Inflammation: The Hidden Fire Behind Pain, Aging, and Disease

A hidden fire called chronic inflammation drives many problems—from joint pain and arthritis to autoimmune conditions, and even faster aging. Typical fixes (like pain meds and steroid shots) calm symptoms but often miss the “why,” and can leave people still hurting or even create more issues. Big triggers of inflammation that impact our joints, and so much more, include sugar and refined carbs, extra weight, leaky gut, toxins, infections, stress, and poor sleep—plus joints naturally get less blood and oxygen as we age. This is why it’s important to create an anti-inflammatory lifestyle plan starting with real whole foods, and incorporating regular exercise, stress management, gut repair, and targeted anti-inflammatory supplements. In this episode, I discuss, along with Dr. George Papanicolaou and Dr. Cindy Geyer, how chronic inflammation, arthritis, and joint pain can be reduced using a Functional Medicine approach, including how to do the anti-inflammatory 10-Day Detox diet. Dr. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. Over time as the healthcare system made it harder for patients to receive personal care, Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health—a practice dedicated entirely to Functional Medicine. In August 2017, Dr. Papanicolaou joined The UltraWellness Center. Dr. Cindy Geyer received her bachelor of science and her doctor of medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N. Y. and is triple board certified in internal medicine, integrative medicine and lifestyle medicine. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN to save 15%. Full-length episodes can be found here: Prolozone and Nutritional Therapy for Osteoarthritis What Causes Inflammation And How Can You Treat It? Is An Autoimmune Condition Driving Your Raynaud's Syndrome? How To Do The 10-Day Detox

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

• 0:00Dr. Mark Hyman?

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

• 0:02Speaker 01

  But today, our modern lifestyle is driving so much hidden inflammation, systemic chronic inflammation, silent inflammation. It's a silent killer. And it turns out that it's not the kind of inflammation that we are familiar with, like a sprained ankle or a sore throat, or something that's an obvious kind of inflammation.

• 0:24Dr. Mark Hyman?

  Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one-on-one, there just isn't enough time in the day. So I built several tools to help you take control of your health. If you're looking for guidance, education and community, check out my private membership, The Hyman Hive, for live Q and A's, exclusive content and direct connection. For real-time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor trusted supplements and health products at drhyman.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad-free with Hyman Plus. Just open Apple Podcasts and tap Try Free to start your seven-day free trial.

• 1:05Speaker 01

  27 million Americans over the age of 25 have osteoarthritis. And the joint that is most commonly affected is the knee. It creates a great deal of morbidity, meaning that- Suffering. Suffering. That's a fancy medical word for suffering. Pain in the ass. So, yeah, so, and our traditional therapies basically help you control the symptoms, but might not necessarily do anything to reverse it. So using Motrin or Advil or Tylenol are common things people will use. And then your orthopedic surgeon may inject it with a steroid or they may use something like a lubricant. Like hyaluronic acid. Yeah, hyaluronic acid.

• 1:49Speaker 01

  And so it's only a lubricant effect. And then you need a knee replacement. Right, and then you're getting, and then you're getting towards a knee replacement. And then we know that 40% of people that have their knee replaced still continue to have pain and loss of motion. So we don't have a lot of real successful treatments out there that are really changing people's lives. Yeah, right, it's true. And I think, you know, we often used to think about osteoarthritis as a-

• 2:16Dr. Mark Hyman?

  Wear and tear problem, you know, you just beat up your joints too much. But it turns out it's really an inflammatory problem as well.

• 2:23Speaker 01

  So what's interesting, there it certainly increases with age and trauma to the knee is certainly part of what creates an inflammation. And that trauma can be repetitive use. It doesn't have to be an ACL tear, you know, from a, you know, football injury. It can just be repetitive use on a person who's carrying too much weight on their body. So obesity is a risk factor for arthritis.

• 2:48Dr. Mark Hyman?

  But obesity also is a generally inflamed state.

• 2:51Speaker 01

  Right.

• 2:51Dr. Mark Hyman?

  So when you're obese, your fat cells are not just there holding up your pants. They're producing tons of inflammatory compounds that are making your whole system inflamed.

• 3:01Speaker 01

  Right. And so if you have an inflamed system and you're creating micro trauma to your joints, you're going to have an overreactive response in the joint. And joints, we, you know, I think we should understand and know about them is that the cartilage and the ligamentous structures of the joint have lower oxygen tension than the rest of your body. Meaning that they don't have an enormous oxygen supply. It's a little bit different than the rest of the body. And that plays a big role into why as we age, that oxygen supply actually decreases. Blood flow to those vital areas of the cartilage and ligaments decrease.

• 3:41Dr. Mark Hyman?

  Yeah.

• 3:41Speaker 01

  So that when you injure them, they're less likely to repair, more likely to have an inflammatory response that leads to degeneration.

• 3:49Dr. Mark Hyman?

  Yeah. Interesting. So what we're also learning about osteoarthritis is fascinating to me was that when they're doing like biopsies and doing analysis, they're finding microbes in the joints.

• 3:58Speaker 01

  Yeah.

• 3:58Dr. Mark Hyman?

  Not an infection, but just like dislocated microbes from the gut. So we're seeing the microbiome of the gut and the knee, which is crazy. So that's maybe also triggering an inflammatory response, right?

• 4:11Speaker 01

  Yeah. Yeah. You know, we are really only 10% human. We understand because we have, you know, 100 trillion bacteria living in and on us. And, and they're only 10, 10 trillion human cells. So, you know.

• 4:23Dr. Mark Hyman?

  So conventional medicine, basically. Your knee hurts, you go to the doctor and you get an X-ray and they go, you have osteoarthritis, here, take some Advil, you know, maybe do some strengthening exercises for your legs. Maybe if it gets really bad, you get a couple of shots in your knee of steroids. That doesn't work anymore. You need a knee replacement. It's kind of a bad trajectory. There's no way to really sort of recover from this. And from a functional medicine perspective, we do a different approach.

• 4:52Speaker 01

  We do. And, and you know, I, we are going to talk about that approach, but exercise does help, nutrition does help, losing weight does help. So there are definitely things that we can do with a person's lifestyle and help them intervene. I worked with a patient that was 45 pounds overweight, was eating a totally processed food diet, was drinking too much and was scheduled for knee replacement in September. I saw them in early July and I said, hey, look, if you do these, these things I'm about to tell you, I bet you, you could be playing golf in January in Miami with your friends instead of recovering from knee replacement.

• 5:34Speaker 01

  And he said, okay, I'll take you on. I said, okay, if you win any money in Miami, I get 10%. All right. So, so guess what?

• 5:42Dr. Mark Hyman?

  Did you get the 10%?

• 5:44Speaker 01

  He got what he wanted. I didn't get what I wanted. Okay. So he lost 45 pounds.

• 5:49Dr. Mark Hyman?

  Amazing.

• 5:50Speaker 01

  Right. I put him in physical therapy with a really good functional physical therapist, strengthened his knee. He canceled, he canceled the, the, um, the knee replacement and came into an appointment like walking, right? And he opened up an envelope with his tickets to Miami.

• 6:07Dr. Mark Hyman?

  Oh, that's amazing.

• 6:08Speaker 01

  And so.

• 6:09Dr. Mark Hyman?

  But, but you, but just to be clear, it wasn't just like eat less, exercise more. You, you put him on an anti-inflammatory diet.

• 6:16Speaker 01

  Yep.

• 6:17Dr. Mark Hyman?

  Which is, is speaking to the point that osteoarthritis is not just a mechanical wear and tear breakdown. It's a chronic inflammatory process.

• 6:24Speaker 01

  Multiple things.

• 6:25Dr. Mark Hyman?

  And so from a functional medicine perspective, we deal with chronic inflammation holistically. So what are the things that you did diet wise and, and supplement wise that actually helped with his chronic inflammation that helped his knees and the weight loss?

• 6:39Speaker 01

  The really key thing was is to get him to decrease his alcohol and also to decrease his intake of of processed foods. These processed foods are are fast carbs that go into your body. They have toxins in them and they also create an inflammatory response driven by insulin.

• 6:57Dr. Mark Hyman?

  So sugar and starch are inflammatory foods.

• 6:59Speaker 01

  Right. And so we took that right out. So we just, you know, basically put him on a Mediterranean diet.

• 7:04Dr. Mark Hyman?

  But not gluten and dairy free?

• 7:05Speaker 01

  Gluten and dairy, oh, absolutely gluten dairy free.

• 7:07Dr. Mark Hyman?

  Why is that important?

• 7:08Speaker 01

  Because as we've talked about before multiple times, you know, they're both inflammatory, right? And so gluten can actually trigger leaky gut, which again triggers that whole process of inflammation in the body. And then if you have any micro trauma to your knee, that inflammation, that cytokine response is going to lead to degeneration of cartilage and even bony structures in the knee.

• 7:30Dr. Mark Hyman?

  So here's the deal, like, not everybody needs to be gluten dairy free.

• 7:33Speaker 01

  No.

• 7:33Dr. Mark Hyman?

  But if you were inflamed.

• 7:35Speaker 01

  You gotta be.

• 7:36Dr. Mark Hyman?

  If you have a chronic problem, it's number one, two, and three on the list, right? You you gotta get rid of. Gluten dairy sugar. And and inflammatory foods.

• 7:45Speaker 01

  Yep.

• 7:46Dr. Mark Hyman?

  As the first step. And then you say, well, is it better? Is it not? Is it something else? Because it's sometimes something else. But but it's really powerful when you put people on an anti-inflammatory diet. So if you have osteoarthritis, this diet is one, two, and three. And and it's really getting on a whole foods, plant rich, good fats.

• 8:02Speaker 01

  Absolutely.

• 8:02Dr. Mark Hyman?

  Like lots of anti-inflammatory foods, getting off gluten dairy sugar, starch, processed foods.

• 8:07Speaker 01

  Yeah. So yeah, and you put them on really good, healthy fats, because fats are really important part process, part of the anti-inflammatory process. I put him actually, um, one of my favorite things to do when I'm dealing with inflammation is high dose omega threes.

• 8:20Dr. Mark Hyman?

  So lots of omega threes, right?

• 8:22Speaker 01

  Yeah. So I use, you know, 4,000 or more. Um, so I put them on omega threes. I use an anti-inflammatory botanical called Kirkumin. And so, uh, it's sort of like a botanical Advil. Uh, so I put them on that. I also use something like it's a supercharged omega three. It's refined omega three is called specialized pro, um, resolving factors, mediators. And they are very potent. SPMS. So they're very potent anti-inflammatories. So between his diet.

• 8:53Dr. Mark Hyman?

  It's sort of like the, it's like taking all the, the good juju out of the omega threes.

• 8:58Speaker 01

  Right.

• 8:58Dr. Mark Hyman?

  And concentrating them. And there's a lot of research done at Harvard on this.

• 9:02Speaker 01

  Oh, yeah.

• 9:02Dr. Mark Hyman?

  And you, your body has this ability to resolve inflammation. It has, it has an auto built in system.

• 9:10Speaker 01

  Right.

• 9:11Dr. Mark Hyman?

  That's called resolvents. So, so resolvents are molecules in your body that resolve inflammation. So these are called specific pro-resolving mediators. So they're really effective.

• 9:25Speaker 01

  They are.

• 9:26Dr. Mark Hyman?

  A lot of research on these.

• 9:27Speaker 01

  And a lot of, and a lot of research with particularly post-surgical recovery, post-trauma recovery, that these will actually enhance recovery and you'll have a shorter recovery time when you're using SPMS.

• 9:40Dr. Mark Hyman?

  Yeah. So they can be very effective. So diet, the supplements and.

• 9:44Speaker 01

  Targeted supplements.

• 9:45Dr. Mark Hyman?

  Yeah. Even vitamin D might be helpful because it strengthens bones and, right?

• 9:49Speaker 01

  Yeah. Vitamin D and omega and omegas are pretty much standard for me when I'm dealing with anybody with any amount of inflammation because of the impact that vitamin D has on the immune system, inflammatory system, mood. It just, it just does so many things. In addition, physical therapy is very important because we do know that the muscular strength around a joint will protect that joint and keep it from the constant damage that it can get from repetitive use. So.

• 10:14Dr. Mark Hyman?

  Yeah, that's right. And I never had any knee problems, knock wood.

• 10:17Speaker 01

  Yeah.

• 10:17Dr. Mark Hyman?

  But I, I, you know, I, I have very big thighs because I was a runner most of my life and biker. So I have like really big thighs and my knees, my leg thighs are strong because my knees always were protected.

• 10:27Speaker 01

  Right. Yeah. So I could tell a personal story. I had my, my right hip replaced. I had no pain and then I fell, I injured it, it got inflamed. And within four months, I had to get a hip replacement. And I asked a surgeon, why did I have end-stage arthritis and not know it? Well, I had been running and I had been racing a bike for 10 years. I mean, I had really strong legs. And he said, there are a couple of things, George. One is you have so much strength in the leg and you may have been a person, because of your diet, you're not very inflamed. And so you're. Kind of response at the joint limited the pain you were going to feel. So strength and anti-inflammatory living can actually keep you from even knowing you have arthritis.

• 11:11Dr. Mark Hyman?

  It's amazing. I had, I had a, I had a lecture I did recently and there was this woman who's like, I did your 10 day reset. And it basically is a anti-inflammatory detox from sugar and starch. And it gets sort of gluten dairy sugar. It's, it's a really nice program and you can go to get pharmacy with an F G E T pharmacy with an F dot com. And you can learn about it. You can download the program free. You can get the extra version if you want. But she did this, eh, not seeing me as a patient, just as on her own. And she said, I was scheduled for a bilateral knee replacement. I did this program and I did it for more than 10 days, obviously. And I canceled them because my knees are fine now, which is pretty amazing story. I've heard this over and over. So I think if you're, you know, if you're facing that level of surgery, I mean, a knee replacement is not easy.

• 11:55Dr. Mark Hyman?

  Hip replacement, you get the hip, you're up and going pretty quick. Uh, knee replacement, you're out for a long time, a lot of hard work, physical therapy. You don't really get back to perfect. I mean, it can be great for people who need it, but there's, there's some other intermediate steps before you get there. Even if you know your diet's great and everything's great, you've done all these things and it's still not working. There's another therapy that emerged that is really powerful.

• 12:17Speaker 01

  Yeah. And this is, this is, yeah, this is very powerful stuff. And, you know, I wanted to make sure we talked about that the lifestyle and it was important thing.

• 12:26Dr. Mark Hyman?

  Yes.

• 12:26Speaker 01

  But what we really wanted to talk about was ozone.

• 12:29Dr. Mark Hyman?

  Yeah.

• 12:29Speaker 01

  And pro ozone and, and what it can do for, um, the, the joints.

• 12:34Dr. Mark Hyman?

  Now, the thing is do this because you know, most of your ozone, they have the ozone layer and it's bad for you and what?

• 12:40Speaker 01

  Right. So, so ozone is a gas. We know that there's oxygen and oxygen is actually two oxygen atoms that come together. And they have to be together because they're very stable together. Oxygen by itself, it needs another electron. So it shares it with a partner. So you have O2, they're married and they're very happy together. But if they get any solar activity in, uh, placed upon them or any electrical activity, they'll split. And that's happening constantly all the time. But they'll come back very quickly together. But sometimes they come back and there's a third person there. Right. There's another extra oxygen molecule that's latched on because you couldn't find a partner. So now you have this, what we call triatomic oxygen or O3.

• 13:23Speaker 01

  And now there's, there's not enough, there's not enough electrons for all three to share. So those, the, the, the two oxygens, like I gotta find a way to get rid of this third wheel. So that becomes a very unstable molecule. And it's that very thing that makes it so effective.

• 13:39Dr. Mark Hyman?

  Tell, tell us how it works. So how would you use that with arthritis?

• 13:43Speaker 01

  So the way it works is, is that we can actually, we have an ozone machine. We have a machine.

• 13:49Dr. Mark Hyman?

  Ozone generator.

• 13:50Speaker 01

  Ozone generator.

• 13:51Dr. Mark Hyman?

  Takes oxygen and runs it to the machine that was invented by Nikola Tesla.

• 13:54Speaker 01

  I was just, he did it again.

• 13:56Dr. Mark Hyman?

  I need to say something too. It's my podcast. It's my podcast.

• 14:00Speaker 01

  So Nikola Tesla in 1898, I think it was like 1893 or so. He developed, he patented the first ozone machine, which is a really cool thing. So, so now we have ozone machines and we have an ozone machine that we hook up to medical grade oxygen. And in that machine, it will take that oxygen, it will hit it with electricity and create ozone. And it can be modulated as to how much ozone you can actually make. And you can, you can make anywhere from one to 5% oxygen ozone mixture in different concentrations. And we can adjust that concentration. So we pick.

• 14:37Dr. Mark Hyman?

  It's mostly oxygen with a little ozone.

• 14:38Speaker 01

  Yeah, mostly oxygen, a little ozone. And that's really critical because part of the, the, the, it's ozone, it's oxygen ozone therapy. Cause part of the benefit comes from getting oxygen into the joint. And then the ozone plays another role. So we then take this ozone and we inject it directly into the joint. It can be the shoulder joint, it can be the knee, it can be the hip. It can be the ankle. If, any joint you can put ozone in.

• 15:17Speaker 01

  The way ozone works is pretty interesting. Because it's unstable, it actually has what we call a hermetic effect. It actually, by the fact that it stimulates the body to do something better by irritating it.

• 15:33Dr. Mark Hyman?

  Yeah, like if you're lifting weights, you tear some muscles and you get bigger, stronger muscles.

• 15:36Speaker 01

  Right. So what happens inside the joint is that it will actually modulate the cytokine response. So when you have that damage to your knee and you're constantly moving it, you're constantly creating that inflammatory response. And there are cytokines. And those cytokines will then, this inflammation will lead to the breakdown of cartilage and eventually even bone, and it also mediates pain. Ozone has been shown to modulate that response so that it will actually produce more of the anti-inflammatory cytokines versus the pro-inflammatory cytokines.

• 16:14Dr. Mark Hyman?

  It also activates your antioxidant system. So it's like an antioxidant for your knee and anti-inflammatory directly in there.

• 16:20Speaker 01

  Exactly. So you get anti-inflammatory, it stimulates antioxidant, an antioxidant effect. But remember what I said earlier, that the knee and the cartilage anywhere and ligamentous structures don't have a great oxygen supply. And when you have that much inflammation in an older person and that oxygen supply and circulation has been diminished, now you have, you don't have any of the healing capacity that you would have had without inflammation or if you were younger. What does ozone do? Ozone actually increases blood flow. It increases oxygen delivery and oxygen utilization.

• 16:58Dr. Mark Hyman?

  Wow, that's good.

• 17:00Speaker 01

  And it stimulates chondroblast and fibroplastic activity so that you can actually build up cartilage and build up the soft tissues around the knee.

• 17:09Dr. Mark Hyman?

  It's amazing.

• 17:10Speaker 01

  It's pretty amazing stuff.

• 17:11Dr. Mark Hyman?

  I'm just going to tell a personal anecdote. So I've also been trained in ozone and we do this here at the Ultra Wellness Center, ProOz and other forms of ozone therapy for chronic illness, which are really effective for so many things and definitely on the margins of medicine, but very, very powerful. And

• 17:27Dr. Mark Hyman?

  I had a broken arm a number of years ago and went to get training and how to do this. And my arm wasn't healing. And then I had a frozen shoulder. I could not move my arm above like, you know, like

• 17:40Speaker 01

  Yeah.

• 17:40Dr. Mark Hyman?

  forty five degrees from my body. It was so painful. And he's like, yeah, I can inject your shoulder. The guy was training us. And he took ozone and injected into my shoulder joint. And literally within five minutes, I was like doing this. I was completely mobile, moving my arm everywhere. There was another doctor in the training as well, who had had a frozen shoulder, not just for six months, but for years. Same thing, injected his shoulder.

• 18:04Speaker 01

  Yeah.

• 18:05Dr. Mark Hyman?

  Wow, this is a miracle.

• 18:06Speaker 01

  Seen it over and over again.

• 18:07Dr. Mark Hyman?

  Yeah.

• 18:07Speaker 01

  It's amazing.

• 18:08Dr. Mark Hyman?

  And I remember a patient, not that was mine, but when I was in training, there was a guy who had been on NHL hockey player and he'd won five Stanley Cups, part of the New York Islanders, and his knees were shot. He couldn't walk. And he'd come in for a number of treatments to this doctor. And, and after the ozone treatments in his knee, which I saw him administer, he just was up and walking. And I've seen people come in with canes and dance their way out. It's pretty amazing.

• 18:31Speaker 01

  I, I know it sounds, you know,

• 18:33Dr. Mark Hyman?

  It's wacky, right?

• 18:34Speaker 01

  It sounds sensational, but it is.

• 18:37Dr. Mark Hyman?

  I mean, I was, I mean, I, that convinced me. I literally could not move. I don't know. I had to go to physical therapy for a year and had to maybe go under anesthesia to mobilize my shoulder and all these things I was getting recommended. And I'm like, it was like five minutes and it was painless.

• 18:50Speaker 01

  Yeah, it is. It is.

• 18:51Dr. Mark Hyman?

  It was a little kneel poke, but that was it.

• 18:52Speaker 01

  And when we do it, we not only inject the ozone in, but because we know what's happening and that the joint hasn't been getting the blood supply it needs, the nutrients it needs, we'll add in some nutrients that are part of the healing process. So we'll add in some methylcobalamin, some magnesium and, and procaine. We use procaine also because it actually changes the, the action potential of the cell and membrane, which has been disrupted by the inflammation and it allows for the cells to become healthier. So the procaine actually is not just for the anesthesia, but it's also to help the, the cells heal.

• 19:36Dr. Mark Hyman?

  That's amazing. So, so tell us about this patient you had who you treated with

• 19:39Speaker 01

  Oh, yeah.

• 19:40Dr. Mark Hyman?

  ozone here at the Ultra Wellness Center using, using prolo ozone, which is a form of ozone that you inject into joints or soft tissues to help with pain.

• 19:47Speaker 01

  Yeah. So this is a, this is a woman who just two years ago went on a pilgrimage and hiked through these very, very high mountains in Spain. And on that hike, she she'd been having pain in her knee on and off, but nothing had ever inhibited her from doing anything she wanted. But on this hike, suddenly it blew up. And she couldn't finish her pilgrimage. So she came home to her doctor, x-rays were done, and she had pretty much bone on bone in her knee.

• 20:15Dr. Mark Hyman?

  Wow.

• 20:16Speaker 01

  And so over the past two years, she has had steroid injections and she's had a lubricant injection with hyaluronic acid. And she had some benefit, but she still wasn't able to hike. So she asked if I would treat her and I evaluated her and I treated her with ozone. And after her second injection, just three days ago, we had her second injection almost two and a half weeks ago, three days ago, she went on her first hike in two years. She hiked six miles.

• 20:49Dr. Mark Hyman?

  Wow.

• 20:50Speaker 01

  And went over mountains that were very high and she didn't have a problem. And the day after, she said, I didn't have any swelling.

• 20:58Dr. Mark Hyman?

  That's amazing.

• 20:59Speaker 01

  That is amazing.

• 20:59Dr. Mark Hyman?

  And, you know, so how many treatments do people often need? It doesn't sound like that many.

• 21:03Speaker 01

  Usually, so, you know, usually I tell people between three to maybe eight injections, usually somewhere between three and six is is the sweet spot.

• 21:13Dr. Mark Hyman?

  And then you can come in for a tuna, but if you need it.

• 21:15Speaker 01

  Absolutely.

• 21:15Dr. Mark Hyman?

  Is it painful?

• 21:16Speaker 01

  Not at all. Not at all. I mean, you'll you'll feel the needle going in initially, but once I am in the joint, you may, it's not painful. You may feel the pressure of the ozone going in, but I monitor that very closely when I'm doing it. And I can actually feel it. And

• 21:32Dr. Mark Hyman?

  You can feel the knee fill up with gas.

• 21:33Speaker 01

  Yeah, you can.

• 21:34Dr. Mark Hyman?

  And it's basically a disinfectant. So there's microbes in there that shouldn't be there. It activates the anti-inflammatory system. It's a powerful antioxidant. And it's like

• 21:43Speaker 01

  And it manages a cytokine response, which, you know, causes the inflammation and the pain.

• 21:48Dr. Mark Hyman?

  It's pretty remarkable. I mean, if I had an experience of myself like that, I would like, oh, this sounds really quacky. And and actually, it's it's a real procedure that's being used all over the world.

• 21:57Speaker 01

  For years.

• 21:58Dr. Mark Hyman?

  Many countries for years. It's used here, you know, to some degree, but in in many other countries like Cuba and South America.

• 22:04Speaker 01

  Spain, Italy.

• 22:05Dr. Mark Hyman?

  Italy, Russia. I mean, they're Doing this extensively.

• 22:08Speaker 01

  Yeah.

• 22:08Dr. Mark Hyman?

  It's extremely inexpensive. It's super effective. It's probably more effective than most traditional treatments for osteoarthritis.

• 22:14Speaker 01

  Absolutely.

• 22:15Dr. Mark Hyman?

  And it's got very low downside and very low cost.

• 22:17Speaker 01

  Right.

• 22:17Dr. Mark Hyman?

  When you inject steroids in your knee over time, it's going to degrade the cartilage. It's going to degrade the knee. It's going to make things worse.

• 22:22Speaker 01

  Right.

• 22:23Dr. Mark Hyman?

  You get a temporary benefit, but then you end up with worse situations.

• 22:25Speaker 01

  10%, 10% of people.

• 22:26Dr. Mark Hyman?

  This actually helps restore cartilage.

• 22:27Speaker 01

  Yeah, that, that, that study that came out in 2019, 10% of the people that get steroid injections, actually their arthritis gets worse.

• 22:35Dr. Mark Hyman?

  Yes.

• 22:36Speaker 01

  And they end up with unexplained fractures.

• 22:38Dr. Mark Hyman?

  Yes.

• 22:38Speaker 01

  So.

• 22:39Dr. Mark Hyman?

  Cause it we, it weakens their tissues.

• 22:40Speaker 01

  Yeah, so we, we know that.

• 22:42Dr. Mark Hyman?

  And with proloosin, we've seen, we've seen cartilage regenerate.

• 22:45Speaker 01

  Right, and that's the difference. That's what I, I wanted to make sure we made that point because it stimulates chondroblasts. Chondroblasts are the cells that rebuild cartilage. It can rebuild the cartilage. And again, what we love in functional medicine is to find those modalities that just don't maintain disease, but will actually reverse it. And proloosin fits the bill.

• 23:05Dr. Mark Hyman?

  And, and you were saying this patient, she's hiked six miles and she was told she needed a knee replacement.

• 23:11Speaker 01

  Yep. Yeah, I'm telling you, it's, it's pretty amazing. And she was, she's pretty near bone on bone.

• 23:17Dr. Mark Hyman?

  That's incredible. Well, it'd be interesting to see her follow up x-rays.

• 23:19Speaker 01

  Yeah, I'm interested, yeah.

• 23:20Dr. Mark Hyman?

  And to continue to do this and track it. But I think, I think people out there suffering from osteoarthritis, you know, the focus really should be on lifestyle. And I think people need to understand they have a lot of power to transform the inflammatory state of their body. And what, what often is, is considered diseases of aging are often inflammatory diseases. We call it inflammaging.

• 23:37Speaker 01

  Yeah.

• 23:38Dr. Mark Hyman?

  And I think the arthritis is part of that. It's not just a bone on bone, you know, mechanical issue. It's a, it's an inflammatory issue. What are the causes and drivers of inflammation? Well, basically number one, two, and three is diet. And guess what? The number one, two, and three in diet thing is sugar, sugar, sugar. Or the equivalent of sugar, starch, starch, starch. So anything that's sugar and starch drives inflammation, particularly high fructose corn syrup. So. That should not be a staple in your diet. Unfortunately, it is about 60% of our calories in America. Soda is the number one source of calories in America, which is terrifying to me. And the average American eats 152 pounds of sugar and 133 pounds of flour a year. That's enough to kill, you know, most of us pretty quickly.

• 24:20Dr. Mark Hyman?

  And it does, which is why we see where the sickest population in the world. And so many people die from diet related diseases. So it's in sugar. It's in high fructose corn syrup. It's in processed flours and foods. Also inflammatory fats may be a factor. So lots of refined oils, nine of omega threes, trans fat, which have been ruled not safe to eat by the government. But they're still everywhere in food. I don't know how that works, to be honest with you. I guess there's little loopholes that the food industry gets to give them maybe years or decades. But this was 2005, seven years ago. They said, hey, guys, trans fat kills you, not safe to eat, don't use it. But if you go to the grocery store, you can find it everywhere, which is terrifying. I mean, more and more companies are removing it, but it's still there.

• 25:05Dr. Mark Hyman?

  Also, what else can cause low grade inflammation? Sitting on your butt, not exercising. Exercise is a powerful anti inflammatory, not over exercising, not running a marathon. But doing a moderate amount of exercise every day really helps lower inflammation. Stress, another big cause of inflammation. So nothing we knew about stress, it's out there. That things happen, reading the news. I try to stay away from the news, by the way, it's so stressful. Like I figure if something really bad is happening, I'll hear about it. But, but the key is to find habits and behaviors that reduce your stress response. Meditation, yoga, you know, hot and cold therapies, massage, breathe, breath work, whatever, whatever works for you, try it. But it's got to be a daily practice.

• 25:50Dr. Mark Hyman?

  I do it every day. Today I worked out, I did a sauna and a ice bath, and that really helped me calm my nervous system. Also deal with toxins. Toxins are also inflammatory. They're called immunotoxins, low levels pesticides, chemicals, petrochemicals, heavy metals. I encourage you to go to the Environmental Working Group's website, EWG, and find out how to reduce your exposure through food, including fruits and vegetables, animal products, fish.

• 26:18Dr. Mark Hyman?

  Household cleaning products and even skincare products. I mean, did you know the lead is in a lot of lipsticks? That a lot of skincare products have petrochemicals get absorbed through your skin and get in your body and cause harm. Yeah, don't, don't be doing that. So also another source sometimes is latent infections. We might not know we have it like a virus or

• 26:43Dr. Mark Hyman?

  tick infection or mold we're exposed to. So those all can drive inflammation. And of course, our microbiome is probably one of the biggest sources of inflammation in us. We all have an imbalance microbiome, mostly from our poor diet, lack of fiber, processed food. So we want to cultivate our inner garden. I've written a lot about this. We create a new product called Gut Food that helps people actually heal their gut and, and, and it's like a multivitamin for the gut. So encourage you to check it out, gutfood.com. So really tending your inner garden is so important because there's actually a phenomenon called metabolic endotoxemia. This is a phenomenon that is resulting from bad bugs that produce these toxic compounds called endotoxins

• 27:24Dr. Mark Hyman?

  that get absorbed through your gut lining into your bloodstream and then activate your immune system. Like, for example, these lipopolysaccharides, which are these little endotoxins. And then your immune system gets activated, triggers inflammation, and there's all the downstream causes, consequences of that. For example, high levels of TNF alpha, one of the inflammatory molecules, and it triggers insulin resistance. So literally not even by changing your diet, you can become prediabetic just by the toxic bacteria in your gut. That's why they call it metabolic endotoxemia. So what is inflammation? What's the big deal? Why does it become so dangerous? Well, inflammation is a natural part of your body's function. It's essential.

• 28:07Dr. Mark Hyman?

  Yes, you cut yourself. What happens? The white blood cells gather. They come to the site to rescue. They create swelling. They bring all kinds of healing factors and what you see is redness and swelling and pain and heat. That is the classic sign of inflammation in the body. We used to call that in medical school, rubor, dolor, corlorn, tumor. Tumor just means swelling, not tumor, you know, it's anyway, Latin, whatever. But the key is that it's this normal process that happens as a result of dealing with problems that go wrong. But here's the rough. In the past, most of what we had to deal with was acute things that caused inflammation, like a cut or an infection.

• 28:51Dr. Mark Hyman?

  But today, our modern lifestyle is driving so much hidden inflammation, systemic chronic inflammation, silent inflammation. It's a silent killer. And it turns out that it's not the kind of inflammation that we are familiar with, like a sprained ankle, or a sore throat, or something that's an obvious kind of inflammation, the kind that's good. The kind that we're talking about is the kind that's bad, and that leads to almost every known disease of aging. Heart disease, cancer, diabetes, Alzheimer's, not to mention things like ADD, depression, obviously autoimmune disease, obviously allergies, asthma, all sorts of gut issues.

• 29:35Dr. Mark Hyman?

  All of these problems are caused by inflammation. Of course, then the question is, what causes inflammation? We're going to get to that. From a functional medicine perspective, I don't care that you're inflamed. I care about why you're inflamed. I don't want to give you an immune suppressant, an anti-inflammatory drug, a pile of aspirin. I want to find out what the cause is and get rid of it. In functional medicine, there's a simple rule, and it's this. It's called the TAC rule. If you're standing on a TAC, it takes a lot of aspirin to make it feel better. Take out the TAC. And if you're standing on two TACs, taking one out doesn't make you 50% better. So get rid of both of them, okay? And all of them. Maybe there's five or 10 TACs. And that's the secret of functional medicine. It's a method of investigating the body as a system,

• 30:19Dr. Mark Hyman?

  looking for root causes, and getting the body back in balance. All right, so what is the deal with this inflammation? I mean, I think, you know, when I was in medical school, heart disease was a plumbing problem. You know, it was clogged arteries. We now know that it's an inflammation problem, that the reason your cholesterol becomes an issue is because it gets inflamed, and white blood cells scoop up the cholesterol and stick it in the arteries, causing plaque. Same thing happens in the brain. Alzheimer's is inflammation in the brain. All those plaques in the brain come from inflammation. So cancer also is a disease of inflammation. And when you, for example, look at various studies, even with cholesterol, if your inflammation level is high, but your cholesterol is also high, you're at high risk.

• 31:03Dr. Mark Hyman?

  But if your cholesterol is normal and your inflammation is normal, you're no risk. But if your cholesterol is high and your inflammation is not high, you're really at not great risk. And the worst is if you have, obviously, both. So inflammation is a real big issue. They did a study of an elderly population. They found that if their CRP was high, which was a blood test for inflammation, and interleukin-6, another cytokine test for inflammation, they had a 260% more likely chance of dying in the next four years. So this is no joke. So you might feel fine. A patient will be like, I don't know what's wrong. I feel fine. I saw my blood test says, I don't really care. I feel fine. Why should I change what I'm doing? I'm like, well, if you don't change what you're doing, it might not go well for you. Now, there's no guarantees that's true, but it's likely true.

• 31:48Dr. Mark Hyman?

  So the real concern isn't our response to an injury or an acute infection or something like that, but this chronic smoldering inflammation that slowly destroys our organs and our ability to function and leads to rapid aging. In fact, I just finished my book on aging called Young Forever, and they talk about the hallmarks of aging. One of the key hallmarks is inflammation, or they call it aging itself, inflammaging. And what happens with aging is it's runaway inflammation that just degrades your whole body. So understanding what inflammation is, how to diagnose it, and how to deal with it and get rid of it is so essential if you want to be healthy. Now, what's the problem with the treatments we use? Why don't I just take Advil or aspirin or take a steroid like prednisone?

• 32:33Dr. Mark Hyman?

  Well, they're fine for acute problems, but...

• 32:37Dr. Mark Hyman?

  When things are in this slow smoldering state, they really don't work. In fact, the new data on aspirin was pretty scary about heart disease. Oh, it's going to help you and stabilize your blood, blah, blah, blah, and prevent clotting. But it turns out that the recommendations for aspirin were over enthusiastic and that there are certain patients who should be on aspirin, but very few compared to the, you know, universal statement that everybody should take an aspirin to prevent heart disease. No, because it causes strokes and it causes bleeding, which is not good, like GI bleeding. So, you know, if you, if you look at those drugs like aspirin or Advil or Aleve, they're not benign. I mean, they, they really helpful when you need them, but they can

• 33:18Dr. Mark Hyman?

  cause terrible gut issues. I had gastritis, for example, after taking them for a broken arm and many, many people die. In fact, many, as many people die from taking those drugs as from asthma or leukemia. So imagine if we literally eliminated those drugs, we'd basically essential, it'd be the equivalent of curing leukemia or asthma. So it's not a joke. So, you know, statins, for example, even cholesterol drugs like statins like Lipitor, they may not have their main effect by lowering cholesterol. In fact, it may be because they actually lower inflammation. That's what they do. It's a side, quote, a side effect of the statin, but actually may be their main effect. So how do you know

• 34:01Dr. Mark Hyman?

  if you have inflammation? Is there a way to test for it? Is there a blood test? Well, there are and there are more and more coming. So the most common one that people do is called C-reactive protein. It's high sensitivity C-reactive protein. It's your, something your doctor can order. It's on any lab panel you can get. And you can also see that as a sign of hidden inflammation. Now, if it's super high, it could be infection. But if it's in the sort of one to 10 range, that's usually the hidden inflammation. There, ideally, it should be less than one. Any higher than that means you're on your way. Now, there are other blood tests you can check, cytokines, CED rate and so forth. May not be as helpful, but there's a new test by, developed by a professor at Stanford called IAGE, I-A-G-E, meaning immune age. And it really looks at

• 34:46Dr. Mark Hyman?

  Your immuno, which are 50 different cytokines, many of which you've never heard of. They're molecules that are regulating immunity inflammation, that he was able to correlate by using artificial intelligence with disease. So he found there really, there were about four that highly correlated with your risk of heart attacks, cancer, diabetes, Alzheimer's, and so forth. What's so amazing, this test is really not that expensive. It's easy to get and you can track it over time. And then the good news is you can change things and change your inflammation. Anyway, enough with that. So, you know, the reason we really don't track this is because doctors just kind of are not thinking about the root causes of disease. They're like, okay, what's your symptom?

• 35:31Dr. Mark Hyman?

  What are you suffering from? Okay, let me find the drug that best matches that. You know, if you have a strep throat and I can give you penicillin, great, I'll get a cure, but most of the time I'm just managing symptoms and, or I'm giving you an immune suppressant and that's not the answer, unfortunately. So, okay, so let's say you've identified the causes, you've figured out you have inflammation. You know, how do you live an anti-inflammatory lifestyle? It's the same old stuff. I hate to say it, but it's eat real food, lots of phytochemicals, all those colorful plant compounds are anti-inflammatory. All the phytochemicals in food are so powerful for reducing inflammation. Also, you know, just real, whole, unrefined, unprocessed foods, not lots of sugar and starch, not, no trans fats, no, no refined oils and get lots of those phytonutrients.

• 36:16Dr. Mark Hyman?

  Good fats are really important, too. Avocados, olive oil, extra virgin olive oil, ideally omega-3 fats, things like sardines, herring, sable, wild salmon, they're all really rich in omega-3 fats and they're very healthy for you. Exercise, lots of research on exercise can reduce inflammation. It supports your immune system, it strengthens your heart, it corrects insulin resistance, it improves your mood, it helps reduce stress. I mean, it's, it's one of those miracle therapies that can really do so much for you at so many levels. Practice active relaxation, which sounds like a contradiction or an oxymoron, but no, you have to actively relax. It's not, I don't mean sitting, watching TV, drinking a beer. I mean, meditating, doing yoga, deep breathing, getting a massage, doing something where

• 37:01Dr. Mark Hyman?

  your body just kind of hits down into the parasympathetic state and calms your nervous system. Hot bath. I love that. Last night I was a little, had a very busy day. Lots going on and I just took a hot bath with Epsom salt and I just kind of floated away. It was great.

• 37:18Dr. Mark Hyman?

  Also, food sensitivities are another big factor. You might not know this, but a lot of hidden inflammation can come from not allergies, but food sensitivities, things like gluten, dairy, and certain things that people react to that they may not know they react to. So I often recommend an elimination diet, like the 10 day detox diet that I created to help people reduce their overall level of inflammation. And then you can add back foods and see what's really the problem. So maybe I eliminate a lot of things and then you just add back one at a time. And for example, dairy, I know causes inflammation. If I have dairy, I get pimples, my skin's weird, I get congestion. So I don't eat dairy. Although I do manage to tolerate goat and sheep. Okay. Healing your gut, you know, doing a gut repair program. That's why we've created gut food. That's so important.

• 38:02Dr. Mark Hyman?

  And I think many people would benefit from actually a focused gut repair program, because a lot of their imbalanced bacteria are causing inflammation. And lastly, take it takes the right supplements, multivitamin, fish oil, vitamin D, all help drop inflammation. What are the things in your mind that you go through as a checklist if someone comes in with an autoimmune disease?

• 38:22Speaker 02

  Well, the, the first step I'm going to go is looking for celiac disease and gluten sensitivity. I mean, that is a do not miss in anybody with an autoimmune condition. I mean, if you, if you just look at the overlap, you see higher prevalence of celiac disease and gluten sensitivity in anybody with any autoimmune condition. I mean, we've talked about this before with Cindy Baker's TAC rules. If you're trying to control the autoimmune condition, but you're sitting on that gluten TAC, it's going to be really hard to quiet everything down and, and feel good. You have to remove the driver of the inflammation and the autoimmune upregulations. That is the first place that I go.

• 39:01Dr. Mark Hyman?

  Before you go on from that, I want you to explain the rest, but I just want to emphasize that because, you know, when someone comes with an autoimmune disease, getting a celiac panel is like checking a blood pressure. It's just the most basic thing you can do.

• 39:18Dr. Mark Hyman?

  And often people misinterpret it because the levels are called normal, but they might be in the continuum. So what if normal is up to 20, but your level is 18 or 17 or 15 or 10? Is it relevant? And the answer is yes, it's relevant because it means your body is having an immune response to an antigen or foreign protein in the gluten that you're absorbing across your gut. And your immune system is seeing and then getting pissed off about and creating a systemic reaction around. Now, how bad is that reaction? Will it cause symptoms? Do you feel bad? Maybe, maybe not, but it is causing some low grade level of inflammation. And it's a low grade hidden inflammation that's driving so many chronic diseases.

• 39:58Speaker 02

  Right. I think that's a really important point. And it's another one of those that sometimes doing more in-depth testing. Somebody might say, well, I don't have celiac disease, but every single other gliadin or gluten protein is showing up elevated. That might be a big motivator to say, all right, I guess I do need to stop eating the bread and remove the gluten from the diet. So sometimes we do more testing to convince people or really engage them because it's hard. If those are foods you love, it's hard to get people to give up what they're used to eating.

• 40:29Dr. Mark Hyman?

  Absolutely. Absolutely.

• 40:32Speaker 02

  And of course, there are other foods that could be culprits too, but gluten is the number one in my list.

• 40:36Dr. Mark Hyman?

  Yeah. So go through now the rest of the kinds of things you think about with an autoimmune disease.

• 40:40Speaker 02

  Yeah. So I also think about gut health and the health of the intestinal lining. Because anything that disrupts the health of that lining creates more input to those antibody producing cells. And I think if we quote Alessio Fasano, unlike Las Vegas, what happens in the gut doesn't stay in the gut. If it's not healthy, if that wall is more permeable and there's more bacterial proteins getting into the bloodstream or more food proteins getting to the bloodstream, there's that immune system just going, ah. And it's not just acting at the gut level. It can start cross reacting to organs that we should normally be tolerant to. Hence, an autoimmune condition. So we really want

• 41:23Speaker 02

  to understand the health of the gut microbiome, the integrity of intestinal lining, how well are we digesting and absorbing our food? Do we have an overgrowth of bacteria in the small intestine? That's, that's the second priority.

• 41:36Dr. Mark Hyman?

  Yeah. So you've got gluten, you've got the gut microbiome, you've got leaky gut. What else goes through your mind when you see someone with autoimmune disease?

• 41:43Speaker 02

  Well, so you also think about whether there could be a toxic insult, a toxic exposure that could be up regulating the immune system. We know that, and I won't say that stress per se necessarily causes an autoimmune condition, but it can certainly perpetuate the cycle of inflammation.

• 42:02Dr. Mark Hyman?

  Makes it worse, for sure.

• 42:03Speaker 02

  Makes it worse, just like sleep deprivation, the same thing.

• 42:07Dr. Mark Hyman?

  Yeah. So toxins, like you said, are, are actually immunogenic and there's a word for the role of toxins in autoimmune disease are called autogens. It literally causes an autoimmune response in the body, whether it's pesticides, heavy metals, and I've seen this and I'm sure you have seen it many times in your practice, and you never know if it's that or so because we've gone through the gluten and we've gone through the microbiome, we've gone through toxins, and there's a few other things I think about, like food sensitivities besides gluten that can be a play role, which just goes along with a leaky gut. And then the last thing I think about are, are infections that are

• 42:43Speaker 02

  Right.

• 42:44Dr. Mark Hyman?

  infections because we often ignore those and the bodies, you know, you're, you're living as a host to all sorts of bugs, right? And when you have AIDS or HIV, you don't die from the AIDS virus. You die from all the latent infections that you actually have already living in your body, like pneumocystis or candida or CMB or tuberculosis or whatever you've got kind of laying around, it's just your body's handling. It's, it's, it, that's what kills you. And in, in autoimmune disease, I think there's an unrecognized role of infectious disease. And, and, and there is some literature about this, for sure.

• 43:17Speaker 02

  Absolutely.

• 43:18Dr. Mark Hyman?

  What was interesting to me is that nobody chases it down. So even though if you look at the, the PubMed, the National Library of Medicine, you look at all the data on autoimmune disease, you can type in autoimmune toxin, and, and diet, and gluten, and allergens, and, and Lyme disease, you can, you can, and you'll find all these papers. But what's striking to me is that when you go see the rheumatologist, they don't go, oh, we should look for these things. They just don't. Sometimes they'll check a celiac panel. That's actually more common now. But they don't really look at diet, they don't look at toxins, they don't look at allergens, they don't look at latent infections. And you'll often see dramatic improvements when you actually help people with those issues.

• 43:58Speaker 02

  Well, you know, Mark, it's interesting. When we were in medical school way back in the day, we learned about Reiter's syndrome, right? Reiter's syndrome, where people would show up with symptoms like rheumatoid arthritis, hot swollen joints, and positive rheumatoid markers. And it either came after a gut infection like Shigella or Yersinia, or it came after a genital urinary infection like chlamydia. So we knew even 30 years ago, that those infections can actually trigger an autoimmune reaction.

• 44:29Dr. Mark Hyman?

  That's right.

• 44:29Speaker 02

  And more recently, there's been a link with Porphyramonis gingivalis, so a, a oral bacteria and rheumatoid arthritis. So.

• 44:38Dr. Mark Hyman?

  Yes, that can also be a source, right?

• 44:41Speaker 02

  Yep, which I didn't mention. So absolutely.

• 44:44Dr. Mark Hyman?

  So if someone comes with Raynaud's, you're thinking about all these things in the back of your head. And you're wondering, oh, what's this person's story? And you go into their story, and you can usually ferret out what the issues are for them. And then you can start to chase down the things that are really abnormal. So tell us about Raynaud's. How common is this problem? What are the symptoms? And, and, you know, what is the general approach with traditional medicine?

• 45:08Speaker 02

  Sure. So you talked a little bit about the symptoms, that it's typically fingers, sometimes toes, sometimes nose, turning white, or blue and old. And then when they come in, and it can be very painful. And then you come inside, and as it warms up, they can turn beet red. So it's small arteries that react to the cold. And there's two primary, there are two types of Raynaud's. There's primary Raynaud's, which supposedly is just the Raynaud's by itself. And then there's secondary Raynaud's, which is associated with autoimmune conditions like rheumatoid arthritis and progressive systemic sclerosis. And the second component tends to be more severe. It can even lead to ulcers on the tips of the fingers and things. It's more common in women.

• 45:54Speaker 02

  It's more common in lean women, interestingly enough. And it can significantly affect quality and quantity of life. And if it's a primary source, it's usually reassurance, wear mittens, stay out of the cold. If it's the more serious issues, sometimes they'll use topical nitroglycerin, calcium channel blockers, even medications like Viagra.

• 46:16Dr. Mark Hyman?

  Wow, so Viagra, which is increases blood flow, so that makes sense, right?

• 46:19Speaker 02

  Yeah, isn't that interesting? Yeah, with, with some benefit, right? But I think the important thing is to say, well, what does it actually mean? Either if you have small arteries that tend to react to cold, or if you've got an autoimmune condition, because that opens the door into thinking about things from a much broader, comprehensive way.

• 46:40Dr. Mark Hyman?

  Yeah. And so from, from the perspective of, of the biology of it, you know, you're getting this sort of contracted blood vessels. What, what is the cause of that?

• 46:51Speaker 02

  Well, we don't know 100%, but those arteries, if we think of the importance of artery elasticity, so your arteries are dynamic, they can dilate and they can constrict when needed. Sometimes it's a way to kind of maintain core body temperature. But those small arteries in particular, we think of that interlining, the endothelium that's responsible for regulating the tone. It is another one of those proverbial canaries in the coal mine. It's affected by a lot of other things besides cold. In fact, it's affected by many of the other factors that increase our risk of cardiometabolic disease. We know that arteries can spasm in response to an unhealthy diet or hydrogenated oils.

• 47:37Speaker 02

  We know that arteries can spasm in response to stress or sleep deprivation. Arteries can spasm in response to pollu-, air pollution. So there are many, many other factors that will make maybe a predisposition become more significant and more.

• 47:52Dr. Mark Hyman?

  Yeah.

• 47:54Speaker 02

  More relevant. And the other piece is there's some evidence that if you have arteries that are prone to spasm, it may be a marker that you are at higher risk down the road of developing high blood pressure, heart risk, and stroke. So it's really a time to pay attention to the health of your arteries.

• 48:12Dr. Mark Hyman?

  So it can be found in isolation, just as a random condition, for random, or it can be associated with other autoimmune diseases that people have, like chovirins, or lupus, or other conditions. And essentially, it's almost an autoimmune disease of the blood vessels, right? And it creates inflammation. So then the question is, you know, how do we think differently? You know, if you're just giving drugs like Viagra, or you're giving drugs to, you know, like, increasing blood flow, like, like, blood pressure pills and so on. What do we do differently in functional medicine? How do we think differently about this problem? What are the diagnostic approaches we use to test and figure out what the cause is? And what do we do in terms of treatment?

• 48:54Speaker 02

  Well, I think it's important, number one, to really do a deep dive into vascular risk measurements. We want to know somebody's quality and quantity of cholesterol. We want to know their glucose and insulin, and how they're able to manage glucose. We want to know their inflammatory markers, like their C-reactive protein, and do they have evidence of oxidative stress? Anybody with an autoimmune condition, Mark, I mean, you've talked about this for such a long time. We want to figure out what the underlying cause is that's upregulating the reactivity and leading to the autoimmune condition. So we want to look for food triggers. We want to look at the health of the gut lining, and all of the other things that people

• 49:37Speaker 02

  are familiar with. So it's really looking for upstream, to see from a vascular standpoint, how healthy that is and what's driving it. And from a Driving and upregulating the immune system, what we can identify and remove and address.

• 49:51Dr. Mark Hyman?

  How do we assess people? Is there a test for Raynaud's or are they just sort of looking at the symptoms?

• 49:56Speaker 02

  You know, it's primarily a symptomatic diagnosis, to be honest. There are tests you can do to look at artery elasticity in general. They're not widely available, but some places will do them. They're usually done in the context of cardiovascular disease to look at how resilient these small arteries are.

• 50:17Speaker 02

  You know, there's one by a company called Idamar, based out of Israel, called Endopat. I don't know if you're familiar with that one. It's not very comfortable. They basically put a little probe on your finger and and pump up a blood pressure cuff to block the blood flow for two minutes. And then measure how quickly it takes for the blood to get back to your finger when they let it down.

• 50:39Dr. Mark Hyman?

  Yeah.

• 50:39Speaker 02

  So they can tell you about arteries.

• 50:41Dr. Mark Hyman?

  It's like medical torture.

• 50:43Speaker 02

  Yeah, medical torture.

• 50:45Dr. Mark Hyman?

  Well, that's fine. So that's good. But then it doesn't really tell you why. It just tells you they're not working, which is what we're really good at in medicine is figuring out what's not working, but we don't know how to figure out why it's not working. You know, what's not working, but not why it's not working. And I think that's the beautiful thing about functional medicine. So and I've seen, you know, patients with Raynaud's, when we start to dig down on these issues, we look at toxins, we look at their microbiome, we look at allergens, we look at food sensitivities, we look at infections. We can really start to ferret out what the issues are and often get these people a lot better. So what is the approach then from a functional medicine perspective for Raynaud's syndrome?

• 51:22Speaker 02

  Yeah. So from a diagnostic standpoint, as I mentioned before, we want to look at all those cardio metabolic risk factors. They want to look for the underlying tax that are upregulating the immune system, whether it's gluten or food sensitivities, or something going on in the gut microbiome, or an infection. And then from a treatment standpoint, a lot of the same lifestyle things that we normally want to do specifically help those arteries be more resilient, less reactive. So we know, for example, that studies on meditation, yoga, biofeedback can show improvements in Raynaud's and artery elasticity after six weeks of a regular, consistent practice. Wow.

• 51:59Dr. Mark Hyman?

  It's yoga meditation.

• 52:00Speaker 02

  Right, it's great.

• 52:01Dr. Mark Hyman?

  So you can, you can basically meditate your blood vessels healthier, right? That's good.

• 52:06Speaker 02

  Yeah, who, what was that story years ago of somebody meditating and they could change the temperature in one hand versus the other by like

• 52:14Dr. Mark Hyman?

  Yeah, yeah.

• 52:14Speaker 02

  Five degrees or something incredible, yeah. So we have more control over that autonomic nervous system than what we thought.

• 52:20Dr. Mark Hyman?

  Mm hmm. You know, I've often found, um, finally other things we go around diet or supplements helpful for these patients.

• 52:25Speaker 02

  Yeah, there's a lot. So, um, against specific food components, omega three fatty acids have benefits on artery elasticity, whether that's fish, fish oil, nuts and seeds. Um, you know, arginine is an interesting amino acid. It's used by the arteries to make their own version of nitroglycerin. So it's a precursor of nitroglycerin, which of course dilates blood vessels.

• 52:48Dr. Mark Hyman?

  Nitric oxide.

• 52:49Speaker 02

  Nitric oxide. Yes, thank you. Nitric oxide. Um, so getting nuts and seeds or maybe even supplementing arginine. Um, the deeply pigmented foods that are rich in bio flavonoids, a lot of those polyphenolic foods also relax the arteries. Um, things like risperitrol, for example.

• 53:08Dr. Mark Hyman?

  Yeah.

• 53:08Speaker 02

  Um, folate rich foods, dark leafy greens, another powerhouse for the arteries. So if we think of that extra virgin olive oil, another food that has natural benefits on relaxing the arteries, so.

• 53:21Dr. Mark Hyman?

  Yeah. That's, that's really a lot of what I use, uh, Simi, and I often, you know, I'll supplement with arginine. They're very symptomatic if they're going out and often even ginkgo, which is a, another product. And I think the nitric oxide is interesting. You can increase nitric oxide by your breathing too. Uh, just putting it in practice is we, we had a, uh, Louis Gnarre on our podcast who won the Nobel Prize for his discovery of nitric oxide and its role in improving overall health, reducing inflammation. And it's incredibly important for lung health as well. And with COVID, they're finding nitric oxide being very effective in, in treating COVID patients. And he talks a lot about that on the podcast, but the, the, um, the nitric oxide can also

• 54:02Dr. Mark Hyman?

  be increased by Viagra or Cialis or any of those drugs that are used for sexual enhancement. But they actually. They actually work by increasing blood flow and circulation. So that's a good thing. So, you know, maybe if you have Raynaud's, that might help as well. Uh, so arginine you can take or you can do the, uh, those drugs or, you know, you can actually inco and other things, bioflavonoids I used to use quite a bit. And combining that with the root cause, the medical detective piece, because you can't just give those, someone's got Raynaud's, oh, give them arginine. No. Well, why does it have Raynaud's? It's like, what is the cause? What is the root? And I think that's what often people miss, even in integrative medicine, they'll say, oh, well, you have Raynaud's, use arginine. I'm like, no, no, no. Why do you have Raynaud's? Like, what is the root cause? And this is the part that we're often miss in medicine.

• 54:46Dr. Mark Hyman?

  And it's why at the Ultra Wellness Center, we really have such a robust practice because we are the medical detectives looking for the root cause. You know, I, I, and I just tell you, I just say like, uh, an anecdote of a patient I just had this week that was just, you know, it's one of those stories. He's really awesome guy and he developed a ticket, tick, tics when he was, um, not tick bites, but he developed like motor tics, you know, when he was eight. Um, and I started asking about his story and the doctor was nothing you can do, take these drugs, whatever. So I said, well, what was it like? What was happening? Oh, did you get infections? Did you have this? You have that? So I started digging into his story. He had tons of infections and slapping, all kinds of things. And, uh, you know, we know there's a syndrome called PANDO's,

• 55:28Dr. Mark Hyman?

  which is pediatric autoimmune disease of neurologic, blah, blah, blah. I don't forget what it stands for so long. And, um, and, and that is associated with strep infections that cause behavior issues, OCD, tics. And when I checked his labs, he had super high antibodies to strep. And on the cutting end panel, he had really high antibodies against some of the components in his brain related to strep. And yet no one had even thought to ask the question of why. And so whether it's taken disorders or whether it's Raynaud's, whatever, you, you, if you get, if you get into the habit of thinking, which is what I, I love about functional medicine, because it makes you think,

• 56:10Dr. Mark Hyman?

  um, as opposed to just sort of rote memorization and knee jerk reaction. It's sort of what we get in medicine, which is we make the diagnosis and then we don't have to think anymore. We just basically say, here's a cookbook protocol that is in 2021 for XYZ disease.

• 56:25Dr. Mark Hyman?

  And functional medicine is different. We have to start thinking, we call it thinking and linking. You know, like, oh, we know why you're, we go, why, we know why your, your fingers get cold and turn white and you have no circulations. Cause you have Raynaud's. Like, no, that's just the name of what it looks like. That's the name of the problem. It's not the cause of the problem. Right. And so that's what's so beautiful about functional medicine is you get to actually go into thinking and linking with what Sid Baker talks about. This whole idea of thinking and linking and changing the way that we actually approach diseases by, once we get the diagnosis, that's the beginning of the process of thinking and connecting the dots and being a medical detective. And that's what we do in functional medicine.

• 57:06Dr. Mark Hyman?

  One of the first principle, the first pillar is eat real food, real whole food. Understand that food is medicine. It's not just energy or calories. It's truly medicine. It's information, it's instructions, it's code that literally programs your biology with every bite. It regulates your gene expression, your hormones, your brain chemistry, your immune system, your microbiome. Pretty much everything is controlled by food. And if you're eating the wrong food, you're sending all the wrong messages. It'll be the right food, you're turning on the right method. So there's a 10 day detox. You're basically taking out the bad stuff and putting in the good stuff. You're taking all the foods that cause inflammation, that are, are toxic to your system, that are inflammatory, can mess with your gut. And you're putting in foods that actually help reset your system.

• 57:50Dr. Mark Hyman?

  But it's pretty much a very simple approach. It's lots of veggies, so mostly veggies, lots of good fat, lots of fiber, lots of good clean protein. And what does that look like? It's tons of non-starchy veggies, like broccoli, any kind of veggie you think up. It's not basically a potato. No, sometimes sweet potatoes are okay for people. Avocado, good shots of avocado, olive oil, nuts and seeds, lots of good protein, grass fed, organic, organic meat, fish, chicken. Sometimes we, you know, for veggie carries, we can, or vegans, we can use plant based proteins like tempeh or, or non-GMO or organic soy tofu.

• 58:33Dr. Mark Hyman?

  Those are the most dense sources of protein, but you do need protein that you detox by. So for the 10 days, you're going to be getting rid of all the other junk, right? Processed food, other. Carbs, sugar, dairy, coffee, gluten, alcohol, uh, pretty much actually all grains and beans. Uh, and the reason we get rid of grains and beans, they're necessarily all bad, is a lot of people have issues. Uh, a lot of people have issues with their gut. A lot of people have issues with inflammation. A lot of people have issues with gluten. A lot of people have issues with, um, insulin resistance and prediabetes and obesity, and they can be problematic for these people. So basically get off all the bad stuff. Now, it's not calorie counting. You can eat as much as you want. We're not like crazy, how much macronutrients and percent of this and percent of that. No.

• 59:18Dr. Mark Hyman?

  It's just pick the right foods and we focus on what to eat. You don't have to focus on how much to eat, right? So, um, when you look at your plate, it should basically look like this. Three quarters of it should be non-starchy veggies. And I use, often will put two or three veggies in my dinner. I'll make mushrooms. I'll have, uh, a, uh, you know, broccoli. I'll make some, maybe a salad. So I'll have lots of veggies and, and I'll have a, a portion of protein that's essentially, uh, the size of my palm. Four to six ounces, usually thirty to forty grams of protein. Now, that's a good amount of protein, but you don't need that much if you're having all protein. It should be very generally raised, should be pasture raised chicken, wild caught fish, should be low mercury, obviously all that.

• 1:00:01Dr. Mark Hyman?

  And we'll put all that show notes. Lots of good fats with dinner, like avocados, nuts and seeds, olive oil in your veggies. Uh, you can even use, for example, ghee, uh, which is a, uh, kind of a butter, but it actually has the, the inflammatory proteins removed, casein and whey. It basically has just, uh, the, the fat. It's called clarified butter, very common. You can get my book, Ten Day Detox Diet. You can get the Ten Day Detox Diet Cookbook, whatever you want. We'll put all the show notes and links together. I do call it the Ten Day Detox Diet, but sometimes you need to do it longer, like two weeks, three weeks, ten months, maybe even ten years, depending on the situation. But we're going to talk about the ten days and how powerful that can be to transform your health.

• 1:00:44Dr. Mark Hyman?

  Now, I find that most people have never connected the dots between how they feel and what they eat.

• 1:00:53Dr. Mark Hyman?

  They walk around with what I call F L C syndrome. That's when you feel like crap. And that is a big problem for people. What do I mean by that? Well, you might be tired, sluggish, you might have brain fog. Maybe I have digestive issues, reflux, heartburn, irritable bowel. Maybe you have nasal congestion, sinus issues, muscle aches, joint pains, headaches, insomnia. Should I go on? Rashes, acne, I mean, it goes on and on and on. And, and many of these things are caused by food. And the only way to know is to do a total body reset. It's like hitting the reset button on your commuter. When all the systems are jammed, it's a complete reboot. So how do you do a reboot?

• 1:01:37Dr. Mark Hyman?

  It's very powerful and most people have never experienced this. And this is what I love to do with people. And I actually run programs all around the world where people can come and actually experience this. We, we do programs where we have people do this just in five days, not even 10 days. People have a 70% reduction in all symptoms from all diseases. Now I'm going to put in the show notes, the medical symptom questionnaire that I use in my practice, which essentially gives you a score based on the degree and frequency and severity of symptoms. So if you have a headache, is it zero, meaning never? Or four, I get it all the time, really that? Or some version in between. And then you get a score at the end and you know, people have a score of 60, 70, 100. It should be less than 10, maybe even zero ideally. I, I mean, should have the symptoms, it's not normal for human beings to suffer this much.

• 1:02:21Dr. Mark Hyman?

  And that's really why I created this, this book and the program, the 10 day detox side, because I was doing this with my patients and seeing such incredible results. So I do this personally regularly. I do it at least two or three times a year, four times a year to really reset my system, to kind of get my body back on track, to get rid of all the bad stuff, put in all the good stuff. Now I want to walk you through how to do this. Uh, I'm going to teach you how to hit the reset button, uh, reboot your system and to optimize your biology to help your gut, help your detox system, help your immune system, help reset your nervous system. And it's powerful. So, uh, if you want to really see how your body can feel and get rid of what we call F L C syndrome, I would do this.

• 1:03:06Dr. Mark Hyman?

  Most people are like, uh, the frog that's in cold water where you turn the heat up slowly and it starts to boil to death. We just kind of get used to it and think it's normal. These symptoms are not normal. I, I want to do this with a junior high school once and, uh, The teachers are like, well, I, we might have to get permission from the parents to see if it's safe. You know, maybe they don't want their children doing this. I'm like, what is it safe to eat fruits and vegetables and nuts and seeds and protein and cut out sugar and starch and processed food? I mean, they should get a note that it's permission to eat the junk food that they have in school. It's the opposite. Anyway, yes, it's very safe. Anybody can do this. And some people, by the way, you know, need more certain things or other things, but, but basically

• 1:03:51Dr. Mark Hyman?

  it's a very universal approach to resetting your system. A second pillar, aside from what you eat, the, the food is really important. And by the need to approach in the morning, you need to make sure you get rid of sugar and starch in the morning. Super important. A lot of people start their diet, their day with carbs, which is the worst thing you can do with sugar, sweetened coffees, teas, cereals, muffins, bagels, breads, done. Second pillar are your daily habit. Essentially, it involves a pattern of eating and living that puts your body back in rhythm. It helps you reset your nervous system. And, and there's two really important habits as part of the 10 day detox. One is when you eat and also when you sleep. Let's talk about when you eat. Now, when you eat might be as important as what you eat. So many of us don't eat in the

• 1:04:35Dr. Mark Hyman?

  right pattern. We tend to, you know, eat all day long. We tend to snack. We tend to eat before bed. We snack late at night. It's kind of bad. So basically, when you eat is very important. Research shows that doing that can really be bad for your health if you eat at night. So the first is make sure you give yourself at least 12 to 14 hours between dinner and breakfast. So dinner is six, breakfast at eight. That's a 14 hour fast. Okay. If you eat at six and then you keep snacking all night, that doesn't count, right? And it's the most simple formula we call time restricted eating. And it's basically giving our body a rest and getting the body to reset. And I wrote a lot about this in my book.

• 1:05:19Dr. Mark Hyman?

  The young forever, but but basically there's all process at night that happens called autophagy and cleanup and repair. You want to give your body the ability to do that. The next is food. Now, you can do a breakfast if you're eating, you know, for example, dinner at six and breakfast at eight or so, that's a 14 hour fast. Really important to have protein in the morning and not carbs and sugar. Also, not eating three hours before bed is really important. So most people eat and snack after dinner. Don't do that. Have at least three hours of time you eat and you go to sleep. That way you will lose weight, your body can repair and heal instead of trying to digest and store the food. What about sleep? Sleep is one of the most underrated pillars of health. It's probably even before exercise, meditation, maybe even before nutrition, because

• 1:06:04Dr. Mark Hyman?

  when you don't sleep well, you're going to eat tons of sugar and carbs, you're going to crave more. So you want to focus on sleep and rest. We know that getting in a routine of waking and sleeping can help with a deeper, more restful sleep. So try to stick the same bedtime every night, try to get off your screens for an hour or two before bed, keep your room or use blue blocker glasses, keep your room dark and cold and probably 65 to 68. Really important because your body does much better with sleep at night. Try to relax at night with meditation, do a guided imagery, do breathe breath work, stretching, journaling, gratitude practice, whatever you like, but do something. Very important. So your evening routine should be like, set a bedtime and stick

• 1:06:45Dr. Mark Hyman?

  it over the 10 days. Turn your phone off and get it out of your bedroom. Turn the TV off for at least an hour or two before you go to bed. And then use the time at night to read, to journal, to meditate, to connect with people you love, and just kind of wind down. The third pillar is extra support we need on the journey, right? Now, we all need nutrients. They're called vitamins because they were vital amines, vital to life, right? And and so we've seen a dramatic reduction in the nutrient density of our food, our organic matter's gone out of our soil.

• 1:07:22Dr. Mark Hyman?

  Nutrients can't be extracted. Foods travel long distances. We have commodity crops which are bred to actually breed out the nutrients and in the starch and, and, and, you know, yield. And so foods aren't nutritious as they once were. And probably ninety percent of Americans, according to the government-owned surveys, are deficient in one or more nutrients at the minimum level to prevent deficiencies. So how much vitamin D or you need to not get rickets? Not very much, like thirty units. How much need for optimal health? Probably three to five thousand. So we need to really probably focus on nutrients. And even with a perfect diet, you know, because none of us are hunter-gatherers anymore, or you know, kinds of food that we never ate, and I'm nutrient depleted. We need, we need the basics. So we need a basic set of supplements.

• 1:08:07Dr. Mark Hyman?

  Some multivitamin and mineral foundational. Magnesium, a lot of us are deficient, probably forty-five percent are low or deficient in magnesium. It involves over three hundred different enzymatic reactions. Super important, helps relax your nervous system at night, help you calm down. Also, people get constipated sometimes when they change their diet. So taking magnesium citric can help. And lastly, vitamin D. It's also like fish oil, but vitamin D is really important. Vitamin D, over eighty percent is low or deficient in vitamin D. It's, it's involved in so many different things in the body. So really important. And it helps your mood, helps your muscle function, helps your brain, helps your energy, helps inflammation, autoimmunity. It's just super important. And most of us are low. Fish oil is also important. And I often recommend fish oil to people, or omega-three fats.

• 1:08:51Dr. Mark Hyman?

  So what are the program steps in the ten-day detox? What should be the ten? And then we're going to go through this. And the first step is to eat from the ten-day detox approval list for ten days. So eat what I'm telling you to eat, right? Whole foods. You need a whole food-based shake in the morning. You could add, you know, protein powder, grass-fed protein if you want. I have a grass-fed protein called super silv protein. But you really need to make sure you have a good breakfast. Second is commitment to daily habits, right? Pick your designated eating window, right? You want a twelve to fourteen-hour overnight fast, which means eating within a ten or twelve-hour window.

• 1:09:31Dr. Mark Hyman?

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

• 1:10:17Dr. Mark Hyman?

  Meats is great. You can have a pasture raised lamb, beef, bison, venison, elk. Grass fed beef, ostrich raised chicken, turkey, duck. All that's fine. What you should avoid is conventionally raised chicken and poultry and eggs and so forth. And by the way, you can also have eggs if they're pasture raised eggs. Meat, get rid of all processed meats, deli meats, all conventionally raised feedlot meats. Get rid of all that stuff. What about fish and seafood? Lots of small fish are good. Big fish are bad, right? Big fish like swordfish, tuna. Sea bass, halibut. Most farmed fish are pretty bad for you. What you should be consuming are things like the, I call this mashed fish.

• 1:10:58Dr. Mark Hyman?

  Small wild salmon, sardines, anchovies, herring, mackerel. You can have black cod, shrimp, scallop, trout. All those are fine. Eggs, as I said, pasture raised eggs are fine. Non-organic regular eggs are not fine. What about nuts and seeds? Very important. Almonds, Brazil nuts, cashew nuts, hazelnuts, macadamia, pecan, pine nuts, pistachios, walnuts. All that's great. You can even have cacao nibs, chocolate, not actually chocolate, but where chocolate comes from. Seeds are great. Chia seeds, flax seeds, hemp seeds, pumpkin seeds, sesame seeds, sunflower seeds, pumpkin seeds, all great. Nut butters also great. So unsweetened nut butters. So almond, cashew, pecan, macadamia, I love macadamia.

• 1:11:43Dr. Mark Hyman?

  A walnut. All that's great. You also eat beans if they're, if you're a vegan and you want to do this, you can use GMO free or non-GMO tofu or tempeh as your protein.

• 1:11:57Dr. Mark Hyman?

  What you should avoid are nuts that are with sugar, they're cooked in oils, uh, that are with gassy candy stuff. A lot of nut butters have sugar, hydrogenated fats, peanut butter, peanuts, uh, can be okay, but I would say mostly avoid peanuts because, uh, they have aflatoxin, um, they often are rancid, uh, and so you want to be careful with that. Um, what about oils and fats? Well, the ones you want to use are organic avocado oil. Uh, you can use organic coconut oil for cooking, grass-fed ghee. Uh, if you want to use tallow, lard, uh, duck fat, chicken fat, that's okay, as long as they're, they're, um, uh, path raised or originally raised. For salads, you can use different kinds of oils like almond

• 1:12:42Dr. Mark Hyman?

  oil, flax oil, hemp oil, macadamia oil, extra virgin olive oil. Um, and you can cook with olive oil, but only like tomato sauces and things like that. Things that are not high heat. Sesame oil, tahini is great as well, great fat. Uh, sesame seed kind of paste, almond oil, those are flavorful oils, they're not named oils, but you want to avoid the traditional oils, all the seed oils like canola oil, partially hydrogenated oils, margarine, peanut oil, soybean oil, sunflower oil, safflower oil, trans fats, vegetable oil, vegetable shortening, all that stuff, that. What about veggies? What should you eat? Well, you want to stick with lots of non-starchy veggies, or artichokes, organic if you can. I use the Dirty Dozen Guide from the Environmental Working Group, EWG.org, tell you which are the clean 15, meaning you can eat things that are not organic, or the Dirty Dozen,

• 1:13:27Dr. Mark Hyman?

  which you definitely not eat if they're not organic. But I love asparagus, artichokes, avocado, bean sprouts, broccoli, Brussels sprouts, cabbage, cauliflower, celery, cucumber, eggplant, garlic, ginger, hearts of palm, kohlrabi, leafy greens, mushrooms of all kinds, onion peppers, radicchio, radish, fruta baga, all that kind of stuff. Steamed wheat is great, lots of minerals, shallots, summer squash, tomatoes, turnips, zucchini, list goes on, we have all in there. You can have some, uh, things like sweet potatoes, I like the Japanese purple sweet potatoes, winter squash, carrots, pumpkin, all that's fine. I mean, carrots are fine, because unless you're drinking carrot juice, or that's a problem, but. Basically try to limit to a like one uh serving, which is like half a cup a day.

• 1:14:11Dr. Mark Hyman?

  Uh, what you should be avoiding is corn and white potatoes, mostly. A little, you know, some of the little uh English potatoes or the proving potatoes, purple potatoes can be fine. What about dairy? Um, you can eat pasture raised butter or ghee, but I encourage you to get all dairy, including sheep and goat, which are mostly fine for people. But I encourage you to just get all other dairy. And if you're having, um, he encouraged you to have, make sure it's grass, grass fed or originally raised. What about beans? Well, uh, you can have green beans, you can have green peas. Uh, you can have a non GMO or organic soy, uh, just tofu or tempeh. Uh, you can have snap beans, you can have snow peas. Um, but otherwise definitely no, no beans.

• 1:14:56Dr. Mark Hyman?

  Uh, what about grains? No grains at all. So, uh, even healthy grains, quinoa, buckwheat, things like that. I incredibly have off, off all of that. Why? Cause it just shuts down the insulin response, helps you lose weight, reduce inflammation. Not that these are necessarily all bad, but eventually you're gonna add them back. But basically get rid of all, all the other, all grains. Wheat, barley, rye, rice, ham, red mullet, tap. Oh, it's everything. Uh, get rid of it. Uh, fruit, fruit can be okay, but um, small amounts of non high glycemic fruits. So organic blackberries, blueberries, cranberries, kiwi, lemons, limes, raspberries, all that's fine. Uh, not too much, right? You don't even like, you know, two pounds of blueberries, but you can have a top half, half a day.

• 1:15:37Dr. Mark Hyman?

  Want to get rid of all the other fruit, all the high glycemic fruit like bananas, pineapple, melons, cherries, grapes is the worst, even foods that, food. So you think, you know, maybe good for you are actually good for you, right? Whether it's, you know, peaches, pears, nectarines, uh, cherries, for example, but you don't want to eat them while you're on the 10 day diet. You want to really shut down the blood sugar and some response. Uh, what about sugar sweeteners? Sorry, none.

• 1:16:04Dr. Mark Hyman?

  You can sometimes have a little monk fruit or CBF you have in the shake, uh, we have, but generally tend to avoid all that stuff. Um, also just get rid of all the other artificial sweeteners, all the sugar, all that stuff. If you have to ask, the answer is no, basically.

• 1:16:20Dr. Mark Hyman?

  Then what should you be drinking? Well, lots of water, herbal tea, green tea. This fellow caffeine, that's okay. A little green tea is fine. You know, if you get off coffee, sparkling water, mineral water, all this, I wish you avoid alcohol, coffee, bottled water, plastic soda, obviously sugary beverages. Basically, that's the programs. If you love this. 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

• 1:17:05Dr. Mark Hyman?

  your disease risk, or you're looking to improve your sleep, blood sugar, metabolism, gut health, you name it, drhyman.com has the world's best selection of top quality premium supplements, all backed by science and expertly vetted by me, Dr. Mark Hyman. So check out drhyman.com because when it comes to your health, nothing less than the very best will do. That's drhyman.com, D R H Y M A N dot com. 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

• 1:17:48Dr. Mark Hyman?

  next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained licensed healthcare

• 1:18:33Dr. Mark Hyman?

  practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.