Why You Keep Getting Sinus Infections, Colds, Urinary Tract Infections, And Other Recurrent Infections with Dr. Elizabeth Boham

Mark Hyman, MD

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Dr. Elizabeth Boham: We'll see that somebody gets an infection, right? For this kid it was his ear infection, or for somebody else it might be a urinary tract infection or a sinus infection. They are given antibiotics, but those antibiotics get rid of the infection, but they also can get rid of all that good bacteria. Dr. Mark Hyman: Welcome to the Doctor's Farmacy. I'm Dr. Mark Hyman and this is a special episode called House Call with my colleague, and friend, and partner at the UltraWellness Center, the medical director Dr. Elizabeth Boham. This is a conversation that you should all pay attention to because it's about how to prevent infections, and given our current situation with COVID-19, we should all be paying acute attention on how to boost our immune systems, how to make ourselves more immune resilient and how to, as my friend Dr. Jeffrey Bland says, how to create a process of immuno-rejuvenation. Dr. Elizabeth Boham: Ooh, I like that. Dr. Mark Hyman: Which is a great word, which is how do we make ourselves immune warriors so our immune is functioning on all cylinders? So one, we may able to resist getting infections, and we'll talk about some cases on how we do that. Not with COVID, but in general. Two, how if we get something, we might not get that sick. I think that yesterday I was talking to a physician's assistant who worked in the emergency room in a hospital in Massachusetts. She was saying how they saw probably 30 to 40 COVID patients a day. Most of them came in for testing with mild symptoms. Then there was a few that were very sick who came in really short of breath, really struggling and unable to manage, who had to admitted to the hospital or intubated. Dr. Mark Hyman: I said, "How many of the patients that end up getting admitted to the hospital, or in the ICU, or on ventilators, how many of those were metabolically healthy?" In order words, how many of those who came in were overweight or had some chronic illness? She said, "There wasn't one." This is her N of one sample, right? It's literally hundreds of patients over weeks. She said, "Not a single one who came in that was metabolically healthy needed to be admitted to the hospital. They all had more mild symptoms." So, that's a really important clue of how we can become COVID resistant, in a sense. How do we become immune resilient and COVID resistant? So, we're going to talk about how to break the cycle of recurrent infections whether it's colds, or flus, or bladder infections, or ear infections. How do we make ourselves more immune resilient? So, welcome to the podcast Dr. Boham. You're probably the most regular guest I've had, and we're going to have lots more of you because we get into such great conversations about common problems with uncommon solutions based on functional medicine that really work. Dr. Mark Hyman: That's what we do here at the UltraWellness Center in Lennox, Massachusetts and it's so exciting now. We can treat so many more patients because we're doing virtual visits. We're doing virtual consultations. So, even new patients we can do virtually now because of the expanded telemedicine rules. It's really great because we can take care of people all over of the world virtually and it's super fun and easy and people can get help, especially now. People have time to take care of themselves. They're at home. They can cook. They can practice a more rhythmic lifestyle. They can exercise more, and they can get into an actually better pattern of living. Dr. Elizabeth Boham: Yeah, and it's so important to now, right? I mean, I had a patient the other day who's like, "I am motivated to really make this stick now. I am." I mean, she was working hard before but she's like, "I have more motivation to really take your advice because I know that when I'm eating that refined, processed sugary food, it's not good for my immune system. I know that when I'm not doing my exercise, that's not good for my immune system, right? I know that if I'm really stressed and not giving my body time to rest and do my breath work and relax my body, we know that's not good for my immune system." Dr. Elizabeth Boham: So she's like, "I'm really motivated now to take this advice and to really focus on self care." Because like you say, we can't always control the virus, but we can control the host somewhat, right? There's a lot that we can all do to really strengthen our immune system, and I've been interested in this topic for so long because I see a lot. Both with myself, but with a lot of my patients of these chronic, cyclical infections, right? Everybody's got their Achilles heel, right? That one person, it might be they get these sinus infections every winter or a couple every winter. For somebody else, it might be they get urinary tract infections all the time, or that kid who's always getting every cold or flu that's floating around. Dr. Mark Hyman: Or strep throat. Dr. Elizabeth Boham: Strep throat, right, and certain people are so much more susceptible. So, I've been working with patients on this for a long time and now that we've got COVID-19, it's so important that we really take these principles and say, "Okay, what can we do to break the cycle of always picking up everything that's floating around?" Right? "What can I do to really improve the functioning of my immune system?" Dr. Mark Hyman: So if you go to the doctor and you say, "Hey, doc. I don't want to get these infections anymore, what do I do?" They go, "I don't know. Well, next time you get sick, come in, I'll give you an antibiotic." Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Right? It's not something we were trained to do. Dr. Elizabeth Boham: No. Dr. Mark Hyman: It's not their fault. Dr. Elizabeth Boham: No. Dr. Mark Hyman: They just don't have the knowledge or the tools, or even the insight that, "Wait a minute." There's two things when it comes to an infection. There's the bug and there's the host, right? Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: There was a very famous debate between Louis Pasteur who discovered the bug, the pathogen, and this guy named Claude Bernard who was a scientist at the same time, another French scientist who said, "No, no, no. It's the biological terrain. It's the host that matters the most." Dr. Elizabeth Boham: Right. Dr. Mark Hyman: So, it was this host pathogen debate, but it's kind of a silly debate. At the end of Pasteur's life he says, "It's not the pathogen, it's the host." I think that's what we're finding with COVID-19 is that people who are not healthy are the ones who are getting really sick and dying. 80% are mildly affected or have no symptoms, which is part of the scary part because people can be walking around and shedding virus, and they feel great. So, that's why the Governor of New York said, "Put a mask on." Right? Everybody's got to wear a mask. It's the law now, but I think we have to think differently about this and say, "Wait a minute. What do we know about how to create immuno-resilience? How to create immuno-rejuvenation? How to make ourselves an unfriendly host to the microbes that we're exposed to?" Because we're all exposed to them, right? Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: I mean, people with AIDS don't die from the HIV virus. The HIV virus cripples their immune system, which means that they are going to die from things that we all live with in our bodies. Whether it's pneumocystis pneumonia, or whether it's cytomegalovirus, or whether it's a different bacteria like microbacterium avium tuberculosis. So, we actually are living in a soup of bugs that live in us all the time, and it's not a bad thing. We're just in balance with them and so when we get out of balance, whether it's a virus like HIV hijacking our immune system, or whether it's the fact that we have a crappy diet and are stressed, and don't sleep, and have nutrient deficiencies, and don't take care of ourselves, well, there's a lot we can do about it. Dr. Mark Hyman: That's what's so great about functional medicine, is it gives us a method of evaluating people and where they break down, and where they're struggling, and where their immune system might not be working optimally. There's so many different reasons for it. We're going to get into that in today's podcast. So, tell us Liz about some of your patients that you've discovered how to actually work with it, because it's something I also have seen in my practice. People get sick over and over again, and you're still seeing these people like, "Why are you always getting sick?" Then you start digging, and what are the kinds of things you find? Dr. Elizabeth Boham: What are out of balance? What's out of balance? So for the first person I wanted to talk about, he was a 10 year old boy and he was coming in because he was getting every cold and flu that was going around. Right? So, his mom was getting frustrated because he was out of school almost a couple weeks a year if not more because he kept getting sick. She of course had to take off work and it was causing some disruption in their house, but she was also really just worried about him. Why was he picking up every cold and flu going around? I got a good detailed history from him, and he had multiple ear infections as a younger child. So when he was in his first few years of life even up to five, he was getting lots of ear infections, and often treated with antibiotics. Right? So he would get an ear infection, and he would take antibiotics, and then he would get another ear infection, and he would take more antibiotics. He had a lot of congestion in his nose and nasal passageway. Dr. Mark Hyman: I mean, even when he wasn't sick? Dr. Elizabeth Boham: Even when he wasn't sick he was dealing with that, and that's an issue we know because when there's a lot of congesting floating around, sometimes it gets stuck. Right? So, kids that have a lot of congestion in their nasal passageways and their eustachian tubes, more likely for it to get- Dr. Mark Hyman: They have more inflammation. Dr. Elizabeth Boham: They have more inflammation and it's more likely to get stuck, and then another infection grows and you get an ear infection, for example. So, he had these recurrent chronic ear infections. Dr. Mark Hyman: So wait, wait. So, this is just to break it down a little bit. What you're saying essentially is that if you're living a lifestyle or you have food sensitivities or something that's causing congestion and inflammation in your sinuses in your nose and your throat, that sets the stage for recurring infections. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: Right? So maybe the treatment isn't to fix the infection, it's to figure out why there's this problem. Dr. Elizabeth Boham: Right, because the congestion gets stuck and then it is a breeding ground for a virus or bacteria to overgrow and an infection to take hold, and for it not to be able to get out of the system. For him, he had these chronic ear infections, but now is getting everything. So when he had the chronic ear infections, it's important to note that he was given lots of antibiotics. For his first five years of life, he was on multiple rounds of antibiotics. Two, three times a year getting antibiotics for these ear infections, and that is something we often see. Right? We'll see that somebody gets an infection. Right? For this kid, it was his ear infection, or for somebody else it might be a urinary tract infection or a sinus infection. That you're given antibiotics, but those antibiotics get rid of the infection, but they also can get rid of all that good bacteria that's lining the sinus passageways, the digestive system, the bladder area. Right? Dr. Mark Hyman: Your microbiome. Dr. Elizabeth Boham: The microbiome. Right? We know that those good bacteria, they're the first line of defense. They're like that army on the front line. Right? They can say, "Okay, virus. Don't get into my body. Okay, another bacteria. Don't come into my nose." Right? Those good bacteria are lining all the passageways in our body. So that when we- Dr. Mark Hyman: They're part of our defense system. Dr. Elizabeth Boham: Huge part of our immune system. Huge part of that innate immune system. That immune system that's going to attack right away when something new or different comes into the body. So when we've been on a lot of antibiotics in the past, we will often see peoples who's immune system is not working as well as we'd like it to. Dr. Mark Hyman: So what you're saying is that antibiotics, even though they treat infections, seem to mess up your immune system. Dr. Elizabeth Boham: I think they do. Yeah, absolutely. I think there's good studies to show that. I mean, sometimes an antibiotic is necessary, but there's definitely been multiple times with lots and lots of people, and of course all the antibiotics in our food supply, they're damaging a lot of that good, protective good bacteria that are our first line of our immune system. So, absolutely. Dr. Mark Hyman: Then it makes you even more susceptible on the next round. Dr. Elizabeth Boham: Exactly, and that's, I think, one reason why we see these chronic infections with people because they take the antibiotics, but then it gets rid of a lot of the good bacteria. So, it's easier then next time for that virus or bacteria to take hold and to become an infection again. So, we see this cyclical thing going on with people. So, I think that's important for us to pay attention to and say, "Okay, let's step back and say, 'Do we absolutely need to use this antibiotic this time for this situation?'" I think as physicians, it's important that we're being more careful with the use of antibiotics. Dr. Mark Hyman: Mm-hmm (affirmative), for sure. Dr. Elizabeth Boham: I think that's an area that we see issue with, and I think one reason for him, one of the reasons why he was more susceptible to these colds and flus, but I don't think it was the only reason. Dr. Mark Hyman: Yeah, what was the other thing you found? Dr. Elizabeth Boham: I think that that's important to note. Right? We always want to find one thing, we always want to say, "Oh, it's the one reason why somebody's immune system isn't working as well," but many times it's multiple things coming together. Dr. Mark Hyman: I just want to stop you for a minute there because in traditional medicine, we are trained to think about the one thing. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: We call it Occam's razor. What's the simplest explanation that could explain all of it? We sort of do that a little bit in functional medicine, but the problem with traditional medicine is it's very reductionist. This is one thing and the truth is, body is complex. It is a system, and it's many things. It's more like a web than a razor. Dr. Elizabeth Boham: Yes, absolutely. Dr. Mark Hyman: Right? Dr. Elizabeth Boham: Right, and many times there's 10 different things going on that are contributing to why this person's immune system wasn't working well. Dr. Mark Hyman: To their microbiome, their diet, nutritional deficiencies, all sorts of things. Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: Hey everybody, it's Doctor Hyman. Thanks for tuning in to the Doctor's Farmacy. I hope you're loving this podcast. It's one of my favorite things to do, and introducing you to all the experts that I know, and I love, and that I've learned so much from. I want to tell you about something else I'm doing which is called Mark's Picks. It's my weekly newsletter, and in it I share my favorite stuff from foods, to supplements, to gadgets, to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health, and I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise, and all you have to do is go to DoctorHyman.com/Picks to sign up. That's DoctorHyman.com/Picks, P-I-C-K-S, and then sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better, and live younger longer. Now, back to this week's episode. Dr. Elizabeth Boham: So for this child, we realized also because of all of this congestion, and frequent infections, and a lot of ear infections as a kid, I said, "Well, you know what? Maybe we need to think about some food sensitivities that may be causing a lot of congestion for this kid, and putting him at increased risk for these ear infections as a kid and infections now," because we do know. We do know that dairy and cow's milk is associated with increased risk of ear infections for some kids. Dr. Mark Hyman: Also mucus production, congestion. Dr. Elizabeth Boham: Absolutely. Dr. Mark Hyman: I mean, I know if I eat dairy I immediately get runny nose and congestion. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: It doesn't affect everybody by that way, but it does affect a lot of people that way. Dr. Elizabeth Boham: Yep, and he was willing. He was willing to say, "Okay." The kid, he was ready to say, "I want to stop getting sick all the time," and so he was willing to do an elimination of dairy from his diet. So, that is one of the things we really focused on and we worked on, and it really did help. His congestion decreased, he wasn't getting as sick as much, but we did more than that. I did some nutritional biomarkers, I realized he was a little low in zinc, which is not uncommon to find. Dr. Mark Hyman: Zinc is so important for your immune function. In fact in COVID-19, they're finding they're actually treating patients with zinc because it helps interrupt the viral replication, and the viral binding to the cells, and the insertion into the host DNA. So, I think it's really interesting to see that even in this crazy, horrible infection of COVID-19, we're going back to basic principles of what's required to a healthy immune system. Zinc and vitamin C, which are being even used intravenously in studies. Dr. Elizabeth Boham: Yes, and so for him we added in 20 milligrams of zinc, and 500 milligrams of vitamin C a day, and that was very helpful too to help him break the cycle. In addition, we found out that he had some elevated levels of heavy metals, so his lead was a little bit high. He was living in a home, he'd grown up in a home that was built in the early 1920s or so. So, it had more just lead in the water and in the walls of the house. It had been refurbished, but his lead levels were higher than we'd like them to be, and we know. Right? What we know about heavy metals, we know that high levels of lead are really a problem for both the neurological system and the immune system, but I think we also know that low levels can result in people's immune systems not working optimally. Dr. Mark Hyman: Yeah, and also mercury and lead also affect the gut. They interrupt the gut function and can cause leaky gut, growth of bad bugs in there. So, you've got other reasons for this. Dr. Elizabeth Boham: Yes. Right? That's true. That's very true, so not only did we pull away dairy from his diet, we put him on a really good probiotic because he had been on so many antibiotics in the past, and probiotics, there's really interesting studies on how well they help the immune system. I mean, we need to do a lot more research here and figure this out a lot more, but they can really help with breaking some of the cycles with people who are chronically getting sick. Dr. Mark Hyman: I mean, I remember the study I read years ago. There was a pregnant woman who took probiotics, and compared to another group that didn't, and the women who took the probiotics during pregnancy, their offspring had dramatically less eczema and asthma. Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: And allergies. Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: Because the mothers took it. So, same thing when you give it to kids. It also helps dramatically with these problems. Dr. Elizabeth Boham: Yeah, absolutely, and it can help improve the functioning of the immune system for some kids in certain situations. Then of course we gave them that zinc and vitamin C, but then I put him on a detox vacation protocol. I really helped with getting these heavy metals down. We did a protocol that had multiple different components in it, but that was because we tested and we found that his heavy metals were a little bit high. So, we worked to really bring them down with glutathione, liposomal vitamin C, some binding agents, things that help supported the detoxification system in his body. That comprehensive approach really helped his immune system improve, and it helped him get out of that cycle of getting sick two to three times every winter. I think it's really fun to watch and see that, because we can see that difference over time. Dr. Mark Hyman: I hear [crosstalk 00:18:48] time, and I don't get sick anymore. My sinuses, this is the first year I've gone without having any antibiotics for my sinuses. Dr. Elizabeth Boham: I know, right? Dr. Mark Hyman: It's so simple. I mean, I remember this kid. You just reminded me of this story when I was in the emergency room years ago, and I was working in an emergency hospital in Springfield, Mass. This woman came in with her toddler who was probably maybe about two years old and had just so many ear infections. One after the other, after the other. I said, "Well, when did this all start?" She's like, "Well, when he was about a year old." I said, "What happened when he was a year old?" She said, "Well, I switched him from breast milk to regular milk." This is before I knew about functional medicine or anything. Dr. Mark Hyman: I was like, "Oh, well that's interesting. Well, why don't you take him off the dairy and see what happens?" The kid was fine. So, I think it's sometimes that simple. I think often it's more comprehensive because one, you changed his diet. You optimized his nutrient levels, and you also went in a little deeper to look at his detoxification and his metal burden, which is also a factor. So, you did diagnostic tests that can help pinpoint these issues, and you can really create a precision approach to each individual. Dr. Elizabeth Boham: I think that's important. Dr. Mark Hyman: This is his problem, but there may be somebody else who might have a different reason for their immune system not working. I think it's really important to understand that we at the UltraWellness Center [inaudible 00:20:03] functional medicine take a very different lens looking at these chronic problems and say, "What is the cause? How do we get rid of the cause, and why isn't the body working properly?" When I learned functional medicine, one of my mentors was a guy named Sidney Baker who was sort of Yale pediatrician. Just brilliant guy, and he was incredibly good at taking incredibly complex ideas and simplifying them into a few principles. One of the most important principles that guides me every day, still today, is a very simple question is what do you need to get rid of in your body that's making it unhappy, and what does your body need to get in order to get healthy? Dr. Mark Hyman: So, what are the things that are the problems that causes these, and what are the missing factors that you need to have a resilient system? So, this is for the immune system [inaudible 00:20:55]. This kid, he had too much dairy that was bugging him. He had too many metals that were bugging him, so you got rid of those things. Then you added in the things the body need to function. You added in the probiotics. Dr. Elizabeth Boham: Yes, probiotics. Yep. Dr. Mark Hyman: You added in the zinc, and the vitamin C, and the body knows what to do. It's like when you take out the bad stuff, you put in the good stuff, it's just that simple. Sometimes it's a tough job to figure out what the bad stuff is that you need to get rid of and what the good stuff is you need to get. That's where the real meat of functional medicine is, is being able to investigate those things properly. Dr. Elizabeth Boham: Figure that out, right? Dr. Mark Hyman: We don't learn that in medical school. Functional medicine, we learn how to dive deep and to be an expert. What are the things that causes these, and how do you create a healthy human? Dr. Elizabeth Boham: I think that's really the power of supplements. Sometimes people are like, "Oh, where do supplements matter? A multi, is this helpful, is this helpful?" Dr. Mark Hyman: It's expensive urine. Dr. Elizabeth Boham: Yeah, but when you can identify what deficiencies people have or what, because of their genetics, they need more of, right? When you can really specialize and give a personalized program for somebody, it makes a world of difference. I remember in my undergraduate degree in nutrition [inaudible 00:22:09], "Oh, don't bother with supplements." It was really food first kind of a program, so I never took supplements. I remember the first time I took a multivitamin I was like, "Whoa. This is amazing," and it was a good quality one with good methylated [inaudible 00:22:24] vitamins. I had so much more energy because I needed that extra methylation because of my genetics. Right? Dr. Mark Hyman: Right, right, right. Dr. Elizabeth Boham: So when you specialize and give a personalized approach, it really makes a huge difference for people. Dr. Mark Hyman: So, so key. So key. So, we see recurrent ear infections, recurrent sore throats, recurrent colds and flu. We all see recurrent sinus issues, which are very similar, but you had a case of a woman with chronic bladder infections. Dr. Elizabeth Boham: It's so common. This is something we see all the time, and we know that at least 50% of women get one urinary tract infection in their lifetime, but lots and lots of women get many, many more. Right? A percentage of women have recurrent bladder infections to the point where they're put on antibiotics for prevention. They might be taking an antibiotic every time they have intercourse. Dr. Mark Hyman: Yeah, I remember that. I remember I learned about that in medical school. I'm like, "Wow, that's such a bad idea." Dr. Elizabeth Boham: Right, because let's go back to the microbiome. Right? We've got microbiome, we've got all that good bacteria that lines our urethra and our bladder, and so that when we take antibiotics all the time, that is killing off some of those good bacteria. Just allowing that bad bacteria to get back in there again, right? So, we've got to work to break the cycle with women all the time with the chronic urinary tract infections. It's something I see so often in my practice. Dr. Mark Hyman: Part of the reason women get it, because of the anatomy. They have a very short distance between the- Dr. Elizabeth Boham: The rectal [crosstalk 00:23:55]. Dr. Mark Hyman: Rectal outlet, right? Of their bladder and the vagina, and then their bladder. It's very short, whereas men it's a lot longer. It's harder for the bacteria to migrate up there, and then it gets easily affected by hygiene, and sex, and [crosstalk 00:24:08]. Dr. Elizabeth Boham: Yeah, I mean there's- Dr. Mark Hyman: Dehydration. Dr. Elizabeth Boham: The most common cause of a urinary tract infection is the E. coli bacteria, which comes from our gut. So like you said, there's not a lot of distance between where the stool is coming out and the urethra and the bladder, so it's a common thing that we see, but there's a lot we can do to prevent that bacteria from taking hold. So this woman, she was a 40 year old woman who had had bladder infections her whole adult life and was at the point where she was needing to take an antibiotic every time she had intercourse. Really that was impacting so many other things. Now she was getting yeast infections, and her digestion was getting off. So we were like, "Okay, we have to work to break this cycle of chronic infections." There's a lot of cool things that really help with stopping that cycle of recurrent bladder infections. I mean, you talked about some of the basics, right? Making sure you're drinking a lot of water, urinating frequently. Dr. Mark Hyman: Peeing after sex. Dr. Elizabeth Boham: Peeing before and after sex, right? Yeah. Wiping from front to back, wearing cotton. I mean, all the basics, but then there's some stuff that really is helpful to help break the cycle. One of those things are the probiotics. There's been a lot of really interesting research showing that there's certain forms of probiotics, the lactobacillus rhamnosus, and the lactobacillus reuteri, which are good bacteria for the urinary tract system. Dr. Mark Hyman: Yeah. Dr. Elizabeth Boham: Right? Those bacteria you want to have a lot of in the urinary tract system, and that when there's good levels of those bacteria, you know things are going to work better there. You might not be as high risk of getting some of those recurrent infections. Dr. Mark Hyman: See, I was always trained that your whole urinary tract system is sterile, but you're saying there is a microbiome in the urinary tract. Dr. Elizabeth Boham: Yes, absolutely. Absolutely, and so you can take these probiotics. You can take them by mouth. We often will have compounding pharmacies mix them and you can apply them vaginally too to make it easier for the- Dr. Mark Hyman: Yeah, that's great for yeast infections and recurrent issues there. Dr. Elizabeth Boham: Yep, yep, and help those good bacteria climb up the urethra and into the bladder, but taking them by mouth is also helpful to create that nice microbiome, or help replete the nice microbiome in the bladder area. We know that cranberry, we've heard forever that cranberry is really helpful because it has a substance that prevents the bacteria from sticking to the bladder lining. So, cranberry is really great. I often don't want to get people to drink too much cranberry juice because it's high in sugar, but you can get powders of cranberry, and there's capsules of cranberry that can be used. D-mannose is another substance. Dr. Mark Hyman: You can get unsweetened cranberry juice. Dr. Elizabeth Boham: Yes you can. Yes. Dr. Mark Hyman: Right? Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: Or unsweetened cranberry concentrate. That stuff is sour, but it really works. You can take a quarter cup of that, you can mix in a little water, and then drink it. There's no sugar, and it really works. People can do it every half hour, every hour, or two hours depending, and really help break the cycle if they don't want to take antibiotics. I've had a lot of women who are just trying to break the cycle and we give them things like cranberry concentrate or cranberry supplements, and there's another one you were just mentioning, D-mannos. Dr. Elizabeth Boham: Yeah. I was just going to mention also the other place to put the unsweetened cranberry is in seltzer water. It's yummy that way. Dr. Mark Hyman: Oh yeah. Yeah, that's good. Right. Dr. Elizabeth Boham: The D-mannose is also another substance that prevents the binding of the bacteria to the bladder lining so it's less likely to stick, and they've done studies showing that two grams of D-mannose can be as effective as antibiotics for prevention of a urinary tract infection. Dr. Mark Hyman: Mm-hmm (affirmative). Dr. Elizabeth Boham: So, both cranberry and D-mannose can be used for prevention and then if somebody's starting to have symptoms, they can really increase the amount that they're using to sort of stop that infection from coming on. Dr. Mark Hyman: Yeah. Dr. Elizabeth Boham: So, I think those can be really helpful as can the probiotics. Dr. Mark Hyman: We use herbs too sometimes. We try to avoid people getting antibiotics. Dr. Elizabeth Boham: Yeah, yeah. I mean, the couple things you want to watch for, if you get a fever, if you see any blood in your urine, if you get any back pain, if it's not getting better or you really work with your doctor on this, because those infections can become serious for some people in- Dr. Mark Hyman: They can go up to your kidneys, which is bad. Dr. Elizabeth Boham: Yeah, in certain situations. Some of those things can be really helpful for breaking the cycle, and I think that's important. I worked with her, with this one patient. We added in some cranberry and D-mannose, she was taking it on a regular basis, but then she also took it after intercourse. She took it frequently when she was starting to feel some sensation like an infection might be coming on. We worked to make sure she was drinking lots and lots of water so her urine was more dilute. Dr. Mark Hyman: You changed her diet too, right? Dr. Elizabeth Boham: I did, yeah. I mean, she was on a little too much sugar. Dr. Mark Hyman: Why is sugar bad? Dr. Elizabeth Boham: Because it can feed the wrong bugs in the body, right? Dr. Mark Hyman: Yeah. Dr. Elizabeth Boham: It can feed the yeast, it can feed bad bacteria, and also- Dr. Mark Hyman: Yeah, it can feed viruses too. Yeah. Dr. Elizabeth Boham: Absolutely, right? Because we know that when blood sugar is too high that the immune system doesn't work as well, right? Dr. Mark Hyman: Mm-hmm (affirmative). Dr. Elizabeth Boham: So for all of those reasons, we cleaned up her diet, we pulled in a lot more of good, healthy vegetables that are rich in phytonutrients, that are antiinflammatory, and can help support the immune system, and we helped her get off of the chronic antibiotics she was using because that is one of the best ways to help break the cycle of getting more and more infections. Dr. Mark Hyman: Yeah. So powerful. Just to recap, you've had a couple of cases. One of recurrent ear infections, and colds, and sore throats, and flus, [inaudible 00:29:52] bladder infections, but this really applies to anybody who's immune system is not working, who tends to get sick more often and get sinus issues. The treatment is just sometimes slightly different, but we look differently at this with the lens of functional medicine. We look at diet, and we look at food sensitivities, we look at the gut where 60% of your immune system is, we look at your nutritional levels like vitamin D. I mean, if your vitamin D level is low, you're much more likely to get the flu and if your vitamin D levels are optimal, you can reduce the flu by 40% to 70%. Just that alone. We look at zinc levels, and levels of your overall nutritional status plays a huge role. Dr. Elizabeth Boham: Yeah, vitamin A, right? Dr. Mark Hyman: Vitamin A, yeah. So, we're really taking a deep, comprehensive look and is there something else that's destabilizing your immune system? Are there toxins, like in this little boy, that might be just destabilizing the immune system? So, we really create a model of real, clear diagnosis through history, a dietary analysis, detailed testing if needed. It's a little bit different than when you get a traditional doctor who looks at these root causes, and then we apply the method of restoring health. So, we remove the bad stuff like you removed the yeast and you removed the bad foods and the inflammation, and dietary factors. Maybe dairy, whatever it is. Then you add in all the things they need to rejuvenate the immune system, right? Dr. Elizabeth Boham: Mm-hmm (affirmative). Dr. Mark Hyman: It's some of the things we didn't talk about like sleep, and moderate exercise, and stress reduction, and a whole foods diet, and getting off of processed foods and sugar. These are so simple and they're so profoundly effective in terms of rejuvenating the immune system. That's what we all need to be thinking about right now in the era of COVID-19, because most of us don't think much about how to rejuvenate and enhance our immune function. Dr. Elizabeth Boham: It's such a great time to really step back and say, "Okay. What do I need? What are the areas I need to really focus on for self care? Where am I lacking?" What am I not doing in terms of all those things you just mentioned, right? "How is my sleep? How is my stress? How is my diet? Am I taking in too much sugar? Am I giving my body time to rest?" Really focus on that right now. It's a great time to do that to help strengthen your immune system. Dr. Mark Hyman: Gut health is so important in this. I mean, we just know that gut health is so important in resisting infection, even things like colds and flus, and getting your gut healthy and leaky gut sorted. I've been thinking a lot about COVID-19 and why people are struggling. People with asthma, people with chronic illnesses, people who are overweight. I came up with this idea that they're pre-inflamed. They're pre-inflamed, so their body is already on fire and you throw a virus on top of that. It's like throwing gasoline on the fire, and why people are getting really sick and dying from COVID-19 is because of this thing called a cytokine storm. Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Cytokines are the messenger molecules of your immune system, and when they're activated you get inflamed. So, these people come in pre-inflamed and those are the ones who are really struggling with this. Dr. Elizabeth Boham: Right. I mean- Dr. Mark Hyman: So, how do you get un-inflamed? That's what we're talking about. That's the whole idea of immuno-rejuvenation, is to calm down the inflammation, to remove the things that are driving inflammation, to add things that help to reduce inflammation and enhance your immune function. Dr. Elizabeth Boham: I mean, we know. We always talk about people sometimes think, "Oh, our fat is just sitting there. We just have this extra fat hanging out," but we know that that fat is really an active endocrine organ, and it's producing a lot of inflammatory markers. Dr. Mark Hyman: It's an immune organ. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: Yeah I mean, it's not just holding up your pants. Dr. Elizabeth Boham: No. Dr. Mark Hyman: It's actually producing all these molecules. Dr. Elizabeth Boham: Right. Dr. Mark Hyman: It's whole thing. Dr. Elizabeth Boham: It's a huge source of inflammation, right? Dr. Mark Hyman: Yeah obesity, and overweight, and belly fat is the number one cause of inflammation in our society today. Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: It is why we're seeing so much of these deaths from COVID-19, because people are inflamed from being overweight and chronic illness is also an inflammatory problem. It's also caused by this metabolic dysfunction, whether it's heart disease, diabetes, even things like cancer are caused by being overweight or having insulin resistance. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: So, it's all connected to this same underlying issue whether you're old and have these diseases, or whether you're young and you're overweight. It's the same problem. So, we're seeing so many people who are younger in the ICUs and admitted, but these aren't healthy young people. These are people who are overweight, and they may not have a chronic disease, but obesity itself is not healthy. It's not normal as being- Dr. Elizabeth Boham: You can shift the level of inflammation in your body immediately by just changing what you're eating. Dr. Mark Hyman: Quickly, quickly. I mean, it's just amazing. I mean, I had a patient once who wanted to do the 10 day reset diet. You can go to GetFarmacy.com to learn how to get off sugar and starch and do the 10 day reset, but she did it and she was a little OCD, and she wanted to check her labs after 10 days. I'm like, "No, don't check your labs after 10 days. It's not going to change." She made me do it and I did it and it was like, "Holy cow." The inflammation levels just dropped dramatically in 10 days. It doesn't take 10 weeks, right? Dr. Elizabeth Boham: Mm-mm (negative). I mean, people see it right? You can see the inflammation go away because you're not as puffy. You look different when you look in the mirror, your rings fit differently. Your weight drops very quickly. That's because the water weight goes away and inflammation, but we also see it with the biomarkers. It's phenomenal. Dr. Mark Hyman: Mm-hmm (affirmative), it's pretty amazing. So yeah, we have really in the midst of all this bad news about coronavirus and COVID-19, we have good news which is that there is a path to immuno-rejuvenation, to actually resisting these infection, to being COVID resistant let's say. It's a path that everybody can follow. Some of it's just basic stuff, and there's going to be great articles that are posted along with this in the show notes so people can refer to those. They can go to UltraWellnessCenter.com and sign up to be a patient. We have great nutrition consults if you just want that. We're doing all virtual consults now so we can take care of anybody, anywhere in the world. We have group visits, so there's a lot of options for people to engage with us, and I just think it's important more than ever now for people to double down on their health so that, one, they may not get COVID-19 and two, if they get it, it won't be that bad. Dr. Elizabeth Boham: Right, absolutely. Dr. Mark Hyman: So if you've been listening to this podcast and you loved what you heard, please share it with your friends and family on social media. Leave a comment, we'd love to hear from you. Subscribe wherever you get your podcasts, and stay safe and focus on making yourself immune resilient. We'll see you next time on the Doctor's Farmacy. Dr. Elizabeth Boham: Thank you, Mark.