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Encore: The Root Causes of IBS & Stomach Digestive Problems | Dr. Mark Hyman
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Hey everyone, it's Dr. Mark Hyman. Thank you so much for being a loyal listener to the Doctors Pharmacy for the holidays. I've decided to give my team a little break to rest up and prepare for more content and the new year ahead. So the Doctors Pharmacy will be replaying some older episodes for the next two weeks. But don't worry, we'll be back with more content and brand new episodes starting Tuesday, December 31st. So for now, here are some of my favorite past episodes of the Doctor's Pharmacy and see you next year. Coming up on this episode of the Doctor's Pharmacy in fact, an 8% higher risk of irritable bowel is associated with every 10% increment in ultra processed food and we eat about 60% of our calories as ultra processed food. That's a 48 increase in irritable bowel given the diet we eat now. Together, the undereating of the good stuff and the overeating of the bad stuff increases the risk of nutrient deficiencies. 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Give the gift of Deeper Sleep Doctors Pharmacy listeners can get an extra $100 off your mattress purchase on top of Essential's holiday sale. Use the code Hyman at checkout to get your extra savings. Learn more at my essential essentia.com drmarkyman that's M-Y-E-S-S-E-N-T A.com Dr. M A R K H Y M A N this episode is brought to you by United Airlines. When you want to make the most of your vacation, book with United. They're an airline that cares about your travels as much as you do. United is transforming the flying experience with Bluetooth connectivity, screens, power at every seat, and bigger overhead bins to help fit everyone's bag. And with their app, you can skip the bag check line, get live updates and more. Change the way you fly. Book your next trip today@united.com before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand. Well, you. If you're looking for data about your biology, check out Function Health for Real Time Lab Insights. If you're in need of deepening your knowledge around your health journey, check out my membership Community Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website supplement store for a summary of my favorite and tested products. Welcome back to another episode of the Doctors Pharmacy and Health Bites, where we take juicy little bites into our current health topics. I'm Dr. Mark Hyman, and today we have we're diving deep into a topic that affects millions of people worldwide and yet often goes undiscussed in public stomach issues. In the social media world, there's a trending hashtag hot girls have IBS and it's caught the attention of over 28.2 million viewers on TikTok. The reason why is it reflects a shift in how women are addressing their digestive health issues. Using humor and community to bring light to what many have kept hidden for way too long. Now, by poking fun at their experiences with IBS and bloating and constipation, other gut troubles, women are challenging the stigma around these taboo bodily functions. Now, it's empowering to see these conversations happening openly, but it's really critical to remember these symptoms are not just everyday annoyances to laugh off. They're real concerns that need to be addressed seriously. And today we're going to discuss why it's important to move beyond the normalization of this to understanding and treating the issues effectively. Whether it's bloating, constipation, diarrhea, or just an uncomfortable feeling of fullness that just won't go away, these symptoms can be more than just a nuisance. They can seriously impact the quality of your life and a whole slew of chronic illnesses. Now, when we talk about stomach issues, we're really opening up a conversation about a range of conditions from irritable bowel syndrome, to with constipation or diarrhea, to indigestion or what we call dyspepsia, or to what some people jokingly refer to as a food baby. I heard that first from one of my patients and I knew exactly what she was talking about. You know that swollen stomach you get after indulging in a big meal, that bloating just feel full and your stomach pooches out? That ain't normal. Okay, something's going on. We're going to talk about what it is and how to fix it. Now, behind these common experiences lies a complex interplay of dietary habits, hormone fluctuations, and even stress and toxins, all of which affect our gut health. Now, our gut is our second brain. There's more neurons in our gut than our spinal cord. The bi directional relationship between irritable bowel and inflammatory bowel and anxiety, depression, stress is really clear. They make each other worse. Okay. Gut bacteria produce hormones and neurotransmitters like serotonin, GABA and dopamine. And if we don't have the right gut bacteria, we can't produce these neurotransmitters that help regulate our nervous system and our immune system. So all that kind of sets the stage. Right. So what, what then causes irritable bowel and stomach issues? Well, it's different for everyone. And we'll go through the reasons. Poor diet and lifestyle are at the top of the List, right. The biggest driver. A population based prospective cohort study published in the Journal of Clinical Nutrition found that an unfavorable lifestyle, looking at modifiable lifestyle factors like weight and bmi, smoking status, diet, physical activity, sleep and alcohol consumption were associated with a 56% higher risk for irritable bowel compared to a favorable lifestyle versus a 12% higher risk among those who are at higher genetic risk compared to those at low genetic risk. So basically, lifestyle had a greater impact on IBS than genetics. Maybe some will have families with irritable bowel and there may be some genetics there, but the combined genetics and lifestyle has a cumulative effect also. People are under eating real food, they're under eating nutrient dense whole foods with the right amount of protein, good fats and all the amino acids they need to function. They're overeating ultra processed foods, right? Even healthy. Quote plant based vegan plant meats, you know I call it a plant meat, plant based meat, cause it's made in a plant, not grown on a plant. And gluten free foods, which are often junk food, they eat ultra processed foods that are high in refined sugars and carbs and refined oils, low quality protein like soy protein, ice slits and processed stuff. In fact, a large scale prospective cohort study reported that compared to the lowest consumption of ultra processed food, the highest consumption of ultra processed food had a significantly higher risk for irritable bowel. In fact, an 8% higher risk of irritable bowel is associated with every 10% increment in ultra processed food. And we eat about 60% of our calories as ultra processed food. That's a 48% increase in edible bowel. Given the diet we eat now together, the undereating of the good stuff and the overeating of the bad stuff increases the risk of nutrient deficiencies like B12, iron, zinc, omega 3s and that actually affects how our gut functions and heals. Also, our diets are often causing disturbances in our gut and that can affect low stomach acid. It can be from taking acid blocking drugs. What else can cause disruption of the gut? Food sensitivities? Food allergens, environmental allergens, all can be a factor. And one of the most common food sensitivities, gluten, dairy, eggs, corn, soy, often grains and beans. Alcohol is not a sensitivity so much as it's just a gut toxin. What these do is they tend to lead to the overgrowth of bad gut bacteria we call dysbiosis. And dysbiosis is basically the phenomena of the imbalance of bugs in your gut that creates more bad bugs and less good bugs. And what does that do? Well, that leads to a leaky gut and inflammation in the body. It can lead to motility issues. It can lead to overgrowth of bacteria, the bad bugs in the wrong spot. It can lead to what we call sifo, or small intestinal fungal overgrowth, what some people refer to as candida. But it can be many species of fungus. And a lot of these symptoms overlap with ibs, right? Bloating, gas, cramping, diarrhea, constipation. So let's get into a more detailed conversation about sibo, because this is really at the root of so many people. Now, whether you have ibs, D or C, constipation or diarrhea, there may be different bugs involved and there's, there's a dump of different gases we measure. Because what we're seeing is when you have overgrowth of bacteria, they ferment the food you're eating, particularly starches and sugars and fermentable carbohydrates. And that causes the production of gases. And those gases are what causes distension. And the food, baby. The first thing that goes wrong is what we call dysbiosis. We talked about that briefly, but there's a lot of reasons for that. It's our poor ultra processed diet, it's our lack of fiber, it's too much starch and sugar, alcohol, artificial sweeteners, all kinds of stuff. And from drugs too. Antibiotics, steroids, the birth control pill, acid blockers which are so common like Prilosec or Prevacid. All these can balance the gut flora, Psychological stress, high carb diet, alcohol, environmental toxins, all these things cause this problem of dysbiosis. And they also can affect the motility of the gut. And there's a lot of things that cause motility issues. It can be diabetes, it can be GLP1 agonists, by the way. And I worry about how they're affecting people's GI tract drugs like Ozempic. And we're seeing even things like small bowel overgrowth. And also, also we're seeing risk of bowel obstruction because of the way in which it affects the gut. So I'm a little worried about that. But they can be a helpful class of drugs. I just think they're overused. But when you have impurant motility from stress or from different kind of inflammatory bowel disease, it can, it can again cause a backup and growth of bacteria in the wrong spot. Basically you've got like 1012ft of large intestine and about 22ft of small intestine. And mostly the small intestine should be mostly sterile. But when the bacteria migrate up to the top of it and then the food ends up hitting it first, that's when you get this food baby stuff. Now, stress also will have an effect on your bacteria. They, they actually are listening to your thoughts, right? Your bacteria listening there. When you have stress, also, it increases permeability of the gut, it causes leaky gut, it affects motility, slows it down, and affects immune system function. So it's quite common. One of the things that happens is, is a low stomach acid. A low stomach acid is not that common, but it can be in degrees. The more severe form is achlorhydria, which happens when you get older and you get atrophy of your stomach. Or if you have B12 deficiency and so forth, that can, that can really affect this. But there's a lot of reasons for it. But a lot of the reason is because we, we take these acid blocking drugs, right? And that leads to low stomach acid and that leads to changing the ph, and that leads to the ph of the small intestine changing and the overgrowth of fungus and bacteria that shouldn't be there because of the change in climate. But aging itself leads to this. Chronic stress leads to low stomach acid. Certain intestinal infections like H. Pylori, autoimmune diseases like hypothyroidism, certain medications. Obviously, if you're blocking stomach acid with acid blockers or PPIs, antacids, certain nutrient deficiencies which are important for the production of gastric acid, like zinc and B vitamins, if you're low in those, that can cause low stomach acid. Also, poor diet will cause sibo, right? High intake of processed foods, sugar, unhealthy fats, also has a negative impact on SIBO and also stomach acid. Also, if you're not eating properly, irregular mealtimes, eating too quickly, overeating, you'll tend to potentially get sibo. And this, this allows bacteria to colonize the upper intestine, which is supposed to have low levels of bacteria. All right, so this is sort of what it is. Basically bad bugs growing in the wrong spot, fermenting the food you're eating, causing you to have a food baby and be miserable and have all sorts of other consequences on your mood, your energy, your cognitive function. It's not just your stomach that's being affected here. Now how do you diagnose it? Well, we use a breath test and There's a number of different kinds of breath tests. There's lactulose, there's glucose. And another test called trio smart test. But essentially we're looking for three gases that are produced after we give you a digestible sugar like lactulose or like glucose. And what these do is they actually help you to identify whether or not you're producing extra forms of these gases. Because the small intestinal bacteria. The trio smart test looks at for three different gases developed by Mark Pimentel and others at ucla. Looks for methane, which is commonly associated with constipation, hydrogen more likely to have diarrhea, and hydrogen sulfide, which is often not tested for. But it can be important to find, particularly in tough cases of sibo. I particularly use the trio Smart test. You can learn about it online, your doctor can order it, but it's a really important test. There are stool tests that help and that'll help you identify what's going on in the gut. Maybe helps you look at the overall health of the microbe. Biome 6 underlying issues. It can help you identify yeast overgrowth, lack of short chain fatty acids, lack of important bacteria like Akkermansia, low growth of bacteria. So all that is sort of like clues that things are going on. Also use organic acid testing, a urine test, because a lot of the metabolites from overgrowth of fungus or bacteria will show up in the urine. And you can measure these. And it's another clue. And there's certain blood tests that are important to look for nutrient deficiencies that can affect your, that can affect SIBO or your body, like B12 or iron that maybe also occlude a malabsorption. So what's a traditional approach? Well, it's pretty good approaches in traditional medicine, but they kind of like stop short. They give you an antibiotic to clear out the bacteria. That's. It's kind of an advanced from what we used to do when I was in training, but it doesn't really address the full spectrum what's going on in the gut. So what's a good comprehensive functional medicine approach to treating irritable bowel and also the related GI stomach issues? Well, we have a methodology. It's basically a system of how we approach people with gut issues. It's called the 5R program. The first is to remove, remove the bad stuff, move foods that might be bothering you. Bacteria, parasites, yeast. Get rid of the bad stuff. The second is replace, replace what's missing, probiotics, prebiotics, enzymes and so forth. The third is to reinoculate, which is use probiotics. The fourth is to repair that means repair the gut lining with the right nutrients that heal the leaky gut and repair your gut lining. The fifth is to restore, which means to regulate your nervous system and stress. So let's go through the 5R program in more detail. The first R is to remove remove common triggers for problems with the gut. These are commonly known as food sensitivities, not true allergies or just things that your body shouldn't be eating that much of gluten, dairy, corn, soy, sometimes eggs for people, certainly ultra processed foods, certainly refined carbs and sugars alcohol. Now a landmark paper published in the prestigious British medical journal Gut found that eliminating foods identified through the delayed food allergy test, which is not typically well accepted by traditional medicine. It measures IGG antibodies, not true food allergy, but food sensitivity. When they eliminated those foods, they dramatically improved their IBS symptoms. If you heard me talk recently, you probably know how much I love Himalayan Tardy Buckwheat. A gluten free seed loaded with longevity promoting nutrients. My good friends at Big Bolt Health have been carefully growing and researching this ancient plant for years. After tons of positive feedback from me and thousands of customers, they produce the world's first 100% organic Himalayan tartery Buckwheat Sprouted powder that's easier to digest, richer in vitamins and minerals and contains up to 10 times more plant nutrients like rutin and quercetin. I love this as a topper in my yogurt, a sprinkle on savory meals, or as an easy add to my smoothies and protein shakes. The sprout powder has no fillers, additives or sugars and is farm sprouted and packaged in the usa. Right now, Big Bolt Health is offering my listeners a special offer of 30% off this amazing product. You can try it now by heading to bigbolt health.com and use the code drmark30. Again, that's bigbold health.com this episode is brought to you by AWS. Amazon Q Business is the new generative AI assistant from AWS. Many tasks can make business slow, like wading through mud. Help. Luckily, there's a faster, easier, less messy choice. Amazon Q can securely understand your business data to help you streamline tasks like summarizing quarterly results or doing complex analyses in no time. Q Got this. Learn what Amazon Q Business can do for you@aws.com learnmore the next thing we want to get rid of are the bad bugs, right? And that means identifying what they are through testing. Maybe it's a breath test, maybe it's stool testing, urine testing, but it involves getting rid of overgrowth of bacteria, overgrowth of fungus, overgrowth of parasites through sometimes medications or herbal therapies. Now the typical medications used are antibiotics. Rifaximin is the most common one now used. This is a non absorbed antibiotic approved for irritable bowel. And a randomized trial published in the ML of internal medicine showed that using rifaximin for 10 days resulted in dramatic improvement in bloating and overall symptoms of irritable bowel syndrome by clearing out the overgrowth of bad bacteria. But sometimes you need to use combinations. For example, if you have methane sibo, you might need neomycin. Sometimes there's resistance. You need to use Bactrim or other antibiotics. But it's important to work carefully with your doctor on this. Also you might need an antifungal to get rid of the bad bugs like diflucan, nystatin or sporonox. You might need an anti parasitic if you find you have a parasite like alinea or flagyl. And then there's some herbal therapies that can be really helpful. There's a product called atrantil or atrantial, which is a specific herbal formula that's designed for methane racebo. That's if you have high methane on your test and tend to have constipation. Certain antibiotics like neomycin can be also important for methane sibo. There are certain herbs that I like to use like candibactin, AR and br, which are herbal. Herbal therapies for bacterial and yeast overgrowth can be great. Sometimes I use a combination of antibiotics followed by herbs for a while and, and I, and I will treat people with an antibiotic regimen and then follow it up with herbal antimicrobials that include oregano, berberine, wormwood, yarrow, thyme, ginger, licorice and other things. And that's the first R. And also we look at toxins. That's the, that's the other thing is to remove toxins. So we have heavy metals, we have pesticides, chemicals. All those need to be reduced or removed. Personally, I had severe sibo from mercury poisoning because it poisoned all my digestive function and enzymes and it didn't work and I had to fix that. Now the next R is to replace so digestive enzymes and hydrochloric acid. And I use digestive enzymes. There's different kinds like digestive enzyme ultra from pure encapsulations. There's digest Gold. There's a lot of other ones. There's SpectraTime 9x which is an animal based enzyme for metagenics. By the way, all these supplements I mentioned you can find, they're usually through professionals but I've curated some of the best in class that I've used for my patients that are available through me. And you can just go to Dr.hyman.com and go to the supplement store there and you'll, you'll be able to find it. Beta nitrochloride, which is kind of counterintuitive if you think you have digestive issues. We're taking all these acid blockers but this is actually giving you stomach acid and it can help digestive food and actually help reduce sibo. And then we re inoculate which is really important and that involves giving you the right probiotics. It's just really important. And that is good. Bacteria can be Lactobacillus, bifidobacterium. Sometimes we'll use saccharomyces which is a yeast against yeast that helps with yeast overgrowth. We use a whole different combination of probiotics. We also use polyphenols and prebiotics to, to actually help fertilize the good bugs. And we now know that polyphenols are colorful compounds in plant foods are really important for helping to improve the growth of the good bacteria. And lastly the next R is to repair and that means repairing the gut lining using food as medicine, eating whole, minimally processed foods, lots of good protein because protein's needed for gut lining repair. Pasture raised eggs, grass fed, organic, non genetically modified sources of food. Lots of low mercury fish like salmon, mackerel, herring, sardines. I, I like seatopia dot fish. It's got a great source of clean fish sometimes that are regeneratively farmed. So you know, be careful of farm fish. But there's a lot of other protein options. Grass fed beef, wild game, buffalo, elk, lamb, venison, all are great. Poultry if it's you know, pasture raised turkey, chicken, that, that's really good. You also need gut healing nutrients like omega 3s and vitamin A. And you can get ghee which has butyric acid which also contains a gut healing compound. Bone broth is really great. It's rich in agglutamine which can help provide you feeling full. But also it can help provide added minerals and collagen support that helps your leaky gut. Also there's certain supplements that are important like omega 3s. I like omega 3 rejuvenate from big bold Health, you can eat, take evening primazole, magnesium, certain vitamins like D and A are important. Zinc, a multivitamin, all help heal the gut. So these are just things that we use to help heal the gut. Now, after you've done the sibo treatment, you don't want to be eating the diet that's going to cause you to reintroduce foods that are going to cause again the overgrowth. So you got to be careful. You also want to learn how to regulate your nervous system because that also is important. Because both stress works to make it worse, but when you're having irrelevant makes your stress worse. So it's a kind of a vicious cycle. Meditation, breath work, yoga, whatever it is to help restore your nervous system. Also, exercise is great exercise that's done regularly. This is from randomized controlled trials, actually helps reduce IBS. Even a 30 minute walk can help. Now let's talk about diet. There's a whole diet that's being used. It's called a low fodmap diet. Low in fermentable starches and sugars, essentially. Right. You're not giving the bacteria something to chomp on and then produce gas and make you miserable. This is crazy. One in seven people in the entire world is affected by symptoms of irritable bowel syndrome. And many have one or more foods that are known to trigger symptoms like gas, bloating or diarrhea. Now, carbs and fiber are the most common because they can be fermented. So this diet is called the low fodmap diet and it was developed in Australia which was extensively researched with irritable bowel. And it's basically considered a low carbohydrate diet. And it can be super effective for treating ibs. Like basically if you eat protein, vegetables, you'll be fine. Okay, except certain vegetables are not great. We'll talk about that. Now many of those iron boss sufferers symptoms improved on this low fad FODMAP diet. And clinical research has shown that low fodmap diets improve the symptoms in 70% of IBS patients. So you both want to do the 5R program and part of the first R is to remove and it means removing some of these fermentable starches. Real world studies continue to show that this works right in in improving abdominal pain, quality of life. So what does actually fodmap stand for? Stands for fermentable olasaccharides, which are fructans and galactooligosaccharides. Basically, oligosaccharides which means single sugars, disaccharides like lactose, monosaccharides like fructose. These are all types of sugars that our gut bacteria feed on. And polyols, which are sugar alcohols. Right. Which is in all the kind of quote health foods that have artificial sweeteners or sugar alcohols to make them sweet, like sorbitol, xylitol, malitol, isomaltal, maltitol. And these are terrible. When I had sibo, I accidentally got, well, not accidentally on purpose, got a chocolate bar that was given to me by patients as a no sugar chocolate bar. You should love it. I'm like, great. I was, I don't know, at work and I was a little tired, stressed. I ate it, the whole thing, and it was full of maltitol. And I was in the bathroom and I was miserable. It's really bad. So you have to be careful. So how do fodmaps foods cause ibs? Well, these carbohydrates and sugars are not readily absorbed in the gut and basically they pass through the small intestines and they attract water and they cause bloating and motility changes that can result in diarrhea, constipation. But once they reach the large intestine, the gut bacteria ferment them and they produce lots of gases like hydrogen, methane, carbon dioxide. And the accumulation of these gases leads to gas bloating, dissension. So what are the foods that have the highest and the lowest amounts of fodmaps? And what are other things that have fodmaps like drinks? Right, so let's just go through the beverages. Apple juice, mango juice, pear juice, high fructose corn syrup, sodas, certain alcoholic drinks like beer, wine, all that will make you worse. Processed foods. I should say no more, but you know, those you shouldn't be eating anyway. But cereals with high fructose corn syrup, snack foods with high fructose corn syrup protein bars, diet foods. Often they'll contain inulin or high fodmap ingredients. So what are the steps to try a low fodmap diet? Well, all these moderate and high fodmap foods should be eliminated for four to six weeks on the low fodmap food plan. So for the next four to six weeks you want to basically do that. Why does a low fodmap diet eliminate healthy foods? Like. Right. Seems like you shouldn't be eliminating healthy foods. But sometimes it says to like asparagus. Right, but that actually has a lot of fermentable starches in it. And you basically do this temporarily until your symptoms get better. Now it's careful. If you have an eating disorder or whatever, you know you want to be be aware of working with someone who can help you do this. Right. But still you might need to fix your gut and that can be a factor in, in even in eating disorders, one FADMAP group is introduced at a time. So you sort of go slowly to monitor your symptoms one food at a time. You start small and you sort of build up your tolerance. Now some people can only tolerate food a specific quantity, so maybe they have a little bit, they'll be fine. If they have a little more, they're going to be in trouble. But some people need to avoid specific foods or FODMAP groups indefinitely. Right? There's an app actually that the FODMAP group in Monash University in Melbourne, Australia put together and it's for the public and it provides a searchable database of foods low and high in FODMAPs. It has recipes, recommended food products and lots more. And there'll be a link in the show notes and on their website. For more information you go to monash fodmap.com it's M O N A S H F O d m a p.com now research shows that tryptophan, which is the precursor to serotonin, which is a neurotransmitter that helps gut motility, can improve constipation in IBS C because it helps increase intestinal transit time, intestinal motility which means moving things through and gastric emptying similar to fiber. So that's good. If you have high levels of tryptophan though, it could make IBSD worse, meaning your diarrhea predominant. You wanna be careful if you're doing this, I encourage you to work with a practitioner. It's pretty restrictive. I don't think everybody needs to be on this actually. I think there's ways of resetting the gut used to the 5 or program and helping people eat more normally. But you wanna work with an experienced nutritionist or functional medicine practitioner who can help you identify what's going on, what you should be doing. And the goal here is to improve digestion, not have a long term restrictive diet. The good news is we now understand a lot more about irritable bowel than we did. We understand what is driving this food baby. It's called SIBO or sifo. We understand how to treat it in the right way with diet changes, lifestyle changes, the right medication, sometimes the gut repair program, and often traditional doctors will might give you the antibiotic, but they won't treat your yeast or fungal issues. They won't put you on a full 5R program to reset you. They won't make a lot of dietary suggestions so you'll get recurrence. So it can be a problem. You can get recurrence if you don't do it properly. As we wrap up things today, I hope you have a better understanding of the complex world of digestive issues that unfortunately disproportionately affect women. And I really hope to underscore the importance of examining the intersection of diet, stress and hormonal fluctuations in digestive health, particularly in women. And hopefully our discussion on the role of the menstrual cycle and iron bowel syndrome symptoms, the impact of stress on gut function, the dietary habits that contribute to conditions like SIBO and dysbiosis helps provide a foundation for really understanding and addressing these issues. Research highlights how hormonal changes affect GI motility and sensitivity, emphasizing the need for a tailored approach to treatment. By integrating this knowledge with functional medicine principles, we can really develop a more effective set of strategies to alleviate these symptoms and improve gut health overall. It's crucial moving beyond just acknowledging these issues as common complaints that have to be tolerated toward really understanding their biological foundations so we can manage them better and treat them better. And if you're struggling with these symptoms, I would consider working with a functional medicine doctor or using some of these strategies we discussed and get better. You don't have to suffer from this. So thanks again for joining me today and see you next Friday for another juicy episode of Health Bites. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts and follow me on all social media channels at Dr. Mark Hyman and we'll see you next time on the Doctor's Pharmacy. For more information on today's episode, please check out my new video and audio podcast, Health Hacks. It airs every Tuesday and includes a more detailed breakdown of these Friday Health Bites episodes. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes and lots more. And now you can have access to all of this information by signing up for my free Marks picks newsletter@drhyman.com forward/markspix I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations. These are things that have helped help me on my health journey and I hope they'll help you too. Again, that's Dr. Hyman.com forward/markspics thank you again and we'll see you next time on the Doctor's Pharmacy this podcast is separate from my clinical practice at the Ultra Wellness center and my work at Cleveland Clinic and Function Health where I'm the Chief Medical Officer. This podcast represents my opinions and my guests opinions and neither myself nor the podcast endorse the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com if you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a Practitioner Practitioner database. It's important that you have someone in your corner who is trained, who is a licensed healthcare practitioner and can help you make changes, especially when it comes to your health. 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