The Ultimate Human with Gary Brecka
229. Dr. Marty Makary: Vaccines, Chronic Disease, Drug Prices & Hormone Therapy
23 Dec 2025
Chapter 1: What is the main topic discussed in this episode?
If we were to evaluate the U.S. healthcare system over the last 50 years in terms of the performance indicator of the health of the population, U.S. healthcare has been a 50-year failure.
Chapter 2: What insights does Dr. Marty Makary share about the FDA's mission?
We have got to do something different. The pendulum has swung so far. We are one of the largest, if not the largest, spender on healthcare worldwide. We're one of the sickest, fattest, most disease ridden nations in the world. 42% of our children having at least one chronic disease. We don't have a lot of education around whole foods.
We know that there's a lot of corruption in our nutritional research, which leads to things like poor food pyramid advice and nutritional guidelines. We've medicalized ordinary life and where we are drugging our nation's kids at scale and not talking about the underlying root causes. And we ignore all those issues.
Chapter 3: How does Dr. Makary propose changing the medical education system?
And all we do is we give doctors a prescription pad and a surgical knife and say, go to work, fix all these problems. You're going to have a dysfunctional system. And that's where we are today. We're very good at disease management and symptom maintenance. We're not very good at disease prevention.
Your intention is to try to keep people out of the system because we know that once they're in the system, they just continue to progress. You have to have a sense of mission that you want to address a broken system. My number one priority is to deliver more cures and meaningful treatments and healthier food for children. And we're getting stuff done.
In a perfect world, what would you like to see accomplished by our FDA for the betterment of the population?
Chapter 4: What are the FDA's new dietary guidelines and their implications?
Look, our legacy, I hope, will be Hey guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist, Gary Brekka, where we go down the road of everything, anti-aging, biohacking, longevity, and everything in between. And I don't know if I've ever been more excited to run a podcast than the podcast that I'm gonna run today. This has been a long time in the making.
For influencers like myself and my community, this is a watershed moment for us to actually have access at this level to our federal government, the government agencies, and the people behind the curtain that are actually moving the ball down the field for the Make America Healthy Again agenda.
And today, I'm really honored to have the 27th Commissioner of the United States Food and Drug Administration, Dr. Marty McCary. Thank you so much for coming on the podcast.
Chapter 5: What is the truth behind hormone therapy according to Dr. Makary?
Good to be with you, Gary.
Yeah, yeah. I mean, and first of all, I love how you rolled in here. We had a whole food meal, right? Yeah, good stuff. And then you did your very first gold plunge. First gold plunge. It was quite an experience. I wouldn't say I'm high risk of recurring and doing it again later today.
Chapter 6: Are children in America over-vaccinated?
High risk of recurrence. Yeah. Spoken like a true physician. I think I'm good for a while. But no, you need to make this a regular part of your daily routine, Marty. How long was I in there for, an hour? No.
Chapter 7: What challenges does the FDA face regarding drug pricing?
minutes. Three minutes at 52 degrees.
Chapter 8: How does the FDA plan to address the microbiome and chronic diseases?
But he did amazing. We did a sauna, then we did a steam room session, then we went right from the steam. He and Kyle Diamantis got right in the cold punch. And I'll give it to both of you guys. You stayed in there for the full three minutes. And the best way to learn about something is to try it. Yeah. No, I congratulate you for that. But you got to admit, you feel a little
I do feel an endorphin rush, similar to when I run say 50 milers, but I've never run a 50 miler. If I did, that would be a similar. Not a high propensity for reoccurrence there either. Yeah, low risk of running long races. So Marty, you are in charge of the Food and Drug Administration. So has that settled in yet? No, actually it has not settled in yet. I still think about it a lot.
Yeah, I mean- Because the FDA oversees 20% of the US economy. It's unbelievable. We've got offices in 50 countries. It's everything. It's cosmetics, it's food, it's- tobacco and vape products. It's devices, wearables, microwave ovens, CAT scan. Microwave ovens? Yeah, the radiation part of it. And then drugs, which is what we're known for probably the most.
I mean, it's a tremendous responsibility. But it's a bit decentralized. We have centers and center leaders. And it's going great. The FDA is strong. And it's going to continue to be strong. I got to ask you, you know, what was the impetus for you to want to take on that kind of role? Because you came out of private practice, your background as a surgeon, right?
I found out you ran one of the first frailty studies linking frailty to, you know, post-operative outcomes, which I find really fascinating. I probably read some of your work because, you know, we know frailty is one of the greatest risks to aging. It's one of the greatest predictors of mortality. That's right.
But what was it for you that made you say, I'm willing to take on this level of responsibility? Because, you know, in some ways it's kind of thankless work. It can't be a part of your get rich quick scheme either. Right. Yeah. Well, I think you have to have a sense of mission that you want to address a broken system.
And I've been at the bedside for a long time, 23 years on faculty at Johns Hopkins. I've had a great run in academic medicine. But when you break bad news and you want there to be something available, or you want to have prevented the tragedy that you're watching unfold, it gives you a deep sense of purpose. And at the FDA, it is all about treatments and prevention and health and the food.
People forget that the F stands for food. It doesn't stand for the word federal. A lot of people think it stands for federal. There was an FDA employee that thought it stood for federal. They didn't read their paycheck. But I mean, for the most part, there are amazing people that work there, amazing scientists, over 16,000 remarkable employees at the FDA. That is incredible.
And so you have to have a sense of, look, we have to challenge deeply held assumptions. Why does it take 10 to 12 years for a new cure to come to market? Why do we accept these animal testing requirements that are now no longer necessary because we have better technology that predicts toxicity? Why do we...
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