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The Dr. Hyman Show
Anxiety, Autism, Allergies: The Hidden Triggers in Children No One Talks About
01:11:10
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- [00:00]
Dr. Mark Hyman
Coming up on this episode of the Dr. Hyman Show. All these kids have massive amounts of neuroinflammation. Their brains are on fire. When your brain is on fire, it's hard for it to function. I'm all about food first, but some nutrients like magnesium, are nearly impossible to get enough of. Through diet alone, our soils are depleted and things like sugar, caffeine and stress drain our levels. Magnesium supports over 300 functions in the body. Think metabolism, sleep, energy, pain and more. That's why I recommend Magnesium Breakthrough by Bioptimizers. It's the only supplement with all seven forms of magnesium for full body support. Get 10% off at bioptimizers.com hyman with code HYMAN10 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've 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 Hymenhive for live Q&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@doctor hyman.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 7 day free trial.
- [01:18]
Dr. Lisa Dreyer
As a pediatrician, I always try to approach things with some fun, you know, some joy, some hope. Because as you said, it can be like, oh my gosh, the world is against me. How can anyone be healthy in this world? And we can. So just, you know, empowering kids and parents to know there are simple steps that we can take to be healthy and that, you know, for our children when we do that as a family, even if they push back as teenagers, right? I mean, the inevitable pushback, right? My kids are preteens, teenagers, and you know there's going to be pushback. That's part of life, right? But if you lay those foundations, they're going to go back to it. I mean, the teenagers who knew how to cook, right? I mean, they were much more likely to choose vegetables when they were off to college, right? I mean, it pays it forward. And so the gut reset is really akin to the five Rs of functional medicine on how to heal the gut microbiome. But the Foundation. So the reset would be really, if your child has any sort of persistent health concern, and we have to presume if your child has a persistent health concern, chances are they have a leaky gut. Chances are they could have gut dysbiosis, right? Maybe not. But in an abnormal balance of bacteria, yeast, parasites, whatever else, I mean, viruses that we're not really yet able to measure yet. Right. But the foundation of that reset. So the r first re return is returning to those five things for microbiome magic. Those are the fundamentals, the essentials. I mean, many people listening have heard the saying that you can't out supplement a bad diet and lifestyle. Well, you can't heal your microbiome. You can't out supplement a poor diet and lifestyle for your microbiome. I mean, I could tell you 10 different supplements to take and you might get a little better. And in fact, I've had kids, you know, going through the gut reset when they're like, okay, not changing the diet, I'm not gonna go to bed, you know, get eight hours of sleep, right? They can get better on the, on the supplement plan and they can even, quote, go into remission. But here's, here's the thing. And as pictures, practitioners listening, we've all had this experience where your patient gets better. I mean, that's awesome, right? They're in remission, but then what happens six months later?
- [03:41]
Dr. Mark Hyman
Yeah, they slide back.
- [03:42]
Dr. Lisa Dreyer
They start sliding back, right? I mean, what we want is, I don't even want to call it remission, right. I want to call it, okay, this is your new state of health, right? This is your new normal now. Right. And so I have parents who are kind of, you know, just holding their breath, waiting for the next shoe to drop because they're like, okay, when's the next time they're going to flare, you know, in their pans. Panis or when's the next time, you know, that their rheumatoid arthritis is going to flare? So those five things, I had this opportunity, it was so fun for my kids. They go to a public charter school and rely on parent volunteers to teach some of their, quote, electives. And so for their third and fourth grade combined class, so 8 to 10 year olds, I created a six week curriculum. We call it Healthy Valley. Happy you. It was so fun. I mean, we taught all about their microbiome, but made it about poop with kids. I bet they like, I mean, poop with kids. All about poop, right? And connected the dots to you. Why they're, they're these tiny little microscopic friends are so important for not missing school so much because you're sick or getting along better with your friends or being sleeping better in school, better in school, running faster down the soccer field, right? So connected the dots. And these kids, they learned how to look at packages, read food labels, check the sugar, make sure there's nothing artificial. They were going home telling their parents, but mom, I shouldn't have more than 25 grams of added sugar in a day. And look at this, they have like this package of, you know, whatever it is, let's say boba tea, right? It's 35 grams of sugar. Now some kids, of course, my kids too included, they may choose to have that, right? But at least they know they're making that informed decision, right? And then they know, okay, how can I get my microbiome to bounce back from that, right? We made kombucha.
- [05:34]
Dr. Mark Hyman
That's so fun.
- [05:34]
Dr. Lisa Dreyer
And sauerkraut. I mean, that's the way to do it, right? So we just spoke about the five things that they have to do every day anyway, so why not just do it for themselves but for all their trillions of microscopic friends?
- [05:49]
Dr. Mark Hyman
You're not alone.
- [05:50]
Dr. Lisa Dreyer
You're not alone, you're not alone. And really and truly with, I mean, the numbers keep changing, right? But whatever. 10 times more bacterial cells on and in us than human cells. I mean, who are we really nurturing, right? And so we have to eat every day, so why not eat to support your microbiome? We have to breathe and drink and sleep and move our bodies. Even if you're a couch potato, you're still moving, right? So how can we do each of those five things in a way that supports your buddies, supports you, and they were all into it. And we go through each of these in the book, but I would say the two most important things are, number one, nourishing your gut microbiome. And that includes what kind of things you get in. So we've already talked about that, right? Fiber, color, fermented foods, prebiotic foods, Prebiotic foods, right? Creating symbiotic meals, right? That means pairing, you know, a fiber filled food with a fermented food. So I mean, just think like yogurt and you know, nuts and granola, right? I mean, right there, right? Or blueberries on top. But equally important, especially for our kids who are, you know, quote picky and for parents who are like, okay, they don't let a vegetable touch their plate, like, I gotta figure something else out. Sometimes even more impactful is to teach Them how to read food labels to know what to keep out. Right. The things that are really especially harmful to their gut, microbiomes. And I don't make it too complicated, but, you know, I really talk about these food additives. You know what was hilarious in doing research for the book? There are over 3,000 FDA approved food additives. Right. And the list, it's called Everything added to food in the United States. I mean, what a silly list, right? But, but three. Over 3,000 to make our food taste better, sweeter, saltier, have a better mouth feel. I mean, it's creepy, right?
- [07:45]
Dr. Mark Hyman
And these things aren't really food and they're. And they're mostly not regulated. They mostly haven't been tested.
- [07:49]
Dr. Lisa Dreyer
Yeah.
- [07:49]
Dr. Mark Hyman
They're often not allowed in other countries, like in Europe.
- [07:51]
Dr. Lisa Dreyer
That's right.
- [07:52]
Dr. Mark Hyman
And we use them here. Right now, Kellogg is, is getting a bit of a backlash because it produces foods in America that have certain colors and additives that they don't allow in Canada and other countries. And they remove those from other countries. Products that they sell, where they sell Kellogg's, but they don't remove it in America. So our kids are getting exposed to very harmful things that they're protected from in other countries.
- [08:13]
Dr. Lisa Dreyer
It's true. You know, they were big to do about getting rid of the artificial colors. You know, this was, I mean, this was probably about 10 years ago. You know, I was really excited. And then they pulled back, right. They said, well, you know, first of all, we're not removing those because they're actually harmful. Right, right. Second of all, the American people, they actually prefer the brighter colors and they prefer X, Y and Z. I mean, come on.
- [08:40]
Dr. Mark Hyman
They might also prefer cocaine in every corner.
- [08:45]
Dr. Lisa Dreyer
So it is true. I mean, Europe, I mean, Europe already for years has had a warning label that foods with artificial dyes and preservatives can affect children's behavior and attention and focus. And so teaching kids how to keep those things out, really impactful. And I'll just, I'll tell you a quick story on just how we had had, you know, before when we bumped into each other in the hallway and we were chatting about just how quickly kids can get better, you know, compared to adults.
- [09:12]
Dr. Mark Hyman
It's true. Yeah.
- [09:13]
Dr. Lisa Dreyer
Kids aren't filled with all the, you know, the, the toxins, whether they're physiologic toxins or environmental toxins and psychological toxins, 100% more resilient. And so small changes can have profound results. And, you know, there's this one kiddo, he was probably about 6 years old, tons of behavioral concerns, tons of sensory issues. He didn't feel right in his skin. He was getting into fights with every kid on his soccer team. Not a good thing. His occupational therapist was really astute and referred him to me and said, I don't think this is just sensory issues. Right. There's something else going on.
- [09:49]
Dr. Mark Hyman
Yeah.
- [09:50]
Dr. Lisa Dreyer
Sat with a mom who was just, I mean, exhausted at her wit's end. One of the things that was heartbreaking for her was this was her son.
- [09:56]
Dr. Mark Hyman
Yeah.
- [09:57]
Dr. Lisa Dreyer
I mean, he just couldn't stand touch. So when she would kiss him, he would wipe it off. Right. He just moved away from her hugs. I mean, that's heartbreaking as a mom.
- [10:06]
Dr. Mark Hyman
Yeah, of course.
- [10:06]
Dr. Lisa Dreyer
And so as we sat and talked about different tests that we might do just to figure out. Dive a little deeper. Could there be some.
- [10:12]
Dr. Cortica
Yeah.
- [10:12]
Dr. Mark Hyman
What did you find?
- [10:13]
Dr. Lisa Dreyer
Well, I mean, this kiddo did end up having pants. Okay. So that's sort of, you know, the backstory There. There was something different going on for his sensory issues. But as you're.
- [10:22]
Dr. Mark Hyman
That you just said pans, so.
- [10:23]
Dr. Lisa Dreyer
Pans. Pediatric acute onset neuropsychiatric syndromes, which is.
- [10:28]
Dr. Mark Hyman
A mouthful, but it just means kids have these weird neuropsychiatric problems. We don't know what it is.
- [10:32]
Dr. Lisa Dreyer
Yeah.
- [10:33]
Dr. Mark Hyman
And it's called the syndrome because we have no clue how to deal with it.
- [10:35]
Dr. Lisa Dreyer
That's right. That's right.
- [10:36]
Dr. Mark Hyman
But we actually do for reason. We do.
- [10:37]
Dr. Lisa Dreyer
We do. Absolutely. And for some kids, an abrupt, pretty dramatic onset of ocd, food restrictions, aggression, separation anxiety, cognitive decline, writing decline. Pans can have many different causes. So that's where, as a functional medicine practitioner, you need to do the digging, because it could be mold, you know, mycotoxins. It could be infections like strep. And when it's caused by strep, it's caused pandas. So pediatric acute neuropsychiatric syndrome. Disorders associated with streptococcal infection. That's another mouthful. But. So he ended up having that. But here's the thing. After his soccer practices and games, often there would be treats of, like the bright neon blue Gatorade. Right. And the Skittles. And the, you know, and the family otherwise was. Was pretty healthy in terms of their diet. But it was just this thing that. Well, it's a treat after soccer. Right. All his friends are doing it. So, you know, as we're thinking about the testing, I said, look, let's just do one thing right now. One thing. Let's just remove all of the artificial colors and Preservatives from his diet.
- [11:44]
Dr. Mark Hyman
It's like the Feingold diet. Right. Feingold was this pediatrician back in the 70s who said food addicts were causing ADHD.
- [11:52]
Dr. Cortica
Yeah.
- [11:53]
Dr. Mark Hyman
There was something to it. It's not in every case, but, yeah.
- [11:56]
Dr. Lisa Dreyer
As a pediatrician, I think it's really important to not just say to do something, but make it concrete. So we went through and figured out, okay, the Gatorade. Okay. What's an equally acceptable non artificial. No artificial sweeteners either. No sucralose. No aspartame. Hydration drink. He can drink. I mean, how about coconut water? Right. But there are other hydration drinks that are much cleaner than the Gatorade. Right. The Skittles. What could be replaced that with, you know, so we really concretely discussed what swaps to make.
- [12:26]
Dr. Mark Hyman
Yeah.
- [12:27]
Dr. Lisa Dreyer
And then she went home. She was a little overwhelmed by everything. Right. As can happen in that first visit. It's like drinking from a fire hose sometimes. But she was committed. And mom took out the artificial dyes, sent me a message two weeks later. Two weeks. Right. Two weeks. I have the message from her in my portal, and I just. It makes me tear up every time I think about it. And she said she just wanted to thank me because for the first time she could remember in so long, he didn't wipe away her kiss. Right. For the first time. And he even asked for a hug.
- [12:58]
Dr. Mark Hyman
That's amazing.
- [12:59]
Dr. Lisa Dreyer
Right? So, I mean, two weeks is not that long. And so that's where the mindset shift has to happen, because a lot of people think, oh, I'm depriving my kid. Or maybe it's like your partner helping your grandparent. I mean, we're not depriving your kids. Right. We're helping them thrive.
- [13:14]
Dr. Mark Hyman
I mean, I want to pause there for a sec because what you said was just so important that there are these kids walking around with all these health issues that are treated by traditional medicine, usually with medications or with nothing. Like, there's no treatment for sensory issues with kids. It just like behavioral therapy or other kinds of therapies that really don't work that well. And what you're saying is that there are underlying biological causes of many of the things that are correctable and that kids respond really quickly and really well to these things in ways that sometimes adults don't. So being a pediatrician has to be extremely satisfying when you're using this approach. When you're not, you're just kind of putting band aids in everything. And it can be very frustrating. I think pediatricians have one of the lowest job satisfactions and the highest burnout rates. And it's because they're really kind of just on this treadmill of traditional care, which isn't actually helping their patients. Your case reminded me of a boy I took care of who was 12 years old, who was so disruptive, severe ADHD, kicked out of kindergarten, you know, I mean, who gets kicked out of kindergarten, you know, on ADD medications? And he had all these other issues that were not, quote, psychiatric. Right. He had stomach aches, he had anal itching, he had asthma, he had allergies, he had headaches, he had anxiety, he had insomnia. Like, he had all the things, muscle cramps. I mean, he had all these things that were really problematic but were treated by all these different specialists who's on seven different medications.
- [14:41]
Dr. Lisa Dreyer
Yeah.
- [14:42]
Dr. Mark Hyman
And what we found was that he lived on a diet of processed food. And we did a bunch of testing. And I want to talk about testing because I think it's an important thing for how do we sort of figure out what's going on with our kids? And we did a number of tests and we found he was severely nutritional deficient in almost everything. Vitamin D, B6, magnesium, zinc, you know, just like omega 3 fats. He had high levels of all these trans fats in his blood. He had from all the processed food. He had high levels of inflammatory fats. He had high levels of really toxic stuff in his system like lead. And his gut was a mess. He had overgrowth of yeast and leaky gut and food sensitivities. And he had gluten antibodies from eating gluten that he was sensitive to. And, you know, all I did was really do what you're talking about, was reset his gut, put him on a whole foods diet, get rid of the bad bugs, put in some probiotics, get him. Get him the nutrients he needed. Some multivitamin, D, fish oil, zinc, magnesium, B6. Two months later, the mom brought him back and said, he's a completely different kid. He's got no add, he's off all his medications. He has no more headaches, no more stomach aches, no more asthma, no more any of the other things he was suffering with. He stopped drinking all the sodas and everything, and he's drinking all the junk food. And his handwriting, which was thing that blew my mind, went from completely illegible to completely perfect penmanship.
- [15:58]
Dr. Lisa Dreyer
Yeah.
- [15:59]
Dr. Mark Hyman
I was like, wow. Like, this is crazy. When you see something like this, you go, as a doctor, you go, either you dismiss it because it doesn't fit your paradigm or you go, wait a minute, there's something I've been missing.
- [16:11]
Dr. Lisa Dreyer
Yeah.
- [16:11]
Dr. Mark Hyman
And that the body and the brain are connected in ways that are so important. So whether kids got sensory or behavioral issues or whether the kids got allergic autoimmune issues, it's so important to get the proper evaluation. When I was just starting my medical journey as an emergency room physician, magnesium was a critical element of our care. We used it to treat all kinds of conditions, from arrhythmia to constipation to preeclampsia. It turns out that magnesium is critically important outside of the emergency room, too. In fact, it's one of the most important minerals for all aspects of health. It participates in over 300 different biochemical reactions in your body. Yet over 60% of the population doesn't get the amount of magnesium they need from their diet alone. That's why I'm such a big advocate of bioptimizers. Their magnesium breakthrough supplement is the only supplement on the market that offers the full spectrum of all seven types of magnesium. Specially formulated to reach every tissue in your body to provide maximum health benefits. Bioptimizers is offering my community 10% off. Just head over to bioptimizers.com hyman with code HYMAN10 that's bioptimizers.com hyman with code HYMAN10 at checkout. So how do you start to think about looking at these kids who are. Who are stuck? One is prevention, right? We talked about that. Getting the mother's health and the father's health. Great preconception. They both need to be on the right supplements, correct the things that are off, fix their guts, get rid of the metals, all the things we talked about. Now you can listen to the podcast on preparing to conceive as it talks about what to do for both men and women. But then we have all these kids who are suffering and these kids with chronic illnesses. I mean, these kids who are on multiple medications and who are stuck in this treadmill that they're on for life and that they're going to have consequences their whole life long from these conditions. And then maybe allergies turn into autoimmunity when they get older, and it's just kind of a mess. So when you have these kids who come in to see you and they have, you know, ADHD or autism or, or autoimmunity or they're allergic to everything or they have eczema, how do you start to think about assessing these patients and helping these parents think about taking care of their Kids in a different.
- [18:18]
Dr. Lisa Dreyer
Way with the child present too. I mean, I always want to educate and inform kids in an age appropriate way. So I think that's where making sure kids are on board with the whole plan is really important that they understand.
- [18:31]
Dr. Mark Hyman
Yeah, of course.
- [18:32]
Dr. Lisa Dreyer
Because if mom comes home and just says, okay, we're gonna overhaul your diet and all, I mean, it's not necessarily. For some kids it might, but for many kids it's not gonna work. Right.
- [18:41]
Dr. Mark Hyman
Kinda showing the kids their test results, like, here, look at this, you're allergic to gluten.
- [18:44]
Dr. Lisa Dreyer
Or look at this, you've got.
- [18:45]
Dr. Mark Hyman
Yeah.
- [18:46]
Dr. Lisa Dreyer
Across the board. When I tell parents and kids, when they're sitting in front of me, if they have any sort of attention concerns, behavioral concerns, focus concerns, anxiety. I mean, so many kids are suffering from anxiety nowadays. And when I tell them that 80 to 90% of the serotonin in their bodies is made by their gut microbiome. Right. And then usually there's a pause in parents and kids are like, what? So that's a perfect segue into, listen, let's think about all the things that are happening that are disrupting your gut microbiome. And so that's an easier in to say, let's look at the foods. Right. It's not just about like what you're eating. It's just, it's about, okay, what factors are, you know, harming your gut microbiome. And you know, guaranteed, no matter what kids have, we can kind of link it to that. That's an easier way, I think, to have a conversation around food. And you have to work with their goals. Right. For parents, it might be, you know.
- [19:40]
Dr. Mark Hyman
To what do they want? They want to feel better.
- [19:42]
Dr. Lisa Dreyer
What do they want exactly?
- [19:43]
Dr. Mark Hyman
Do better in school. They want to.
- [19:44]
Dr. Lisa Dreyer
Yeah, yeah. The foundations, as you said. I mean, we always talk about the foundations of food as medicine. That sometimes is the hardest thing to change, honestly. Right. For a lot of kids and talking about, I mean, even for this one teenager who came in and he's been gluten free on and off and I mean, he knows it makes a huge difference for him, but he was having a flare of his.
- [20:05]
Dr. Mark Hyman
Sometimes the kids just want to eat that pizza.
- [20:07]
Dr. Lisa Dreyer
Well, so he was having a flare and he came to me and we did some testing. He's like, just please, please don't tell me I have to go off the gluten. And I'm like, look, I'm not going to tell you. You have to. But I'm going to tell you what decisions are going to Help serve your body and your brain and make you feel better. Right. And he took some time to think about it. And of course, I expect that in a teenager. Right. But especially for teenagers. And, you know, I let them know that we're working as a team and the decisions you make. I mean, teenagers, they're all about, you know, trying to make it be an adult. You know, I'm independent. But if you're going to be given the opportunity to make adult decisions, then you have to make them like an adult and make them with information. But the foundations really, you know, in healing the gut are. I mean, the foundations. Right.
- [20:56]
Dr. Mark Hyman
But you test kids. I mean, do you do testing and diagnosis?
- [20:58]
Dr. Lisa Dreyer
So I do. I mean, when I. The first thing I'll test is blood work for nutrient deficiencies. You have to optimize. So the foundations are the cbc. I do aperitin. Yes. Complete blood count, a ferritin, which looks at iron, that looks at iron stores. I'd like to do a comprehensive metabolic panel that's fasting because I want to see what their blood sugar is doing, even for fit, active, slim kids. So many more kids are showing signs of insulin resistance.
- [21:24]
Dr. Mark Hyman
Yeah. Pre diabetes in kids, right?
- [21:26]
Dr. Lisa Dreyer
Yep. Even for kids that don't fit the overweight.
- [21:28]
Dr. Mark Hyman
Can you measure the insulin levels?
- [21:29]
Dr. Lisa Dreyer
So I measure fasting. Insulin, fasting, blood sugar in the comprehensive metabolic panel. I look at their liver enzymes specifically too, because AST and ALT can start to creep up. I do hemoglobin A1C, but that's rarely high, I mean, because it's just the average blood sugar. Right. So if they're. Most kids are kind of roller coastering up and down. Right. So if they have low lows and high highs, their A1C might look perfect. I do a red blood cell, zinc, a red blood cell, magnesium, 25 hydroxy, vitamin D. So those are kind of my foundations.
- [22:01]
Dr. Mark Hyman
Omega 3s.
- [22:02]
Dr. Lisa Dreyer
I do an Omega 3 profile. It's not always, not always available, but I do add that Omega 3, Omega 6 profile. So. And also for the young kids, you can only take so much blood at a time. But those are my foundations. Lately I've been, you know, really trying.
- [22:17]
Dr. Mark Hyman
And are you seeing a lot of nutritional deficiencies in these kids?
- [22:19]
Dr. Lisa Dreyer
100%.
- [22:20]
Dr. Mark Hyman
100% of kids have nutritional.
- [22:22]
Dr. Lisa Dreyer
I mean, I'm not going to say 100%, maybe 99.9%.
- [22:25]
Dr. Mark Hyman
Okay, that way. Stop right there. Stop right there. So what you're saying is in the world's most affluent country, where you're probably seeing a fairly high end population of people, not people who are highly underserved.
- [22:39]
Dr. Lisa Dreyer
Many who are already healthier, already quote healthier.
- [22:43]
Dr. Mark Hyman
Parents are very proactive. They're coming to see you. In this population, you're seeing almost 100% of kids have one or more nutrient deficiencies.
- [22:51]
Dr. Lisa Dreyer
And I'm going to say. I'll back that up a little bit and say nutrient deficiencies and insufficiencies.
- [22:57]
Dr. Mark Hyman
So not optimal levels.
- [22:58]
Dr. Lisa Dreyer
Yes. So suboptimal, bottom of the barrel. Right. And the most common is zinc.
- [23:05]
Dr. Mark Hyman
Yeah.
- [23:05]
Dr. Lisa Dreyer
Okay. Zinc is the most common nutrient insufficiency and deficiency. Sometimes it's shocking how low a red blood cell zinc is. If you were to eat, you'd have to eat the equivalent of eight oranges today to get the nutrients that your grandma had with one orange. I mean, it's probably not quite as simple as that, but our food is less depleted dense. It's depleted from the glyphosate from.
- [23:28]
Dr. Mark Hyman
Yeah, we're not talking about processed food. We're talking about, like fruits and vegetables and food that should be nutrient dense. Right.
- [23:34]
Dr. Lisa Dreyer
So that's why even kids who have the healthiest diet, it's not uncommon to see these nutrient deficiencies.
- [23:40]
Dr. Mark Hyman
And by the way, what you're talking about, Lisa, is not something that most doctors or pediatricians will check. They don't check nutrient levels on kids. It's just not done. Maybe you'll check an iron level on a little kid, but that's really unusual.
- [23:51]
Dr. Lisa Dreyer
It's unusual for parents listening who are thinking, there's no way I'm gonna get my kid to do a blood draw. There's a numbing. A Lidocaine Priloc numbing cream that is magic. You put it on your elbows and I mean, kids just.
- [24:03]
Dr. Mark Hyman
Is that Emla?
- [24:03]
Dr. Lisa Dreyer
Emla. It's Emla cream.
- [24:05]
Dr. Mark Hyman
Emla.
- [24:06]
Dr. Lisa Dreyer
Yep. I would highly recommend that at least that first blood draw that you use, Emla, so that your kid doesn't feel the poke and you know, just have a distraction. Right. This is. This is screen time has a pass for this. Where, you know, they can, they can watch Dora, they can do whatever, Right. So our food is depleted. Ultra processed foods deplete our nutrients eating even further.
- [24:26]
Dr. Mark Hyman
Explain why.
- [24:27]
Dr. Lisa Dreyer
Well, so some of the these kind of anti nutrients, right? I mean, they compete with absorption for our proper nutrients, even if we're kind of pairing it with healthier foods and ultra processed foods, they're devoid of most nutrients anyway. So the thing with the ultra processed foods is when you read labels, I used to say, if you can't pronounce something, put it back. But some of those things are things like riboflavin and methyl and cobalt.
- [24:53]
Dr. Mark Hyman
They add them to enrich the.
- [24:54]
Dr. Lisa Dreyer
Have to add back vitamins and minerals.
- [24:57]
Dr. Mark Hyman
They always say they're enriched because they're so impoverished in the first place. They have to eat.
- [25:00]
Dr. Lisa Dreyer
That's right. Why would you need to add back nutrients to a real food? Right. And I also think our kids have a higher need for nutrients. Yeah.
- [25:12]
Dr. Mark Hyman
More stresses, more toxins, less nutrients.
- [25:14]
Dr. Lisa Dreyer
Yep. Less nutrients, getting in, more use of them because psychological stress. You need zinc, you need magnesium as cofactors for many of your neurotransmitters. You need your B vitamins. All of these are getting depleted.
- [25:28]
Dr. Mark Hyman
Also when you eat ultra processed food, you're not getting all the co factors that you need to metabolize that food. So basically, in order to process your food in your body, you need a lot of vitamins and minerals to run the chemical reactions to turn the food into energy and do everything else. So you're kind of in a double whammy. You're not getting the nutrients and you need more of them.
- [25:46]
Dr. Lisa Dreyer
I mean, it's. Yeah, it's like a double triple whammy. You know, it's. And zinc especially, just as a little pearl for parents listening and for practitioners. If you have kids who are super picky, sensory, you know, cover their ears when they're in a public toilet or parents have to, the kids have to leave if they run the blender or the vacuum. Or maybe they, they, they know to buy seamless socks or cut off all the tags on the shirts. So if you have a kid like this, you know exactly what I'm talking about. Right. And that can be one of the most challenging things. Well, zinc deficiency alters your taste profile, so it can trigger pickiness, low appetite, low. Also, there's amplification. It's called auditory gain, where sounds sound louder. The sensory issues, the tactile tags, socks, shoes, all of that. If you have a pediatrician or a physician who is not ordering tests for you, or you're not able to find a practitioner order test, sometimes just supplementing with a little extra zinc and parents will say, oh my gosh, they got out the door in five minutes, not 20 because I had to tie their shoes over and over again because they weren't tight enough. Right. Or palate is actually expanding a little bit. It could be as simple as that. But knowing that zinc is one of the most common nutrient deficiencies in kids, it can be so profound. Just see. I mean, there are clinical clues that kids may be deficient. But I always look at it.
- [27:08]
Dr. Mark Hyman
Have you ever used a zinc taste test?
- [27:10]
Dr. Lisa Dreyer
The tally? Yeah. I mean, sometimes it's harder for kids, but yes.
- [27:13]
Dr. Mark Hyman
You basically take this zinc liquid and if you don't taste anything, then you're deficient.
- [27:18]
Dr. Lisa Dreyer
That's right.
- [27:18]
Dr. Mark Hyman
Because instead of doing a blood test, you can actually do a, just like a test in the office or at home using sulfate. Yeah. So this is amazing. So that sort of speaks to, you know, the need for supplements because you think, oh, kids are healthy, they're young or they don't need supplements. But do kids need supplements? And if so, what? Supplements are non negotiable and you know, what should kids be taking?
- [27:41]
Dr. Lisa Dreyer
You know, especially if I don't.
- [27:42]
Dr. Mark Hyman
And not Flintstone vitamins.
- [27:45]
Dr. Lisa Dreyer
Not Flintstone vitamins, please. If I have the opportunity to check lab work, then I will supplement individual nutrients based on the lab work. You know, many, many kids are going to have, especially if they have chronic issues, they will have issues with methylation and need more methyl factors. But I have yet to see a young kid with an elevated homocysteine, maybe on their urine. So I will do urine organic acid tests because they're so much easier to get, so much easier to get a poop test than a blood test sometimes. A pee test than a blood test sometimes. If we want to look at methylation stress, you can look at methylmalonic acid or fig glue, formiminoglutamic acid. Right.
- [28:20]
Dr. Mark Hyman
These are just markers of folate or B12 deficiency that you can see in the urine.
- [28:24]
Dr. Lisa Dreyer
Yeah. And then, you know, even on stool testing, if I see inflammation or digestive insufficiency. Right. They're not digesting, they're not absorbing their fats or, you know, their proteins or their carbohydrates. I might do digestive enzymes. But across the board, I would say virtually all kids need extra vitamin D. Even in the middle of summer when kids are out at summer camp and they have that golden tan. Even then, when I've measured kids, they are not optimal. Yeah, right. So. And in the northern hemisphere, where we live, apart from summer, you're really not going to get enough conversion through your skin in any other season.
- [29:00]
Dr. Mark Hyman
And unless you're running around half naked in a bathing suit for, you know, at least half an hour a day from 10 to 2 in the afternoon.
- [29:06]
Dr. Lisa Dreyer
Not lathered in sunscreen.
- [29:07]
Dr. Mark Hyman
Not lathered in sunscreen, you're not going to get exposures that are going to make a difference. Yeah, maybe for a life card, you'll be all right.
- [29:13]
Dr. Lisa Dreyer
That might be fun, but. So almost all kids and I would bet their parents to need vitamin D. So vitamin D3, do they need K2? I'll add K2 when they get older. For sure. For teenagers, almost all kids need an omega 3A fish oil. Right.
- [29:31]
Dr. Mark Hyman
So important for ADD, depression, skin, health, hair, all of it. Yeah.
- [29:36]
Dr. Lisa Dreyer
And their kids hormones. If, if kids have atopy, eczema or asthma. I'll make it a 369 fish oil, Omega 6 supplement with GLA. So that's an Omega 6, guys. Found in borage, black currants, even primrose. It's really good for autoimmune and atopic conditions.
- [29:55]
Dr. Mark Hyman
Yeah. People think all Omega 6s are bad. They're not. They're not good or bad. It's the quantity we have. And certain types are actually really beneficial. Like you're talking about gla, which is from evening primrose or borage oil.
- [30:06]
Dr. Lisa Dreyer
Yeah, yeah. Yes. It's so important. So I would say those are my staples. And I will say I am forever on the hunt for a high quality children's multivitamin that I love.
- [30:18]
Dr. Mark Hyman
You haven't found one?
- [30:19]
Dr. Lisa Dreyer
I mean, I found a few that I'm okay with. Right. And none is perfect. But there are some that are better than others. What I would move away from are some of the over the counter gummy vitamins. Gummy vitamins. Now some, like we carried a gummy line that was awesome because each gummy only had 0.5 grams of sugar. But some of them, if kids are getting the gummy vitamin D and some extra gummy magnesium and you know, gummy vitamins, I mean, in that like handful of gummies that they're gladly chomping away on, you know, before they head off to school, they might have had like four teaspoons of sugar in that one sitting. Right. And so we don't want to send our kids off with, with a mouthful of sugar.
- [31:06]
Dr. Mark Hyman
How parents go about finding good products like, you know, omega 3, vitamin D and multi, maybe zinc if they need it. Magnesium, probiotics. I mean, it's, it's kind of a zoo out there to find the right.
- [31:17]
Dr. Lisa Dreyer
It is. It is kind of a zoo. I mean, I use the practitioner brands. Brands. Right.
- [31:22]
Dr. Mark Hyman
Because now they're available to consumers.
- [31:24]
Dr. Lisa Dreyer
That's right. Encapsulations or designs for health now is available to consumers. I think Zymogen now is available to consumers, so it's much easier to find. And what I tell folks is either purchase from your practitioner who, you know, is, you know, storing, handling things. Well, if you're going to buy from Amazon, make sure you buy it from the manufacturer's store, not from like Judy's health food store.
- [31:47]
Dr. Mark Hyman
Yeah. Because a lot of these, like you might, they might buy a lot that's almost expired that might have it on sitting on the tarmac, you know, in a warehouse that's at 120 degrees. And it's a problem out there. So you have to be careful for products you buy on Amazon.
- [31:59]
Dr. Cortica
In just the past 20 years alone, the prevalence of autism has risen 400%. 400%, 400%. And sure we know part of it is related to changing diagnostic criteria, greater awareness, but there's a big part of that increase that isn't, you know, it can't be attributed just to greater awareness or changing diagnostic criteria. And we know actually a lot about the different causes, contributing factors. So the way I like to explain it to professionals and to caregivers is that there are a set of factors related to genetics. So we know genes matter, but they also aren't the entire story. So there are over 100 different genetic variants that we know can influence brain development in a way that can lead to autism, usually not just so genetic susceptibilities. Genetic susceptibilities is usually a complex interaction of many, many genes. Right. And then on the other side, there are also non genetic factors or environmental type factors, and usually it's not just one, it's many. And those interact with genetic factors in complex ways. So it's a complex picture. But those non genetic factors are really interesting because many of them give us insight into autism biology and some in a sense are modifiable too. So we know that there are a set of parental health factors that are increasingly common over time and are very likely contributing to the rise in autism. Things like parental age, things like maternal health factors, maternal metabolic conditions, maternal autoimmune conditions. We even know there are certain they fall in the category of toxins, things in our environment like industrial chemicals, pesticides, a whole range of things that are now really widespread in the environment. And a lot of research has been done showing that they affect brain development and brain health. So how that influences our approach at Cortica is that we really seek to understand a child's medical history. So we get a lot of information about the pregnancy, the birth, family history, family health conditions. And then we also do a deep dive into the child's own biology by looking at a range of different test results. So these Might be done on saliva, on blood, on stool, on urine, all ways, in addition to a very thorough physical and neurological exam, of course. But these are all ways to try to gain insight into what is happening for that child.
- [34:35]
Dr. Mark Hyman
And many of these tests are not things you get when you go to your regular doctor or neurologist. They're things that are kind of outside of mainstream.
- [34:41]
Dr. Cortica
Yeah.
- [34:42]
Dr. Mark Hyman
Looking at, you know, toxic load and urinary, organic acids at nutritional levels, methylation, and all these genes that are in combination. Often said that environment is, is a big factor, but genes load the gun, the environment pulls the trigger.
- [34:57]
Dr. Cortica
Yeah.
- [34:57]
Dr. Mark Hyman
So it's this sort of interplay environment across, across these kids, genetics. And I've seen this, you know, I've seen all these different genetic patterns of low glutathione genes and methylation genes and detoxification genes that are really common in these kids. And they tend to be sort of at risk, you know, And I think, you know, one of the things that really struck me when I started learning about this was the work of Martha Herbert, and I'm sure, you know, is another Harvard neurologist who studied autism and brain imaging. Yeah. And she, you know, she talked about these biopsy studies on kids who accidentally died with autism. And all these kids have massive amounts of neuroinflammation. Their brains are on fire. And when your brain is on fire, it's hard for it to function. And Alzheimer's is a brain on fire. Depression, we now know, is a brain on fire. Right. Schizophrenia, we now know is a brain on fire. So what's causing the fire?
- [35:51]
Dr. Cortica
Yeah, well, we actually. So prior to establishing Cortica, I was on faculty at Columbia University and we had an NIH funded research program using multimodal brain MRI to study autism in children and adults. And one of the research studies that we published showed that there was a pattern of neurochemistry essentially that really pointed to both mitochondrial dysfunction and inflammation in the brain. And when, as a neurologist, when I think about inflammation in the brain, there are kind of, there's sort of a set of maybe more acute or sudden onset fulminant types of brain inflammation. And then there's this other category of more low grade, chronic smoldering types of inflammation. And the research is really pointing to autism falling within that second category.
- [36:45]
Dr. Mark Hyman
Sure. It's not encephalitis that you get from a virus like meningitis. It's really a much more low insidious.
- [36:53]
Dr. Cortica
Inflammation and harder to detect. Some of our tests, it may not show up On a routine mri, for example. Sometimes it does though, and I certainly have seen that in my practice. So yeah, it's the mitochondrial dysfunction which is linked to this chronic low grade inflammation is influencing the function of the brain and autism. And, and it's also quite dynamic. So it's not. There's a term used for a very long time in pediatric neurology called static encephalopathy. And that couldn't have been. Now we know, couldn't be farther from the truth. The brain is not at all static. It's extremely dynamic and influenced by so many factors. And so we do as much as we can in our practice to try to understand what those factors are for a particular child and then we can take steps that can really be very impactful, like making changes to. So I think of these interventions as falling in six categories. The first, lifestyle changes. So things like making changes to sleep, routine, movement, what part exercise plays. Really fascinating is that there's now a lot of research in autism showing that exercise improves the core features of autism. So socialization, communication, executive function, anxiety, not to mention endurance, stamina, physical health. So just tremendous benefits to some of those lifestyle changes.
- [38:23]
Dr. Mark Hyman
And it's an anti inflammatory for the brain.
- [38:24]
Dr. Cortica
Yes.
- [38:25]
Dr. Mark Hyman
And it increases new brain connections.
- [38:27]
Dr. Cortica
That's right.
- [38:27]
Dr. Mark Hyman
With bdnf, brain derived neurotrophic factors like miracle growth of the brain.
- [38:31]
Dr. Cortica
Yes.
- [38:32]
Dr. Mark Hyman
So yeah, that's amazing.
- [38:33]
Dr. Cortica
Huge, huge benefits. The second category changes to the diet. Third related to that dietary supplementation.
- [38:40]
Dr. Mark Hyman
Anyways, before you go off the diet, don't just like bump right over that. What role does nutrition play? Because I want to go slow with these six things because I think you've got a lot in there that's really powerful and very unique. So what is the role of nutrition and diet in autism?
- [38:55]
Dr. Cortica
Yeah, well, there's a really very big role. I mean there's a very big role for nutrition and diet in health for all humans.
- [39:03]
Dr. Mark Hyman
For all of us.
- [39:04]
Dr. Cortica
Yeah, yeah. And for in autism, there's a lot of interest in diet. There always has been, but I think some of that interest, not just to.
- [39:13]
Dr. Mark Hyman
Be healthy, but as a therapeutic tool.
- [39:14]
Dr. Cortica
Yes. The emphasis in the past has been on various types of elimination diets. So diets where you remove something from.
- [39:24]
Dr. Mark Hyman
The diet like gluten or dairy, which are the most common.
- [39:27]
Dr. Cortica
Right, yes. And then see how that might affect a child's behavior and their learning. What I found in clinical practice is that because many autistic children tend towards a more restricted diet anyway because of sensory sensitivity or this reduced flexibility.
- [39:47]
Dr. Mark Hyman
Picky eaters, basically.
- [39:49]
Dr. Cortica
And so the diet often is very, very limited already to begin with, and also often limited to highly processed foods. So if you remove Mac and cheese diet. That's right. Or a goldfish or potato chips, french fries, you know, a standard American diet, unfortunately. But if you remove something from a diet that's already very restricted, you risk some serious nutrient deficiencies. So we find it's almost always a better approach to work on first expanding the diet. So expanding whole foods, nutrient dense foods.
- [40:21]
Dr. Mark Hyman
But you add, right?
- [40:22]
Dr. Cortica
Yes. And so we have a nutrition and feeding program that's a collaboration between our medical providers and our feeding therapists, our speech therapists, our occupational therapists who help a child. So it's both what you eat, the nutrition side and how to eat the feeding side. And then once you've increased a child's diet to a degree where you then feel comfortable eliminating things. And there are a lot of elimination diets worth exploring. So we do know that, for example, celiac disease, gluten allergy is more common. It's actually considered a co occurring condition.
- [40:58]
Dr. Mark Hyman
Isn't it like 6 or 17% of kids with autism have elevated gluten antibodies.
- [41:03]
Dr. Cortica
I don't know the exact percent, but it definitely.
- [41:06]
Dr. Mark Hyman
20% of schizophrenics.
- [41:08]
Dr. Cortica
Yeah. It's more common in autism. And the signs may be a little bit harder to detect. Also in a child who has behavioral differences already, who may have a harder time communicating.
- [41:20]
Dr. Mark Hyman
We call these co occurring or comorbidities. But that's really a false term. These are things that are all interrelated.
- [41:25]
Dr. Cortica
They are very interrelated. Yeah. It's been a huge step just to get to the stage of thinking of co occurring conditions. But you're right. Why do they co occur? Because they all have common underpinnings.
- [41:37]
Dr. Mark Hyman
Yeah. And the gluten triggers leaky gut, which creates inflammation in the body, then inflammation in the brain. So we know that gluten can be really a problem for a lot of brain issues. So sometimes that's a big factor. And you can measure antibodies in these kids and often they're high and you're just like, wow, I didn't know that. And you see a big change when you get rid of it. I've seen this in my patients. What about dairy?
- [41:59]
Dr. Cortica
Yeah. So what's very interesting about dairy is that there's some research suggesting that it can interfere with folate metabolism.
- [42:09]
Dr. Mark Hyman
That's right.
- [42:11]
Dr. Cortica
So there are some tests available to look at folate receptor antibodies, for example, doing those for years produce on A dairy free diet. So all of that's very important information to get for a child.
- [42:23]
Dr. Mark Hyman
So what she just said in English for everybody was basically what happens when you eat dairy? There are antibodies that form. Your immune system produces antibodies that attack the receptors for a vitamin called folate or folic acid. And this is a critical nutrient in regulating mitochondrial function. Detoxification, neurotransmitter function, inflammation, glutathione production. It's so critical, it's called methylation. And when that doesn't work and these kids almost all have these methylation issues, they get pretty significant dysfunction. So, you know, as you're saying is it's not one thing, there's like no one thing to do, but there's many things to do that is personalized based on what you find in each kit.
- [43:02]
Dr. Cortica
Exactly, exactly. And so you, it means looking at a lot of things. You know, we, we do pretty intensive, for example, genetic testing because those genetic markers are very helpful information.
- [43:12]
Dr. Mark Hyman
And just be clear, the genetic markers aren't like I have the gene for autism. It's this, maybe you have these methylation genes that are off or glutathione genes or other genes that relate to oxidative stress or other things that you're looking at.
- [43:23]
Dr. Cortica
Right, yeah. Relate to mitochondrial dysfunction, genes that relate to ion channels in the brain and different. So yes, there are a whole host of different genes that can be really.
- [43:33]
Dr. Mark Hyman
Informative and you can modify treatment based on those genes, right?
- [43:38]
Dr. Cortica
That's right.
- [43:38]
Dr. Mark Hyman
They're not fixed. You can actually improve their function by giving them nutrients or changing different things in their diet or lifestyle or environment or maybe medications. Right.
- [43:47]
Dr. Cortica
That's also a huge misconception. Sometimes parents will say to me, well, why should we test genes? We can't change them. Well, we can change the effects the genes have. We can influence gene expression. And there are as you know, lots of technologies now that actually do change genes in various ways. And so it's that the future of gene modification, gene therapy is on the.
- [44:08]
Dr. Mark Hyman
Horizon and it's pretty exciting.
- [44:10]
Dr. Lisa Dreyer
Yeah.
- [44:11]
Dr. Mark Hyman
So you combine these sort of genetic testing with other things that look at nutritional factors and dietary testing. So you mentioned we could spend the whole time on diet because I think that plays a role. I actually had a kid, I remember who many kids respond to gluten, dairy free diets. And you're right, you have to add in real food, you have to kind of get them. That's a really important point. But one kid was really violent. He was like an 8 year old autistic Kid and was just really aggressive, really violent. The parents didn't know what to do. I said, well, why don't we try a ketogenic diet? And they did. He ate it and completely changed him, completely changed him. He became more normal. No violence, got more speech. You know, all the autistic features kind of regressed. I wouldn't say he was perfectly normal, but he went from like a non functioning, non verbal kid to a more kind of normal kid. And so, you know, that taught me a lot. It's like, wow, you know, these kids, something in these kids. Diets can be playing a role.
- [45:12]
Dr. Cortica
Yes, well, diet, I mean, just has such a profound influence on the body's metabolisms, biochemistry and therefore behavior and learning. So it's hugely important. But it's also an area that can be hard to change.
- [45:24]
Dr. Mark Hyman
It's very hard for children, particularly this case, because you're so picky. You mentioned the next step, which was supplements.
- [45:30]
Dr. Cortica
Yeah. So dietary supplementation can be very impactful as well. There's so much to potentially say about this area too. But I think as it relates to my area of specialization around mitochondrial function, there are a lot of blood tests that we can do to look at to give us insight into a person's mitochondrial function. Carnitine, like carnitine levels, coenzyme Q10, liver function, lactic acid, mesylcarnitine profiles, urine, organic acids, amino acids. So there are a lot of markers.
- [46:04]
Dr. Mark Hyman
Not what you're going to get at your typical checkup with your regular doctor. So if you go to your regular neurologist, they're not going to know what you're talking about. But there are neurologists and doctors like you around the country in your centers do all this, which is really revolutionary.
- [46:15]
Dr. Cortica
And fortunately more and more, you know, I think the. Because the research has really caught up. Yes. So there's more awareness now, but it's still, you're right, it's still a work in progress.
- [46:25]
Dr. Mark Hyman
So you're actually testing their mitochondrial function through tests that are available.
- [46:30]
Dr. Cortica
Yes.
- [46:31]
Dr. Mark Hyman
And then you're customizing the treatment based on what you find.
- [46:34]
Dr. Cortica
That's exactly right. So for example, if there are levels that are low, so you know, there's so much, you know, mitochondria are complex, you gave a really nice description earlier. So they, you know, one of their major functions is to fuel the body. They're sort of an energy currency or powerhouse. But there are things like low carnitine levels or even supplementation with carnitine, supplementation with creatine.
- [47:00]
Dr. Mark Hyman
It's like what bodybuilders use. Yes, but it's a mitochondrial cofactor.
- [47:05]
Dr. Cortica
B vitamins can be really helpful antioxidant vitamins. So there are dozens of different dietary supplements that we might think about for a particular child that could help a lot with their learning and their development.
- [47:18]
Dr. Mark Hyman
I know when I first learned about your work, I read some of your papers that looked at brain imaging and the metabolic function of the brain, meaning the mitochondrial function of the brain. And you're some of the first to show in addition to neuroinflammation, there was mitochondrial dysfunction.
- [47:32]
Dr. Cortica
Yes.
- [47:33]
Dr. Mark Hyman
And that led you to kind of go, well, maybe if we tried to correct some of these mitochondrial pathways, which we learned about, you know, with these inherited metabolic mitochondrial diseases that are really rare, you actually could help these kids. It was the hypothesis. And you actually studied it and it worked.
- [47:48]
Dr. Cortica
Yes.
- [47:49]
Dr. Mark Hyman
So tell us a story about what. What you've done in a patient that use this approach for diet, mitochondrial therapy.
- [47:56]
Dr. Cortica
Yes.
- [47:57]
Dr. Mark Hyman
What did you find?
- [47:58]
Dr. Cortica
Well, there are some. So mitochondrial dysfunction is actually very common in many different neurological conditions. Very common in autism. There are now research studies showing that in blood, in muscle, in brain. So some of the research that we did using brain imaging showed patterns of which parts of the brain even are affected by mitochondrial dysfunction and autism. Interesting. And then there's also a lot of research showing the value of certain supplements like the ones I mentioned and many others. And so as part of.
- [48:30]
Dr. Mark Hyman
You mean supplements just don't cause expensive urine, as most doctors say?
- [48:35]
Dr. Cortica
No, they can for the. When they're matched. When you have the right supplement for the right person.
- [48:39]
Dr. Mark Hyman
Exactly. Right. There can be just personalized nutrition.
- [48:42]
Dr. Cortica
Yeah, yeah.
- [48:43]
Dr. Mark Hyman
So you use these compounds and.
- [48:45]
Dr. Cortica
Yes, so. So as an example, children, there's a pattern of regression, developmental regression, that's quite common in autism, where a child loses developmental skills. As you can imagine, it's really frightening for parents to see very often that regression in autism happens between 18 months to 3 years of age. And it also is often associated with what we think of in medicine as a physiological stressor. So, you know, an illness of some kind or a surgical procedure, or even something like starting a new school or new daycare or the birth of a sibling or moving to a new city.
- [49:25]
Dr. Mark Hyman
I'm going to jump into a really controversial topic, which I'm sure you know this is coming that I've seen in my practice and is almost heresy to say in medicine. But is there a role of vaccines in maybe being one of these triggers? And the reason I say that is I had a kid who was 22 months old, perfectly normal kid. His mother worked for a major pharmaceutical company and he had a vaccine at 15 months and started to progress and lost all his developmental milestones, became non verbal and fully autistic and, you know, and, and so I don't know if that was the cause, but it was a moment where things changed. And I've heard the story so many times from so many patients that there's got to be something there. And I'm not saying vaccines cause autism, but they may affect a kid who's vulnerable. Because this kid, you know, typically, you see, they're born by C section, they don't breastfeed, they've had lots of ear infections, they've had lots of antibiotics, their microbiomes messed up and so they're kind of sitting ducks. And maybe they have all these polygenic risks for getting into trouble when they have an insult. So could this play a role? What's your take on this?
- [50:37]
Dr. Cortica
Well, I will say, and you're right, vaccines is a topic that unfortunately is so polarizing in autism, pro life or pro choice.
- [50:44]
Dr. Mark Hyman
Like it's. So it's not really religion. Let's talk about the science.
- [50:49]
Dr. Cortica
So it is an area where I certainly wish there could be much more open discussion and less controversy, less heated debates. But I will say, you know, when it comes from the point of view of mitochondria, it actually, a stressor is a stressor, you know, and like all this that I just mentioned, whether it's a psychosocial stressor, you know, or whether it's an illness, in many ways the mitochondria respond in the same way.
- [51:18]
Dr. Lisa Dreyer
Yeah.
- [51:19]
Dr. Cortica
So, and I think as physicians, we all have very. When a patient comes to us and the parents have observed something, we really, I think it's important to believe. It's important to believe the parents and what they've seen and understand their experience and then to really, that's a radical idea.
- [51:38]
Dr. Mark Hyman
As a doctor, we know how it's supposed to go. So that doesn't fit my theory. So it's not relevant. But actually it may be very relevant.
- [51:45]
Dr. Cortica
I think now doctors are partners. Doctors shouldn't be viewed as authorities or those who have the answers.
- [51:51]
Dr. Mark Hyman
Amen.
- [51:58]
Dr. Cortica
Especially when children go through a period of developmental plateau or regression, it is a red flag. It is an emergency. And so I think of, there's a term in neurology, time is brain.
- [52:11]
Dr. Mark Hyman
Time is brain.
- [52:12]
Dr. Cortica
Time is brain. And it first developed around stroke to get people to act more urgently around stroke. But I think time's brain really applies also to autism.
- [52:23]
Dr. Mark Hyman
Yeah.
- [52:24]
Dr. Cortica
And why is it that a child might be diagnosed with autism? Sometimes a child will have the first signs of autism at a year or 18 months, not get a diagnosis until they're 3 or 4, not get any medical testing until they're 6, 7 or 8 or 15 or 21. I've certainly seen. I know you've seen that too. And so we have to be much more quick to identify when the brain is struggling, when it's not getting the energy it needs, when it's under excessive stress, and then be much more quick to act. Action means doing the appropriate tests and then taking steps in lifestyle changes, dietary changes, dietary supplementation, or some very interesting newer approaches like neuromodulation. There are different ways of using electrical and magnetic stimulation to improve brain function, certainly medications, but not just hyperbaric oxygen I've seen used. Yeah, there are a variety of. Some of these novel interventions that are really exciting. So in the area of neuromodulation, one that we use is a form of tiny microcurrent electrical stimulation that stimulates the vagus nerve, which is the major nerve of the body, of the parasympathetic nervous system. And we know that it helps to then counter the body's chronic stress response and sympathetic overstimulation, which is so common in many conditions, including autism. That's yet another really exciting category. Then the final one of the six is what I call developmental behavioral approaches. This is a huge, huge category, including things like occupational therapy, speech therapy, dance, movement therapy, art therapy. You know, it's all these ways that we can teach children and create those, you know, learning opportunities.
- [54:17]
Dr. David Ludwig
The average child is consuming 270 calories a day, which is 10 to 15% of their total caloric intake on sugar sweetened beverages. So that's 10 to 15% of calories that are nutrient devoid, no nutritional value, and are only leading to this whole problem of weight gain, insulin resistance, type 2 diabetes, and metabolic issues throughout their whole life. You know, as we've talked in the past, all about how that shifts your fertility and your. I mean, there's so many aspects to it. So, I mean, that's a great place to start. And really, most of our kids, all our kids, very few of our kids need any sort of sports drinks at all.
- [55:00]
Dr. Mark Hyman
Energy drinks.
- [55:00]
Dr. David Ludwig
Sports drinks, Energy drinks, Sports drinks, juice boxes.
- [55:03]
Dr. Mark Hyman
Yeah, I mean, it's terrible. One, one soda increases a kid's risk of being obese by 60%. One soda a day.
- [55:12]
Dr. David Ludwig
It's, it's Crazy.
- [55:13]
Dr. Mark Hyman
It's pretty crazy. And, and, and it's, it's, it's, it's a huge part of their caloric intake. It's up to 15% of the average kid's intake. And it's, it's something that's just so unnecessary. I, I was, I was at a conference on childhood obesity and it was in Atlanta and Bernice King was there. It was really fascinating with, it was with, you know, one of the major universities there, Emory, I think, and there was a guy, a doctor there who was a liver specialist. And I'm like, what are you doing here? He's a pediatric liver. I'm like. He said, well, you know, we're seeing enormous rates of fatty liver in kids and we're seeing teenagers on the transplant list for livers.
- [55:56]
Dr. David Ludwig
Yep. All because of insulin resistance and mostly from sugar sweetened beverages.
- [56:01]
Dr. Mark Hyman
Yeah, right. From high fructose corn syrup, which is specifically targets liver in terms of creating a fatty liver. And for those of you who really want to understand a lot about these issues, there was a movie a few years ago, came out in 2014 that I starred in. Well, not really started, but I was in it and it's called Fed up. It's on Netflix. And I encourage you to watch it because it really highlights the ways in which our children are so affected by this. I mean, the. There's a kid who's 16 years old who needs a gastric bypass.
- [56:26]
Dr. David Ludwig
Right, Right. Huge.
- [56:28]
Dr. Mark Hyman
How does that make sense?
- [56:29]
Dr. David Ludwig
It doesn't make any sense. So we want to talk about what can we do? What can you do when, you know, how can you feed your child right from the start?
- [56:35]
Dr. Lisa Dreyer
Right.
- [56:36]
Dr. David Ludwig
And so the first thing we always talk about is the importance of breastfeeding. You know, we know that whenever possible you want to breastfeed your child because it decreases their risk of obesity lifelong. So, you know, that is an important thing. There's you.
- [56:48]
Dr. Mark Hyman
Really? How does that work?
- [56:50]
Dr. David Ludwig
So, you know, that's a great question.
- [56:52]
Dr. Mark Hyman
I have some ideas, but here I go.
- [56:55]
Dr. David Ludwig
You know, you're shifting. It's the composition of the breast milk. You're shifting. There's better limitations on what the baby will consume. So when they're breastfeeding, they don't consume as much as when they're bottle fed. You know, the bottle feeding, you get more milk faster through a bottle than you do through a breast. And so that actually impacts the amount of calories that the consumes it. There's probably issues.
- [57:23]
Dr. Cortica
Sure.
- [57:24]
Dr. David Ludwig
There's issues with the microbiome that gets shifted through breastfeeding. That, that is not happening. When babies are bottle fed, there could be even what's in the bottle itself. Right. So if the bottle is a hard plastic, we know, you know, for example, BPA is impacting our metabolism and our weight.
- [57:42]
Dr. Mark Hyman
Prediabetes.
- [57:43]
Dr. David Ludwig
Yes. So, so there's probably so many issues with, with the, with.
- [57:48]
Dr. Mark Hyman
Yeah. Is when you drink formula, it actually changes the microbiome and feeds bugs that are pretty toxic and create inflammation in the body.
- [58:01]
Dr. David Ludwig
Yep.
- [58:01]
Dr. Mark Hyman
And what's really fascinating about breast milk is that there's all these undigestible fibers and starches in there called these oligosaccharides that, you know, have no nutritional value for the baby, but they're designed completely to feed the microbiome, which is just this beautiful sort of virtuous cycle that is allowing these kids to thrive and get healthy and reduce inflammation and really get them healthy. So not everybody can breastfeed, but it is really important. I think that's really key.
- [58:32]
Dr. David Ludwig
What else can parents do in avoiding those sugar sweetened beverages? As we've mentioned, that's no liquid sugar, calories, period, period.
- [58:40]
Dr. Mark Hyman
No juice.
- [58:41]
Dr. David Ludwig
No juice, no sports drinks, no soda, you know, no, I don't know, you know, Kool Aid or any of those. There's just no need for any of it. It's, it's empty calories and there's, there's no need. Every once in a while, you know, you can give a child some diluted 100% juice if you want to, but it's not necessary. It's not something they should have every day. And, and it's not part of their.
- [59:04]
Dr. Mark Hyman
Fruit and vegetable consumption.
- [59:05]
Dr. David Ludwig
No, it's not part of their fruit and vegetable consumption. So that's, that's key. You know, getting your kids moving, getting them outside every day, you know, that's really important. It gets them, you know, unfortunately, it's harder to move these days unless you, you put it into your schedule. And we need to put it into our kids schedule. We need to make it part of their day that they get out and they move and they either they're playing a sport or they're just having fun. And they, you know, they're doing a.
- [59:30]
Dr. Mark Hyman
Lot of finger exercises on their phone.
- [59:31]
Dr. David Ludwig
Oh my goodness, the phone. It's, you know, it's scrolling. It's making it so much harder for parents it's making it so much harder for parents to help their kids grow and develop. So screen time, really, the recommendations are none for kids under the age of two. And then, you know, Less than two hours after that, you know, you want to limit screens in the bedroom. You know, there's no need for tv, phone or computer in the bedroom. So you just have the kids not have it in there. It helps with their sleep, which is another thing that's critical. Most kids are not sleeping enough in this country and that has a huge impact on their metabolism. We know that when we're sleep deprived, we're more likely to gain weight, we have higher levels of insulin, we have higher levels of insulin resistance and metabolic syndrome. So it's really important that you put restrictions on your children's sleep and wake cycle. That really is helpful. Our teenagers still need 8 to 10 hours a night. Those 6 to 12 year olds need 9 to 12 hours of sleep a night. And of course, you know, the 1 to 2 year olds are needing 11 to 14 hours. So you know, as you get younger you're needing more sleep. But even though teenagers need eight to ten hours of night of sleep and that's, you know, gets harder when they get older. They want to stay up late, they want to be on their phone, they want to talk to somebody. And you know, it's really important we know that children in the children years, if they get to sleep before 8pm, they have a lower rate of obesity, they have a lower rate of weight gain, they have less of course, sleep deprivation, they get better sleep. We know that sleep deprivation, as I mentioned, increases insulin. It increases ghrelin, which makes them hungry.
- [61:18]
Dr. Mark Hyman
Yeah. If you don't sleep enough, you're hungrier and you crave more sugar and carbs.
- [61:21]
Dr. David Ludwig
Absolutely. And then you create this.
- [61:23]
Dr. Mark Hyman
It's true for adults as well.
- [61:24]
Dr. David Ludwig
It is, it creates this inflammatory process in the body that even if you're eating the right, right foods, you're more likely to gain weight. Which I think is important to remember that you know that even if you're eating the right foods, if you're not sleeping enough, your metabolism can be messed up. I talk to my daughter about this one all the time.
- [61:40]
Dr. Mark Hyman
I bet, you know. Well, you know, the other thing I often talk about is, is how do you make your home a safe zone?
- [61:46]
Dr. David Ludwig
Yes.
- [61:47]
Dr. Mark Hyman
I mean, you know, the kid who's 3 years old who's gaining weight or 5 years old isn't saying, hey dad, can I have the keys? Go to car, I'm going to go to McDonald's or I'm going to 711 to get a Big Gulp. But they're not doing that. How do you make your home a safe zone? I think this is so important. Yes. It's okay to have treats. If you're making. Make cookies yourself. Like, make it from real ingredients. Don't eat a ton of them. You can have stuff, but if you want French fries, make them yourself. You know, like, I think there's a level of responsibility the parents have, which was also important for themselves to actually create a safe home environment for their children. People put little things in the plugs. I mean, the kid is less likely to die from electrocution than they are from the bad food that you have in your cupboard than the Fruit Loops you're serving them for breakfast, or the French toast, or the, you know, the sweetened yogurt, which has more sugar per ounce than a can of soda.
- [62:43]
Dr. David Ludwig
Yeah.
- [62:44]
Dr. Mark Hyman
So we really have to take that seriously. And in my house, you know, my son wants said, you know, dad, I want to invite my friends over, but there's nothing to eat in the house. Right. And of course, there was a lot to eat. It just was stuff you had to cook and make. And it was, you know, real food. I said, okay, let's go to the grocery store. I said, you can get whatever you want, buy whatever you want. There's one condition, and you have to read the label, and it can't have any trans fats or high fructose corn syrup. He's like, dad, there's nothing to buy.
- [63:15]
Dr. Lisa Dreyer
Nothing.
- [63:17]
Dr. Mark Hyman
And I'm like, exactly. Like, there are grocery stores where you can buy healthier forms of snacks. There are a place like Thrive Market. You can go to thrivemarket.com and find delicious snacks that are lower in sugar, that are higher in protein, that have good fats, that don't have all the refined starches and sugars. So you can do it, but it takes a little work and it takes a little education. And I think that's the problem is we really aren't taking this seriously as a society.
- [63:41]
Dr. David Ludwig
And now your son is an amazing cook, and he loves to cook and make delicious food that I've gotten the great opportunity to consume. So, I mean, I think it's. I think we have to be getting our kids into the kitchen at a young age. As, you know, even when they're. When they're two, you know, having that high chair or, you know, their bouncy seat right in the kitchen, getting them used to and around your cooking, getting them involved, having them have input, you know, really is helpful. You know, we don't want to be just like, oh, you can't have this, and you want to have this. You want them involved in the process, it makes it a lot, lot better. Absolutely. You know, you want them having suggestions like what? You know, let's. Let's come up together with some healthy food that you want to have tonight. What would you like to help me cook? Let's. Can you help with preparation? Peeling or cutting or mixing. That really gets them involved, and they become part of the. The recipe and the preparation, and then they love it more, and then they. They want to eat it more.
- [64:36]
Dr. Mark Hyman
Yeah, like, and you can make cool stuff that's delicious. Like, instead of making waffles from, you know, white flour, you can make wash waffles from cashews, for example. So I make cashew waffles. Or you make almond flour pancakes. So you can. There's substitutes and swaps that kids can still have fun. And, you know, you don't have to put a ton of maple syrup. You can use fruit. You can use fruit spreads. So there's a ways. There's a lot of hacks. When I, when my kids were young, we had a book called Pretend Soup, which was like, 50 recipes that are fun to make with your kids that have fun names that are delicious to eat, that are made from real ingredients. And so. So I think, you know, we all have to get back in the kitchen. I think the average, you know, a person in America spends more time watching cooking on television than actually cooking themselves. So I think we have to get back into the cooking situation. It doesn't have to be that hard. We had a doctor dinner at our house the other night, and you came a little bit late, but, like, George was there and Ty was there early, and literally nothing was ready. And it was 5:15, and everybody was coming over at 5:30. And literally dinner was ready on the table at 5:45. And we made this incredible meal. I just stuck some, you know, lion's mane's mushrooms in the oven. We. We sauteed some Chinese cabbage and garlic, which took three minutes. We put a, you know, roasted salmon in the oven for 20 minutes and roasted squash, butternut and kabocha squash, and tossed some cinnamon on there, and we just threw it all in the oven. It was. It was, like, delicious.
- [65:55]
Dr. David Ludwig
It was delicious. Thank you.
- [65:57]
Dr. Mark Hyman
Gourmet meal. But it doesn't have to be so hard, and it can be. Be incredibly yummy and delicious.
- [66:02]
Dr. David Ludwig
And I think, you know, that was delicious. Thank you. And I think what's really critical is just recognizing how important it is to be working right from the beginning, right when your kids are. When they're born. And early in life and not just sort of putting it off because it really makes a huge difference for them later on.
- [66:23]
Dr. Mark Hyman
Don't forget there's a way to listen completely ad free with Hyman on Apple Podcasts. You can enjoy every episode without any breaks. Just open Apple Podcasts and tap try free to start your seven day free trial. If you love this podcast, please share it with someone else you think would also enjoy it. Don't forget there's a way to listen completely ad free with Hyman plus on Apple Podcasts. You can enjoy every episode without any breaks. Just open Apple Podcasts and tap try free to start your seven day free trial. 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. Markhiman 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 professional 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.