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Episode 24
The Doctor's Farmacy: House Call

A Simple Diet Experiment That May Solve Most Of Your Health Issues with Lisa Dreher

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

Tap the subscribe button and new shows will be added to your library.

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Symptoms like bloating, brain fog, poor sleep, poor digestion, skin rashes, mood issues, hormonal issues, joint pain, and many, many others can all be caused by food sensitivities. Food sensitivities might affect you immediately or it might take a few days. This can make it difficult to determine what foods might be causing various problems. Eliminating specific trigger foods such as gluten, dairy, grains, sugar, alcohol, and caffeine for a duration of time is a way for your body to hit the reset button on your health. After following an elimination diet for a certain period of time, you can then strategically add foods back in to see how you tolerate them.

In this episode, Dr. Hyman sits down with Lisa Dreher to discuss how they use elimination diets to identify and treat food sensitivities in their patients.

Lisa is a registered dietitian who got her undergraduate nutrition degree at the Rochester Institute of Technology and completed a dietetic internship through Cornell University. Lisa first worked in the acute care hospital setting and became a Clinical Nutrition Specialist working in Pediatric Gastroenterology at the University of Rochester Medical Center. At the same time, she pursued her Masters degree in Nutrition and Integrative Health from the Maryland University of Integrative Health and started practicing integrative and functional nutrition in private practice before joining UWC in 2015. She has since received additional training through the Institute for Functional Medicine.

Over the past 10 years, Lisa has delivered several public health lectures on the role of food as medicine and her work has been showcased in Reader’s Digest, on National Public Radio, and she was featured in the Broken Brain 2 series. She also developed the Digestive Health and Gut Microbiome training module for the Dietitians in Integrative and Functional Medicine practice group through the Academy of Nutrition and Dietetics.

This episode is sponsored by Paleovalley. Right now, Paleovalley is offering Doctor’s Farmacy listeners 15% off your entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal.

In this episode, Dr. Hyman and Lisa discuss:

  • The difference between food allergies, food intolerances, and food sensitivities
  • The broad range of food sensitivity symptoms
  • Why we develop food sensitivities
  • What is leaky gut, what causes it, and how gut health is related to food sensitivities
  • The importance of working with a healthcare practitioner while doing an elimination diet and during the reintroduction process
  • Why gluten reaction and sensitivities are so prevalent
  • Addictive properties in dairy

Learn more about The UltraWellness Center’s upcoming “Eliminate To Feel Great” program.

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Lisa Dreher, MS, RDN, LDN

Lisa Dreher is a registered dietitian who received a Masters degree in Nutrition and Integrative Health from the Maryland University of Integrative Health. She has experience working with adolescents and their families dealing with complex gastrointestinal conditions. She has additional training through Center for Mind Body Medicine and the Institute for Functional Medicine.

Show Notes

  1. Elimination Diets: Still the Gold Standard?
  2. For more information on the House Call series and becoming a patient at The UltraWellness Center visit
  3. Got Acne? What You Put IN Your Body is More Important Than What You Put on Your Skin
  4. How Hidden Food Sensitivities Make You Fat
  5. Should We All Avoid Gluten
  6. To Gluten or Not To Gluten?
  7. What Is Leaky Gut And How Can You Treat It? with Dr. Elizabeth Boham
  8. Dr. Hyman’s 10-Day Reset
  9. Dr. Hyman’s 10-Day Reset - Free Guide

Transcript

Lisa Dreher(00:00):
That’s what I help people with is, how do you do this in a way that we can really identify which foods might you need to stay off of a little bit longer? But as we’re working to heal the gut, as we talked about before, how can we bring these foods back in so that you can start having more variety and more diversity?

Dr. Mark Hyman(00:19):
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman and that’s farmacy with an F. F-A-R-M-A-C-Y a place for conversations that matter. And if you think food might be messing with your health and making you sick, you better listen to this podcast because it’s with none other than our nutritionist here at The UltraWellness Center, Lisa Dreher on our new episodes of house call, which is a special Doctor’s Farmacy series of episodes that are focused on real problems with real people that have real solutions using the power of functional medicine. Lisa is one of our key nutritionists here, and she is just an extraordinary young lady. She’s a registered dietician. Maybe she’s not so young, but I don’t know. She looks young to me. Everybody’s young, I’m six years old. So she got her undergraduate degree in nutrition at Rochester Institute of Technology.

Dr. Mark Hyman(01:03):
She did her dietetic internship at Cornell University, which is my alma mater. She’s worked in acute care hospital settings. She’s a clinical nutrition specialist and worked in pediatric GI. She also got her master’s degree in nutrition and integrative health from the Maryland University of integrative health, and has been practicing with us here since 2015, and is also certified in functional medicine through the Institute for Functional Medicine and has lectured all over the place. Has been showcased in national magazines like Reader’s Digest on NPR and featured in the Broken Brain 2 series.

Dr. Mark Hyman(01:36):
She’s also developed digestive health and gut microbiome training for dieticians. So she is just on it. And we are so lucky to have her here, because we’re going to talk about something today, which you might not have heard about, but is probably the most important tool to treat disease. Now, I always say if I were stranded on a desert Island or a deserted Island, and I only had one drug or tool to bring with me as a doctor to treat my patients, what would it be? It would be an elimination diet, which I don’t really like the term, because it sounds like you’re depriving yourself. It’s actually an addition diet because you’re adding on all the good things and you’re taking out the bad thing. So that’s what we’re going to talk about today. We’re going to talk about all the various ways in which food can influence our health from the perspective of allergy intolerance and sensitivity.

Dr. Mark Hyman(02:31):
So we know that there’s foods that help promote wellbeing and health and blood sugar and so forth, but there’s a whole other set of ways in which food interacts with your biology, that creates inflammation and that creates chronic symptoms. And then it’s not typically like, “Oh, well, it’s just eat this bad sugar or bread or whatever.” It’s much more nuanced than that. And I think it’s an incredible subject that we haven’t really taken a dive into, but it really, for me, in understanding the role of food as medicine, is really the kingpin of treatment and functional medicine is using food as medicine, not just eat healthy food, don’t eat unhealthy food. But very specifically understanding what people’s unique needs are and what particular foods for them are causing a problem and why.

Dr. Mark Hyman(03:20):
So Lisa, tell us a little bit about your first understanding of the elimination diet and as a dietician, it’s probably not something you really learned much about, except maybe as an elemental diet and someone who’s got Crohn’s disease. But what was the light bulb moment for you when you went, “Wait a minute, this is a game changer when it comes to dealing with chronic disease.”

Lisa Dreher(03:40):
Yeah. Well thank you for the introduction, Mark. It is great to be here. And no, it’s true. I learned a little bit about it in school, but when it comes to how powerful removing certain foods are and adding certain foods in. I only learned that once I actually got to here, got to learn more about functional medicine, learn more about integrative health.

Dr. Mark Hyman(04:01):
Here at The UltraWellness Center.

Lisa Dreher(04:03):
Here at The UltraWellness Center. There are many different ways that a person can react to foods. It’s not just like, as you said, sugar causes inflammation. We know that, but there are these nuances that there are a few different ways I’d like to talk about first being probably the most obvious one, which is allergies. So there’s something called immunoglobulins. And these are antibodies that they’re designed to protect us against invaders, whether that be in the environment, food, I mean, it goes into our digestive tract and that is our first line of defense. So if we have certain invaders or the body perceives them as invaders, we need to be protected. So there are these immunoglobulins. And when we think about allergies, we think more about like a peanut allergy or a cow’s milk allergy, and this is not-

Dr. Mark Hyman(04:48):
Strawberry or shellfish or something where you blow up and you get your tongue swells.

Lisa Dreher(04:51):
Those like top eight allergens, and those are immunoglobulin E or IgE reactions. So these you think of sort of immediate reactions, you think of hives, you think of swelling of the lips, the tongue, more extreme reaction would be anaphylaxis.

Dr. Mark Hyman(05:07):
Yeah. You could die.

Lisa Dreher(05:08):
You could die. It’s a very life threatening, potentially condition. So that happens pretty immediate. People realize that they have that pretty quickly, but there are these other ones-

Dr. Mark Hyman(05:18):
A quick story about, you remind me of this patient I had when I was an intern, I was in the emergency room and this guy came driving up to the front of the emergency room and we heard this horn going nonstop. Like someone’s had their hand on the horn, except he’d have his hand on the horn. He had his head on the horn and he had literally died and his face was in the horn and he drove himself to the emergency room. We brought him in and he was a young guy. We threw him on a stretcher. We put in epinephrin. We put in steroids, we shocked his heart. We brought him back to life, did all the great fun things that we do in medicine. And then we said, “What happened?” He says, “Well, I’m allergic to fish. And my friend was cooking fish.” And I was in his apartment and I smelled the fish. I didn’t even eat the fish. And I noticed I started to react and I’m two miles away from the hospital. And I figured if I waited for the ambulance, I’d be dead.”

Dr. Mark Hyman(06:15):
So he jumped in his car, drove there and it’s that level of reaction. That’s a true allergy. But when we in functional medicine deal with allergies, we’re mostly talking about something quite different, which is a different kind of food reactions. There’s a lot of ways your body reacts to food. That’s only one of them. And it’s not one of the most common ones.

Lisa Dreher(06:35):
No, more common are intolerances and sensitivities. So intolerance, this is a non-immune reaction. So the IgE is an immune reaction. Intolerance, a lot of people might think, okay, lactose intolerance, even fructose intolerance or histamine intolerance or intolerance to sugar, alcohols. These compounds that are poorly digested and absorbed and can lead to symptoms such as abdominal pain, diarrhea, headaches, and that-

Dr. Mark Hyman(07:00):
Yeah. You eat ice cream and you get gased, your stomach blows up. You feel like bad and you get diarrhea. That’s not an allergy.

Lisa Dreher(07:05):
Right. That’s not an allergy. It’s a little bit different than a sensitivity, which I’ll explain. But these, these are a little bit easier to pick up on, the symptoms usually show up within an hour or so after eating the food, like you said, eat milk, drink milk. Then you’re in the bathroom, not too long after.

Dr. Mark Hyman(07:22):
And there are also these things like other reactions that are not even related to intolerance, like for example, MSG or aspartame, which are these excitotoxins. So these are compounds that do have reactions in the body that are not really immune related. They’re more related to the neurologic effects of the amino acid like compounds that can alter your brain functioning and headaches, or make you hyperactive.

Lisa Dreher(07:43):
[crosstalk 00:07:43]. All that.

Dr. Mark Hyman(07:43):
Migraines.

Lisa Dreher(07:46):
Yes, exactly. So there’s that whole series. And then I would argue probably the most common, but the hardest to pick up on are the food sensitivities. So going back to the IgE reactions, these food sensitivities are IgG and IgA. So just the different way that the body reacts. In fact, IgGs are the most common antibodies in the body. So-

Dr. Mark Hyman(08:04):
These are delayed. It’s like, if you eat a peanut you know-

Lisa Dreher(08:07):
You’re going to know pretty quickly.

Dr. Mark Hyman(08:08):
You’re going to know within minutes. If you eat, let’s say you’re allergic to I don’t know like onions.

Lisa Dreher(08:15):
It could be gluten.

Dr. Mark Hyman(08:17):
Or maybe it’s-

Lisa Dreher(08:19):
Any.

Dr. Mark Hyman(08:20):
… Eggplant and you feel sick three days later. You’re not going to know that it was from-

Lisa Dreher(08:26):
It’s several hours or days. Exactly.

Dr. Mark Hyman(08:27):
Yeah. It can be hours or days later. So you’re not always going to connect the dots.

Lisa Dreher(08:31):
Right. And unless you’re writing down everything you eat, I know if you asked me, “What did you eat two days ago?” Unless you’re eating the same thing every day, it’s going to be very hard to-

Dr. Mark Hyman(08:39):
I ate an artichoke.

Lisa Dreher(08:41):
I ate an artichoke with some sauerkraut. So no, it’s very hard. So if you have these, the other thing that makes it difficult too, to pick up on this is the symptoms range so broadly. So it’s not like, “Oh, I’m going to have hives and swelling of the lips.” It could be anything from brain fog, hyperactivity. It could be depression, anxiety. It could be weight gain, could be FLC syndrome, feel like crap, right? And it could be anything else, really.

Dr. Mark Hyman(09:11):
Sleep, depression, mood changes, eczema, acne-

Lisa Dreher(09:15):
Eczema. Yes. So much.

Dr. Mark Hyman(09:17):
Hormonal changes, menstrual issues-

Lisa Dreher(09:20):
Joint pain.

Dr. Mark Hyman(09:22):
Joint pain. Aching.

Lisa Dreher(09:24):
And so a lot of people don’t associate so many of these symptoms with the food that they’ve eaten.

Dr. Mark Hyman(09:29):
Sinus issues, allergies.

Lisa Dreher(09:30):
Absolutely. It could be GI, could be changes to the bowels. It could be constipation, diarrhea, abdominal pain. But again, it’s not so acute. So it’s difficult to recognize which foods are associated with that. And we do check here at the UltraWellness Center. We do have testing to check for these IgG, IGA antibodies, but there’s no one test that’s perfect. There’s no one test that checks every way that a food can interact with somebody or cause these symptoms, which is really why the elimination diet continues to be the gold standard. And that’s what we do pretty much with all of our patients.

Dr. Mark Hyman(10:04):
Yeah. There’s even another response. Because what you’re talking about is antibody responses that the body creates. And antibodies are sort of like smart bombs. There are specific. So you can antibody to dairy or an antibody to eggs or an antibody to chicken.

Lisa Dreher(10:19):
Corn, whatever.

Dr. Mark Hyman(10:19):
Corn, whatever. But there’s another part of your immune system. It’s the ancient immune system. It’s your primitive immune system. We call it your innate or cell-mediated immune system. And that creates a sort of a general response and you can’t measure that and it just creates this just generalized inflammation and it can be to anything. And also gluten is commonly causing this type of innate immune response, which is really hard to measure. So even if you check for gluten antibodies or celiac, you’ll miss it.

Lisa Dreher(10:50):
You may not pick it up.

Dr. Mark Hyman(10:50):
Right?

Lisa Dreher(10:50):
Right. Exactly. No, that’s very true. And there are many reasons why we can have these types because we’re always thinking in functional medicine why, why is it?

Dr. Mark Hyman(11:00):
Yeah. Why do people get these weird sensitivities because it seems like odd that we would be reacting to all these foods that we should be eating and they’re actually probably even good for us. Why would you be reacting to an egg or kidney beans or?

Lisa Dreher(11:12):
Yeah. All these things. Or strawberries like you said before.

Dr. Mark Hyman(11:17):
Or strawberries. It’s like, they’re good for you, Right?

Lisa Dreher(11:18):
Well, there are a number of different reasons. And I would say in relation to sensitivities specifically, number one, you think about what’s the variety in our diet? Our diets are becoming less and less varied. Okay. I don’t even need to, I’m preaching to the choir here, but just with subsidies and just all of the foods, it’s like you go into the supermarket and they’re all made with the same five basic ingredients.

Dr. Mark Hyman(11:41):
Yeah. I mean, 90% of our diet is 12 plants and 60% of our diet is three plants, wheat, corn.

Lisa Dreher(11:47):
Soy.

Dr. Mark Hyman(11:48):
Soy and rice, depending on where you’re from.

Lisa Dreher(11:50):
Exactly. So the lack of variety really, really is a problem. But also if you’re eating a high quantity of certain foods, let’s say it is eggs, which eggs are a wonderful food, very high in nutrient density, but there are higher allergenic potential food. So if you’re eating multiple eggs every day and I talk to people who do this because they love it and it’s easy and it’s quick, but eventually with enough exposure, those proteins can start to become what the body interprets as an invader.

Lisa Dreher(12:19):
So it can begin to develop a sensitivity if there’s not enough variety and rotation in the diet. But then you also have to think about the gut microbiome, how balanced is it? Do we have dysbiosis or lack of balance of gut bacteria and how can that be influencing the inflammation in our gut, the integrity of the lining of our gut? All the things that can lead to leaky gut or intestinal, permeability, herbicides, pesticides, overuse of medications, nonsteroidal anti-inflammatories, antibiotics. I mean the list goes on and we’re all bombarded with this all the time.

Dr. Mark Hyman(12:52):
Okay. You just said something really important Lisa. You said leaky gut.

Lisa Dreher(12:56):
Leaky gut.

Dr. Mark Hyman(12:57):
So I want to backpedal on that. What is leaky gut and why should I care?

Lisa Dreher(13:01):
Okay. I love explaining this. It’s like you can really get the visual because our gut really-

Dr. Mark Hyman(13:08):
It sounds kind of messy actually. I don’t know. I don’t want to-

Lisa Dreher(13:10):
I mean [crosstalk 00:13:11].

Dr. Mark Hyman(13:12):
I don’t know if I want the visual on this one.

Lisa Dreher(13:14):
I’ll make it. I won’t get too crazy with it. So what we eat and what we-

Dr. Mark Hyman(13:20):
There might be children listening.

Lisa Dreher(13:20):
What we eat and what we drink. We want those things. Especially what we eat to break down to there basic molecules. We want the vitamins, the minerals, the amino acids, all these things that our body needs to be absorbed. And we need everything else to get excreted in the stool, urine, all that.

Dr. Mark Hyman(13:37):
That was like a bug filter.

Lisa Dreher(13:38):
It’s a filter. Exactly. It’s a protector, which is why 70 to 80% of our immune system is in the lining of our gut because so much goes through there. So there’s basically one cell thick that helps protect us between whatever is in there. All the toxins and everything.

Dr. Mark Hyman(13:54):
It’s like a sewer.

Lisa Dreher(13:55):
Yes, it is a sewer, right? And everything else that gets absorbed. There’s this one cell lining that we want those cells to be tied together unless we give that… Unless we’re in a place where those foods are completely broken down and then those gaps can open up a little bit, allow some of the amino acids and all the vitamins and minerals to go through. We absorb them. We utilize them in a perfect world, but all these things that we’re talking about, herbicides, pesticides, medications, all that, and certain foods can actually cause gaps to form in between the cells inappropriately and allow larger protein molecules from our food as well as bacteria viruses, all the things that are in our gut to start leaking through into our circulatory system, into our blood, where it shouldn’t be. And then our body sees that as an invader, because technically it is, it shouldn’t be there. It should be in our gut. And so there’s that, and of itself is leaky gut.

Dr. Mark Hyman(14:52):
Yeah. I think, so your gut lining us a coffee filter, right?

Lisa Dreher(14:57):
Yeah.

Dr. Mark Hyman(14:57):
So you want the good stuff to go through the coffee filter, but you don’t want the grounds in your coffee. So if the holes are too big, then all this coffee grounds end up in your coffee. It’s not so great. And the reason the lining is there is to allow the right stuff through and to keep the bad stuff out. And what happens with all the things you’re talking about are processed diet, pesticides, glyphosate, for example, which destroys your microbiome. It’d be overuse of medications, stress, all these various things cause damage to the gut. And so if you look at the microbiome of some indigenous cultures or people who are living more traditional lives and diets, their microbiomes are incredibly diverse, incredibly healthy, and they don’t have allergies. They don’t have asthma. They don’t have autoimmune disease. They don’t have sinus problems. They don’t have eczema. They don’t have many of these problems because their guts are different. And their microbiome is very diverse. It’s like a rainforest instead of a monocrop soybean field.

Dr. Mark Hyman(15:56):
And I think that’s what we’re facing in this country is a devastation of our microbiome. We’re worried about the rainforest. We got a rainforest inside of us. We should be worrying about that and how do we restore that? How do we plant the good trees in there? And I think that the whole concept of these food sensitivities is being completely neglected in traditional medicine. Is thought as quackery, the tests are challenging. They can be helpful, but they’re not like a perfect test. Right? So often for example, I just had a patient yesterday who we did a test on five years ago, she had 26 different foods that she was reacting to.

Dr. Mark Hyman(16:36):
Doesn’t mean she’s allergic to 20 different foods, but she had a terrible gut. She had Giardia, she had terrible bloating, she had irritable bowel. She had all these issues. We fixed her gut and her reactions went down to nine. And in fact, not only did they go to nine, but they were very, very little levels of reaction. And they were only to the things that we knew she was really reacting like gluten. So it was Rye, barley, oats or wheat, those are the ones that she was reacting to. So out of the nine, five of them were like gluten grains, which we knew anyway.

Dr. Mark Hyman(17:08):
So I think the key is you can heal a leaky gut. And if you were allergic to peanuts, you probably want to stay away from peanuts forever. There may be new treatments and so forth that we can modify that, but you don’t want to mess with that. If you’re sensitive to a food, it doesn’t mean that you need to stay away from it forever. You need to fix the cause. And that’s what functional medicine really is focused on.

Lisa Dreher(17:30):
Absolutely. And I think another point of what you’re saying is we’re trying to increase and improve the resilience of the body. So the goal is to not keep those foods out that we see on these sensitivities or if we’re doing some kind of comprehensive elimination diet. We’re not trying to keep those foods out for the next 10 years of your life. We’re trying to heal and seal the lining of the gut, help improve the microbiome to the point where you can then be more varied with your diet, expose yourself to new foods that before perhaps were giving you a problem, but won’t be as much of an issue down the road. So yes, I think that’s a very good point.

Dr. Mark Hyman(18:04):
Hey everybody, it’s Dr. Hyman, thanks for tuning into The Doctor’s Farmacy. I hope you’re loving this podcast. It’s one of my favorite things to do and introduce to you all the experts that I know and I love, and that I’ve learned so much from. And 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 drhyman.com/picks to sign up. That’s drhyman.com/picks P-I-C-K-S. And 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.

Dr. Mark Hyman(18:58):
Now, back to this week’s episode. It’s not just about getting rid of the foods, it’s about figuring out why the gut is a mess and-

Lisa Dreher(19:07):
And what can you add to help heal it?

Dr. Mark Hyman(19:10):
… What can you add to heal it? So it’s not just about what you take out.

Lisa Dreher(19:11):
It’s a huge part of it.

Dr. Mark Hyman(19:12):
That’s why we should call it an addition diet instead of elimination diet.

Lisa Dreher(19:13):
Yes, I know. I really, I’m with you.

Dr. Mark Hyman(19:16):
It’s bad marketing.

Lisa Dreher(19:17):
It is.

Dr. Mark Hyman(19:17):
I think we should come up with a better name for it.

Lisa Dreher(19:19):
Yes. I don’t like the elimination part. That’s one thing. There are two things that I really like to emphasize with my patients. And one is, it’s not just about what you can’t eat. I know it’s easy and it’s very natural to see this list of foods, whether it’s a short list or a comprehensive elimination diet where we have a ton of foods that we take out like corn, soy, wheat, gluten, dairy, all these things. And then they’re left thinking, “Well, what can I eat?” Well, the reality is there’s a lot more you can eat than you can eat in the situation. But it’s so easy because food isn’t just calories and fat and protein. It’s also what connects us. It’s part of the community and emotional connection we have. So if you’re used to eating these foods all the time, it’s a big shock to some people. So then that’s all they can see is what they can eat. But it’s really-

Dr. Mark Hyman(20:07):
Yeah. “You’ve taken away my cheese. Oh my God.”

Lisa Dreher(20:10):
I’ve got a story about that.

Dr. Mark Hyman(20:11):
“Wait.”

Lisa Dreher(20:12):
Yeah. Exactly. But it’s also about what you can add in not only in terms of whole foods that are rich in polyphenols, these things that protect and heal the lining of the gut. But it’s like getting more diversity in your diet, learning how to get into the kitchen, cook with all these different flavors and textures, reconnect with food.

Dr. Mark Hyman(20:33):
Spices.

Lisa Dreher(20:33):
Exactly. That are actively healing, but you’re also enjoying the food.

Dr. Mark Hyman(20:40):
Yeah. I was joking about the artichoke, but that’s great-

Lisa Dreher(20:41):
No, it’s not a joke.

Dr. Mark Hyman(20:42):
… Prebiotic food. And I eat them like every week-

Lisa Dreher(20:45):
Yes, they’re wonderful.

Dr. Mark Hyman(20:45):
… Multiple times a week. And it’s so delicious. I dip them in extra-virgin olive oil, balsamic vinegar, which also helps your gut. And so-

Lisa Dreher(20:51):
Exactly. Polyphenols.

Dr. Mark Hyman(20:52):
Right. And so it’s really fun and easy.

Lisa Dreher(20:55):
It is. It can be fun.

Dr. Mark Hyman(20:56):
And then you get to add stuff back. Right?

Lisa Dreher(20:59):
Right. And that’s so important. And that’s what people don’t realize. And a lot of people come to me and either they’ve already tried an elimination diet, let’s say they’ve done gluten and dairy free. My first question always is, “Did you have any help? Did you do this on your own? Did you go online? Did you find something or did you have a professional who knows how to guide you through this?” First question. Second question is, “How do you reintroduce? Like, what do you do?” “Well, I went and had a pizza.”

Dr. Mark Hyman(21:25):
I had a pizza. Well, that’s like three or four different-

Lisa Dreher(21:28):
Gluten, dairy. All these things, and we’re not even talking about good quality gluten, we’re talking about white flour. So that-

Dr. Mark Hyman(21:36):
I had this patient she had rheumatoid arthritis and she was overweight and she really was struggling and she was tested gluten. She was definitely tested for gluten sensitivity and she had elevated anybodies. And I said, “You really can’t be eating any gluten.” And she’s like, “Well, I’m not. I’m not. I’m not. I’m not.” I’m like, “Well, let’s do an experiment. Let’s put you on a…” The point at that time was so just to… We call it an ultra clear fast. So for 10 days, all she did was this rice protein shake, which is hypoallergenic. And that was it. All of her symptoms went away. She dropped a ton of weight and she realized that there was gluten in her diet and it was hidden.

Lisa Dreher(22:14):
Hidden sources.

Dr. Mark Hyman(22:14):
It could be in soy milk that you’re having. It could be in-

Lisa Dreher(22:19):
Dressings and all of that.

Dr. Mark Hyman(22:20):
Dressings. And it’s got all these names that you don’t even know.

Lisa Dreher(22:23):
It’s like sugar, they disguise it.

Dr. Mark Hyman(22:25):
And then in processed food, there’s something called microbial transglutaminase. So gluten is what is often used to make things stick together because it’s like glue. If you ever made flour or bread, it’s like that sticky thing. And it makes processed foods stick together. And so they have bacteria make these actually bacterial versions of gluten, essentially that then they put in food and it doesn’t have to be on the label. So pretty much if you’re eating any packaged or processed food, you don’t know what you’re eating. And so I think, and people are really, really sensitive even a fly by if they’re eating out of a grill that somebody cooked something on was breaded.

Lisa Dreher(23:06):
Cross-contamination.

Dr. Mark Hyman(23:07):
You’re going to get it. So I think I did that and then I saw her a few months later and I was like, “What happened to you?” And she lost 40 pounds, all of her sinus went way. So I think people have to understand like, “Oh, I just had a little bit.” For some things that may not be a big deal, but if you have a little bit of gluten, even a thumbnail full in three months, you’re back to square one.

Lisa Dreher(23:25):
Yeah. It’s tough. And in terms of gluten there’s so many people, I’m sure you’ve had this experience too, where people will go over to Europe and have the gluten there and they won’t react as much. And for some people that is the case for some people, they just have to keep it out entirely no matter where they are. But I think there are two major reasons why. Number one, in this country, we’ve hybridized and basically genetically modified wheat to have double the amount of gluten, because of exactly what you’re saying, that stickiness that we like, the texture we like, it’s just trying to make it more powerful.

Dr. Mark Hyman(23:57):
Those giant freaking croissants and bagels instead of little ones.

Lisa Dreher(24:01):
Yes. And then also we spray wheat with herbicides, pesticides, all these things, and the combination of the excess gluten with all of these chemicals, just it’s a perfect storm for our gut and leaky gut and dysbiosis. And then all of the other symptoms that come from that, and that I think of joint pain. I think of headaches. I think of ADHD. I think of a lot of things that are associated with that sensitivity specifically.

Dr. Mark Hyman(24:26):
Yeah. I mean, the gluten story is really interesting because you’ve watched these movies like, “Hey, I’m gluten free.” It’s like, “What’s that?” It’s like, “I don’t know, but everybody is doing, it must be good.” Right?

Lisa Dreher(24:35):
All those. Yeah. I’m seeing them. Exactly.

Dr. Mark Hyman(24:36):
And it’s sort of become this cultural meme. Most people don’t even know what gluten is, but it’s a protein that’s in wheat that can be very inflammatory. And the modern wheat has much more of these gluten proteins. And tell us why gluten is of all foods is so critical in terms of driving this leaky gut and leading not only to gluten sensitivity, but to all these other sensitivities that sort of follow on that are like hangers onto the gluten?

Lisa Dreher(25:04):
Exactly. Well, there’s one thing that I will say in terms of when you eat gluten, that’s one of the major drivers of something called zonulin. And zonulin, it was discovered and found actually drive leaky gut. So to give signals to the lining of the gut to open up and make those gaps so that things fall through. So it actually is one of the major drivers of leaky gut for that reason. And as I said before-

Dr. Mark Hyman(25:29):
So basically this is a natural molecule in our bodies. It’s designed to take care of things. For example, if you get calories, I mean, sometimes it’s good to have a leaky gut.

Lisa Dreher(25:38):
It can be. Sometimes.

Dr. Mark Hyman(25:39):
But gluten tends to trigger this according to Dr. Alessio Fasano who’s the world’s expert in gluten at Harvard, that it triggers some degree of increase in zonulin in everybody which can trigger some degree of leaky gut in everybody.

Lisa Dreher(25:55):
Regardless, yes.

Dr. Mark Hyman(25:55):
Some people do fine and they’re okay with it and they’re really healthy and it doesn’t matter. But if you’re looking to dramatically reduce inflammation, making glutton a staple in your diet is not a great idea and particularly modern wheat. So if you want to eat ancient spelt or-

Lisa Dreher(26:10):
Einkorn.

Dr. Mark Hyman(26:10):
Or Einkorn wheat, or Kernza wheat, or certain rye, those might be better tolerated.

Lisa Dreher(26:17):
Spelts, especially those that have been sourdough or the traditional way of actually creating and making breads-

Dr. Mark Hyman(26:23):
Actually Dr. Fasano said here we have these fast-rising breads, like one hour boom, two hours. He said in Europe, it’s 12 hours, 18 hours, 24 hours, they make their bread rise. So it actually creates a very different process in the wheat that breaks down some of the gluten and creates less reactivity. So there’s a lot of explanations.

Lisa Dreher(26:41):
Absolutely. So yeah, eventually, no matter who you are. And I think he said, this Dr. Fasano said, regardless of your predisposition to gluten sensitivity, celiac disease, if you have gluten in your diet long enough and in large enough quantities, you are going to lose, it’s the human that’s going to lose, it’s the gluten that’s going to win.

Dr. Mark Hyman(27:00):
And basically if anybody has any chronic disease or any inflammatory problem.

Lisa Dreher(27:04):
Auto immune condition. Absolutely.

Dr. Mark Hyman(27:06):
Pretty much anything that it’s sort of like for me it’s like getting someone’s blood pressure, checking to see if they’re reacting to gluten is checking their blood pressure and-

Lisa Dreher(27:17):
It’s the standard here.

Dr. Mark Hyman(27:17):
It is because partly because we see people who have seen everybody else and done everything else and gone everywhere and they’ve come here because nothing else is working, but it also is so common and it’s so missed and it’s so misdiagnosed. And so we have different diagnostic tests that can help us look at different gluten antibodies. Look at zonulin antibodies. We have very sophisticated ways of looking at this. And I think for people who are struggling, it’s very helpful. And then you can actually implement a program of a diet to eliminate the foods that are reactive.

Lisa Dreher(27:45):
Very specific to them. Exactly.

Dr. Mark Hyman(27:46):
So you can do testing, or you can just do an elimination diet, but I love you to share some stories of some patients we’ve had here at the UltraWellness Center who struggled and tell me what was going on with them and how did this approach impact them?

Lisa Dreher(27:58):
Yeah. So one comes to mind. I would love to share. So there’s a 47-year-old woman who came with constipation. She was pooping maybe twice a week. I’m like, “We got to get you pooping twice a day. Let alone twice a week.” So constipation-

Dr. Mark Hyman(28:12):
Yeah. That reminds me of a patient I had. I said, “So how are your bowel movements?” She says, “They’re regular?” I said, “How often do you go?” She goes, “Once a week.” I said, that’s not regular. She says, “It’s regular for me. I go every week.” I’m like-

Lisa Dreher(28:26):
Exactly. Just painful.

Dr. Mark Hyman(28:27):
One woman said, she’s “Dr. Hyman, I didn’t know it was normal. I thought going every day, this is like a whole thing.”

Lisa Dreher(28:33):
Exactly. That’s normal to them. That’s what they think is normal. But this person had constipation. At least she recognized that it was constipation. She had joint pains, but she had sinuses, recurring sinus infections that would happen every year, once or twice a year. So when I hear constipation, when I hear sinus congestion and inflammation in general, I think of dairy, dairy products. And when I hear joint pain, I think of gluten. Sure. It could be a lot of other foods, but we thought, okay, let’s start off with gluten and dairy free. Of course sugar-free and preservative and [crosstalk 00:29:03] free.

Dr. Mark Hyman(29:03):
Processed. Yeah. Gluten dairy, sugar, and processed food. 90% of the time is all you need.

Lisa Dreher(29:07):
Exactly. So at first she sounded like she was on board. I just kind of gave her the overview and then it was like a light bulb just went off. So she grabbed-

Dr. Mark Hyman(29:20):
Yeah. Told you you had to take away her cheese.

Lisa Dreher(29:20):
Yes. She’s like, “Are you telling me that I have to give up my cheese?” So when I told her, I said, “Well, unfortunately, yes.” And I thought it was just going to be like a little back and forth. She started sobbing.

Dr. Mark Hyman(29:31):
Oh no.

Lisa Dreher(29:32):
I mean. Sobbing. I had to give her the tissues. And I said, “You know what? This is the first time I’m really seeing in real time the power of food addiction.” And I let her finish obviously, I didn’t interrupt her, but I said, “Have you ever heard of casomorphins before? Or gluteomorphins and these opioid like peptides that cross the blood brain barrier and can actually not only influence you neurologically, but cause you to feel addicted to these foods like you need to have more.” She’s like, “No, I haven’t heard of it, but it sounds like me.” And I was just kind of nervous. I wasn’t sure if she was really going to be on board. Because she, again, I’d never seen something so reactive before.

Lisa Dreher(30:13):
Four weeks later, she comes back. I’m like, how’d she do? Different person, different person entirely. Even the way she spoke was more clear. She sounded more confident. Like there wasn’t something holding her back as she was pooping five times a week, her joint pain went away. But she was like, “The most remarkable thing about this is not just the fact that I was able to give up cheese, but the fact that I don’t have any cravings for it anymore, I don’t need it. I don’t even want it. Because I can’t believe something had such a tight hold over me.”

Dr. Mark Hyman(30:44):
Well you mentioned these casomorphins and this is a real thing that we actually test for at The UltraWellness Center. We used urine testing and we can see both gluten and dairy. They do react with the basically heroin receptors in your brain and the opioid receptors in your brain. And they create this pleasure, but they also are highly addictive. And it’s not that it happens in everybody, but it’s not that uncommon. It’s more common in autistic kids and others. So really, very great story because people often don’t connect the dots. And when you give people a chance to stop the foods that are problematic and add in the good foods, then their body’s going to tell them, they don’t need you or me or a doctor or anybody else to tell them what works. They see the difference, their sinuses clear up, their headaches go away. Their skin clears up. They feel better, their digestion improves. So I think that’s a great case. And you had another case of a young man with depression and anxiety and acne.

Lisa Dreher(31:40):
He was 20 years old. It was very, very sad. The depression was debilitating for him for many years, anxiety, as you said, acne, cystic acne. And so he was a bit more complicated. He had been struggling for a while. So we did a comprehensive elimination diet. So we took out all the heavy hitters. Of course, like we said before, all the processed foods, but corn soy, even shellfish and tree nuts. And we took out, made sure alcohol, caffeine, all of that. And that’s the diet where people are like, “What should I be eating then if I have to give up all these foods?” That’s also-

Dr. Mark Hyman(32:11):
“What am I going to eat?”

Lisa Dreher(32:12):
I know. “What am I going to eat? What the heck should I eat?” That’s like your book. So

Dr. Mark Hyman(32:16):
My food group is pizza.

Lisa Dreher(32:19):
All the things you can’t eat, it’s devastating. But number one, that’s why it’s so important to work with somebody that you can have guidance. You have ideas for meals, snacks, and that’s what every patient walks away with is, is a very individualized meal plan that provides what should they be eating and recipes, resources, all of that. But so going back to this case, we knew that it was going to be a little bit longer term. I knew that he was going to feel better to some degree, but I thought it was going to take a little bit longer. So after four weeks, which is a typical amount of time between when somebody first comes to see me and the follow-up. He started to feel a clarity that he hadn’t had in a while. He still had the depression. He still had the anxiety, the acne was still there, but he said, I feel well enough that I’m motivated and I want to keep doing this. And that was going to be my recommendation anyway. So I was like, “Okay, great. We’re on the same page.” Another month goes by-

Dr. Mark Hyman(33:09):
Because it doesn’t take a long time. It’s not like you do this for six months and see how you feel. Literally the first few days are hard because you want to withdraw. And then after three or four days by day five, six, seven, you start to see such dramatic changes. It’s pretty remarkable.

Lisa Dreher(33:23):
Yep. And the people that I would least expect to be on board with these types of diets are the ones that do the best, to be honest with you. And so after a month he said, “Okay, I’ve got this clarity. I do want to continue on.” The second month I mean, the acne was next to God. It was so cleared up.

Dr. Mark Hyman(33:43):
And cystic acne is a big deal. Plenty of big, giant welts in your face.

Lisa Dreher(33:47):
It really was devastating his confidence. And so that was very clear. Then by the third month he was in much better spirits. He was having much more awareness of just his emotional reaction to things. Depression was much less overwhelming. And so we started to do the reintroduction process because that is so important. People don’t realize how important it is to do the reintroduction process in a structured way. Not just throw in like, okay, I’m going to just eat a pizza.

Dr. Mark Hyman(34:12):
“Okay. 10 days are over. Boom. I’m going to live it up.”

Lisa Dreher(34:15):
No, we can’t do that. We have to be very structured. And that’s what I help people with is how do you do this in a way that we can really identify which foods might you need to stay off of a little bit longer, but as we’re working to heal the gut, as we talked about before, how can we bring these foods back in so that you can start having more variety and more diversity? So with him, by the third month we reintroduced one food at a time, it usually takes about three days each food. We found that when he had cow’s milk and gluten, and I think it was corn, those three triggered his symptoms to get worse. So we kept those out, but he was able to have a variety of pretty much all the other foods we’re talking whole foods here. We’re not like, “Oh yeah, try reintroducing MSG.” We’re not going to do that. But we’re talking about whole foods. And it was just, it was remarkable to see the difference and to watch him be able to eat these foods again, without problem.

Dr. Mark Hyman(35:06):
It’s pretty amazing when you see this, that’s why I say if I had one tool to use on a deserted Island as a doctor, it would be this. It’s usually the place I start. It’s really what I’ve written about in so many of my books, whether it’s a 10-Day Detox Diet or Food: What the Heck Should I Eat?

Lisa Dreher(35:21):
Blood Sugar Solution and all that.

Dr. Mark Hyman(35:23):
Yeah. All of those things are real just understanding that food is driving so much inflammation and inflammation is causing most of our chronic diseases that affect six out of 10 Americans and also driving weight gain. People don’t understand that if you have a food sensitivity, you could be eating the right foods, but you may be just not able to lose weight because of the inflammation. And then also you mentioned mental health. We don’t think of depression or anxiety or OCD or ADD being related to food sensitivities, but they often are.

Dr. Mark Hyman(35:52):
So a lot of the problems that we see are really, really driven by this problem of an imbalance in our ability to tolerate the foods that we should be eating. And of course, nobody should be eating processed food and junk food, but even if you’re eating good food, if you could have like dairy could be okay right. Corn should be okay, eggs should be okay. I had a patient that had debilitating migraines for decades, turned out she had a very high reaction to eggs, got rid of the eggs and her migrants were done.

Lisa Dreher(36:26):
I know, it’s a common one.

Dr. Mark Hyman(36:26):
So sometimes it’s just so super simple. People can do anything for 10 days, a couple of weeks. And if you try it, if you’ve never done it in your life, it’s worth a try because you can really see a radical change very quickly. And we’ve created a program called The 10-day Reset, and you’ve got to get Farmacy with an F getfarmacy.com and learn about The 10-day Reset, which is a powerful self-guide. And you can join the group and also get support if you want. But program that allows you to do an elimination diet. And of course the UltraWellness Center here we’re to help you, we have nutrition only consults. And we have an incredible team of nutritionists and dieticians here who’ve been working in this space for a long time and are leaders in the field. And sometimes it’s more nuanced than just taking out their foods.

Dr. Mark Hyman(37:12):
Depending on the person, you might have bacterial overgrowth in your gut and bad bugs growing. So you have to eliminate all the fermentable foods, or you might have histamine intolerance, or you might have fructose intolerance. So we’re very good at diagnosing those things, which are unique to you being a problem.

Lisa Dreher(37:29):
Individual.

Dr. Mark Hyman(37:29):
Individuals. And when you do, it’s like a miracle, except it’s not really a miracle. It’s just good science and it’s good medicine. It’s what we should all be doing.

Lisa Dreher(37:37):
It seems like a miracle to people but-

Dr. Mark Hyman(37:39):
This whole area of food sensitivities, unfortunately, is something that traditional medicine is just a total blind spot too. And maybe because they don’t like the testing. And I don’t think the testing is a foolproof system. You’re looking for patterns. So when I see 26 foods, I’m like, she’s not allergic to 26 foods, she’s got a leaky gut. Let me fix her gut. And then here we are. And she’s better now and she’s looking better on paper, but all of her chronic fatigue sensors are gone.

Lisa Dreher(38:06):
She feels better.

Dr. Mark Hyman(38:07):
She feels better. She’s doing so much better. So at the UltraWellness Center here, we are really focused on getting to the root of people’s problems and we’re now seeing people virtually come virtually and visit us and consult with us and we’re happy to see you. We’re also running a eliminate to feel great. Maybe we should change the eliminate. We’ve got to figure out a better marketing for this elimination diet, the healing diet or something like that. They’re going to be done by Zoom. It’ll be led by one of our nutritionists who’s going to guide the group through an elimination and reintroduction process.

Dr. Mark Hyman(38:40):
You can look at the UltraWellness Center website, call our office at the UltraWellness Center, check on our Facebook page for the exact date. It’s going to be five weeks long, it’s going to be fabulous. If you’ve never done it, it’s great to do it with a group because then you feel like you can compare notes, you get the support. And it’s a pretty remarkable strategy for creating healing. And Lisa, I am so excited for you having your first appearance here on The Doctor’s Farmacy podcast, hope for many more.

Lisa Dreher(39:05):
Yes. Me too.

Dr. Mark Hyman(39:08):
And I think we’re just really glad and gifted to have you here and teaching us about nutrition, working with our patients. So thank you so much.

Lisa Dreher(39:16):
Thank you. The honor is mine. Thank you.

Dr. Mark Hyman(39:17):
And if you’ve been listening to his podcast and you love it, please share it with your friends and family on social media. Leave a comment we’d love to hear from you, maybe your experiences with elimination diets, and what’s that’s done for you and subscribe wherever you get your podcasts. And we’ll see you next time on The Doctor’s Farmacy.

Lisa Dreher(39:32):
Thank you, Mark.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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