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What if brain fog, anxiety and mood swings aren't simply all in your head? What if the health of your mind actually starts deeper in your body, in your gut, in your hormones, metabolism and your immune system? Well, let me tell you, the connection is real. And it affects how you think and you feel every single day. And that's why I created Brain Shaping Academy, a six week program that shows you how healing your body can help you heal your mind. Brain Shaping Academy relies on the same targeted nutrition and lifestyle strategies that I've used for 30 years to help my patients improve their their mental, emotional and cognitive health. So if you want to feel calmer, clearer and more in control and stay sharp and protect your brain as you age, check out Brain shaping academy@Dr.hyman.com brainshaping that's Dr. Hyman.com brainshaping let me ask you this. If cholesterol were truly the main cause of heart disease, then why do half the people who have heart attacks have normal LDL levels? There was a study of like 136,000 people had heart attacks, went to ER and 75% had a, quote, normal LDL level. So that begs the question then what the hell is going on here? Welcome back to Office hours. Over the summer.
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We're revisiting a few of the conversations that resonate with most with our audience. And this one was at the very top of the list.
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When this episode first aired.
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It sparked a huge response because it challenged something many of us have been told for decades and that is this cholesterol is the primary driver of heart disease.
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Well, it might not be and find out why.
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If you listen in this conversation, I dive into the latest science around cholesterol and inflammation, around insulin resistance. And so they call apob, which is super important to know about, and metabolic health. And I ask whether we've been focusing on the wrong markers all along.
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What's interesting is that since this episode
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first came out, the conversation around cardiovascular risk has only continued to evolve.
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And listening back today, many of these insights feel even more relevant than they
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did the first time.
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So whether you're hearing about it for
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the first time or coming back for a second listen, I think you'll walk away with a different perspective on what really drives heart disease risk and what you can do about it.
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Let's get into it. This episode is brought to you by Function Health, empowering you to live 100 healthy years with over 160 lab tests for just $365 a year and use the code MARK2026 to get $50 off your membership. So today I want to talk about something I've changed my mind about over the years. Cholesterol and heart disease. Now, heart disease is the number one killer of Americans since the 1950s, and yet so many are still approaching it with the same outdated framework that we'd used for decades. Now, for a long time, cholesterol was seen as the enemy. You got to get it as low as possible, you got to avoid fat, you got to take a statin. And that was what we're all told. That's what doctors are trained in. And that's the story most people still believe. You go to your doctor, they check your labs, they do a cholesterol test, and they do the wrong one, by the way. And that's why at Function Health, we do the right ones, including ones you never get from your doctor, like apob, which is far more important than all the other cholesterol tests, and lp, which most people don't check, which is highly important genetic marker. So you gotta know your numbers, but you gotta know the right numbers. So doctors check your old cholesterol number, they see your LDL high, they go, LDL high. Let's get lower. Take a statin without really much thought. And that's unfortunate because it's a much more nuanced problem than just a statin deficiency that's causing heart disease. Now, the latest research shows that we need to think about this differently. With my patients, I've also learned a lot and how variable people respond to different things. I've had people with extremely high cholesterol that do extremely well on an extremely high fat ketogenic diet and lower their cholesterol, and other people who are the opposite, who will take a keto diet and actually make their cholesterol worse. So you've got to really look at individuals and figure out what's going on. Here's what I used to believe. I got trained like every other doctor, that LDL was the issue, that you had a high cholesterol, high ldl, that causes heart attacks, cause and effect. And the goal was to lower your LDL no matter what, at all costs. Get as low as possible. We also learned that saturated fat is bad because it can raise your cholesterol, particularly LDL cholesterol. So the message was pretty simple, but it wasn't accurate for most people. Real life clinical work really changed that simplicity. When you graduate from medical school, you think you know everything, but you start practicing medicine, and after 30 or 40 years, you really don't know that much and how everybody's different. And there's not the. The simplicity that we think applies to certain things like ldl, heart disease, statin cure. It's just not so simple. We've treated cholesterol like a villain, but the truth is really way more nuanced. What did the old model get wrong? Well, the new science that's emerging has identified a couple of key problems. The first is that total cholesterol is actually a poor predictor of heart disease. Up to 50% or even more in some of the studies of people who have heart attacks, have a, quote, normal LDL level. The risk really comes from something that's not being tested by almost every doctor in the country. I mean, I asked Quest, who is our lab testing partner in Function Health, how many cholesterol tests use the right cholesterol test, which looks at the quality and the size and the number of your cholesterol particles, not just the weight of them, which is what you get with your normal cholesterol test, but the quality and the size, whether they're small or big, whether they're dense or not. And how many of those particles do you have? And you know what they said? Less than 1%. 1% of their tests do this. The second big aha that came actually, since I graduated medical school probably in the late 1990s, maybe early 2000s, was the insight, particularly from, from Harvard and the scientist Paul Ritker, who wrote a very seminal paper in the New England Journal of Medicine, that it was inflammation, inflammation that was causing heart disease, not cholesterol. He even showed that if you had a high cholesterol and low inflammation, your risk was pretty low. But if you had a high cholesterol and a high inflammation, your risk was higher. Even if you had a high inflammation and a normal cholesterol, your risk was higher. So the inflammation is what's going on. So your arteries are inflamed, and that's what caused the cholesterol to get deposited. Cholesterol isn't bad. It's bad when it gets oxidized or turns rancid. When you look at data from Harvard Cleveland Clinic and these large meta analysis, actually, the crp, this is another test, your doctor's own check, and it's on the function panel. This high sensitivity C reactive protein is important, maybe more important, an ldl, in predicting heart disease. Now, what is causing this inflammation? And this is what most people don't realize, aside from a certain subset of the population who has a genetic cholesterol disorder, which is independent of your metabolic health and who do get heart disease. And that's a very small number. Maybe it's 10%. The real problem is what we call metabolic dysfunction. This means pre diabetes insulin resistance. Anywhere along the spectrum where your body is not dealing with sugar and insulin very well because you're eating a high starch and sugar diet and you're not exercising or you have extra belly fat, I mean, you have a little bit of belly fat, you're starting to, to get this problem and you get high insulin resistance. And that means your cells don't respond to insulin. So you need to be more and more and more to make it work. And that causes what we call atherogenic dyslipidemia. And that's a mouthful, but what it means is athero means plaque. So atherogenesis means plaque. Atherosclerotic vascular disease. Hardening the arteries, whatever you wanna call it, clogs in your arteries from plaque and cholesterol deposits that is caused by, by these small, dense cholesterol particles. It's not the cholesterol itself, it's one there when you have insulin resistance and that drives inflammation. What's really important to understand is that LDL is an ldl, is an ldl. There are different types of ldl. There's large, there's medium, and there's small sizes. And then there's the number of particles. So think about like, you know, the weight of a cholesterol would be if you get your cholesterol number of 100 or 1 LDL 130. And that just means the weight of your cholesterol. But it doesn't tell you how many LDL particles that is made up of. It could be a thousand small particles or it could be a hundred large particles. But you don't know that unless you do the right test. And that's really again why we did Function Health. Now we have to understand it's not just cholesterol as a simple problem. It's nuanced. And there's many different types of cholesterol. There's different sizes, there's different types of HDL and ldl. And, and so you have to really have a more nuanced understanding and what's causing it. But the real take home here is that here's the headline. It's sugar, not fat that's causing you to die of heart attacks. It's sugar, not fat that's the problem. And that's why I wrote a book called Eat Fat, get Thin, why I wrote a book called the blood sugar solution. Why I written end day detox. Sugar is the boogeyman, not fat. Now, that doesn't mean that some people don't respond well to fat. They don't. Some people don't. So there's a lot of variation in the population, but in general, this is the big issue. It's a metabolic dysfunction that affects 93% of the population, is causing this heart attack epidemic. So it's not that cholesterol doesn't matter. We're just asking the wrong questions. All right, so what is the new science? What's really causing heart disease? One of the friends of mine sent me this email. He's an older guy, he's like 78. And he sent me this email, like, hey, this great new discovery, this new lab test that you can get that tells you your risk of heart disease is more predicted than any other testing possibly you could get for heart disease. And I'm like, wow, this is interesting. I wonder if I'm going to learn something. I click on it and I'm like, oh, okay. Well, I've been testing this for 40 years. Well, probably 30 plus years. And this is called APOB. Again, it's not part of a regular cholesterol panel, but it is the most reliable marker of your risk of heart attacks. Why? Because it's a surrogate marker for poor metabolic health, meaning insulin resistance, prediabetes, blood sugar issues, belly fat. This is what goes up when you have some degree of this and it shows you all the bad cholesterol particles in your blood almost in the same time. Now, in 2023, 2024, the guidelines for cardiology have finally recognized. I've been doing this for 30 years, guys finally recognize APOB is a causal factor for heart disease. It's not just associated with it. And the beautiful thing about it, you can do the lipoprotein fractionation, which is important, but I think it's also important to track apob. And we do that with function health. These APOB really shows you how many of these damaging little cholesterol particles, these small, dense LDL particles like bbs that go and damage the lining of your arteries and allow the cholesterol to deposit. Another really important test that I mentioned earlier called lipoprotein little A or LP. One in five people, which is 20% of the population, have an elevation of this particular number. It's a genetic problem. There are drugs coming that can help it. There are ways to lower it through lifestyle supplements and certain other treatments. But when you have it, it's really important to regulate and address all the other heart disease risk factors. Your blood sugar, your blood pressure, obviously, don't smoke, gotta exercise, don't eat sugar, starch, get rid of belly fat, get your cholesterol, other cholesterol numbers optimized through a whole set of different interventions we're gonna talk about. But really, really important. Cause you can't directly change it right now very well. So. But it is a very strong independent risk factor for heart disease. And it's. It's especially worse if your cholesterol is abnormal. Medication is coming, but metabolic and lifestyle health are really the key. As I said earlier, the real problem causing our epidemic of heart disease is not a high fat diet. It's sugar. And it's insulin resistance that results from eating a lot of starch and sugar. When I say sugar, I mean anything. Like anything that's got sugar or starch. It could be bread, it could be rice, it could be potatoes or. No, they're not so bad. If you eat the little small ones, anything that's starchy. If you are someone who's susceptible, and most of us are, you can get insulin resistance. I mean, I'm. I'm pretty healthy. My body fat's about 10%. I exercise every day. I eat pretty good. Occasionally I have a cookie or ice cream, but it's not my staple. And I. And I'm pretty lean. But when I went to Italy, you know, last summer, I kind of went crazy. And I had, you know, wine and I had lots of pasta and whatever, bread, and I gained like 5 or 10 pounds. And it went right to my belly. And then as soon as I came home, it went right away because I went back to my basic habits. But most people don't do that. And when you look at the data. This is from Tufts. 93.2% of Americans have some degree of metabolic dysfunction. And it shows up as high blood pressure, high cholesterol or abnormal cholesterol, high blood sugar, having had a heart attack or stroke, or being overweight or obese. That means that only 6.8% of Americans don't have that. Think about it. Research shows also that insulin resistance is a problem even if your cholesterol is normal. And I kind of want to just touch base on this for a minute. And I talked about this study in my book Eat Fat, Get Thin. But it was a very interesting study where they mentioned where they took 136,000 people who showed up in the ERS across the country for heart attacks, and they measured their total cholesterol LDL, triglycerides, HDL. And what they found was really fascinating. 75% had normal LDL, but almost nobody had normal triglycerides or HDL. And the higher triglycerides and the lower your HDL, the more you had a higher risk for heart attack. Now, what do those numbers mean? Those numbers are a great and simple way to test your degree of insulin resistance. Your triglyceride divided by your HDL, your HDL should be over 60, ideally over 50 if you can manage it. Your triglyceride should be less than 100. And even under 70 is better. And if your ratio of triglycerides to HDL is 1, that's great. If it starts to go to 2 or 3 or 4 or 5, that's bad. So if your triglycerides are 1:50 and your HDL is 30, that's a ratio of 5 to 1. That's a disaster. Even if your total and LDL cholesterol are perfectly normal, you will have an extremely high risk of having a heart attack. Most people believe that getting their annual exam means they're on top of their health. I understand why. But most anter panelists weren't designed to catch what's coming. They were designed to confirm what's already obvious. And those are not the same thing. LDL cholesterol can fall within range, while APOB and lipoprotein ly, which are more precise indicators of cardiovascular particle risk, are never measured. Glucose can look normal while fasting insulin rises in the background. TSH for your thyroid can seem fine while thyroid antibodies are quietly targeting your thyroid gland. We have extraordinary tools for measuring human biology. We know which markers tend to move earlier. We know what the small shifts look like. The question is whether you're measuring them. Function gives you accuracy. Access to 160 lab tests every year across your heart, thyroid, immune system and more. So you can see patterns that the standard exam misses. You don't have to wait for a diagnosis to start paying attention. Clarity is a Choice. Go to functionhealth.com, and if you're one of the first 1,000 people this week, use the code MARK2026 for a $50 credit toward your $365 a year membership. That's functionhealth.com, and use the code MARK2026 today. Let's talk about the other piece here, the inflammation model. Why is there inflammation? There's a lot of reasons. Environmental toxins, your microbiome, stress, infections. Lots of reasons. The main reason the main reason, Sugar. I know it sounds like a broken record, but this is the problem. The biggest driver of inflammation in our society is our starch and sugary diet. 60% of our calories is junk food. The average American eats about a pound of sugar and flour a day. It's about 152 pounds of sugar, 133 pounds of flour a year. That's almost three quarters of a pound of, of flour and sugar per person per day. Now, I'm not eating that much, so some of y' all eating a lot more. The key is if you eat that, it's going to drive the deposition of belly fat, visceral fat we call visceral adipose tissue. But this is angry fat. It's not just regular fat holding up your pants. It's angry fat and it's inflamed fat and it's spewing out tons of inflammation. When you have inflammation, guess what happens? You oxidize the ldl. Like, you know, when your oil goes rancid or nuts go rancid, that rancid fat is dangerous. It's harmful. It's oxidized fat. It's like a car rusting. And that causes damage to your blood vessel lining. And that leads to the ability for the cholesterol to enter the arteries and form these plaques that end up causing heart attacks. There's a lot of other markers of inflammation that you can see. Hscrp, we talked about ferritin, something that is, can go up in certain people, particularly if you have severe insulin resistance. IL1, which is a cytokine, homocysteine, also can be elevated. So a lot of clues you can get for inflammation. So just to reiterate a little bit, on diet, there are people who are sensitive to saturated fat. And I want to just be clear that not everybody responds the same to the same diet. We're all different. On the whole, if you're overweight, if you have belly fat, you're more likely to do better on a high fat diet than a low fat diet. You're more better likely to do better on a low sugar starch diet than a, a low fat diet. Really important and large studies have shown this large meta analysis, pure, the pure study Framingham data show that dietary saturated fat is not the primary driver of heart disease. I think there was a study I reviewed in my book, there was like 72 different studies. There were randomized control trials, population studies. They looked at blood levels of fats, they looked at dietary intake. I mean, it was really quite an Extensive study and they could show no correlation at all with saturated fat. Trans fat for sure increased the risk. That's hydrogenated fat and omega 3 fats lowered it a little bit. But saturated fat were neutral. Now that doesn't mean for some people it's not a problem, but it's in general that's the case. Now as I mentioned, the thing that's far more dangerous is refined starches and sugar. So bottom line, think of sugar as a recreational drug. Okay, so what do I think now? I think now that heart disease is primarily for most people without these genetic lipid disorders is primarily a metabolic, meaning blood sugar regulation and inflammatory disease. First, cholesterol is just a bystander in this whole process. And what matters most to check for you now is something called apolipoprotein B or apob and what we call lipoprotein fractionation, which we do on Function Health panel and lipoprotein little A, which we do on the Function Health panel and hscrp, which we do on the Function Health panel. And measure of insulin resistance, which we check, fasting insulin. Again I asked the question how many tests that you get from doctors around the country include insulin. It's like less than 1% never checked, almost never checked. It's probably the most important test for understanding your health and longevity. There's an even better test we offer through function, which is an insulin resistance score, which uses newer technology to get a very predictive result. That's better than even taking a glucose tolerance test. The other thing I mentioned, you want to look at triglyceride to HDL ratio, that's your triglycerides. HL should be one to one or, or even less. And then there's a really easy test. It's the tape measure test. You basically get a tape measure and you remember, measure around your fattest part of your belly and if it's too much fat there and you're not, your waist isn't good, you're in trouble. And there, there are some benchmark numbers we can give you, but basically, you know, if you got that in there, it's just you could use the mirror test. You don't even need a tape measure. Just jump in front of the mirror, up and down. If your stomach jiggles, you probably have this problem. So let's kind of reiterate. The things that make the most important are the quality of the diet you're eating, whole foods, low glycemic, anti inflammatory, good fats, exercise, managing stress, getting up, sleep, all those things are critical. Those matter. What mattered less than we thought is the total cholesterol is. Your LDL alone in the dietary fat intake is not as important as we thought. The cholesterol in your food is certainly not important. In 2015, the Dietary Guidelines Committee said, listen, guys, we got it wrong. They said cholesterol is no longer a nutrient of concern. Meaning eat your eggs, don't worry about it. In functional medicine, we don't really treat the numbers. We treat the whole body. We treat the system. And the system that drives heart disease is your metabolic health. And people who have poor metabolic health have heart disease. Guys, there's always more studies coming out, but there's an amazing study in 2024 looking at metabolic cardiology, and they showed that metabolic syndrome, pre diabetes increased your heart disease risk by fourfold. That's 400% heart, independent of your LDL cholesterol. We're always focused on LDL cholesterol. But your doctors aren't checking your insulin. They're not checking your A1C, they're not checking your blood sugar, they're not looking at some resistance scores, they're not looking at your triglyceride HL ratio, they're not looking at hscrp. They're not looking at all the things that matter. And again, that's why I co founded Function Health, because people need to get access to their own biology and know their numbers and know their data, and they're not getting that from their doctors. Sadly. Next thing I learned, which I think is really important, is that people think, oh, if you're normal weight, you're fine. But there is a problem that we call tofi. Thin on the outside, fat on the inside, or I like to call it skinny fat. You look skinny on the outside, but you're fat on the inside. And this means you can be normal weight, your body mass index can be normal, but your body composition is bad, meaning you have more body fat than muscle, particularly belly fat. 20% of people who are normal weight have insulin resistance and have the same heart disease risk as obesity. And that is why we see the data that 75% of Americans are overweight. When we check their blood tests, 93% of Americans have poor metabolic health, meaning they're insulin resistant. That's the 20% right there. So it's really a problem. Now, the good news is we have new technologies that can help us understand what's happening with our metabolic health and blood sugar, like a continuous glucose monitor. I really love those because they can help you understand what's happening and how your different foods affect you. And everybody needs to do this, at least for a short period of time. Because when you understand what your body's doing and how it's reacting to different foods, then you can modify your diet. Then you'll say, well, you know, if I eat a orange, it's fine, but if I eat a plum, it goes way up. Or if I have this bread, I'm fine, but if I have that bread, I'm not fine. So you can actually see how your body responds. And it's much better predictor of heart disease risk than just a static blood sugar. What can you do about this today? First thing you do is get the right test. Tests don't guess. You can ask your doctor for these tests and they may or may not do them, but you can get all of them on your basic panel@functionhealth.com so just to reiterate, the tests you want to get are Apo lipoprotein B or apo B lipoprotein, little A hscrp, fasting insulin. Of course, you want to know your triglyceride and HDL ratio. And also I would really recommend a lipoprotein fractionation as part of the basic panel function. It looks at your particle size, particle number, quality of your cholesterol, really important. And then a calcium score, which I think is important for most people as a baseline. Again, we offer that through Function Health through our partner Ezra, which you can do imaging. It's very cheap, very quick, very safe, and you get a quick idea of whether or not you have plaque development and then you can manage it. Because cholesterol is just a surrogate marker. It doesn't tell you if you have the disease. You have to actually image to see if you have the disease. Right. It's not like if you have high blood sugar, really, you know, you have diabetes. That's pretty black and white. You have a cholesterol. I've had people with the worst cholesterol profiles you could possibly imagine, and they have completely clean arteries. You have to actually image to figure out what's going on. When you test, you have to remember you want to track your trends over time, not just one point in time. And that's what's so beautiful about a function membership. It's every year, a dollar a day, you track your numbers over time, you get twice your testing and you see what's going on. And you can modify things, you can change things, you can adjust your diet, lifestyle, see what changes happen. And that really helps you manage. So you Gotta really understand what you're doing in order to manage it. I think some investor dude said, you know, what gets measured, gets managed. So if you don't measure it, you can't manage it. The second thing you wanna do is, is eat in a way that lowers inflammation and helps to correct insulin resistance. How do you do that? Cut out the biggest source of both, which is sugar and starch, refined starches. Eat more whole foods. Eat more inflammatory, anti inflammatory foods. Lots of colorful fruits and vegetables, lots of omega 3 fats. Get rid of ultra processed food, they're not even food. Food is defined as something that supports the health and development and growth of an organism. Ultra processed food does the exact opposite. So it technically isn't even food. We shouldn't be eating it. It looks like food, but it ain't food. Next, you know, work on your lifestyle. Exercise, building muscle, really important. I was in the gym this morning for an hour. It was really painful. My trainer was crushing me. But I know it's helping me and it helps to build muscle, it helps to lower apob, corrects insulin resistance. Your muscles become a better sync. Also, strength training is not the only thing. Cardio is also important. Learning to regulate stress, cause that can also affect heart disease risk. Sleep, really important. All those things are really important. And just keep going, moving throughout the day. Get your steps in now. What about supplements? Well, I want to be really clear here. Supplements are not one size fits all, they're not a replacement. They're called supplements for a reason, not placements. And you need really to understand what's going on to get a personalized prescription. What you need depends on your health history, your medications you're taking, your labs, your unique biology, your genetics. Not medical advice here, but you should basically check with your doctor before starting anything new. But there's some basic principles that are pretty safe. First, you want a good high quality omega 3 fish oil to lower your triglycerides and inflammation and your blood blood pressure. I recommend Omega 3 rejuvenate by big Bold Health. I'm an investor in the company Transparently. It's started by my mentor Jeffrey Bland, who's a father of functional medicine. Extremely high quality, very pure, really important to get the right one. Next you want a good quality multivitamin mineral. Cover all the gaps. Folate, zinc, magnesium, CoQ10 is also really important for heart health. Really supports mitochondria, vascular health, really helps blood pressure. And mitochondria, magnesium really important, helps to relax your blood vessels, helps with insulin, blood sugar regulation, heart rhythm Also is helped by that. I like magnesium glycinate. Or if you're constipated, you can use magnesium citrate. There's also plant compounds that work really well. Fiber is great. Plant sterols also are there compounds that come from food like soy can be very helpful in lowering LDL cholesterol and just balancing your lipids. And you can get, you know, fiber as a supplement or just eat more fibrous foods, which I do. I've changed my mind about cholesterol because the science has changed. And the truth is when we look deeper, when we look at things like inflammation, insulin resistance, apob metabolic health, we actually are finally getting a clear picture of what really causes heart disease. It ain't cholesterol by itself. It's all these cascading factors. Here's the most important part. By understanding your numbers, by knowing what's going with your biology, you have the power to change your heart health. Right now you're not really at the mercy of your genetics or your numbers. You can understand your biology, you can take charge of it. And sometimes, yeah, you might need medication, but you can regulate everything in such a powerful way using these foundational principles. So I'm sure you know someone who's had a heart attack or has heart disease. Please share it with them. Share it with anybody who's worried about their cholesterol is on a statin. The more we understand the whole picture, the healthier we're all gonna become, the better our society's gonna be. And obviously we're gonna lower our healthcare costs and everybody's gonna do better. What if brain fog, anxiety and mood swings aren't simply all in your head? What if the health of your mind actually starts deeper in your body, in your gut, in your hormones, metabolism and your immune system? Well, let me tell you, the connection is real and it affects how you think and you feel every single day. And that's why I created Brain Shaping Academy, a six week program that shows you how healing your body can help you heal your mind. Brain Shaping Academy relies on the same targeted nutrition and lifestyle strategies that I've used for 30 years to help my patients improve their mental, emotional and cognitive health. So if you want to feel calmer, clearer and more in control and stay sharp and protect your brain as you age, check out Brain shaping academy@Dr.hyman.com brainshaping that's Dr. Hyman.com brainshaping thanks for joining me for office hours. I love diving into these topics with you. Remember, you are the CEO of your own health and every choice you make can move you closer to healing and vitality. I want to keep these episodes as relevant and useful as possible. So tell me, what do you want to explore next? What questions are you wrestling with? What breakthroughs are you chasing? Share your ideas in the comments on social media or through the link in the show notes. I'm listening. Until next time. Keep taking charge, keep asking questions and keep showing up for your health.
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If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels Dr. Mark Hyman, please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness center, my work at Cleveland Clinic, and Function Health where I am Chief Medical Officer. This podcast represents my opinions and my guests opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical 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.
The Dr. Hyman Show – Encore: Why Normal Cholesterol Doesn't Always Mean Low Heart Disease Risk
Host: Dr. Mark Hyman
Date: June 29, 2026
In this encore episode, Dr. Mark Hyman challenges the conventional wisdom that cholesterol is the single most important factor in heart disease risk. Drawing from decades of clinical experience and the latest research, he explains why normal cholesterol—especially LDL—doesn't always predict low risk for heart attacks. Instead, he explores how metabolic health, inflammation, and more nuanced biomarkers (like ApoB and Lipoprotein(a)) are much more predictive. The episode empowers listeners to seek better testing, understand their metabolic health, and take actionable steps to reduce risk beyond what routine blood work can reveal.
Dr. Hyman leaves listeners with a new framework for assessing and lowering heart disease risk, focused less on cholesterol numbers and more on metabolic health, inflammation, and advanced biomarkers. The practical, personalized approach empowers you to become the "CEO of your health" and make choices rooted in the full picture—not just old, outdated markers.
Notable Final Word:
“By understanding your numbers, by knowing what’s going on with your biology, you have the power to change your heart health. Right now, you’re not really at the mercy of your genetics or your numbers.” – Dr. Mark Hyman [41:50]