Why Younger Women Are Getting Breast Cancer at Record Rates (And How to Reduce Your Risk)

A normal mammogram can bring a real sense of relief. But when it comes to understanding your breast cancer risk, what else should you know? Today, I’m joined by OB/GYN and SHE MD podcast co-host Dr. Thaïs Aliabadi. Helping women get answers about their health has been central to her work for decades. Yet when she faced her own breast cancer diagnosis, she experienced the same dismissal so many of her patients had described. You’ll learn: How to understand your breast cancer risk, even without a family history What to ask about your breast density and screening options Why irregular cycles, acne, and weight changes may be connected Why painful periods shouldn’t be something you simply learn to live with How to approach hormone replacement therapy with your personal risks and needs in mind Dr. Aliabadi made a point that really stayed with me. Understanding your health is part of advocating for yourself. You don’t need to have every answer. But knowing what to ask and having a doctor who listens to what you’re experiencing can help you make more informed decisions about your care. Last Chance to Vote in the Signal Awards This is the final week to help The Dr. Hyman Show win a Signal Awards Listener’s Choice Award. If these conversations have helped you think differently about your health, I’d be grateful for your vote. Just create an account and vote by October 15. If you’ve already voted, thank you. Your support means a lot to me. View Show Notes From This Episode Sign up for Dr. Hyman’s Brainshaping Academy to learn how to nourish the biological systems that support your mental, emotional, and cognitive health https://drhyman.com/products/brainshaping?utm_source=dr_hyman_show&utm_medium=newsletter&utm_campaign=may_27&utm_content=link Get Free Weekly Health Tips from Dr. Hymanhttps://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journalhttps://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Healthhttps://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Resultshttps://drhyman.com/pages/hyman-hive This episode is brought to you by Perfect Amino, Cozy Earth, Seatopia, BON CHARGE, Made In, and Rho. Help fill protein gaps at bodyhealth.com and use code HYMAN20 for 20% off. Upgrade your sleep setup with cozyearth.com and enjoy 30% off with code HYMAN. Find a cleaner source of seafood. Check out seatopia.fish and use code HYMAN for free shipping on your first order. Explore red light products at boncharge.com/hyman and enjoy 15% off with code HYMAN. Explore kitchen essentials at madeincookware.com and save 10% off your first order with code DRHYMAN10. Explore science-backed products at rhonutrition.com and use code HYMAN for 20% off the entire site. (0:00) Dense Breasts and Missed Cancers (3:02) Breast Cancer Risk and Dismissal (8:41) Thaïs Aliabadi’s Diagnosis Story (14:08) Mammograms, Density, and Better Screening (20:58) Genetic Testing and Polygenic Risk (24:17) Metabolic Health and Cancer Risk (30:01) Dismissed Women and Pelvic Ultrasound (35:32) PMOS, Insulin Resistance, and Inflammation (48:08) Lowering Risk Through Lifestyle (53:48) Hormone Therapy and Breast Cancer (59:03) PMDD, Dismissal, and Women’s Health

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

• 0:00Speaker 00

  You know, mammograms pick up 75 to 85% of breast cancers. More than half of women above age 40 who had mammogram had dense breast tissue. The more dense the breast tissue is, the harder it is to catch that cancer on breast imaging. A dense breast tissue is white. Cancer lights up as white under, when you look at mammograms. That, that little lesion, white lesion gets lost in this, in the background. Women, if you have dense breast tissue, you need to ask for 3D mammogram. Because 2D mammogram is a 2D x-ray of the breast. And the radiologist will just say on the report, well, we didn't see anything. That doesn't mean there's no cancer.

• 0:41Dr. Mark Hyman?

  Now, there are some things I do every single day for my health. And Perfect Aminos is one of them. I started using it because I wanted a really simple way to supplement my protein intake and make sure I was getting the essential amino acids my body can't make on its own. Perfect Aminos gives me all nine essential amino acids without adding a lot of calories. So it's easy to work into my day. I take it when I'm traveling or on my workouts, or simply when I know my meals haven't given me as much protein as I'd like. It's not a replacement for eating real whole foods. I think food should always be the foundation. But after using Perfect Aminos every day for years, it's become one of those simple tools that I don't really think twice about anymore. If you're looking for help to fill protein gaps, go to bodyhealth.com and use the code Hyman20 for 20% off. Sleep isn't just downtime.

• 1:24Dr. Mark Hyman?

  It's an active biological process that helps you regulate your hormones, your blood sugar, your immune system, your brain function, and so much more. And that's why sleep is one of the foundational areas I focus on in functional medicine and one of the first things I want to understand when I'm working with a patient. And while there are a lot of factors that affect sleep, one simple place to start is your sleep environment. Is your bedroom comfortable? Is it a place where you can actually relax and wind down? That's one reason I've been using Cozy Earth Sheets. They're incredibly comfortable and they make my bedroom feel like a place I generally go for to ending the day in. So go to cozyearth.com and use the code Hyman for up to 30% off home and sleep bar. That's cozyearth.com and use the code Hyman. And when they ask you where you heard about them, say Dr. Hyman sent you.

• 2:09Dr. Mark Hyman?

  Hey everybody, I've got some really exciting news. The Dr. Hyman Show is a finalist for two Signal Awards this year. Now, first nomination is for the best live podcast for my conversation with Halle Berry at Udemonia, where we had an incredible discussion about menopause, women's health, and why we completely need to rethink how to support women through this stage of life. We're also nominated for my thought leadership for my conversation with Doctors Michael Okun and Ray Dorsey about the alarming rise of Parkinson's disease and what the latest science is teaching us about the connection between the gut and the brain, environmental toxins, and a whole bunch more. And I'm really proud of both these conversations and now we need your help. Please, help me. Voting is open through October 15th.

• 2:50Dr. Mark Hyman?

  Just head to vote dot signalaward dot com and vote for the Dr. Hyman Show. And as always, thank you for listening, for watching, for sharing these conversations and being part of this community. We couldn't do it without you. Welcome, Dr. Ray, to the Dr. Hyman Show. So good to have you.

• 3:04Speaker 00

  Thank you for having me.

• 3:06Dr. Mark Hyman?

  Well, we're going to talk about a topic today that is, terrifies most women, that you unfortunately experience, which is breast cancer. And unfortunately, it seems to be increasing, and particularly in younger women, who are actually having worse outcomes and higher mortality, meaning they're dying from it. This is kind of scary. And personally, I've had some very close friends who've had this and died from it, you know, young, in their 30s, 40s. And the question is, why? And why are we missing it? And why are these cancers being caught late? You know, there's a screening protocol, it's now 40 years old every two years, but still...

• 3:45Speaker 00

  And I'm here to debate that.

• 3:47Dr. Mark Hyman?

  Okay.

• 3:48Speaker 00

  I want to start by talking about access, right? 50% of counties in this country don't have an OB-GYN. Five, zero, 50%. So that's the first problem. Patients, they find lumps, they don't even, they can't even go see an OB-GYN. That's number one. When women get to that medical office, whether it's their primary care or gynecologist, they're more likely to be dismissed. Their pain is minimized, their symptoms are completely ignored, and that's a fact. So I think a lot of this, that's the first, that's where we start. That's the baseline. The standard of care, I always say, in women's health is underground. We're not, really, we're not doing any favor to any of our patients.

• 4:33Speaker 00

  Right now, the, you know, women think that they don't need to have a mammogram until age 40. That is so misleading. In my opinion, every single woman, and let's go back to the incidence, breast cancer affects one in eight women, right? So, an average American woman has a 12.5% chance of getting breast cancer. If I told you, you're about to board the plane with your family members that has a 12.5% chance of crashing, what would you say?

• 5:03Dr. Mark Hyman?

  I'd say, don't get on that plane.

• 5:04Speaker 00

  Don't get on that plane. But when I say, an average American has a 12.5% chance of getting breast cancer, what I hear is, it's okay. I don't have it in my family. I'm not going to get breast cancer. And that's the misinformation, and that's why I love talking about this topic.

• 5:20Dr. Mark Hyman?

  Yeah, people think, oh, so I have a BRCA gene or family history, then I have to worry about it, but you're saying no.

• 5:24Speaker 00

  No. 85% of women who get breast cancer don't have it in their family. I had no family history of any cancers. I didn't have a genetic mutation. I was very healthy. I never smoked. I've never done drugs. I had maybe, I've had 20 alcoholic drinks all my life. I've always been thin. I've, I used to exercise a ton when I was diagnosed with breast cancer. You can't really say, you know, I don't have it in my family, so I'm not at risk. So that's the first misconception that we need to address. The most important thing is, obviously, if you have family history, if you have dense breast tissue, if you're, if you have a genetic mutation, if you've had a biopsy that shows

• 6:06Speaker 00

  atypia, if you had radiation to your chest at a young age, if you're overweight, if you're drinking a lot of alcohol, those are all risk factors that can increase your lifetime risk of breast cancer beyond that 12.5%.

• 6:19Dr. Mark Hyman?

  So is not breastfeeding.

• 6:20Speaker 00

  Absolutely.

• 6:21Dr. Mark Hyman?

  So is having babies late. So is not having a lot of babies.

• 6:24Speaker 00

  Right.

• 6:25Dr. Mark Hyman?

  Because when you have a lot of babies and breastfeed a lot, don't seem to get as much breast cancer, right?

• 6:29Speaker 00

  Right. So, there's so many risk factors, and that's why one of my missions in life is, I always say, if you know your first name, if you know your last name and your date of birth, you need to know your lifetime risk of breast cancer. Literally, I go to a party and I see, I always want to see a number above everyone's head.

• 6:48Dr. Mark Hyman?

  How do you, how do you calculate that?

• 6:49Speaker 00

  So I recommend using the Tyracusec risk assessment tool. It's a tool we use that calculates, you basically enter your age, your height, your weight, the density of your breasts, your family history, age at menarche, age at menopause, whether you've had any abnormal breast biopsies, like atypical lobular hyperplasia, some basic questions. And at the end, it calculates your lifetime risk of breast cancer. If that number is 20% or more, I want to change that in function health for you. I want every woman to have their lifetime risk calculated.

• 7:26Dr. Mark Hyman?

  Yeah.

• 7:27Speaker 00

  I would love to help you do that, honestly. Because anyone that has any platforms, I want to grab those women and say, calculate your lifetime risk of breast cancer. If that number is 20% or more, you do not start your imaging at age 40. You actually start it as early as age 30, and you get a mammogram. If you have dense breast tissue, you do an ultrasound. And for high-risk patients that fall above this 20, 25%, we also add a breast MRI annually. So these are women who, at 38, they show up with stage three, four breast cancer, because no one really calculated their lifetime risk of breast cancer. I had no family history of cancer.

• 8:10Speaker 00

  I had no genetic mutation, but my lifetime risk was high based on this biopsy they did in my breast that showed atypical lobular hyperplasia, that pushed my lifetime risk to 37%. But if you look, my doctor would look at me and say, you're going to be okay. Look at you, you have no family history, you have no genetic mutation, don't worry about this atypical lobular hyperplasia. Yes, I worry about it, and I don't want to come back in six months.

• 8:36Dr. Mark Hyman?

  So what happened? You were 48, you had atypical cells in your breasts, but your imaging didn't show it?

• 8:41Speaker 00

  I had a negative mammogram, I had negative ultrasound, and my MRI was read as benign. Looking back, my lesion was sitting in my MRI, and it's okay. People can, radiologists can miss, you know, can, you know, we're not robots, we can make mistakes.

• 8:57Dr. Mark Hyman?

  But you insisted to have a biopsy? That's why you found you had...

• 8:59Speaker 00

  No, I went for my mammogram and they said, you need a biopsy. So they biopsied it. They biopsied my left breast. They called me, they said, it's atypical lobular hyperplasia. They did an excisional biopsy, removed that lump, and they told me to come back in six months. I always calculate everyone's lifetime risk of breast cancer in my office. So at that point, I had no reason calculating mine because I had no risk factors. But as soon as that atypia showed up, I went back to my office and I calculated my lifetime risk. And Mark, I almost fell off my chair when I saw that number. It popped out 37%. And I'm like, wait, what? That's a mistake. Me? No. Like, look at me, I'm not going to get breast cancer. And I recalculated it, and it was 37%.

• 9:42Speaker 00

  And that's when I called my breast surgeon and I said, you told me to come back in six months. I have three little kids at home. I have a busy practice. I love my husband, I love my life. I don't have time for breast cancer. I already have implants, take my breasts off, put bigger implants in, let me go on with my life. That's when they started telling me, I'm being anxious, I'm being too nervous, why am I so paranoid? You know, everything that women hear again, and for me...

• 10:11Dr. Mark Hyman?

  Women are dismissed typically by medicine.

• 10:13Speaker 00

  I mean, if I get dismissed, if I'm told I'm crazy, I literally have had colleagues who called me crazy, anxious, paranoid, I heard it all. But it didn't matter, I was so laser focused. I finally found a doctor who was willing to do my double mastectomy. And the day before surgery, she's like, you know, I'm doing this, but it's against my wish. And I'm like, why? Why so much resistance? It's my body, why do you care so much? You know what she said? We have really good chemo for breast cancer.

• 10:42Dr. Mark Hyman?

  Wow.

• 10:43Speaker 00

  Do you understand that?

• 10:45Dr. Mark Hyman?

  Wow.

• 10:45Speaker 00

  I don't want chemo, you go get chemo. I don't have, I don't wanna get chemo. I don't wanna put that poison in my body. So she did it. I almost died because the surgery was 10 hours. I bled out. You would appreciate this. My hemoglobin the day after surgery was five and my blood pressure was 60 over 20. It took them two, three, two days to transfuse me with blood. I don't even have a memory of that. But one thing I remember, the minute they woke me up from anesthesia and I, my husband came to hug me. The first thing I told him is, go home, tell our girls mommy will never come home telling them she has breast cancer. Go tell the kids that I did this. Of course, a week later, I'm in the car back to school shopping with my husband and I get a call.

• 11:30Dr. Mark Hyman?

  Pathology report.

• 11:31Speaker 00

  Yep. And you know, when your doctor calls you, it's never good. When the doctor says, I got off the phone from pathology, my brain shut down because I knew what he was gonna say.

• 11:40Dr. Mark Hyman?

  Yeah.

• 11:40Speaker 00

  And all this time they were digging in my left breast. My cancer was actually invasive stage one in my right breast. People say, why did you pick a double mastectomy? It's so aggressive. It's this, it's that. You've obviously never had a mammogram and you've never had a breast MRI. But you go, you have to take like literally half a day off. You go sit. They put you in these machines. They squeeze your breast. They put you in an MRI. They give you contrast. And then you have to wait four or five days for one phone call and you still don't know. And in my case, I was right, whether or not they can read it correctly, right? Cause it's human error anyways involved in it. So my, I felt like my life was in the hands of these radiologists reading these.

• 12:24Speaker 00

  And I didn't wanna put myself every six months through these imaging. And that's why I decided to do the double mastectomy, but it doesn't end there. Uh, back two weeks later and I was, I was still, even though I was upset. And you know, my doctor who didn't wanna do this for me and kept calling me, you know, told me it's a, you know, don't do it. You're paranoid. She called me and you know, cause these hospitals turned upside down when my path report came back. And um, she told me, Thais, you're so lucky. I never forget where I was standing in my room when she called me. She's like, you're so lucky. We caught this early.

• 13:03Dr. Mark Hyman?

  You caught it early.

• 13:04Speaker 00

  I'm like.

• 13:05Dr. Mark Hyman?

  Not they.

• 13:07Speaker 00

  I'm like, lucky? What? I'm not lucky. No one with cancer thinks they're lucky. Do you know what I'm saying? Cause it's always in the back of your head. When someone tells you have cancer, you go to the worst case scenario.

• 13:21Dr. Mark Hyman?

  This is such an important lesson for people. You know, you were a doctor.

• 13:24Speaker 00

  A women's health advocate.

• 13:26Dr. Mark Hyman?

  A women's health advocate. You had a funny little thing in your one breast. You had a biopsy. You made you calculate your risk. You made a pretty radical decision, you know, like Angelina Jolie had the breast cancer gene. So she took off both her breasts and that was a big public event that got people's attention, but you didn't have that. You were like, I just don't wanna take the risk, which is a pretty aggressive decision for most women. But it turns out that you were right and that there was, there was something there. And I think, you know, for women listening, you know, women can have a completely normal mammogram. You had a quote, normal MRI, like you, you know, what are the limitations of mammograms? Particularly for younger women who have denser breasts, like what were the, were the problems with this? Cause people think I have a mammogram. It's normal. I'm okay. Not necessarily.

• 14:08Speaker 00

  No. And uh, you know, mammograms pick up 75 to 85% of breast cancers, right? Let's start there. So we're still missing a lot of cancers screening women, like 15 to 25% of women with cancer will still go out. Like just like myself and they're told they have a negative mammogram. More than half of women above age 40 who had mammogram had dense breast tissue. What does dense breast tissue mean? The more dense the breast tissue is, the harder it is to catch that cancer on breast imaging. Ma- dense breast tissue is white. Cancer lights up as white under, when you look at mammograms. So when someone has fatty breasts, right?

• 14:50Speaker 00

  And they don't have any dense breast tissue, which 10% of women have fatty breasts. Uh, in this group of women, cancer is picked up easily on mammogram. I had extremely dense breasts, extremely dense breasts. There's so much background noise that that little lesion, white lesion gets lost in this, uh, in the background of dense breast tissue. So for patients like myself, A, women, if you have dense breast tissue, you need to ask for 3D mammogram. Because 2D mammogram is a 2D x-ray of the breast. And the radiologist will just say on the report, well, we didn't see anything. That doesn't mean there's no cancer. If you can't see something, if this window was muddy and you told me to describe the view, I wouldn't be able to describe it, right?

• 15:36Speaker 00

  But if you took a Windex and cleared it, I could see, I could see better. So as AI is improving and with 3D imaging, with adding breast ultrasound, it's that Windex that we can clear some of this and be able to see outside.

• 15:50Dr. Mark Hyman?

  And the 3D mammograms is a better technology.

• 15:52Speaker 00

  Yes.

• 15:53Dr. Mark Hyman?

  But it's not something that's standard or people get it.

• 15:55Speaker 00

  It is pretty much standard right now. And I, if I would tell your listeners, if you, you know, and um, as of a few years ago, uh, radiologists need to report on the density of the breast on the mammogram and recommend maybe a follow-up with additional breast imaging or uh, breast ultrasound. And for high-risk patients with a breast MRI afterwards. But if you look at your mammogram and it says dense breast and the, on top, it says a 2D mammogram. Next year, go ask your doctor for a 3D. If you have dense breast tissue, ask for bilateral breast ultrasound. Calculate your lifetime risk by age 30. If that lifetime risk is 20% or more, ask your doctor for a breast MRI. Unfortunately, a lot of doctors will give a pushback.

• 16:40Dr. Mark Hyman?

  Can people calculate their risk on a website or how do people calculate?

• 16:43Speaker 00

  I have it on CMD, uh, on our podcast. It's free. They can literally go there, but before they.

• 16:49Dr. Mark Hyman?

  CMD.com?

• 16:50Speaker 00

  Yeah, sheMDpodcast.com.

• 16:51Dr. Mark Hyman?

  SheMDpodcast.com. Okay. Cause people are gonna say, how do I find that out? They wanna know.

• 16:55Speaker 00

  They wanna know and they should. And that's why I literally want Function Health to do that for every woman. Every single woman that you're sending labs. I love that. I'll help you with it. I mean, you should do it. It's a, you will see, you will save millions of lives.

• 17:12Dr. Mark Hyman?

  Yeah.

• 17:13Speaker 00

  Doing this because you know, someone like me with no family history, no risk factors, my risk was still 37%. And you know, people say it's so aggressive to remove your breast, but 37% chance of boarding a plane.

• 17:29Dr. Mark Hyman?

  It's gonna crash.

• 17:30Speaker 00

  That's gonna crash? That's not crazy. If I say, I don't wanna board this plane and someone's calling me crazy, how would that make you feel? If you're about to board a plane and I say you have a 37% chance of crashing and you say, I don't wanna board. It's, I don't wanna go. I don't wanna take my kids on that plane. And people called you crazy. How would you feel?

• 17:50Dr. Mark Hyman?

  Uh, I would think they're probably crazy.

• 17:53Speaker 00

  It's like, you're crazy. I'm not crazy. You're crazy. You're the crazy one.

• 17:57Dr. Mark Hyman?

  Yeah, exactly. Exactly. Wow. When patients start their health journey, they often ask where to start. My first recommendation is to eat whole, clean, unprocessed foods. And that is where Sea Topia comes in. Sea Topia is how I stop worrying about microplastics and mercury. Because third-party labs test all of their suppliers to ensure they meet the Sea Topia standard for nutrient density and cleanliness before it makes the cut to receive the Sea Topia brand. All their seafood is packed with omega threes, blast frozen at peak freshness, delivered to your door. And most importantly, delicious. My favorite is their salmon. An omega capsule gives you two molecules. A filet gives you the whole nutrition matrix. Get your first box at sea topia dot fish and use the code Hyman for free shipping.

• 18:41Dr. Mark Hyman?

  Last year I had a bike accident. It left me with some pretty significant road rash on my face. And if you've ever had an injury like that, you know that once the initial heals, there's still the question of what happens the next. What is the skin gonna look like months and years down the road? I'm always interested in the ways to support my body's natural ability to heal and repair and regenerate. So I started using red light as part of my routine. I wanted to support the healing process and over time improve the appearance of the scar. Bon Charge's red light face mask helped me significantly. Bon Charge is an amazing brand of science-driven products designed to help you optimize your health and your environment. From blue light blocking glasses and circadian lighting to red light therapy and EMF solutions. The red light face mask combines red and near-infrared light, which penetrates the skin and supports cellular energy production.

• 19:25Dr. Mark Hyman?

  And it's designed to improve the appearance of fine lines and wrinkles, support firmness in your skin and elasticity, and promote a brighter, more reading complexion. And honestly, one of the things I like most about it is that it's so easy to use. I can put it on for as little as 10 minutes while I'm reading or meditating. It's lightweight. It's adjustable. It's designed for home use. So it's easy to make it part of your regular routine. If you wanna try it for yourself, go to boncharge.com. It's B O N C H A R G E dot com. And use the code Hyman to save 15% site-wide. Bon Charge also offers free shipping on every red light face mask and a 12-month warranty. And the mask is HSA and FSA eligible for up to 30% savings. Get yours today. And, and I don't think people have heard about this lifetime risk calculator.

• 20:08Dr. Mark Hyman?

  There are, there are calculators for heart disease and other things, but this is relatively unknown thing. And I don't think most doctors know about it. And I think it's a useful tool. So I think, I think, you know, I don't think you're saying everybody with a high risk should go get their breast lopped off, but.

• 20:22Speaker 00

  Oh God, no.

• 20:23Dr. Mark Hyman?

  You know, but I think it's important to really be careful about screening, understanding what's happening. And there's new diagnostics at Function Health. We use the Gallery test, which is a multi-cancer early detection test. It's not perfect, but it picks things up. There's new tests. MD Anderson's providing protoemic tests that are looking at risk, including breast cancer. Help get ahead of this. And I think, you know, better early, you know, I always say the cancer's worst enemy is early detection. And there's still some emerging cancer therapies that are really optimistic and improving. But still, cancer is not a great diagnosis and it's not well-treated by traditional medicine and we're getting more and more of it.

• 20:58Speaker 00

  I wanna talk to you before we leave this topic of genetic testing.

• 21:02Dr. Mark Hyman?

  Yeah, I was gonna bring that up.

• 21:03Speaker 00

  Because I, that was your next question. I love that. Because I feel like at the latest, by 25, every single woman with family history of not just breast cancer and ovarian cancer, pancreatic cancer, prostate cancer, ask your doctor for genetic cancer testing. When we do genetic cancer testing, they look there, they look at maybe 48 to 80, 90 cancer, cancer-causing genes. When it comes to breast cancer, there's a lot, about 11 uh, single gene mutations that are pathogenic. Like the BRCA, PALB2, checkpoint, ATM gene, uh, and the list goes on and on. And these are gene mutations that will increase someone's uh, lifetime risk of breast cancer.

• 21:48Speaker 00

  It doesn't mean they're gonna get breast cancer, but it's, it can significantly increase that risk uh, from like 25% to 35% to 50% to 80%. So it's very important by 25, in my office, I used to be, I used to do it at 25, but because of all this cancer that we're seeing, I've dropped it to about 20 with the patient consent, obviously. I do genetic cancer testing because I don't wanna miss anything.

• 22:12Dr. Mark Hyman?

  So people understand. Everybody out there has heard about the BRCA gene, or most people have heard of it, which is the most common thing discussed around breast cancer. And it was interesting, if you look at the data, like in the 30s and 40s, that we were able to track some of this, that if you had that gene, your risk of cancer wasn't as high as it is now. Now it's about 75% if you have that. And so that speaks to the fact, one, that there's environmental factors that play a role. And two, what you were speaking about was what we call polygenic risk score.

• 22:43Speaker 00

  That's what I was gonna get there.

• 22:44Dr. Mark Hyman?

  Really important concept that means that it's not just one gene that matters, it's the cocktail of genes that all influence your risk. And we're able to do these around heart disease, around cancer now, and they're very helpful.

• 22:58Speaker 00

  And they're very helpful for breast cancer. So you can do your genetic cancer test and look for these gene mutations, like the ones I listed, but that's less than 10% of women with breast cancer will have that. A lot of us are walking around with this high polygenic risk score, meaning we have these variants in our genes that individually, these are markers that by themselves, they don't have much power, but someone like me can walk around with a lot of these markers. And if I'm not mistaken, they're, right now, they're checking anywhere from 86 to 305 markers, variants for the polygenic risk score, and they report on that.

• 23:42Speaker 00

  And breast cancer is one of it. If you fall in that bell curve, above 90th percentile for the polygenic risk score, that can increase your risk. So someone like me, actually, I didn't have any genetic mutations, I didn't have any family history, I really didn't have any obvious risk factors, but if you look at my polygenic risk score, it flags at high risk for breast cancer, which means I had a lot of these variants in my DNA.

• 24:09Dr. Mark Hyman?

  And there are also a lot of labs that can be really helpful, besides just the genetic screening. Can you, can you maybe touch on some of the things that play a role in breast?

• 24:17Speaker 00

  You know what? I want to clarify one thing. There's no blood test that will tell you if you're gonna get breast cancer, or if you have breast cancer right now.

• 24:25Dr. Mark Hyman?

  But there are things in your body that increase your risk, right?

• 24:28Speaker 00

  Right. But, you know, I think we talked about this, your metabolic dysfunction is huge. Inflammation, I always tell my patients, if you want to reduce your risk of any cancers, not just breast cancer, there are certain lifestyle changes you need to do. The basics, sleep seven hours, exercise every day, optimize your metabolic health. You know, we talked about this, majority of people on this planet will go through life and will have metabolic dysfunction. I'm sitting here, you know, my entire mom's side of the family, they're prediabetic and diabetic. So we are, we have some, you know, your genetics load the gun, but your environment

• 25:11Dr. Mark Hyman?

  Pulls the trigger.

• 25:12Speaker 00

  pulls the trigger. So optimizing your metabolic dysfunction, lowering inflammation, I think is huge.

• 25:18Dr. Mark Hyman?

  And you can measure these things, like insulin, CRP.

• 25:20Speaker 00

  Yeah, I do that every single patient, literally. Besides the hormone panels that I run, I check their hemoglobin A1C, I check their lipid panels, we talked about this, I check ApoB, lipoprotein little A, high sensitivity CRP, homocysteine, and their vitamins, vitamin B12, vitamin D, ferritin, iron.

• 25:40Dr. Mark Hyman?

  Always play a role.

• 25:41Speaker 00

  All of it. So it's not just one thing, it's a combination of everything.

• 25:45Dr. Mark Hyman?

  And we test all that at Function Health, so you really can get a comprehensive screening.

• 25:48Speaker 00

  I'm so proud of you guys, honestly, for provide, you know, I do it for my little office, you're doing it for, for people who have no, which is unbelievable, and I'm so proud of you guys for doing that. And honestly, I will tell you, I've practiced, I've been in private practice in my own little world for 25 years, I've never lost a patient under my care to cancer who did what I told them to do.

• 26:14Dr. Mark Hyman?

  That's amazing.

• 26:15Speaker 00

  But I do everything. I do genetic testing, I do this liquid biopsy that we talked about. I order the total body MRI on my patients, you know, after 45, I always recommend it, obviously.

• 26:28Dr. Mark Hyman?

  And we do that with Function too, we can do it through as a full body MRI.

• 26:31Speaker 00

  I love, I love that.

• 26:32Dr. Mark Hyman?

  It's very affordable.

• 26:33Speaker 00

  Yes. Every single patient of mine has had their lifetime risk calculated, every single patient of mine, if they need genetic testing, it's already done in their chart. If they, if they're at high risk, they have an order for ultrasound 3D mammogram. I fight with insurance companies if they have a high lifetime risk to get their MRIs approved. I optimize their metabolic dysfunction. I mean, I'm a gynecologist and I'm running ApoB and lipoprotein little A, I don't have time to do that. And my physician assistants who work for me, they're frustrated because I do so many labs on every single patient, but I do it because nobody else is doing it.

• 27:08Dr. Mark Hyman?

  Yeah, it's like, you wouldn't be like driving your car with blinders on, you want to see what's going on, like you need to see the spectrum. I want to sort of dive into a little bit of this kind of science around why this is happening, because, you know, I'm in the medicine 40 years, and I don't remember this level of breast cancer in the younger population. And what really seems to be interesting is that these are, these are estrogen-related cancers primarily, because there's many different kinds of breast cancer, but these are estrogen receptor positive driven cancers. And what we learn in functional medicine is this concept of estrogen dominance or excess. And it's, it's either relative or absolute. And a lot of things affect your lifetime exposure to estrogen, which is when you had

• 27:52Dr. Mark Hyman?

  your puberty, and women are getting it earlier than ever, some girls get it at eight now, when they give birth, the first age of birth.

• 28:02Speaker 00

  At what age, right?

• 28:03Dr. Mark Hyman?

  They're having less pregnancies, they may not be breastfeeding, all these increase your risk of breast cancer. And this is not to shame women or to make them feel bad, but these are just the facts. And then, and then there's obesity on top of that, which

• 28:15Speaker 00

  Huge.

• 28:16Dr. Mark Hyman?

  is a huge driver of cancer in general, particularly breast cancer because of insulin resistance. And we have lack of exercise, which increases your risk of breast cancer. And we have alcohol consumption, which increases your risk. I mean, I was shocked when I remember reading in JAMA, that was like, if women had one glass of wine a day, their risk of breast cancer was increased by 40%.

• 28:33Speaker 00

  Right.

• 28:34Dr. Mark Hyman?

  That's just one glass a day.

• 28:35Speaker 00

  Yep.

• 28:36Dr. Mark Hyman?

  Then on top of that, we have all these environmental chemicals that are what we call zenoestrogens, or foreign estrogens, that are very powerful estrogen mimicking compounds that mind nester receptors, whether they're PCBs or phthalates, they're in makeup, they're in sunblock, their face creams are, they're in plastic, they're pretty much everywhere. And these are petrochemical derived products, these are huge toxic burden, PCBs, BPA, phthalates, parabens, all this stuff. And then obviously there's heavy metals, so all this stuff is going on at the same

• 29:09Speaker 00

  All day long, we're exposed to this.

• 29:10Dr. Mark Hyman?

  And then our microbiome plays a huge role in cancer. And again, there's another big factor, our microbiomes, because our ultra processed diet have changed, our guts aren't healthy, and there's a whole estrogen processing system in your gut with bacteria, if they're the right bacteria, it works, if they're not, it doesn't, and you recirculate the estrogens and increase your estrogen. And this is called the astrobiome, it's a whole field of medicine, just understanding the, the way the microbiome is related to your estrogen metabolism. And all in all, we see these is really increasing numbers of estrogen, even things like PMS or fibroids or

• 29:46Speaker 00

  PMDD.

• 29:47Dr. Mark Hyman?

  PMDD, or all these things are related to imbalances in estrogen, and there's ways to treat it and diagnose it that I think most people aren't really looking at.

• 29:55Speaker 00

  I want you to open an office right next to me. I found my twin.

• 30:00Dr. Mark Hyman?

  Yeah, well.

• 30:01Speaker 00

  It's really, you know, I always call my office the office of dismissed women. If you spend a day with me in my office, you will go home with a broken heart. These are women who travel from everywhere, and they only come, they already know, they know they have endometriosis, they know they have PMOS, they know they're at risk for breast cancer, and someone's not writing an MRI order for them. They want genetic testing. The dismissal, so when I started this podcast and I said access is one issue, but once they, even when they have access and they end up in the medical office, their symptoms are dismissed, and the right tests are not ordered for them. Let's start with even, you were talking about other cancers, pelvic ultrasound.

• 30:46Speaker 00

  Do you know how long it takes to do a vaginal ultrasound?

• 30:48Dr. Mark Hyman?

  Five minutes?

• 30:49Speaker 00

  No!

• 30:50Dr. Mark Hyman?

  One minute?

• 30:51Speaker 00

  One minute. One minute, if you've done it for 25 years or 30 years. It takes me one minute, right? It's an uphill battle for women to get a pelvic ultrasound.

• 31:02Dr. Mark Hyman?

  Yeah, just, just so people are listening, we're learning medical school that in order to check a woman's reproductive health, you do a pelvic exam, which is where you use your one finger in the vagina or one hand in the vagina, one on the abdomen, and you feel around and you try to feel the ovaries, you try to feel the uterus, you try, it's like, you know, it's like kind of braille, you know, instead of sticking an ultrasound in the vagina and actually being able to see everything in 3D clearly what's going on.

• 31:27Speaker 00

  What's going on?

• 31:28Dr. Mark Hyman?

  Yeah, and it's, and it's, it's a, it's a device that most gynecologists have in their office. It takes, like you said, I thought it was five minutes, it takes one minute. And it's very inexpensive, it's very easy, it's very fast, and there's no reason it shouldn't be part of an annual screening exam.

• 31:43Speaker 00

  But you know what? It's not in every gynecologist's office. That's the problem. These people still get a prescription if the doctor writes for it. Women, I think women should get a pelvic ultrasound every single year. As soon as you become sexually active, get that transvaginal ultrasound. If I don't do an ultrasound, if you decline an ultrasound in my office, it's like you're covering my eyes and telling me to drive. I need to see, do you have a polyp? Do you have fibroids? Do you have a septum? Do you have, do I see endometriomas on your ovaries? Do you have ovarian cyst? What is going on? I need to see, do you have polycystic ovaries on ultrasound? There's so much I can tell.

• 32:21Dr. Mark Hyman?

  And there's no radiation.

• 32:22Speaker 00

  Nothing.

• 32:23Dr. Mark Hyman?

  Safe to do.

• 32:24Speaker 00

  And by manual exam is very invasive.

• 32:27Dr. Mark Hyman?

  Yeah.

• 32:27Speaker 00

  To have a guy gynecologist to put their fingers inside, like, it's uncomfortable. I don't want anyone doing that to my daughters.

• 32:34Dr. Mark Hyman?

  Yeah.

• 32:34Speaker 00

  So why not just be more civilized and put an ultrasound you're gonna get? What is by manual exam gonna tell you?

• 32:40Dr. Mark Hyman?

  Yeah, metal speculums are terrible.

• 32:43Speaker 00

  Wasn't it terrible? It's uncomfortable for the doctor doing it, it's uncomfortable for the patient, and you really don't get that much information from it. So it's, it's, it's really sad. So I, I would say, start with the, start with basics when it comes to women. A, listen to them. B, don't dismiss what they're telling you. Women are very in tune with their bodies. If they tell you, if a woman comes to my office and says something's wrong, almost always something's wrong. Women are not crazy. We're far from crazy.

• 33:13Dr. Mark Hyman?

  Well, it's, it actually harks back to the 90, early 9000s when women were diagnosed with hysteria. It was a medical diagnosis in their diagnostic code book. Hysteria derives from the word hysterectomy or uterus. So it's like, what? Women are hysterical. That's actually a pejorative against women that people are talking about all the day. No, no.

• 33:35Speaker 00

  I've, I've gotta change that. That's gotta change. It's like, it's unacceptable.

• 33:40Dr. Mark Hyman?

  Yeah, no, I think as a doctor, uh, who's been practicing medicine for 40 years, I'm old, um, it's, it's shocking to me how, uh, doctors don't often listen carefully to their patients, because they will, they will usually tell you what's wrong with them, or they'll tell you the clues that will help you figure out what's wrong with them if you ask enough questions. And I think it's easy to say, oh, we know better, we're dismissing this because it's nothing. And I, I always said to my, my, my talks, I would say, well, you go to your doctor, you know something's wrong, you feel bad, something's off, the doctor says, well, I've done your labs, I've examined you, which means he's done like 20 different lab tests, not 150.

• 34:21Speaker 00

  Right.

• 34:21Dr. Mark Hyman?

  And everything seems fine, so maybe take some Prozac. And I said, there's only one of two possibilities in that situation. One, your doctor's missing something, or you're crazy. And I don't think most people are crazy. So it's usually.

• 34:35Speaker 00

  Women, we're not crazy.

• 34:36Dr. Mark Hyman?

  It's usually doctors missing something. And I think it's, it's so important. I, I would love you to sort of talk a little bit more about how to reduce your risk, because, you know, we've talked about this early screening, we talked about your left humorous breast cancer, we're talking about mammograms, 3D mammograms, best MRIs, ultrasounds, all this is really important. And this is about, uh, detection. But I want to talk about addressing the factors that are increased risk, because it's not because we don't have good detection that women are getting cancers earlier and dying of them at a higher rate. It's because of something else. So I want to get into the something else. I touched on a lot of these issues, but I'd love you to sort of dive into, how do women address these, these fundamental drivers of breast cancer? Because people who are dealing with cancer is just thinking,

• 35:18Dr. Mark Hyman?

  I got cancer, like, I got a, I got a virus. No, it's something that develops from a foundation of disturbances in your biology that can be modified if you know what they are and if you look for them. So can you talk to us about that?

• 35:32Speaker 00

  I think environmental factors are huge. When it comes to breast cancer, obviously, you know, there are certain factors like your genetics, your density of your breasts, there are certain things you can't really change, but there are other factors that you can address that will lower your chances of getting breast cancer. If you're overweight, drop your weight. If you're not exercising, exercise. If you're stressed and not sleeping, address that. If you're not eating healthy food, if you're eating a lot of processed food, deal with that. Toxins, we talked about, um, how, how we're all exposed to toxins, from the air we breathe, to the water we drink in plastic bottles, to the, uh, you know,

• 36:12Speaker 00

  to the processed foods we eat, uh, to all the products that we put on our skin. So this is just four ways of getting toxins in your body. It's hard to live in a world where you have zero exposure.

• 36:24Dr. Mark Hyman?

  Yeah.

• 36:24Speaker 00

  But I feel like if you address all of it a little bit, from your sleep to your exercise, to your diet, to your hydration, to your stress level, to your sleep, to your uh, metabolic health, lowering your inflammatory markers.

• 36:38Dr. Mark Hyman?

  And you're toxic.

• 36:39Speaker 00

  And your toxic levels, all of it, all of it. And you know, for example.

• 36:44Dr. Mark Hyman?

  Alcohol.

• 36:44Speaker 00

  Alcohol, oh my God, huge. Alcohol, smoking. And you know, like, I treat a lot of PMOS patients, and, um, these, you know, PMOS is the leading cause of infertility on the planet.

• 36:56Dr. Mark Hyman?

  And PMOS is?

• 36:56Speaker 00

  It's a new name for the old PCOS. You know, it took us years to bring awareness to PCOS, and then they changed the name to PMOS, which is better, because polycystic ovary syndrome does not describe the condition.

• 37:09Dr. Mark Hyman?

  No.

• 37:10Speaker 00

  It's actually polyendocrine metabolic ovarian syndrome.

• 37:15Dr. Mark Hyman?

  Yeah.

• 37:15Speaker 00

  What does that mean? PMOS, you know, it's the leading cause of infertility, lead, one of the leading within the etriosis for women.

• 37:21Dr. Mark Hyman?

  It affects 10 to 13% of women.

• 37:22Speaker 00

  Majority of these women go through life, they're never diagnosed. These are women, in order to diagnose it, you need to meet two out of the three criteria: irregular period, PCOS looking ovaries on ultrasound, or elevated AMH. And the third criteria is symptoms of high testosterone. It could be facial hair, body hair, acne, hair thinning. So you need to meet two out of the three criteria. But PMOS patients are anxious, they're depressed, they have PMS, they have PMDD, they have mood disorder. 75% of them gain weight, they can't lose it, they have a really hard time losing it. They're at a high risk for eating disorder. You know what I always say, you want to find PMOS patients? Go knock on the doors of eating disorder centers. They're all sitting back there.

• 38:01Dr. Mark Hyman?

  That's right.

• 38:02Speaker 00

  But instead of someone saying, let me address your metabolic dysfunction, what do they do? They, they bring him a psychiatrist.

• 38:09Dr. Mark Hyman?

  Right.

• 38:09Speaker 00

  And they get treated for, with Zoloft and Lexapro and this and that, but no one's addressing their underlying metabolic. It's really, really sad, and it's the leading cause of infertility. If men had a leading cause of infertility, and majority of them would go through life not diagnosed.

• 38:26Dr. Mark Hyman?

  That's crazy to think.

• 38:27Speaker 00

  It would never happen.

• 38:27Dr. Mark Hyman?

  No.

• 38:28Speaker 00

  Right?

• 38:28Dr. Mark Hyman?

  No, you're right. I mean, I think, I think this is important. I, I've been saying for literally decades, probably 30 years, that PCOS is not an ovarian problem, it's a metabolic problem.

• 38:38Speaker 00

  Yes.

• 38:39Dr. Mark Hyman?

  And, and it's really an attritional problem primarily, and, and it shouldn't be treated as if it's an ovarian problem. And they give people metformin or sprenelactone, or they give them the birth control pill, or all these things that actually just may mask the symptoms instead of actually dealing with the real issue and helping women get pregnant.

• 38:59Speaker 00

  I actually listened, I was listening to this huge podcast, and they had a gynecologist, and the host asked the gynecologist, so what is the treatment for PMOS? She said birth control. I wanted to fall off my chair, like, what? No. The underlying condition is metabolic dysfunction. Did you know that?

• 39:16Dr. Mark Hyman?

  And what you mean by that is insulin resistance.

• 39:18Speaker 00

  Insulin resistance.

• 39:19Dr. Mark Hyman?

  This whole spectrum of insulin resistance, prediabetes, type 2 diabetes, that's the whole spectrum.

• 39:24Speaker 00

  Because what happens with these patients, because of that insulin resistance, when they eat carbohydrates and their body releases insulin, their cells are insulin resistant. So instead of the sugar going into the cell and turning into energy, it bounces into blood, pushes their insulin to go up, in simple terms. This spike in insulin causes these, um, symptoms, uh, or the cascade of events in their body. This high insulin tells their liver, take the sugar and store it as fat, but the fat that they store is visceral fat, it's highly inflammatory. It causes more insulin resistance, brain fog, fatigue, all of it. The high insulin stimulates their theca cells in the ovary to pump out testosterone.

• 40:04Dr. Mark Hyman?

  Yeah.

• 40:04Speaker 00

  Testosterone is toxic to these little follicles. So these follicles, these antral follicles that come to the surface every month, and one of them becomes dominant and ovulates, that whole thing with testosterone around, these follicles freeze, that's why you get that polycystic look. These are not cysts, these are sack of pearls inside the ovary. And what happens, this testosterone not only is toxic to these follicles, so ovulation goes away, the periods become irregular.

• 40:31Dr. Mark Hyman?

  And heavier, and they get more bleeding. And we get more iron deficiency.

• 40:34Speaker 00

  Exactly, but they also get facial hair, body hair and acne. Why would a thirty year old have acne?

• 40:39Dr. Mark Hyman?

  They get, they go bald, get pimples and get facial hair.

• 40:42Speaker 00

  Yeah, so.

• 40:43Dr. Mark Hyman?

  It's not good.

• 40:43Speaker 00

  So, and then you have, you have a condition, we already know inflammation is high. We already know androgen is high. We already know there's no ovulation, so progesterones are down. And we know these follicles are secreting erratic estrogen. So of course, all of it affects your limbic system. Your limbic system, which is your emotional headquarters, in order to be calm, it needs high progesterone, normal amount of estrogen, testosterone and low inflammation. All of it is the opposite in a PMOS patient. But instead of someone addressing their metabolic dysfunction, that first domino that dropped was their metabolic dysfunction and insulin resistance. No one addresses that. They get the Zoloft, they get the spirinol lactone from the dermatologist, Zoloft from the psychiatrists, birth control from the

• 41:27Speaker 00

  OB GYN, but no one looks at these patients holistically. Say, wait a minute, these are not separate. These are all part of one condition. Address their metabolic dis- address their, look at their lipid panel, look at their high sensitivity CRP. These patients have so much inflammation and from my studies, sixty one percent of PMOS patients have endometriosis.

• 41:51Dr. Mark Hyman?

  Yeah.

• 41:51Speaker 00

  And another leading cause of infertility takes doctors nine to eleven years to diagnose these patients. And so, think of, think of this one woman who's gaining weight, who has irregular periods, who has all these symptoms, painful periods. A, doesn't have access to an OB GYN, and then when she gets to that office, the doctor says there's nothing wrong with you.

• 42:13Dr. Mark Hyman?

  I, I just, I just had a patient like this. It was quite amazing. She was twenty eight. She had high in, very high insulin of like, I think thirty fasting. She had very high testosterone. She was quite anemic, her iron stores, her ferrin was threeish, she'd be forty five because she'd been having heavy periods because she wasn't ovulating and making progesterone, so she wasn't regulating her cycles. She had anxiety, she had depression, because progesterone is a relaxation hormone. And when you don't ovulate, you don't make progesterone, because you were talking pretty fast. I'm just gonna, I'm gonna slow it down a little bit. And so people, women who have low progesterone, too much estrogen, it creates emotional dysregulation. Not to mention all the other factors. And, you know, obviously she had, um,

• 42:57Dr. Mark Hyman?

  uh, you know, lots of inflammation, high CRP, and all these things going on that were all indicative of, of this metabolic syndrome. And I basically treated her with just diet and a few simple supplements and exercise. And her testosterone went back to normal, her insulin went back to normal, her uh, LH, FSH ratio went back to normal, her progesterone started coming up, started ovulating again. And we didn't give her any drink, and didn't give her any drugs. And, and the problem is, most doctors don't know how to prescribe food or prescribe exercise. It's not like, eat better, exercise more. Like, that's not helpful. Have three balanced meals a day. What's that? Like, how do you do it? What do you eat?

• 43:38Dr. Mark Hyman?

  Like, I, I think there's just such a lack of, of nutrition training for physicians, and it's, these are nutritional diseases.

• 43:44Speaker 00

  For anyone listening, I would say I have a platform with an easy test. Obviously, I can't diagnose people online, but it's free. If you're listening to this podcast and you have irregular periods, you're gaining weight, you have acne, hair loss, facial hair, body hair, you have disordered eating, eating disorder, fertility issues, take the quiz. I can tell them whether or not, by answering a few questions, whether or not they have the likelihood of having PMOS. And if they do, I've created this amazing supplement with vitamin D, with an acetyl blend, with uh, wild mob, all this stuff that will address their underlying metabolic dysfunction, inflammation. One of the most important things for PMOS patients, walk after each meal.

• 44:23Dr. Mark Hyman?

  Yeah.

• 44:23Speaker 00

  Go for a walk, simple things.

• 44:25Dr. Mark Hyman?

  And, and, and it's true, because I think there's all the history that'll help you, and it's really important to start there. But lab testing is now so affordable through Function Health, and we test all of these things. We test your LH, your FSH ratio, your estrogen. We check for inflammation, we check for insulin levels, we check for A1C, we check for your lipid particle size and number, which reflects all that. We check for your vitamin D, we check for your iron, we check for B vitamins, we check for all the things that regulate all these pathways. And we can actually fix them if we find out what's going on, and you'll get a clear plan of what to do and what's going on. And, and it's, it, these are the things that even if your doctor's not helping, because by the way, the doctor's not going to give you anything except drugs.

• 45:04Dr. Mark Hyman?

  So the rest of the stuff you do on your own, what you eat, exercise, your lifestyle, sometimes, these are things you don't need a doctor for, if you actually know what to do.

• 45:11Speaker 00

  So here's, I want to add another thing to Function Health.

• 45:14Dr. Mark Hyman?

  What?

• 45:15Speaker 00

  When you have a PMOS patient, please screen them for endometriosis. Because the gynecologists are not doing it, so function.

• 45:22Dr. Mark Hyman?

  That's not a blood test.

• 45:23Speaker 00

  It's not. Well, there is a blood test now. It's called Her Resolve.

• 45:30Speaker 00

  And it was just released, it's not public, I mean, not most doctors don't have access to it yet, but soon they will. It's a blood test. It picks up eight out of ten patients.

• 45:41Dr. Mark Hyman?

  What is it measuring?

• 45:42Speaker 00

  Circulating mRNA, micro RNAs. And they look, they add an AI algorithm to it, and they tell you the likelihood, like whether or not you have endometriosis or not. So it's actually a good test when it's positive. If it's negative, it doesn't mean you don't have it. Mike, you know, by listening to women, you can get as accurate as ninety nine percent in diagnosing them with endometriosis, but this test is eighty percent. I'll take it. There is a saliva test right now, you know, hopefully it'll be available soon. It's ninety seven percent accurate.

• 46:16Dr. Mark Hyman?

  I'm busy. Between seeing patients, traveling, my podcast, everything else, I don't have time to cook elaborate meals every night. But I've always believed that cooking for yourself is one of the best things you can do for your health. And it doesn't have to be complicated. A simple protein, some veggies, and a good pan can go a long way. In fact, with a few basic tools and a little planning, cooking at home can take less time than ordering takeout. And that's why I like Made In Stainless Clad Collection. It's cookware made without synthetic coatings and it's nonreactive, ensuring zero leaching of metals or chemicals into your food. And with five ply stainless steel construction, they heat evenly and have precise heat control. These are the pans chefs actually use, and have been found over four thousand top rated restaurants. It's built for real everyday cooking, from sauteing veggies to searing protein.

• 47:01Dr. Mark Hyman?

  And if you're interested in learning more, head over to madeincookware.com and use the code DRHYMAN10 for ten percent off your first order over a hundred dollars. That's M A D E I N cookware dot com. This episode is brought to you by Rose Nutrition Liposomal Glutathione. You got a lot on your calendar this time of year. Making sure you're supporting your immune system is part of the plan. Every day, your body is loaded with more environmental stressors than it's designed to handle. Enter glutathione, a powerful antioxidant that supports natural detoxification, oxidative stress defense, skin health and immune function. Glutathione is a tripeptide your body produces in nearly every cell. And its job is to keep those cells protected. This antioxidant helps you maintain healthy immune cell function and neutralizes free radicals, which is

• 47:44Dr. Mark Hyman?

  extra important this time of year. And since glutathione is highly sensitive to digestive breakdown, Row uses liposomal delivery to support nutrient protection and enhance absorption. If you want to take a simple step to support your immunity this holiday season, start here. Go to rhonutrition.com and use the code HYMAN for twenty percent off site wide. That's the code HYMAN at R H O nutrition dot com. So essentially what you're saying, Dr. A, is that the same things that help you prevent breast cancer will also address PCOS or PMOS now?

• 48:16Speaker 00

  Endometriosis.

• 48:18Dr. Mark Hyman?

  And it's basically eating a whole foods diet, getting off all your processed food,

• 48:24Dr. Mark Hyman?

  dialing way back on the starch and sugar, alcohol is an occasional treat, like rarely, exercising regularly, which really helps the metabolic health and hormonal health, managing your stress levels, which affects your hormones, managing sleep, which affects your hormones, getting your lifestyle, reducing the toxic load by filtering your water, maybe an air filter, not using plastics, basic stuff. You know, I'm in the Board of the Environmental Working Group, and there's a whole guides on how to reduce your exposures from household cleaning products, from food, from skincare, and so forth. And not get obsessive about it, but if you just focus on these basic things, you can dramatically reduce.

• 48:59Speaker 00

  I mean, that's the right way to say it. You can dramatically reduce your risk, but it doesn't take your risk to zero. Endometriosis can still show up, PMOS can still show up, breast cancer can still show up. But you can do something about it to reduce this risk.

• 49:16Dr. Mark Hyman?

  Yeah, it's really important. And I think your, your story in particular, as a doctor facing breast cancer yourself, identifying this when no one else was looking at it, being your own advocate. It, it sort of speaks to a really important point, which is you have to be the CEO of your own health. That's why we created Function Health. So people can be the CEO of their own health. You know, I had a friend who, who developed rare cancer, and she was going to doctor after doctor, and she says, she started a new company, which is Save My Ass Technologies, Inc. Basically, she realized she had to take ownership of the, her own health, and, and now she's still alive, you know, decades later. And, and she wasn't supposed to be. So I think people, people can have a lot of power in, in, in

• 49:58Dr. Mark Hyman?

  understanding how their health works, what's going on underneath the hood, using tools like your breast cancer risk stratification questionnaire, or Function Health lab testing, to really understand what's happening in their bodies, and not just sort of wait around for something to happen.

• 50:13Speaker 00

  Absolutely.

• 50:14Dr. Mark Hyman?

  In terms of like metabolic markers that, that are really hormone markers that people should be testing, we kind of touched on a lot of them, but like, just kind of recap, what do you think the most important things to look for are?

• 50:24Speaker 00

  So in my practice in women in reproductive age, if I could check one thing, I would check their account. Especially women who want to. Children, it's a simple blood test.

• 50:34Dr. Mark Hyman?

  AMH, we do it on function.

• 50:36Speaker 00

  I love that. AMH is very important, right there. I just did a podcast with a young girl at nineteen who had breast cancer. She had a check two mutation, no family history of breast cancer. And basically, her AMH, when they went to freeze her eggs, her egg count was really low. And as I was interviewing her, she still didn't know why. And I'm like, do you have painful periods? She's like, well, now I don't because, you know, they're suppressing my ovulation. But prior to that, yes, very painful periods. And that endometriosis can destroy your egg count and quality. So AMH for reproductive woman is very important. I, every year, I check, do a full hormone panel on my patients. I check their testosterone because I see a lot of PMOS patients.

• 51:20Speaker 00

  Even though you don't have to have a high testosterone in the blood to get the diagnosis of PMOS, I still check free and total testosterone, DHEAS, to see what their stress level is. If they have irregular period, I check their prolactin. If they're overweight, I get a hemoglobin A1C. Every woman, once a year, twice a year with me, is vitamin D, a B12, iron, ferritin. I check high sensitivity CRP. I check homocysteine. I check their ApoB if they're fasting. They come in, I always do a full blood panel. And part of that is their ApoB and lipoprotein little A. ApoB, I always say is a bucket of four particles that can cause plaque. And in that bucket, one of them is genetic, which is lipoprotein little A. Twenty percent of women have it.

• 52:04Speaker 00

  No, if you have lipoprotein little A, that does increase your risk of stroke, heart attack. It can increase, you know, I check for ApoE4 for my perimenopausal women because that increases the risk of dementia, inflammation, stroke. And for those patients, actually, there's new data that if you give them hormone replacement, you can actually reduce the risk of dementia. So ApoE4 positive women. And two percent of women have two copies of the ApoE4.

• 52:30Dr. Mark Hyman?

  Genetic risk factor for Alzheimer's.

• 52:31Speaker 00

  For Alzheimer's, absolutely. So those women, actually, if you treat them early in perimenopause and menopause for seven years with hormone replacement, there's new data that you can probably reduce the risk of dementia. Again, it's multifactorial.

• 52:44Dr. Mark Hyman?

  And not if you start it later, when you start it right after.

• 52:46Speaker 00

  Right, yeah, right, right.

• 52:48Dr. Mark Hyman?

  So people can find out this information now.

• 52:51Speaker 00

  It can change their life.

• 52:52Dr. Mark Hyman?

  Because if you go to your doctor and you ask for all these tests, their likely answer is going to be it's not necessary, it's too expensive, it's going to chase down things that are important and make you scared. I would say nonsense because information and knowledge is power. And if you don't know what's going on, you can't act on it. So I, I agree, I hundred percent agree with you. That's the conclusion I've come to as a doctor, which is opposite of what we were trained to do.

• 53:17Speaker 00

  And honestly, for, for all your clients who are coming on function health, the other advantage that I see is that when you do a blood test request, let's say, your ApoB of less than ninety is considered normal. It's not. Your AMH of one and above is normal. It's not, it's not normal. So you have to start looking at these. It can range in different ages.

• 53:43Dr. Mark Hyman?

  I want to, I want to sort of end by kind of doubling down on a bigger topic, which is hormone replacement therapy. Because essentially, what we've been saying for the last almost hour is that excess estrogen stimulation from all the reasons, from being overweight to sugar, to alcohol, to environmental toxins, to so forth, are increasing your risk of breast cancer. And yet, we're also in a moment where the fear about hormone replacement therapy has reduced. It was, was triggered from the Women's Health Initiative, which was a little bit overinterpreted for that reason. And now, there's a sort of an increasing movement to put more women on hormone replacement therapy around perimenopause and menopause.

• 54:28Dr. Mark Hyman?

  So how do you reconcile those two? And how do you handle that threading the needle on that?

• 54:32Speaker 00

  I see like.

• 54:32Dr. Mark Hyman?

  I imagine people are having that question mark in their head.

• 54:35Speaker 00

  And let me tell you, I feel like.

• 54:36Dr. Mark Hyman?

  And by the way, not just for, for the hormone replacement therapy, not just to just help your health, but it helps reduce osteoporosis. It helps your symptoms, it helps your sexual health, it helps.

• 54:45Speaker 00

  Cognitive health.

• 54:46Dr. Mark Hyman?

  Cognitive health. I mean, there's so many benefits. It's, it's kind of like a, how do you thread that needle?

• 54:50Speaker 00

  I feel as a gynecologist, and I've been in women's health for thirty years now, I feel like the pendulum went from all the way from this end, now it's swinging all the way to the other end. And there's a happy medium, right? I have patients who come to me and they're like, we heard on this podcast, you know, I've had an estrogen receptor breast cancer, but I've been cancer free for, I don't know, seven years, and now I want to do hormone replacement. I will not start that patient on hormones yet. Because especially estrogen receptor positive patients, you know, these are patients who twenty years down the line, they can show up with breast cancer again. So I think you have to personalize care. In my practice, if you come to my office and you want hormone replacement,

• 55:33Speaker 00

  I've already, I already know your lifetime risk of breast cancer. I've already done genetic test, testing if you have family history. So let's say I have a patient with ATM gene or check two who has a higher risk of breast cancer, who falls into the high risk category. If that patient wants to have hormone replacement, and I understand, I couldn't have hormone replacement, and I understand all the bad things that can come with it. But then I might have a discussion. If your lifetime risk of breast cancer, let's say it's fifty percent, and with risk reduction, one option is to put these patients on Tamoxifen, hormone blockers. If they take Tamoxifen every day for five years, that you can reduce their risk by like fifty percent for the following ten years.

• 56:15Dr. Mark Hyman?

  But that throws them in the menopause.

• 56:17Speaker 00

  It, it has side effects, yeah. Hot flashes, vaginal dryness, mood, fatigue, all of it, right? But you reduce their risk of breast cancer. So one discussion that I'm having them is, here's, here are your options for risk reduction. Let's say your lifetime risk is really high and it's at fifty percent. I can give you Tamoxifen. But if I give you Tamoxifen, I can't give you hormone replacement because they're doing the opposite. They're like, I'm trying to block the hormones. I'm not going to give you hormones. Or the other option is, you know, let's say, when I did my double mastectomy, if they didn't find cancer, I would have been on hormone replacement right now. Do you know, remove your breasts, reduce your risk, and then start hormone replacement. But if someone has a intermediate risk, low risk, they have symptoms,

• 57:01Speaker 00

  I'm all for hormone replacement. Give them hormone replacement. But I, I take every patient.

• 57:07Dr. Mark Hyman?

  It's individualized.

• 57:08Speaker 00

  It's individualized. It's not a blanket, everyone take hormone, nobody takes hormones. You know, it's the discussion, again, like everything else we did. Look at their metabolic function, look at their inflammation, look at their family history, look at their genetics, look at their polygenic risk score. Look at all of that, their cardiovascular health, and then decide whether or not they're a good candidate. But I love hormone replacement. I think for women who, you know, have the advantage of taking it, they should absolutely take it. The sooner you take it, the better it is. A lot of people think they have to wait for their periods to end and be menopausal to start hormone replacement. It's not true. Average age of menopause is fifty one and a half, seven to ten years,

• 57:52Speaker 00

  and the range is forty five to fifty five. Seven to ten years before menopause, women can go through perimenopause. So if you're someone who at forty five, let's say you're going to be menopausal, you could be perimenopausal in your late thirties. And there's nothing wrong with treating that patient with hormone replacement if she's having hot flashes, night sweats, mood swings, sleep disturbances, you know, all these other symptoms. There's like thirty some symptoms that can happen with perimenopause and menopause, vaginal dryness, painful sex, joint pain. And, but again, individualized care. And that's what I do in my practice. I do a lot of preventative testing, a ton.

• 58:33Speaker 00

  But I also offer hormone replacement to majority of the patients.

• 58:38Dr. Mark Hyman?

  Yeah, I mean, this is really functional medicine approach. It's just personalized care. It's looking in deep at your biology. It's understanding the risk factors and modifying those. It's working to help your overall health. I think we didn't talk a lot about the microbiome here, but I think it's a big factor in hormone metabolism, particularly cancer and overall hormone metabolism for women. So there's a lot of things that can be done if you know what's going on. And, and I think most people don't have that information. And your, your work, your practice really is, is such a gift because you're actually helping people to understand that these are not just things they have to suffer from. And, you know, I, I wrote this article years ago, it was about PMS. And it was like seventy five percent of women have some version of PMS or premenstrual syndrome.

• 59:25Dr. Mark Hyman?

  And I'm like, is, is this just a design flaw? Or is something else going on here? Like, to me, it doesn't make any sense that our biology was designed to make women suffer the way they do. And that these are things that are modifiable risk factors that we can change.

• 59:43Speaker 00

  I mean, my daughter's at Stanford, Delara, she's a senior and she is, her, her project is on PMDD, gut microbiome.

• 59:52Dr. Mark Hyman?

  Yeah.

• 59:52Speaker 00

  You know, wearables for PMDD. I mean, these all have underlying risk factors.

• 59:57Dr. Mark Hyman?

  And PMDD is like a severe form of PMS. It's premenstrual dysphoric disorder, which means you're like, it's, you get temporarily insane for the last two weeks of your cycle.

• 1:00:07Speaker 00

  Yeah. It's so sad for these girls. And, you know, again, it affects three to 5% of women. No one diagnoses them, no one. And I, you know, I say they destroy every relationship.

• 1:00:18Dr. Mark Hyman?

  Yeah.

• 1:00:19Speaker 00

  During those two weeks and then they spend the other two weeks going back and cleaning up. And then here comes again, and they start thinking, and it's so traumatic, these 10 days before their period is so traumatic to them, that eventually it causes chronic anxiety and depression.

• 1:00:36Dr. Mark Hyman?

  Yeah.

• 1:00:36Speaker 00

  Um, and no one addresses this. They have a higher suicide rate, they, it affects their work, it affects their relationships. And again, it's, the list goes on. I mean, I can sit here until tomorrow and talk to you about every condition that women get dismissed. That's why, again, I started this podcast by saying women, A, don't have access, but even for women who have access, they're still being dismissed. They're still being told they're crazy.

• 1:01:04Dr. Mark Hyman?

  Well, they might have access to certain types of doctors, but not other types of doctors. And you have to think out of the box, and we didn't learn any of this in medical school.

• 1:01:10Speaker 00

  No, none of it.

• 1:01:12Dr. Mark Hyman?

  And yet the science is there. Like, the science, the data is there. It's, it's just hard to change paradigms. It's hard to change the way people think or practice. And it's also hard for doctors to focus on things that they're not trained with, which is lifestyle or prevention.

• 1:01:25Speaker 00

  But look, all the labs you do with, with Function Health, right? How much time would that take for a doctor in the office to explain all that to the patient?

• 1:01:35Dr. Mark Hyman?

  Yeah.

• 1:01:35Speaker 00

  Doctors don't have time. They have 10 minutes with the patient. A woman's health exam right now, everything I told you I do and more, because I haven't talked about colonoscopy, bone density, cardiovascular, all of it that I do, it takes 45 minutes.

• 1:01:49Dr. Mark Hyman?

  Yeah, it's a long time.

• 1:01:50Speaker 00

  You know what patients get? A pap smear, a bimanual exam, maybe a prescription for birth control if the patient's sexually active, maybe an STD check, and maybe a breast exam. And if they're 40, they get a mammogram and off they go. That's not well, woman. That's dismissal.

• 1:02:08Dr. Mark Hyman?

  That's not comprehensive care.

• 1:02:09Speaker 00

  No, this is nothing. It, it shouldn't even, I don't even want to call it standard of care, because that shouldn't be standard of care.

• 1:02:16Dr. Mark Hyman?

  Unfortunately, it is.

• 1:02:17Speaker 00

  It is.

• 1:02:18Dr. Mark Hyman?

  Yeah. Well, thank you so much for your work, what you do. Where can people learn more about you, your work, and, and how to calculate your lifetime risk cancer risk?

• 1:02:26Speaker 00

  You know what? I started my SheMD podcast with my partner, Mary Alice Haney, about two years ago, and it exploded because we really talk about women's health. We take every topic in women's health, we cover it, we go in details of it, and from prescriptions to what they ask, we make women become their own health advocate. The only way to advocate for yourself in this healthcare system is to be educated about that condition, and that's exactly what we do. So I say, go find me on SheMD Podcast. I have all the information there. I have the.

• 1:03:00Dr. Mark Hyman?

  So sheMDpodcast.com.

• 1:03:01Speaker 00

  SheMDpodcast.com. I also have OV.com, OVII.com, for anyone with metabolic dysfunction, anyone struggling, needing hormone balance, metabolic, struggling with metabolic dysfunction. It's a great platform. It has a calculator for PMOS, and we have the most amazing supplement. Thank you for having me.

• 1:03:24Dr. Mark Hyman?

  Thank you, and thank you for your work. Thank you for not dying and helping us learn a lot about this.

• 1:03:29Speaker 00

  I love that. Make sure you add the lifetime risk calculator for all your patients and make sure you're screening for endometriosis in all women.

• 1:03:38Dr. Mark Hyman?

  We'll work on that. We'll work on that. Thank you. Thank you so much. Hey, everybody, it's Dr. Mark here. I'm so excited to share that my new book is officially available for preorder today. After more than 30 years of practicing medicine and caring for tens of thousands of patients, I've written the book that brings everything together that I've learned about helping people get healthy and stay healthy as they age. It's called A Hundred: What to Do Today to Live 100 Healthy Years. It's a whole body guide to living 100 healthy years. It's grounded in a new understanding of how our bodies work. It's the new map of the body. And inside, I walk you through the seven core systems that drive your health from your gut and hormones to how your cells make energy, to help you understand the signals your body's been sending you all along. Now, a lot of what's in the book, I learned the hard way, through my own body.

• 1:04:23Dr. Mark Hyman?

  When I got sick, the medicine that I trained in did not have any of the answers I needed. So I had to go look for them myself, and that search became my life's work. This book brings together decades of my learning from my patients, from the scientific research and scouring that, from the things I got wrong and the things I had to rethink along the way. I don't want you to have to struggle the way I did to find those answers. So much of our health is shaped by what happens outside your doctor's office. And I want you to feel confident knowing how to care for yourself every day. I put so much of myself into this book, and I'm really excited to finally share it with you. It's really my life's work. It's my capstone of my career. I put everything I know. It's finally available for order today, preorder, everywhere books are sold. Go get a copy. Please support me, and this is my life's work, so I think you're gonna love it.

• 1:05:09Dr. Mark Hyman?

  If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at DrMarkHyman. 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 DrMarkHyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.

• 1:05:54Dr. Mark Hyman?

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

• 1:06:38Dr. Mark Hyman?

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