Dr. Elizabeth Boham
Appearances
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
You know, the food that you're putting in your mouth is so much more important than what topical things you're putting on your skin. And so it made us start to have this conversation, which I thought I was saying all the time, but that I think sometimes people don't realize or understand or the connection is not made.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yeah. So we put her on some zinc and vitamin A. Now, the both of those, you know, I just want to caution listeners, if you're not working with the doctor, you know, both of those you can get too much of, and they can cause imbalances in other vitamins. And vitamin A is fat soluble. So you have to, if you're going to use a higher dose. You can't OD on it. Yeah. I use 10,000 I use per day with her.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
A vitamin A. A vitamin A. But you don't want to be on that for a long, long time. No. We did it for three months, and then we started to spread it out. And I was monitoring her levels. And the same thing with zinc. You just have to be a little bit cautious of just taking a lot of this on your own, because it can throw off some of your vitamin levels, or vitamin A can be toxic at high doses.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
It really helped, I mean, the whole comprehensive approach really helped her skin improve. And she was able to stop using both the oral antibiotics and the topical antibiotics. She was able to get off of them. And her skin, that dysbiosis started to rebalance and she wasn't getting all the acne all the time.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
That how important what you're choosing to eat every minute of the day, you know, how much that impacts your skin.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And a lot of times with the topical treatments, whether it's steroids for eczema or topical antibiotics for acne, they can work in the short term, but in the long term, they disrupt your skin and make you more prone to getting it in the future. For example, we know both topical steroids and topical antibiotics are going to get rid of that really important layer of good bacteria. Yeah.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I know, it's kind of cool, huh? Not only in our digestive system, but lining our skin. And so those medications, though they can be helpful in the short term, in the long term, they're damaging, they're getting rid of all of those good bacteria, which are really important first line of defense. And so then you create a dysbiosis or an imbalance in the good and bad bacteria on your skin.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
So we can do tests like you said on, is there increased intestinal permeability or leaky gut? Because we know that those imbalances cause inflammation. And we know inflammation causes all sorts of things, including acne.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And then that just makes you more prone to getting more acne in the future. So it may be okay in the short term, but it's not getting to that underlying root cause.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yeah. I mean, one of the things we know with foods is that when you eat foods that are really refined and processed, foods that are high in sugar and refined carbohydrates, you'll get a spike in your blood sugar. And you'll often get that spike in insulin after you get a spike in blood sugar, right? So you eat food, your blood sugar goes up, the body makes a lot of insulin.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And that spike in insulin and blood sugar will cause a follicular hyperkeratinosis.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I know, right? Which just means that there's extra, that in the follicles of the skin, the skin's not turning over as well as it should. And so cells get stuck in the skin. And then those stuck cells can get more inflamed and acne can get produced. So one of the major things we always start with is pulling away the refined and processed foods and the sugary foods.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And starchy foods, right? Anything that's going to cause that insulin spike. You can really see signs of insulin resistance on the skin in so many different ways.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yes. Right? Right. So their insulin is higher than somebody who doesn't have insulin resistance. And that high level of insulin causes a lot of shifts in the skin. It causes that follicular hyperkeratosis that causes the acne. It can cause more skin tags. It can cause something called
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
acanthosis nigricans which is this darkening of the skin folds like in your neck and in your armpit and so you can by just examining somebody right away you can get a sense of do they have insulin resistance or that pre-diabetes state because it shifts the um the the growth factors the high inflammation from eating these high sugary foods causes changes in your
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Which is amazing to see. I mean, we know that when we pull away those refined and processed foods and the sugary foods, most of our patients, so many of our patients see great improvement in their acne right away.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Dairy. I mean, because dairy is, you know, all of our dairy food, our milk, our cheese, our ice cream, you know, all of that is very high in hormones.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
It helps the calves grow, right?
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yes. And we know that those growth factors can stimulate acne in some people. You know, not everybody, but for some people, they're more sensitive to them and they definitely will cause more acne. Actually, for a lot of people.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Absolutely. And I think it depends, like the question of sheep or goat, I think it depends on the person. There's some people that it really, all types of dairy bother their skin. And for other people, there's some that is better than others. And what we know is sometimes the testing, like the food allergy testing or food sensitivity testing doesn't always pick it up.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I mean, we do it often, but there are times when we get a negative test result, but even if we still pull it away and people's skin improves.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Not necessarily. It could be just like you said, all the hormones in dairy too.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Absolutely. So there's so many ways, and I always say this, there's so many ways that somebody can react to food, right? And people get confused all the time because they get one negative report and they say, oh, then I must be fine to eat that food, right? You can get an immediate reaction to food or an IgE.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
You can get a delayed reaction to food or an IgG, but you can also have a food intolerance. There's just so many ways you can react to food. So just because you have one negative food test result doesn't necessarily mean that food is not causing you problems.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Or how food changes your microbiome, and then that changes the inflammation.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Absolutely. Absolutely. And I think that this first case that we were going to talk about, this 22-year-old who came to see me, it really kind of pulls in the importance of the microbiome in terms of your immune system, but also in terms of your skin. She was a 22 year old and she had, she started to develop acne when she was around 12.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
When we got more history from her, I realized she had had multiple antibiotics as a kid. She had chronic ear infections and especially when she was getting those ear infections, they were treating most of them with antibiotics. And I think we've kind of calmed down a lot on treating every ear infection with antibiotics, but she got a lot of antibiotics because of her ear infections.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
So she came in to see us because she was using a lot of different topical treatments. She was also taking a low-dose antibiotic. And her skin was better, but she didn't want to stay on these antibiotics and she wanted to really look at it a different way. And when she stopped taking the oral antibiotic, which she realized she didn't want to be on forever, her acne started to get worse again.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
So she said, okay, I really want to figure out.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
it becomes a vicious cycle. We see these vicious cycles all the time with medications, right? Because they're shifting, because there's antibiotics, as we've mentioned, are shifting the microbiome.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
They're shifting the microbiome in your gut, they're shifting it on your skin, they're getting rid of that first line of defense, and then they're allowing, then it's more common to get the acne again when you stop them.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And so just because of her history of all of those antibiotics as a kid and being on the antibiotics, and because we got more information, she was having a lot of digestive issues. She was having some bloating, some diarrhea, constipation. Her digestion was off.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Right. No, he didn't ask that. So because of that, I said, you know what? I really need to focus on the microbiome here for this woman to help improve her acne. And so we did a stool test, which is kind of a neat, it's a neat way to get a sense of what's going on in the microbiome.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
You know, it looks at a lot of different biomarkers, right? So it's looking at all of your levels of commensal bacteria, like all the good bacteria, and is there an imbalance in the good and bad bacteria? So it does look for acute infections, for real infections as well, but it also is really paying attention to something we call dysbiosis. Yeah.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
which is an imbalance in the good and bad bacteria and trying to get a sense of is there an overgrowth of not good bacteria or not good yeast or it also looks at parasites. It looks at digestion and absorption and inflammatory markers.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Right, so when the stool test came back, we found that there was this overgrowth of unwanted bacteria and there was an overgrowth of unwanted yeast. And yeah, and so we can do tests like you said on, is there increased intestinal permeability or leaky gut? And she of course had that because of these imbalances and the inflammation going on in her digestive system.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Because we know that those imbalances cause inflammation. And we know inflammation causes all sorts of things, including acne, right? So we said, okay, we need to work to fix. We need to work to fix this imbalance. Let's work to rebalance the bacteria in her gut.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
and so for her she wanted to use an herbal approach and i agreed with that so we put her on a combination of a couple different um herbs that can work to get rid of the overgrowth of bacteria and yeast and and that worked really well the one thing i always say about skin though is you you kind of have to be patient sometimes so if you're
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
if you are pulling away a food like dairy or, which we did with her, we took her off of dairy. We took away a lot of added sugar. If you're adding in something to treat the dysbiosis, and we also gave her a lot of probiotics too, you got to give it some time for the skin to improve. You might see some improvement in the
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
inflammatory acne right away but for the skin to really improve it takes like six weeks for the skin to turn over so you want to give it some we always give it some time to say okay how is this how's this improving yeah um and so and and we also we also added in some nutrients that are really important for skin turnover so we know that zinc and vitamin A are
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
What you're eating is so much more important than what you're putting on your skin.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
are really critical nutrients to help the skin turn over so you don't get so much of that hyperkeratinosis, that elevated levels of the skin not turning over, which can cause more acne to develop.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Histamine is found naturally in the body. The body makes histamine. We also consume histamine. And the interesting thing about histamine is it is also part, it's released by mast cells. as part of our first response to offending organisms like viruses.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
It's not forever. That's the thing is I think you're absolutely right. Like an elimination diet is not something that you do forever. And a low histamine diet is also something that you don't necessarily have to do forever. And I think that the key thing is really working with a really good
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
well-trained, experienced functional medicine nutritionists who can help you navigate all of the nuances of what to eat, what to avoid, what to take in terms of supplements can be very, very helpful.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Well, you bring up an interesting thing because, you know, as I have seen more and more patients, and I think we are seeing more patients who have, you know, histamine intolerance, call it mast cell activation syndrome, to what degree, is there are certain individuals who can be a little bit more predisposed towards this.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
So people who have Ehlers-Danlos syndrome, you know, the hypermobile people can actually have, for whatever reasons, will have a higher incidence of histamine intolerance. The other thing in the case I recently had was a patient who came in to me with severe mast cell activation syndrome.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
It was on a whole bunch of different medicines, including chromium, which we talked about earlier, to decrease food reactions to histamine. And I saw the patient, and he gave a very interesting history. He had this skin lesion, which sort of like morphed into this almost like an ulcer. scarring type ulcerated lesion on his back area.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
He saw multiple dermatologists, had a biopsy, had part of the area removed, and was ultimately diagnosed with some type of form of a scleroderma, sort of like a malignant scleroderma, which is sort of interesting and like, oh, what's that related to? But he was also having all of these histamine type reactions.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And then when I asked him a bunch of questions, I started thinking about, well, guess what? Lyme disease is also associated with histamine intolerance because Lyme bacteria resides in the connective tissues in the body. It sort of hides there.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And that in turn can actually activate those mast cells, which mast cells are the first line defense or one of the first lines of defense against infectious agents. And when I asked him, because he had a lot of fatigue and brain fog type symptoms too, but maybe that was related to something else. So I asked him about potential exposure.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
So lo and behold, he ended up having a low CD57 count, which is oftentimes a marker. It's not diagnostic of Lyme, but it tells you that the immune system is not working so well. And when I did advanced testing on him, he had actually had conventional lab testing. I think we talked about that in another podcast, how regular conventional lab testing for Lyme disease is not that helpful.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Exactly, yes. Type of white blood cell. Type of white blood cells, yeah. And the also interesting thing is that histamine actually works as a neurotransmitter. And when you think about this, this is really an interesting thing.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
But I did a specialized T-cell Eli spot test on him, and his Lyme Eli spot test lit up like a Christmas tree. Wow. Right. So he had Lyme disease. He had Lyme disease, which was actually... triggering a lot of his mast cell activation type symptoms. So I've been working with him for a while and he did very well.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
I put him on a supplement, which is a combination of quercetin, which can help with- It's like a natural antihistamine. Natural antihistamine. Turns out it's really good for COVID too. Yeah, exactly. Very powerful phytochemical. And he did very well by adding nettles along with quercetin in supplement form.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
He also worked with nutritionists, got on a low histamine diet, dramatically made a huge, huge improvement. His brain was working better. And his energy was better, but he still wasn't 100% better. So that's where I went to the next level. And he's currently actually being treated for Lyme. And it's in the medical literature.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And I sort of stumbled upon this because I had this patient come into me. And she had the same thing. She had severe mast cell activation. She was on Zolair. She was on injections for- It was like 20 grand a year. Yeah. Yeah, 20 grand a year.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Exactly. And her condition actually turned out to be the same thing. It was actually undiagnosed Lyme disease. And this is, I think, one of those things where you have to think about it. Not that Lyme disease causes everything, but Lyme disease is such a tricky condition that you've got to be thinking about it. It's a great masquerader. It's like syphilis, exactly. It's like the great masquerader.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And as I was preparing for this, I sort of stumbled upon some things, which I thought was really quite fascinating, is that when you take antihistamine, what happens to you? You get drowsy. Exactly. So histamine, when it's at high enough levels, it stimulates the brain. Histamine is actually involved in the sleep-wake cycle.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And people can come in. I've seen people with Parkinson's symptoms. I've seen people with brain fog. I've seen people with rheumatoid, you know, seronegative rheumatoid arthritis.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Exactly. Exactly. I had one patient with fibromyalgia who was, you know, quote, unquote, fibromyalgia, whatever that means. I mean, it just means you're hurt all over. So Lyme can actually mimic fibromyalgia. So you really gotta think about it, and it doesn't present as one neat little boxed diagnosis. You gotta really think about it.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Right. So it's a balance. Like, you know, too much histamine is bad. Too little histamine is also bad. So when you actually totally block histamine, you actually get sleepy. It'll actually be involved with the sleep-wake cycle. And modafinil, which is the drug that people take, that actually works on histamine. It's Pro-vigil. Pro-vigil, exactly. Actually, part of that works on the histamine.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
So it keeps the histamine levels higher, so it keeps your brain sort of awake, if you will.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And that's actually a poor man's way. I oftentimes will use that with patients to determine how much histamine they're having in the connective tissue, because the mast cells are the type of white blood cells that are in the connective tissue of the body. And when they have excess amounts of histamine in them, or they release histamine too easily,
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
you will get this thing called dermatographism where you can take your finger and stroke on the skin and you will form a red line and it'll stay there. And sometimes it'll get really welty and raised. And that will tell you that there is a problem with excess amounts of histamine in the body.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yeah. And there's a term out now, which when I was in medical school, we didn't even have it. It's now called MCAS, Mass Cell Activation Syndrome. Like it's a real medical diagnosis. It's a real medical diagnosis. I mean, we're seeing a lot of it now. And the question is, is why are we seeing so much mast cell activation? Hmm. It's a it's a really it's a and I've been puzzling on this myself.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yeah, I never took that class in med school. I know. Right. Exactly.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
We're seeing a lot of it. And it's not like there's one cause for mast cell activation. There are multiple causes. And I actually even, when I deep dived into the literature, one of the things that I stumbled upon was the effects of EMF on mast cells. EMF EMF is electromagnetic frequency. So like your cell phone background cell towers, Wi-Fi. Absolutely. Absolutely.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And there's some there's some work by a woman, Johansson, out of I think it's Sweden, who's done some work on the effects of EMFs on mast cell degranulation. And there's some good studies showing that EMFs are one of the things insusceptible individuals that cause their mast cells to release more histamine that drives this allergic inflammatory response.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Well, they oftentimes, uh, will react to every food. They're sort of the people who they can't, they, they, they have a more and more restricted diet because the more foods that they eat, it'll trigger because lots of foods contain histamine, uh, or we'll get broken down. Uh, histidine is an amino acid and that, uh, um,
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
When you consume foods that are high in histidine, things like meats have a lot of histidine, your body will actually break it down into histamine. And normally the body can process that, but when you have problems with either too much ingestion or too much production of histamine or not enough breakdown of the histamine, then you'll have problems with histamine intolerance.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And these are typically a lot of people who have food allergies. And Mark, I think you've done this yourself. This is really interesting, is the old way of treating food allergies was what? Chromalin sodium. Remember using that? It's actually a pretty good treatment for people who are really, really reactive to foods.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And the way that chromalin sodium, because chromalin is actually used for patients with asthma. Yeah, you inhale, it's an inhaler. It's an inhaler, exactly. It's a very effective drug for really bad cases. Chromalynsodium can be very, very helpful for patients who have severe histamine responses to foods.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
body and their tissue because it's puffy swollen you can get edema in the legs you can see just people carrying a lot of extra weight and fluid yep there's often some type of histamine activation there well sure because well the mast cells which are the one the cells that contain histamine they're actually found in the spaces the interstitial spaces uh in the connective tissue of the body so that's why they get puffy because that those are where those cells that are high in histamine reside
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yeah. Well, again, we talked on the last podcast about the role of leaky gut in the microbiome. Interestingly, when you have dysbiosis, some of the bacteria will actually cause more of your body to produce excess amounts of histamine.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
So that's another thing where when the histamine is in excess in the digestive tract, that can be related to food consumption, which are high foods in the histamine, or the bacteria are actually causing the breakdown of histidine as an amino acid to go into histamine. So dysbiosis is one of the things that can trigger excess amounts of histamine.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Well, you can measure histamine in the blood. You can also measure tryptase, which is another marker for mast cell activation. You can also measure, there's another test, which in my preparation for this, I've not measured, I haven't found the lab that does it, but it can be measured as N-methyl histamine, which is a breakdown product of histamine. That is another one that can be done.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And then, again, I think one of the tests for me is dermatographism. I find that a very helpful clinical test to determine if a person's mast cells in interstitial spaces are overly reactive and releasing lots of histamine.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
This is where these really good foods in someone who has histamine intolerance is like putting gasoline on a fire. And they're like, well, I'm getting worse. It's like, well, no, you should be getting worse. These are good foods for you. No, you have histamine problem.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yes. So DAO is a diamine oxidase. So this is an enzyme that our body has and it helps to break down histamine. So histamine has to be, you know, consumed, it's used, and then it has to be detoxified. And if this enzyme is lacking in a person for whatever reasons, the enzyme may be turned off. you will have problems with detoxifying histamine, especially in the gut.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And there are enzyme products that you can use, DAO enzymes that you can use, that patients respond very, very well to this.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Absolutely, yeah.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yeah, exactly, yeah. And then, you know, you can use antihistamines. And the other thing, we had another podcast earlier on migraines. And this is, I found this also very interesting, is one of the things that is a histamine blocker is butterbur. And Butterbur is used in migraines. And the reason why Butterbur works in migraines is it actually is working on an antihistamine level.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Because you can get an allergic brain, if you will. We know about that where you get fuzzy in the head and you can get headaches and things like that. So excess amounts of histamine has an impact on the brain. Yeah.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Yeah, so basically the way to think about it is bacteria produce histamine. So if you have food that's old, if you have food that's sitting in the refrigerator for a couple of days, guess what happens? The bacteria actually break down histidine, the amino acid, into histamines.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Leftovers, exactly. Leftovers, exactly.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
And then fermented foods. Fermented foods are fermented by bacteria. So anytime we have food that's old or fermented, things like Parmesan cheese, aged meats, et cetera, cured meats, et cetera, they have high histamine and that's part of the fermentation process.
The Dr. Hyman Show
Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance
Exactly. And this is where these really good foods in someone who has histamine intolerance is like putting gasoline on a fire. And they'll say, well, I'm getting worse. It's like, well, no, you should be getting worse. These are good foods for you. No, you have histamine problems.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Well, I think the first thing that as functional medicine docs we recognize is that we're not asking that question why, right? So we're not looking for that underlying root cause, which so often helps us when we're treating our patient because it helps us figure out for them, for that individual person, what do we need to do to help their thyroid work better.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
So is it because of a nutritional deficiency? We know that we need iodine and selenium and iron and all sorts of good amino acids.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Yes, yes. And so if people aren't eating enough of certain foods, we might see nutritional deficiencies, or maybe if their digestive system is a mess, they're not absorbing their nutrients well. So we have to ask that question, why? Because sometimes that will just help the thyroid work better when we help support it nutritionally.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Or maybe it's an autoimmune condition, like you mentioned, Hashimoto's. And then it gets us thinking of a lot of different things, right? It gets us thinking about, well, why does this person have autoimmunity?
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Well, you know, the body, when in an autoimmune condition, the body starts to fight itself off, right? So it starts to, it looks at the thyroid gland and says, okay, I'm gonna fight you off. I'm gonna attack you. And when it attacks the thyroid gland, the thyroid gland doesn't work as well.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
and so then you get low well in many cases you get a low thyroid so what causes the autoimmune disease is the big question we always ask in functional medicine why right and and everybody's different right for one person it may be gluten we know gluten uh is associated with a lot of hashimoto's thyroiditis not all but some but my experience like you look at thyroid antibodies and you compare it with the gluten antibodies in that patient and it's about my thing is about 30 of the time
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Yeah, I think it could be. It could be. It might even be a little higher. It depends because of the patients we're seeing. So we might be seeing more patients who have a lot of different digestive issues going on. And so I might see it even a little more frequently.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
But we always think about the digestive system, right? You've got autoimmunity, you've got to think about what's going on in the digestive system. But then you think about, could there be an overgrowth of bacteria? Certain bacteria in either the digestive system or other parts of the body have been shown to trigger autoimmunity in some people.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
We know that imbalances in iodine, actually excessive amounts of iodine.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Yeah. Hashimoto's, because it was found first in Japan, where they have lots of iodine. We know iodine's important for the thyroid. But too little is not good, but too much is also not good. So we pay attention to that. And toxins, of course, right? Toxins can be triggers for autoimmune disease in some people.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Yeah, fluoride. Fluoride. Yeah.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Absolutely, right? They say, okay, you know, we're just going to look at the TSH. And if it's in the normal range... you're fine, or we're gonna give you medication to get it in the normal range, but not really look a lot deeper.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Talking about goitrogens.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
you're having raw brussel sprouts or raw you know eating it in a level that's beyond just like a normal food portion yeah right but but as you mentioned if you cook it if you cook it you get rid of a lot of that goitrogenic potential that the part that's going to damn or interfere with thyroid function yeah so you don't have to be concerned when you have cooked cruciferous vegetables but it's that like you said should i worry about having a kale juice every day
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Ah, it's a good question. Depends how much kale you put in it, right?
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
A little bit of kale is fine.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
And it depends on the person, of course, right?
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
So, you know, that's a good question too. You know, I think that if... Because a lot of people are like, soy is really bad.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
I think if we're going with non-GMO organic soy as a whole food, like edamame and tofu, then I'm not concerned. Tempeh, right. Yeah, tempeh. I'm not concerned.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
The fermented soy, too, right? Yep.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Or like the texturized soy protein that they put in cereals and bars just to get that protein content up. We, you know, we don't.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
That's stuff I, yeah, I tell people to stay away from.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Right, so they typically test your TSH.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Your TSH is your thyroid stimulating hormone. And there's a feedback loop in the body. So if your thyroid level is low, then the body will get triggered to make more TSH.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Yeah, and then that TSH will say, okay, make more thyroid. So if the TSH is high, then the doctor says, okay, your thyroid is underactive and we need to treat it. So that's typical. That's the only thing they test. Often, often.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
So what kind of things would you look at? We always start with a full thyroid panel where you look at TSH, but you look at free T3 and free T4. So free T4 is one thyroid hormone that's floating around in your body, but then the T3 is the active form that your body needs for all the thyroid functions to occur. So we look at all three of those at least.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Then we often look at thyroid antibodies, and sometimes we'll even do things like reverse T3 and the reverse T3, total T3 ratio.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
So the reverse T3 is a thyroid hormone that the body, when the body is, I always think of it almost as the brake that the body puts on itself. So when the body is saying, okay, I've got to slow myself down, it takes some of its T3, which is your active thyroid hormone, and it converts it to reverse T3, almost in a way to slow down our metabolism. It's a protective mechanism I think of, right?
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
And it makes sense that we have that in times of stress.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
That's very true. So if there was a major stress going on, you'd want to have that mechanism in place so you didn't starve to death. But with a lot of chronic stress, which we see a lot these days, we can sometimes see high reverse T3. And the other thing we see a lot that causes that high reverse T3 is sometimes toxins.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
So it can be a sign that we've got to look deeper and say, okay, is this person under a lot of chronic stress? How is their adrenal gland functioning? How are they, are they working to activate that parasympathetic nervous system, that calming nervous system, which helps the body heal. And then we look for toxins.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
I'm not sure why they don't look at them enough. But the antibodies are giving us a signal that the body is attacking its own thyroid. And it's a sign that there's autoimmune disease going on in the body. And we've got to figure out that question. Why is that? Why is that going on? So I had a woman who came in to see me.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
And she was 40, and she had been struggling with all those symptoms we talked about with low thyroid. She was cold all the time, her hands were cold, she was gaining weight, she was tired, she was constipated, she was losing hair, her eyebrows were thinning.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
I know, right? So I'm like, okay. But then her primary doctor did her TSH, and it was normal. So we then went deeper.
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
Right, and many, many studies are saying people between one and two feel the best, right?
The Dr. Hyman Show
Is Your Thyroid the Hidden Root Cause of Your Health Issues?
And I think that's really important. And the physician sometimes thinks, well, I'll just wait until these antibodies damage the thyroid enough, and then I'll treat. That's the way they, you know. I'm gonna wait until, but we say, okay, no, there's so much we can do. There's so much we can do right away.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
When I see a woman, so often we're dealing with hormone imbalances. They're so prevalent. Everything from, as you mentioned, PMS to issues with menopause and perimenopause to issues with estrogen dominance, right? Or over levels of estrogen, high levels of estrogen in the body, which can lead to breast tenderness or more PMS or cancers like uterine cancer and breast cancer.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So we're really thinking about hormones and hormone balance when anybody comes into the office. So, I mean, that's something, I think that that's an area- And it's so common, right?
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Absolutely. So then we need to ask that question, why? Why are the hormones out of balance? and we look at everything from how is the body metabolizing the hormones, how is the microbiome and how is that influencing it, how is the person dealing with stress and is that influencing their hormone balance.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So you wanna look at the whole body when you're trying to figure out what may be out of balance with somebody's hormones. Oh, that's, it's getting so common, right?
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So often they'll say, okay, I'm going to put you on birth control pills. Oh, yeah. Right? Right? Like with PMS or regular cycles or perimenopause, that is the common response, you know, is let's just start some birth control pills. Is that safe? And that's going to even everything out.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
I don't know. I mean, it's a good question, right? I mean, there are side effects to birth control pills. You know, we see stroke and blood clots with some women with birth control pills.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Absolutely. There's some women where we know that the longer you've been on birth control pills, or if you're on them more than 10 years, or if your risk for breast cancer goes up. So there is an association with long-term use of birth control pills.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Just breast cancer. Yeah.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Yeah. For women, when they're on the birth control pill or if they've been on it a long time, they have a slightly higher risk. And, you know, so that's something we got to pay attention to. Not everybody handles the hormones in the birth control pills the same.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right, migraines too, absolutely. So you want to ask, well, why is there that imbalance in the hormones and what may be out of balance for that woman? I think perimenopause is such an interesting time where we get a lot of women who come in to the office at that time because they're just feeling so crummy.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Perimenopause is the timeframe between when your cycles are normal and you can easily get pregnant and menopause. So perimenopause are those years, you know, it can be like 10, 13 years of perimenopause, and it can occur anytime. You can go into menopause anytime between 45 and 55. That's typical.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
And that perimenopause can be 10, 6 to 10 to 13 years beforehand before you actually go into menopause is considered perimenopause. And it just means, yeah, I mean, there's just, the hormones are not as regular and consistent, right? So what happens a lot in perimenopause is during those years, women will have what are called anovulatory cycles. So
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So they don't ovulate every time they have a monthly cycle. Right. And so those anovulatory cycles, meaning no ovulation that month, results in less progesterone being produced in the body.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right. You think of it as, you know, when you're having regular cycles with ovulation, you have estrogen and progesterone and they sort of balance each other out. And then when you're in those perimenopausal years, you're going to have so many women will have cycles where they don't have that cycle. progesterone spike.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So it feels like their body feels like it's higher in estrogen because they don't have that progesterone to balance it off. And so you feel like you have high estrogen. And like you mentioned, you get more breast tenderness or more clotting or heavier bleeding. And the low progesterone makes us often feel crummy. So you can be more irritable. You can just, you know, cranky.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Harder time sleeping because progesterone really is a calming hormone. It helps us, helps women, helps people sleep better. So when it's low, many times you don't sleep as well. You'll have irregular sleep patterns where you've never had that before. Yeah. And, and, and you just feel more irritable and cranky and, and, and it's no fun.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Absolutely. And I'm so glad.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Yeah, yeah. And I'm so glad you brought that up because all of our hormones are interrelated. They're all playing off each other. They're all influencing each other. And so that's important to really understand because that's how we can really help women feel better.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
so when you really focus on the adrenal glands for example so you have you have two adrenal glands typically they sit up on top of your kidneys and those glands produce cortisol and they produce dhea and they a bunch of other things yeah so cortisol is one of your stress hormones so when you're under a lot of stress if you're under chronic stress for example i mean you know your body is going to be producing a lot of cortisol all the time
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
And so what can happen, what can happen is then the body is spending all this time making cortisol to handle that chronic stress you're under. You're dealing with your kids and then your parents, as you talked about. You know, you're working all the time, your job. You're not giving your body enough time to rest. You're not getting enough sleep. You might not be eating right.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
You know, you might be just running from one thing to the other. It may not be taking the time to do your meditation or your exercise, right? You're just not doing that self-care, which is so important for your adrenal glands. And when that's happening, then your body's spending all this time producing cortisol that it can't do as good a job at producing progesterone.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right. And so then you have more of those signs of low progesterone, which we talked about before, which is irregular sleep, irritability, you know, more crankiness, more PMS, right? So it's really important that we step back and say, okay, how can we support your adrenal glands? And that's really a lot of self-care, you know, by saying, okay, I need to give myself time to rest.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
I need to give myself enough time to sleep. Meditate maybe. Exactly. I got to get my meditation in, right? And I think that makes a big difference. It can really help with balancing the hormones. We know, right, that even simple meditation, 15 minutes twice a day can cut back on, can significantly cut in half the amount of hot flashes a woman has during those perimenopause.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
We haven't even talked about hot flashes yet, right?
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right, right. We were talking about how when you get more insulin resistance, you gain more weight around the belly, right? And we know that when we gain more weight around the belly, that we have more of that aromatase enzyme, which makes more estrogen and again, throws us out of balance.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Yeah, alcohol really is a concern because the way alcohol, and there's multiple ways that alcohol can impact risk of breast cancer, for example, but it also seems to result in a higher level of free estrogen in the body. And so we know it disrupts sleep.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Yeah, you know, unfortunately, there's a linear relationship between alcohol and breast cancer risk. So for every drink a woman drinks per day, like every time she increases the amount that she drinks per day, her risk of breast cancer goes up even further.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So, you know, what's considered moderation for women is five or less drinks a week, with a drink being, you know, five ounces of wine or, you know, an ounce of... One ounce of hard liquor, yeah. It's not very much.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
And that's for a whole week. But what's interesting is you're right. There has been even studies showing that even one drink a day is linked with an increased risk of breast cancer. And it may be because it is impairing, well, partly because it's impairing our liver and our ability to detoxify. And it's shifting estrogen levels. And it also depletes the body of B vitamins.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
So there's so many impacts that alcohol has there.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right, absolutely. That's something we're always measuring, right? We're looking at how the body is metabolizing hormones, and we're looking at the microbiome. And I think that that's important when we're dealing with a woman in perimenopause. Sometimes they just don't even understand, why am I feeling this way? Why am I all of a sudden more irritable? Why am I having a harder time with my periods?
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
You know, why are they heavier? Why can't I sleep? Why am I getting hot flashes now? Right. And so sometimes just educating them is a great first place to start. And a lot of times women just feel better when they start to understand, OK, this is this is going to you know, my hormones are shifting. And then what can I do to support them? Yeah. And we were talking about how great meditation is.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right. Because it's oh, yeah.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
we should probably talk about soy a little bit because honestly, this is probably the most common question I get because people are so confused about soy and like, oh my goodness, should we eat soy or not eat soy? Um, so, so soy, right? Soy foods.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
are in they have these things called phytoestrogens in them and this is what got everybody nervous right so they have these they have these these components these phytonutrients these components in them that can actually impact the estrogen receptor and so For a bunch of years ago, oncologists used to say, oh no, it can impact the estrogen receptor. I don't want you to eat soy.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
But what we know, actually, is that they bind to the estrogen receptor, preventing your own estrogen from binding to the estrogen receptor. And as a result, you have a lower estrogen-like impact in the body. And so multiple studies have shown that soy is actually associated with a lower rate of breast cancer.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Yeah, like balancing your blood sugar, balancing your blood sugar by making sure that every meal has a good source of healthy fat, has a good source of fiber, and has a good source of protein, right? So that prevents the spikes in blood sugar and the spikes in insulin, right? So you make sure your meals are balanced like that, then you won't get those ups and downs in your energy.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
And so you just feel better. And that helps with preventing that high insulin.
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
Right, right, right. So then that helps with the balance of all the hormones, as you were mentioning earlier. And so when a woman is going through perimenopause, you know, the first place we look at is, okay, what are these personalized lifestyle factors? What can we really focus on with them?
The Dr. Hyman Show
Reclaim Your Hormones: How to Treat PMS and PCOS Naturally
I mean, there might be times where we at the Ultra Wellness Center may use some hormones to help with their... Regesterone. Yeah, to help with their sleep if necessary. But many times just a woman understanding what's going on and then making some shifts in their lifestyle can make a huge impact and make them feel better.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So we want to really help focus the treatment plan on that individual patient. And I think that's what's so special about functional medicine is it's really looking for that underlying root cause for that underlying patient so that they can reach their optimal health. And we know that problems with the liver and fatty liver impact our immune system and how well we fight off infections.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
It impacts how we can digest food, metabolize food. It impacts our nutritional state in our body. So there's so many reasons why we really want to
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Fatty liver is when the liver cells, the cells in your liver are replaced with fat cells. So fatty liver just means that some of the cells in your liver have been replaced with fat cells. And so there's fat deposited within your liver. Why do we care? Because then that means your liver can't work as well because it doesn't have all those liver cells doing the job that the liver does, right?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Look deeper here.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So the liver really helps our body detoxify, metabolize chemicals from the environment, metabolize our own hormones, metabolize and get rid of toxins. And so we definitely don't want to have an under-functioning liver, that's for sure. And this is the prevalence of fatty liver disease.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
is is is it is it is really really high and unfortunately it's increasing um but about 90 million people in the u.s have fatty liver disease and so that's uh it's and it's increasing in this country it's increasing worldwide the amount of fatty liver we are seeing so um
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Yeah. So. I had a 50 year old gentleman who came in to see me and he was told by his primary doctor that his liver function tests, his ALT and AST were mildly elevated. And so he came in because he was frustrated with his weight. He wanted to lose some weight. He was about 25 pounds overweight.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We're seeing this huge rise in fatty liver, not only because of alcohol, but because of how high blood sugar, high levels of insulin, toxins like glyphosate and all the other toxins you mentioned, medications that people are taking, all are putting stress on our liver.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And he just mentioned to me that his doctor had said his liver function tests were a little elevated and that they were gonna be rechecking them in a few months.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so, you know, we really got a good detailed history from him and we got a sense of what he was what his diet was like and and and, you know, what his what his alcohol consumption was like, because, you know, that's one of the first things, of course, we think about with, you know, fatty liver or.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
or these elevated liver function tests were like, okay, how much alcohol is this person consuming? And what was interesting to me about him was he was pretty moderate in his alcohol consumption. He was having about two glasses of wine a night. And so not for a man, that kind of almost falls within what's considered moderation. So I was, um, you know, he was not a binge drinker.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
He was not overusing alcohol from the, from the criteria we were talking about earlier, but I think the amount of alcohol he was consuming in, in connection with his diet and probably his genetics and many other things like his microbiome that we've spoken about, you know, that altogether was really impacting these liver functions for him. And so, um,
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We noticed with his diet, it was not rich enough in vegetables, that's for sure. And really, that was probably the biggest thing I would say with his diet. It was just devoid of a lot of vegetables. And you were talking about some of the things, supplements we use for... helping the liver. You know, one of the things we think a lot about is sulforaphane, right?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Which comes from your cruciferous vegetables that helps and encourages the production of glutathione in the body. And so one of the things we really worked on with him is making sure he got some cruciferous vegetables every day, broccoli, cauliflower, cabbage, kale, Brussels sprouts, you know, really to help support, uh, the, uh, liver and help it heal. Essentially.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We also had him take a break from alcohol. You know, we said, you know, let's just pull away alcohol for a period of time, really help that liver heal. calm down and let it give us some time to heal. And as I was mentioning earlier, we really can see the liver function tests go down pretty quickly for some patients.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We can see if somebody did have fatty liver, you can watch it improve within a few weeks of cleaning up the diet and, and decreasing alcohol intake. So it's, it's, it can be, especially if it's not too far progressed, we can see changes pretty darn quickly. And so with him, we really focused on cruciferous vegetables, lots of the sulfurous vegetables like onions and garlic.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We gave him turmeric, we gave him dandelion root to help his liver and gallbladder work better, lots of green leafy vegetables. we made sure he was eating enough protein. We know that protein is really important for the detoxification process in the body. We need to be eating enough protein to do that.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so we made sure he was getting enough and foods that were rich in fiber to bind toxins, things like the beans and legumes and nuts and seeds, ground flaxseed. And I did, I gave him some N-acetylcysteine, some NAC. I gave him some liposomal glutathione and milk thistle. We put him on a really good multi that had methylated B vitamins in it.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
I gave him a little bit of an extra methylated B vitamin and really focused on those nutrient dense foods so that he wasn't wasting his calories because he was 25 pounds overweight and we needed to cut back on that weight. So we really needed to pull away those foods that were not nutrient dense.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So things that are just people are eating way too much of that are getting into our diet that are not giving us all of the nutrients the body needs to work properly.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Yeah, I mean, within four months on the plan, his liver functions came down to totally normal. He lost 10 of those pounds, and then within a few more months, he lost another 10 pounds. And his fasting insulin came down to normal. His liver function tests, his – his markers of inflammation in the body improved. And then eventually, I've been seeing him for a while.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So at this point, he does have one or two glasses of wine a few days a week. He does drink some alcohol at this point. He never, as I said, he never had a problem with alcohol abuse or alcohol overuse disorder. It just was, he was drinking too much for his body. And so at this point in time, he's having a little bit of alcohol and doing okay with that.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And it's not causing a bump in those liver function tests or some problem with his weight or insulin resistance anymore. So he did really well.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Right. I mean, they can happen quickly. Fatty liver can develop quickly. They know that within two weeks of heavy drinking, having one and a half to two ounces of hard alcohol every day for two weeks, you can start to see signs of fatty liver, which is, you know, It can develop very quickly. What's great to also understand within a lot of this research is that it can resolve quickly.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So when somebody has fatty liver because of alcohol and you take them off of alcohol, that you can see resolution of fatty liver within four to six weeks. So that is interesting. It can progress, unfortunately, quickly if we're not taking care of ourselves. And then it also regresses when we start to make some shifts.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And as you were mentioning, we're seeing this huge rise in fatty liver, not only because of alcohol, but because of how high blood sugar, high levels of insulin, toxins like glyphosate and all the other toxins you mentioned. medications that people are taking all are putting stress on our liver and making it so then our liver can't do what it needs to do to detoxify.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So it becomes this vicious cycle of we're inundated with toxins that are impacting our liver, but then the liver can't work as well. And so then we can't get rid of the toxins that we're inundated with. So it becomes a vicious cycle of having issues with our detoxification system in our body.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And as we've spoken about before, the liver is such a critical organ within the body's natural ability to detoxify and handle all the toxins we're exposed to. Maybe we weren't put together to handle all of these toxins, unfortunately, that we're exposed to, but we do have this ability to handle toxins and we wanna take care of our body so we can handle the toxins that we are exposed to.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so it's really important that we take care of our liver. And so what's considered normal for alcohol intake? For men, it's less than 10 drinks And for women, it's less than five drinks a week. And so we know that problems with the liver can occur when we're drinking too much.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So we see problems when people are binge drinking or consuming more than 14 drinks a week for men or more than seven drinks a week for women. So I think it's important we also talk to our patients about what is moderation with alcohol? How do we take care of our liver, both from all aspects of nutrition and lifestyle?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
You know, one of the first ways we find out is with general blood work. So if you do a metabolic panel, comprehensive metabolic, a panel on a patient, and we look at these markers like the AST and the ALT, and if they're elevated, either high end of normal or elevated above the normal range, you know, that's something we really have to be thinking about is, is this fatty liver?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Should we go on and do an ultrasound? of the liver to see if we are seeing some fat deposition in the liver. And so that's one of the ways we start to see it most frequently with our patients.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
I mean, one of the first things we do, right, is of course we get a good detailed history from our patients. and try to get a sense of what's going on for them. Get an understanding of their timeline of their health. And that can help us find out what may be driving health problems in that person.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So if there is some concerns about fatty liver, you wanna get a sense of what their toxic load has been in their lifetime. What is their weight? What is their nutrition? What are they eating? And what is their microbiome like? And so we can really evaluate all of that. and get a sense of how best to help this patient, that individual patient improve.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Because we know that for some people, it may be more focusing on toxic load. For somebody else, it may be focusing more on alcohol intake. For somebody else, it may be more they're eating way too many carbohydrates, refined sugars, soda, you know, coffee drinks, muffins, and not exercising enough, and that whole metabolic syndrome process.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
We're removing unhealthy foods or inflammatory foods for that person.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Food allergies, food sensitivities, yeah.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Oh, yeah, that's for sure. And sugars and, you know, excess sugar, which is feeding the wrong bacteria. And then we're removing... the unhealthy bugs or yeasts or viruses.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Because now you're actually absorbing the nutrients you're eating, which just helps the body heal.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Replace means just to replace some of those digestive enzymes if needed. Re-inoculate.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Yeah, and to help get them off of the acid blockers, which we know are creating a lot of problems because we need that acid in our stomach to digest our food.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Right, because you need the acid in your stomach. And when you block that acid, then there can be an overgrowth of bacteria where there's not supposed to be, and that can cause all those slew of problems.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And then you're not absorbing your minerals, so you can get osteoporosis, and you're not absorbing your B12, so you can get fatigue and dementia, right? It just goes on and on and on.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
It goes on and on, right? And it takes some work sometimes. When people have been on an acid blocker for a long time, it takes some work for us to help wean them off because their body has gotten pretty used to it. Their body wants to make acid, so it's working against the medicine. So when you wean them down, sometimes they get more acid production.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
We do it all the time. So re-inoculate, giving all the good prebiotics and probiotics, the good bacteria and all the things that feed the good bacteria. And then the fourth R is repair.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Oh, that's a great question. I wanna know, what do you prescribe? Oh my goodness, that's such a, that goes on and on. We could talk about that for the next hour. Yes, it's true. Right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
I mean, there's some great brands that I trust and I use all the time. But when somebody doesn't maybe know what to do, I'll say, go to a reputable place, a reputable pharmacy or a good wellness store pharmacy, and get a probiotic. Try it. If it makes you feel worse, then stop it. Because there's some good bacteria that make people feel worse. Well, they have bacterial overgrowth. Exactly.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And they cause lots of bloating. And so that means we just have to do more work before we can start it. Yeah. So... So you got the re-inoculate and then you got the... And then repair. And that's the fourth R. So that's things like giving good protein, good amino acids, which are the building blocks of protein. To repair. Yeah, to help repair that barrier, that coffee filter.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
We have to repair it with good protein. And sometimes we use amino acids like glutamine that help repair it. We'll give more zinc, whether it's from food sources or as a supplement. Maybe we'll give some vitamin A, which also helps with healing that barrier. It helps with healing the endothelium in the gut. So those are things we will do to repair. And then rebalance, right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
That's the fifth R, which is really focused on managing our stress and how we're reacting to the world. Because we know that when our parasympathetic nervous system is engaged, when that calming nervous system is engaged through meditation and yoga and breath work, that our body has the ability to heal. And it heals better when our body is at rest.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Yeah. Because it's impacting your immune system too, right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
So it was a 24-year-old gentleman who came in to see me and was really struggling over the last year with his digestive system. He was having a lot of bloating and gas, pain in his stomach every time he ate. He was having diarrhea and sometimes he was getting constipated and He went to his traditional GI doctor, and they told him you have irritable bowel, but he wasn't getting any better, right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And he was just really, because he was having so much stomach pain, he had lost some weight. So he wasn't, you know, he was on the thin side to begin with, but because he was having stomach pain when he ate, he wasn't able to eat as much, and he was even losing more weight. He was feeling really weak and tired, right? and sad, depressed, right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
When you have the wrong bacteria and the wrong yeast levels, you can get a lot of bloating after you eat, you can get a lot of fatigue after you eat, you can get those symptoms of constipation and diarrhea, and that causes this inflammation in the digestive system, so all of your digestive enzymes don't work well.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And so for him, well, for everyone, the timeline is so important, right? That's what we learn in functional medicine is the gathering that information, learning about that individual patient's story, seeing their timeline.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
So, you know, because, because for this gentleman, for example, you know, he really didn't have stomach pain before a year ago, but what we found out is that when he was a kid, he had ear infections. So, and he had asthma. Probably because he was eating dairy. Probably, right? So it's such a common connection. Oh my God.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And the kid was fine. That's such a common connection. I mean, even my son, when he started dairy, he got asthma and eczema. It's unfortunately such a common connection. So for this child, he had a lot of ear infections and eczema. And so he was on antibiotics about once or twice a year in his childhood. And he really didn't think that was very much.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
He's like, that's not, you know, that wasn't too much. But, you know, it makes a huge impact on the microbiome as we're learning. And then he started to have acne as a teenager, maybe because of dairy more, right? Or some of the imbalances in the microbiome, right?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And so this history of antibiotics sort of set him up. And about a year ago, he had some sort of stomach bug. So some probably viral stomach infection. And then since that time, he started to have all these digestive issues and was losing weight.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Right. So with him, as we do with most of our patients, we do food first, right? So we said, okay, we've got to really focus on this person's diet and help him start feeling better right away so he can start to eat more and regain some of his strength. So we pulled away inflammatory foods. We took them off of gluten and dairy while we were waiting for tests to come back.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Sometimes we will do some tests that look at, of course, we'll test for celiac disease.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Yep, that's for sure.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
And he didn't have that.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Absolutely. And even if people are negative totally for celiac, if they have increased intestinal permeability, they start reacting to a lot of different foods. So then you start to see with that leaky gut, as we talked about before, the coffee filter and things are coming through, then the body's reacting to lots of foods that it maybe never reacted to before.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Sensitivities. And because of, and the real thing is it's because of this increased intestinal permeability. So our job is we have to heal that increased intestinal permeability so that they don't have to be so restrictive with their foods. I mean, we still always want them to be on a healthy diet, but we want to relax those restrictions over time. Most of the time we can.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Right. So we did a stool test that looked at his microbiome. And what we noticed is that there was an overgrowth of unhealthy bacteria and unhealthy yeast. So he had this, you know, probably because of years of antibiotics, he developed this dysbiosis, this imbalance in the bacteria and yeast. And so there was an overgrowth of the unhealthy things.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Yeah, right. It's not always like one of those, you think of a stomach infection and you're getting really, really sick, you're throwing up or having diarrhea. This is this, it's an imbalance. and it's called dysbiosis, but that imbalance causes a lot of symptoms in people.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
When you have the wrong bacteria and the wrong yeast levels, you can get a lot of bloating after you eat, you can get a lot of fatigue after you eat, you can get those symptoms of constipation and diarrhea, and that causes this inflammation in the digestive system, so all of your digestive enzymes don't work well.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
So you're not breaking down your food well, you're not absorbing your nutrients well, and it becomes this vicious cycle that people are dealing with and we see all the time.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
You can test to see if there's leaky gut. I love that test too because it's a great way for us to follow up and see how much we're seeing improvement. Are we doing enough? Are we seeing improvement in their leaky gut or increased intestinal permeability?
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Right, right. So for him, we removed the inflammatory foods and we removed the bacteria and yeast. I actually treated him with an antibiotic, a non-absorbed antibiotic and an antifungal. So I treated him with prescription medication. Yeah, weed killer. So that was the remove, right? And then the replace.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Because he was underweight and because of that inflammation in his digestive system, I gave him some digestive enzymes for a short period of time just to help him, to help it so the food wasn't as inflammatory for him and to help him absorb more nutrients. And then we worked on re-inoculating, right? So after we gave him some good probiotics.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Put in the healthy bacteria. Some good prebiotics, right? So we know that there's... What are prebiotics? Prebiotics are the things that help feed the good bacteria. So they're the food for the probiotics.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
like fibers. Fibers are amazing prebiotics. We know a lot of phytonutrients are prebiotics. So this, I think, is really exciting research when we're looking at our phytonutrients. What are phytonutrients? I know, it's amazing, right? So our food has minerals in it, it has vitamins, but it also has these things called phytonutrients, which are these components in our plant foods.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
that have these amazing health benefits for us. So that can include things like ellagic acid that we see in pomegranate that can feed some of the good bacteria, that acromantia that we know can lower inflammation. We know that...
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
We can feed it. We can feed it with all these amazing phytonutrients like what's in pomegranate, the ellagic acid. And also we know that sulforaphane from our cruciferous vegetables feeds the good bacteria.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
Right. Brussels sprouts, all those good ones. We know that green tea, you know, that has good phytonutrients in it that's good for the digestive system. So we always say to people, you know, get something from every color of the rainbow every day. You know, you get some plant foods from every color of the rainbow every day. Get some good red foods like the pomegranate or cranberry.
The Dr. Hyman Show
The 5R Protocol That’s Helping People Reverse Disease Naturally
um get something orange and yellow and green blue purple white tan you know those all those good healthy plant foods um that we you know like our vegetables our fruits our spices our teas our coffees really actually are impacting our microbiome which is is fascinating it's so great and you know just a great uh anecdote from a colleague of mine dr lee who was on our podcast talking about eat to beat disease his mother had stage four uterine cancer