Heal Your Autoimmune Disease: What’s Causing It and How to Stop It with Dr. Robert Rountree

Mark Hyman, MD

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Dr. Mark Hyman
Coming up on this episode of The Doctor's Farmacy.

Dr. Robert Rountree
People develop these symptoms like join aches or rashes, things like that. They go see the doctor, the doc says, okay. You've got these antibodies, or maybe you don't have any antibodies at all. In which case, you don't qualify. You don't have the disease.

Come back in a year. Yeah.

Dr. Mark Hyman
Come back when you're sicker.

Dr. Robert Rountree
Yeah. Come back when you're sicker, and we'll do the test, and we'll see if you got the

Dr. Robert Rountree
end of

Dr. Mark Hyman
the day. Criteria, we don't care how you feel. But when you meet the criteria, then we can give you Now before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, There's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand Well, you. If you're looking for data about your biology, check out function health for real time lab insights.

And if you're in need of deepening your knowledge around your health journey, well, check out my membership community, Doctor Hyman Plus. And if you're looking for curated trust supplements and health products for your health journey, visit my website, doctor hyman.com for my website store and a summary of my favorite and thoroughly tested products. Welcome to The Doctor's Farmacy. I'm doctor Mark Hyman. That's pharmacy for that for place for conversations that matter.

And if you or anyone you know has suffered from autoimmune diseases, I would listen up because we're gonna get a deep insight today into this whole explosion of autoimmune diseases happening in our society with one of my mentors and an incredible physician, Doctor Robert Rountree. He, graduated from the University of North Carolina Greensboro in 1976, He has his medical degree from UNC School of Medicine at Chapel Hill in 1980 and has done a residency in family and community medicine. And he's just a brilliant dude. He's been practicing family medicine in Boulder since 1983. And he's done a lot in his career.

Is really, really one of

Dr. Robert Rountree
the main thinkers that has been behind the development of functional medicine.

Dr. Mark Hyman
He's written many, many books, in and many chapters and books on integrative nutritional medicine, including the textbook of functional medicine, the clinical natural medicine handbook and so forth. He's an amazing scientist. He's a comedian when he gets up on stage. He's a good friend. He won the Lineus of Pauling Ward in in 2015.

And it's just a a legend in this field. So, Bob and I get deep into this conversation about autoimmune disease. We're seeing this being the number one condition affecting Americans today when you aggregate them altogether. There is really something that is going on here that nobody's really talking about, which is why. And functional medicine's all about why.

And Bob and I get into The why, why are these diseases on the rise? What causes them? What are the most prevalent ones? How toxins play a significant role? In them as well in immunotoxicity and how these conditions are treated with functional medicine.

So I would encourage to listen up. He's a brilliant guy. It's gonna be a great conversation. And I hope you enjoy this conversation with Doctor Bob Rountree. So, Bob, welcome to the podcast.

It's great down to you.

Dr. Robert Rountree
Hi, Mark. Great to be here.

Dr. Mark Hyman
Listen. You know, we've known each other for better parts. 3, 3 decades.

Dr. Robert Rountree
Yeah. Yeah.

Dr. Mark Hyman
Yeah. Yeah. And, you were this kind of iconic figure when I first mentioned my mind, this guy got up on stage and unraveled the mysteries of human biology in ways that just left me in awe and left me rolling on the floor laughing. And, hopefully, we'll do both of those today. And I I think, you know, the topic today is one that is affecting more people Yeah.

Than almost any other health condition probably except metabolic syndrome and and, prediabetes and the whole phenomena of poor metabolic health. It's autoimmune disease.

Dr. Robert Rountree
Yes.

Dr. Mark Hyman
And if if you look at it collectively, autoimmune disease affects more people in cancer, heart disease, and diabetes combined. It's over 80,000,000 Americans who have some form or another, serious or less serious, and It's gone crazy. I mean, when you look at the data from a 100 years ago, we didn't have these autoimmune seasons. I've been traveling out to remote areas in the jungles and Ecuador to remote areas where people live in traditional ways, and they don't have a lot of muses. They don't have allergy.

Right. And so something's kinda gone wacky. And, you know, as part of a company that I cofounded function health, we've been tracking people's data. We've done over 3,000,000 data points. On over 25,000 people.

Dr. Robert Rountree
Mhmm.

Dr. Mark Hyman
And, we're looking at the biomarkers that pop up that are, you know, abnormal, and 30% and this is a health forward population. 30 percent of the people who test at function health have a positive A and A. Which is staggering to me.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
I mean, it's 1 third of people are walking around with either some form of auto community or pre auto community

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
And, you know, it's it's affecting so many of us in so many ways. I've had autoimmune diseases. I've had positive antibodies. I've had ulcerative colitis. I've had all kinds of inflammatory syndromes, and I've had to learn about it from the inside out.

And I've been able to heal myself by using the model of functional medicine. And I think, you know, You've you've been really one of the key thought leaders, thinkers kind of concoctors of the model, and and in fact, you you lead the,

Dr. Robert Rountree
like concoction.

Dr. Mark Hyman
Yeah. The immune the immune module at the super functional medicine, which changed doctors on how to think about this. But you know, why why are we seeing so much of a rise in autoimmune conditions, like lupus, rheumatoid arthritis, MS, colitis, Crohn's disease, Hashimoto's, why are these On the rise, why are we seeing this this whole phenomena of this disease where the body's attacking itself?

Dr. Robert Rountree
Well, you have to start with where we were 100 years ago, there was a doctor Paul Erlick who's considered the founder of modern immunology. Right? And doctor Erlick said autoimmune diseases incompatible with life. Yeah. Cannot have it.

And if you did have it

Dr. Mark Hyman
That's not true.

Dr. Robert Rountree
And if you did have it, you would call it the horror autotoxicous. Or autotoxicous.

Dr. Mark Hyman
Or autotoxicous? Like a lot of people's lives without immune disease.

Dr. Robert Rountree
Or autotoxicous because that if the body is immune system attack itself everything would fall apart and you would die. Right? And doctor Erlick was a big head honcho. You know, no one disagreed with him. And so he said, It doesn't exist, and everyone looked the other way.

Yeah. Even though they knew for a long time about anti nuclear antibodies. Yeah. For example. That's the positive test that I was talking about.

Dr. Mark Hyman
The 30% of the population we're testing. Yeah.

Dr. Robert Rountree
Population. So it wasn't till around the 19 forties or fifties that it began to make knowledge that autoimmune is ex his disease exists. Right? So we start from it doesn't exist at all. The crazy So okay.

Maybe a few people have. There's auto It wasn't that prevalent, in fact. It didn't seem to be. Mhmm. Didn't seem to be that prevalent.

We weren't checking for it the same way. We're checking for it now. Right? So part of it could be that we didn't believe it. We weren't looking for it.

And so Now we have ways to look for it we can investigate, so that might be part of it, but then the feedback you might get around that as well isn't that the same with autism Yeah. Right? Do we really have more autism now, or are we just better at looking for? I think there's more to it. And I think the more to it, which has actually gotten to the point now where the latest stuff that the researchers are saying is that maybe we all get out of them.

Dr. Mark Hyman
That this always have something to do.

Dr. Robert Rountree
All the get get it to some degree. So staging is sort of a immune condition. Engaging is kind of an autoimmune condition, right, because anti nuclear antibody levels, the titers go up Yeah. With aging, what are anti nuclear antibodies? They're antibodies against the nucleus of the cell which could be any material to solve against the DNA.

Yeah. Or the proteins that wrap around the DNA. Right. Why would we add that? Yeah.

Right? Something's gotta be damaging the cells so that the cellular contents, specifically the nuclear contents, are getting out into the bloodstream, And then the immune system sees that and starts making antibodies. Now our friends, Arissa Verjdani, and, They've done some very interesting studies on antibodies against toxins. Talks?

Dr. Mark Hyman
Like, I've molds.

Dr. Robert Rountree
Right. They go to people that live in a manufactured home facility, right, where there's a lot of you know, formaldehyde and other kind of chemicals there. And they measure antibodies against the common materials that are found in those homes. And all these people are making antibodies. Yeah.

So, you know, we start with this observation that there's antibodies against nuclear material. What else are there antibodies against? Yeah. All kinds of things. And why don't we make antibodies?

Yeah. Because something is perturbing the immune system. Yeah. Right.

Dr. Mark Hyman
Yeah. What you're really talking about is is this this phenomena where the body is attacking itself.

Dr. Robert Rountree
Yes.

Dr. Mark Hyman
And there's gotta be some trigger, but in traditional medicine, we're just really good at describing the symptoms. And the pathology. So you have you have psoriatic arthritis.

Dr. Robert Rountree
Yes.

Dr. Mark Hyman
You have rheumatoid arthritis. I mean, you meet these diagnostic criteria that are set up by the the, you

Dr. Robert Rountree
know, government bodies. Right. Right. Right. Right.

Or something like that.

Dr. Mark Hyman
Right? That are on high that say, okay. If you have this disease Right.

Dr. Robert Rountree
Lupus, you've got these 5 criteria. You gotta meet those 5 criteria.

Dr. Mark Hyman
And so but it doesn't tell you anything about the why. And functional medicine all about the why. Why do you have this problem? Why is the body attacking itself? And so they they really, you know, have a very archaic way, in my view, very almost, frightening way of dealing with these diseases, which is using very powerful drugs.

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
Things like prednisone, immune suppressants, TNF alpha blockers, things that, like, tend to have serious side effects. So they can be lifesaving and they can help people relieve suffering and they can relieve pain and They're not a problem to use in every case. But what I'm what I'm suggesting is that they're missing the point. You know, one of our our mentors, Cindy Baker, always said it, you know, that we should pay attention to what we call the attack rules of medicine. Yeah.

Standing on attack, it takes a lot of aspirin to feel better.

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
If you're eating gluten and that's causing your autoimmune disease, it takes a lot of prednisone to suppress that immune response. Why wouldn't you just get rid of the gluten in the first? Right. Right. So I'm I'd love you to sort of unpack how in in functional medicine we begin to think about causes because and maybe I even shouldn't say functional medicine because if you look at the scientific literature

Dr. Robert Rountree
It's all there.

Dr. Mark Hyman
It's all there. Like, when you just talked about with the immune system, right, there there's a whole series of of, chemicals that our body is causing an autoimmune response to. And this is a phenomenon called immunotoxicity. Yes. And it happens in very, very low levels of these chemo that are ubiquitous forever chemicals that were exposed to.

Whether it's plastic, you know, phthalates, petrochemicals, pesticides, herbicides, sides? Have you met a pharmaceutical? Pharmaceuticals. Okay. We'll get into that.

Yeah. There is I know there's some partners close to caught autoimmunity, but but, you know, This is stuff that we we don't really pay attention to in traditional medicine. You know, the science is all there. So can you just sort of, at a high level breakdown? 1 of the top causes of things that make our immune system so pissed off because that's what's different about functional medicine.

It's not like, okay. Your immune system pissed off. Let's find the drug to calm it down. Like, no. We're gonna find out why your immune system's pissed off.

Dr. Robert Rountree
So in order to, get across the mechanism of this root cause thing, I've gotta talk a little bit about the immune system.

Dr. Mark Hyman
Please.

Dr. Robert Rountree
Right. 2 major parts of the immune system that we know. The innate immune system, which is the ancient part, you know, jellyfish have an innate immune system.

Dr. Mark Hyman
The jellyfish immune system.

Dr. Robert Rountree
The jelly immune system, and then the acquired immune system, which is the part that gets activated with exposure to a virus or vaccines or things Yes.

Dr. Mark Hyman
When you get antibodies against COVID,

Dr. Robert Rountree
that's from That's from

Dr. Robert Rountree
That's from

Dr. Robert Rountree
he left the sides. That's the evolved immune system. And so if you look through the literature on autoimmune disease. It's all about the acquired immune system. The drugs that were developed to treat autoimmune disease are all drugs targeted at t lymphocytes or b lymphocytes.

So they're all working on only one

Dr. Mark Hyman
part of the

Dr. Robert Rountree
immune system. And so the assumption, or in you start thinking that way, is that there's aberrant functioning Right? Barron, what does that mean? Right? It means that you're walking down the street and one day rheumatoid arthritis falls out of the sky and hits your t lymphocytes or your b lymphocytes and you start making antibodies that gets rheumatoid factor.

Right?

Dr. Robert Rountree
It's

Dr. Robert Rountree
the IGM against IgG. And so that kinda sets you up, right, for this lifelong problem and the the sort of joke that I tell is that people develop these symptoms like joint aches or rashes, things like that. They go see the doctor of the doctor says, Okay. You've got these antibodies, or maybe you don't have any antibodies at all. In which case, you don't qualify.

You don't have the disease. Come back in a year. Yeah.

Dr. Mark Hyman
Come back when you're sicker.

Dr. Robert Rountree
Yeah. Come back with your sicker, and we'll do the test, and we'll see if you got the

Dr. Robert Rountree
end of

Dr. Mark Hyman
the day now. Criteria, we don't care how you feel, but then when you meet the criteria, then we can give you a drug.

Dr. Robert Rountree
Then we give you the drug. And You've made the team. You've made the team rheumatoid arthritis. Yeah. You've made the team multiple sclerosis.

You've made the team Hashimoto's. Yeah. Right? But what they don't tell you is that the jersey for the team is welded to your back for life. Yeah.

Because now you've got it. You're stuck with it.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
So that's all based on the premise that this is an acquired immune system dysfunction

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
That has mysterious origins. We don't know why maybe something in the environment may be a virus like Fc BAR virus triggered this, right, but that's all out in the disty distant sort of Misty pass. Right? The disty pass.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Right? So who cares about what the triggers might be? Yeah. But if you bring in the innate immune system, And you began to realize that the innate immune system actually programs the acquired system. Mhmm.

Right? So everything that the T lymphocytes are doing, that B lymphocytes are doing, They're doing it because antigen presenting cells like dendritic cells, macrophages, etcetera, sampled something from the environment display the to a naive lymphocyte and programmed it to go down a particular path. Yeah. And why the heck do we get into all that physio? Why does it matter?

Dr. Mark Hyman
Yeah. Why didn't you just confuse the heck out?

Dr. Robert Rountree
Well, it just confuses my view because that innate immune system, that's the part that is sensing the external world.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Right? That's what's in touch with what you eat. Yeah. That's what's in touch with what you breathe.

Dr. Mark Hyman
It's the 1st line of defense. It's sort of the undifferentiated response to bad stuff.

Dr. Robert Rountree
To bad stuff? Yeah. Okay. So let's back up a little bit and say, what's the number one risk factor for getting rheumatoid arthritis? Cigarette smoking.

Interesting. So you might think, oh, it's leaky gut or gluten or something like that. But, actually, the best research risk factor for RA is smoking. And number 2 to that is air pollution. Interesting.

So maybe rheumatoid arthritis starts in the lungs. Oh. Alright. So that opens up.

Dr. Mark Hyman
Me bone's connected into the shin bone.

Dr. Robert Rountree
Everything that's connected in a very mysterious systems biology cutaway, which what functional medicine is applied systems file. Exactly. Yeah. Right? So if you start thinking that way, then you wanna ask the question, Well, what happened to the lungs, exactly.

And now we know what is going on is that inflammation in the lungs caused by the cigarette smoke or free radicals, right, activate certain enzymes. And these enzymes are called the PAD enzymes, the pad enzymes. Right? Septodilargineine deaminases.

Dr. Mark Hyman
Everybody. Why does that matter?

Dr. Robert Rountree
Everybody write that down because a drug called these are making drugs

Dr. Robert Rountree
right

Dr. Robert Rountree
now Yeah. To inhibit this. So rather than saying, well, maybe you shouldn't smoke. Yeah. Or maybe you should get a good air filter Yeah.

Instead, they're saying, here's a drug you could take that would turn off the enzyme that stopped the process Yeah. That led to all these things downstream. So here's the deal. The cigarette smoke causes inflammation activates those enzymes. The enzymes cause a change in the molecular structure of the proteins that line alone.

Mhmm. So sticking out of those proteins is an amino acid. We've all heard of gulp arginine. Yeah. The enzyme cuts off the arginine and puts on an amino acid called citraline, and that changes the whole structure of this change is everything.

Yeah. Uh-huh. Suddenly, it's a freak molecule. Right? It's nothing wrong with centrally.

Dr. Mark Hyman
It looks foreign. For it.

Dr. Robert Rountree
Right?

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
It's this is something that the immune system doesn't recognize. So it goes, wait a minute. This is a stranger, and I think it's a dangerous stranger. That's what the immune system is looking for. Strainer danger.

Strainer danger.

Dr. Mark Hyman
Strainer. Strainer. Immunization.

Dr. Robert Rountree
So that's what autoimmune diseases is. Yeah. Is the these innate immune cells get the signal, stranger danger, stranger danger, and then they go to the naive lymphocytes that are not programmed and say, you guys better watch out. There's a war coming.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
The bad guys are here.

Dr. Mark Hyman
Now the the the way in which I think about this is that, you know, that's the underlying immunology that which is important to understand if you wanna kinda figure out how to work with it. Right. And play with it with food, with nutrients, with various compounds, various interventions that we use. But but I I kinda wanna back up a little bit more because you mentioned a few things. One, you mentioned air pollution.

Yes. It's just smoking. These are positive factors. Right. That are modifiable.

Dr. Robert Rountree
And and changing in our society in parallel with the rise in all kinds of diseases, not just on immune diseases. Right.

Dr. Mark Hyman
Immuno toxicity is a big category. Yeah. What what's what's environmental toxins says a big trigger of autoimmune disease? And I see this all the time. I see it.

I remember I actually had a case of a guy who had ulcerative colitis years ago, and I tried all the normal functional medicine stuff, fixed his gut, 5 hour program, and elimination died, the whole thing, all my best tricks, didn't get better. Was losing weight, you know, it's really sick. It was, you know, getting about needing to be on some serious drugs. And I said, well, you know what? I'm gonna remember what Sid said and and have I forgot anything about this patient.

Is there something I missed? Is there something I didn't think of? How do I think about

Dr. Robert Rountree
Something good wood or something to get? Yeah.

Dr. Mark Hyman
Is there something he needs to get rid of that's bothering him or something he needs to get to get better? And it turned out he had extremely high levels of mercury.

Dr. Robert Rountree
Oh, yeah.

Dr. Mark Hyman
And we did a heavy metal collation protocol with him. We got rid of all the mercury, and it's got completely normalize, and he's completely fine years later. And and so that kinda made it really clear to me that toxins were a big factor. What else are the big factors that are the positive factors for autoimmune disease?

Dr. Robert Rountree
Pet, so heavy metals definitely up there. One of the people don't about a lot is arsenic. Right? Harsenic is definitely implicated autoimmune diseases. There's certain Countries and certain parts of the United States where our state levels in the water supply are pretty elevated.

And, you know, we could spend an hour or 2 talking about all the mechanisms by which that happens. It doesn't really matter. The fact is that arsenic is really widespread. They used to put it in the wood and picnic tables. Picnic tables

Dr. Robert Rountree
or your deck and

Dr. Mark Hyman
your your your pressure

Dr. Robert Rountree
feed it rains, and you go and you lay on your deck after which one it's still wet, and the arsenic is absorbed through your skin.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Right? And, again, of course, they can cause

Dr. Mark Hyman
They're wine because although the the the the pressure treated lumber post that the wine, grape wines are into. Yeah. And that was the soil, and the the grapes are contaminated. It's a wine is that shit, red, white source of,

Dr. Robert Rountree
how much where you're getting this. Yeah. Yeah. Right? It's it's like green wood when you see wood with a greenish tent too.

Yeah. Yeah. That's what you need. Yeah.

Dr. Mark Hyman
So toxins. Okay. What are

Dr. Robert Rountree
Meadow heavy metals arsenic, Cabian. Yep. Lead led still with us. Yeah. Still a problem.

And there are a lot of mechanisms by which that can happen that metals can can cause free radicals, which is oxygen rusting, basically, oxygen damaging molecule. Yeah. But they could also bind the enzymes. They can bind to molecular compounds and cause free molecules. Yes.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
So that's all leads to what's called break intolerance. Yeah. You know, tolerance is the state of normalcy for the immune system. Yeah. You're able to so you're

Dr. Mark Hyman
able to detect friend from FO and not react to everything in your environment. Like, you know, people have allergies, Polin, well, they shouldn't or cat dander. They shouldn't. And they're overreacting to something in the environment that's harmless. Right.

But their immune system's lost tolerance for them. Right. Or food. Right?

Dr. Robert Rountree
Right. And that taller and the important thing to understand about tolerance is that it's an active process. It's not a passive process. So immune cells don't just ignore what's there. They're paying attention, but they're you know, this is anthropomorphic.

They're they're actually choosing not to react. Yeah. And there's a lot that goes on inside of the cell that keeps that happening. Right? And part of it is the balance of the free radicals, the, what's called the redox potential inside the cells.

That's gotta be, and perfect balance or these dendritic cells that we talked about, you know The

Dr. Mark Hyman
immune sensing cells.

Dr. Robert Rountree
The immune sensing cells will start getting how to whack. Yeah. And start reacting in a very aberrant way.

Dr. Mark Hyman
Yeah. So it's an abnormal reaction to a normal thing. It's essentially what is going on. And and, you know, toxins we think of as poisons that can poison cells and poison raised cellular mechanisms in mitochondria, but, and it's sort of dose dependent, you know, the more the more the poison the worst of the effect. But with with immunotoxicity, it's not like that.

It's it's very low levels Right. And create a massive reaction. And and the ex explanation I always get for that is this case I had when I was, I think I was a medical resident. I was in the ER, and this, you know, this big loud horn going off front of the ER doors and Yeah. This like, a car horn wouldn't stop.

We all ran out. So and there was a young guy slumped across the wheel face down, and it was basically dead So we we dragged him out of the car. We, threw him on a stretcher. We ran him into the ER. We, you know, paddle them, you know, with the cardiac paddles, we pumped them full epinephrine, pumped them full of steroids, got to wake up, woke up.

Like, what to happen? He's like, well, I'm allergic to fish. And I was in my friend's apartment, and he was cooking fish. And I just smelled the molecules. Yes.

In the fish. I didn't eat it. Molly cake. The molecules in the air from cooking the fish across the room.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
And it triggered an anaphylactic reaction. He didn't feel it coming on. He knew he wouldn't make it for the ambulance to come. So he got his car and drove two miles to the emergency room. Yep.

And that taught me that infant testing small amount of an insult can create a massive reaction.

Dr. Robert Rountree
Massive reaction.

Dr. Mark Hyman
It's not just yeah. So so the environmental toxins are like that. It's not like if they have a load of them, and we all, by the way, do, But but it's it's really huge issue. So besides

Dr. Robert Rountree
actually might be the small quantities that are the problem, right, and that the term for that is Ormedesus. It's a great term. You know it well. Yeah.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Right? And that came from work. I got an Ed Calabrese who probably met her interviewed, you know, who talked about the fact that in higher doses, things may not be very toxic.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
But especially certain compounds with hormonal like properties

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Right? The color what's called endocrine disruptors.

Dr. Mark Hyman
Yeah. Well, these are immune disruptors. Right.

Dr. Robert Rountree
Well, endocrine disruptors and immune disruptors, sir.

Dr. Mark Hyman
Same chemicals.

Dr. Robert Rountree
Yeah. That very much same chemicals, but in particular, ones that have an effect that is like estrogen. Yep. Right? So who gets most of the autoimmune?

Dr. Mark Hyman
Yeah. Interesting.

Dr. Robert Rountree
80, 90% women. Interesting. Right? So it turns out the same enzymes of process estrogen in the woman's body also process these Xeno, which is foreign. Yeah.

Zenoestrogens. Trister. So the Xenoestrogens are immune toxins and endocrine disruptors

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
At the same time.

Dr. Mark Hyman
So we get it. We get toxins are bad. What else is on the list of things that cause auto immune?

Dr. Robert Rountree
Well, Guess you would call them toxins, but microplastics. Microplastics have been found in the stool in higher quantities than people with ulcerative colitis.

Dr. Mark Hyman
And now there's Nano Plastics, which are worse

Dr. Robert Rountree
than microplastics. Micro, but, basically, plastics you can't Yeah. See without a microscope. Yeah. Help We don't really understand the mechanism of toxicity of these.

I mean, they are toxins. Right?

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
But they're doing other things that are irritating Yeah. Quite understand. It's not the scary thing because they found it in organic foods. Yeah. Right?

Or in bottled water. Yeah. You find these microplastics. So

Dr. Mark Hyman
Yeah. Think I think the nano plastic data just came out too, and it was even more terrifying because the volumes are much higher and, really exposed to much more of these we thought even just drinking a bottle of water. Okay. So toxins.

Dr. Robert Rountree
Socks? What about

Dr. Mark Hyman
besides toxins?

Dr. Robert Rountree
So microbes.

Dr. Mark Hyman
Microbes. But

Dr. Robert Rountree
Right. So you said you you have been like, call over the jungles of Ecuador, and I'm sure you know about the research that was done in Venezuela Yeah. You know, with the the the tribes that had never contacted the outside world. Right? I can't remember the name of the the doc, but it was Blazer's wife, I think, was the one that did this research.

These anthropologists descend from the sky on this remote jungle tribe and sample their stools.

Dr. Mark Hyman
Yeah. Paleo poop. Which I thought, like Paleo poop.

Dr. Robert Rountree
I wonder if the the the people that were there, how did they take that? Right, when the, you know, they've never met people from the outside world and all they're interested in is doing these stool samples, these poop samples. Right? So they do these poop samples. And what are they found?

Parasites? Or worms, spirochetes, all the stuff that we look in our patient's stool. We found that. We'd say, oh my god. Unique to be on a dozen drugs.

Dr. Mark Hyman
You need a parasite, Clint.

Dr. Robert Rountree
You got you need it, Clint. You know, all the Clark, you've got the the co but these people had no autoimmune diseases.

Dr. Mark Hyman
Yeah. And no allergies.

Dr. Robert Rountree
They had no allergy to autoimmune disease. So heart disease to asthma, they, you know, No.

Dr. Mark Hyman
The inflammatory diseases of chronic illness.

Dr. Robert Rountree
Right. Yeah. But, I mean, they were dying from snake bites falling out of trees, getting bitten by. Sure. You know?

Sure. Big lizard, something like that. So they were dying from trauma, but they weren't dying from chronic disease. And so the point is, and this is what doctor Blazer says in seeing microbes is that it's not the presence of something as much as it is the absence Mhmm. Of something, right, that there were microbes that were normally there when we were babies the 1st year of life.

Yeah. And those microbes send us signal to the dendritic cells again. Back to the cells that line that got, they send a signal and say, you know, it's okay to have some foreigners here. Yeah. It's okay to have strangers here as long as they're not dangerous strangers that are causing injury to the lining of the car.

Yeah. So there's 2 parts to this microbe thing. One is the good guys, sort of good guys that are missing, but not even good guys. Right? Just they weren't causing a problem.

Dr. Mark Hyman
Yeah. They called the epidemic of absences.

Dr. Robert Rountree
The, yeah, the epidemic, there's a whole

Dr. Mark Hyman
Book on it.

Dr. Robert Rountree
Yeah. There's a whole Like a bug. Yeah. Yeah. It really

Dr. Mark Hyman
talks about this fascinating. Yeah.

Dr. Robert Rountree
Yeah. Epidemic impact.

Dr. Mark Hyman
We're using worms to actually treat autoimmune disease, which is now happening in even condition.

Dr. Robert Rountree
Okay. Big confession. I have given worms to patients with autoimmune diseases and seen beneficial effects. Yeah. Yeah.

I had a guy with ulcerative colitis. I gave him a certain kind of worm egg. HDCs? It was no. It was

Dr. Mark Hyman
I got it from Thailand. Oh, yeah. T h 100. Yeah. Yeah.

Yeah.

Dr. Robert Rountree
T t s o one. T s

Dr. Mark Hyman
o one. Yeah.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Yeah. I gave it his his Ultra of plays went away for a year.

Dr. Mark Hyman
That's the same.

Dr. Robert Rountree
He stopped everything. He stopped all of his drugs, everything. He was fine. Right? And then it came back.

You know? It stopped taking it? Yeah. It stopped taking it, and it came back.

Dr. Mark Hyman
If it's you keep yet to keep taking it. Yeah.

Dr. Robert Rountree
I have to keep taking it. Right? Yeah. I mean, you don't Well,

Dr. Mark Hyman
that was like that was like, well, you know, historically, we had an immune system that was used to deal with all these bugs, worms, and parasites, and and then we took them all away They call it the hygiene hypothesis.

Dr. Robert Rountree
Yes. Yes. And all

Dr. Mark Hyman
of a sudden, the immune system is kinda looking for something to do. Yes. And it starts reacting to stuff that it should react to. And that's when you is not immunity. So Right.

Dr. Robert Rountree
I

Dr. Mark Hyman
don't know. The answer for salt to kinda eat dirt and take worms and, you know Well,

Dr. Robert Rountree
maybe when you're older, maybe eating dirt is not such a good idea. But, you know, the word of eggs, there's no I mean, there's still interesting research. Windstock is still doing research on that.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
You know, they're What they're asking is what is it the worms do? Yeah. Right? It turns out they secrete a glycoprotein, a protein that's bound to a sugar that's an immune regulator Yeah. It's to their advantage to not get kicked out of the apartment.

Yeah. They don't wanna get evicted. Yeah. So they've made these chemicals, and we know what some of them are now And the chemical's saying, okay. I know I'm a foreigner, but just ignore me.

Yeah. Leave me alone. So that's part of the puzzle.

Dr. Mark Hyman
So so gut is a big issue.

Dr. Robert Rountree
Gut is microbes. And lungs, got in lungs.

Dr. Mark Hyman
So it's microbes that are are mainly non infections, although some infections obviously cause rheumatoid arthritis like yersinia or Yep. And to and Tameva has to let it Right. That's been mapped to causing rheumatoid arthritis in certain sub types. Proteus

Dr. Robert Rountree
for hats according to doctor and have younger.

Dr. Mark Hyman
And there's some, you know, we call it, you know, infectious arthropathies, which we learned about medicsable, like, from Yep. Okay. You know, you just Yeah.

Dr. Robert Rountree
MITRE Syndrome, it's called r e I t e r e.

Dr. Mark Hyman
Yeah. And, the the this whole phenomenon is is kind of bugs that aren't necessarily terrible infections, but they do cause autoimmunity. Yep. Ersinia. Yep.

You know, in functional medicine, we we take a look at the whole ecosystem of the gut, try to optimize it. And that's a key way we treat issue, but it's not just that there's bad bugs. There's other things that happen. Right, that that are going on in the gut that drive it. And you talk a lot in about the barrier functions.

Dr. Robert Rountree
The barrier.

Dr. Mark Hyman
And and these the barriers that help us sift through and determine what's friend from Foe. Right? You have a a gut lining that's, you know, arguably the size of a tennis court that he laid out flat

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
That is one self effect.

Dr. Robert Rountree
Not

Dr. Robert Rountree
for a minute, Blake.

Dr. Mark Hyman
Yeah. It's huge. Yeah. Huge. And it and it's one self

Dr. Robert Rountree
Visualize your gut. Like, it's a tennis court?

Dr. Mark Hyman
Like, it's big.

Dr. Robert Rountree
And what's going on on that ten

Dr. Mark Hyman
And it's only one cell thick, which is, like, you're you're basically one cell away from a sewer. Yeah. Yeah. And from all these foreign food programs.

Dr. Robert Rountree
Yeah. Yeah. Yeah. So tell us what happens. Sell away from a sewer.

Dr. Mark Hyman
So tell tell those what happens when that lining breaks down, why it breaks

Dr. Robert Rountree
down, how it breaks down, and what happens, and why that's

Dr. Mark Hyman
linked to autoimmune disease.

Dr. Robert Rountree
Robert Frost, the famous physician, said good fences make good neighbors. Yeah. Right? Yeah. So the whole idea is that certain bugs or chemicals don't cause a problem if they're hitting the right compartment.

Dr. Robert Rountree
Uh-huh.

Dr. Robert Rountree
Right? So as long as they stay in your gut, it's not an issue, but what would affect that thin lining in such a way that it becomes leaky. Yeah. Well, first of all,

Dr. Robert Rountree
now we know that

Dr. Robert Rountree
there's this mucus layer And there are a lot of things that go into maintaining a healthy mucus layer. I mean, it's a very complicated material Yeah. That mucin. And one of the things that's necessary for maintenance is certain kinds of bacteria. There's one called Hakar Mansia.

You said to fill it, which is noted good friend of yours.

Dr. Mark Hyman
Yes. Good friend of mine.

Dr. Robert Rountree
Yeah. You you got I

Dr. Mark Hyman
I we I lost him for a while, actually, when I was sick a few years ago, I got ulcerative.

Dr. Robert Rountree
This he went away.

Dr. Mark Hyman
And I was like, he was gone. And I had to I had to get him back, and it was it was a big project I go out looking for him. And Yeah. Hard to find, but I I was able to grow him back, actually, by using food, polyphenols,

Dr. Robert Rountree
which So there there was a really interesting study that was done a few years back where they actually got Mevett Oz's signature smoothie Yeah. And measured people's Scott Flora. Yeah. And one of the things they measured was Akramanzio. Yeah.

And they went on the Oz Flynn, smoothie.

Dr. Robert Rountree
I think

Dr. Robert Rountree
I helped them. Went way up.

Dr. Robert Rountree
I think

Dr. Mark Hyman
I helped them develop that, actually. You haven't. I got the smoothie. Right? Yeah.

Dr. Robert Rountree
Right. So Akramante went through the roof. But then as soon as you stop the smoothie Right. The Hakar Munzhi would disappear. Yeah.

So we wanna maintain Alker Munzhi because it helps with the turnover of the Munson Lane. Yeah. So that's an important concept because most people just like, well, it's a cellular layer, and that's all they're in. But

Dr. Mark Hyman
when was the last time dermatologists and they checked your toxins or looked for acromancy levels.

Dr. Robert Rountree
Or even acknowledge that I had poop. Right? Right.

Dr. Robert Rountree
Oh, yeah.

Dr. Robert Rountree
That there was something to look at. And Yeah.

Dr. Mark Hyman
Your rheumatology should be doing a stool test, but they don't do that.

Dr. Robert Rountree
Oh,

Dr. Mark Hyman
no. I mean, if if you're rheumatologist, it's probably the most important test you

Dr. Robert Rountree
Probably the most important test if you do this. That is silly. I can call. What's the mix of their so the other part of it is that we know that the cells that Lively got have these junctions called tight junctions. Right?

And when you look at them under a microscope, especially electron scope, you realize that it's a very complicated, scenario that's going on. You don't remember, you know, came out thrones. Right?

Dr. Mark Hyman
Yeah. Of course.

Dr. Robert Rountree
Yeah. You

Dr. Robert Rountree
know, remember the northern wall? Yeah. To keep the night walkers out that that's a complicated wall, and they had little doors that are going in and out. Yeah. Well, if that wall, the the the lining, if it's completely tight, nothing ever gets in, you don't absorb nutrients.

Yeah. So you gotta be able to open it and close it at will. You know, you imagine I hear what I got. With levers in there, opening these levers.

Dr. Mark Hyman
I think it was like a coffee filter, right, because Basically, the food the food and, the nutrients are supposed to go through the cells. Yep. And not in between the cells. Yes. And when these site junctions break down, the food and bacterial toxins and proteins leak in between the cells.

Yep. And that's what causes the problem. That's called the leaky gut.

Dr. Robert Rountree
Yeah. Leaky gut.

Dr. Mark Hyman
And intestinal permeability increase or whatever we're gonna call it. I think, you know, it's amazing to me that we've been talking about leaky gut, and it people used to laugh at us for talking about it. Now it said the mainstream leadership. It's like and it's all came from functional medicine, but then we acknowledge that. But it's now it's on the mainstream channel.

Dr. Robert Rountree
But it said from Leo Gallon 40 years ago. Right? And, again, the mainstream dogs, the gastroenterologists, is like leaky gut. What kind of problem is that? What a joke?

Yeah. Right. Right? You know? And now we've got electron microscopy that shows what's going on.

We know about claudins and occludins and all the different proteins involved and then along comes to Lesio.

Dr. Mark Hyman
Yeah. Right? Doctor Fasado. We got him on the podcast.

Dr. Robert Rountree
Yeah. Alessio Posado, who had the gall to actually study the mechanism involved in this. And then he tells a great story about it. That it was all about, cholera. Right?

Dr. Mark Hyman
Cholera. Yeah.

Dr. Robert Rountree
He was trying to figure out what caused that intense diarrhea would get with cholera and discovered this protein called Zanulin. Yeah. Right? And Zodulin changed everything. Wouldn't you say?

Dr. Mark Hyman
Yeah. Yeah. It basically is is a protein that's expressed in the body that's something the body makes. When there was some insult that required you to kind of adapt to some bad circumstances like cholera. Yep.

Dr. Robert Rountree
But but

Dr. Robert Rountree
what

Dr. Mark Hyman
we now know is that the other main trigger for increasing zonulin is

Dr. Robert Rountree
is Gluten. Gluten. Yeah. Yeah. Gluten.

Dr. Mark Hyman
And that's and that and and I think that's a big factor. What would you say in terms of the sort of hierarchy of things that you see autoimmune disease that are at the top. Is it gluten?

Dr. Robert Rountree
Gluten is definitely in the top 10, if not the top 5.

Dr. Mark Hyman
Yeah. It it's

Dr. Robert Rountree
It's way Yeah.

Dr. Mark Hyman
There's no one comes in with an inflammatory condition or

Dr. Robert Rountree
Of any time.

Dr. Mark Hyman
Or of any type or any autoimmunity of any type that doesn't get a full celiac panel worked out not just a normal one you get from the doctor's office, which is TTG, which is barely ever positive, but a full panel of, you know, 80 glide anybody's IgA, IDG, TTG, IgA, and IDG. These are really important to look at. And and then, you know, it's a lot of words and a lot of mumbo jumbo We offer this testing at function health, which allows you to get access to your labs, and it's usually a really detailed view. It's something your doctor may not wanna look at or order, but it's essential to know because if if you have any antibodies and this is I learned this real lesson. If you have any any body level, even within the quote normal range, it means when you've been exposed to gluten, 2, you have somewhat of a leaky gut

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
Because it's gotten through. And, 3, your immune system pissed off to some degree about it.

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
It may not be full blown celiac, but there's something going on inflammatory wise. And many of us can tolerate a little bit, but, you know, the amount of flour and gluten we have and the kind of gluten we have is very different.

Dr. Robert Rountree
And I

Dr. Robert Rountree
think that's certain blue?

Dr. Mark Hyman
Yeah. It's like the dwarf wheat, which is when they breed when they breed wheat plants, they breed plant style humans where you get 23 perish of chromosomes, you know, once we're bombing your dad, it would be like, you know, instead of we got each person as 46, it would be like having 46+46, which would be 92. Like, I'm good with them at.

Dr. Robert Rountree
Set that out. Right?

Dr. Mark Hyman
And and so to all of a sudden, you got all these extra chromosomes, which means extra genes, means extra proteins.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
Which means sometimes different proteins than you're just getting, which is what is actually happening. So all these anything in a very inflammatory gliadin proteins now in wheat that we didn't even have a 100 years ago.

Dr. Robert Rountree
Yes.

Dr. Mark Hyman
And so that may be part of it as well. And then they drove glyphosate on there when A lot of it, not all, but a lot of the weak crops. They're from glyphosate to dry it out so they can harvest it easier. And that glyphosate is a microbiome killer.

Dr. Robert Rountree
Yeah. So

Dr. Mark Hyman
then you're doing a double Yep. Yep. So do you do you think, to me, I think gluten is sort of like the gateway drug in a way. It's like, it causes the initial insult. Damage is the gut, but then we see all the other foods as to our people start reacting to.

Right? Right. So can you talk about, like,

Dr. Robert Rountree
not just the cross reactivity Yeah. Yeah. It's called bystander, you know, it's a bystander intolerance. Yeah. So I set her a fact.

Dr. Mark Hyman
You know, this is not really well accepted by official medicine that there's these food sensitivities. They're not true allergies. They're not like a peanut allergy.

Dr. Robert Rountree
Well, it is showing up a little right now. Yeah.

Dr. Mark Hyman
It is. It's and it's a different part of your immune system. Right? It's kind of a slow reacting part as opposed to, like, a fast reacting part. Like, the guy told a story about with anaphylaxis with the fish smoke, green up in the fish market.

Dr. Robert Rountree
Yeah. Yeah.

Dr. Mark Hyman
But it but but a lot of people would start to have other foods, or dairy, and nightshades, and not and other kinds of stuff that may be a healthy food, but, actually, they're reacting to. So how how did that play a role in autoimmune disease?

Dr. Robert Rountree
Okay. So the there's 2 things going on here. One is there's a concept called epitope spreading. Okay. That's a pretty important concept.

So when you say your immune system is reacting to gluten or to gliadine, you know, type of protein called prolemon Right? It's because there is recognition like a lock and a key of a certain sequence of amino acids. Right? So your immune cells, your native immune cells, you know, they recognize that. And then, again, they pass on that recognition to the acquired immune cells, and then they start making clones of themselves.

Winston. Right? And then they start making antibodies against tissue transglutaminase, etcetera. But then that damages tissue in the surrounding areas. So if you make antibodies against tissue transglutaminase, which is an important enzyme, and you start damaging the tissue, say, in the vicinity of the gut, now you get what Poly Mattsinger, the famous immunologist said, a dangerous drink.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
So you get a dangerous stranger and suddenly other structures that maybe look a little bit like the gliadine, but not quite, you know, they're close enough Yeah. That the immune cells start going, well, maybe that's a bad guy too. Maybe that's a bad guy. Maybe that's a bad guy. So one example of this is not quite about the food thing, but, you know, I've I've seen faces that would get diagnosed with celiac disease.

And I'd say, how's your thyroid? And I go, why are you asking about your thyroid? I don't have a thyroid problem. I've just got a gut problem. Right?

Yeah.

Dr. Robert Rountree
Oh.

Dr. Robert Rountree
I got a gut problem. Like, we need to check your thyroid.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Well, I don't have a thyroid problem. Okay. Let's check your thyroid. So you, you know, you do it TSA, 103. And sure enough they got antibodies against Yeah.

TPO.

Dr. Mark Hyman
I would say it's about a third of my Hashimoto's patients, which is the most common, I think, autoimmune disease we have Yep. Have some level of thyroid thyroid problem. Thyroid problem. They'll have have a gluten antibody.

Dr. Robert Rountree
Have cat gluten. So it starts with the gluten or maybe other way around. I don't know. But, you know, typically, what I would see is that patient that's got celiac or maybe they didn't know they had celiac. You know, they just had some weird maybe that's a joint aches, or a weird rash.

There's one called dermatitis for petaphormous.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Right? It looks like herpes. And then you'd check them for celiac antibodies and they're positive.

Dr. Mark Hyman
That's right.

Dr. Robert Rountree
But then you gotta start checking for antibodies to other tissue. Yeah. So I saw one patient that started out celiac, and then it spread to her thyroid. She got thyroiditis, and then she got multiple sclerosis. Yeah.

Right? So the question that gets raised is is gluten the trigger for all those diseases, or is gluten causing leaky gut? And the leaky gut sets you up for all those diseases?

Dr. Mark Hyman
I think it's both.

Dr. Robert Rountree
Or is it both? For example. Yeah. You talked to Prasano, said both. Yeah.

Dr. Mark Hyman
I mean, I I actually had a patient at Cleveland Clinic. They had 3 autoimmune diseases, and, they were

Dr. Robert Rountree
How was that possible? Treating all

Dr. Mark Hyman
these different things? I'm, Has anybody checked your gluten? Anybody's like, no. When we checked in, he had full blown celiac, like, not.

Dr. Robert Rountree
And they had to even look.

Dr. Mark Hyman
Let me look. Yeah. And it's staggering to me because it's this is not something that's in, you know, some crazy alternative, you know, handbook of medicine. It's it's in the scientific literature.

Dr. Robert Rountree
It's right there.

Dr. Mark Hyman
Natural Library Medicine. It's all the evidence points to this. And, you know, it's like a blind spot of traditional medicine in which makes me so frustrated because, you know, autoimmune disease is really a horrible condition. I mean, I I I didn't tell you when I was sick, because I had a long story. I had, root canal, followed by a hospital, had root canal.

It went bad. I need to take an antibiotic after I got my tooth if it was infected, I Clindamycin. I got C. Difficile. That didn't go away.

The C. Difficile went away, but it turned into full blown ulcerative colitis. And I I was taking And

Dr. Robert Rountree
you didn't get a poop transplant at the

Dr. Mark Hyman
Well, I know I I did not get a poop transplant. It's hard to, you know, standing on the corner. Poop. Anybody got that poop when I

Dr. Robert Rountree
showed you.

Dr. Robert Rountree
Yeah. Yeah. Yeah.

Dr. Mark Hyman
But but I I ended up I ended up being really sick, and I saw one of the top, GI docs in, you know, in, IBD inflammatory bowel disease at Harvard and really nice guy. You know, he was looking at all kinds of, you know, actual alternative therapies and diet. And I tried everything I knew, like, I threw the kitchen sink at at what I I literally saved I would say dozens of patients from having their colon removed, and I couldn't fix mine.

Dr. Robert Rountree
Yeah. Yeah. Yeah. And I was,

Dr. Mark Hyman
like, so sick. I took, like, 60 milligrams of prednisone for

Dr. Robert Rountree
Oh, wow.

Dr. Mark Hyman
Didn't touch it. Wow. Didn't touch it. I was having 20 painful bloody bowel movements a day. Oh.

I was in bed. I lost thirty pounds.

Dr. Robert Rountree
Well, no.

Dr. Mark Hyman
Yeah. I was I was in bad shape. I was, like, mere debt. Yeah. And they were about to put me on one of those big heavy duty, you know, TNF alpha blockers or other drugs.

And I was like, No. I'm gonna just do it. I'm gonna do a hail Mary here. Yeah. And I know I've got some massive inflammatory process going on, so I'm just gonna basically do a bunch of stuff.

Like, I basically took IV, a lot of IV nutrients. Yeah. High dose vitamin c. I did IV ozone, which sounds crazy, but it's it's a powerful anti infectious agent that Yeah. In room modulator.

I do hyperbaric oxygen Okay. Middle, within days, it went away. Run days.

Dr. Robert Rountree
In days.

Dr. Mark Hyman
In days. Yeah. So, like, and and and so, you know, and not all of me is really simple, but I just remember how horrible it was to be in that state. Yeah. So many people are suffering, and they're taking so many of these drugs with without actually getting to the root cause.

And often, is is is sometimes simple. Like, I you know, we've had cases where you just do one thing and

Dr. Robert Rountree
it's gone. Oh, the drug, it isn't really changing

Dr. Mark Hyman
what's going on. Or you just stop glued and then people get Right. Right. Sometimes it's a little more complicated to reset their gut microbiome. Like, I had this one little girl, Isabelle, who was ten years old.

She had a mixed connective tissue disorder, and she was on 1200 milligrams IV of SoluMagil every 3 weeks, which is like a horse dose of a NASA steroid. And she was on methotrexate, which is a chemo drug. And she was on a pile of other drugs to deal with the symptoms like nifedipine for her ring nodes and, acid blockers for reflux and aspirin for the blood vessel clotting she had. So she was on a a mess, I think, that she had every auto antibody you can imagine. She had muscle enzymes that were high.

She had high alveoli, she had high rheumatoid factor, A and A, high, ATR and P. I mean, you named the antibody. And they were just, like, a little bit elevated, but they were, like, off the chart, elevated. And we and we learn, by the way, in medicine. If if those antibodies are high, you check them once, and that's a, you know, Richard.

Dr. Robert Rountree
Right. Why do you need to check something else? Have this for life. Right.

Dr. Mark Hyman
Like, they're gonna have this disease.

Dr. Robert Rountree
Who cares if your handbag goes up or down or any Right. And I think You've got it.

Dr. Mark Hyman
I think it's important for you and really listening to understand that when you have an autoimmune disease, it's not a life sentence, even though traditional medicine says it's a life sentence. And when you get to the root causes, things that Bob and I are talking about, it literally can be undone like it was with me. And this girl, I found out she loved she loved the sugar and dairy. She loved tuna sushi. She had ton of it with a little girl.

And, when we did her lab, she was very low in vitamin d. She had high mercury she had gluten antibodies. She had high calprotectin, which is a measure of inflammation in her gut, even though she had no

Dr. Robert Rountree
gut symptoms. And and we just basically put her elimination diet

Dr. Mark Hyman
I gave her a multivitamin fish oil vitamin d probiotics, and I got her eventually accumulated with with, DMSA for heavy metals. And within 2 months, she was dramatically better, within, a year, she was off all her medications and had normal antibodies and was completely cured. Right. And I talked to her 10 years later, and she's fine. So, you know, and it just tell tells you that No.

What we're doing is so off base

Dr. Robert Rountree
Right.

Dr. Mark Hyman
In traditional medicine. And we have

Dr. Robert Rountree
to So down straight.

Dr. Mark Hyman
So down So

Dr. Robert Rountree
the antibodies are down straight. Right. You just cause. We're putting all our attention to the antibody. So they're helpful diagnostically.

Right? Yeah. But the antibodies don't tell you about root cause. The root cause is in the innate immune system. Right?

Yeah. If the innate immune system is generating this problem, then the things you're changing with lifestyle, etcetera, have to do with getting your innate immune cells happy.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
So I gotta tell you, I have I have, like, UC story.

Dr. Mark Hyman
Yeah. Yeah.

Dr. Robert Rountree
No. It's great because I had a patient

Dr. Robert Rountree
that I had

Dr. Robert Rountree
dealt with a couple years and had bad ulcerative colitis you know, we got it reasonably out of control, but not in remission. And then somebody told me about these 2 Israeli guest meteorologists that we're doing research on, an old compound in Chinese medicine called indigo.

Dr. Robert Rountree
Oh, yeah.

Dr. Robert Rountree
And they were combining indigo with curkevin I said, okay. We've done a lot of other things. You're a lot better. You know, you're you're still not off your meds, though. I put this guy in to go, and then I forgot about Right?

And then, I don't know, about a month later, I get his routine labs, and all of his markers were normal. Normal. And I called him up, and I said, I think they got the wrong blood. I think they got the wrong blood just to react to protein this normal. Yeah.

That came in. He goes, I went into complete remission it's 2 weeks after starting this indigo.

Dr. Robert Rountree
And it's

Dr. Robert Rountree
like Wow. Oh, so every now and then, and, you know, I'm not talking about magic bullets here.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Every now and then you find something for that one person

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
That really makes a difference.

Dr. Mark Hyman
I think that's an important point, Bob, because people listening. I go, well, I'm gonna take this That's

Dr. Robert Rountree
the one I want

Dr. Mark Hyman
is the ending. Actually,

Dr. Robert Rountree
It's that guys. It's that guy.

Dr. Mark Hyman
Everybody that everything works. Right? So, like, obviously, if you know the name of the disease, you don't know what's wrong with you.

Dr. Robert Rountree
Right. Right.

Dr. Mark Hyman
If you say I have all fighting. It doesn't mean you know what's going on. Right. This means you know,

Dr. Robert Rountree
the SIM I like the name in blame. Yeah. I, you know, it makes me feel good. Yeah.

Dr. Mark Hyman
Yeah. When was that Right. That's right. That's really nice.

Dr. Robert Rountree
You used to say, neurologist, diagnose, and audios. Yeah.

Dr. Mark Hyman
Treat them and treat them.

Dr. Robert Rountree
Treat them and treat them, diagnose, and audio.

Dr. Mark Hyman
Oh, it's red diagram.

Dr. Robert Rountree
Right?

Dr. Mark Hyman
Yeah. But we we really have a different model of functional medicine, and we so we took take a look at all these factors unpacking a little more. We talked about toxins we talked about. The Food. We talked about The micron.

We got, we talked about certain food reactions, but y'all there are also other microbes that are playing well. And one of the things that I'm seeing a lot now is the consequence of lung COVID Yeah. The autoimmune Right. Reaction. Right.

And and reactivation of others.

Dr. Robert Rountree
Sign off all those antibodies.

Dr. Mark Hyman
But we know we know in traditional medicine that many infections can cause automated lime Right. The FC bar. It's been it's been linked to, for example, NAMS, I've seen bar.

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
But, you know, long COVID now seems to be showing up with a lot of autoimmune antibodies, particularly to your autonomic nervous which is causing people to have Pot. Pots, which is north of static hypertension where you get dizzy when you stand up or you can't stand for long periods. Yep. So so there's there's a whole realm of infections that that often are a cause. Right.

And, you know, like Viral

Dr. Robert Rountree
effects, it's a particular, seems like Viral

Dr. Mark Hyman
and tick infection, I think.

Dr. Robert Rountree
Yeah. Tic infection.

Dr. Mark Hyman
And tick infectious. Lyme would be super And so, you know, part of influencer medicine workup is looking for those things.

Dr. Robert Rountree
Yep. You

Dr. Mark Hyman
know, you don't have rheumatoid arthritis. You have blindness. Right. Right.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
But it happened that's caused all this autoimmune antibody.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
So we gotta really dig. The other thing I think is is is really important is is sleep and stress. So, those are really I

Dr. Robert Rountree
thought you might bring that up. I don't know why.

Dr. Mark Hyman
Those are big factors. Yeah. And they're, you know, that there's So

Dr. Robert Rountree
it's the guy who never sleeps. Right? No.

Dr. Mark Hyman
I sleep. Are you kidding? I'm, like, I'm in bed about 8 a half to 9 hours a night.

Dr. Robert Rountree
Yeah. Yeah.

Dr. Mark Hyman
And, and so I think it's just gonna grow 19 bucks. I mean, I don't sleep. But the the the immune modulation is really interesting with our with our first response. So Right. You might have trigger, like, gluten or a toxin or or some virus, but it doesn't really do anything until there's some triggering event, like a stressful event.

Right.

Dr. Robert Rountree
And

Dr. Mark Hyman
I I noticed I I saw this happen to me as well, and I've seen many of my patients, And and so that trigger can be modulated. And I I remember the work of, I think there's a langer or clue that, that's let me read somebody else. Where they did journaling. It was simple journaling about you, not just, like, what I did for today. And I went to the grocery store, but, like, your inner experience.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
At 20 minutes a day, and they measured, you know, hard outcome by markers for rheumatoid arthritis and for asthma. Yeah. And after all, I think it was, like, 12 weeks. And it went down. It went down.

Okay. And they got better.

Dr. Robert Rountree
Well, I gotta use that new iPhone app, right, journal. It's just come out of the iPhone. So it's a plug for the guy. Don't work for out. Okay.

Yeah. Okay. So did you know that when you're really stressed, You release mitochondrial contents into your bloodstream? No. In huge quantities.

Dr. Mark Hyman
Wow. Tell me.

Dr. Robert Rountree
Liventia, when people go on stage, right, and they're dressed about being on stage, you can actually measure mitochondrial fragments in their blood stream by where their mitochondria They're bacteria. Wow. Right? So it's essentially the same as if you had bacterial fragments in your bloodstream. So it causes this low level endotoxinia.

It's like metabolic endotoxinia.

Dr. Mark Hyman
So you're saying the body doesn't recognize mitochondria as self?

Dr. Robert Rountree
Oh, not at all. No. They gotta be in the right compartment. If your money country inside your cells, that's great. Because

Dr. Mark Hyman
they have different But if

Dr. Robert Rountree
your cells open up, right, they have different DNA. They have rickettseal d n a.

Dr. Mark Hyman
Your mother's DNA. Rickettes seal d

Dr. Robert Rountree
n a.

Dr. Mark Hyman
As a tick, kind of

Dr. Robert Rountree
That's where mitochondria came from. It's ricketts Really?

Dr. Mark Hyman
So rickettsia are not are not aware is a really rare and usual affection that you can get out west, but it's where you live?

Dr. Robert Rountree
Potted fever or something like that, but mitochondria are made from Rickettsia. Wow. And when you're stressed, you release that into your bloodstream. Right? Your immune cells see that, and you may not go into septic shock, but they get activated, and you start making cytokines.

So why bring that up? Because the hot drugs and rheumatology now are the biologics, right, which go after cytokines, like tumor necrosis factor alpha, and or Luca 1. So I say, well, okay. You can take a drug that knocks out TNF alpha where you can meditate and do heart map and Tai Chi and get more sleep. Think about it.

Which one would you prefer? Right?

Dr. Mark Hyman
Yeah. Yeah.

Dr. Robert Rountree
I know. And I'm not saying if somebody is really inflamed, I'm not gonna tell them don't do the biologic. You would never say that. Yeah. But you know, in the long run, is that important to me if It's

Dr. Mark Hyman
important to me. So your lifestyle stress, relationships, sleep, all those things modulate your immune response. Yeah. So, basically, high level the way I think about it. Like, what are the things that are pissing off your immune system?

Right? It's toxins, allergens, microbes, stress, or diet. Right? Trauma. Trauma.

Right. And then psychological stress, physical stress is Yes. But there's also things we're missing. Right? So we know, for example, that, you know, if you're, like, the Sid Baker model of what you need to get, they'd be healthy and what you need to get rid of, you know, to actually, be healthy.

Right?

Dr. Robert Rountree
Because Well, there is vitamin d.

Dr. Mark Hyman
Right. By. So vitamin

Dr. Robert Rountree
D There is a omega 3 fatty acids. Right?

Dr. Mark Hyman
And and 80% or lower or

Dr. Robert Rountree
or deficient or just insufficient in vitamin D,

Dr. Mark Hyman
probably 90 plus percent are in fish, or low, and omega 3 fats in America. And this is an epidemic. And yet, you know, when you go to your rheumatologist or your gastroenterologist or inflammatory bowel disease, you're checking this stuff. So

Dr. Robert Rountree
Why is this concept so hard?

Dr. Robert Rountree
It's not that far.

Dr. Robert Rountree
It's vitamin d. It's cheap. Right? It's it's really non toxic. You have to take a lot of it to get sick from I mean, a lot of over 10,000 units a day for a long period of time to get into toxic levels.

And even then, you stop it

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Yeah. Your your calcium levels go down. So why is there so much resistance from rheumatologists, from endocrinologists, to just do in this simple thing. Michael Hogg's been talking about this Yeah.

Dr. Mark Hyman
Ever Yeah.

Dr. Robert Rountree
With good science and the New England Journal of Medicine

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
And he's just like, hey. Take vitamin d. Oh, no.

Dr. Mark Hyman
Yeah. Right.

Dr. Robert Rountree
Oh, we can't do that.

Dr. Mark Hyman
We could take this $50,000 drug. Right.

Dr. Robert Rountree
Because is wrong. It's only $5000 a month IV, and it might give you tuberculosis.

Dr. Mark Hyman
Yeah. Right? But but avoid this vitamin. It's lots of pennies a day.

Dr. Robert Rountree
Say he'll take vitamin d, and it could make you sick. Right. You could get toxic. And the press puts an article out about this, like, once a week.

Dr. Mark Hyman
Yeah. That's

Dr. Robert Rountree
I don't get it.

Dr. Mark Hyman
Yeah. So there's some of these, like, with MS screen, for example, those who are low vitamin a year, higher risk for MS. That's why it's higher in Northern Latitude. So there's low biting me, exposure to sun and so they get more vitamin need efficiency.

Dr. Robert Rountree
Yeah. And vitamin a is important too. I think, like, vitamin a has gotten a bad rap. Right? Oh, you can get toxic chromat.

It can cause osteoporosis, etcetera. But in reasonable quantities, regular vitamin a, you know, 5, 10,000 units a day. It doesn't take a lot. Yeah. But I'm talking about real vitamin a, not beta carotene.

Yeah. Because a significant percentage of the population doesn't convert beta carotene into retinol. Which is vitamin a. So a lot of people leave that out, but it induces immune tolerance. Yeah.

It's So I'm a big fan.

Dr. Mark Hyman
Yeah. So so we can use nutrients when they're optimized to help regulate our immunity. We know that vitamin a and vitamin d and zinc and selenium and vitamin c all are part of our immune system.

Dr. Robert Rountree
Yeah. Yeah.

Dr. Mark Hyman
Right? And how modulate things. So why not

Dr. Robert Rountree
immune cells are like any other cell in your body. They need a whole range of nutrients.

Dr. Mark Hyman
I wanna sort of now and talk about so that we've covered the causes. Yep. How we begin to approach people and treat them? Because people are going, okay. I get it.

Now you know, what do I have to do diagnostically? What are the kind of options for me therapeutically so that I can reduce the level of inflammation, reduce my symptoms, feel better, deal with the cause, and actually maybe even reverse the problem. Yeah. And by the way, I just just wanna reemphasize, I said earlier, is that we were all trained in official medicine that could it's a terminal illness. Like, you got MS What

Dr. Robert Rountree
you got? You got?

Dr. Mark Hyman
Got rheumatoid arthritis. You've got lupus.

Dr. Robert Rountree
Jersey's welded to your back.

Dr. Mark Hyman
Yeah. It's that's And there's no way back. You maybe you can modify it, reduce it, it comes and goes, but it's a lifelong sentence.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
In our experience, and I think in many functional misimpactive spirits, this is not the case. There are people who've had it and don't have

Dr. Robert Rountree
it. Right.

Dr. Mark Hyman
Right? Who's completely recovered from it. Right? It might not be that they're still not predisposed to it if they don't take care of themselves, but that it's something that can be reversed. And the automated antibody can be reversed.

And, again, it's something that we just don't see. So I just wanna emphasize that.

Dr. Robert Rountree
So, yeah, so what they always ask is is autoimmune disease reversed? And, again, my response is how far long is it? How much destruction of tissue is there? Is mean, particularly with a disease like rheumatoid arthritis. Yeah.

If your joints are gone, your joints

Dr. Mark Hyman
are gone.

Dr. Robert Rountree
Your joints

Dr. Mark Hyman
are gone. Your joints are gone. But some things like, you know, ulcerative colitis, your gut can regenerate.

Dr. Robert Rountree
Right? Complete regeneration. Yeah.

Dr. Robert Rountree
I

Dr. Robert Rountree
have seen people go into remission

Dr. Mark Hyman
I mean, I anytime. I had my god because I had a scope top and bottom. At Harvard, full red gastritis all the way down, full, colitis all the way through. It was like it was just like a red carpet. It's not the one you wanna walk on.

Yep. And and it's all gone. Yeah. It's a 100% normal. My cow protector was, like, a 1000.

Now Yeah. Perfect. Right? So I have experience

Dr. Robert Rountree
How do we remake our bodies? Every 7 year Yeah. For something new cells

Dr. Mark Hyman
or And and MS, you know, we have a colleague Terry Walls.

Dr. Robert Rountree
Yeah. Oh, Terry Walls. Because in

Dr. Mark Hyman
a wheelchair, in a wheelchair and could not walk.

Dr. Robert Rountree
And Yeah. Go dancing with her.

Dr. Mark Hyman
And now done dancing with her. She rides her bike twenty miles a day. And she's been able to reverse her MS using a functional medicine approach.

Dr. Robert Rountree
And something that Terry has said that's important, if you look at her brain scan, Then you might say, well, I don't know if it's really gone away. So you're treating the brain scan or the person? Well, the brain's Terry's moving around. I mean, she's got function. Yeah.

But her brain scan shows scarring.

Dr. Mark Hyman
Yeah. So sometimes scarring, you can't get rid of.

Dr. Robert Rountree
Right. The scarring you can't get rid of, but the brain can rewire self around the scar.

Dr. Mark Hyman
Exactly. So when someone comes to you and they have rheumatoid arthritis or they have ulcerative colitis or they have MS. How do you start to think about approaching a patient like that?

Dr. Robert Rountree
Yeah. Well, I I think I start focusing on anything that might be obvious. Right? Do they smoke cigarettes?

Dr. Robert Rountree
Right? It

Dr. Mark Hyman
should take a detailed list.

Dr. Robert Rountree
So I think I'm yeah. Okay. So that's probably the most important thing that we teach in functional medicine. Yeah. Is you you take the most detailed history you can imagine.

You know, we have, like, a 10 page form that people Hello? Where were you born?

Dr. Mark Hyman
How long was it? Where were

Dr. Robert Rountree
you born? Were you breastfed?

Dr. Mark Hyman
Right. C Sex, you have

Dr. Robert Rountree
Alec when you're a kid. They're like, I'm sixty years old. You're asking me if I call it. You're right. Right.

You know, did you take antibiotics? Did you have a tightest media when you're six

Dr. Robert Rountree
months old?

Dr. Mark Hyman
Infections. Right.

Dr. Robert Rountree
Like, I wanna know about all these things. And, you know, that's really critical information. So the history is a huge

Dr. Mark Hyman
I mean, did you tuna fish every day for year.

Dr. Robert Rountree
I did.

Dr. Mark Hyman
I mean, I do. I did. I do every sandwich every day. How? Lunch.

You know, like, did you did you have exposure to other than remember, I can't

Dr. Robert Rountree
You gotta be careful. I mean, I have a patient with MS where I'm telling you, you gotta eat more fish. Right? So then she goes out and starts eating tuna every day, and I'm like, Oh, I didn't spec. You gotta be very specific.

Yep.

Dr. Robert Rountree
Correct.

Dr. Robert Rountree
So I like to start really simple.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
And we've talked about Sid Baker a couple of times. I trained with Sid 40 years ago. Yeah. Right? So, you know, Sid's basic principle, what does a person need to get, and what do they need to avoid?

Said that a few times, but you cannot stress that enough.

Dr. Mark Hyman
Yeah. That's that's the crux of how

Dr. Robert Rountree
Always start with that. Is there anything obvious that this person needs to get. You know? Maybe they just need to get more love. Yeah.

Right? They're in a bad relationship. So I try to do the obvious stuff first. Yeah. But and and I may get a point about this because sometimes people have the idea Functional medicine is all about the grocery bag of supplements.

Dr. Mark Hyman
Yep. Right? Definitely not.

Dr. Robert Rountree
Somebody comes in, they've gone from a tortoise or MS then you just give them the grocery bag and they walk out with the cart, but it's not like that at all. Now it may evolve to that point, You know, they may end up on quite a few things if you start tweaking. Yeah. Right? They still don't take as many supplements as I'd Right.

Right? Or you do.

Dr. Mark Hyman
Yeah. Right? It's a thinking. The problem is functional medicine corrects the thinking problem.

Dr. Robert Rountree
So I'm looking at the whole system. Right. So what's off in the system? So what's the outer layer? What's obviously off here?

Is the person not getting, you know, the problems of lifestyle factors, not getting enough sleep, not getting enough exercise, not, getting enough fresh air, all of those things, Really obvious maybe to you and me.

Dr. Mark Hyman
Yeah. Yeah.

Dr. Robert Rountree
But, you know, it wouldn't be obvious to a rheumatologist. They say, well, get some house plants, get an air purifier. Clean up your gut. And then the next layer is gonna be to talk about diet, you know, the gluten, the dairy, etcetera. Am I gonna test for balloon sensitivity.

This is a high likelihood that I will. Yeah. Am I gonna do a gut microbiome test? Quite frequently, I do. Yeah.

You know? So I'll do the standard test, the blood count, the metabolic panel, the antibodies, the basic immune stuff.

Dr. Robert Rountree
Do you look

Dr. Mark Hyman
for toxins on everybody?

Dr. Robert Rountree
Not that everybody no.

Dr. Mark Hyman
Heavy Metals? I mean, if you have a history of someone's

Dr. Robert Rountree
If I've got a history, if I have any reason to suspect that I'll do it.

Dr. Mark Hyman
Like, if you're a vegan and don't have fillings, basically. Yeah.

Dr. Robert Rountree
Then I was not gonna

Dr. Mark Hyman
do that. You don't need to worry about it.

Dr. Robert Rountree
I don't do that.

Dr. Mark Hyman
But, I mean, if you're always been a vegan

Dr. Robert Rountree
It's going hard to test for to be honest, you know, there used to be a few labs Yeah. Where you could do really comprehensive things. Like, look for glyphosate, I look for a round up and everybody? Yeah. Well, everybody's got round up.

I got it. I tested myself.

Dr. Mark Hyman
I don't need to.

Dr. Robert Rountree
It scared me. I'm like, what do I do? Well, maybe I just sit and test for this and

Dr. Mark Hyman
Don't eat at restaurants.

Dr. Robert Rountree
Alright. Don't don't go out the heat. Yeah. Don't drink anything out of a bottle, then you'll be fine. So I don't do it unless there's a big red flag that says, okay.

Here's the person that say was well, and they went out and sprayed their yard. Yeah. And they went downhill after that. Yeah. Oh, I'm thinking some kind of organic phosphate.

Dr. Mark Hyman
Yeah. Yeah. Yeah. You don't actually have to assess that. You know, I think you you just wanna emphasize what you said about history important.

I think I'm sure you've seen this, I've seen this in patient after patient. You take the United history starting from birth Yeah. Where you see section

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
Did you breastfeed? Did you have antibiotics from your own?

Dr. Robert Rountree
Yep.

Dr. Mark Hyman
Did you have colic? Yep. Did you take antibiotics? Yep. And did you have acne and take antibiotics for that?

You're on the birth control pals again. So you start to get a a story, and then you have your old bow when you're a kid. Then you have asthma, your allergies, if you have eczema, and you start to see and the sort of low grade inflammatory analysis that starts to accumulate over their lifetime. And it sort of it sort of progresses by the time you're in their thirties or forties it becomes autoimmune disease. Yep.

And and often, it traces back to the gut and the damage that we've done to the gut through the diet, through the antibiotics, through lack of breastfeeding through C sections, through, all of the ways we sort of deal with with our toxic diet and all the environmental chemicals, which by the way, all affect the gut. So I I think your history point is really important.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
And and then I always make sure I I check for, you know, have you been exposed to tick infections to get dip fights? So you have mold in your house. Do you do you a lot of fish? What kind of fish? So I take a very detailed history.

Dr. Robert Rountree
Any flooding. Yeah. Exactly. Flood. Right?

Dr. Mark Hyman
And then you got, okay. Well, then you know where to find things. One of the top diagnostics. You mentioned a celiac panel. You mentioned

Dr. Robert Rountree
stool tests. Panic panel. I do a stool test. So they're all pretty high up. You know, I I find a lot of weird immunodeficiency syndromes and apple too.

So IGA is probably one that people would never think about it. Right? But I g a, one of the standard immunoglobulin. So so there were there's a, g, d, and e. Right?

But the a, you know, people know that you make IGA in your spit and your tears, etcetera. And, you know, it's it's present, but what's the problem if it's not there? Yeah. Very high incidence of autoimmune disease. Yeah.

And it's really common to see congenital deficiency of IGA, but also an induced deficiency of IGA. So it's really worth testing for that. Yeah. Yeah. So, you know, I have a battery of immune test.

I do the CCP test, the cyclic citrolinated peptide test. I do that. Oh, law. I do a and a. Like, you know, you should just

Dr. Mark Hyman
do it. Standard biomarker.

Dr. Robert Rountree
Yeah. A and H should be a biomarker for everybody.

Dr. Mark Hyman
Yeah. We we use that on the the standard function panel, which your doctor's not gonna do, but we detect all these things vitamin d. We check for inflammation. We check rheumatoid factor, A and A, all those things that help people get a sense, and we're shockingly finding 30% of people have this phenomenon. And so in a way, you know, you people will have to wait till they get a non immune disease.

They can have preaut immunity. And I, you know, I wanna get into that in a minute, but Yeah. I wanna kinda talk about we talked about some of the diagnostics, and there's lots more. You can Yeah. For line disease.

You can look for tick infection. You can look for viruses. You can look for

Dr. Robert Rountree
And then we'll have to do standard panels. Exactly. Now that make so much easier.

Dr. Mark Hyman
Exactly. And yeah.

Dr. Robert Rountree
And you

Dr. Robert Rountree
know what? I certainly do a vitamin d level. You know, why don't you

Dr. Mark Hyman
do it? Level.

Dr. Robert Rountree
You know, make a 3 level. Something I measure a law is oxidized LDL. Yeah. Right?

Dr. Robert Rountree
Would you

Dr. Robert Rountree
believe that does it? Cleveland Heartland does And so it's really easy test to do. And there are studies showing that when people live in polluted areas

Dr. Robert Rountree
Yep.

Dr. Robert Rountree
Their ox LDL goes up.

Dr. Mark Hyman
It's basically rancid Fat.

Dr. Robert Rountree
It's rancid Fat. It's probably the best simplest marker there is out there.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
So, you know, a patient with MS recently in. And she said, what kind of blood test do you wanna do? I said, let's get it off LDL. Why would you wanna do that? Well, you know, explain it to her.

It makes a whole lot of sense. EVD, you know, as well that really single out, like to do EVD panels Yeah. Quite a bit on people.

Dr. Mark Hyman
So, basically, you're looking for toxins, allergens, microbes, Right? For mole, you're looking for, you know, dietary nutritional efficiencies. You're basically doing that whole algorithm of what do you need to get rid of and what do you get?

Dr. Robert Rountree
Right. Right.

Dr. Mark Hyman
And then once you get all that data and it and it is really it's really personalized. You know? And, like, you don't treat everybody who comes in the rheumatoid arthritis the same way where everybody with, lupus the same way, everybody with colitis the same way. Everybody gets a different treatment depending on what their particularly unique characteristics of causes are and balances are. Right.

So where do you start with a patient in terms of the intervention submission died a little bit. So maybe kinda take us through the the thinking about the approach to treatment. And then some of the other things people can do on their own. They don't even need a doctor for, What what are the things that you think are the the

Dr. Robert Rountree
most important? Really simple thing is to have a person do a modified bass, and there are a lot of different ways to do that. Yeah. You know, There's been a lot of protein powders that have been rallied for years. And especially somebody that's hurting

Dr. Mark Hyman
Yeah. You

Dr. Robert Rountree
know, person with RA Yeah. Or person with ulcerative colitis, They're having a lot of symptoms. Yeah. You rest their gut. You do it for 3 days, maybe 5 days.

Rest their gut and see if anything changes

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
And the reason I like that is because it gets their attention.

Dr. Mark Hyman
Yeah. Right. Right.

Dr. Robert Rountree
Right? Right. Yeah. Because they You

Dr. Mark Hyman
pull everything out and you just give them a odd allergenic

Dr. Robert Rountree
protein drink. Did this, you know, couple scoops of this powder for three times a day. And 2 days later, they go, woah. Yeah. What's going on here?

I feel different. Yeah. Right? It really gets their attention. And then you start working with diet in a really specific

Dr. Mark Hyman
That's interesting. I it reminds me of a patient I had about years ago. Her name was Judy. I don't remember her. She she said she was listening to my advice because I said, I want you to be in a gluten free diet when

Dr. Robert Rountree
we used

Dr. Mark Hyman
to diet. I want you to just just like, I am. I am. I'm not getting better. I'm not getting better.

I'm not getting better. I'm like, Okay. Well, how about we just do 10 days of Ultra clear plus, which is basically a metagenet for ice protein powder? We just use a lot. And it's hypoallergenic, and it's got nutrients in it.

And, basically, you can live on. Yeah. Everything went away

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
10 days. And then she got it. Yeah. And she Oh. And then she lost her teeth.

Dr. Robert Rountree
I coulda had a V Eight. Right?

Dr. Mark Hyman
Yeah. Her real drive drive went away with it. So it's it's a very powerful it's a very powerful strategy, and it's it's very inexpensive. And it's something that anybody can do. Yeah.

You know, I think we'll put it in the show notes some of the way even do a modified fast using some of these protein things, but I think, you can't live on that forever. No. No. And what And

Dr. Robert Rountree
I do wanna add to there is a clinic out in California. I think there's a couple Yeah. That actually do water fast.

Dr. Mark Hyman
Water fast.

Dr. Robert Rountree
For long periods of time sometimes for weeks and like don't try this at home. Right? They keep this under supervision. But, you know, I'm a a editor of a journal, and we publish some of their articles and they've had some remarkable results. Yeah.

And you go, wait a minute. This isn't supposed to be good for you. You're supposed to lose your muscles and

Dr. Mark Hyman
food is one of the causes of inflammation. If you have a leaky gut and you're eating foods that you're reacting to, then, yeah, you're gonna get better. Yep. So there's a whole movement out there of elimination diets.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
There's many different kinds. Right. There's the autoimmune paleo diet.

Dr. Robert Rountree
Right. They I p.

Dr. Mark Hyman
Yeah. Which is essentially is basically what

Dr. Robert Rountree
There's nothing. Nothing. No. No.

Dr. Mark Hyman
It's basically what I wrote in my 10 day detox side book, which was essentially no gravy. It'll be no dairy or sugar, no processed food. Right. Protein vegetables, nuts, seeds, and berries left fat. And they remove also night shades.

They remove nuts, and they remove eggs. Yeah. So it's a it's a pretty restrictive diet. Right. But it's been shown in peer reviewed journals to actually be very effective for treat, disease.

And it's often where I'll start. And, you know, some of the people say, well, eliminate one thing. Like, just get rid of gluten and see how you do. Or you're rid of Darius. Yep.

Like, no. Because you don't know. You could you could have 5 different things you're reacting to, and you could take 4 of them. Well, you still react. You still have to It's

Dr. Robert Rountree
gonna be a middle of, like, 5 to 10 things. Yeah.

Dr. Mark Hyman
And that's the I've that's the 2nd rule of Sid Baker, which is the 2nd tax rule is if you're standing on 2 tax, taking one of them out doesn't make you 50% better.

Dr. Robert Rountree
Right.

Dr. Mark Hyman
Right? So you've gotta actually find all the things that are pissing immune system. So I I tend to do more aggressive elimination diets and then add things back. But, what do you think about, you know, things like an autoimmune paleo or the lectin free diets? And is that a is that, you know, other we should pay.

Dr. Robert Rountree
Okay. Well, that's a whole can of worms. Right?

Dr. Mark Hyman
Just go go to Steve

Dr. Robert Rountree
on that. I I'm in. So the AIP, I do use that in people. There is some public research on it. Yep.

So it's not totally made up. The thing I like about it is it basically just takes everything that might be a problem. And says, okay. Rather than trying to figure this out and sort through it, let's do it. Now a lot of people just find it to restrict.

They can't do it, but at least they've been there. They've been down on that. Pathway, and they've said, okay. I've explored that. You know, let's liberalize just a little bit.

Right? But I think most people are sensitive to a relatively limited number of food. Yeah. You know, so that's just it. People get really confused about it, and they say, well, thirty things I'm reactive to.

Like, most people don't have that many reactions unless they got leaky gut, in which case you treat the leaky gut.

Dr. Mark Hyman
Got right.

Dr. Robert Rountree
Right? So let's go after that.

Dr. Mark Hyman
It's not not what foods are you sensitive to, but why are you so sensitive?

Dr. Robert Rountree
Why are you so sensitive to the the next step?

Dr. Mark Hyman
And I think that's the next step, right, in the treatment of the new elimination diet? You find all these simple cause that you can fix, and then you have to fix the gut. I think it's the next step. Right?

Dr. Robert Rountree
Is that is that is that your next step? To fix the gut?

Dr. Mark Hyman
That's, like, the first step after your diet in terms of And that's part of the diet's fixing gut is how do you how do you start with

Dr. Robert Rountree
thinking about the gut wall? Like, use a lot of glutamine, I I like n acetylglucosamine, n a g. Gray compound, it's been around forever. It comes from Shrimp from Titan. Right.

Right? So it's pretty safe. Yeah. To use, I've had a few people be allergic to it, but otherwise, it's completely nontoxic. So I use that.

I use Zinc. I like curcumin. I mean, what what can go wrong with curcumin? Right? It does increase bio flow because, you know, it's a color ready company.

Dr. Robert Rountree
Yeah. Yeah.

Dr. Robert Rountree
So people will say, hey. My my poo's a little bit greener, but okay. Yeah.

Dr. Robert Rountree
Okay.

Dr. Robert Rountree
You can live that. Yeah. Yeah. So, you know, there's some basic go tos that I would use like that for the gut.

Dr. Mark Hyman
So there is something that's been we have a whole protocol at functional medicine called the 5 r

Dr. Robert Rountree
5 hour program. Yeah.

Dr. Mark Hyman
5 hour.

Dr. Robert Rountree
No. I don't necessarily do them in order.

Dr. Mark Hyman
Right. Yeah.

Dr. Robert Rountree
Right? I mean, I I wanna know what's going on in regards to microbiome. Yeah. Right? So I might go after a particular bug first if I find it.

Yeah. But if I don't find a pathogen, I don't necessarily think you know, the person needs to be on, you know, some kind of potent antimicrobial.

Dr. Mark Hyman
No. No. No. But but it's like, basically, take away the bad stuff. Right?

Yeah. Yeah. So it's removed. So we've got bad food connected too. It could be bad bugs, bacterial overgrowth, yeast, maybe it's a parasite, something, you know, like, intermediate analytic guy, you might need to treat.

And then you, you know

Dr. Robert Rountree
Then I go for the prebiotics because I think prebiotics are fond of the that's the big thing that's really chains that are understanding of the gut. Yeah. Prebot. And now he's he's getting really specific with prebiotics. I remember reading you posting something about Bob's potato flower.

Dr. Robert Rountree
Yeah.

Dr. Robert Rountree
Bob's red mill potato flower. Like Yeah. Was that 10 years ago? That's right.

Dr. Mark Hyman
For Mike's RJ. Yeah.

Dr. Robert Rountree
I'm like, what is talking about potato starch. You gotta be kidding me. Right? Well, the data's pretty good. Yeah.

Yeah. I know. I love everybody on that. Yeah.

Dr. Mark Hyman
Yeah. That's right. That's right. Right? I remember that.

Yeah. So so there's probiotics that are fertilizing the good button. So the second r is

Dr. Robert Rountree
Right.

Dr. Robert Rountree
Is kinda that's a good long travel thing. You know, that explains why when people do that smoothly thing for 3 days, the occupancy goes up and comes back down again. He's like, well, we really need to feed it for a long

Dr. Mark Hyman
time. Yeah. The one the only thing I think changed in my thinking a lot, Bob, was was I understand prebiotic fibers.

Dr. Robert Rountree
Yes. Polyphenols. Yes. Colorful. Yes.

Yeah. Macha Yeah. For, you know Like,

Dr. Mark Hyman
when I had no acromancy, I took a lot of concentrated cranberry Yep. Not like Sherry cranberry juice, but Yeah. Every concentrate, pomegranate concentrate

Dr. Robert Rountree
Right.

Dr. Mark Hyman
And green heat powder a lot of other polyphenol powders every day in this movie, and that's what actually reset my gut to. Yep. Yep. It was quite quite amazing. And so, the the replace is replacing things like probiotics and polyphenols and

Dr. Robert Rountree
And hands on. Yeah. Ends on, which is an old naturopathic thing. I mean, I heard about this hurt Bernard Jensen talk when I was in medical school. Right?

The old time naturopath, and I thought, Well, this guy's really obsessed with his bowels, right, because, like, that's all he wants to talk about. It's good bowel health, etcetera, using enzymes and Yeah. Now it makes total sense I don't hear the gastroenterologists talking about the gestive enzymes. Right? No.

Etsocrine pancreatic deficiency And maybe you could take Creon or something like that.

Dr. Mark Hyman
Cystic fibrosis, or you're fine.

Dr. Robert Rountree
Oh, you're fine. Alright. Otherwise, everybody else is fine. Well, wait a minute. What about BinO?

Dr. Mark Hyman
Yeah. You know? I mean

Dr. Robert Rountree
Is there a problem with Nina? I'm glad to hear

Dr. Mark Hyman
you were talking about fartspot.

Dr. Robert Rountree
Really? I well, it's okay. There's a reason I bring this up. Is because they did a study a few years ago, and I think it was in Italy, where the the question is, Are fodmaps good for you bad for you? So that verminable oligodimodosycorides on polyols.

Right? Yeah. People eat these foods and get gassy, is that a problem for inflammation? So should you and if they are, should you would have? So a lot of people eat those foods, They get a lot of gas.

They get bloating. They get Cboe or Cboe, whatever you wanna call it. And so the assumption is, well, this is a bad thing. Right? Well, this study that was done in Europe, they actually put people on a low five map diet and then put other people in a Mediterranean diet with a lot of fiber.

And they had them record the amount of gas that they're that gave them little clickers. Yeah. Yeah. Yeah. Right?

And they recorded the gas. So of course, the people in the Mediterranean diet just had lots and lots of gas. You know Is

Dr. Mark Hyman
there any beans?

Dr. Robert Rountree
They were eating beans, booms, you know, all kinds of stuff. Right? Yeah. Then they looked at their microbiome. The people in the low 5 app diet, their microbiome went to hell.

Dr. Mark Hyman
Yeah. Interesting.

Dr. Robert Rountree
With the hell. But people on the Mediterranean diet who were having all the gas and maybe a little discomfort, their microbiome had all the good stuff to you.

Dr. Mark Hyman
But I wonder if if you have someone with really bad natural lower growth and you give them five maps that make them worse.

Dr. Robert Rountree
Oh, So it's Yeah. So that's a harder diet. Right? It's just not a long term diet because we're talking about what diets

Dr. Mark Hyman
or, you

Dr. Robert Rountree
know, are you gonna do for long term for the gut to get the healthy and a low five map diet is not part of that. No. It's a it's an elimination diet. Right. Because I want the person to know, well, I can't eat leek garlic and onions.

That's just a no to for me. I can't eat that, but don't avoid all fodmaps because it turns out fraud maps for prebiotics.

Dr. Mark Hyman
Right. Exactly. That's why they that's why they caused them. Yeah.

Dr. Robert Rountree
That that's why they caused it to gas. And so here's this real trade off. The person's got floating. Maybe they got Sibo. And they're saying I should eat low fiber.

Yeah. But that might kick off your autoimmune disease Yeah. In the long run Yeah. Because then you get this fibrosis.

Dr. Mark Hyman
Yeah.

Dr. Robert Rountree
Right? So it's a really important concept there.

Dr. Mark Hyman
So that so then we've sort of gotten through that. And then we then the next step, right, which is re inoculate, which is probiotics. Yeah. From when we started to now, it's become somewhat sophisticated, complicated, sophisticated, or understanding. We thought we knew a lot.

We knew it. Yeah. Now we know we know so little. But we know enough. And there's a lot of data on probiotics.

Dr. Robert Rountree
We know what probiotics make a difference. Yeah. Right? Cylon probiotics work for some people some at the top. Yeah.

Really well. Some of on. Yeah.

Dr. Mark Hyman
And then there's acromancy or probiotics that people can take. So it's interesting, but I

Dr. Robert Rountree
was yeah.

Dr. Mark Hyman
When I was sick, I couldn't take them because they didn't even exist, but now

Dr. Robert Rountree
they're good.

Dr. Mark Hyman
And then you met we mentioned, like, the repair part, which a lot of things we're talking about, like zinc, and glutamic acid, vitamin a, and fish oil, and other compounds. So we have a whole, approach who kinda reset the gut. And, you know, for me, in my practice, I know it's, like, for you, but when I do the dietary stuff and the resetting the gut, it often works for a lot of people. It's kind of a 80%.

Dr. Robert Rountree
Yeah. Maybe 90% of people.

Dr. Mark Hyman
And then those who don't get better, I dig a little more. I look for lime. I look gravie metals. I look for mold. I cut it

Dr. Robert Rountree
talks

Dr. Mark Hyman
Like viruses post COVID. And, you know, we got questions from X, and we we posted. We're gonna do this podcast with you, and everybody started gonna ask it. Okay. Why don't I ask Bob about this now?

But we've kinda actually actually answered most of the questions around, you know, lung COVID and COVID, causing odd muni vaccines causing on muni environmental connections and trauma from childhood. So we talked a lot about these things in in the podcast. So I think we've covered a lot of it. I think you know, what I I kinda wanna lead people with is is that this isn't just Bob and I being too quacks doing functional medicine for 30 years.

Dr. Robert Rountree
We've

Dr. Mark Hyman
thought about this. You know, Bob, we're at the integrative health, symposium in New York City, and, you know, Bob just was on stage doing a tremendous lecture with an incredible amount of scientific evidence that backs this up. And, you know, what what often frustrates me, and I I'm sure it fetches you, Bob, is in traditional medicine, There's enormous swaps assigned to evidence that has just ignored because it doesn't fit the current model of thinking. Yeah. You know, Okay.

Well, okay. I'm a rheumatologist. It says that I should be paying attention to toxins and poop, but I have no clue. I was ever training this. I don't know how to look at this tool test.

I don't know what to do if I

Dr. Robert Rountree
find time.

Dr. Mark Hyman
Out of time, I don't even want to. So it's like, I'm just gonna do what I do. And I think I think it's unfortunate. And now there's more and more, traditional doctors who were coming over to the other side and actually understanding this, even at a at a high conceptual level they get that that things are changing. And I saw this at clinic clinic, our rheumatologists, there were so forward thinking and were so progressive and really understood this.

In fact, we did, a retrospective analysis of some of our patients looking who had rheumatoid arthritis as psoriatic arthritis in our clinic at Cleveland Clinic Center for Functional Medicine, and we and we had a fellow from the rheumatology department, not one of us, but one of their fellows, analyze our data, and their matched cohort data. And we outperformed them in terms of better improvement outcomes using functional medicine Yeah. Compared to the top rheumatologist. Nothing. They're not amazing doctor.

They are They were using the best tools available, but they weren't dealing with the, the root causes, and they had the wrong map for the territory of illness that they were navigating. Yeah. I think that's what functional medicine is a different map that we can use, and it can create profound changes. And I I and because I'm talking, remember this one case I had a Cleveland Clinic a woman. She was like a fifty year old coach, business coach.

She had everything. She was depressed. She had pre diabetes. She was overweight. She had migraine headaches.

She was severely, affected by irritable bowel syndrome, bloating, and, she had reflux she also has psoriatic arthritis. So she had terrible arthritis plus arthritis that went with it. She was on this drug that was, like, Salera, $15,000, a year drug, and she was on drugs for the psychiatrist drugs. And the GI doctor, drugs from the migraine doctor drugs from the psychiatrist for every, like, every Do

Dr. Robert Rountree
you like polyphenols, not polypharmacy?

Dr. Mark Hyman
Holy cow. There you go. And and, and I'm like, Okay. Well, let's see. What do all these problems you have in common have in common?

Yeah. Yeah. Depression is inflammation in the brain?

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
Obviously, it reflects the irritable bowel inflammatory gut diseases.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
And migraines are in inflammation. Yep. Psoriasis inflammation or arthritis inflammation.

Dr. Robert Rountree
Yeah. Yep. Yep. Right?

Dr. Mark Hyman
And and so I just sent I think she's got really and she's designed tons of steroids in the past in any box. I'm like, I'm just gonna guess. But I think she has really bad Cbo, which is back to her growth. Yeah. And this bio says, and she has used overgrowth.

So I'm gonna clear out her gut. Yeah. I'm gonna give her some probiotics and some fish show vitamin d and put her elimination diet, and we'll see what happens. Yeah. I said, don't stop any of your medications.

Come back in senior in 6 weeks. We'll go through the test and see what's going on. How's back in 6 weeks? If as well, I stopped on my medications, I lost £20. I don't need more migrants.

I'm not depressed. I don't have reflex. I don't have a real bow, and my psoriasis and arthritis went away. I saw it from my medication. I'm like, oh, okay.

Dr. Robert Rountree
Yeah.

Dr. Mark Hyman
So sometimes it's that easy. It's not always that easy, but the point is that that we're often have the wrong map. And that's why I, you know, I really was so excited about this conversation with you today because it's is this such a big issue for people, autoimmune diseases is the number one scourge from modern society. We think it's heart disease and diabetes, but it's actually

Dr. Robert Rountree
How do we

Dr. Mark Hyman
it's out of you. It's so it's and it's so poorly address. I mean, we know that if you eat better and exercise, you can reverse diabetes. I mean, most doctors it's not like a puzzle. But autoimmune disease is like a black box, and it really is it.

And and we we wanna accelerate the adoption of the scientific knowledge that we have now. I mean, we've been doing this for 30 years, and we knew this 30 years ago.

Dr. Robert Rountree
Yeah. Yeah. Yeah.

Dr. Mark Hyman
But it's still, it's, like, so slow, and it's frustrating. And so many people out there are frustrated. And I I think, people, you know, need to understand that we we have this opportunity to really rethink medicine, rethink disease, and particularly autoimmunity. So if you're suffering with autoimmune disease out there, I encourage you to check out this approach. Bob, where can they find more about you?

Dr. Robert Rountree
About me. Yeah. Oh, well, LinkedIn answers you for functional medicine.

Dr. Mark Hyman
The What about your practice, actually?

Dr. Robert Rountree
Actually, not taking new people.

Dr. Mark Hyman
Oh gosh. Okay.

Dr. Robert Rountree
You know, that's Too busy.

Dr. Mark Hyman
His wife is jumping up and down. Yeah. It's tough because, you know, you're probably like me. When someone comes in, I have this and that, you go, oh, I know how to fix that in 5 minutes. Right.

They didn't see doctor after doctor.

Dr. Robert Rountree
Right. It's like, oh, take some of this. Okay. Yeah.

Dr. Mark Hyman
But now there's there's the issue for functional medicine. You can go find a practice.

Dr. Robert Rountree
Yeah. Yeah. So I'm training the doctors, the next iteration. So that they can serve the people that need us.

Dr. Mark Hyman
It's amazing. You've taught me so much over the years. You're just an incredible physician and had a great, asset to this whole field. And I think, if if people really understood what's possible, they wouldn't just passively accept that this is a chronic issue that they have to live with and manage that this is actually treatable or reversible.

Dr. Robert Rountree
Yeah. Absolutely.

Dr. Mark Hyman
Trollbot, thanks for being on the podcast. You're a a superstar in my view, and, great to have you as a friend in college for so many decades.

Dr. Robert Rountree
Pleasure, my friend.

Dr. Mark Hyman
Alright. Great.

Dr. Robert Rountree
Keep up with that, Bob Stradmill.

Dr. Mark Hyman
Is that your brand, Bobby? Alright. Thanks, everybody.

Dr. Robert Rountree
Listen. Thanks.

Dr. Mark Hyman
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This podcast is separate from my clinical practice at the Delta wellness center and my work Clevelin Clinic And Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guest opinions, and neither myself nor the podcast endorsements of views statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services.

Now if you're looking for your help in your journey, seek out a qualified medical conditioner. You can come see us at the UltraWellness Center in Lenox, Massachusetts. Just go to ultrabellnesscenter.com. If you're looking for a functional medicine practitioner near you, you can visit ifm.org a search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed health care practitioner, and can help you make changes, especially when it comes to your health.