morning. I did 10 grams of creatine. I had chronic fatigue syndrome as a result of mercury poisoning, living in China. And I can tell you my CPK, which is muscle enzymes, were 600 for years until I figured out how to fix my mitochondria. So, you know, then there's things that help like other antioxidants, like N-acetylcysteine, things that boost glutathione, there's phytochemicals like resveratrol, curcumin, green tea extract, carnitine, all the B vitamins are your cofactors, riboflavin, niacin, B1, I mean, B2, B3, all the methylation vitamins, B6, bole, B12, magnesium. And even there's interesting things like peptides, like SS31 and humanin and matzi, which are

• 1:22:15Dr. Mark Hyman?

  kind of a little bit beyond the conversation we're having here, but that are our body's own biological way of regulating our mitochondrial function. Peptides are essentially the bodies' like communication superhighway system. And we've been using them in medicine for years. Insulin's a peptide, GLP-1's are peptide. So like there, there, there are things that can Help the body function better. So what I find is those things can be really great, but you have to first deal with the gut. You have to first deal with reducing toxic load. And so that's where I think, you know, you know, we really need to start funding these trials on using these, these multifactorial assessments, like let's look at all the potential causes. Do you have mold? Do you have mercury? Do you have pesticides? Do you have, you know, suffering household cleaning chemicals? Are you exposed to particularly air pollution?

• 1:23:00Dr. Mark Hyman?

  Like what's your?

• 1:23:01Speaker 01

  And we have AI. We have the ability to now deal with multiple factors, right? Like never before, like today in the age that we're in, yet we don't study.

• 1:23:09Dr. Mark Hyman?

  We don't. And then, and then, you know, we, once you, once you understand those, you start to kind of address all those systematically and then you start to resuscitate and repair the body. So you take out the bad stuff, put in the good stuff. That's what functional medicine is really. And I think, um, you know, what, what I'm also wanted to ask you about before we get into the whole detox thing. Cause I think I don't want to just end because we're, we're going on a long time. I could talk to you guys forever. Recently, there's been some real advances in blood biomarkers for Alzheimer's like P tau 217 and neurofemand light chain and other, other biomarkers. Are there biomarkers for Parkinson's? Cause it's a syndrome. What it means is syndrome is that it's a clinical diagnosis. You go to an expert, you, you meet these criteria for these features and you go, okay, you got Parkinson's.

• 1:23:52Dr. Mark Hyman?

  But it's not like, you know, you do a, like a, like a blood test for blood sugar and you see have diabetes. So is there, uh, now, or will there be soon, blood biomarkers?

• 1:24:01Speaker 01

  So Alzheimer's is, is just a little bit ahead of us and, you know, and they have, uh, you know, evolving. And, and people should understand these things are evolving because we get better and better and we should get better and better. It shouldn't be a static, you know, type of, uh, type of deal. Where we started was by saying, oh, we just have the clinical examination. But if, you know, if you only train 40 or 50 docs or healthcare practitioners in the United States alone, you know, and Medicare doesn't even cover those. They're covered by grants and, and philanthropy and things like that. We are going to, you know, have a public health crisis. We already have a public health crisis. All right. So we're gonna need biomarkers, both to tell we have the disease and also to.

• 1:24:43Speaker 01

  Tell how the disease is progressing over time. And so when we make measurements on all these things that you're interested in, we have a way to biologically measure them.

• 1:24:51Dr. Mark Hyman?

  The DUI?

• 1:24:51Speaker 01

  So, so, so the things that we have so far. Okay. So we've got a test called a dopamine transporter test. It's a one, two, three. It's a cocaine analog. Don't get scared if you don't get cocaine, or don't get excited, you know, Mark, you know, like on any way, the other, but, but, but it's a test that you can tell how the dopamine transporter is in the brain. Doesn't tell you if you have Parkinson or not, but tells you have a dopamine transporter deficit.

• 1:25:11Dr. Mark Hyman?

  And it's an imaging test.

• 1:25:12Speaker 01

  It's an imaging, right?

• 1:25:13Dr. Mark Hyman?

  It's an MRI.

• 1:25:14Speaker 01

  Take a picture. It's like a nuclear medicine.

• 1:25:16Dr. Mark Hyman?

  Nuclear medicine.

• 1:25:17Speaker 01

  Yeah. So we have that. We now have, you know, it was a 21 center study that was just done by David Valencourt. I was part of that study from the University of Florida. He developed a free water imaging. So we can tell the difference between Parkinson PSP and another mimic called MSA. So there are two other Parkinson common mimics. These are things that look like Parkinson, but aren't exactly Parkinson. Progressive super nuclear palsy, Dudley Moore had MSA is multiple system atrophy. He has all those autonomic features, the fight or flight things associated.

• 1:25:47Dr. Mark Hyman?

  So in English is diseases that seem like Parkinson's, but aren't, that you can kind of test for?

• 1:25:50Speaker 01

  Exactly. And, and now we can do something the eyes can't see. It's really cool. The eyes can't see it, but the AI can. So they can take your MRI with this six minute sequence and tell the difference between these diseases. And then the, the latest evolution has been blood and skin tests.

• 1:26:07Dr. Mark Hyman?

  Yeah, blood.

• 1:26:07Speaker 01

  Okay. And so when people are really interested in measuring the protein called alpha synuclein. Okay. So you talk about PTOW 217, which is really hot and really important for Alzheimer's disease. People have been talking about alpha synuclein, which is that protein that gets deposited in something called the Lewy body, again, named after the guy Lewy, who described it in the microscope, right? So, but.

• 1:26:27Dr. Mark Hyman?

  Lewy body is like a combo of Parkinson's and Alzheimer's.

• 1:26:30Speaker 01

  Yeah. So that, so, so.

• 1:26:32Speaker 02

  More Parkinson's, but like, it's like, it's like the amyloid plaque that you see in Alzheimer's disease, the pathological hallmark, what you see under the microscope and Parkinson's is a Lewy body.

• 1:26:41Dr. Mark Hyman?

  I've had many patients of that, actually.

• 1:26:43Speaker 01

  So we're interested, right, in measuring that. And that is huge, right? So when we can start to measure that and the fluid that bathes your brain and spinal cord called the cerebrospinal fluid.

• 1:26:53Dr. Mark Hyman?

  Get you a spinal tap or

• 1:26:54Speaker 01

  Well, that's how it started, you know, with with spinal taps and and looking at it. But now there are now evolving ways to look at this in the blood and in other areas. And it's getting better and better. And then also skin, so skin biopsies, you talk about fat biopsies, but skin biopsies. And then, you know, no, for for sin nucleus.

• 1:27:14Speaker 02

  The misfolded protein is not just found in the brain. It's not just found in the gut. It's actually found in the skin.

• 1:27:18Dr. Mark Hyman?

  And just for people understanding, like, you know, genes make proteins. That's all they do. And one of the hallmarks of aging is proteostasis or just funky, weirdly misshapen and folding proteins. It don't work properly.

• 1:27:33Speaker 02

  Yeah, so you fold the sheet and you know, if you have a regular sheet, it's easy to fold. It's nice and neat, but trying to fold a fitted sheet is a really big pain in the behind.

• 1:27:40Dr. Mark Hyman?

  Right, exactly.

• 1:27:40Speaker 02

  And so a miss of a fitted sheet is always misfolded. And so in Parkinson's disease and Alzheimer's disease and ALS and a lot of other brain diseases, the hallmark of the disease, when you look on the microscope are misfolded proteins.

• 1:27:52Dr. Mark Hyman?

  But I don't know if this is true. I'm just hypothesizing because the genes make proteins and the proteins have functions. And they're damaged because of environmental factors that change the gene expression or the what we call post-translational gene products, the thing, the proteins that genes make through proteomics, which is like a new way of actually testing large numbers of proteins in the blood at very low cost. Are we seeing protein signatures of Parkinson's that can be identified?

• 1:28:21Speaker 01

  Yes, we are starting to see them, but as we get more data, we're overwhelmed by the data. Where AI is helping us, but now you have imaging, you have blood, you have spit, you have you have skin, and the answer isn't going to be in one thing, you know, people like to go binary. Yes or no.

• 1:28:35Dr. Mark Hyman?

  Because it's like, if you're making a difference, how do you know? Like, I know if I had ten with Alzheimer's and I checked their P tau 217 and I do 10 things and I check it again six months from now, it can go down.

• 1:28:46Speaker 02

  What gets measured gets managed.

• 1:28:47Dr. Mark Hyman?

  Right, so is there anything like that coming?

• 1:28:49Speaker 01

  So that is is is right now, like right now, Mark, what so many people all over the world, multiple laboratories are working on, because we're not quite there with the with the statistics to say it's good enough yet, but we're smashing these tests. Together and my prediction is and I think Ray feels the same way when we were writing the book is it's going to be a combination of these tests that are gonna are gonna give us those markers but what you said is so important and I just want to reemphasize that we have to be able to measure trajectory it's not good enough to just diagnose like we don't need a biomarker just for diagnosis like you can see a lot of Parkinson you know it's a clinical

• 1:29:24Dr. Mark Hyman?

  stat and your cholesterol goes down right like you want to know what

• 1:29:26Speaker 01

  Yeah you have Parkinson if you respond to the dopamine and everything that's pretty doggone good what we need to do is we need to be able to see how it changes over time and then when we intervene you know do these things that we're given because it might be some of the things we've tested actually did work but we couldn't measure it as Ray said and so it's a it's a problem it's a challenge let's say

• 1:29:46Dr. Mark Hyman?

  Yeah this is really great I want to wrap up because I don't want to put you on the spot because you didn't learn this in medical school and I spent the last forty years studying this which is how do you help someone detoxify how do you measure toxins how do you detoxify so in functional medicine we can do heavy metal challenge testing we do blood testing for heavy metals we can do blood testing for things like PFAS BPA glyphosate also urine testing you can look at urine testing for a lot of the things like atrazine and all the things like the pesticides and paraben so we can actually look at all these things in the urine and there are specialty labs that do that it's typically not your average lab and then we're going to say so okay based on someone's history based on their load where are they at

• 1:30:28Dr. Mark Hyman?

  and then then we design a detox program which essentially which uses all your body's built in waste management systems right so sweat saunas are a great way to mobilize toxins

• 1:30:42Dr. Mark Hyman?

  making sure you drink a lot of water and pee and clear urine simple fiber like make sure you're pooping and not constipated you know I had a patient once I said do you have regular bowel movements she goes yeah I said how often you how often do you go she says I go once a week I'm like what do you mean that's not regular she goes yes regular for me I go every week you know but you want to go every day at least once or twice these are just basic things and then there's all the things you can do to up regulate your body's own built in detox pathways and that includes things to do to with diets So you obviously reduce all the crap in your diet, all the sugar, all the processed food. That goes without saying, but there's certain foods that have the ability to boost your own detox enzymes,

• 1:31:22Dr. Mark Hyman?

  like glutathione, which actually you can use intravenously in Parkinson's and temporarily see reductions in tremors. So it's really, it's like one of the most important anti-inflammatory mitochondrial compounds. So we basically give them broccoli and collards and kale and other things like garlic and onions that boost that. And we give them foods that help with B vitamins and methylation. And we do all these dietary interventions and we've been talking about maybe keto diets may be helpful. And then you kind of obviously can fix the gut and that's a whole nother functional medicine domain. But in terms of detoxification, you know, there's, there's chelation, which can be used for heavy metals. And that's been published, ADT chelation, DMSA chelation.

• 1:32:05Dr. Mark Hyman?

  These are things that are published in JAMA and in, in fact, in one study, they did it for kidney failure. And they found that people that had lead, they're more likely to progress to dialysis. And they did ADT chelation and those who went through it didn't progress. So we had, we had some data. We don't have enough, but we have some data. So you can do chelation for heavy metals. And then, you know, for the, you know, the mitochondrial rejuvenation and the cellular removal of toxins, it's a lot harder. And this is where things are kind of, I think, need some funding to see what's going on here. Cause clinically, I can tell you when we do things like give intravenous glutathione or intravenous NAD, or we give something we call the PK protocol, which essentially is a cellular washout.

• 1:32:47Dr. Mark Hyman?

  It's like using high doses of the fat, phosphocalcine that your membranes are made out of. Where all the toxins are, it flushes them out. And then you also combine it with things like glutathione and the B vitamins and carnitine. And you see people's mitochondria come back online. And I have a patient who's like a rock star and, and that rock star couldn't play the guitar because they had Parkinson's. And all of a sudden they did this protocol and boom, they're back on tour. So I think there's a whole bunch of things that aren't drugs, that aren't. Anybody who's going to fund, you know, a billion dollar study unless it's the government or philanthropist, but that actually have real promise. And I would love to sort of hear your thoughts on how we start to take some of these things that are in the anecdotal or anecdotal stage and, and actually start to apply them and do clinical trials, sort

• 1:33:32Dr. Mark Hyman?

  of like Richard Isaac's doing, because what all you guys are talking about in here is amazing and it's, it's going to get a lot of the way there. But there's a whole nother level of thinking about this. I'd love to just get your final two cents on.

• 1:33:43Speaker 01

  I think I love the term anecdotal, right? You know, and I think that's really important. And, and I'll just say it's, it's, it's tricky because, you know, in the New England Journal, they tried to, there's a whole bunch of iron, as you know, in the brains of, of folks with Parkinson and everything. So they tried to use the standard, you know, chelation, you know, and for iron and that actually did work.

• 1:34:05Dr. Mark Hyman?

  Well, sure. Sure. Here's why. Here's why. It's, it's a problem of thinking. If you give someone a drug for chelation and you don't make sure that that compound gets out of their body by peeing a lot, pooping a lot, making the liver enzymes work and binding them up in the gut and doing all these things, of course you're going to get worse. And that happens also when you do treatment for heavy metals. If you don't, if you just give the chelator without all the other support, then of course they're going to get.

• 1:34:31Speaker 01

  Yeah. And we're not, Ray and I aren't experts on this, but, but I will say that I was so enthusiastic when the government was investing and that we had a center for alternative medications where they were funding, starting to fund clinical trials. This was many years ago. One of my mentors, Malin DeLong, was involved in some of those original discussions. And, and we just need to do more of it. I mean, this is super interesting, super important. And, and what excites me, and I'm interested to, to hear what Ray thinks, what excites me about it is the why and looking upstream, like, right? So, so what you're talking about is looking for the root cause. And so, so when the guys.

• 1:35:09Dr. Mark Hyman?

  Cause or causes.

• 1:35:10Speaker 01

  Yeah. Root cause or causes. And so when the guys that discovered Helicobacter pylori, which was this, you know, infectious agent.

• 1:35:16Dr. Mark Hyman?

  You guys, the very marshal of neurology?

• 1:35:18Speaker 01

  Yeah. Well, we have the story and the.

• 1:35:20Dr. Mark Hyman?

  But please don't take the toxins.

• 1:35:22Speaker 01

  Yeah.

• 1:35:25Dr. Mark Hyman?

  Yeah, an ulcer, but don't drink a beaker of toxins and then get Parkinson's.

• 1:35:29Speaker 01

  Yeah, so we have the story in the book about how nobody believed them. That this could be infectious, causing all the peptic ulcers. And, and it turns out it was infectious. They ended up winning the Nobel Prize on this, you know, and it was really important and fundamental. And people, what were they saying? Oh, you, you need to eat less spicy foods. You need to do all this. They didn't understand upstream what was going on. So, I don't know, what do you think?

• 1:35:51Dr. Mark Hyman?

  If you guys keep going, I want to be at your Nobel Prize ceremony. Cause I think this is worthy of a Nobel Prize.

• 1:35:57Speaker 02

  Well, I think the credit really goes to Dr. Caroline Tanner for 40 years. She's been detailing this and we haven't been paying enough attention to her. You know, in my mind, she's a giant. In reality, she's like maybe five feet tall. She's over 70. She looks like your prototypical grandmother and she's been doing this for 40 years. She did studies in China as a woman in the 1980s, looking at chemicals and Parkinson's disease. Just imagine that.

• 1:36:21Speaker 02

  We want to say yes, we want to say, right? We want to say yes to everything that you're saying. We just don't have the evidence. And I think both Michael and my minds have been open. We did, if you had told, asked us 15 years ago about chemicals, we would have been poo pooing or soft pedaling them. And we know, we just don't have the evidence. We do know the Mediterranean diet, for example, high in fruits and vegetables, low in animal products, perhaps low in toxins. It get magnified as they go up the food chain is beneficial for people with Parkinson's disease and might even prevent you from getting it. We know that vigorous exercise is helpful for people with Parkinson's disease and might reduce your risk of ever getting Parkinson's disease. We know that these chemicals are causing, likely causing disease. And we know that stopping exposure to these chemicals is potentially beneficial.

• 1:37:05Speaker 02

  We just don't have the data to answer to you here in 2020, 25. You know, what complement of mitochondrial supplements or other complementary medicines would make a big difference for people?

• 1:37:16Dr. Mark Hyman?

  But the NIH needs to focus on this, right?

• 1:37:17Speaker 02

  And then we're going to come back, you have us come back in five years and we'll tell you what, what has been found because people like you are constantly pushing the envelope. And you've been doing this for, you know, 30 years, right? And you were, you know, not widely, you know.

• 1:37:29Dr. Mark Hyman?

  Respected. Don't rain my Wikipedia page, please.

• 1:37:34Speaker 02

  You, you and others. Have made us think about things in a more holistic manner. And you've told us that the power of prevention, you've told us that the roots of these chronic diseases, many of them lie in our environment. If we pay attention, more attention to the Mark Hyman's of the world. If we pay attention to the people who are out there on the front, Vanny Harry and others.

• 1:37:54Dr. Mark Hyman?

  Yeah.

• 1:37:54Speaker 02

  Who are out there telling us that chemicals in our food, water and air are fueling the rise of chronic diseases. We can prevent them, we can slow them, we can treat them and potentially we can even cure them. Once we know the cause.

• 1:38:06Dr. Mark Hyman?

  And I'm just going to say by, by as an add my anecdote, I've treated dozens of Parkinson's patients over 30 years. Or people with Lewy body disease. I've had many of those as well, surprisingly. And I'm not a neurologist, but when people try everything and they can't get any help, they come to me. And we treat them at the Ultra Wellness Center. And I can tell you, I've had so many patients who we've slowed, stopped, or even reversed. Significantly their Parkinson's by using this kind of a systematic approach. And I think people should be hopeful out there. And I'm really hopeful that, that, that you guys are doing this because. You know, we need real scientists. I'm just a science reader. I'm not like a, I mean, I publish some papers, but I'm like, that's not my gig. But, but I read the science and I'm like, I know that the smoke signals are there.

• 1:38:51Dr. Mark Hyman?

  And that there needs like to be a serious investment in this, in this field and. In the kinds of therapies that can really improve people's lives, especially as we're seeing the acceleration in this whole thing. So. I want to just thank both of you for what you're doing. I think this is such an important book. It's the Parkinson's Plan, a path to prevention and treatment. You can get it anywhere you get books. It's out now. I would encourage you to get a. Copy and check it out. If you know anybody with Parkinson's, if you have it in your family.

• 1:39:17Speaker 02

  Or you don't want to get it.

• 1:39:18Dr. Mark Hyman?

  If you don't want to get it, uh, which would pretty much be everybody.

• 1:39:23Speaker 02

  And the seeds of the disease are planted early. So.

• 1:39:26Dr. Mark Hyman?

  Decades before.

• 1:39:27Speaker 02

  Decades as a child.

• 1:39:29Dr. Mark Hyman?

  Yeah, as a child. So.

• 1:39:30Speaker 02

  Teenager.

• 1:39:30Dr. Mark Hyman?

  It's never too early to start. Yeah. So I, I just honor you both for what you're doing. Uh, and the courage you have to go against the grain, to speak the truth, to, you know, honestly, to be exposed to the potential ridicule of your colleagues. It's not easy, right? And, and yet here you are. And I'm just so impressed in having this conversation and you guys are great. Let's keep talking. Let's revisit this. And when we have more blood bio markers, when we have more treatments, if you want anybody to kind of give you my anecdotal data from my decades of doing this to kind of guide some things that could be helpful. If you want to get some research funded, if you have some philanthropists or if anybody's listening out there who's a philanthropist, who has any of this like Lewy bodies or Parkinson's, like please, we need help because the government's not doing it.

• 1:40:14Dr. Mark Hyman?

  Pharma for sure isn't doing it. And I think, you know, these guys are doing the work. So, so let's, let's get some help for all the needless suffering out there. Thanks, Ray. Thanks for having me. Really great conversation. 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.

• 1:40:59Dr. 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. 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.

• 1:41:38Dr. Mark Hyman?

  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. This podcast is provided with the understanding that it does not come 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.

• 1:42:19Dr. Mark Hyman?

  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.