The Mouth-Body Connection: How Oral Health Shapes Whole-Body Healing

Most people don’t realize that what happens in the mouth can ripple through the whole body. The balance of the oral microbiome—the community of bacteria living in our mouths—can either protect us or trigger widespread inflammation that affects the heart, joints, and brain. Hidden dental infections or mercury fillings can quietly drive fatigue, autoimmune issues, or dementia—and fixing the mouth often helps the rest of the body heal, too. The good news is that with simple steps like eating whole foods (often removing gluten), cleaning the mouth well, and breathing through the nose, we can protect both our smile and our overall health. When we care for the mouth as part of the body, lasting wellness becomes possible from the inside out. In this episode, Dr. Todd LePine, Dr. Elizabeth Boham, James Nestor, and I talk about how a healthy mouth microbiome is a key to whole-body wellness. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. James Nestor is an author and journalist who has written for Scientific American, Outside, The New York Times, and more. His book, Breath: The New Science of a Lost Art, was an instant New York Times and London Sunday Times bestseller. Breath explores how the human species has lost the ability to breathe properly—and how to get it back. Breath spent 18 weeks on the New York Times bestseller list in the first year of release, and will be translated into more than 30 languages. Breath was awarded the Best General Nonfiction Book of 2020 by the American Society of Journalists and Authors, and was nominated for Best Science Book of 2021 by the Royal Society. Nestor has spoken at Stanford Medical School, Yale School of Medicine, Harvard Medical School, The United Nations, Global Classroom, and appeared on more than 60 radio and television shows, including Fresh Air with Terry Gross, the Joe Rogan Show, and more. He lives and breathes in San Francisco. 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:The Functional Medicine Approach To Oral Health Getting Rid of Cold Sores and Canker Sores The Power Of Breath As Medicine

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

  And there's a lot of organisms that are in the mouth. In fact, the oral organisms, we have hundreds of oral organisms. There's about a 45% concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract. And you can think of the whole body as being like a tube.

• 0:21Dr. 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 As, 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.

• 1:02Speaker 01

  The gut is sort of where everything starts, and it can either lead you down the path of health, or it can lead you down the path of disease. And the beginning of the gut is the mouth. So as you mentioned, you know, in medical school, we didn't learn anything about the mouth. That was like for the dentist, you know, we'll just ignore that. And the dentist just basically stay in the mouth, and they don't really realize that there's a whole body connected to the mouth, or some of the dentists don't. And this is where I think a lot of both, you know, even functional medicine physicians and dentists really miss the connection. So unless you're working with a holistic, smart dentist, or a functional medicine doctor

• 1:42Speaker 01

  who's aware of the connection between the mouth, and the gut, and systemic immune system, you're going to be missing a lot of things. And as you mentioned before, you know, there are a host of conditions, including premature birth, obesity, diabetes, cardiovascular disease, rheumatoid arthritis, inflammatory bowel disease, and even dementia, that are directly connected to poor oral health.

• 2:13Dr. Mark Hyman?

  It's incredible. Yeah, I mean dementia and they're finding that the microbes in the mouth can absorb and then go up into the brain and create inflammation in the brain. Pretty wild. We know that your risk of having heart attacks is higher if you have gum disease. We know that even, you know, weight metabolism are related to what's going on in your mouth. So, you know, what's, so what's wrong with traditional dentistry and its overall approach? Because you know, a dentist does your teeth cleaning, they might treat your gum disease, they'll fill your cavities, they'll stick in root canals. So what, tell us what is the problem with traditional approaches to dentistry?

• 2:47Speaker 01

  Though, you know, you know, traditional dentistry and dentistry has gone a long way. You know, the original dentists were actually barbers, you remember that? The barbers used to like pull the teeth out. And, and the, and the dentists have come a long way since being barbers. But, you know, a lot, you know, dentists are what we call drill and fill. And, you know, then, then you can do root canals, and then you can do implants and those kinds of things. A lot of that's related to structure function and cosmetics. People want to have white teeth and you don't realize, okay, just because you have white teeth doesn't mean you have a healthy, a healthy oral microbiome. And you really have to look at the, the whole picture because, you know, the beginning of digestion starts

• 3:29Speaker 01

  with your mouth, starts with healthy saliva. And all of those things are, are interrelated to being able to digest and absorb your nutrients from the get-go. You need to have a proper salivary pH, you need to have sufficient amylase. So there's a lot of, of happening in the mouth that is the beginning of digestion.

• 3:48Dr. Mark Hyman?

  All right. So, you know, one of the challenges is traditional dentistry is they use certain techniques that we find problematic. For example, putting in silver fillings or mercury fillings. And recently you sent me a link to the FDA's new ruling that fillings were not acceptable for pregnant women and babies and kids. So why is it good for the rest of us?

• 4:07Speaker 01

  It's not good. It's not good for the rest of us. And, and you know, the thing is, is that interesting thing about that is that, you know, I think, you know, as you said before, there's no safe level of mercury. You know, the mercury is a known neurotoxin. And some people are better able to detoxify it. My, my father is an example of that. My father, he practiced dentistry up until his eighties and he used to literally handle a mouthful in his hands. And he'd be, you know, throwing it on the floor and, and I can remember going to his office and playing with the mercury in his office. And lo and behold, you know, people, there are some people who are better at detoxifying mercury. And there are others that don't detoxify mercury as well. But mercury is definitely for some people, a real problematic issue.

• 4:52Speaker 01

  As that case, you experienced that yourself. And there's testing that we do for mercury. You can check for mercury body burden and you can check for both organic and inorganic mercury. One of labs quicksilver that we use does is that, does that test? And it can tell you how you're extruding both organic and inorganic mercury. And the one from fillings is the inorganic mercury, which is the more toxic to the brain.

• 5:18Dr. Mark Hyman?

  Right. And so we've got the filling problem, which really nobody should ever have silver fillings. And if you have them, you know, it's tricky that, you know, you get them out, you not get them out. How do you determine when? I think you need to know that there are biological dentists who do it safely. And there's a website called I A O M T dot org. I'm putting the show notes, I A O M T dot org, which is a resource of learning more about biological dentistry and finding a biological dentist in your area who, who knows how to practice safe removal and all, and other dental techniques that actually help to rejuvenate your mouth. One of the other challenges is root canal. So I think, you know, people are getting a lot of root canals. I certainly had one and I had to take it, had to take it out. But tell me, what is the problem with root canals?

• 6:03Dr. Mark Hyman?

  Why should we be concerned? And should everybody with root canals have their teeth pulled or what do we do?

• 6:08Speaker 01

  All right. So, okay, so I'm not, I'm not an endodontist who does root canals. And you, and I spoke with my, my, my family members about this. And if somebody is really, really skilled at doing a root canal, you can do a root canal. The real, I think the key thing about root canal, uh, doing a root canal is to make sure that you're dealing with a sterile environment, which is very, very difficult in the mouth. Um, because, uh, you know, when you're doing a root canal, my sister, uh, Gail, she made a a comment that like a, a root canal is basically a dead tooth. And if you had a dead spleen, would you leave a dead spleen in your body? No, you just, you know, you want to remove a, a, a dead, uh, organ. And, uh, uh, a tooth that's devitalized doesn't have nerves.

• 6:49Speaker 01

  So if you get an infection, you oftentimes won't get pain unless it starts surrounding to the, uh, other area. You don't have a lymphatic system to drain, uh, infections. You don't have blood supply, uh, arterial and venous supply. So you can really get these, you know, these stealth infections. Uh, and by that, you know, we typically think of an infection as someone who's, you know, got a fever, there's swelling, et cetera. But you can have these smoldering infections and I, I've seen, you know, just this past week, I've had two patients who had a history of, uh, uh, root canal issues that were manifesting as systemic issues and they really didn't have a whole lot of oral issues. They're having peripheral issues. Yeah, that's interesting. Exactly. Yeah.

• 7:31Speaker 01

  And then when they open, uh, open those, uh, root canals up, uh, if it's a bad root canal, root canal, uh, gone bad, um, they often find these anaerobic infections and they are foul smelling. Uh, they're, you know, the anaerobic, um, bacteria produce things like putrescine and cadaverine and you don't want a lot of cadaverine in your body unless you're a cadaver. Uh, and putrescine is very, sure. Doesn't sound good either. And there's a lot of, yes, you're right. And there's a, there's a lot of organisms, uh, that are, uh, in the mouth. Uh, in fact, the oral organisms, we have hundreds of oral organisms. There's about a 45% concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract.

• 8:13Speaker 01

  Um, and you can think of the, the whole body as being like a tube. And the opening of the tube starts at the mouth. And then it goes all the way down into the stomach, the small intestine, uh, large intestine, then out the anus. And, uh, those bacteria that are in the mouth get swallowed, uh, by the body. I mean, you, you, uh, uh, will swallow about, uh, 10 billion bacteria per day. Um, and some of those bacteria, when you swallow them can actually. Cause systemic inflammation and those systemic inflammation can manifest in the joints, in the heart or in or in the brain. It can also promote systemic inflammatory diabetes as we as you well know.

• 8:58Speaker 01

  So it's it's a real, you know, important issue and it's not just, you know, just having, okay, my teeth look white, everything's fine. You can't see the types of bacteria that you have in your mouth and not only that, but your individual immune response to the bacteria is really critical. We know that in terms of, you know, with like, say, for example, COVID, you know, COVID is a virus. And as a virus, you know, for the vast majority of people, it's not going to kill you. You get it and you may be totally asymptomatic, you may have a mild cold or you may die from it. The same thing with certain types of bacteria. Everybody's immune system is unique. And when certain people are exposed to certain organisms at at critical levels, it provokes a low grade inflammatory response, or in some cases, actually even more acute.

• 9:42Speaker 01

  And that can lead to a whole host of systemic issues.

• 9:47Dr. Mark Hyman?

  Yeah, I think that's true. And I think both of us have seen patients who, when addressing their dental issues, often resolve other systemic issues. So maybe you could share a little bit about some of the patients you might have seen that have links to their systemic health from their oral health.

• 10:02Speaker 01

  Oh, absolutely. I have three three cases. Real briefly, the first case is a patient who actually was a friend of mine. And I remember we were talking over a beer and he was telling me, you know, some of his health issues. And, you know, he was bemoaning the fact that he was having all these symptoms and nobody could figure it out. And and I said, well, why don't you come see me? I'll, you know, I'll do a consult on you. We'll take a look at it. That's what sort of what I do. And he told me, you know, in going over his history, that he had a Cadillac in his mouth. And I said, what do you have a Cadillac in your mouth? The guy got about $40,000 worth of dental work in my mouth. And he goes, you know, the dentist said I have weak enamel.

• 10:44Speaker 01

  And I said, well, what do you mean weak enamel? And I said, you know, weak enamel is not normal. I said, did he tell you why you have weak enamel? And the first thing that popped into my head is that he probably had undiagnosed celiac disease, which we thought weak enamel. And lo and behold, I tested him and sure enough, he had marked a response to gluten. And when he got off of it, I mean, all of it, a lot of his symptoms, they didn't affect his teeth because, you know, the horse was already out of the barn. But he also was having sort of unexplained fatigue and malaise and all that kind of stuff. And, and actually just getting off of gluten cleared up those other conditions. And we all, you know, you and you and I well know that there are multiple

• 11:28Speaker 01

  autoimmune conditions that are associated with gluten sensitivity. But weak enamel is one of those things. And I also, I try to get my patients and the dentists who I see, either as patients or dentists who I meet in social circles, to really be aware of that because I just think it's below everybody's radar. That's incredible. Yeah, that was, yeah, it was really, and it was a very life changing for him. Another case is a patient who I saw who was diagnosed as having rheumatoid arthritis. And this is a woman over from Europe, and she wasn't getting anywhere in the European system. Not that the European system is better or worse, it's just different than our system. But she was not getting

• 12:10Speaker 01

  any significant help over there. They wanted to use the disease modifying anti rheumatologic drugs for the DMards. And when I did a workup on her, I did a deep dive in her and she had a seropositive rheumatoid arthritis. And by seropositive, meaning that when you check for rheumatoid arthritis, you can have a positive rheumatoid factor, or you can have a positive CCP antibody, or both of them, one or the other, or both of them. You can also have sero negative rheumatoid arthritis. And as we talked about earlier, rheumatoid arthritis is just a label that we put on things and lots of different things can cause rheumatoid arthritis. The most virulent aggressive type of rheumatoid arthritis is the one that has both RA positive

• 12:55Speaker 01

  and CCP antibody positive. Now, if you go into the medical literature, CCP antibodies are associated with periodontal disease. So anytime I see a rheumatoid patient who's got a positive CCP, there are other things that can do that. Epstein-Barr virus can do it also, but it's strongly associated with the periodontal disease. And you, then they have to start doing a deep dive. So what I did with her is I did a deep dive and lo and behold, she had a lot of dental issues. She had old root canals. She had silent infections. And I did as much as I could and then I also referred her to a very good colleague of mine, Doug Thompson, who runs the Wellness Dentistry Network out of Michigan.

• 13:40Speaker 01

  And he helps to teach other physicians about integrative dentistry. So I referred my patient to see him and he did all of the different things that he did. In addition to having rheumatoid arthritis, she also had undiagnosed Lyme disease. Ah. So she had, yeah, exactly. So she had two things going against that can affect the joints. So I basically treated her Lyme disease, did that successfully over a period of time, had her see an integrative dentist. We did testing on her oral microbiome. He did his thing and she had a dramatic improvement. She also really changed her diet. And all of those factors really, really made a huge difference in her life.

• 14:25Speaker 01

  She was basically not able to function. And when we treated, you know, the underlying causes, the root causes, she had a dramatic improvement in her health.

• 14:36Speaker 01

  And then one other case, and this is a really anecdotal case. I really like this case. And Mark, you probably have seen some patients or, you know, I'm certain in your career that you've seen a lot is a patient who has a frontotemporal dementia.

• 14:50Dr. Mark Hyman?

  Yeah.

• 14:51Speaker 01

  Right. That's a bad, it's a bad thing. And it's like Lewy body, you know, we don't really understand, you know, these kinds of conditions. And I saw the, the lady, and she was actually quite advanced with her frontotemporal dementia when I saw her. And I did a big workup, did the ion test, nutritional metabolic testing, testing for leaky gut, testing for heavy metals. And I did, and actually at the time, I did relatively new tests, which is the my perio path test, which is looking at the DNA of the oral microbiome. And she had one of the worst oral bacterial microbiology analysis that I've ever seen. And my hypothesis was, is that I think

• 15:33Speaker 01

  her frontotemporal dementia was really being driven by undiagnosed severe periodontal disease that was spreading up to her brain.

• 15:50Dr. Mark Hyman?

  Well, you just said a mouth, you just said a mouthful there because I just, I just wanted to highlight a couple of things. One, there is an oral microbiome.

• 16:00Speaker 01

  Yes.

• 16:01Dr. Mark Hyman?

  And just like there's an intestinal microbiome, and that has implications for your health. And there's ways that now we can test this. And this is not something you're going to get at your traditional doctors. What we do here at the Ultra Wellness Center that's so unique, we, we do to dig down below the layers to see what's really going on. There's also genomic variations in our, in our own DNA that affect our risk of periodontal disease. And there's also tests we can look at to look at the heavy metals in the mouth and see if the mercury in your fillings is getting off gassed and if you're absorbing it and detoxifying it or not. So there's a lot of tests that we do in functional medicine. We very helpful identify whether the issues you're having are oral. So the, um, yeah. So the, the other thing is, you know, what do we do to, to change our diet,

• 16:46Dr. Mark Hyman?

  to keep our gums healthy and keep our teeth healthy? And, and what do, what do we know about food and nutrition and oral health? And then of course, basic lifestyle hygiene stuff that we should all be paying attention to?

• 16:57Speaker 01

  Yeah. So I, I actually, Mark, when I, I prepared for this, I made a couple of slides, which should be available as an add-on, uh, for the, for the podcast, for those who want to look at it. But the big thing is, um, the introduction, uh, in the diet, uh, in the modern day diet, the standard American modern day diet is the introduction of acellular starchy, uh, fiber or foods. Um, and when you think of this, it's very sort of, sort of simple to think of it. These are the things like, you know, uh, rice crackers and pretzels. They basically have, uh, very little nutritional value. And then sugars, um, and, uh, the modern American diet is very high in these types of foods. And these types of foods

• 17:38Speaker 01

  are basically, uh, instant sugar. And they've, they feed the oral bacteria. And those bacteria also will multiply in the body. We obviously know that, you know, you can have, uh, bacteria that can cause dental caries and, and, uh, do tooth decay. But it can also feed some of these other, uh, pathogenic bacteria. Um, and you mentioned the, um, the, the role of the various types of bacteria. There are, there's a couple of bacteria which, um, I like to see on the, the myperio path test, which is, um, uh, Pusobacterium nucleatum. Uh, and then another one, which is a real bad actor, which is the, uh, Porphomonas gingivalis. And these, um, uh, organisms are in the mouth and you're swallowing them. So the diet

• 18:23Speaker 01

  that you eat will feed both the bacteria in the mouth and then also the bacteria in the gut. So some simple things that you can do is avoid snacking, you know, drink water after you've had a meal, uh, watch for, uh, you know, processed carbs, uh, uh, sort of fake food, if you will, uh, in your diet. Um, chewing xylitol gum is actually something that is a simple, uh, thing to do, uh, that can actually have, uh, an, uh, anti dental carries, uh, type of an effect. Um, and then, uh, using electric toothbrush, uh, that's another thing that is a simple thing to do. I pretty much recommend that for all my patients. Uh, and you can, you know, use that right after, uh, right after you eat. And then also, um, having lots of fiber in your diet. When you eat or eating fiber, it basically is cleaning the teeth.

• 19:09Speaker 01

  And we all know, we've all woken up in the morning with that film over our mouth. Well, you know, that film is actually a biofilm. And unless you're actually keeping your, your oral hygiene clean, you're going to get, you know, some, uh, some slime on your teeth. And that's really where the, the, the bacteria really sort of take hold in the mouth. And a good integrative dentist will actually work on oral biofilms also.

• 19:32Dr. Mark Hyman?

  That's great. And you know, it's often, there's a lot of things we can do to improve our oral health through supplementation. Uh, things like CoQ10 is very important. Proanthocyanidins from colorful plant foods, uh, vitamin C for gum disease. Uh, even, even things like vitamin D to help the bone structure and prevent osteoporosis in the jaw, which can cause gum, uh, you know, uh, weak teeth and so forth. So there's a lot of things you can do to actually help improve your overall oral health. Uh, one of the things that I loved was, was developed, um, by a friend of mine who was a dentist in Lennox years ago. It's called the Dental Tooth and Herb Gum Tonic. And essentially it's a series of herbs. And it was amazing. He, he basically showed me, he would scrape my mouth and he would put it on a slide and he showed all the little bugs swimming around.

• 20:17Dr. Mark Hyman?

  Then I'd, I'd do the, the dental swish with this dental tooth and gum tonic, this herbal tooth and gum tonic, and it was just totally different. And all the bad spirochetes and things that are causes of gum disease would improve. So there's a lot of simple things you can do from, you know, absolutely electric toothbrush to water picks and, and flossing to, uh, you know, um, using, using these different kinds of herbal tonics. It can really help to keep your teeth and gums healthy. And it is really important because your oral health is so connected to your overall health.

• 20:50Speaker 01

  That's interesting that you mentioned that, Mark, because, um, I, uh, there, there's-

• 20:54Dr. Mark Hyman?

  You probably knew him, remember? He was in Lennox years ago.

• 20:56Speaker 01

  I, I don't remember, but you know what? There's, there's a, there's a company, I believe it's up in New Hampshire. Uh, I don't know if it's the same company or are they, there's a, there's another company that uses, it's like an, uh, a tooth tonic, if you will, uh, which is an antimicrobial. Um, so yeah, that's, that's actually, uh, quite interesting. The other thing is, is, um, uh, which I'll mention because this is, it sounds, um, sort of hokey, but it's actually, it's in the medical literature. In fact, I, I, I, I, preparing for the talk, I actually looked on PubMed and there's an article from 2020 about oil pulling and the benefits of oil pulling on, uh, oral, uh, the oral microbiome and oral hygiene. So you can do that with a variety of different oils. You can do it with coconut oil. I don't know if you've ever done it, Mark,

• 21:37Speaker 01

  but it also leaves them out with a very clean taste, a very clean feeling in the body. And then that also comes out to the other aspect of the oral hygiene is halitosis. So if somebody has really bad-

• 21:52Dr. Mark Hyman?

  Bad breath.

• 21:53Speaker 01

  Yeah, bad breath. Exactly. So bad breath is not just, you know, an embarrassment. It's telling you that you've got some bugs in there that are producing chemicals that are not very good for your body. And these are usually the, some of the bacteria that can actually reside in the tongue and the tongue fissures. And they're what we call sulfite or sulfur reducing bacteria. And there's a dentist who came up with a product, which is a very effective one. It's called Therabreath, which I oftentimes will have patients use. And that's, that's a very effective way of dealing with halitosis, but then also then looking at how can we actually improve

• 22:34Speaker 01

  the oral microbiome in addition. And there are some products that are out there, you know, with

• 22:41Speaker 01

  some Lactobacillus salivarius and such that are oral probiotics to also help balance out the microbiome.

• 22:51Dr. Mark Hyman?

  Canker sores. What are canker sores? We've all probably had them one time or another. Why are they a problem? And what do they signify? And how do we think about them differently in functional medicine than traditional medicine?

• 23:04Speaker 02

  Absolutely. So canker sores are those ulcers, those sores that you get in your mouth. They're usually at the side of your mouth, you know, by your cheek, inside of your cheek, that is, underneath your tongue. Those are some typical places for them and- And they are about three to five millimeters in size and they are sore that comes if you look at them, they'll look like a round circle. They're reddish. Sometimes they'll have like a yellow coating on it. Yeah.

• 23:39Dr. Mark Hyman?

  And they hurt like heck.

• 23:40Speaker 02

  They hurt like heck. Yes. And, and like you said, most of us have had them at least once or twice. And having one once or twice is not a big deal, right? Or even more than that. But what we get concerned about, or what we want to talk a little bit about are those people that are getting lots and lots of canker sores. And could that mean that there's something we need to be looking into and, and thinking about?

• 24:03Dr. Mark Hyman?

  Yeah, I mean, I think that's right. I think, you know, in traditional medicine, we go, oh, well, canker sore is not a big deal, you know, swish your mouth with like tetracycline and Benadryl was the cocktail we used to use. And that'll help reduce the pain and inflammation. But it really wasn't ever, ever a conversation about, well, what was the cause of these? And how do we diagnose the root cause and make it so people don't get them anymore?

• 24:27Speaker 02

  Absolutely. And, you know,

• 24:29Dr. Mark Hyman?

  And what does a functional medicine doctor think when they see a canker sore?

• 24:32Speaker 02

  You know, if, again, if it's been like, if it's an isolated incident, it might not be a big deal at all. But if they're, if people are getting them all the time, or even a couple of times a month, or even, you know, five or six times a year, it makes you want to ask that question, why? What could be going on? And there could be many things from, from celiac disease, to an impact in the immune system not working properly, to eating a food that causes inflammation for your body. So celiac disease, it would be gluten, but there's other foods that for people can be inflammatory for them. It's like a food sensitivity or a food reaction. Definitely, we see it with some food additives. So some food coloring

• 25:15Speaker 02

  and some food additives, people will get canker sores. There are some

• 25:21Speaker 02

  Uh, more rare situations where people get lots and lots of canker sores, uh, Bichette's, uh, they'll get sores in their mouth and other areas of their body. So, you know, that's an autoimmune process. Uh, uh, another autoimmune process, lupus can, can cause some recurrent sores in the mouth as well. Um, and of course nutritional deficiencies, you know, it's something I think about all the time. We know B12 deficiencies, B vitamin deficiencies. Um, so I'm thinking when somebody's coming in with recurrent, uh, canker sores, those are things I'm thinking about.

• 25:54Dr. Mark Hyman?

  Yeah. So it could be some of the foods we're eating or chemical, the chemicals in our food. There's, you know, the average American needs three to five pounds of food additives a year. And we go, there's a little additive here. You add it all up with all the crap we eat, it's three to five pounds. And there are a lot of these things are really immunoreactive. It can be very inflammatory, irritating, uh, and can cause these canker sores. Uh, but you, you know, we mentioned also Bichette's and lupus. These are autoimmune diseases. Uh, but what, what's really striking to me and, and, and after doing functional medicine for decades is that so many people with canker sores really have gluten problems.

• 26:31Speaker 02

  Absolutely.

• 26:31Dr. Mark Hyman?

  And I remember one of my friends was a Harvard trained doctor who started having really severe recurrent canker sores. We call it aphthistomatitis, but it's like a really nasty, nasty case of this. And I said, have you checked yourself for celiac disease? He's like, no. And I'm like, well, check. And he had it and he stopped eating gluten and everything went away.

• 26:52Speaker 02

  I see that all the time. I mean, that's probably one of the, the most common reasons when, when we have people who have a lot of canker sores, you know, whether they test positive for celiac or just we think it's gluten sensitivity, or we don't have a full, full positive celiac test. But when they take away gluten, they often will, will, will clear up, which is phenomenal and a wonderful response. The other thing, you know, I was thinking when you were talking about the food additives. And food coloring, you know, Halloween is a time where kids will get canker sores all the time right after Halloween, you know, all of those, all of that, you know, the candies that have, they're eating so much of it with a lot of additives and coloring and stuff. And so, you know, people will notice that that's a time where they get a lot of them.

• 27:37Dr. Mark Hyman?

  That's true. And I remember when I was really sick with, you know, chronic fatigue and my immune system wasn't working right and my gut was a mess. I used to get tons of canker sores and it was terrible. I'd get them on my tongue, I'd get them on my cheeks. It was horrible. Once you start to get things back in balance and fix your gut and your nutritional status, really, really makes a huge difference. So tell us about this patient you had. It was a young woman who had really bad canker sores.

• 28:02Speaker 02

  Yeah, you know, I just want to mention one thing about that and then we'll delve into this case. You know, when, when things are out of balance in the digestive system, there's a lot of inflammation in there. And so the ability for the body to digest and absorb your nutrients is much less. And so, and, and the, the oral mucosa, the, the cells in your mouth and the digestive system, you know, need a lot of regular nutrition. So, so many times we see nutritional deficiencies show up first in the mouth and the gut area because they're just getting turned over so quickly. And so, you know, you think a lot about those B vitamins that are necessary for healing and zinc that's necessary for

• 28:44Speaker 02

  healing. So when you mentioned when the body, when your body was depleted, you know, there may have been some just decreased absorption of some nutrients that are, that are so necessary.

• 28:53Dr. Mark Hyman?

  Yeah, I think you're right. And you get those cracking at the corners of your mouth. That's called kelosis. That can be also from B vitamin deficiencies. So yeah, I had that. I mean, it's interesting to see what happens when you start looking at this stuff. You go, wow, because you teach a whole course on the nutrition physical examination.

• 29:09Speaker 02

  Yes.

• 29:10Dr. Mark Hyman?

  Where through looking at various signs on your body, you can pick up nutritional deficiencies. They may be related to some of these things.

• 29:16Speaker 02

  Yeah. So with Dr. Michael Stone. So that's fun. So yeah, so this, um, this woman was a 25 year old woman who had regular canker sores her, her whole life. She had them as a kid. She had them in her teenage years. She was getting them probably once a month and sometimes she'd have multiple canker sores and they were kind of. They were painful and no, no fun. Like, you know, you mentioned and, um, and she was always thin. So she was always on the thin side. She had some digestive issues, some diarrhea, some bloating. Um, but otherwise, you know, she was, she was healthy. Oh, she was told she had iron deficiency. So she was low in iron, but otherwise not really anything that would

• 29:58Speaker 02

  make you think she was ill or, or, um, or sick in, in any way. But she just wasn't, you know, she wanted to kind of deal with these canker sores and came in. And so we decided to test her for celiac disease because, because as we were mentioning, it's gluten and wheat can be a common cause of these canker sores for some people. And

• 30:15Dr. Mark Hyman?

  It also causes irritable bowel and prevent you from absorbing iron and make you not be able to gain weight, all the things she was exhibiting.

• 30:22Speaker 02

  Exactly. Exactly. And so, and she tested positive conventionally with regular, uh, celiac testing. She was, she was, uh, positive. Her tissue transglutaminase was elevated. So we were like, oh my goodness, you have celiac disease. And, um, um, and so she stopped eating gluten.

• 30:41Dr. Mark Hyman?

  It was like a miracle.

• 30:42Speaker 02

  It was kind of, she stopped eating gluten and the canker sores went away.

• 30:45Dr. Mark Hyman?

  And so did irritable bowel and her iron deficiency.

• 30:47Speaker 02

  Exactly.

• 30:48Dr. Mark Hyman?

  She started gaining weight, I'm sure.

• 30:49Speaker 02

  She did. I mean, the iron and the weight took a little bit more time, but, but the, but the canker sores and the irritable bowel went away right away.

• 30:56Dr. Mark Hyman?

  It's pretty amazing when you think about how common this is, you know, because, you know, we've talked a lot about gluten on this podcast, but, you know, even people who don't have celiac, they can have non-celiac gluten sensitivity. So they're not, they're not on the full blown celiac numbers on the lab test, but they're, they're in that continuum and they can still have all the same problems.

• 31:17Speaker 02

  Yes.

• 31:17Dr. Mark Hyman?

  And the thing people don't realize is that doctors don't realize is that they, you know, they, they think, oh, the problem you have is canker sores. That's the diagnosis. That's just not, that's not the diagnosis. That's just a symptom. What's the cause? And that's what's so different about functional medicine. It's what we do here at the Ultra Wellness Center that's so unique is we really medical detectives that look at the cause and it may be different for different people. Some people's canker sores might be caused by a food additive. Or, or, or, or maybe it's because of a food sensitivity, or maybe it's gluten, or maybe something else. So I think that's really the beautiful thing about functional medicine is we can kind of drill down.

• 31:50Speaker 02

  Yeah, you want to look for that underlying root cause. And then, you know, if it is more of an autoimmune, if for somebody it's more of an autoimmune condition, then you have to ask that question, why, right? Why do they have this autoimmune condition? What is out of balance in their body? What's triggering it? Um, and we can't always answer those questions, but they're really important questions to ask because that really influences how we treat them. So we're not just treating the, the outlier outward symptom of the canker sore, but looking for that underlying root cause.

• 32:19Dr. Mark Hyman?

  Yeah, amazing. And people don't have to suffer from it because it's so annoying.

• 32:23Speaker 02

  Yeah.

• 32:25Speaker 03

  People are disconnected from their breathing when they're mouth breathing at night, when they're over breathing in the day, when they're hunched over and their posture is bad. They are perpetuating this feedback loop of constant stress. And breathing is the quickest way of breaking that stress feedback loop. So you can change your breathing and break your stress and you can measure what happens to your body when you do that.

• 32:53Dr. Mark Hyman?

  You know, as a doctor, you know, it's really clear when you look at the biology of breathing, that, that there, I mean, there's a lot going on. Uh, and often people are shallow breathers or they're mouth breathers. Um, there's all kinds of, of challenges that happen biologically when you do that. Uh, but one of the things that people don't realize is that their, their diaphragm, which is basically the muscle that moves when you breathe, expands and contracts in order to actually fill up and empty your lungs. The main nerve that relaxes your body goes through there. And that's why when you take a deep breath, you relax and it's called the vagus nerve. And, and what's fascinating is there's all this incredible science around how we have to do,

• 33:38Dr. Mark Hyman?

  you know, injections around the vagus nerve, or we do sort of certain kinds of, you know, trans like magnetic therapies for the vagus nerve, all those different things. But we always have access to be able to activate the vagus nerve through our breath. So can you kind of explain how that all works and why, why the diaphragm is so important? And why we need to understand how to breathe differently and what it does to our biology?

• 33:59Speaker 03

  Sure, that vagus nerve travels right along our throats as well. So this is one of the reasons why yoga practices have a lot of humming and singing and om. That allows for better vagal tone, it calms you down. But the vagus nerve is also, I mean, it spreads throughout the whole abdomen. It's, it's the longest nerve in the body, vagus, like a vagrant, a wandering nerve. So when you are breathing in a shallow way, you are sending messages through the vagus nerve and the phrenic nerve to your brain that you are stressed. So 80% of the messages between the body and the brain are coming from the body.

• 34:41Speaker 03

  So you can send your brain, if you want to do this, constant stress signals by breathing too much and by breathing in a shallow way. And the lungs don't inflate themselves, right? They need something to do that, and that's what the diaphragm does. So most people understand the role of the diaphragm in, in expanding the lungs and deflating the lungs. But what I didn't know, and I'm learning more recently, is that the diaphragm is also essential, that diaphragmatic movement is essential in the circulation of lymph fluid and in circulation of blood. This is a pump. This is like, you can think of your body as a, there's a piston in your body.

• 35:23Speaker 03

  Okay, it's the diaphragm and you need those fluids constantly moving in an efficient way. You can get by by breathing in this very short and stilted way. A lot of people do, but compensation is different than being healthy.

• 35:38Dr. Mark Hyman?

  Yeah, that's a very important point because the, you know, the body, we think, you know, exhale, exhales carbon dioxide as, as a way of detoxifying something that can actually be harmful to us in excess, right? And that's what the breath does. You breathe out carbon dioxide, you breathe in oxygen. But also what you're saying is that it detoxifies us in way more complicated ways through the lymph system, which actually clears out all the waste and metabolites from your tissues and your cells and brings it back to the heart to filter and do all that stuff it has to do with the liver and clean it up. So it's a, if you don't have your lymph circulating, you're going to get sick. And I actually had a podcast with Dr. Mehmet Oz and his father-in-law, Jerry Lamell, talking about the importance of lymph and lymph

• 36:21Dr. Mark Hyman?

  function to health. And breath, like you said, is one of the most powerful doorways to actually activate lymph circulation. So very, very important. Tell me, tell me how you got into breath, because I think you had a particular story that was quite interesting. And it really kind of laid you down this rabbit hole, researching what actually was causing some of your issues.

• 36:45Speaker 03

  Yeah, as a science journalist, you don't think that you're going to one day write a book about breathing, which seems like such a simple and mundane and completely boring subject. But I had, this was a long time ago, about 10 years ago, plus, I had constant respiratory problems. I was eating the right food, was exercising all the time, I was sleeping eight hours a night. You know, I was tuned into my health, but I kept getting bronchitis, I kept getting mild pneumonia, I was wheezing when I was working out. Every time I went to my doctor, I was told it was normal. And whenever I got mild pneumonia, you know, I'd get a Z-Pak and be sent on my way. And it worked, but, but it didn't fix the core problem. Every year,

• 37:27Speaker 03

  I kept coming back. And they were just like, oh, you're back, you have pneumonia. Yeah, I have pneumonia again. And so it just, something seemed a little off. That went on for years. Until one doctor friend said, oh, you should explore breathing classes. What does breathing have to do with immune function or my chances of getting pneumonia or bronchitis? She said she had had experience with yoga. She said you'd be surprised. So in San Francisco, you know, it's hard to throw a tennis ball and not hit four different breathing classes. So I just sort of spun the roulette wheel, found one and had an extremely powerful experience. But as a journalist, I'm not going to write a memoir about breathing. So I didn't know what to do with this experience. And years went by before I found a way to tell

• 38:11Speaker 03

  a larger story. And it was specifically learning from freedivers, people who are doing things that are supposed to be medically impossible with their bodies. And they do it every day.

• 38:23Dr. Mark Hyman?

  Like 10 minutes underneath, right. It's a whole doorway to health that we hadn't really thought about. And, you know, a lot of us, we don't think about our breath, but we often don't breathe very well. My mother had lung issues and she was a mouth breather. And I was always trying to get her to breathe through her nose. And she just couldn't do it. But tell us about the distinction between nose breathing and mouth breathing. You know, why is mouth breathing not good for you? And why is nose breathing good for you?

• 38:51Speaker 03

  So when we breathe through our mouths, we're exposing ourselves to everything in the environment. If you live in a city like me, that means pollen, that means pollutants, means smog, it means mold. And there's nothing filtering that air all day long. If you breathe through the nose, and I so happen to have a special guest here, is a cross section of a human head. And if you see what happens when you breathe through the nose here, you're forcing this air through all of these very ornate structures. And as that air goes through these structures, it's heated up, it's moistened, it's filtered, and you get this huge profusion

• 39:34Speaker 03

  of nitric oxide as well, which guess what? Nitric oxide helps kill viruses and bacteria.

• 39:41Dr. Mark Hyman?

  Yes.

• 39:42Speaker 03

  And it's a vasodilator. So when you're breathing through the mouth, you get none of those advantages. You can survive mouth breathing, but it's going to wear you down and make you sick. And that's just how things work. And you can very clearly see this by just looking at our physiology and looking at our anatomy.

• 40:03Dr. Mark Hyman?

  It's quite amazing. What you just brought up is really important because we had Louis Ignaro on the podcast who won the Nobel Prize for his discovery of nitric oxide. He's this cute little like 80 year old Italian guy who thinks he'd be like your uncle or something. And he's so sweet and he just, he just really explained how important it is to breathe through your nose and how nitric oxide is produced, which is like you said, antimicrobial and also increases in your ability to fight inflammation as an antioxidant. And you know, it's the main, main thing that happens when you take Viagra, which is you increase nitric oxide, which is dilation of blood vessels and so forth. So it's fascinating. And he's, he even said, and this was fascinating, they were doing some preliminary studies around COVID where they were giving

• 40:44Dr. Mark Hyman?

  nitric oxide gas to COVID patients and seeing remarkable changes in their biology and improvement in their lung function and their overall health. So it's kind of interesting that our body knows what to do, but we often have, have sort of lapped to these habits around mouth breathing. And actually there's this, this is kind of new trend out there. I'd love to hear what you think about it. Using mouth tape at night for people to breathe through their nose at night instead of through their mouth. What do you think about that?

• 41:13Speaker 03

  Well, what I learned about nitric oxide was from Ignaro. So he won the Nobel in the 90s. And I think last time, last interview I heard with him, he said there were 11 clinical trials looking at patients who had severe COVID and giving them nitric oxide. Some of those trials have come out. They're official published studies and it works incredibly well because of course it does. You know, it's just we're supplementing what our natural body in its natural form would be doing otherwise. It's important to note too, if you hum, you increase that nitric oxide 15 fold. So I think that this would be an interesting thing to explore. And there are a lot of yoga

• 41:55Speaker 03

  practices have you hum. I wish someone would do this study, you know, it's never going to get funded, but he's, he's an amazing guy. I've learned so much from him.

• 42:06Dr. Mark Hyman?

  That's so great. And you, and you did an interesting study where you were at Stanford, when you were sort of researching the breath for your book, where your nose was completely plugged for 10 days and you had to breathe just through your mouth. So what was that study and what did you find out?

• 42:22Speaker 03

  So I've been working with a chief of rhinology research at Stanford, a guy named Dr. Jaiakar Niyak, who probably knows more about the nose and nasal breathing than anyone on the planet. So we had had several interviews and there had been animal studies looking at what happens when you make an animal, a monkey specifically, a mouth breather and all the awful things that happen to their health and their facial structure. Don't read those studies. They're horrendous. But I asked Niyak, I said, has there ever been a human study of this? And he said, no. And I said, well, why don't you do it? You're at Stanford. You you study this stuff all the time. He said, doing so would be unethical because he knew of all the damage it it could do. So I said, well, why don't I volunteer

• 43:07Speaker 03

  for an experiment? I'll try to make it-

• 43:09Dr. Mark Hyman?

  I can inform consent, right?

• 43:10Speaker 03

  Yeah. And to, you know, I wish it were 100 people. We had to pay for the study ourselves, which at Stanford was was not cheap. And the longest we were allowed to do this was for 10 days. 10 days, just mouth breathing, 10 days nasal breathing. And as advertised, it completely destroyed us. And we have all the data to show that. There was extreme fatigue. My blood pressure went through the roof. I got home after about three hours of mouth breathing. My blood pressure was 158 over 100, which was about 30% higher than I had ever seen it. And I said, oh, you know, I'm stressed out. I need to go to sleep. For the first time that I'm aware of, I started snoring. Then I started

• 43:55Speaker 03

  getting sleep apnea. It got worse and worse the longer we had this. The other subject in the study had the exact same thing at the same time. We had trouble focusing. Our mouths were completely dry. We were miserable. Athletic performance plummeted. I mean, this, to be clear, two people in an experiment means nothing. What I was doing was personally experiencing what science has known for for literally decades and decades.

• 44:26Dr. Mark Hyman?

  Well, there are N of 1 studies, so I don't think it's meaningless. You know, there are, there is a whole science and the NIH is actually advancing this, which is looking at changes in an individual and that being relevant. And if you measure changes before and after, it's actually not insignificant. So I wouldn't discount what you're saying as being more widely available to to sort of think about. And I think, I think that, you know,

• 44:49Dr. Mark Hyman?

  You actually have a lot of different things that you talk about as a way of fixing your breathing pattern. Maybe you can share a little bit of what are the tips? How should we breathing? How do we get enough quality breath? How do we stop mouth breathing? What do we have to do?

• 45:02Speaker 03

  Luckily, in that Stanford study, we did 10 days of mouth breathing, followed by 10 days of just nasal breathing. This is where the sleep tape comes in. So it's easy to nasal breathe in the day. You just shut your mouth. But at night, more than 60% of us breathe through our mouths. And so how do you keep your mouth shut at night? About 100 years ago, they used to have chin straps. So they knew how damaging mouth breathing was 100 years ago. We seem to have lost that knowledge. But nowadays, we have tape. So I learned from a breathing therapist at Stanford. She prescribes tape for her patients, for every one of her patients, to tape their mouths at night.

• 45:44Speaker 03

  This is not full on hostage situation stuff. This is

• 45:48Dr. Mark Hyman?

  It's not duct tape.

• 45:50Speaker 03

  No.

• 45:51Dr. Mark Hyman?

  And there's a little hole in it. There's a little hole in it.

• 45:53Speaker 03

  There's a specific tape. It's a surgical tape. It's called micro pore tape, and it's very light adhesive. You want to take this stuff off with your tongue. Never pull it off of your lips. That's where people go wrong. But what this tape does is it's just a gentle reminder. At any time in the night, you can go if you're uncomfortable and it pops off. But this has been, all of that snoring that I was doing mouth breathing immediately went away by just with one hack, closing my mouth. And this is the one thing I've literally heard this from thousands of people have written. And they said, this was the most profound health hack that they've experienced.

• 46:38Speaker 03

  It's for a lot of people.

• 46:39Dr. Mark Hyman?

  I've heard the same thing.

• 46:40Speaker 03

  And I'm not saying it's going to work for everyone, especially with advanced severe sleep apnea. You're going to need more treatments, but it's free. And breathing through your nose is only going to help you. So you may benefit a little or you may benefit a lot. And I cannot sleep. I mean, technically I can sleep, but I can't sleep well without sleep tape now. It's a real affliction.

• 47:04Dr. Mark Hyman?

  All right, James, so tell us what tape you use? And what are the options out there for people? Because it sounds like after this conversation, a lot of people are going around and want to buy tape. I don't want them to get like Scotch tape or some masking tape or something. It's not the right tape.

• 47:16Speaker 03

  Well, there's, there's so many different types of tape that work and it really depends on the person and their preference. I went through about 30 different types of tape before I found one that I really liked and that worked for me. It's, I'm not getting paid to say this. It is a micro pore tape, a surgical tape by 3M, has a really light adhesive for sensitive skin. That's the best stuff I've found. Other people like different brands, there's specific brands now that are just sleep tape that you can buy on Amazon or wherever else. They work great. So I would say play around, find something you like. You want something with a very light

• 47:58Speaker 03

  adhesive. And most importantly, as I mentioned, you don't need a very fat strip of this stuff. All you need is something about the size of a postage stamp. This is the whole technology here. That's sleep tape. Okay. It's just keep, I can even talk to you when I have this stuff on. You take it off with your tongue. Not, don't rip it off. Take it off with your tongue and you won't get any irritation to your mouth that way.

• 48:26Dr. Mark Hyman?

  Love that. That's amazing. Okay. That's a wonderful hack. You think everybody should do that? Or how many people breathe through their mouth at night? Is it a common thing? Or why, why, why would we if it's not supposed to? Is it like just because we're unhealthy? Or because we're stressed or what?

• 48:38Speaker 03

  I think that about 60%, this is the, the percentage I heard, more than 60% of us breathe through our mouth at night. And if you were like me, you would go to sleep with a huge mug of water because you would wake up throughout the night and be hitting on this water because your mouth was so dry. Breathing through the mouth at night, especially for eight, eight hours at a time will also change the pH in your make, in your mouth and make you much more susceptible to having cavities and periodontal disease. So everyone should be breathing through their noses at night. You need to find a way of doing this.

• 49:12Dr. Mark Hyman?

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

• 49:56Dr. Mark Hyman?

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

• 50:39Dr. Mark Hyman?

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