← The Dr. Hyman Show
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- [00:00]
Dr. Mark Hyman
Coming up on this episode of the Dr. Hyman Show.
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Dr. Todd Lapine
So even though we call it non alcoholic fatty liver, what they're actually doing is they're becoming like a brewery. The bacteria in the gut and the food that the person's eating is actually having a low grade production of alcohol which is like sort of like dripping alcohol into the person's liver. 24, 7.
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Dr. Mark Hyman
Before we jump into today's episode, I want to share a few ways you.
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Can go deeper on your health journey.
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While I wish I could work with.
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Everyone one on one, there just isn't.
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Enough time in the day. So I've built several tools to help.
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You take control of your health.
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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.
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Insights into your biology, visit Function Health.
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You can also Explore my curated doctor.
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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 seven day free trial.
- [01:03]
Hey everybody, it's Dr. Mark Hyman and welcome to our series about chronic disease where we focus on a functional medicine approach that's quite different and highlights the things that we do at the Ultra Wellness center in Lenox, Massachusetts, a practice I've had for 20 years. We've got five doctors, three physicians, assistants, I think five to seven nutritionists. We do deep dives on people to find out root causes of all sorts of issues, stuff that you just don't get when you go to your regular doctor. And it's stuff that we should be doing because the science is here. It's just not getting into practice. So we've got a great topic today and a great story that we're going to share with you around a common problem, fortunately way too common, which is fatty liver disease. And joining me today is my friend and colleague, Dr. Todd Lapine. We've been working together since the mid-90s, believe it or not, still are going at it long time, a long time. I think we have over probably 120 years of collective experience in functional medicine at our practice. Really incredible group of physicians and providers and helpers and a great team. And we help people deal with stuff when they've done everything else and tried everything else and they can't get the answers. And we think about things differently and we use the lens of functional medicine to think about how do we understand the root cause of disease? And today our topic is going to be something all too common, which is fatty liver disease. It used to be called non alcoholic fatty liver disease and now it's changed the name because before we used to see this in alcoholics because they drink too much and would mess up their liver. We see this in, in about 40 to 50% of the American population, which is kind of terrifying. You know, it's 70 to 90% of people who have pre diabetes or type 2 diabetes. It's the most common liver disorder in the United States. And now the new name for it is metabolic associated fatty liver disease. Metabolic, meaning your metabolism's busted, meaning you have high blood sugar, high insulin, and you're on that trajectory to pre diabetes and type 2 diabetes. And it's, it's scary because it's not affecting just adults, it's affecting kids. And that's what's terrifying to me. There's, I saw this guy once, Todd, at a, at a conference on childhood obesity. And I was there and I, and there was this guy who was a hepatologist. And I'm like, well, what are you doing here? You're like a liver specialist, liver surgeon. Like, what, what are you. He's like, well, a lot of kids who are young and drinking soda have fatty liver disease. And we do liver transplants on 15 year olds.
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Dr. Todd Lapine
Oh my God.
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Dr. Mark Hyman
Oh my God. Really? And so this is a real problem. It's mostly undiagnosed, mostly untreated, because there's no, quote, drug for it. But there's a lot of things we can do when we think through the lens of functional medicine. And I personally have seen this so much and I've seen it reverse so quickly using a really intelligent approach of getting with the root causes. So Todd, I want you start by walking us through what are the factors from a root cause perspective that are driving this epidemic which is affecting probably one in two Americans. I mean, you know, anybody who's overweight probably has this right, 75% of Americans overweight. About two thirds of people who are skinny also have metabolic issues. So maybe it's like, you know, when you look at, how do you define it? Because most people aren't getting liver scans and we'll talk about the diagnosis of it. You know, if you have a MRI or you have a, a fatty liver scan and ultimately you can actually, you can actually see the amount of fatty liver, but most people don't have that. And, and, and you really want a liver fat less than 2%. And over that, you're starting to get into trouble. So, Todd, what are the things that from a functional medicine perspective we think about? How do we start to diagnose these problems? What are the clues that you have? It kind of walk us through that thinking about it.
- [04:35]
Dr. Todd Lapine
You, you, you, you, you actually read my mind, Mark, because basically I was going to bring in two topics, which is basically just, you know, to sort of wrap your head around what's happening when you get fatty liver disease. I want you to think of soda and the Big Gulp sodas, which are laden with high fructose corn syrup. And then you also think of foie gras. So the French have a wonderful, delicious, fatty delicacy called foie gras. And the way that they make foie gras is that they force feed ducks, grains, and they literally just shove it down their throat for days at a time. And eventually they overwhelm the liver's ability to process food. So there's a metabolic overload. And what happens is those calories can't be burned. They get stored as fat. And that's what's really happening with people who have fabulous liver disease, is that it's a metabolic mitochondrial traffic jam. What's happening. And yes, you see this more commonly in people who are overweight. People are consuming too many calories, but you can also see in people who are not. So there's multiple ways of looking at what is going on in patients who have fatty liver. Sometimes it's picked up because somebody does some liver tests or chem panel and they notice that the liver tests are slightly elevated. One of the tests that is a really sensitive marker is a liver test called gamma glutamine transferase or gtt. And that is one of the most sensitive markers that you can pick up fatty liver disease very early on.
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Dr. Mark Hyman
And again, your routine panel. Right.
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Dr. Todd Lapine
No, it's actually, it's interesting. You actually bring up a good point because the reason why it's not brought up is because so many people have abnormal GGTs that they don't do it anymore routinely because they say everybody's got elevated GGT and. Yeah, right. You don't. Right. That's good. So, and the other aspect of that is that an elevated GGT is actually a sign of glutathione deficiency. And glutathione, as we, as we've all heard, is one of the major antioxidant systems in the body. So when you have an elevated gtt, it tells you that there's, it's like the check engine lights coming on in the liver saying something's wrong here. And that can be an early sign to tell you that a person has fatty liver disease. And again, like you were saying, you know, one out of three Americans have metabolic syndrome, which is what you get years, you develop diabetes. So catching this early is really, really critical because, you know, if you let it go long enough, like you're saying, you're going to be doing liver transplants in the teenagers. And that's not where we, you know, we need to be headed. So it's really one of those conditions that you have to think about. And as a physician, you don't want to be fooled because somebody can have it and not actually be overweight or markedly obese. So you really have to have your, your, your henna's up to try to pick it up early.
- [07:28]
Dr. Mark Hyman
You know, there are other diagnostic tests we do because the GGT and liver function tests are telling you that you have a problem, but they don't really necessarily tell you why. It's a good screening tool and it should be done for everybody. And we do this at the Ultra Wellness Center. But the other big thing we look at carefully is insulin resistance. And there are some really interesting ways to actually diagnose this phenomena, which can happen obviously when you have diabetes, type 2 diabetes, when you have pre diabetes, but even before that you can have low grade insulin resistance that can still cause problems. And so how do we, how do we diagnose this problem of insulin resistance you bring up?
- [08:03]
Dr. Todd Lapine
We just, actually just had a topic with one of my, my colleagues about that. And, and you typically can, I think the gold standard in my opinion for checking for insulin resistance is the glucose tolerance test, which measures both glucose and insulin levels simultaneously. And some people will say, you know, they'll check your hemoglobin A1C and if it's, if it's normal, they say, oh, you don't have insulin resistance, but you actually can have insulin resistance even with the normal hemoglobin A1C. And I recently had a patient who had a normal fasting glucose and a normal fasting insulin. And when I did the glucose tolerance test and the person was, you know, maybe 10 pounds overweight, but I just had a sneaking suspicion based upon the history that there was probably some insulin resistance. And when I did the insulin glucose tolerance test, the patient's insulin level maxed out at one point. The gold standard is really the glucose tolerance test, which is really like a stress Test for your pancreas. If you want to know what's going on with the heart, you get on the treadmill. This is like a treadmill for your, for your, your pancreas.
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Dr. Mark Hyman
Good. It's a really good test. We've done it for decades. But, you know, I don't know if you're aware, we're Todd. But there's a newer test that's been developed by Quest that uses mass spectrometry to measure insulin and C peptide, and that is as good as the glucose tolerance tensor, if not better. And it's, it's sort of even equivalent to what they use in research called the euglycemic clamp test. So. Oh, yeah, really, it's really sensitive. And now we can, with a simple blood test, without drinking the equivalent of two Coca Colas, which we used to do, actually measure this. And again, it's one of those things that is not getting picked up by your traditional doctor. But there's all this emerging diagnostics available to help us understand this problem. What are some of the other things, you know, we would look at that help us sort of diagnose this and that sort of. See there's a problem besides looking at your liver function test, looking at your blood sugar, insulin fasting or the insulin resistance score. There's somebody I read once had high levels of blood alcohol. Yeah. But they didn't drink at all. And because they had this auto brewery syndrome where the sugars were being fermented by the bacteria in their small bowel because they had gut issues.
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Dr. Todd Lapine
Yeah. And you can actually, you can actually get the, the auto brewery syndrome from both yeast. Because when we make alcohol, we basically take sugar grapes or whatever, and then you add in yeast and they ferment it and the waste product is actually alcohol. That's why alcohol is a toxin, because it's a waste product. And that can happen both from yeast and also from bacteria. So you can get it from both of the organisms which can produce alcohol. And that is one of the risk factors for developing fatty liver. I did a deep dive on this. I did a series of seminars with a good friend of mine, David Brady, and we did it on diabetes or metabolic syndrome, all the implications thereof. And as you mentioned, we used to call this non alcoholic fatty liver disease. And you know, back in the day, I used to work at the VA hospital and used to see a lot of patients who were alcohol abusers and alcoholics. And that was one of the main things that you would see where people would get fatty liver disease. Now the interesting thing is the gut microbiome and this is in the literature, this is really quite fascinating. There's specific bacteria which, and there's probably multiple ones, but one of the biggest ones is when you measure the gut microbiome and you see high levels of klebsiella. Klebsiella is a gram negative bacteria. It's found naturally in people. But when you have overabundance of klebsiella, Klebsiella bacteria actually produce alcohol. So even though we call it non alcoholic fatty liver, what they're actually doing is they're becoming like a brewery. The, the bacteria in the gut and the food that the person's eating is actually having a low grade production of alcohol, which is like, sort of like dripping alcohol into the person's liver 24,7 because they're eating highly processed foods, highly glycemic foods. And a lot of times when you see these patients, these are patients who like, they walk around like I've got brain fog. Well, they have brain fog because they're, they're having low levels of alcohol 24,7 in their body. So that's another thing that you can, that you can have to think about in terms of diagnostics is to look at the gut microbiome and also leaky gut.
- [12:17]
Dr. Mark Hyman
I think people in here, fatty liver think, oh, I'm going to eat fat, I'm going to get fatty liver. It's actually the opposite. You kind of hinted at it, you know, to get these duck to have, or goose have a fatty liver. And by the way, fragra is means fatty liver in French basically. And what they do is they force feed them like corn and that, that turned into fatty liver. But what we're seeing now is this increase in high fructose corn syrup in our population which can be anywhere from 55 to 75% fructose. Now you know, people say, oh, it's the same as regular sugar and in many ways it is. But the one significant difference is that high fructose is what drives fatty liver. It won't cause your blood sugar to go up or your insulin to go up directly, but indirectly it would lead to fatty liver in insulin resistance over time. So this is a big factor and why these kids who are drinking like Big Gulps or you know, two liter bottles of Soda Day are getting fatty liver.
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Dr. Todd Lapine
Yep, absolutely. You break, you, you, you actually just you. That's a nice segue into the next aspect of fatty liver that I want to talk about. And fructose, as you mentioned, is one of the big drivers. And high fructose. So we find fructose in. In, in, in. Please. So if you have an orange or an apple and it's in season, there's a small amount of fructose, and the liver can only process so much fructose. What happens is when you overwhelm the liver's ability to metabolize fructose, you deplete ATP. So ATP is the fuel that our mitochondria use to generate energy or energy. That's how we power our cells in our body. And what happens is you actually get mitochondrial dysfunction when you overwhelm the liver with too much fructose, because the incidence of fatty liver rises to two to three times when you have a high fructose diet. So, yeah, mitochondria is another aspect. And the way to also remember that is that when we burn our calories, where do we burn our calories? We burn our calories in the mitochondria via the. On the fireplace of the cell. So you, you want to, you know, put the log in your fireplace and burn it. Well, my analogy to patients is that when you have dysfunctional mitochondria, it's like having a log that doesn't fit into the fireplace. So you start stacking the wood on the side. And that's essentially the buildup of adipose tissue throughout the body, especially in the liver and the visceral fat, et cetera. And that's where it is. It's coming from.
- [14:45]
Dr. Mark Hyman
And I think, you know, we'll get back to the diet, the causes, but, you know, in terms of just diagnosis, you know, you know, you can look at your liver test, and it could be a lot of things. You could be taking too much Tylenol, you could be doing other things, so. Or drinking too much. So. So there's other factors that we now know that, that we can look at, like C reactive protein, which measures inflammation, nonspecific, or ferritin. But there's some really cool kind of diagnostic tests that are derivative from irregular blood work. And for example, there's something called the fib4 test, which is a fib4 index. And it basically can help you identify issues without biopsy. So it looks at platelets as well as your liver function tests, ast, L elt and there's another test called nafld, or maybe it's nafld, fibrosis score. And that fibrosis score takes into six variables that are easy to measure. Your age, your body mass index, your blood sugar. Right. If you have impaired fasting glucose, your ast, alt, which are your liver test, your platelets and your albumin. And that gives you an idea through without a lot of invasive testing, what's going on. And so that's another way you can screen for it. And that can be done through regular lab work. And then there's imaging tests, which can be very helpful. I mentioned the mri, but there's ultrasound and there's also called the fiber scan, which sort of checks this pulse wave into the liver and sees how the wave goes and the elasticity of the liver. And if it's fatty, you can tell if there's some fatty liver, you can tell if there's more serious versions of this. You can tell if there's like more scarring. So it's a really, it's a really interesting way to kind of measure problems. It only takes a few minutes. And of course there's the mri. So there's a lot of ways to sort of figure this out. And it's important people understand that, you know, you know, most traditional doctors don't really measure this, don't look at these things, don't send people for these tests. If you're a hepatologist, you do, but otherwise, in your most primary care internal medicine, doctors just don't have a clue about how to really diagnose this. And then they're like, what are you going to do about it? Right, so let's talk about some of the causes of fatty liver. We kind of hinted about fructose and diet.
- [16:45]
Dr. Todd Lapine
One other thing, Mark, I just wanted to you talk about the diagnostic test. One test that I been using a lot in my patients, which measures six biomarkers, is a test called Fibrochure, and that's available by mainstream labs. And that's another way of. They have an algorithm where they're checking the various biomarkers and they put it into the algorithm after the blood draw. And that can help you to risk stratify how bad the fatty liver disease is. That's another. Another one.
- [17:10]
Dr. Mark Hyman
Yeah. So you, you know, there's other reasons to have liver damage, like environmental toxins, you know, deficiency of certain nutrients like choline. But, and obviously you can look indirectly at lipids because you'll see lipid abnormalities when you have a fatty liver, like small particles or high triglycerides, because liver can't process all the less triglycerides. And, and so, you know, we can kind of start to measure something. Stool testing, looking at the gut and, and kind of get a pretty Good sense of like what's causing it. I think, you know, when you look at our current diet, I mean 60% of it's ultra processed food. There's a lot of fructose in that through high fructose corn symphony, most of them. There's starches in those.
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Dr. Todd Lapine
Yeah.
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Dr. Mark Hyman
There's also things that damage. They've got lining like emulsifiers and so you have a whole perfect storm. Plus we live in a toxic stew of chemicals and pesticides and herbicides and plastic, microplastics, you name it, heavy metals, all that stuff puts a load on the liver. So it's no surprise that we have this. And I wonder, you know, when you're seeing a patient with this, how do you start to think about, you know, what to do with this person, what's the sort of recommended treatment? Because like I said, there's no drug for treating this. If there was, you know, it would be a multi billion dollar drug. I'd buy stock in it. We don't have one. So you have to use a functional medicine approach to really heal a fatty liver, which by the way is really reversible. Unless you've already gotten to the point of cirrhosis and scarring, which is the end stage of this. This is why kids need liver transplants. They get cirrhosis just like an alcoholic from the sugar.
- [18:35]
Dr. Todd Lapine
And then that's why like anything, like any, any condition, the earlier you can catch it, the better. And, and you're exactly, you're hitting the nail right on the head because this is something that you want to be preemptive. You don't want to wait till there's, you know, fibrosis and scarring and there's going to be irreversible damage. You want to catch this way before it happens. And you know, obviously the first thing you're going to do is, is dietary changes. And like we're saying, there's a lot of different things that can contribute to disruption of the gut microbiome and disruption of the gut barrier. We call that leaky gut. There's different tests that you can do that can determine if you have leaky gut. Always remember, this is another thing that I like to emphasize my, to my patients is the connection between the gut and the liver. So all of the blood from the gut, guess where it goes. It doesn't go into the circulation. It actually goes from the gut into the portal system up to the liver to be filtered out before it goes into the systemic system. And that's where patients who have clinically we used to see patients with hepatic encephalopathy because their, their blood would, wouldn't be able to get filtered to the blood and that causes all kinds of mental conditions. So having a healthy gut so that the blood that's then flowing into the liver is not going to be as pro inflammatory with all of these lipopolysaccharides, the coating of the gram negative gut bacteria which provoke inflammation and then aggravate like adding gasoline fire.
- [20:13]
Dr. Mark Hyman
So so basically diet would be starting with, you know, a low or no ultra processed food, right? Getting rid of high fructose corn syrup in your diet. I think if people listening can do one thing and this is, you know, again we focus on food is medicine at the ultra wellness Center. We focus on how to treat many chronic conditions with food. And, and you can dump huge amounts of liver fat by simply cutting out the starch and the sugar, particularly the high fructose corn syrup which is in almost every packaged processed food there is. I mean it's not something you have in your cupboard, right? It's an industrial food product. And.
- [20:47]
Dr. Todd Lapine
Yeah, it's added, added to many foods. I mean if you start reading labels and again we always talk about that like the best food is food that doesn't have a label, right? It's not, it's not manufactured, it's not franken food, it's not processed food, it's real food. And you know, in addition to, you know, the fructose content process carbs so that when we want to fatten up cattle, what do we do? We feed them grains. And highly processed grains is another thing which is basically acting just like sugar in the diet. It increases insulin and glucose levels which in turn drive the whole dysfunctional metabolic pathways.
- [21:26]
Dr. Mark Hyman
It's interesting also I remember reading a study where they did this in mice. But there's also in human trials where they gave the mice alcohol to cause fatty liver. But at the same time they gave something called MCT oil which is medium chain triglycerides. It's a special kind of fat that's absorbed directly, not through your lymph like most of your fat is, but actually directly into the liver. And it has a lot of benefits in the liver. It helps get rid of liver fat, it helps reduce inflammation, it helps mitochondrial function, it helps improve insulin sensitivity, gets rid of all your organ fat. But here you, here you are treating a fatty liver with a fat and it works pretty darn well. Pretty interesting to see those studies. I thought I was like, wow, basically even though they're giving a liver toxin, it still worked. I was like, wow.
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Dr. Todd Lapine
And the interesting thing is I use MCT quite a bit in my patients, and MCT is basically readily available to mitochondria for metabolism. So it's like a clean fuel. It's very, very clean. And it's also been shown to improve cognitive function in patients with dementia or early Alzheimer's because it's a cleaner fuel. It's just a burn through the mitochondria, much cleaner than other food.
- [22:44]
Dr. Mark Hyman
So what other foods should we be thinking of that support the liver and help and help deal with the issues that can.
- [22:50]
Dr. Todd Lapine
Another one, which in preparing for this, another one, that which you're familiar with is fatty 15, which is another name for docohexaenoic acid. And there's studies showing that a lot of people are deficient in docohexaoic acid because of the decrease in dairy consumption. That's one of the big sources of fatty 15, and that has been shown to actually help with mitigating the effects of fatty liver. Other things that can be done are flaxseeds. There's a great paper which I just stumbled upon, and all they did was just use ground of flaxseeds. And there's probably multiple mechanisms for why that happens, because it changes the gut microbiome, gives good fatty acids. And there was a significant improvement with adding flaxseeds to people's diet. We sure oftentimes will do that for people with Ala Alpha linoleic acid deficiency. Another thing that can be used for patients with fatty liver is cocotrienol, which is made from annatto. So it's a special form of vitamin E and that also is very effective. And then, as I mentioned before, glutathione, but it's basically, it's a derivative from the annatto seed and it's highly concentrated gamma vitamin E. It's a form of tocotrienol. And there's some really good studies on that having benefit in patients with fatty liver. And then the other thing is supporting glutathione. Remember, people who have fatty liver oftentimes have elevated ggt, and that is a sign of oxidative stress. So anytime you can mitigate oxidative stress, you're also going to be supporting the resolution and Ruben and fatty liver disease.
- [24:30]
Dr. Mark Hyman
And so the supplements that you can take, you can actually take supplements that help boost glutathione, right?
- [24:34]
Dr. Todd Lapine
Yep.
- [24:35]
Dr. Mark Hyman
Like N acetylcysteine or milk thistle is an herb. Often use these in people with fatty liver disease. And lipoic acid. These are things that you can actually help use to repair the liver once it's been damaged. So you start with diet, right? You start with low sugar starch diet with more good fats, lots of fiber. You talked about flaxseeds, MCT oil. But you can layer in things that really help the liver repair and heal and boost the glutathione levels, which helps it, helps it get rid of the inflammation and the fatty liver. So N acetylcysteine, lipoic acid, milk thistle, they're, they're great. And even herbs like turmeric or curcumin can be very helpful.
- [25:12]
Dr. Todd Lapine
Yeah. And the other, the other thing I always give credit to Jeff Bland, to bringing to my awareness of the role of glycine. So glycine is what's called a conditionally essential amino acid. And when you make, when your body makes glutathione, it's made from three different amino acids. It's made from glutamine, glycine and cysteine. And there's an interesting paper that looked at the combined use of glycine with NAC or N acetylcysteine. And those are basically the building blocks of glutathione. And in this particular paper, they basically said this is an anti aging combination. It decreases inflammation, improves mitochondrial function, it helps with healthy aging. It's a real winner. So anytime you can support glutathione production is good. You mentioned alpha lipoic acid. So the other important thing is that glutathione goes between what's called the oxidized form and the reduced form. So it's like a battery that has to sort of get charged. And the reduced form of glutathione is the active form. And in order to recycle your glutathione, you need the things like alpha lipoic acid and also vitamin C. And you know, I think that's to some degree, you know, Linus Pauling, who was big on vitamin C, I think vitamin C has many, many different functions in the body. But I think vitamin C actually helps to recycle your glutathione, which helps with the aging process.
- [26:40]
Dr. Mark Hyman
I mean, you know, there's so much you can do to really heal this. And it's, it's something I've treated and I know you've treated many times in many patients at the Ultra Wellness center that we see who have, you know, that along with other metabolic issues, they usually have pre diabetes, they usually have abnormal lipids that are high triglycerides low hdl, they usually have high CRP and inflammation. And we created a holistic approach to these patients using diet and lifestyle and exercise, stress reduction, sleep optimization, all those things. But then you, you sometimes need some of these additional supplements and nutrients like choline you can get from food, for example, but also you can take it like eggs have it, grass fed meats have it, sometimes soy has it actually from lecithin. And Christopher's vegetables are great for boosting glutathione. That's a broccoli family. Omega 3 rich foods help reduce inflammation. But sometimes you need more stuff like you can take Omega 3 supplements. You can take, you know, the tocotrienols and the, the certain forms of vitamin E that can help. You can take MCT oil, you can take n acetylcysteine and glycine and things that help boost glutathione. You can milk. This also does that. Berberine, another one that helps improve liver fat and, and help blood sugar regulation.
- [27:45]
Dr. Todd Lapine
Yeah, berberine. Berberine is actually I always tell my patients that berberine is really almost like a, a natural form of metabolic, very, very similar effects as metformin. So what you're really saying, it's a diabetes. Yeah, diabetes drug. And what you're really saying is that, you know, all these things that you're, that you're mentioning are what we call nutraceuticals as opposed to pharmaceuticals. So yes, I still prescribe medications. I trained as an internal medicine and I send patients to surgeons and I give patients thyroid and insulin and you know, blood pressure medicines, whatever when needed. But you know, getting out the prescription pad is the last thing that I do now. I don't want to use the prescription pad, but I can use a prescription pad. If I need an elephant done, then I'm going to, you know, use the elephant. But a lot of things that we, that we can do are relatively inexpensive. They're very safe. There's science behind it. So it really makes sense to be using diet, combining that with supplements. I always, one of the other my pet peeves is that I tell people that I've never cured anyone with a pharmaceutical drug and I never cured anyone just with a supplement. Supplements really complement a healthy diet. So if you're not, if you don't have a good foundational diet, supplements are not going to have it be as effective. You have to really have a healthy foundational diet. Then you complement that with the nutraceutical.
- [29:06]
Dr. Mark Hyman
That's right, Supplements, other called supplements or supplement your diet. They're not replacements. Right, right. So I think this is so important. And so, you know, there's a few other things we do with these patients. You know, get them to exercise, get them to optimize their sleep, manage stress, get rid of toxins, because, you know, if you have a dietary induced fatty liver, it's going to be exacerbated or worsened by exposure to pesticides and plastics. And one of the things that really commonly affects insulin resistance is bpa, which is ubiquitous. It's, it's a bisphenol A. It's one of the most ubiquitous toxins. It's on all plastics, lined cans, packages, boxes. And we, we were all like credit card receipts, ATM receipts, you know, your gas station receipts, if you get those, I don't touch those, so I can avoid it, you know, and, and those are often just these hidden exposures exacerbate things. So we help people reduce their exposure to toxins and improve the microbiome and, and then we kind of follow them and see how they do, but we see usually complete resolution most of the time for these patients.
- [30:04]
Dr. Todd Lapine
The other thing you mentioned, BPA is a lot of times they'll say, this is BPA free. But what they do is they actually put other chemicals that are cousins to bpa. So just because it's BPA free and it's still in plastic is not necessarily. Yeah, that's, that's a big thing because they, they have like, oh, we're, this is BPA free plastic bottle or whatever. That doesn't mean squat.
- [30:24]
Dr. Mark Hyman
It's true. I mean, it's, it's, it's a tricky, slippery slope.
- [30:27]
Dr. Todd Lapine
It's all marketing. It's all marketing because people, they, they're aware that, okay, if you have BPA in your product, people aren't going to buy it. So we have a BPA plastic BPA free product.
- [30:37]
Dr. Mark Hyman
So you're buying another petrochemical toxin.
- [30:40]
Dr. Todd Lapine
Exactly, exactly. And it's, you've got to be, you know, you know, you're, you've got to be a savvy consumer and a, you know, you have to do your own homework. Because when you go into the, the regular, you know, mainstream grocery stores, the way that I look at it is most people are being slowly poisoned. I mean, literally, it's. When you look at the processed food in this country with the preservatives, the food coloring, the food additives, highly processed foods, people are literally being slowly poisoned in this country. Robert Kennedy is bringing awareness to this, which is really all about making America healthy again. Because we have an epidemic of autism in this country, we have an epidemic of obesity in this country, we have an epidemic of metabolic syndrome. And we're not going to be the leading country no matter what our military is, if we have a bunch of sick population.
- [31:38]
Dr. Mark Hyman
One of the things that this traditional medicine really sucks at is dealing with chronic illness. Unless you have a pill for it, like a high ldl, which by the way, I don't think the main cause of heart disease, but like statins, we don't do anything. Like we don't diet. Go down the diagnostic rabbit hole like we just talked about with all the different kinds of diagnostics, and most of these are available through conventional medicine. They're just not used by traditional doctors. Unless you're a liver specialist dealing with someone with more end stage liver problems, by the time it's that bad, you can pick it up. And so at the Ultra Wellness center, you know, we have five physicians and three physicians, assistants, seven nutritionists on a great team, all working to help people understand root causes and get to the bottom of what's going on with them and then teach them after we've discovered through, you know, advanced diagnostic testing what's going on, we teach them how to do all the things they need to do, whether it's optimize their diet, heal their gut, get rid of toxins, both through reducing your exposures, but also through helping the body eliminate them, optimizing your nutritional status and dealing with all those factors that are modifiable and obviously lifestyle stuff so that we can actually help people get back to well. And it's really, we've been doing this together for, God, almost 30 years now, Todd. I think next year might be 30 years.
- [32:53]
Dr. Todd Lapine
We're 30 years young, right?
- [32:55]
Dr. Mark Hyman
And it's really remarkable how people recover and do well when they have the right insights. And everything we talked about today is science backed, is based on the scientific literature. It's just not stuff that's gotten into practice and often takes a decade or two or three or sometimes more for stuff from the bench and the scientific discovery to its implementation in clinical medicine. And that's all we're doing. We're kind of accelerating that gap and we're thinking about the body as a system through the lens of functional medicine. So anybody listening, if you have friends or family who have issues chronic disease, we'd love you to come see us at the Ultra Wellness center. Just go to ultrawellnesscenter.com, you can learn more about what we're doing. Sign up as a Patient talk to our team and they'll walk you through what you, what you need to know. But, you know, we love doing this and we really help so many people. And again, people are just desperate. And I probably get like, you do probably 10 to 15 emails and texts a day of, I got this, my friends got this, my sister's got that, my uncle's got this. Can you help? Can you help? Can you help? Because they're not getting the answers from Mayo Clinic or Cleveland Clinic even, which is a great institution, but just limited unless they're going to the center for Functional Medicine. So we really, we really have this chance to do better.
- [34:02]
Dr. Todd Lapine
You're absolutely right, Mark. I mean, the, the, the, I think the masses of people are waking up to realize that, you know, when you have these chronic conditions now, mainstream medicine is really good. You break your bone, you have a stroke or a heart attack, you can sort of do aggressive interventions. But for chronic disease, I'm going to say that mainstream medicine is actually dangerous. I think that the pharmaceutical approach of adding pill after pill to suppress this, and then you got a side effect for that, so you add another prescription medication. It's, you know, polypharmacy. And I'm going to venture to say that a lot of what regular doctors are doing, not that they're intending to create, you know, iatrogenic, which is physician induced illness, but a lot of stuff that we're seeing nowadays is atrogenic illness. People are trying to treat these chronic complex lifestyle conditions with pharmaceuticals and they're lowering the cholesterol, they're lowering the blood sugar, but they're not actually addressing the root cause problem.
- [35:01]
Dr. Mark Hyman
That's what we do at Tiltsho Wellness center, and we'd love you to check it out. And Todd, thank you for joining us today. And we'll see you again when we're going to keep doing these case studies and talk about chronic disease and how we deal with it differently. So we'll keep you hopefully thinking about things differently and get you on a path to wellness.
- [35:18]
Dr. Todd Lapine
All right, thanks, Mark. Enjoy.
- [35:20]
Dr. Mark Hyman
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- [36:04]
This podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels @ Dr. Mark Hyman, please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast, 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.