Chronic stress isn’t just an inconvenience—it’s a silent killer affecting your health in ways you might not realize. In this episode of “The Doctor’s Farmacy,” I revisit conversations with Dr. Rangan Chatterjee and Dr. Elissa Epel to uncover the truth about stress, its surprising connections to diet, and actionable strategies to combat its effects. Whether it’s balancing your blood sugar, improving your heart rate variability, or creating restorative daily habits, these insights will empower you to take control of your health. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Full-length episodes of these interviews can be found here: Is There An Antidote To Stress? How Chronic Stress Creates Hormonal Havoc How To Reduce The Harmful Effects Of Chronic Stress Which diet really gives you the best shot at optimal health? On Wednesday December 4th, Mark Hyman, MD will answer that question during The Diet Wars, a LIVE digital experience. Joined by Dr. Gabrielle Lyon, they’ll break down the science, debunk the myths, and share their expert perspectives to help you make the best choices for your health. Find out more and get tickets now at https://www.moment.co/markhyman This episode is brought to you by Seed, ButcherBox, and Essentia. Seed is offering my community 25% off to try DS-01® for themselves. Visit Seed.com/Hyman and use code 25HYMAN for 25% off your first month of Seed's DS-01® Daily Synbiotic. ButcherBox is new users can select between ribeye, NY strip or filet mignon in every box for a year + 20 off. Visit ButcherBox.com/Farmacy and use code FARMACY. Get an EXTRA $100 off your mattress purchase, on top of Essentia’s Big Black Friday Sale! Just use code HYMAN at checkout to get 25% OFF + an EXTRA $100 OFF + 2 FREE organic pillows ($330 value). Go to Myessentia.com/DrMarkHyman
Chapter 1: What is chronic stress and why is it a silent killer?
100%.
Chapter 2: How does the gut-skin axis relate to stress?
Even if you're not mentally stressed, it makes you physically stressed. If you're a regular listener, you know that I often talk about the gut being central to your whole body health and the key to living those hundred healthy years. And this includes your skin.
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That's S-E-E-D dot com slash hymen, H-Y-M-A-N, and use the code 25hymen to redeem 25% off your first month of Seeds DS01 Daily Symbiotic. That's seed.com forward slash hymen, and use the code 25hymen. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there's simply not enough time for me to do this at this scale.
And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real-time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, hymenhive.com.
And if you're looking for curated and trusted supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite and tested products. Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to the doctor's pharmacy.
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Chapter 3: What role does diet play in stress management?
Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in.
The World Health Organization, right now, if you go on their website, will say that stress is the health epidemic of the 21st century. That's an alarming statement. The health epidemic. Wow. Yeah. I mean, that's incredible. And then... I might fight a little bit with that. I think food per food problem is a big one. Right up there. It's right up there.
Well, I think stress and food is linked, actually, because... Actually, our diet... You probably know this, but our diet, if it's bad, causes physiologic stress. So when you eat sugar and crap, it actually raises your cortisol and stress hormones. Even if you're not mentally stressed, it makes you physically stressed.
Well, a lot of these things actually, as you know, Mark, work both ways. So yeah, the poor dietary choices can send stress signals up to your brain. Good food choices can send calm signals up to your brain. This is all to do with the gut-brain axis, which you've written about before, I've written about in this book. But also I would say it works both ways.
So if you are chronically stressed, it's quite hard to make those good healthy food choices. And I, you know, let's take January in the UK and the US, every January people are trying to get healthy, right? I'm gonna reduce my sugar intake this year. I'm gonna cut out alcohol this year. But here's the problem I've seen is that people can use willpower for a week, for two weeks, maybe three weeks.
But if the sugar or the alcohol was being used to help them soothe the stresses in their life, they're never gonna maintain it long term. So I actually, I agree food is a big problem, but I found with some patients, Addressing their stress levels means they feel less of the need to binge on sugar because they're not feeling as stressed.
If you're happy, you're not going to eat that bag of Chips Ahoy cookies. Yeah, because a lot of our food choices are dictated by our emotions. And if we're feeling down, if we're feeling stressed, we feel we've got too much on, actually that sugary chocolate bar or that bag of chips actually helps us feel good in that moment. So short term benefit, but long term harm.
But, you know, the other thing.
It was interesting, last night I went out, I recorded my public television show for my new book, and it was a very intense day, and I'd been really, you know, sort of under a fair bit of pressure writing the script and getting it all done and performing it and rehearsing it. You know, it's a big production.
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Chapter 4: How can heart rate variability indicate stress levels?
Yeah, but that's actually incorrect. What we're looking for is a high degree of variability. Complexity. Yeah, complexity. And it shows that we're constantly adapting and able to adapt to this changing environment around us.
And what was interesting to him... I mean, the worst heart rhythm is got no variability. It's a flat line.
Yeah. So a low heart rate variability is actually indicative that we've got high stress levels in our body. And this chap actually on a... Wednesday evening, he would find that he was drinking a lot of alcohol. He wasn't sleeping well. He was having a lot of caffeine on Thursday, more alcohol on the Thursday. He was basically, he came in, he was really, really stressed.
It was impacting his relationships, impacting his sleep, et cetera, et cetera. The very common story. But as we start to look at his life and actually use HRV, heart rate variability readings, we could see that everything changed for him on a Wednesday. So what happened? On a Wednesday lunchtime, he had a team meeting, right? he found that incredibly stressful.
He had to present to his team, it was quite a high pressure meeting, and that stress would last throughout the day. So what would happen is on a Wednesday late afternoon when he would leave work, he had to compensate with that stress. How would he do that? Alcohol. Alcohol. So he'd open a bottle of wine. He'd have a glass. That glass, one glass would turn into two. Two would turn into three.
And by the end of the evening, he'd had the whole bottle of wine. So what happens then? He doesn't sleep well on the Wednesday nights. So Thursday morning, he's feeling groggy. He needs... Lots of coffee, lots of sugar to get him through, coffee in the afternoon as well, which again impacts his ability to sleep on Thursday nights.
He's not feeling good and that cycle continues where he's having a bottle of wine on Thursday, two bottles of wine on the Friday, and et cetera, et cetera. But what did we do? We identified his trigger point was a Wednesday lunchtime. So I could show him that on the data, he could see it very clearly.
So we discussed about certain things he might be able to do on a Wednesday evening instead of alcohol. Now, there was a yoga class very near his office. So before he went home, he went to the yoga class. So what happens then? He goes to that yoga class, that helps him de-stress. When he gets home, he no longer feels the need to drink a bottle of wine.
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Chapter 5: What are practical steps to manage chronic stress?
So he might have a glass, but it's one glass and it stops there. He sleeps well. Thursday, he feels fresh. He doesn't get as stressed at work. He doesn't have as much coffee. And before you know it, all we had to do was give him a yoga class on a Wednesday afternoon, and suddenly that changed his whole week.
And people who are listening to this, I'd really ask them to reflect on their own life and think, actually, is there a trigger point in my week where things start to go downhill? Because if you can identify that and change your behavior, it is incredible what you can achieve.
It's true. I mean, most of us understand, you know, we need to eat well. Most of us understand how to exercise and what that means. But very few of us understand how can we actually deactivate that stress response, activate what we call the relaxation response or the healing response in the body. in a deliberate methodical way, just like we exercise or eat well.
And I think those are skills we never learn that are hard for people to understand how to incorporate. And yet they're pretty easy to do and they're actually fun and you feel amazing after.
Yeah, that's the beautiful thing about this is that they're not as hard as we think. They're quite simple. Most of them, I think pretty much all of the recommendations in my book, I think are free. Like literally, you don't have to buy fancy equipment or fancy apps. Actually, a lot of this is accessible to all of us.
But just to put in context the scale of this problem, Mark, I mentioned what the World Health Organization say. But there was a paper in the Journal of the American Medical Association in 2013, I think it was an editorial piece, which suggested that between 70 and 90% of what a primary care physician like me season any given day is in some way related to stress. These are remarkable statistics.
100%.
And I think once people understand... I mean, if you're stressed, your blood sugar goes up, your blood pressure goes up, your blood vessels get stiff and hard, right? Yeah, I mean, I try to explain this. Create more inflammation.
Yeah, I find that when patients understand what the stress response is, I find they're really engaged in trying to change it. So I say to them, look, your stress response is ultimately trying to keep you safe. It's when your body thinks you're in danger, it's trying to keep you safe. So let's go back two million years ago, and then you can understand what the stress response is, how it's evolved.
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Chapter 6: How can finding purpose reduce stress?
is that sometimes we can't, as physicians, change the stressors in our patients' lives. Right, no, no, you can't change what's happening out there.
You just can't.
But we can make them more resilient to that. Yes. And regularly doing things that you love makes you more resilient to stress. At the same time, being chronically stressed makes it harder for us to experience pleasure in day-to-day things. So one of my recommendations to my patients is have a daily dose of pleasure, even if it's just for five minutes.
Can you each day give pleasure the same priorities you might give to the amount of vegetables you have on your plate? Or whether you go to the gym, this could be going for a walk, it could be reading a book, listening to a podcast. It could even be coming home from work, putting on YouTube, watching your favorite comedian for five minutes and laughing. That is very important and very valuable.
And it makes a huge difference. I mean, I, I, you know, I'm not in California doing my public television show and I, you know, I was at the hotel and I was right on the beach and I went out to the beach and I jumped in the water, swam a little bit and I came back and I literally just laid there in the sand doing absolutely nothing.
And I can't tell you how pleasurable that was to just be unplugged for a minute and stop. And most of us just keep go, go, go all day long and distract, distract, distract.
Well, there's obviously the nature piece there as well, which is very impactful for stress. But let me talk about a patient I saw recently. I think you'll find this interesting. 54-year-old chap, I think he was, certainly mid-50s. He was the CFO of a local plastics company. And, you know, he was in a good job, earning good money, married with two kids.
He came in to see me and he said, Dr. Chachi, look, I'm sort of, I'm struggling a bit. I find it hard to get out of bed sometimes in the morning. I find it hard to concentrate at work. You know, I just feel a bit indifferent to things. Is this what depression is? I started to chat to him. We did some tests. I was looking into all aspects of his lifestyle.
But ultimately one thing was quite clear to me is that he never did anything that he loved. So I asked him, you know, how's your job? He said, yeah, it's fine. You know, I don't really enjoy it, but it pays the mortgage, pays the bills, feeds the family. I said, okay, how's your relationship with your wife? Yeah, so-so, you know, I don't really see her much, but it's, you know, it's fine, I guess.
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Chapter 7: What is the importance of pleasure and joy in life?
Exactly.
But it may not be the advice that he was expecting from his doctor, but he said, yeah, okay, sure, I'll do that. Then this was in a conventional medical practice. These were 10 minute consultations. This is in the National Health Service in the UK. We don't get the chance to follow up all our patients. We see maybe 40 to 50 patients a day. We simply can't follow them all up.
I didn't know what was going on with him. Three months later, I'd finished my morning surgery and I was in the car park about to go and do my home visits. And I bumped into his wife and I said, hey, how's your husband getting on? She said, Dr. Chastity, I cannot believe the difference. I feel like I've got the guy I married back again. My husband comes home from work.
He's pottering around on his train set. He's always on eBay looking for collector's items. And he's now subscribed to this, you know, this magazine. I thought, okay, that's incredible. I still hadn't seen him. Three months after that, he comes in for a well man check to my office and he comes in with his blood tests. I'm about to go through them with him. And I said, hey, how are you doing?
Dr. Chachi, I feel incredible. I've got energy. My mood is good and I feel motivated. I said, how's your marriage? Marriage is great. I'm getting on really, really well with my wife. How is your job? Love it. Really, really enjoy the job. So why is that so powerful, Mark, is this. Did he have a mental health problem? He had a train set deficiency.
Or did he have a deficiency of passion in his life? And when he corrected that passion deficiency, everything else starts to come back online. So I want to expand the conversation about stress to go, yeah, sure. Breathing, nature, meditation, exercise, these things are fantastic. And of course I talk about them and I go into the science and the practical implications of people.
But what about something about passion, doing things that you love? It's just as important.
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Chapter 8: How does diet influence our stress response?
That lack of sleep creates a whole host of diseases, but also increases our reactivity, our stress response, cortisol levels, makes us hungrier, increases rail in the hunger hormone, decreases PYY, the appetite suppressing hormone. So sleep is a big, a big medicine when it comes to helping reduce stress.
We are more stressed now than in previous years and decades, but even worse, I think of our youths, like 70% are, you know, reporting stress that they, such extreme stress, they don't know how to manage it. It's interfering with their life. These are really serious red flags. We know what that means biologically.
It's a leading indicator to the wear and tear on our cells, on our brain, the conditions we're always trying to avoid. So it's a serious prescription that we don't have to live each day with this excessive level of stress, which really rules out those states that you've been cultivating, which is the restorative states. And it's a beautiful example you gave how you are consciously changing them.
Because it's not our fault. There's no judgment. We all come out with different levels. That question about why do some people expect negative things to happen, that can't stand ambiguity, that uncertainty feels intolerable, that's part of it. It's partly from how our stress response systems are shaped from all these different influences before our life, including our life starting in the womb.
And it can change. That's the beautiful thing is like we can rewire our nervous systems. And I think the difference between chronic stress and acute stress is nothing we mostly think about. But, you know, one of my favorite scientists is Robert Sapolsky, who wrote a book, Why Zebras Disappear.
don't get ulcers which is essentially the idea that that no zebras are out there eating their whatever their grass and then the line comes and chase them they all run like crazy super stressed and then line catches and zebra and then who's eating it right next to all the other they really just go back to eating their grass and so they have like a cute cute massive stress and then it goes away um i want i want to talk about how uh you kind of frame um
stress in your book around our mind states and then how our mind can create physiological stress or conversely can actually restore us to health. And you sort of mapped out these different spectrums of mind states that kind of help us think about how to understand stress, how to navigate it, how to think about discharging it.
I say the stress reduction or stress management is not a passive process. It's an active process. And it's like you have to exercise if you want to build your muscles. You kind of have to practice various techniques in order to reset your nervous system from this chronic unremitting stress, which is so pernicious and driving so many of our diseases.
Yes, so you wanna hear about these mind states.
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