Exposing The Flaws In Our Broken Healthcare System with Dr. Marty Makary

Mark Hyman, MD

Full Transcript

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

Dr. Marty Makary
We have yet to really understand what's going on here. The rise in colon cancer and young healthy people. Right. Turns out that there's an association with the microbiome. Being born by C section and going on to have colon cancer before age fifty was an association just published in JAMA surgery.

Dr. Mark Hyman
Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice. There's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand. Well, you, if you're looking for data about your biology, check out function health for real time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hyman Hyve.

And if you're looking for curated and trusted supplements and health products for your routine, visit my website supplement store for a summary of my favorite and tested products. Welcome to doctor's pharmacy. I'm doctor Mark Hyman, and this is a place for conversations that matter. And if you've ever wondered if there's corruption and dysfunction in the medical system, then you have to wonder no longer because our guest today, Marty Macquarie is a professor at Johns Hopkins University School of Medicine and the author of 2 New York Times best selling books that have kind of pulled the curtain back on a lot of the dark side of medicine that you're gonna hear about in this podcast. Doctor Macri served in leadership at the World Health Organization.

He's a member of the National Academy of Medicine, one of the highest honors you can get in the field of science. He's published over 250 papers. His newest book, blind spots, challenges the conventional medical dogma to educate people about their health. Clinically, he's the chief of islet transplant surgery. That's getting something in your pancreas, when your pancreas isn't working at Johns Hopkins.

He's the recipient of the nobility and science award in the national from the National pancreas Foundation. He's been a visiting professor at over 25 medical schools. And he's just a very courageous doctor because he has pushed the limits of what we should be talking about in medicine because we are told to keep the secrets. He wrote a book called unaccountable what hospitals won't tell you and how transparency can revolutionize health care. He also wrote another book at the price we pay, what broke American health care about the lack of transparency in pricing and how we can fix it.

He's, just an incredibly brilliant man who has just on a mission to tell us the truth that you have not been hearing. And today, we talked about all sorts of things from the concern about vaccines and should we actually be vaccinating certain people and groups of people with a code vaccine or not. Why has the microbiome been ignored in medicine? Why is our medical education system completely teaching the wrong things? Why are ours our national Institute of Health actually have nothing to do with health and is all about disease and is not even funding the things we should be funding.

How has the range of, roles of GLP 1 agonists been ignored and why are we concerned about that? He's also we also deep get into the topic of of of health care financing payments, how researchers funded the corruption of evidence based medicine. I mean, we talk about it all. I think you're gonna love this podcast. So let's dive right in.

With the doctor Marty Macquarie. Welcome Marty to The Doctor's Faramcy podcast. It's so good to have you. I followed your work. And, honestly, I'm kinda shocking because you're Johns Hopkins professor and you're Lahertic in

Dr. Mark Hyman
the middle of the

Dr. Mark Hyman
belly of the beast Right. And you're kinda telling tales that we've traditionally kept secret in medicine. It's kinda like a guilt, you know, or like, you know, it's a club. And you don't you don't tell in your neighbors or your colleagues or your friends about what's really going on in medicine and health care. And what's really struck me as I've, you know, been a doctor god for almost 40 years now is the is the level of, co optation and capture of medicine by industry.

And it's less about health care. It's more about business. Whether it's private equity taking

Dr. Mark Hyman
over health care practices and emergency rooms or whether it's, you know, just pharma controlling

Dr. Mark Hyman
policy and influencing medical education or whether it's lack of of a real accountability and transparency in health care and medicine, you know, you you've been really outspoken about these things that

Dr. Mark Hyman
we've kept quiet about for a long time as doctors. And you have, you know, quite a

Dr. Mark Hyman
pedigree. And, you know, it means a lot coming from you. I mean, I'm just a heretic on the margins and a little fringe doctor, but you're on RD, a real doctor.

Dr. Mark Hyman
I

Dr. Mark Hyman
just play one on TV. And, and I think that, although I do see patients, but I'm kinda kidding.

Dr. Marty Makary
Yeah. You're big

Dr. Mark Hyman
but I I really am so excited about your work about your new book, blind spots. It's a great book. When medicine gets it wrong and what it means for our health and your other books, which I think are also very compelling and and touch on areas that are also quite concerning for me, which is really the lack of accountability and transparency in medicine. It's called unaccountable where hospitals won't tell you in how transparency can revolutionize health care and another book you wrote called the price we pay. What broke American health care and how to fix them.

I mean, why are we spending twice as much as any other nation getting half the results. So, I'd love to kinda hear how you went from being like a, you know, revered surgeon at Johns Hopkins where the sort of the birthplace of modern medicine with William Olser to kinda calling calling out what's really wrong with the system.

Dr. Marty Makary
Well, it's great to see you, Mark. You know, I think I it hit me at a certain point. I went as far as you can go in academic medicine, all the regalia, all the societies and honors and promotion and tenure. And it hits you at a certain point. I don't know if it's after I wrote 200 scientific articles or 250, but you realize no one's reading these things.

Yeah. The system is so broke And the problem is we have a lot of smart people in a system where they're just collecting their paycheck every 2 weeks, putting their head down. This shouldn't be. This should, you know, this isn't right. And we feel like we're cogs in the wheel, And people are afraid to get off the hamster wheel, take risks, and call things out.

So in the book, the price we pay, we, my research team brought attention to this issue of price gouging and predatory billing, which is the term we called these kind of crazy bills that get thrown at people, they want a price that are not giving a price. And it ruins lives. And now we have this massive trust problem where some 62% of Americans say they have avoided care or delayed care for fear of the bill. Yeah. So you can have the cure for pancreas cancer now, but if 62% of the population, it doesn't trust you, that pills only 38% effective, not a 100% effective.

Dr. Mark Hyman
No. It's true. I mean, I I literally had direct experience. I had any issues, so I needed an MRI. And I went to Chinatown, New York City.

I got one for 400 bucks. Had to get one in, in Berkshire and and where I live in the Massachusetts. And and it was 25100 bucks for the same MRI, same machine. I just went and had back surgery and had hyperbaric oxygen. I I went to this hospital and I said, I wanted to get it.

And I said, okay. But it's $5000 a session. Like, jeez. And I talked to the the head and everything goes well, if you do it this way, not through Medicare, and you do it through, you know, an off label use. It's a $175.

So, like, a 175, 5000 exactly the same procedure. How does that happen in medicine?

Dr. Marty Makary
Yes. Exactly. Right. So this is the game. I call it the game in the book, the price we pay.

And we found that the game is designed to maximize profits. It's not designed to be honest with patients. And so, the book actually led to some real legislation and an executive order from the White House that was entirely bipartisan that now requires hospitals to start posting cash prices for common shoppable services. And the secret insurance discount, that the insurance companies have with hospitals

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Will all be public. All of that is gonna start to happen this year. And, that is because we felt firmly, like, we gotta do something.

Dr. Mark Hyman
All the doctors lobbying organizations out there are just fighting for

Dr. Marty Makary
more money for doctors. And that's the common trade association thing. Yeah. That's not bad. That's what I'm saying.

You know, we're not getting cut on Medicare, but this health care system is more than just fighting for more money for your own special interest.

Dr. Mark Hyman
And yet and yet the average consumer is kind of just, you know, at the effect of all this and has no power and they cost our escalating and, you know, we spend so much money in health care and we're getting less and less and the outcomes are worse and worse. And we don't have in line incentives. And so It's kind of kind of messed up. You know, I I I think you you also, talk about in your book blind spots some really interesting things that that, we screwed up in medicine or things that we're not looking at. And, you know, when I remember I gave a lecture at Cleveland Clinic, once, and it was it was just a whole audience of, you know, doctors and scientists.

And it was it sort of gave some case presentations, and I presented a case around autism that I treated where we really helped to reverse the case using very intensive lifestyle dietary changes fixing the microbiome, which was as an issue for 98% of these kids have really screwed up guts. And he says, well, you know, you know, this is just an anecdote and, you know, where's the evidence? And I'm like, this I said, look, you know, can you help me explain how the microbiome affects almost all known health from heart disease to cancer, diabetes, to dementia, to autism, to allergies, to immunity, to depression, add to eczema, to asthma, and if I'm allergic to chronic I mean, I literally could go on forever. Right? How can you explain that with your current set of facts and theories.

Like, boy, it can't. Like, so when you have a set of facts that present themselves to you when the science changes, you have to change your thinking and your practice yet. We don't do that. It's just so evident to me that despite knowing now that so many of our diet, our disease are diet related or there's so many related to the microbiome, which is controlled by our diet, or that so many diseases are related to environmental toxins. Doctors don't learn about this.

They don't put it in their practice, and it's sort of this this kind of blind spot. Can you kinda talk about who came up with this idea of blind spots and why the microbiome is such a blind spot and we'll get into more of them?

Dr. Marty Makary
You know, maybe we need to be treating more diabetes with cooking classes instead of just throwing insulin at people. We have the most over medicated generation in the history of the world. Right? And so we can keep treating high blood pressure with first line after second line, or we can start talking about sleep quality and stress management. And this is the new movement now in medicine.

It's a real tension. To address these giant blind spots. The microbiome is one of them. Food, medicine, general body inflammation, all the stuff that you've been teaching the public and the medical community about for a long time now. The microbiome may be this central organ health but it has no center at the NIH.

There's a little tiny unit, and I talked to the person who runs it and they're massively underfunded. Right. But the microbiome trains the immune system, digests food, produces vitamins, it's involved in mood because some of the bacteria produce serotonin. It even regulates estrogen, it deconjugates estrogen into an active form. And so

Dr. Mark Hyman
you sound like a functional medicine doc there, Marty.

Dr. Marty Makary
I think hard. I wanna be one, but, know, I don't have the expertise on which foods, vitamins, but what I'm interested in as almost a a journalist within the medical profession is we have new exciting research that relates to every disease process, every specialty and it gets almost no attention. Yeah. And, this one study by the Mayo Clinic, I think maybe the most significant study the last 10 years, in my opinion, that got almost no attention. They looked at 14,000 kids and compared kids who got antibiotics in the 1st couple years of life compared to kids who did not.

Dr. Mark Hyman
Yes.

Dr. Marty Makary
And the kids who got antibiotics in the 1st few years of life went on to have higher rates of chronic diseases. They had a 20% higher rate of obesity, a 21% higher rate of learning disabilities.

Dr. Mark Hyman
Mhmm.

Dr. Marty Makary
A 32% higher rate of attention deficit disorder. All these things are on their eyes. 90% higher rate of asthma Almost a 300% increase in celiac disease. Yep. All these diseases are going up.

We're messing up the microbiome. That was the mechanism believed to the end, which how the antibiotics worked. To induce the increased risk of these diseases. And how can you look at that and say, yeah. No.

No. Let's ignore that. There's nothing there. We may have

Dr. Mark Hyman
because there's no pill, Marty, to fix it. There's no. There's no statin for the microbiome.

Dr. Marty Makary
No pharma company CEO gets rich. But it's amazing now. The research on the microbiome

Dr. Mark Hyman
is is blowing me away. And they published this study in the Mayo Clinic

Dr. Marty Makary
seatings, which is in our world of research. It's a little bit of a flag that no one else would take it.

Dr. Mark Hyman
Right.

Dr. Marty Makary
I think it's probably the most important, significant study in the last 10 years.

Dr. Mark Hyman
Wow. Okay. Tell us about it.

Dr. Marty Makary
So, I mean, I mean, the fact that you have all these chronic diseases. I mean, We all the stuff, all the stuff that is increasing attention deficit disorder, learning disabilities, we scratch our heads. People come in and we diagnose them with celiac. And they say, doc, how could this possibly happen? And we come up with some non answer.

Like, well, it's unknown or, you

Dr. Mark Hyman
know, genetic. Genetic.

Dr. Marty Makary
And no. We have I mean, there's a study here telling us 300% increased risk when you alter the microbiome with antibiotics early in life. And it's other things that see sections, it's ultra processed foods. It's high refined carbohydrates. So we have yet to really understand what's going on here.

The rise in colon cancer and young healthy people.

Dr. Mark Hyman
Right.

Dr. Marty Makary
Turns out that there's an association with the microbiome. There's, an association with polyps and antibiotic use. There's an association with c section delivery being born by c section and going on to have a colon cancer before age fifty was an association just published in JAMA surgery. So you have this incredible body of literature emerging on this central organ system that is highly actionable that we can talk about that we can study. And it kinda lives in this corner because What specialty is it?

And what NIH center is it? Is it infectious diseases? GI? Is it oncology? Is it primary care?

Is it functional medicine? And it has no home because we've created these Right. Silos. Right?

Dr. Mark Hyman
Well, that's really the fundamental issue with medicine, right, is this is the sub specialization, the specialization that dividing the body into parts and geography and specialization based on that, but it has no scientific rationale. Like, when you actually look at how the body is truly organized as one integrated ecosystem. And it's not a bunch of separate different parts that have no relation to one another. They're all doing

Dr. Marty Makary
It's so connected. It's it's, yeah,

Dr. Mark Hyman
and it's it's really connected. And and the microbiome isn't is, I would say, the best example of that. And in in the functional medicine world, it's always been the place we start. When anybody comes in with almost anything, we get optimized or nutrition and we fix their gut. Now when I say fix the gut, most traditional doctors, well, I don't know what you mean.

Like, take a laxative. You're constipated take mo a modem if you have diarrhea, if you have a parasite, take a drug. Like, people don't know in the medical world how to optimize the microbiome. That's why it's ignored.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
It's not taught. It's people don't understand how to regulate it, and it's possible. And it's doable. And that's what we do every day in functional medicine.

Dr. Marty Makary
It's inherited the microbiome. So you pass on the skeleton of the microbiome to, offspring antibiotics and C section save lives. We've we've both seen that. Yeah. But they're massively overused, and they're messing up the microbiome in ways.

We don't even appreciate and people are being given options without really knowing what is potentially happening because of this. Now I don't know what causes autism. Other smarter people may have ideas. But the researchers that did this study, and they're not no name researchers. Talking to Marty Blazer, who I think is the world expert

Dr. Mark Hyman
on micro on the

Dr. Mark Hyman
micro mouse.

Dr. Marty Makary
Missing microbes. Great book. He, told me that while there they did not find an association with altering the microbiome and autism, they believe there is an association there. They think maybe they haven't sampled enough children or something. Now I don't know if he's right, but if he's right, that is a massive signal in the data that we should be following.

Dr. Mark Hyman
Well, I

Dr. Mark Hyman
know it's true. I mean, it's not it's not surprising. When you look at the data on autism, almost all the kids have some kind of gut issue. They have bloating. They have distension.

They have sticky smelly poops.

Dr. Marty Makary
Really? I did not Yeah.

Dr. Mark Hyman
It's it's it's really common. I mean, it's it's really out there, and and it's in the literature. And I can tell you if you talk to parents with kids with autism, they all have gut issues. And it's not, and it was sort of a it's not a a sort of a kind of a a sort of a red herring finding. It's a core finding.

And and about 75% have altered immune systems and inflammation. And if you look at the brain of kids with autism, they're bigger on MRI. This is worked on by Martha Herbert at at Harvard. And and there's also, if you look at kids who've died from from accident or something who had autism, their brains are all full of inflammation. They're microglia just which is the immune system of the brain are all just on fire.

And when you look at the history and I've treated many, many, many dozens of kids with autism over the years, the stories are almost sort of universally similar. The kids you know, have borne by C section. They're not breast fed. They get lots of colic.

Dr. Mark Hyman
They

Dr. Mark Hyman
get antibiotics. They got eczema. They get earaches. They it's like and then they get piled down with tons of vaccines. Not saying vaccines cause autism, but, like, It's just a lot for these kids' immune systems, and then something flips.

Dr. Marty Makary
I I'm chuckling a little bit. I mean, I love what you're saying, but I'm chuckling because I, had this kid come in a teenager who had the classic, sort of irritable bowel, lip chronic abdominal pain, no one knows what it is, has had a 1,000,000 tests done. It doesn't show anything definitive. And I decided to take a lot of time. It was something we're not incentivized.

Do. It took a lot of time.

Dr. Mark Hyman
I mean, you took more than 8 minutes with

Dr. Marty Makary
the patient. I listened to the patient. I didn't look at the EHR. And it turns out that the kid hit that had that same profile. Born by C section, constant antibiotics unnecessarily, it sounded like throughout their early childhood, especially in the 1st 3 years when the microbiome is being formed and had eaten terrible food their whole life.

And then the mom tells me this, you know, this condition, which we just give this diagnosis of irritable bowel, how could this possibly happen to my son? Well, you know, we I don't I wasn't there when you got all these choices, but you've also been feeding the kids shit for the last 12 years. And and so we're shocked. And then we have this massive whack a mole at medical industrial system that's gonna order millions of tests and put the kid on some kind of IVIG or some kind of Keytruda. Yeah.

It's like Yeah. Can we talk about root causes?

Dr. Mark Hyman
Root cause. Exactly. You know, I was I was in the intellectual problem. I mean, I I gave a lecture about 500 people on Aspen Institute last week. And I asked talking about something, I think, similar to this.

I said, how many of you in the audience have never had antibiotics and not a single person raise their hand? Right? So and if you look at, for example, there's work done on Bifidobacterium and Fantis, which is a really key important keystone species that proliferates in an infant is supposed to be there, but if the mother's taking antibiotics, it will it's very sensitive. It will get wiped out. And this is important for the development of immun tolerance for the allergy, autoimmunity, eczema, inflammation, asthma, all these conditions.

And and there's actually a company that's been funded. I think 100 of 1,000,000 of dollars called it. I think it's, even in the company about the product, Vivo, e v ivo, and it's basically a baby probiotic that you can give to the baby. And the thing that's unique about it is that it colonizes because when you take any probiotics as an owl, they don't really stay. They kinda go through.

They they have an impact, but it's like tourists going through an economy. This is actually building a house. Yeah. And it's it's quite amazing how it prevents a lot of these conditions.

Dr. Marty Makary
So that's what we need research on.

Dr. Mark Hyman
There's a lot.

Dr. Marty Makary
The the thing is that there's

Dr. Mark Hyman
a lot, like, if you if you Yeah. You know, this is we won't practice any faith medicine. Like, have you looked at the evidence? There's like 10,000,000 articles on pubmed. Have you actually read all of them and you actually know what you're talking about because this this sort of veil of evidence based medicine often is a sort of a smokescreen for people not knowing, all the data and saying it it just because they don't know it.

It means it's not true. And I think that's unfortunate because they're like you said, when you start to look at the research of the microbiome, you found so much.

Dr. Marty Makary
I saw a trial in China where they're treating autism with, combination of bacteria therapy or basically probiotics. Fecal transplants and Shepherd Pratt with affiliated with my hospital, John Hopkins, is doing a trial with probiotics and bipolar to treat bipolar. So it's like, this is, you know, we how much have we spent on cancer? And we what have we gotten for it? Almost nothing.

Yeah. The ROI is almost 0. I mean, the top paper at ASCO, the cancer meeting, was like, oh, if we use Avastin for GBM of the brain, you can get another

Dr. Mark Hyman
Couple months.

Dr. Marty Makary
Couple months. No added cure. Right? So, anyway, I I love what you're saying a 100%. So so I wanna go into, like,

Dr. Mark Hyman
a a a kind of

Dr. Mark Hyman
related by the little bit of a touchy subject, which is the subject of vaccines. And it's one of those subjects that is so confusing to me as a doctor as a scientist because Science is about asking questions.

Dr. Marty Makary
They can't ask questions about it.

Dr. Mark Hyman
It's about having hypothesis and proving it negative. Right? That's kind of the

Dr. Mark Hyman
basic scientific method. And if you question

Dr. Mark Hyman
anything at all, about any vaccine. You're immediately able to be an anti vaxxer. And you can't say, well, is this vaccine safe? Is that vaccine safe? What are the risks and and benefits of each one individually?

What about them combined? And and and it's it's just the weirdest thing. It's like, heresy. And I experienced this personally, like a Cleveland Clinic when I was there, somehow I I because I I people thought I was an anti vaxxer, they they the pediatric department, like, very upset.

Dr. Marty Makary
Get that label.

Dr. Mark Hyman
And and and and I literally had to write a letter like, no. I'm not. I've been vaccinated. My kids are vaccinated, but it's important to actually ask questions about this because if there's signal somewhere that there's an issue, we should look at it and And you wrote a very, a very courageous paper that was published, that you coauthored in in it was published in, journal medical ethics, and it was talking about whether or not we should be giving vaccine boosters to young adults going back to school. And you basically said that in a survey of all the data, I'll let you unpack it, but the punch line was that the risk of getting it was worse than the risk of not getting it.

And and, I wonder, 1, can you tell us about that study? And, 2, what has been the reaction? And have you been now labeled in any vaccine?

Dr. Marty Makary
Yeah. Sure. Okay. I've gotten that label a little bit for, questioning the booster vaccine in young healthy people, especially who have already had COVID. The question is with the vaccine booster in young healthy people, is there a benefit And there was so much controversy.

And I saw how at the FDA, it was pushed in with the political might of, you know, a top down order that it, made me ask some questions. 2 the 2 top vaccine experts that the FDA were fired directly fired, by their superior for questioning the COVID vaccine approval for young, healthy people. That is the booster, the booster, not the original. So the CDC never released the data. And only data we had was observational.

The clinical trial data on the booster, it was basically just reamed through. They didn't go through the normal process. So then when you look at the risk of myocarditis, not to mention the other claims that are out there of people being messed up or injured or not the same after the vaccine, again, high risk people early in the, pandemic, it was very clear. The the benefits outweigh the risks. But when you get down to young, a young healthy twelve year old girl, does she really need 6 COVID vaccine doses in 3 years?

Dr. Mark Hyman
We basically said

Dr. Mark Hyman
Well, yes, because the journey needs to make a profit.

Dr. Marty Makary
Well, they they weren't too happy with me. Moderna,

Dr. Mark Hyman
constantly has

Dr. Marty Makary
people at their company trying to reach out to me. Yeah. And, so the what is the risk of myocarditis of the COVID vaccine in a young health of the COVID booster in a young health person. I I ask that every time I'm engaged on this topic with someone who's like, how dare you not support the vaccination with the COVID booster in young, healthy people? What is that risk of my record?

I just It's 1 in 22100 to 1 in 28100. Heart injury from myocarditis. One person in a study of about, 2000 died in an ICU. Come off. 22 others were admitted to an ICU.

The New England journal. This is New England Journal. It's not like I'm making. So on a societal level, is there a net benefit or a net harm to giving the COVID booster to a young healthy population? It would it's a net harm.

If we actually do the math, It's in that harm. Very small harm, but to mandate it, to force, you're gonna create never vaxxers by doing that.

Dr. Mark Hyman
Right.

Dr. Mark Hyman
I mean,

Dr. Mark Hyman
in your in your study, you basically could have, like, over forty thousand people, young adults, so and found you to prevent one COVID hospitalization. You would have to trade that for 18.5 serious adverse events from the mRNA vaccines, including the, myo and pericardotis.

Dr. Marty Makary
We don't even have that hospitalization. That's based on data where we don't know if the hospitalization is for COVID or with an incidental COVID positive test.

Dr. Mark Hyman
Yeah. But you're talking about, like, you have to vaccinate, you know, 40,000 people to prevent one hospitalization, but you get 18 serious centers. You

Dr. Marty Makary
gotta burn the village to save it.

Dr. Mark Hyman
That's the problem. And so what's been the reaction to this this this article that you published and to this view? Because it's it's like you can't have this conversation. It's like you you're not allowed to have this conversation in medicine. And so how how Have you been able to still have a position at Johns Hopkins?

Dr. Marty Makary
They've been great, actually. Hopkins, the school of medicine has been terrific. My Dean, asked me to present to all the other department leaders. Along with 1 or 2 other infectious diseases, experts. And my Dean said, I know you have a slightly different perspective on COVID and the vaccine booster in young healthy people.

So I'd like the the department leaders at

Dr. Mark Hyman
Johns Hopkins to hear both perspectives, and we had a wonderful dialogue. I mean, I've been I've been active there as a surgeon and public health researcher for over

Dr. Marty Makary
20 years before COVID. So they knew you were in a nut job. Yeah. They knew I'm a reasonable guy, and I work hard. And I mean well, and I love this country.

So I didn't get that kind of anonymity based accusations you see on Twitter. To

Dr. Mark Hyman
convince them?

Dr. Marty Makary
I don't know. You know, you have people privately come up all the time to me. I don't know if you had this happen. We're like, Marty, I love what you're saying. I love you.

Keep going. I can't say anything, but you keeps that's perfect.

Dr. Mark Hyman
Right. Right.

Dr. Mark Hyman
I'm like,

Dr. Marty Makary
what are you afraid of? You know, too many people are afraid of speaking up. It's still happening in so many years

Dr. Mark Hyman
of medicine. Like, I do. I was like, how many doctors I raise in an audience? How many doctors here take, neck vitamins and, like, almost everybody raise their hand? How many doctors recommended their patients and, like, you know, half the hands go down?

So, exactly. Alright. You know, the other thing you talk about, you know, this whole idea of of of, the GLP 1 agonist. And they've been around for a while. Some of them were than others.

And, you know, we're we're in this moment where we are in a metabolic crisis in America. 93% have poor metabolic health, which means they have some degree of insulin resistance, pre diabetes on the spectrum, even if they're normal weight, because they eat too much crap and sugar and ultra processed food, you know, 42% are obese. And and these drugs seem like a panacea. Wow. This is a miracle drug.

Get this shot once a week and, like, lose weight and everything's gonna be great. I'd love to hear your thoughts on on this perspective of of kind of widespread use, Medicare coverage you're talking about, ensures covering it. You know, there's a new study after a new study coming out, and I just wanna give a little little background on this, showing that and and here's my belief. And I don't I don't really have any evidence back it up, but it's like, I see a new study almost every day about the benefits of of these GLP 1 agonists coming out in major journals. It works for heart disease.

It works for depression. It works for this. It works for that. You know, it seemed like everything. You know, in my head, I'm, like, thinking, is it the GLP 1 agonist or is the weight loss?

Right? And in in in in a bariatric surgery study, they they looked at, for example, what the difference was because, you know, bariatric surgery can cure diabetes in 2 weeks. And they basically did bariatric surgery in one group and then No biometric surgery on the other group, but they fed an exact same diet that the bariatric surgery group ate. They also reversed her diabetes in 2 weeks. No difference.

Dr. Marty Makary
Yeah. Sometimes out of the operating room, in the recovery room, we noticed the requirements go down. Right.

Dr. Mark Hyman
Right. But but but I'm saying it's even without the surgery Without

Dr. Marty Makary
the surgery.

Dr. Mark Hyman
So so is it the GLP 1 or is the weight loss? And and there was a a guy who met recently named Sammy who started coming called Verta Health, which uses ketogenic guides to reverse diabetes. And he said they they've actually done the study where they've actually looked at this, and they found it wasn't really the GLP 1. It was just the weight loss and the improvement in metabolic health as a result of it. So I'd I'd love to hear your perspective on that because You know, it's hard to to learn how to eat right, and it's hard to how to do it.

And and, yes, everyone wants that easy fix. And the news is appropriate for some patients, but, you know, I know people who wanna lose £10 for the bikini, and I'm, like, thinking this is a good idea. So can you tell us your perspective on that?

Dr. Marty Makary
Well, one thing that that is a theme in blind spots and a theme in in the research I learned was that if somebody put something out there with such absolutism, when the scientific evidence is really inconclusive or there's a lot of opinion, We just don't know what the long term effects of GLP 1 are. For example, they just haven't been around long enough. How can you say with such absolutives and that there's no long term downside? We may see a benefit in the short term with some of these chronic diseases. But we may be accelerating frailty, which is basically

Dr. Mark Hyman
Loss of muscle mass.

Dr. Marty Makary
Loss of muscle mass. And that is, as you know, the number one predictor of longevity is muscle mass. And that's why we want people to be active when they're older. So, We we don't have that data and people are acting as if it didn't matter. It'll go the way we want it to go.

There are bacteria in the microbiome that produce GLP 1. Yeah. And maybe we should be talking more about Probiotic. Having a a very healthy yeah. Maybe we you already make some.

So it's like, how can we not crush that? We're on a path of having every eight year old in America on 3 or 4 medications. It's scary.

Dr. Mark Hyman
Maybe their children or when they're adults?

Dr. Marty Makary
When they're children. Yeah. I mean, already half of America are taking chronic medications and the average number is 4. Once you get over 65, it's like you gotta have these boxes to remember what to take. And, look, medication save lives.

You and I have seen that. That's that's part of the medicine we're trained in. But We're gonna convert America's children into a generation of patients. Maybe we need to talk more about school lunch programs than putting every kid on Ozempic. And that is not a conversation that we're having.

We're just sort of celebrating Hey. Highfive. We found a way to, you know, create a GLP 1 agonist. We'll see about these new generation GLP 1 drugs that have a blocker on the muscle receptor supposedly. They're gonna they're gonna enter clinical trial soon.

Yeah. But I So to prevent the muscle loss. To to, yeah, prevent it or reduce it. Maybe, and I I I believe in impeccable objectivity changing positions as the data evolves. Right now, I have serious concerns about just giving out GLP ones like candy.

First side effects.

Dr. Mark Hyman
Why is there just beyond the muscle loss?

Dr. Marty Makary
The acceleration of frailty, the muscle loss, there some people don't do well with the profound loss of muscle. So, you know, there have been studies that have looked at weight. And it turns out that fluctuating weight all the time is worse for

Dr. Mark Hyman
you than staying overweight.

Dr. Marty Makary
That's right. That's right. So are people gonna be I'm doing better now, and I don't need it. I need. I'm going on this vacation.

I'm coming back. It's like, that's not that's not good medicine.

Dr. Mark Hyman
No. And I and I I don't have, that many patients on these jpy 1 agonists, but you know, I'm seeing side effects. Like, 1% pancreatitis the other day.

Dr. Marty Makary
Yeah. No one side effects.

Dr. Mark Hyman
And

Dr. Mark Hyman
this is a 900% increase in the risk of pain. I mean, I never see pancreatitis unless you have somebody with a serious problem. And see from a drug like this, it's very concerning. That's you're a pancreas surgeon. So you get on point of the pancreas.

Dr. Mark Hyman
I love

Dr. Marty Makary
the pancreas.

Dr. Mark Hyman
You love the pancreas. So this is is is concerning to me. And I think, the perverse incentives in medicine are driving this kind of crazy trend. Yeah. And and in in your book, you also talk about sort of the the blind spot around around the way we do research and the profit motive in research.

And I I, you know, when I entered medical school, I thought science was this sort of ethereal thing, which

Dr. Mark Hyman
was pure and independent and and completely

Dr. Mark Hyman
objective and just, like, you know, just had this kind of halo around it. And what I realized is that science is really freaking corrupt and that, that and and then what I was at a as a a passover dinner with my with my, one of my cousins and their husband. I was like, what do you do? And he's like, well, you know, I I I I I am a I'm a contract research organization a run contract. I'm like, oh, really, what's that?

He says, well, that's where pharma companies pay us to find experts in different domains and then fund the drug studies, do the studies, write the paper And then we pay them to put their name on it.

Dr. Marty Makary
Like a super pack.

Dr. Mark Hyman
Yeah. And I'm like, really? Leaving this is not right. Corruption. It's so cro can you so can you speak to that in in this and the challenges around around the the sort of the peer review process, the weaknesses in that, the the how do we address this whole phenomena?

Because it's, you know, it's it's, there's so much conflict of interest in medicine, and it leads to, like, the massive funding. So for example, if the amount of money It was now going into GLP 1 research. We're going into food as medicine research. Right? We would be showing phenomenal outcomes if we did the right kind of research.

Right? So how do we how do we deal with this?

Dr. Marty Makary
I do think everyone that goes into medicine is going in it for amazing reasons. And one thing that unites everybody in medicine is everyone has a sense of compassion that drew us into this calling. So we've got good people, but we walk into a bad system, and it's not a system we design. It's system we inherited, but we shouldn't defend it. It's entirely broken.

We have a bloated NIH that funds

Dr. Mark Hyman
research worse than the government

Dr. Marty Makary
funds, the postal service. We have silos. Pretty bad. We have there's a small group of people making all the decisions. At the very top, these are folks where we need term limits, the folks where they decide what's important or not important, and it's based on their understanding of the world.

Medical school education at every school in the United States is controlled by nineteen people that serve on the board of a private company that determines the curriculum of every medical school in the country. And if you wanna do something creative, talk about food or inflammation, You gotta get back

Dr. Mark Hyman
to mind. Company that's that creates the licensing exam, or is this

Dr. Marty Makary
Double AMC, they run, yeah, the US Emily. Yeah. And so these, you know, I've talked to Dean's of medical schools that have said, Marty, I'd love to talk about this stuff. All this stuff you talk about, all these stuff that are in the blind spots, modern medicine, and they say, we can't because the students know exactly what their learning objectives are for the boards. Yep.

And if we teach something else, they're gonna skip that class and I'm gonna focus on memorizing and regurgitating the 55 enzyme names they have to spit on on an exam. Why are we forcing our youngest, brightest, creative, most altruistic minds? To regurgitate the names of enzymes that you can look up on a smartphone.

Dr. Mark Hyman
Right. Right.

Dr. Marty Makary
And so we have this system now where a small group of people are controlling medical education, a small group of people control where the NIH dollars go. And who are funding the big questions central to health? For example, there's a new practice that's taking off of cutting the tongue under infraenulum.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
The friendulum under the tongue. Sometimes they'll even do the side of the tongue or the friendulum under the inside of the upper lip. Sounds it's crazy to me. I have ENT docs that say there's a subset of kids that may benefit from

Dr. Mark Hyman
the rounded tongue tied, like fully tongue tied.

Dr. Marty Makary
If it's truly a foreshortened tongue, they believe there's there could be a benefit. It's never been proven, but they do believe there's clinical benefit. But then they say going to the upper lip and the side is crazy. They also say we need a good study on it. Well, there's a group of people out there that are calling every kid tongue tied, doing it routinely.

Who's gonna this desperately needs a randomized control trial. Who's gonna fund it? Pharma, no way, NIH, not one of their silos, American Academy of Pediatrics, unlikely. And so this practice will

Dr. Mark Hyman
go on. Freemium fenulum cutting.

Dr. Marty Makary
May maybe sometimes it is the advocacy groups, the philanthropists that fund research. Most of our research at Johns Hopkins on my team, which is it's a we call it the redesign of health care. It's on All the major topics in medicine that we are not talking about that we should be talking about. And we our rapid response team, when the opioid epidemic hits, we go to work in days. When COVID hits, we go to work in days.

The old NIH, you know, take a couple years, work on formatting a grant. They're funding these tiny incremental little I don't even call them discoveries, like findings, Yeah. Like, is it interesting what the average size of stones are on the street? No. Is it research?

I guess. Yeah. But we're funding these little dumb things, and then the big questions go unfunded. So we think the solution is philanthropic funding, reorganizing the NIH, term limits at the NIH, and a small

Dr. Mark Hyman
For the for the director of the NIH?

Dr. Marty Makary
Or For all, all people who are in decision making leadership, power over grants at the NIH. And grants, I, my opinion, when I say, we, these are my opinions, the grant should be funded when one reviewer loves the idea and then it goes into a pool and you could give out the grants randomly to when one person thinks that's a big idea that could be interesting, why do you have to have a consensus among the old guard establishment that, yes, we're gonna fund another study on stents.

Dr. Mark Hyman
And there's unconscious bias. You know, like, I I was talking to Francis College, who's a wonderful man. Really kind, good, harded man, brilliant guy, you know, who is the director of an age. And I said to him, and I I think I've talked about some podcast before. I said, Why didn't you use COVID to educate the American public about the importance of nutrition in optimizing your health to prevent COVID?

Because 63% of the hospitalizations in deaths from COVID were because of poor diet. Yeah. And we know that we are 4% of the population in the world and 16% of the cases in deaths. He's like, oh, well, we couldn't do that because it would basically blame the victim, and we don't wanna do that. And in another meeting, I was like, no, it's not their fault.

It's it's just because we have a toxic food system. Right. Talk about that as the and and then at another meeting, he got up and said, well, there's no we don't really know that much about nutrition, and there's no national and student nutrition at at the NIH. And many other countries have this, and nutrition is the biggest cause of all the diseases we see today. Period.

Like, no argument. All the science says this.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
And I and and and he got up and said, we don't really know much, and there's not much data. And at the same meeting, doctor Dardis Mazafarian was there, who's the, was the dean of the Tufts School of Nutrition Science And Policy is now the head of Fuddhist Medicine Institute there. He said, well, like, for instance, Doctor Collins, I I beg to differ with you, and and then he went to this long, kind of, scientific unpacking of the literature that we do know.

Dr. Mark Hyman
You should

Dr. Mark Hyman
tell. I was like, wow. You know, it's it's it's not necessarily been, malevolence. Sometimes it's just, oh, ignorance. You know, but I'm like, wow.

Yeah. And and I also in terms of the the medical school stuff, it it you're right about the licensing exam, and I think one of the things we're working on in in Washington, my nonprofit called a food fix campaign, is to change the licey exams because that's what der term is a curriculum. And my my daughter's in medical now, and and I'm like, if you learn about this now, if you learn about the micro learning about the inflammation. Like, all the things that matter, she's not learning about. And she's all I know is that I have to pass the test, and I just have to study what's up for the test.

And that's it. Right. And I have the practice test. I have the questions, and I have Yep. And it's It's like if there was 5% of the questions on nutrition and chronic disease, that would force the change in the curriculum.

If there was 5% of the questions on the microbiome or on inflammation and health or in, like, any of these things

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
On mitochondrial function and how to treat mitochondrial. This is another black hole. Right?

Dr. Marty Makary
Yes. Yes.

Dr. Mark Hyman
Blind Spot. I don't know if you're talking about

Dr. Mark Hyman
that. Yeah.

Dr. Marty Makary
It's a big blind spot energy in micro mitochondrial. I mean, it's essential to connected, you know, sort of universal theory behind health is that there are these basic principles of mitochondrial health, inflammation, nutrients. We have such a nutrient poor diet. All the stuff you've been working on. But next time you see Francis Collins, you can remind him that the h in NIH stands for health.

Dr. Mark Hyman
I know. I said, and I said, that's what I say. We don't have nationals who are healthy. We have national institutes of diseases. That's right.

It's amazing. So how how do you think that that we can kind of reform the system besides just changing the term limits and besides, you know, do we get pharma money out? Do we do we try to sort of have special barriers that prevent them from manipulating the science and the papers. You know, I mean, it's like half the time what it says in the abstract isn't actually what it says in the data. Most people just read the abstract.

Like, there's all kinds of monkey business going

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
Right? It's a rookie business.

Dr. Marty Makary
Yes. Well, I, first of all, I think we insist on rules of transparency for clinical trials. Number 2, if you're gonna opine about a topic, do a clinical trial. The amount of opining around topics that the NIH throws out there. Oh, we don't have good data on this.

Well, you control the $80,000,000,000 budget over there at NIH. We saw this all during COVID. All the COVID controversies could have been settled immediately by them doing the proper clinical or randomized control trial on that question. All those questions, masking toddlers, natural immunity, the booster 6 do the trial. You know, isn't spread airborne from or from touching services?

In the summer of 2026 months into COVID, the NIAad and Doctor Fauci sorry. I said something I shouldn't have said there. I mentioned his name. He was telling teachers. It's okay.

I mean, he's very some people love him.

Dr. Mark Hyman
Some people hate him. I try

Dr. Marty Makary
to be objective, but it's so he was telling teachers to wear gloves and goggles in class. Do the freaking study. If you think it's spread by service transmission and you don't believe it's airborne, do the study. You got the $80,000,000,000 budget at the NIH. So one is in he

Dr. Mark Hyman
actually admitted that. He says, I just made this stuff up. I just made up the 6 feet thing. I just made up the mass thing. Like, I just made this stuff up.

I'm like, wow. Okay. Well, thanks for telling us.

Dr. Marty Makary
I think one of the biggest propagators of mis information during the pandemic was the United States government itself. And it's not new, the food pyramid.

Dr. Mark Hyman
And And it wasn't just trump saying put, bleach in your veins. It was more than that.

Dr. Marty Makary
Yeah. I like that. Yeah.

Dr. Mark Hyman
It was the actual NII. It was the actual CDC.

Dr. Marty Makary
And it's not new. Peanut allergies, same thing we get people the wrong guidance. There's so many recommendations that, people should be able to ask questions. I'm not saying be cynical. I'm not saying don't trust your doctor, but people should be able to ask questions.

So if pharma does a study, Regardless if that study goes their way or not, we should get the results immediately. Okay. That is a basic new principle of transparency we need to adopt in the United States. When PACSlovid just as an example, the antiviral used, made by Pfizer to treat COVID. When that came out, the government recommended that for everyone.

They promoted. It was one of the biggest public health campaigns in the last year and after the pandemic. A study came out in the New England Journal of Medicine just a number of months ago that showed zero benefit in people under 65, none, zilch. The study now that's studies go different ways, and that's the way science is the but the study ended nearly 2 years prior. If you look at the actual tables, the results were the study was done.

Why did the public not see it

Dr. Mark Hyman
for nearly

Dr. Marty Makary
2 years? Because it didn't go their way. When the COVID vaccine booster goes their way, they tell you before anything's even published. Just a press release, and it's a CEC. Yeah.

Dr. Mark Hyman
Yeah. They got a full page eye in the New York Times.

Dr. Marty Makary
Yes. So this is the type of trial level transparency we need. Yeah. And we gotta do it now because otherwise, we need we need better funding and academics. We need more civil discourse in medicine.

We need less cancer culture.

Dr. Mark Hyman
Yeah. Yeah. It's so true. It's so true. You know, well, I'm just like, we totally agree on everything here.

One of the things that, shocked me that I found out, you know, because as a doctor, you think, okay. Well, the literature is published. It's it's they're publishing all the data on particular drug or particular intervention that they're that they're studying. And it turns out that that pharma has to present all their data to the FDA, but they don't have to publish all the data. And and typically, they only publish the positive data.

They don't publish any of the negative trial data.

Dr. Marty Makary
That's right.

Dr. Mark Hyman
And so the public has no clue that there's all these other studies that contradict the one study that showed there was positive, and the FDA is is a captured agency because it's like a revolving door for pharma and farmer leadership. And and so like, it was sort of shocking to me as I sort of even as a doctor that I found that sound like, what do you mean? They don't they don't publish all the data. Like, they just hide all the negative data.

Dr. Marty Makary
Yeah. You can do that. Yeah.

Dr. Mark Hyman
Yeah. And that's how it is. So Yeah. So for people listening, it's it's you know, you've gotta be smart on your own, and you've gotta be your own advocate, and you've gotta be proactive about your health, and you've gotta not just take things at face value, and you gotta do a little digging. And now with the AI, it's gonna be easier and easier with doctor to use to be Doctor Google, but

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
Not always right, but it's at least a good start. You know, one of the things y'alls talk about in your book was this whole idea of of blood tests that are not being ordered that everybody needs. And I thought that was really intriguing because I just cofounded a company called function health. To which is a health platform that allows you access to your own health data and lab testing without having to go through a doctor insurance company and you get, you know, for 4.99, you get over a 100 and 10 biomarkers would be $15,000 retail. And there's been huge consumer interest.

We're like 60,000 members in the 1st year. And we we had 10,000,000 biomarkers. Fascinating. And and it's and we're we're doing a lot of tests proactively. Now you and I know when went to medical school, we're like, only test to confirm a diagnosis that you've already made through history.

Right? Diagnosis history history history. And yet you're saying maybe we should be reconsidering this because there may be things that we can do proactively and practice more proactive preventive predictive medicine than reactive medicine. Can you tell us about what you're thinking there and what these tests are?

Dr. Marty Makary
Yeah. So, a buddy of mine will, just graduated from medical school at I don't know if I should say that in school, but it's in the south. And he basically, said he got 2 hours of, teaching on all of nutrition and cholesterol and lipoproteins, basically. And in those 2 hours, and he got 8 hours on a bunch of nonsense that he can't, you know, the disparity is unbelievable. The, 2 hours on nutrition, he said it would have been better not to have those 2 hours because there was so much misinformation in him.

All it was was He feels good. Yeah. Exactly. Oh, go forth. Preach to the world.

You know, check their total triglycerides. Turns out lipoprotein a and apoprotein b are very good predictors, at least better than the current old crude predictors.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Of people that have early heart disease looking for general body inflammation. The tests aren't great, but I get a highly selective C reactive protein. Said rate, not very good, but something. So trying to measure general body inflammation the deposition of the types of lipoproteins that result in that plaque buildup. And when you put that together Are

Dr. Mark Hyman
there lipoprotein fractionation?

Dr. Marty Makary
Yeah. Lipoprotein fractionation, the the high density particles, l p a.

Dr. Mark Hyman
So looking at the quality and number of the particles, not just the weight, which is what you got on a regular cholesterol test, which in my view should be banned.

Dr. Mark Hyman
It should yeah. It's such

Dr. Marty Makary
little useful information. It's misleading.

Dr. Mark Hyman
It is.

Dr. Marty Makary
Yeah. And when somebody has an early heart attack in their 40, or early fifties, and it shocks everybody. Sometimes we'll go back and get that test, and it turns out their LP little a was up or the APO protein was up, even though the other numbers showed that things were okay. Yeah. Next time somebody gets to set a lab test, I usually tell them, make sure that you've got that tested for at least once.

Lp at least once. It's a lot genetically driven. 99% of cholesterol is made by your own body. And so these are some basic things that people can test for. And I I'm really fascinated with the micronutrients and allergy testing, and I and that's something where you've got more expertise than I

Dr. Mark Hyman
do.

Dr. Mark Hyman
Yeah. Right. True. You mean you mean, like, true allergy IgE, or you mean like more food sensitivity testing?

Dr. Marty Makary
Food sensitivity because And nutritional testing. Nutritional testing because we've had this dogma from the American Academy of Pediatrics starting 24 years ago. That don't feed young kids, any peanut butter related, stuff, milk. Yeah. Eggs.

There was this 1, 2, 3 saying. You I don't know if you heard of this, like, your kids should get, milk at age 1. You can introduce a little bit of eggs at age two and then peanut butter at age three. Well, you got it so backwards. Yeah.

Peanut butter should get introduced a little bit, not in place of breast milk, but a little bit at age at 4 months, 5 months, 6 months. Soon as the kid can eat, there's the studies have even shown that 5 months prevents peanut allergies more than introducing it at 6 months, 4 more than 5, And so it there's a strong association with what we call oral tolerance. And that's what the American Academy of Pediatrics got perfectly backwards. When they told lactating and and pregnant mothers, total peanut abstinence for you and kids 0 through 3. They didn't prevent peanut allergies with that recommendation.

They cause them.

Dr. Mark Hyman
So we have evidence based medicine or other things we wanna say we prove, and we for the things we have no evidence on, we say that we say them with such authority that they they act like they have evidence, but they don't.

Dr. Mark Hyman
Well, that's the thing. If you're gonna

Dr. Marty Makary
put out a strong recommendation, others say, you know, this is based on just me shooting from the health care. I don't know. Or reverse it once the study comes out, showing that it was wrong with the same vigor that you put it out. When the study came out in the New England Journal 2015, what's that? 9 years ago, showing peanut avoidance causes an eightfold increase in peanut allergies.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Say, gosh, we got this so wrong as an academy. We need to tell the world. Instead, they kinda fade out, you know, get the low fat diet wrong for 60 years. It kinda fade out, you know. Get hormone replacement therapy wrong.

Just kinda fade out. Where's the humility?

Dr. Mark Hyman
Yeah. Yeah. Right? Oh, shoot. We got it wrong.

Like, let's let's make a call, like, let's let's set directly straight. Right. Yeah. It's crazy. And, you know, the test you mentioned, the the APO B

Dr. Mark Hyman
Mhmm.

Dr. Mark Hyman
Which is early measure of of small dense particles and all the bad particles that cause heart disease and LPA, which is a a marker that's genetic, but also is increased your risk. The particle size and the number of life approaching fractionation since high sensitive CRP. These are all tests that are just part of the standard function health profile. Yeah. And we also test all the nutritional stuff.

We're finding that 51% have abnormal APO B. We'd find that 4089 percent have abnormal lipoprotein particle size and number. We find that 46% have elevated CRP. This is in a health board population, and 67% have a deficiency in 1 or more nutrients.

Dr. Mark Hyman
And this is not at the

Dr. Mark Hyman
level that would be optimum for health, but the minimum to prevent a deficiency disease. So a ferritin of 16, not an optimal ferritin of 45, for example, or a vitamin d of 20, not, you know, of optimal vitamin d of 50. And and so we've been fighting this in the population and And so I'm a big advocate of of tests don't guess and of knowing your numbers and of actually being proactive about optimizing them because they may not cause an immediate issue, but, there was a a brilliant scientist, Robert Heaney, who who's an out of debt, who was a vitamin d researcher, and he wrote a article a long time ago called long latency deficiency diseases. And it was fascinating because he talked about, well, if you have, like, you know, acute you know, folate deficiency, you know, you'll get megaloblastic anemia, which is for Temanema. But if you have, like, low grade, like, low folate, you might get dementia.

Or if you have, like, you know, a little bit low on an optimum vitamin d, very low, you'll get rickets if it's acute deficiency, but if it's a little over your lifetime, you'll get osteoporosis, long latency, deficient disease. And he goes over nutrient like this. And it was it was fascinating to me to really change my thinking about being more proactive because you're optimizing the body's systems, and they all have to be functioning. And and it's it's amazing to me how many doctors don't even think about this, don't know about it, aren't educated about it. And, I mean, even asking my daughter, you learn about lipoprotein fractionation in medical school, which is, like, should be the goal standard.

I mean, I I mean Yes.

Dr. Marty Makary
I shouldn't

Dr. Mark Hyman
be telling these tales, but I was at Cleveland Clinic and there's a there's a doctor there who wonderful man, but he, you know, he's older and he throughout the executive health program. I don't think he's there anymore, but I met with him and I said, listen, you know, you should update the executive health program to include the life approaching fractionation. Yes.

Dr. Mark Hyman
Because there's a much better representation of cardiovascular. You have something with a normal perfectly normal cholesterol under 200. They're LDL under a 100. They're triglycerides normal.

Dr. Marty Makary
HTL looking

Dr. Mark Hyman
like 4550, everything looks great, but they could have the worst particle and and size and density that you could imagine and be at very high risk. And he's like, well, you know, we only like to introduce things after we have a lot of research. I say, well, This has been around for 40 years. I've been doing this test personally for 30 years. Yes.

Ronald Krause developed this at, you know.

Dr. Marty Makary
It's been around.

Dr. Mark Hyman
Yeah. And and he's one of the most brilliant lipidologists in the world. I'm like, you know, this is so slow to adopt actually the science into what we know. And and people are suffering because of it. And that's kinda why I think, you know, some of these things can be solved from the inside, but like you said, some of this has to be solved from the outside.

And we need, you know, we we need philanthropy. We need you know, better policy regulations. We need better, you know, reimbursement around medicine that pays for the things that actually work like food as medicine. You know, we, you know, we need to have companies from the outside changing things from the inside. So it's pretty it's it's it's kind of an exciting moment, but, like, you're like, know, like, you know, the wizard of Oz when the curtain gets pulled back, you're that guy.

Like, you're the guy pulling back the curtain and there's, like, this little old guy back there with no pants on. Yeah. And it's it's, it's quite amazing what you've done. Well, you know,

Dr. Marty Makary
I go around. I talked to so many experts. And I ask them, is there dogma in your field that is wrong or has been proven wrong or you believe is wrong, but it's still heralded out there as science when it's really just the way we it's been done. It's just sort of custom. And they start unloading and they start telling you things.

And actually, the lipidology community

Dr. Mark Hyman
has evolved entirely independent of the cardiology community. So the cardiologist kinda claimed lipid

Dr. Marty Makary
science at a certain point But the lipidology community is like, Hey, wait a minute. We've been studying this for a long time with hyperlipidemia, and they have very different views on things. So for example, lipoprotein a testing was recognized in the lipidology community of saving lives, as you mentioned. Yeah. But not in the cardiology community because all their tests just use the crude LDL.

Right. So I went to the, head of the cardiology lipid center at Hopkins, and I asked him. I said, I've been reading about LP a, Seems like it should be this subject of a massive universal public health campaign Yeah. To get everyone to get it done. It'd be a lot better than trying to get a defibrillator in every bathroom in the mall,

Dr. Mark Hyman
you know, which is actually

Dr. Marty Makary
a real campaign Hopkins chair champion. And so lives for sure, but Saves lives, but, like, here's something that's so that RTC is the number one cause of death. So he acknowledged. Yeah. There's some new research, and we we did put it in our new guidelines.

I'm like, you know what? It was I read those guidelines, American Casualty. It was a footnote. Yeah. Like, where's the enthusiasm?

Where's the vigor? Where's the it's just like molasses sometimes.

Dr. Mark Hyman
Yeah. Well, because there's no good drug for it. Right? I mean, there's platinum freezes. There's certain supplements at work.

Sometimes the piece, CSK inhibitors lowered a little bit.

Dr. Marty Makary
Yeah.

Dr. Mark Hyman
But it's it's, you know, it's it's a harder to treat problem. And and we're very, very cited about testing things for which we have great drugs because the pharmaceutical companies, you know, make it easy for us. They do all these studies. They kept their drug risks calm. They they have great commercials and tell the patients what to ask for

Dr. Mark Hyman
her. Yeah.

Dr. Marty Makary
There is a drug in phase 3 clinical trial. That this targets lipoprotein little a. So we'll see what the results of that show. But I wonder if, you know, those are the people you wanna just be more aggressive on, maybe. Yeah.

Totally. Track. Maybe you get the cardiac, CT angio on them instead of just the calcium score. You know, those are the ones. Well, with function health, we had a

Dr. Mark Hyman
young thirty five year old who did the test, and he had high APO B. He had high LPA. He had really horrible lipid particles. The rest of his cholesterol, normal cholesterol profile looked pretty good. And, you know, he was 35, and we sent him for a CCTA, but cor coronary your entry game with the with the CT scan, but we added the AI interpretation with a test call clearly.

I don't know if you've heard of this test. Have you? No. It's really amazing because you actually can see soft plaque inflamed plaque, not just calcified plaque, and you get a much better read on every artery. And Shot a plaque?

Dr. Marty Makary
But You found a plaque. Yeah.

Dr. Mark Hyman
And he

Dr. Mark Hyman
and, yeah, and this guy's 35, and he's headed for heart attack. And he had no clue because he was dandy, he's healthy, he's fit. He exercised. He's great. It's like some genetic thing going on.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
And and so, you know, we're often kind of walking into our futures without any idea of what we're heading into because, you know, we're not taking advantage of the latest science.

Dr. Mark Hyman
And and, I mean, I wrote a book like more than 20 years ago where I was talking about APO B and LPA

Dr. Mark Hyman
and CRP and testing insulin. Mean, insulin's another one of those tests. You know? Yeah. You know, thank god.

Quest now has a test. It's called the insulin resistance score, which uses mass spec to measure insulin C peptide, which is a I mean, your pancreas guy, I don't tell you, but it's a yeah. And telling your audience, it's it's it's the precursor of the insulin molecule. And and when you get this ratio, it it's as good as what we call uglycemic clamp test, which is the gold standard. It's a very invasive test that you do in the hospital for insulin resistance, but it's as good as that test.

And it's cheap and it's something umbrish you get because it is the biggest driver of cancer, heart disease, dementia, and and even it's linked to depression and fertility, acne, and a bunch of other stuff. Uh-huh. Even low sex drive and erectile dysfunction and, I mean, you name it. And that it nobody's doing that test.

Dr. Marty Makary
So I

Dr. Mark Hyman
I mean, I ask quest, like, how many people are getting lipoprotein fractionation, like, less than 1%. How how many people are testing insulin when they were doctors order insulin? It has less than 1% of our test. I'm like

Dr. Marty Makary
Tell them we don't need AI. We just need I. We just need some Oh my god. Yeah. Basic.

Dr. Mark Hyman
Well, I actually I I actually talked about this. I don't know if it's not right. Maybe in your wheelhouse, you can tell me, but, I've I've kinda come up with this new concept. What I call MI. And not MI like heart attack, but MI like medical intelligence.

Dr. Mark Hyman
Uh-huh.

Dr. Mark Hyman
Which is something we don't have. It it we have a single doctor that you rely on for his own experience, however smart they are, whatever they've learned, whatever course they went to, whatever school they went to, whatever residency they went to. Like, that's what you're getting. And and they haven't certainly read all of 10,000,000 papers on PubMed. They certainly haven't read every textbook and article about every disease and and you're and you're kinda relying on there and good will and intelligence and kindness to figure out what's going on.

And and, you know, we do a pretty good job most of the time, I would say. But, you know, I feel like we're entering this moment in health care where we're gonna be able to draw through technology, all the world's scientific literature that it consume every single textbook, you know, up to date, all the the latest met medical knowledge, patient reported data, all their lab data, all their omix, all their imaging, all their biosensors and wearables, all their medical history to track it over time, you know, when Lee or I could call this dense dynamic data clouds of information that give you personalized predictive models of where you're headed and what to do about it. To me, you know, having that be able to sort of inquire to that that that your own data set, about what what's really going on and see those patterns and correlations that, you know, the average doctor is gonna miss. I mean, would you rather have your dermatology exam by, you know, an AI, computer or by a dermatologist. Like, I went to a dermatologist and I'm a doctor.

I know I had a precancerous lesion, and and he completely missed it. And he was like the head of, you know, I don't know, dermatology, the major academic, you know, medical school. And I was like, I wanna go to the top guy and

Dr. Marty Makary
give it down professor and chairman.

Dr. Mark Hyman
And you, you know, he looked at me, like, turn me around, looked at his eyeballs. I'm like, no magnifying glass. No light. I'm like, goddamn. I'm no I know better than this.

I was like, And I was like, so walked out, so disappointed. And I'm like, you know, so what do you think of this idea? And could this really change things? Because then all of a sudden, all the things you're talking about will bubble up. Like, the the the the the pharma, and and the medical industrial complex won't be in charge anymore because you've got, you know, free access to data and information that's been locked away.

Dr. Marty Makary
I tell all our Johns Hopkins students and residents that what will make you a great doctor is knowing your limit It's your humility. It's saying, I don't know when that's the right answer. And that was the right answer during COVID a lot of times. We didn't hear it. And so when I talked to a pediatrician and asked them about peanut allergies, you'll have somebody who will just recite a catechism.

Well, according to the guideline of the American Academy, you know, somebody else will think independently and creatively, and they'll say, You know, there is a guideline out there, but there's this study, and I've heard doctors suggest this. And my this has been my experience. And I'm not sure, or this is what one mentor thinks. This is what that is a creative. That's a doctor you want.

Doctor who thinks independently and isn't just, you know, falling in line with some dictum that says everyone obey and and and get in place. When we, as a medical profession, have use good scientific studies to make broad health recommendations, we shine. We help a lot of people. But when we wing it, when there's broad health recommendations made by a small group of people who are just ruling on a on an opinion, and making it sound absolute like at scientific data, we have a terrible track record. We ignite epidemics.

We ignited the opioid epidemic saying opioids were non addictive.

Dr. Mark Hyman
Yeah. Pain is the 5th vital sign.

Dr. Marty Makary
Pain is the 5th vital sign. These are manufactured peanut allergy epidemic, you go down and down the down the line. Even you could argue the low fat contributed to obesity rates,

Dr. Mark Hyman
the low fat. I'm not gonna argue that. I think that's pretty much a fact. Yeah. That's you

Dr. Marty Makary
don't need AI. Just die for that.

Dr. Mark Hyman
Yeah. No. It's true. And and and then we stuck and don't wanna say that we made a mistake either.

Dr. Marty Makary
That's the key. That's the key. And patients are very forgiving if you're honest

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
In real time. Yeah.

Dr. Mark Hyman
I was talking to a friend about that about that. You know, if you're a doctor and you're telling the patient the truth and you say, I don't know or I fucked up, Like, they're less likely to sue you.

Dr. Mark Hyman
Yeah. Then

Dr. Mark Hyman
if you're just trying to hide hide what's going on. Right? And we're kinda trained to kind of circle ranks and hide and not telling each other. And I'm I'm so impressed by you. You're actually out there saying something.

I've been saying forever, but I'm like, kind of, you know, on the fringe. You're you're in the center of the belly of the beast.

Dr. Marty Makary
I've, I've ushered so many people to the afterlife in the ICU, and, you know, I've done a lot of cancer care that I'm constantly reminded how life is short in these folks that are just afraid of what somebody's gonna think. If you just speak in your honest opinion, I don't think that's healthy, and that's what we need more of.

Dr. Mark Hyman
And so so in in the policy realm, because you've you've mentioned how your book really helped shift some policy around cost transparency.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
You know, what are the other big levers besides term fixing the NIH and putting in a national assumed nutrition and funding the right research and getting rid of all the the kind of old cronies in there that just kinda don't want the to get the kind of new science out there What what actually can we do, on a policy level? Cause I I'm curious. I I have a nonprofit that works on food policy. I mean, I'm actually going to be doing a hearing in front of the Ways Means Committee, September 18th, in front of the health sub communities in charge of all Medicare and reimbursement. You know, and I and and and, like, you were talking about, like, for example, about diabetes, and I had had, spent the option with Sammy who who started for the health.

Dr. Mark Hyman
And

Dr. Mark Hyman
they they really deeply studied that they could save $6000 per patient after cost by putting them on this program to reverse diabetes and they reversed diabetes, which is not something the ADA even basically recognizes as something you can do. And if if Medicare implemented this, it overnight, it would save a $100,000,000,000. Yeah. Looks like that. Boom.

Because there's sixteen and a half million people on Medicare, who have diabetes.

Dr. Marty Makary
So Sammy's the endocrinologist that started Verda?

Dr. Mark Hyman
No. Sammy is a is a is an entrepreneur.

Dr. Marty Makary
Okay.

Dr. Mark Hyman
Who

Dr. Mark Hyman
is an elite athlete who found that he had metabolic syndrome because he was using all these sports goos that are full of sugar to fuel his endurance athlete, performances. And so he was like, what's going on here? And then he basically trained and did a cross, the ocean road from California, Hawaii doing a keto diet and show that you could you could do it. And He rode from California, Hawaii. Robo with his wife.

Wow. Like, robo. Nice part. I mean, I don't think it's not safe, but it was hardcore. He said, like, twenty foot seas.

It was, I'm pretty rough. But but the point is that, you know, I'm having this hearing, and and I I I imagine it's gonna be very tough to to get Medicare reimbursement for a program like that, even though the data's so clear, even though they've shown that it proves all lipid parameters, it's like it's sort of the opposite of what you think by being eating only fat. Right?

Dr. Marty Makary
It's, the policy world is tricky because There are so many things we can do without the government that we're not doing. For example, the Verde company that you mentioned, and I had met with the endocrinologist too as one of the, I think, co founders or something. And he showed me that data. It was super impressive. Finney.

I I think that was gonna be. Super impressive data. Just like you said, this is clearly something we should be doing, and it fits the whole what we've known and seen on the ground as doctors for many years, and that is the hard part of treating chronic diseases, not telling people what to do. It's helping them do it. Its behavior changes, checking in with them.

It's being their friend. It's going along the walk with them. If I tell I see somebody smokes on their chart. I don't do what I used to do and tell you, oh, yeah. You should stop smoking.

You're gonna die. Now I ask them, you know, some people

Dr. Mark Hyman
go outside and have a cigarette. I'll tell you to do a talk. Almost.

Dr. Marty Makary
I almost do that. I'd say some people really don't wanna quit. They don't wanna talk about it. And other people really want to. Where do you stand?

And whatever answer you say is okay with me. Most people say, I don't wanna talk about it. And they're you're not gonna affect them no matter what. But then you meet somebody that says, I just had a granddaughter. I'm dying to quit.

We should put all of our energy in to help them with medication, behavior, all And that's what Virgil's doing. It's saying, if you want someone to help and go down this walk with you and help pick foods and and manage your diabetes instead of just pumping insulin and We're gonna be there for you. And those are the solutions that the in the private sector, employers that pay for health care, what we call, erisa plans, employer sponsored health care plans. They're saying know, I'm gonna make Verda available to my employees at this company. I'm gonna make Teladoc.

I'm gonna make and they're piecing together what we call these point solutions. So now you can be creative and come up with a foodist medicine program You don't need to wait for Medicare and there are 50 bureaucratic red tape steps. And you can go go to work right away. And that's the exciting thing. That's why I'm so optimistic about some ray of hope in this broken health care system because employers are are standing up, and they're they're saying yes to the challenges.

So they're in

Dr. Mark Hyman
the financial incentives are online. The pioneer that they the privately insured large corporations who are footing the bill.

Dr. Marty Makary
They are, but at the same time, They see the demand for this. And if there's demand, they wanna make those employees happy because they wanna attract employees. Fertility services. Is there an ROI on it? No.

But they know there's demand for those fertility services. So that that is now enabling smart people to say, hey. This makes sense medically in terms of improving health. Let's do it. Let's try it.

Let's do a pilot. Let's and it's happening fast. Like, we don't have to wait, you know, these diabetes alternative, these companies now. They're not anti dialysis. Sorry.

I meant dialysis. So in dialysis, we have a system where just kinda let people go into renal failure, then we put them on the machine. Well, what about actively getting them to avoid dialysis before they become dependent on it? Yep. So there's a couple companies now.

They're not the big ones. And they are actively working with people in that pre dialysis phase of their life. And if they can avert one pace

Dr. Mark Hyman
patient becoming dependent, it pays for itself. So this is the exciting stuff right now in in

Dr. Marty Makary
medicine.

Dr. Mark Hyman
It's true. I mean, I I I've, you know, with aggressive lifestyle intervention, you can reverse renal insufficiency. You can. And I and I had a patient who was, like, you know, typical insulin resistance and cardiovascular disease and hypertension and kidneys starting to fail as Gf far was just the measure of kidney function was going down and kidney level tests were going up. And, you know, I put him on

Dr. Mark Hyman
a program and he lost weight. He did amazing. Got the inflammation down.

Dr. Mark Hyman
And his kidney's normalized. The protein went out of his urine. And his nephrologist was like, what the hell did you do? I've never seen this before. This doesn't happen.

It's not possible. Like, well, what's going on? Like, and we don't see it because we don't know to tell people what to do. Like, we just don't have the knowledge or education, and it goes back to your licensing exam. That's one of the things we're working on is also changing the licensing exams, getting, ACCME to change those requirements.

Graduate medical education, we spent $17,000,000,000 a year from the federal government paying for these residency programs and fellowship programs. We have no strings attached about how that money is used or what they're teaching or anything. Like, and so we can put some guardrails on that. Yeah. You know, it's is this amazing.

Your your your work is tremendous. I'm I'm super excited about it. Marty McRe from Johns Hopkins written so many books as late as one of his blind spots when medicine gets it wrong and what it means for health. You will not be sorry to read these books. You will educate yourself.

You become empowered. And I think what you're doing is speaking out telling through the speaking truth of power and actually empowering patients to learn how to become, agent have agency over their own health and do us right for themselves and not be just at the sort of whims of a paternalistic system that has immense, financial perverse incentives and commence corruption, and it's not giving us what we need to know. So thank you for speaking out. Thank god you're there in doing this work. I'd love to have you on the podcast.

Any final words or thoughts and advice for listeners about how to navigate all this?

Dr. Marty Makary
Was great to see you, Mark, keep up the great work. So, you know, I felt like there's so much new research that is directly speaking to these blind spots in medicine that people should know about it, not just in the medical community, but If my colleagues are fascinated by some new research that I'm presenting to them in a lecture, some of that research has direct implications for everyday folks out there. And so that's why I put this book together. So I hope people enjoy it.

Dr. Mark Hyman
Well, thank you. You can find it everywhere you get books. It's out there now. And you can go to Marty, and Macri and just check take out his work. His website is macrimd.com.

Dr. Marty Makary
Marty MD. Yep.

Dr. Mark Hyman
Oh, Marty MD. Okay. Martmd.com. I should let you say what do you have social media? What is that?

Dr. Marty Makary
I'm on Twitter. It's a bit of a nasty place, but I I try to encourage people on it and, LinkedIn a little bit, but, great to be with you. So thanks so much, Mark. Okay.

Dr. Mark Hyman
I can't wait to have you back for your next book. And, like, I think there were, like, four thousand tops we didn't cover. So get the book, check it out, and, and Like,

Dr. Marty Makary
to push the field.

Dr. Mark Hyman
Yeah. Let's go. Thanks so much, Marty.

Dr. Marty Makary
Great. Thanks.

Dr. Mark Hyman
Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at doctor Mark Hyman, and we'll see you next time on The Doctor's Faramcy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more.

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This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland 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 guest endorsement of views or 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 medical professional.

This podcast is provided on the understanding that it does not constitute medical or other professional advice or service Now if you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.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.

Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. Keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible.Dr. Mark Hyman
Coming up on this episode of The Doctor's Faramcy.

Dr. Marty Makary
We have yet to really understand what's going on here. The rise in colon cancer and young healthy people. Right. Turns out that there's an association with the microbiome. Being born by C section and going on to have colon cancer before age fifty was an association just published in JAMA surgery.

Dr. Mark Hyman
Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice. There's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand. Well, you, if you're looking for data about your biology, check out function health for real time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hyman Hyve.

And if you're looking for curated and trusted supplements and health products for your routine, visit my website supplement store for a summary of my favorite and tested products. Welcome to doctor's pharmacy. I'm doctor Mark Hyman, and this is a place for conversations that matter. And if you've ever wondered if there's corruption and dysfunction in the medical system, then you have to wonder no longer because our guest today, Marty Macquarie is a professor at Johns Hopkins University School of Medicine and the author of 2 New York Times best selling books that have kind of pulled the curtain back on a lot of the dark side of medicine that you're gonna hear about in this podcast. Doctor Macri served in leadership at the World Health Organization.

He's a member of the National Academy of Medicine, one of the highest honors you can get in the field of science. He's published over 250 papers. His newest book, blind spots, challenges the conventional medical dogma to educate people about their health. Clinically, he's the chief of islet transplant surgery. That's getting something in your pancreas, when your pancreas isn't working at Johns Hopkins.

He's the recipient of the nobility and science award in the national from the National pancreas Foundation. He's been a visiting professor at over 25 medical schools. And he's just a very courageous doctor because he has pushed the limits of what we should be talking about in medicine because we are told to keep the secrets. He wrote a book called unaccountable what hospitals won't tell you and how transparency can revolutionize health care. He also wrote another book at the price we pay, what broke American health care about the lack of transparency in pricing and how we can fix it.

He's, just an incredibly brilliant man who has just on a mission to tell us the truth that you have not been hearing. And today, we talked about all sorts of things from the concern about vaccines and should we actually be vaccinating certain people and groups of people with a code vaccine or not. Why has the microbiome been ignored in medicine? Why is our medical education system completely teaching the wrong things? Why are ours our national Institute of Health actually have nothing to do with health and is all about disease and is not even funding the things we should be funding.

How has the range of, roles of GLP 1 agonists been ignored and why are we concerned about that? He's also we also deep get into the topic of of of health care financing payments, how researchers funded the corruption of evidence based medicine. I mean, we talk about it all. I think you're gonna love this podcast. So let's dive right in.

With the doctor Marty Macquarie. Welcome Marty to The Doctor's Faramcy podcast. It's so good to have you. I followed your work. And, honestly, I'm kinda shocking because you're Johns Hopkins professor and you're Lahertic in

Dr. Mark Hyman
the middle of the

Dr. Mark Hyman
belly of the beast Right. And you're kinda telling tales that we've traditionally kept secret in medicine. It's kinda like a guilt, you know, or like, you know, it's a club. And you don't you don't tell in your neighbors or your colleagues or your friends about what's really going on in medicine and health care. And what's really struck me as I've, you know, been a doctor god for almost 40 years now is the is the level of, co optation and capture of medicine by industry.

And it's less about health care. It's more about business. Whether it's private equity taking

Dr. Mark Hyman
over health care practices and emergency rooms or whether it's, you know, just pharma controlling

Dr. Mark Hyman
policy and influencing medical education or whether it's lack of of a real accountability and transparency in health care and medicine, you know, you you've been really outspoken about these things that

Dr. Mark Hyman
we've kept quiet about for a long time as doctors. And you have, you know, quite a

Dr. Mark Hyman
pedigree. And, you know, it means a lot coming from you. I mean, I'm just a heretic on the margins and a little fringe doctor, but you're on RD, a real doctor.

Dr. Mark Hyman
I

Dr. Mark Hyman
just play one on TV. And, and I think that, although I do see patients, but I'm kinda kidding.

Dr. Marty Makary
Yeah. You're big

Dr. Mark Hyman
but I I really am so excited about your work about your new book, blind spots. It's a great book. When medicine gets it wrong and what it means for our health and your other books, which I think are also very compelling and and touch on areas that are also quite concerning for me, which is really the lack of accountability and transparency in medicine. It's called unaccountable where hospitals won't tell you in how transparency can revolutionize health care and another book you wrote called the price we pay. What broke American health care and how to fix them.

I mean, why are we spending twice as much as any other nation getting half the results. So, I'd love to kinda hear how you went from being like a, you know, revered surgeon at Johns Hopkins where the sort of the birthplace of modern medicine with William Olser to kinda calling calling out what's really wrong with the system.

Dr. Marty Makary
Well, it's great to see you, Mark. You know, I think I it hit me at a certain point. I went as far as you can go in academic medicine, all the regalia, all the societies and honors and promotion and tenure. And it hits you at a certain point. I don't know if it's after I wrote 200 scientific articles or 250, but you realize no one's reading these things.

Yeah. The system is so broke And the problem is we have a lot of smart people in a system where they're just collecting their paycheck every 2 weeks, putting their head down. This shouldn't be. This should, you know, this isn't right. And we feel like we're cogs in the wheel, And people are afraid to get off the hamster wheel, take risks, and call things out.

So in the book, the price we pay, we, my research team brought attention to this issue of price gouging and predatory billing, which is the term we called these kind of crazy bills that get thrown at people, they want a price that are not giving a price. And it ruins lives. And now we have this massive trust problem where some 62% of Americans say they have avoided care or delayed care for fear of the bill. Yeah. So you can have the cure for pancreas cancer now, but if 62% of the population, it doesn't trust you, that pills only 38% effective, not a 100% effective.

Dr. Mark Hyman
No. It's true. I mean, I I literally had direct experience. I had any issues, so I needed an MRI. And I went to Chinatown, New York City.

I got one for 400 bucks. Had to get one in, in Berkshire and and where I live in the Massachusetts. And and it was 25100 bucks for the same MRI, same machine. I just went and had back surgery and had hyperbaric oxygen. I I went to this hospital and I said, I wanted to get it.

And I said, okay. But it's $5000 a session. Like, jeez. And I talked to the the head and everything goes well, if you do it this way, not through Medicare, and you do it through, you know, an off label use. It's a $175.

So, like, a 175, 5000 exactly the same procedure. How does that happen in medicine?

Dr. Marty Makary
Yes. Exactly. Right. So this is the game. I call it the game in the book, the price we pay.

And we found that the game is designed to maximize profits. It's not designed to be honest with patients. And so, the book actually led to some real legislation and an executive order from the White House that was entirely bipartisan that now requires hospitals to start posting cash prices for common shoppable services. And the secret insurance discount, that the insurance companies have with hospitals

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Will all be public. All of that is gonna start to happen this year. And, that is because we felt firmly, like, we gotta do something.

Dr. Mark Hyman
All the doctors lobbying organizations out there are just fighting for

Dr. Marty Makary
more money for doctors. And that's the common trade association thing. Yeah. That's not bad. That's what I'm saying.

You know, we're not getting cut on Medicare, but this health care system is more than just fighting for more money for your own special interest.

Dr. Mark Hyman
And yet and yet the average consumer is kind of just, you know, at the effect of all this and has no power and they cost our escalating and, you know, we spend so much money in health care and we're getting less and less and the outcomes are worse and worse. And we don't have in line incentives. And so It's kind of kind of messed up. You know, I I I think you you also, talk about in your book blind spots some really interesting things that that, we screwed up in medicine or things that we're not looking at. And, you know, when I remember I gave a lecture at Cleveland Clinic, once, and it was it was just a whole audience of, you know, doctors and scientists.

And it was it sort of gave some case presentations, and I presented a case around autism that I treated where we really helped to reverse the case using very intensive lifestyle dietary changes fixing the microbiome, which was as an issue for 98% of these kids have really screwed up guts. And he says, well, you know, you know, this is just an anecdote and, you know, where's the evidence? And I'm like, this I said, look, you know, can you help me explain how the microbiome affects almost all known health from heart disease to cancer, diabetes, to dementia, to autism, to allergies, to immunity, to depression, add to eczema, to asthma, and if I'm allergic to chronic I mean, I literally could go on forever. Right? How can you explain that with your current set of facts and theories.

Like, boy, it can't. Like, so when you have a set of facts that present themselves to you when the science changes, you have to change your thinking and your practice yet. We don't do that. It's just so evident to me that despite knowing now that so many of our diet, our disease are diet related or there's so many related to the microbiome, which is controlled by our diet, or that so many diseases are related to environmental toxins. Doctors don't learn about this.

They don't put it in their practice, and it's sort of this this kind of blind spot. Can you kinda talk about who came up with this idea of blind spots and why the microbiome is such a blind spot and we'll get into more of them?

Dr. Marty Makary
You know, maybe we need to be treating more diabetes with cooking classes instead of just throwing insulin at people. We have the most over medicated generation in the history of the world. Right? And so we can keep treating high blood pressure with first line after second line, or we can start talking about sleep quality and stress management. And this is the new movement now in medicine.

It's a real tension. To address these giant blind spots. The microbiome is one of them. Food, medicine, general body inflammation, all the stuff that you've been teaching the public and the medical community about for a long time now. The microbiome may be this central organ health but it has no center at the NIH.

There's a little tiny unit, and I talked to the person who runs it and they're massively underfunded. Right. But the microbiome trains the immune system, digests food, produces vitamins, it's involved in mood because some of the bacteria produce serotonin. It even regulates estrogen, it deconjugates estrogen into an active form. And so

Dr. Mark Hyman
you sound like a functional medicine doc there, Marty.

Dr. Marty Makary
I think hard. I wanna be one, but, know, I don't have the expertise on which foods, vitamins, but what I'm interested in as almost a a journalist within the medical profession is we have new exciting research that relates to every disease process, every specialty and it gets almost no attention. Yeah. And, this one study by the Mayo Clinic, I think maybe the most significant study the last 10 years, in my opinion, that got almost no attention. They looked at 14,000 kids and compared kids who got antibiotics in the 1st couple years of life compared to kids who did not.

Dr. Mark Hyman
Yes.

Dr. Marty Makary
And the kids who got antibiotics in the 1st few years of life went on to have higher rates of chronic diseases. They had a 20% higher rate of obesity, a 21% higher rate of learning disabilities.

Dr. Mark Hyman
Mhmm.

Dr. Marty Makary
A 32% higher rate of attention deficit disorder. All these things are on their eyes. 90% higher rate of asthma Almost a 300% increase in celiac disease. Yep. All these diseases are going up.

We're messing up the microbiome. That was the mechanism believed to the end, which how the antibiotics worked. To induce the increased risk of these diseases. And how can you look at that and say, yeah. No.

No. Let's ignore that. There's nothing there. We may have

Dr. Mark Hyman
because there's no pill, Marty, to fix it. There's no. There's no statin for the microbiome.

Dr. Marty Makary
No pharma company CEO gets rich. But it's amazing now. The research on the microbiome

Dr. Mark Hyman
is is blowing me away. And they published this study in the Mayo Clinic

Dr. Marty Makary
seatings, which is in our world of research. It's a little bit of a flag that no one else would take it.

Dr. Mark Hyman
Right.

Dr. Marty Makary
I think it's probably the most important, significant study in the last 10 years.

Dr. Mark Hyman
Wow. Okay. Tell us about it.

Dr. Marty Makary
So, I mean, I mean, the fact that you have all these chronic diseases. I mean, We all the stuff, all the stuff that is increasing attention deficit disorder, learning disabilities, we scratch our heads. People come in and we diagnose them with celiac. And they say, doc, how could this possibly happen? And we come up with some non answer.

Like, well, it's unknown or, you

Dr. Mark Hyman
know, genetic. Genetic.

Dr. Marty Makary
And no. We have I mean, there's a study here telling us 300% increased risk when you alter the microbiome with antibiotics early in life. And it's other things that see sections, it's ultra processed foods. It's high refined carbohydrates. So we have yet to really understand what's going on here.

The rise in colon cancer and young healthy people.

Dr. Mark Hyman
Right.

Dr. Marty Makary
Turns out that there's an association with the microbiome. There's, an association with polyps and antibiotic use. There's an association with c section delivery being born by c section and going on to have a colon cancer before age fifty was an association just published in JAMA surgery. So you have this incredible body of literature emerging on this central organ system that is highly actionable that we can talk about that we can study. And it kinda lives in this corner because What specialty is it?

And what NIH center is it? Is it infectious diseases? GI? Is it oncology? Is it primary care?

Is it functional medicine? And it has no home because we've created these Right. Silos. Right?

Dr. Mark Hyman
Well, that's really the fundamental issue with medicine, right, is this is the sub specialization, the specialization that dividing the body into parts and geography and specialization based on that, but it has no scientific rationale. Like, when you actually look at how the body is truly organized as one integrated ecosystem. And it's not a bunch of separate different parts that have no relation to one another. They're all doing

Dr. Marty Makary
It's so connected. It's it's, yeah,

Dr. Mark Hyman
and it's it's really connected. And and the microbiome isn't is, I would say, the best example of that. And in in the functional medicine world, it's always been the place we start. When anybody comes in with almost anything, we get optimized or nutrition and we fix their gut. Now when I say fix the gut, most traditional doctors, well, I don't know what you mean.

Like, take a laxative. You're constipated take mo a modem if you have diarrhea, if you have a parasite, take a drug. Like, people don't know in the medical world how to optimize the microbiome. That's why it's ignored.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
It's not taught. It's people don't understand how to regulate it, and it's possible. And it's doable. And that's what we do every day in functional medicine.

Dr. Marty Makary
It's inherited the microbiome. So you pass on the skeleton of the microbiome to, offspring antibiotics and C section save lives. We've we've both seen that. Yeah. But they're massively overused, and they're messing up the microbiome in ways.

We don't even appreciate and people are being given options without really knowing what is potentially happening because of this. Now I don't know what causes autism. Other smarter people may have ideas. But the researchers that did this study, and they're not no name researchers. Talking to Marty Blazer, who I think is the world expert

Dr. Mark Hyman
on micro on the

Dr. Mark Hyman
micro mouse.

Dr. Marty Makary
Missing microbes. Great book. He, told me that while there they did not find an association with altering the microbiome and autism, they believe there is an association there. They think maybe they haven't sampled enough children or something. Now I don't know if he's right, but if he's right, that is a massive signal in the data that we should be following.

Dr. Mark Hyman
Well, I

Dr. Mark Hyman
know it's true. I mean, it's not it's not surprising. When you look at the data on autism, almost all the kids have some kind of gut issue. They have bloating. They have distension.

They have sticky smelly poops.

Dr. Marty Makary
Really? I did not Yeah.

Dr. Mark Hyman
It's it's it's really common. I mean, it's it's really out there, and and it's in the literature. And I can tell you if you talk to parents with kids with autism, they all have gut issues. And it's not, and it was sort of a it's not a a sort of a kind of a a sort of a red herring finding. It's a core finding.

And and about 75% have altered immune systems and inflammation. And if you look at the brain of kids with autism, they're bigger on MRI. This is worked on by Martha Herbert at at Harvard. And and there's also, if you look at kids who've died from from accident or something who had autism, their brains are all full of inflammation. They're microglia just which is the immune system of the brain are all just on fire.

And when you look at the history and I've treated many, many, many dozens of kids with autism over the years, the stories are almost sort of universally similar. The kids you know, have borne by C section. They're not breast fed. They get lots of colic.

Dr. Mark Hyman
They

Dr. Mark Hyman
get antibiotics. They got eczema. They get earaches. They it's like and then they get piled down with tons of vaccines. Not saying vaccines cause autism, but, like, It's just a lot for these kids' immune systems, and then something flips.

Dr. Marty Makary
I I'm chuckling a little bit. I mean, I love what you're saying, but I'm chuckling because I, had this kid come in a teenager who had the classic, sort of irritable bowel, lip chronic abdominal pain, no one knows what it is, has had a 1,000,000 tests done. It doesn't show anything definitive. And I decided to take a lot of time. It was something we're not incentivized.

Do. It took a lot of time.

Dr. Mark Hyman
I mean, you took more than 8 minutes with

Dr. Marty Makary
the patient. I listened to the patient. I didn't look at the EHR. And it turns out that the kid hit that had that same profile. Born by C section, constant antibiotics unnecessarily, it sounded like throughout their early childhood, especially in the 1st 3 years when the microbiome is being formed and had eaten terrible food their whole life.

And then the mom tells me this, you know, this condition, which we just give this diagnosis of irritable bowel, how could this possibly happen to my son? Well, you know, we I don't I wasn't there when you got all these choices, but you've also been feeding the kids shit for the last 12 years. And and so we're shocked. And then we have this massive whack a mole at medical industrial system that's gonna order millions of tests and put the kid on some kind of IVIG or some kind of Keytruda. Yeah.

It's like Yeah. Can we talk about root causes?

Dr. Mark Hyman
Root cause. Exactly. You know, I was I was in the intellectual problem. I mean, I I gave a lecture about 500 people on Aspen Institute last week. And I asked talking about something, I think, similar to this.

I said, how many of you in the audience have never had antibiotics and not a single person raise their hand? Right? So and if you look at, for example, there's work done on Bifidobacterium and Fantis, which is a really key important keystone species that proliferates in an infant is supposed to be there, but if the mother's taking antibiotics, it will it's very sensitive. It will get wiped out. And this is important for the development of immun tolerance for the allergy, autoimmunity, eczema, inflammation, asthma, all these conditions.

And and there's actually a company that's been funded. I think 100 of 1,000,000 of dollars called it. I think it's, even in the company about the product, Vivo, e v ivo, and it's basically a baby probiotic that you can give to the baby. And the thing that's unique about it is that it colonizes because when you take any probiotics as an owl, they don't really stay. They kinda go through.

They they have an impact, but it's like tourists going through an economy. This is actually building a house. Yeah. And it's it's quite amazing how it prevents a lot of these conditions.

Dr. Marty Makary
So that's what we need research on.

Dr. Mark Hyman
There's a lot.

Dr. Marty Makary
The the thing is that there's

Dr. Mark Hyman
a lot, like, if you if you Yeah. You know, this is we won't practice any faith medicine. Like, have you looked at the evidence? There's like 10,000,000 articles on pubmed. Have you actually read all of them and you actually know what you're talking about because this this sort of veil of evidence based medicine often is a sort of a smokescreen for people not knowing, all the data and saying it it just because they don't know it.

It means it's not true. And I think that's unfortunate because they're like you said, when you start to look at the research of the microbiome, you found so much.

Dr. Marty Makary
I saw a trial in China where they're treating autism with, combination of bacteria therapy or basically probiotics. Fecal transplants and Shepherd Pratt with affiliated with my hospital, John Hopkins, is doing a trial with probiotics and bipolar to treat bipolar. So it's like, this is, you know, we how much have we spent on cancer? And we what have we gotten for it? Almost nothing.

Yeah. The ROI is almost 0. I mean, the top paper at ASCO, the cancer meeting, was like, oh, if we use Avastin for GBM of the brain, you can get another

Dr. Mark Hyman
Couple months.

Dr. Marty Makary
Couple months. No added cure. Right? So, anyway, I I love what you're saying a 100%. So so I wanna go into, like,

Dr. Mark Hyman
a a a kind of

Dr. Mark Hyman
related by the little bit of a touchy subject, which is the subject of vaccines. And it's one of those subjects that is so confusing to me as a doctor as a scientist because Science is about asking questions.

Dr. Marty Makary
They can't ask questions about it.

Dr. Mark Hyman
It's about having hypothesis and proving it negative. Right? That's kind of the

Dr. Mark Hyman
basic scientific method. And if you question

Dr. Mark Hyman
anything at all, about any vaccine. You're immediately able to be an anti vaxxer. And you can't say, well, is this vaccine safe? Is that vaccine safe? What are the risks and and benefits of each one individually?

What about them combined? And and and it's it's just the weirdest thing. It's like, heresy. And I experienced this personally, like a Cleveland Clinic when I was there, somehow I I because I I people thought I was an anti vaxxer, they they the pediatric department, like, very upset.

Dr. Marty Makary
Get that label.

Dr. Mark Hyman
And and and and I literally had to write a letter like, no. I'm not. I've been vaccinated. My kids are vaccinated, but it's important to actually ask questions about this because if there's signal somewhere that there's an issue, we should look at it and And you wrote a very, a very courageous paper that was published, that you coauthored in in it was published in, journal medical ethics, and it was talking about whether or not we should be giving vaccine boosters to young adults going back to school. And you basically said that in a survey of all the data, I'll let you unpack it, but the punch line was that the risk of getting it was worse than the risk of not getting it.

And and, I wonder, 1, can you tell us about that study? And, 2, what has been the reaction? And have you been now labeled in any vaccine?

Dr. Marty Makary
Yeah. Sure. Okay. I've gotten that label a little bit for, questioning the booster vaccine in young healthy people, especially who have already had COVID. The question is with the vaccine booster in young healthy people, is there a benefit And there was so much controversy.

And I saw how at the FDA, it was pushed in with the political might of, you know, a top down order that it, made me ask some questions. 2 the 2 top vaccine experts that the FDA were fired directly fired, by their superior for questioning the COVID vaccine approval for young, healthy people. That is the booster, the booster, not the original. So the CDC never released the data. And only data we had was observational.

The clinical trial data on the booster, it was basically just reamed through. They didn't go through the normal process. So then when you look at the risk of myocarditis, not to mention the other claims that are out there of people being messed up or injured or not the same after the vaccine, again, high risk people early in the, pandemic, it was very clear. The the benefits outweigh the risks. But when you get down to young, a young healthy twelve year old girl, does she really need 6 COVID vaccine doses in 3 years?

Dr. Mark Hyman
We basically said

Dr. Mark Hyman
Well, yes, because the journey needs to make a profit.

Dr. Marty Makary
Well, they they weren't too happy with me. Moderna,

Dr. Mark Hyman
constantly has

Dr. Marty Makary
people at their company trying to reach out to me. Yeah. And, so the what is the risk of myocarditis of the COVID vaccine in a young health of the COVID booster in a young health person. I I ask that every time I'm engaged on this topic with someone who's like, how dare you not support the vaccination with the COVID booster in young, healthy people? What is that risk of my record?

I just It's 1 in 22100 to 1 in 28100. Heart injury from myocarditis. One person in a study of about, 2000 died in an ICU. Come off. 22 others were admitted to an ICU.

The New England journal. This is New England Journal. It's not like I'm making. So on a societal level, is there a net benefit or a net harm to giving the COVID booster to a young healthy population? It would it's a net harm.

If we actually do the math, It's in that harm. Very small harm, but to mandate it, to force, you're gonna create never vaxxers by doing that.

Dr. Mark Hyman
Right.

Dr. Mark Hyman
I mean,

Dr. Mark Hyman
in your in your study, you basically could have, like, over forty thousand people, young adults, so and found you to prevent one COVID hospitalization. You would have to trade that for 18.5 serious adverse events from the mRNA vaccines, including the, myo and pericardotis.

Dr. Marty Makary
We don't even have that hospitalization. That's based on data where we don't know if the hospitalization is for COVID or with an incidental COVID positive test.

Dr. Mark Hyman
Yeah. But you're talking about, like, you have to vaccinate, you know, 40,000 people to prevent one hospitalization, but you get 18 serious centers. You

Dr. Marty Makary
gotta burn the village to save it.

Dr. Mark Hyman
That's the problem. And so what's been the reaction to this this this article that you published and to this view? Because it's it's like you can't have this conversation. It's like you you're not allowed to have this conversation in medicine. And so how how Have you been able to still have a position at Johns Hopkins?

Dr. Marty Makary
They've been great, actually. Hopkins, the school of medicine has been terrific. My Dean, asked me to present to all the other department leaders. Along with 1 or 2 other infectious diseases, experts. And my Dean said, I know you have a slightly different perspective on COVID and the vaccine booster in young healthy people.

So I'd like the the department leaders at

Dr. Mark Hyman
Johns Hopkins to hear both perspectives, and we had a wonderful dialogue. I mean, I've been I've been active there as a surgeon and public health researcher for over

Dr. Marty Makary
20 years before COVID. So they knew you were in a nut job. Yeah. They knew I'm a reasonable guy, and I work hard. And I mean well, and I love this country.

So I didn't get that kind of anonymity based accusations you see on Twitter. To

Dr. Mark Hyman
convince them?

Dr. Marty Makary
I don't know. You know, you have people privately come up all the time to me. I don't know if you had this happen. We're like, Marty, I love what you're saying. I love you.

Keep going. I can't say anything, but you keeps that's perfect.

Dr. Mark Hyman
Right. Right.

Dr. Mark Hyman
I'm like,

Dr. Marty Makary
what are you afraid of? You know, too many people are afraid of speaking up. It's still happening in so many years

Dr. Mark Hyman
of medicine. Like, I do. I was like, how many doctors I raise in an audience? How many doctors here take, neck vitamins and, like, almost everybody raise their hand? How many doctors recommended their patients and, like, you know, half the hands go down?

So, exactly. Alright. You know, the other thing you talk about, you know, this whole idea of of of, the GLP 1 agonist. And they've been around for a while. Some of them were than others.

And, you know, we're we're in this moment where we are in a metabolic crisis in America. 93% have poor metabolic health, which means they have some degree of insulin resistance, pre diabetes on the spectrum, even if they're normal weight, because they eat too much crap and sugar and ultra processed food, you know, 42% are obese. And and these drugs seem like a panacea. Wow. This is a miracle drug.

Get this shot once a week and, like, lose weight and everything's gonna be great. I'd love to hear your thoughts on on this perspective of of kind of widespread use, Medicare coverage you're talking about, ensures covering it. You know, there's a new study after a new study coming out, and I just wanna give a little little background on this, showing that and and here's my belief. And I don't I don't really have any evidence back it up, but it's like, I see a new study almost every day about the benefits of of these GLP 1 agonists coming out in major journals. It works for heart disease.

It works for depression. It works for this. It works for that. You know, it seemed like everything. You know, in my head, I'm, like, thinking, is it the GLP 1 agonist or is the weight loss?

Right? And in in in in a bariatric surgery study, they they looked at, for example, what the difference was because, you know, bariatric surgery can cure diabetes in 2 weeks. And they basically did bariatric surgery in one group and then No biometric surgery on the other group, but they fed an exact same diet that the bariatric surgery group ate. They also reversed her diabetes in 2 weeks. No difference.

Dr. Marty Makary
Yeah. Sometimes out of the operating room, in the recovery room, we noticed the requirements go down. Right.

Dr. Mark Hyman
Right. But but but I'm saying it's even without the surgery Without

Dr. Marty Makary
the surgery.

Dr. Mark Hyman
So so is it the GLP 1 or is the weight loss? And and there was a a guy who met recently named Sammy who started coming called Verta Health, which uses ketogenic guides to reverse diabetes. And he said they they've actually done the study where they've actually looked at this, and they found it wasn't really the GLP 1. It was just the weight loss and the improvement in metabolic health as a result of it. So I'd I'd love to hear your perspective on that because You know, it's hard to to learn how to eat right, and it's hard to how to do it.

And and, yes, everyone wants that easy fix. And the news is appropriate for some patients, but, you know, I know people who wanna lose £10 for the bikini, and I'm, like, thinking this is a good idea. So can you tell us your perspective on that?

Dr. Marty Makary
Well, one thing that that is a theme in blind spots and a theme in in the research I learned was that if somebody put something out there with such absolutism, when the scientific evidence is really inconclusive or there's a lot of opinion, We just don't know what the long term effects of GLP 1 are. For example, they just haven't been around long enough. How can you say with such absolutives and that there's no long term downside? We may see a benefit in the short term with some of these chronic diseases. But we may be accelerating frailty, which is basically

Dr. Mark Hyman
Loss of muscle mass.

Dr. Marty Makary
Loss of muscle mass. And that is, as you know, the number one predictor of longevity is muscle mass. And that's why we want people to be active when they're older. So, We we don't have that data and people are acting as if it didn't matter. It'll go the way we want it to go.

There are bacteria in the microbiome that produce GLP 1. Yeah. And maybe we should be talking more about Probiotic. Having a a very healthy yeah. Maybe we you already make some.

So it's like, how can we not crush that? We're on a path of having every eight year old in America on 3 or 4 medications. It's scary.

Dr. Mark Hyman
Maybe their children or when they're adults?

Dr. Marty Makary
When they're children. Yeah. I mean, already half of America are taking chronic medications and the average number is 4. Once you get over 65, it's like you gotta have these boxes to remember what to take. And, look, medication save lives.

You and I have seen that. That's that's part of the medicine we're trained in. But We're gonna convert America's children into a generation of patients. Maybe we need to talk more about school lunch programs than putting every kid on Ozempic. And that is not a conversation that we're having.

We're just sort of celebrating Hey. Highfive. We found a way to, you know, create a GLP 1 agonist. We'll see about these new generation GLP 1 drugs that have a blocker on the muscle receptor supposedly. They're gonna they're gonna enter clinical trial soon.

Yeah. But I So to prevent the muscle loss. To to, yeah, prevent it or reduce it. Maybe, and I I I believe in impeccable objectivity changing positions as the data evolves. Right now, I have serious concerns about just giving out GLP ones like candy.

First side effects.

Dr. Mark Hyman
Why is there just beyond the muscle loss?

Dr. Marty Makary
The acceleration of frailty, the muscle loss, there some people don't do well with the profound loss of muscle. So, you know, there have been studies that have looked at weight. And it turns out that fluctuating weight all the time is worse for

Dr. Mark Hyman
you than staying overweight.

Dr. Marty Makary
That's right. That's right. So are people gonna be I'm doing better now, and I don't need it. I need. I'm going on this vacation.

I'm coming back. It's like, that's not that's not good medicine.

Dr. Mark Hyman
No. And I and I I don't have, that many patients on these jpy 1 agonists, but you know, I'm seeing side effects. Like, 1% pancreatitis the other day.

Dr. Marty Makary
Yeah. No one side effects.

Dr. Mark Hyman
And

Dr. Mark Hyman
this is a 900% increase in the risk of pain. I mean, I never see pancreatitis unless you have somebody with a serious problem. And see from a drug like this, it's very concerning. That's you're a pancreas surgeon. So you get on point of the pancreas.

Dr. Mark Hyman
I love

Dr. Marty Makary
the pancreas.

Dr. Mark Hyman
You love the pancreas. So this is is is concerning to me. And I think, the perverse incentives in medicine are driving this kind of crazy trend. Yeah. And and in in your book, you also talk about sort of the the blind spot around around the way we do research and the profit motive in research.

And I I, you know, when I entered medical school, I thought science was this sort of ethereal thing, which

Dr. Mark Hyman
was pure and independent and and completely

Dr. Mark Hyman
objective and just, like, you know, just had this kind of halo around it. And what I realized is that science is really freaking corrupt and that, that and and then what I was at a as a a passover dinner with my with my, one of my cousins and their husband. I was like, what do you do? And he's like, well, you know, I I I I I am a I'm a contract research organization a run contract. I'm like, oh, really, what's that?

He says, well, that's where pharma companies pay us to find experts in different domains and then fund the drug studies, do the studies, write the paper And then we pay them to put their name on it.

Dr. Marty Makary
Like a super pack.

Dr. Mark Hyman
Yeah. And I'm like, really? Leaving this is not right. Corruption. It's so cro can you so can you speak to that in in this and the challenges around around the the sort of the peer review process, the weaknesses in that, the the how do we address this whole phenomena?

Because it's, you know, it's it's, there's so much conflict of interest in medicine, and it leads to, like, the massive funding. So for example, if the amount of money It was now going into GLP 1 research. We're going into food as medicine research. Right? We would be showing phenomenal outcomes if we did the right kind of research.

Right? So how do we how do we deal with this?

Dr. Marty Makary
I do think everyone that goes into medicine is going in it for amazing reasons. And one thing that unites everybody in medicine is everyone has a sense of compassion that drew us into this calling. So we've got good people, but we walk into a bad system, and it's not a system we design. It's system we inherited, but we shouldn't defend it. It's entirely broken.

We have a bloated NIH that funds

Dr. Mark Hyman
research worse than the government

Dr. Marty Makary
funds, the postal service. We have silos. Pretty bad. We have there's a small group of people making all the decisions. At the very top, these are folks where we need term limits, the folks where they decide what's important or not important, and it's based on their understanding of the world.

Medical school education at every school in the United States is controlled by nineteen people that serve on the board of a private company that determines the curriculum of every medical school in the country. And if you wanna do something creative, talk about food or inflammation, You gotta get back

Dr. Mark Hyman
to mind. Company that's that creates the licensing exam, or is this

Dr. Marty Makary
Double AMC, they run, yeah, the US Emily. Yeah. And so these, you know, I've talked to Dean's of medical schools that have said, Marty, I'd love to talk about this stuff. All this stuff you talk about, all these stuff that are in the blind spots, modern medicine, and they say, we can't because the students know exactly what their learning objectives are for the boards. Yep.

And if we teach something else, they're gonna skip that class and I'm gonna focus on memorizing and regurgitating the 55 enzyme names they have to spit on on an exam. Why are we forcing our youngest, brightest, creative, most altruistic minds? To regurgitate the names of enzymes that you can look up on a smartphone.

Dr. Mark Hyman
Right. Right.

Dr. Marty Makary
And so we have this system now where a small group of people are controlling medical education, a small group of people control where the NIH dollars go. And who are funding the big questions central to health? For example, there's a new practice that's taking off of cutting the tongue under infraenulum.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
The friendulum under the tongue. Sometimes they'll even do the side of the tongue or the friendulum under the inside of the upper lip. Sounds it's crazy to me. I have ENT docs that say there's a subset of kids that may benefit from

Dr. Mark Hyman
the rounded tongue tied, like fully tongue tied.

Dr. Marty Makary
If it's truly a foreshortened tongue, they believe there's there could be a benefit. It's never been proven, but they do believe there's clinical benefit. But then they say going to the upper lip and the side is crazy. They also say we need a good study on it. Well, there's a group of people out there that are calling every kid tongue tied, doing it routinely.

Who's gonna this desperately needs a randomized control trial. Who's gonna fund it? Pharma, no way, NIH, not one of their silos, American Academy of Pediatrics, unlikely. And so this practice will

Dr. Mark Hyman
go on. Freemium fenulum cutting.

Dr. Marty Makary
May maybe sometimes it is the advocacy groups, the philanthropists that fund research. Most of our research at Johns Hopkins on my team, which is it's a we call it the redesign of health care. It's on All the major topics in medicine that we are not talking about that we should be talking about. And we our rapid response team, when the opioid epidemic hits, we go to work in days. When COVID hits, we go to work in days.

The old NIH, you know, take a couple years, work on formatting a grant. They're funding these tiny incremental little I don't even call them discoveries, like findings, Yeah. Like, is it interesting what the average size of stones are on the street? No. Is it research?

I guess. Yeah. But we're funding these little dumb things, and then the big questions go unfunded. So we think the solution is philanthropic funding, reorganizing the NIH, term limits at the NIH, and a small

Dr. Mark Hyman
For the for the director of the NIH?

Dr. Marty Makary
Or For all, all people who are in decision making leadership, power over grants at the NIH. And grants, I, my opinion, when I say, we, these are my opinions, the grant should be funded when one reviewer loves the idea and then it goes into a pool and you could give out the grants randomly to when one person thinks that's a big idea that could be interesting, why do you have to have a consensus among the old guard establishment that, yes, we're gonna fund another study on stents.

Dr. Mark Hyman
And there's unconscious bias. You know, like, I I was talking to Francis College, who's a wonderful man. Really kind, good, harded man, brilliant guy, you know, who is the director of an age. And I said to him, and I I think I've talked about some podcast before. I said, Why didn't you use COVID to educate the American public about the importance of nutrition in optimizing your health to prevent COVID?

Because 63% of the hospitalizations in deaths from COVID were because of poor diet. Yeah. And we know that we are 4% of the population in the world and 16% of the cases in deaths. He's like, oh, well, we couldn't do that because it would basically blame the victim, and we don't wanna do that. And in another meeting, I was like, no, it's not their fault.

It's it's just because we have a toxic food system. Right. Talk about that as the and and then at another meeting, he got up and said, well, there's no we don't really know that much about nutrition, and there's no national and student nutrition at at the NIH. And many other countries have this, and nutrition is the biggest cause of all the diseases we see today. Period.

Like, no argument. All the science says this.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
And I and and and he got up and said, we don't really know much, and there's not much data. And at the same meeting, doctor Dardis Mazafarian was there, who's the, was the dean of the Tufts School of Nutrition Science And Policy is now the head of Fuddhist Medicine Institute there. He said, well, like, for instance, Doctor Collins, I I beg to differ with you, and and then he went to this long, kind of, scientific unpacking of the literature that we do know.

Dr. Mark Hyman
You should

Dr. Mark Hyman
tell. I was like, wow. You know, it's it's it's not necessarily been, malevolence. Sometimes it's just, oh, ignorance. You know, but I'm like, wow.

Yeah. And and I also in terms of the the medical school stuff, it it you're right about the licensing exam, and I think one of the things we're working on in in Washington, my nonprofit called a food fix campaign, is to change the licey exams because that's what der term is a curriculum. And my my daughter's in medical now, and and I'm like, if you learn about this now, if you learn about the micro learning about the inflammation. Like, all the things that matter, she's not learning about. And she's all I know is that I have to pass the test, and I just have to study what's up for the test.

And that's it. Right. And I have the practice test. I have the questions, and I have Yep. And it's It's like if there was 5% of the questions on nutrition and chronic disease, that would force the change in the curriculum.

If there was 5% of the questions on the microbiome or on inflammation and health or in, like, any of these things

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
On mitochondrial function and how to treat mitochondrial. This is another black hole. Right?

Dr. Marty Makary
Yes. Yes.

Dr. Mark Hyman
Blind Spot. I don't know if you're talking about

Dr. Mark Hyman
that. Yeah.

Dr. Marty Makary
It's a big blind spot energy in micro mitochondrial. I mean, it's essential to connected, you know, sort of universal theory behind health is that there are these basic principles of mitochondrial health, inflammation, nutrients. We have such a nutrient poor diet. All the stuff you've been working on. But next time you see Francis Collins, you can remind him that the h in NIH stands for health.

Dr. Mark Hyman
I know. I said, and I said, that's what I say. We don't have nationals who are healthy. We have national institutes of diseases. That's right.

It's amazing. So how how do you think that that we can kind of reform the system besides just changing the term limits and besides, you know, do we get pharma money out? Do we do we try to sort of have special barriers that prevent them from manipulating the science and the papers. You know, I mean, it's like half the time what it says in the abstract isn't actually what it says in the data. Most people just read the abstract.

Like, there's all kinds of monkey business going

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
Right? It's a rookie business.

Dr. Marty Makary
Yes. Well, I, first of all, I think we insist on rules of transparency for clinical trials. Number 2, if you're gonna opine about a topic, do a clinical trial. The amount of opining around topics that the NIH throws out there. Oh, we don't have good data on this.

Well, you control the $80,000,000,000 budget over there at NIH. We saw this all during COVID. All the COVID controversies could have been settled immediately by them doing the proper clinical or randomized control trial on that question. All those questions, masking toddlers, natural immunity, the booster 6 do the trial. You know, isn't spread airborne from or from touching services?

In the summer of 2026 months into COVID, the NIAad and Doctor Fauci sorry. I said something I shouldn't have said there. I mentioned his name. He was telling teachers. It's okay.

I mean, he's very some people love him.

Dr. Mark Hyman
Some people hate him. I try

Dr. Marty Makary
to be objective, but it's so he was telling teachers to wear gloves and goggles in class. Do the freaking study. If you think it's spread by service transmission and you don't believe it's airborne, do the study. You got the $80,000,000,000 budget at the NIH. So one is in he

Dr. Mark Hyman
actually admitted that. He says, I just made this stuff up. I just made up the 6 feet thing. I just made up the mass thing. Like, I just made this stuff up.

I'm like, wow. Okay. Well, thanks for telling us.

Dr. Marty Makary
I think one of the biggest propagators of mis information during the pandemic was the United States government itself. And it's not new, the food pyramid.

Dr. Mark Hyman
And And it wasn't just trump saying put, bleach in your veins. It was more than that.

Dr. Marty Makary
Yeah. I like that. Yeah.

Dr. Mark Hyman
It was the actual NII. It was the actual CDC.

Dr. Marty Makary
And it's not new. Peanut allergies, same thing we get people the wrong guidance. There's so many recommendations that, people should be able to ask questions. I'm not saying be cynical. I'm not saying don't trust your doctor, but people should be able to ask questions.

So if pharma does a study, Regardless if that study goes their way or not, we should get the results immediately. Okay. That is a basic new principle of transparency we need to adopt in the United States. When PACSlovid just as an example, the antiviral used, made by Pfizer to treat COVID. When that came out, the government recommended that for everyone.

They promoted. It was one of the biggest public health campaigns in the last year and after the pandemic. A study came out in the New England Journal of Medicine just a number of months ago that showed zero benefit in people under 65, none, zilch. The study now that's studies go different ways, and that's the way science is the but the study ended nearly 2 years prior. If you look at the actual tables, the results were the study was done.

Why did the public not see it

Dr. Mark Hyman
for nearly

Dr. Marty Makary
2 years? Because it didn't go their way. When the COVID vaccine booster goes their way, they tell you before anything's even published. Just a press release, and it's a CEC. Yeah.

Dr. Mark Hyman
Yeah. They got a full page eye in the New York Times.

Dr. Marty Makary
Yes. So this is the type of trial level transparency we need. Yeah. And we gotta do it now because otherwise, we need we need better funding and academics. We need more civil discourse in medicine.

We need less cancer culture.

Dr. Mark Hyman
Yeah. Yeah. It's so true. It's so true. You know, well, I'm just like, we totally agree on everything here.

One of the things that, shocked me that I found out, you know, because as a doctor, you think, okay. Well, the literature is published. It's it's they're publishing all the data on particular drug or particular intervention that they're that they're studying. And it turns out that that pharma has to present all their data to the FDA, but they don't have to publish all the data. And and typically, they only publish the positive data.

They don't publish any of the negative trial data.

Dr. Marty Makary
That's right.

Dr. Mark Hyman
And so the public has no clue that there's all these other studies that contradict the one study that showed there was positive, and the FDA is is a captured agency because it's like a revolving door for pharma and farmer leadership. And and so like, it was sort of shocking to me as I sort of even as a doctor that I found that sound like, what do you mean? They don't they don't publish all the data. Like, they just hide all the negative data.

Dr. Marty Makary
Yeah. You can do that. Yeah.

Dr. Mark Hyman
Yeah. And that's how it is. So Yeah. So for people listening, it's it's you know, you've gotta be smart on your own, and you've gotta be your own advocate, and you've gotta be proactive about your health, and you've gotta not just take things at face value, and you gotta do a little digging. And now with the AI, it's gonna be easier and easier with doctor to use to be Doctor Google, but

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
Not always right, but it's at least a good start. You know, one of the things y'alls talk about in your book was this whole idea of of blood tests that are not being ordered that everybody needs. And I thought that was really intriguing because I just cofounded a company called function health. To which is a health platform that allows you access to your own health data and lab testing without having to go through a doctor insurance company and you get, you know, for 4.99, you get over a 100 and 10 biomarkers would be $15,000 retail. And there's been huge consumer interest.

We're like 60,000 members in the 1st year. And we we had 10,000,000 biomarkers. Fascinating. And and it's and we're we're doing a lot of tests proactively. Now you and I know when went to medical school, we're like, only test to confirm a diagnosis that you've already made through history.

Right? Diagnosis history history history. And yet you're saying maybe we should be reconsidering this because there may be things that we can do proactively and practice more proactive preventive predictive medicine than reactive medicine. Can you tell us about what you're thinking there and what these tests are?

Dr. Marty Makary
Yeah. So, a buddy of mine will, just graduated from medical school at I don't know if I should say that in school, but it's in the south. And he basically, said he got 2 hours of, teaching on all of nutrition and cholesterol and lipoproteins, basically. And in those 2 hours, and he got 8 hours on a bunch of nonsense that he can't, you know, the disparity is unbelievable. The, 2 hours on nutrition, he said it would have been better not to have those 2 hours because there was so much misinformation in him.

All it was was He feels good. Yeah. Exactly. Oh, go forth. Preach to the world.

You know, check their total triglycerides. Turns out lipoprotein a and apoprotein b are very good predictors, at least better than the current old crude predictors.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Of people that have early heart disease looking for general body inflammation. The tests aren't great, but I get a highly selective C reactive protein. Said rate, not very good, but something. So trying to measure general body inflammation the deposition of the types of lipoproteins that result in that plaque buildup. And when you put that together Are

Dr. Mark Hyman
there lipoprotein fractionation?

Dr. Marty Makary
Yeah. Lipoprotein fractionation, the the high density particles, l p a.

Dr. Mark Hyman
So looking at the quality and number of the particles, not just the weight, which is what you got on a regular cholesterol test, which in my view should be banned.

Dr. Mark Hyman
It should yeah. It's such

Dr. Marty Makary
little useful information. It's misleading.

Dr. Mark Hyman
It is.

Dr. Marty Makary
Yeah. And when somebody has an early heart attack in their 40, or early fifties, and it shocks everybody. Sometimes we'll go back and get that test, and it turns out their LP little a was up or the APO protein was up, even though the other numbers showed that things were okay. Yeah. Next time somebody gets to set a lab test, I usually tell them, make sure that you've got that tested for at least once.

Lp at least once. It's a lot genetically driven. 99% of cholesterol is made by your own body. And so these are some basic things that people can test for. And I I'm really fascinated with the micronutrients and allergy testing, and I and that's something where you've got more expertise than I

Dr. Mark Hyman
do.

Dr. Mark Hyman
Yeah. Right. True. You mean you mean, like, true allergy IgE, or you mean like more food sensitivity testing?

Dr. Marty Makary
Food sensitivity because And nutritional testing. Nutritional testing because we've had this dogma from the American Academy of Pediatrics starting 24 years ago. That don't feed young kids, any peanut butter related, stuff, milk. Yeah. Eggs.

There was this 1, 2, 3 saying. You I don't know if you heard of this, like, your kids should get, milk at age 1. You can introduce a little bit of eggs at age two and then peanut butter at age three. Well, you got it so backwards. Yeah.

Peanut butter should get introduced a little bit, not in place of breast milk, but a little bit at age at 4 months, 5 months, 6 months. Soon as the kid can eat, there's the studies have even shown that 5 months prevents peanut allergies more than introducing it at 6 months, 4 more than 5, And so it there's a strong association with what we call oral tolerance. And that's what the American Academy of Pediatrics got perfectly backwards. When they told lactating and and pregnant mothers, total peanut abstinence for you and kids 0 through 3. They didn't prevent peanut allergies with that recommendation.

They cause them.

Dr. Mark Hyman
So we have evidence based medicine or other things we wanna say we prove, and we for the things we have no evidence on, we say that we say them with such authority that they they act like they have evidence, but they don't.

Dr. Mark Hyman
Well, that's the thing. If you're gonna

Dr. Marty Makary
put out a strong recommendation, others say, you know, this is based on just me shooting from the health care. I don't know. Or reverse it once the study comes out, showing that it was wrong with the same vigor that you put it out. When the study came out in the New England Journal 2015, what's that? 9 years ago, showing peanut avoidance causes an eightfold increase in peanut allergies.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Say, gosh, we got this so wrong as an academy. We need to tell the world. Instead, they kinda fade out, you know, get the low fat diet wrong for 60 years. It kinda fade out, you know. Get hormone replacement therapy wrong.

Just kinda fade out. Where's the humility?

Dr. Mark Hyman
Yeah. Yeah. Right? Oh, shoot. We got it wrong.

Like, let's let's make a call, like, let's let's set directly straight. Right. Yeah. It's crazy. And, you know, the test you mentioned, the the APO B

Dr. Mark Hyman
Mhmm.

Dr. Mark Hyman
Which is early measure of of small dense particles and all the bad particles that cause heart disease and LPA, which is a a marker that's genetic, but also is increased your risk. The particle size and the number of life approaching fractionation since high sensitive CRP. These are all tests that are just part of the standard function health profile. Yeah. And we also test all the nutritional stuff.

We're finding that 51% have abnormal APO B. We'd find that 4089 percent have abnormal lipoprotein particle size and number. We find that 46% have elevated CRP. This is in a health board population, and 67% have a deficiency in 1 or more nutrients.

Dr. Mark Hyman
And this is not at the

Dr. Mark Hyman
level that would be optimum for health, but the minimum to prevent a deficiency disease. So a ferritin of 16, not an optimal ferritin of 45, for example, or a vitamin d of 20, not, you know, of optimal vitamin d of 50. And and so we've been fighting this in the population and And so I'm a big advocate of of tests don't guess and of knowing your numbers and of actually being proactive about optimizing them because they may not cause an immediate issue, but, there was a a brilliant scientist, Robert Heaney, who who's an out of debt, who was a vitamin d researcher, and he wrote a article a long time ago called long latency deficiency diseases. And it was fascinating because he talked about, well, if you have, like, you know, acute you know, folate deficiency, you know, you'll get megaloblastic anemia, which is for Temanema. But if you have, like, low grade, like, low folate, you might get dementia.

Or if you have, like, you know, a little bit low on an optimum vitamin d, very low, you'll get rickets if it's acute deficiency, but if it's a little over your lifetime, you'll get osteoporosis, long latency, deficient disease. And he goes over nutrient like this. And it was it was fascinating to me to really change my thinking about being more proactive because you're optimizing the body's systems, and they all have to be functioning. And and it's it's amazing to me how many doctors don't even think about this, don't know about it, aren't educated about it. And, I mean, even asking my daughter, you learn about lipoprotein fractionation in medical school, which is, like, should be the goal standard.

I mean, I I mean Yes.

Dr. Marty Makary
I shouldn't

Dr. Mark Hyman
be telling these tales, but I was at Cleveland Clinic and there's a there's a doctor there who wonderful man, but he, you know, he's older and he throughout the executive health program. I don't think he's there anymore, but I met with him and I said, listen, you know, you should update the executive health program to include the life approaching fractionation. Yes.

Dr. Mark Hyman
Because there's a much better representation of cardiovascular. You have something with a normal perfectly normal cholesterol under 200. They're LDL under a 100. They're triglycerides normal.

Dr. Marty Makary
HTL looking

Dr. Mark Hyman
like 4550, everything looks great, but they could have the worst particle and and size and density that you could imagine and be at very high risk. And he's like, well, you know, we only like to introduce things after we have a lot of research. I say, well, This has been around for 40 years. I've been doing this test personally for 30 years. Yes.

Ronald Krause developed this at, you know.

Dr. Marty Makary
It's been around.

Dr. Mark Hyman
Yeah. And and he's one of the most brilliant lipidologists in the world. I'm like, you know, this is so slow to adopt actually the science into what we know. And and people are suffering because of it. And that's kinda why I think, you know, some of these things can be solved from the inside, but like you said, some of this has to be solved from the outside.

And we need, you know, we we need philanthropy. We need you know, better policy regulations. We need better, you know, reimbursement around medicine that pays for the things that actually work like food as medicine. You know, we, you know, we need to have companies from the outside changing things from the inside. So it's pretty it's it's it's kind of an exciting moment, but, like, you're like, know, like, you know, the wizard of Oz when the curtain gets pulled back, you're that guy.

Like, you're the guy pulling back the curtain and there's, like, this little old guy back there with no pants on. Yeah. And it's it's, it's quite amazing what you've done. Well, you know,

Dr. Marty Makary
I go around. I talked to so many experts. And I ask them, is there dogma in your field that is wrong or has been proven wrong or you believe is wrong, but it's still heralded out there as science when it's really just the way we it's been done. It's just sort of custom. And they start unloading and they start telling you things.

And actually, the lipidology community

Dr. Mark Hyman
has evolved entirely independent of the cardiology community. So the cardiologist kinda claimed lipid

Dr. Marty Makary
science at a certain point But the lipidology community is like, Hey, wait a minute. We've been studying this for a long time with hyperlipidemia, and they have very different views on things. So for example, lipoprotein a testing was recognized in the lipidology community of saving lives, as you mentioned. Yeah. But not in the cardiology community because all their tests just use the crude LDL.

Right. So I went to the, head of the cardiology lipid center at Hopkins, and I asked him. I said, I've been reading about LP a, Seems like it should be this subject of a massive universal public health campaign Yeah. To get everyone to get it done. It'd be a lot better than trying to get a defibrillator in every bathroom in the mall,

Dr. Mark Hyman
you know, which is actually

Dr. Marty Makary
a real campaign Hopkins chair champion. And so lives for sure, but Saves lives, but, like, here's something that's so that RTC is the number one cause of death. So he acknowledged. Yeah. There's some new research, and we we did put it in our new guidelines.

I'm like, you know what? It was I read those guidelines, American Casualty. It was a footnote. Yeah. Like, where's the enthusiasm?

Where's the vigor? Where's the it's just like molasses sometimes.

Dr. Mark Hyman
Yeah. Well, because there's no good drug for it. Right? I mean, there's platinum freezes. There's certain supplements at work.

Sometimes the piece, CSK inhibitors lowered a little bit.

Dr. Marty Makary
Yeah.

Dr. Mark Hyman
But it's it's, you know, it's it's a harder to treat problem. And and we're very, very cited about testing things for which we have great drugs because the pharmaceutical companies, you know, make it easy for us. They do all these studies. They kept their drug risks calm. They they have great commercials and tell the patients what to ask for

Dr. Mark Hyman
her. Yeah.

Dr. Marty Makary
There is a drug in phase 3 clinical trial. That this targets lipoprotein little a. So we'll see what the results of that show. But I wonder if, you know, those are the people you wanna just be more aggressive on, maybe. Yeah.

Totally. Track. Maybe you get the cardiac, CT angio on them instead of just the calcium score. You know, those are the ones. Well, with function health, we had a

Dr. Mark Hyman
young thirty five year old who did the test, and he had high APO B. He had high LPA. He had really horrible lipid particles. The rest of his cholesterol, normal cholesterol profile looked pretty good. And, you know, he was 35, and we sent him for a CCTA, but cor coronary your entry game with the with the CT scan, but we added the AI interpretation with a test call clearly.

I don't know if you've heard of this test. Have you? No. It's really amazing because you actually can see soft plaque inflamed plaque, not just calcified plaque, and you get a much better read on every artery. And Shot a plaque?

Dr. Marty Makary
But You found a plaque. Yeah.

Dr. Mark Hyman
And he

Dr. Mark Hyman
and, yeah, and this guy's 35, and he's headed for heart attack. And he had no clue because he was dandy, he's healthy, he's fit. He exercised. He's great. It's like some genetic thing going on.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
And and so, you know, we're often kind of walking into our futures without any idea of what we're heading into because, you know, we're not taking advantage of the latest science.

Dr. Mark Hyman
And and, I mean, I wrote a book like more than 20 years ago where I was talking about APO B and LPA

Dr. Mark Hyman
and CRP and testing insulin. Mean, insulin's another one of those tests. You know? Yeah. You know, thank god.

Quest now has a test. It's called the insulin resistance score, which uses mass spec to measure insulin C peptide, which is a I mean, your pancreas guy, I don't tell you, but it's a yeah. And telling your audience, it's it's it's the precursor of the insulin molecule. And and when you get this ratio, it it's as good as what we call uglycemic clamp test, which is the gold standard. It's a very invasive test that you do in the hospital for insulin resistance, but it's as good as that test.

And it's cheap and it's something umbrish you get because it is the biggest driver of cancer, heart disease, dementia, and and even it's linked to depression and fertility, acne, and a bunch of other stuff. Uh-huh. Even low sex drive and erectile dysfunction and, I mean, you name it. And that it nobody's doing that test.

Dr. Marty Makary
So I

Dr. Mark Hyman
I mean, I ask quest, like, how many people are getting lipoprotein fractionation, like, less than 1%. How how many people are testing insulin when they were doctors order insulin? It has less than 1% of our test. I'm like

Dr. Marty Makary
Tell them we don't need AI. We just need I. We just need some Oh my god. Yeah. Basic.

Dr. Mark Hyman
Well, I actually I I actually talked about this. I don't know if it's not right. Maybe in your wheelhouse, you can tell me, but, I've I've kinda come up with this new concept. What I call MI. And not MI like heart attack, but MI like medical intelligence.

Dr. Mark Hyman
Uh-huh.

Dr. Mark Hyman
Which is something we don't have. It it we have a single doctor that you rely on for his own experience, however smart they are, whatever they've learned, whatever course they went to, whatever school they went to, whatever residency they went to. Like, that's what you're getting. And and they haven't certainly read all of 10,000,000 papers on PubMed. They certainly haven't read every textbook and article about every disease and and you're and you're kinda relying on there and good will and intelligence and kindness to figure out what's going on.

And and, you know, we do a pretty good job most of the time, I would say. But, you know, I feel like we're entering this moment in health care where we're gonna be able to draw through technology, all the world's scientific literature that it consume every single textbook, you know, up to date, all the the latest met medical knowledge, patient reported data, all their lab data, all their omix, all their imaging, all their biosensors and wearables, all their medical history to track it over time, you know, when Lee or I could call this dense dynamic data clouds of information that give you personalized predictive models of where you're headed and what to do about it. To me, you know, having that be able to sort of inquire to that that that your own data set, about what what's really going on and see those patterns and correlations that, you know, the average doctor is gonna miss. I mean, would you rather have your dermatology exam by, you know, an AI, computer or by a dermatologist. Like, I went to a dermatologist and I'm a doctor.

I know I had a precancerous lesion, and and he completely missed it. And he was like the head of, you know, I don't know, dermatology, the major academic, you know, medical school. And I was like, I wanna go to the top guy and

Dr. Marty Makary
give it down professor and chairman.

Dr. Mark Hyman
And you, you know, he looked at me, like, turn me around, looked at his eyeballs. I'm like, no magnifying glass. No light. I'm like, goddamn. I'm no I know better than this.

I was like, And I was like, so walked out, so disappointed. And I'm like, you know, so what do you think of this idea? And could this really change things? Because then all of a sudden, all the things you're talking about will bubble up. Like, the the the the the pharma, and and the medical industrial complex won't be in charge anymore because you've got, you know, free access to data and information that's been locked away.

Dr. Marty Makary
I tell all our Johns Hopkins students and residents that what will make you a great doctor is knowing your limit It's your humility. It's saying, I don't know when that's the right answer. And that was the right answer during COVID a lot of times. We didn't hear it. And so when I talked to a pediatrician and asked them about peanut allergies, you'll have somebody who will just recite a catechism.

Well, according to the guideline of the American Academy, you know, somebody else will think independently and creatively, and they'll say, You know, there is a guideline out there, but there's this study, and I've heard doctors suggest this. And my this has been my experience. And I'm not sure, or this is what one mentor thinks. This is what that is a creative. That's a doctor you want.

Doctor who thinks independently and isn't just, you know, falling in line with some dictum that says everyone obey and and and get in place. When we, as a medical profession, have use good scientific studies to make broad health recommendations, we shine. We help a lot of people. But when we wing it, when there's broad health recommendations made by a small group of people who are just ruling on a on an opinion, and making it sound absolute like at scientific data, we have a terrible track record. We ignite epidemics.

We ignited the opioid epidemic saying opioids were non addictive.

Dr. Mark Hyman
Yeah. Pain is the 5th vital sign.

Dr. Marty Makary
Pain is the 5th vital sign. These are manufactured peanut allergy epidemic, you go down and down the down the line. Even you could argue the low fat contributed to obesity rates,

Dr. Mark Hyman
the low fat. I'm not gonna argue that. I think that's pretty much a fact. Yeah. That's you

Dr. Marty Makary
don't need AI. Just die for that.

Dr. Mark Hyman
Yeah. No. It's true. And and and then we stuck and don't wanna say that we made a mistake either.

Dr. Marty Makary
That's the key. That's the key. And patients are very forgiving if you're honest

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
In real time. Yeah.

Dr. Mark Hyman
I was talking to a friend about that about that. You know, if you're a doctor and you're telling the patient the truth and you say, I don't know or I fucked up, Like, they're less likely to sue you.

Dr. Mark Hyman
Yeah. Then

Dr. Mark Hyman
if you're just trying to hide hide what's going on. Right? And we're kinda trained to kind of circle ranks and hide and not telling each other. And I'm I'm so impressed by you. You're actually out there saying something.

I've been saying forever, but I'm like, kind of, you know, on the fringe. You're you're in the center of the belly of the beast.

Dr. Marty Makary
I've, I've ushered so many people to the afterlife in the ICU, and, you know, I've done a lot of cancer care that I'm constantly reminded how life is short in these folks that are just afraid of what somebody's gonna think. If you just speak in your honest opinion, I don't think that's healthy, and that's what we need more of.

Dr. Mark Hyman
And so so in in the policy realm, because you've you've mentioned how your book really helped shift some policy around cost transparency.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
You know, what are the other big levers besides term fixing the NIH and putting in a national assumed nutrition and funding the right research and getting rid of all the the kind of old cronies in there that just kinda don't want the to get the kind of new science out there What what actually can we do, on a policy level? Cause I I'm curious. I I have a nonprofit that works on food policy. I mean, I'm actually going to be doing a hearing in front of the Ways Means Committee, September 18th, in front of the health sub communities in charge of all Medicare and reimbursement. You know, and I and and and, like, you were talking about, like, for example, about diabetes, and I had had, spent the option with Sammy who who started for the health.

Dr. Mark Hyman
And

Dr. Mark Hyman
they they really deeply studied that they could save $6000 per patient after cost by putting them on this program to reverse diabetes and they reversed diabetes, which is not something the ADA even basically recognizes as something you can do. And if if Medicare implemented this, it overnight, it would save a $100,000,000,000. Yeah. Looks like that. Boom.

Because there's sixteen and a half million people on Medicare, who have diabetes.

Dr. Marty Makary
So Sammy's the endocrinologist that started Verda?

Dr. Mark Hyman
No. Sammy is a is a is an entrepreneur.

Dr. Marty Makary
Okay.

Dr. Mark Hyman
Who

Dr. Mark Hyman
is an elite athlete who found that he had metabolic syndrome because he was using all these sports goos that are full of sugar to fuel his endurance athlete, performances. And so he was like, what's going on here? And then he basically trained and did a cross, the ocean road from California, Hawaii doing a keto diet and show that you could you could do it. And He rode from California, Hawaii. Robo with his wife.

Wow. Like, robo. Nice part. I mean, I don't think it's not safe, but it was hardcore. He said, like, twenty foot seas.

It was, I'm pretty rough. But but the point is that, you know, I'm having this hearing, and and I I I imagine it's gonna be very tough to to get Medicare reimbursement for a program like that, even though the data's so clear, even though they've shown that it proves all lipid parameters, it's like it's sort of the opposite of what you think by being eating only fat. Right?

Dr. Marty Makary
It's, the policy world is tricky because There are so many things we can do without the government that we're not doing. For example, the Verde company that you mentioned, and I had met with the endocrinologist too as one of the, I think, co founders or something. And he showed me that data. It was super impressive. Finney.

I I think that was gonna be. Super impressive data. Just like you said, this is clearly something we should be doing, and it fits the whole what we've known and seen on the ground as doctors for many years, and that is the hard part of treating chronic diseases, not telling people what to do. It's helping them do it. Its behavior changes, checking in with them.

It's being their friend. It's going along the walk with them. If I tell I see somebody smokes on their chart. I don't do what I used to do and tell you, oh, yeah. You should stop smoking.

You're gonna die. Now I ask them, you know, some people

Dr. Mark Hyman
go outside and have a cigarette. I'll tell you to do a talk. Almost.

Dr. Marty Makary
I almost do that. I'd say some people really don't wanna quit. They don't wanna talk about it. And other people really want to. Where do you stand?

And whatever answer you say is okay with me. Most people say, I don't wanna talk about it. And they're you're not gonna affect them no matter what. But then you meet somebody that says, I just had a granddaughter. I'm dying to quit.

We should put all of our energy in to help them with medication, behavior, all And that's what Virgil's doing. It's saying, if you want someone to help and go down this walk with you and help pick foods and and manage your diabetes instead of just pumping insulin and We're gonna be there for you. And those are the solutions that the in the private sector, employers that pay for health care, what we call, erisa plans, employer sponsored health care plans. They're saying know, I'm gonna make Verda available to my employees at this company. I'm gonna make Teladoc.

I'm gonna make and they're piecing together what we call these point solutions. So now you can be creative and come up with a foodist medicine program You don't need to wait for Medicare and there are 50 bureaucratic red tape steps. And you can go go to work right away. And that's the exciting thing. That's why I'm so optimistic about some ray of hope in this broken health care system because employers are are standing up, and they're they're saying yes to the challenges.

So they're in

Dr. Mark Hyman
the financial incentives are online. The pioneer that they the privately insured large corporations who are footing the bill.

Dr. Marty Makary
They are, but at the same time, They see the demand for this. And if there's demand, they wanna make those employees happy because they wanna attract employees. Fertility services. Is there an ROI on it? No.

But they know there's demand for those fertility services. So that that is now enabling smart people to say, hey. This makes sense medically in terms of improving health. Let's do it. Let's try it.

Let's do a pilot. Let's and it's happening fast. Like, we don't have to wait, you know, these diabetes alternative, these companies now. They're not anti dialysis. Sorry.

I meant dialysis. So in dialysis, we have a system where just kinda let people go into renal failure, then we put them on the machine. Well, what about actively getting them to avoid dialysis before they become dependent on it? Yep. So there's a couple companies now.

They're not the big ones. And they are actively working with people in that pre dialysis phase of their life. And if they can avert one pace

Dr. Mark Hyman
patient becoming dependent, it pays for itself. So this is the exciting stuff right now in in

Dr. Marty Makary
medicine.

Dr. Mark Hyman
It's true. I mean, I I I've, you know, with aggressive lifestyle intervention, you can reverse renal insufficiency. You can. And I and I had a patient who was, like, you know, typical insulin resistance and cardiovascular disease and hypertension and kidneys starting to fail as Gf far was just the measure of kidney function was going down and kidney level tests were going up. And, you know, I put him on

Dr. Mark Hyman
a program and he lost weight. He did amazing. Got the inflammation down.

Dr. Mark Hyman
And his kidney's normalized. The protein went out of his urine. And his nephrologist was like, what the hell did you do? I've never seen this before. This doesn't happen.

It's not possible. Like, well, what's going on? Like, and we don't see it because we don't know to tell people what to do. Like, we just don't have the knowledge or education, and it goes back to your licensing exam. That's one of the things we're working on is also changing the licensing exams, getting, ACCME to change those requirements.

Graduate medical education, we spent $17,000,000,000 a year from the federal government paying for these residency programs and fellowship programs. We have no strings attached about how that money is used or what they're teaching or anything. Like, and so we can put some guardrails on that. Yeah. You know, it's is this amazing.

Your your your work is tremendous. I'm I'm super excited about it. Marty McRe from Johns Hopkins written so many books as late as one of his blind spots when medicine gets it wrong and what it means for health. You will not be sorry to read these books. You will educate yourself.

You become empowered. And I think what you're doing is speaking out telling through the speaking truth of power and actually empowering patients to learn how to become, agent have agency over their own health and do us right for themselves and not be just at the sort of whims of a paternalistic system that has immense, financial perverse incentives and commence corruption, and it's not giving us what we need to know. So thank you for speaking out. Thank god you're there in doing this work. I'd love to have you on the podcast.

Any final words or thoughts and advice for listeners about how to navigate all this?

Dr. Marty Makary
Was great to see you, Mark, keep up the great work. So, you know, I felt like there's so much new research that is directly speaking to these blind spots in medicine that people should know about it, not just in the medical community, but If my colleagues are fascinated by some new research that I'm presenting to them in a lecture, some of that research has direct implications for everyday folks out there. And so that's why I put this book together. So I hope people enjoy it.

Dr. Mark Hyman
Well, thank you. You can find it everywhere you get books. It's out there now. And you can go to Marty, and Macri and just check take out his work. His website is macrimd.com.

Dr. Marty Makary
Marty MD. Yep.

Dr. Mark Hyman
Oh, Marty MD. Okay. Martmd.com. I should let you say what do you have social media? What is that?

Dr. Marty Makary
I'm on Twitter. It's a bit of a nasty place, but I I try to encourage people on it and, LinkedIn a little bit, but, great to be with you. So thanks so much, Mark. Okay.

Dr. Mark Hyman
I can't wait to have you back for your next book. And, like, I think there were, like, four thousand tops we didn't cover. So get the book, check it out, and, and Like,

Dr. Marty Makary
to push the field.

Dr. Mark Hyman
Yeah. Let's go. Thanks so much, Marty.

Dr. Marty Makary
Great. Thanks.

Dr. Mark Hyman
Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at doctor Mark Hyman, and we'll see you next time on The Doctor's Faramcy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more.

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This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland 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 guest endorsement of views or 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 medical professional.

This podcast is provided on the understanding that it does not constitute medical or other professional advice or service Now if you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.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.

Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. Keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible.Dr. Mark Hyman
Coming up on this episode of The Doctor's Faramcy.

Dr. Marty Makary
We have yet to really understand what's going on here. The rise in colon cancer and young healthy people. Right. Turns out that there's an association with the microbiome. Being born by C section and going on to have colon cancer before age fifty was an association just published in JAMA surgery.

Dr. Mark Hyman
Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice. There's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand. Well, you, if you're looking for data about your biology, check out function health for real time lab insights. If you're in need of deepening your knowledge around your health journey, check out my membership community, Hyman Hyve.

And if you're looking for curated and trusted supplements and health products for your routine, visit my website supplement store for a summary of my favorite and tested products. Welcome to doctor's pharmacy. I'm doctor Mark Hyman, and this is a place for conversations that matter. And if you've ever wondered if there's corruption and dysfunction in the medical system, then you have to wonder no longer because our guest today, Marty Macquarie is a professor at Johns Hopkins University School of Medicine and the author of 2 New York Times best selling books that have kind of pulled the curtain back on a lot of the dark side of medicine that you're gonna hear about in this podcast. Doctor Macri served in leadership at the World Health Organization.

He's a member of the National Academy of Medicine, one of the highest honors you can get in the field of science. He's published over 250 papers. His newest book, blind spots, challenges the conventional medical dogma to educate people about their health. Clinically, he's the chief of islet transplant surgery. That's getting something in your pancreas, when your pancreas isn't working at Johns Hopkins.

He's the recipient of the nobility and science award in the national from the National pancreas Foundation. He's been a visiting professor at over 25 medical schools. And he's just a very courageous doctor because he has pushed the limits of what we should be talking about in medicine because we are told to keep the secrets. He wrote a book called unaccountable what hospitals won't tell you and how transparency can revolutionize health care. He also wrote another book at the price we pay, what broke American health care about the lack of transparency in pricing and how we can fix it.

He's, just an incredibly brilliant man who has just on a mission to tell us the truth that you have not been hearing. And today, we talked about all sorts of things from the concern about vaccines and should we actually be vaccinating certain people and groups of people with a code vaccine or not. Why has the microbiome been ignored in medicine? Why is our medical education system completely teaching the wrong things? Why are ours our national Institute of Health actually have nothing to do with health and is all about disease and is not even funding the things we should be funding.

How has the range of, roles of GLP 1 agonists been ignored and why are we concerned about that? He's also we also deep get into the topic of of of health care financing payments, how researchers funded the corruption of evidence based medicine. I mean, we talk about it all. I think you're gonna love this podcast. So let's dive right in.

With the doctor Marty Macquarie. Welcome Marty to The Doctor's Faramcy podcast. It's so good to have you. I followed your work. And, honestly, I'm kinda shocking because you're Johns Hopkins professor and you're Lahertic in

Dr. Mark Hyman
the middle of the

Dr. Mark Hyman
belly of the beast Right. And you're kinda telling tales that we've traditionally kept secret in medicine. It's kinda like a guilt, you know, or like, you know, it's a club. And you don't you don't tell in your neighbors or your colleagues or your friends about what's really going on in medicine and health care. And what's really struck me as I've, you know, been a doctor god for almost 40 years now is the is the level of, co optation and capture of medicine by industry.

And it's less about health care. It's more about business. Whether it's private equity taking

Dr. Mark Hyman
over health care practices and emergency rooms or whether it's, you know, just pharma controlling

Dr. Mark Hyman
policy and influencing medical education or whether it's lack of of a real accountability and transparency in health care and medicine, you know, you you've been really outspoken about these things that

Dr. Mark Hyman
we've kept quiet about for a long time as doctors. And you have, you know, quite a

Dr. Mark Hyman
pedigree. And, you know, it means a lot coming from you. I mean, I'm just a heretic on the margins and a little fringe doctor, but you're on RD, a real doctor.

Dr. Mark Hyman
I

Dr. Mark Hyman
just play one on TV. And, and I think that, although I do see patients, but I'm kinda kidding.

Dr. Marty Makary
Yeah. You're big

Dr. Mark Hyman
but I I really am so excited about your work about your new book, blind spots. It's a great book. When medicine gets it wrong and what it means for our health and your other books, which I think are also very compelling and and touch on areas that are also quite concerning for me, which is really the lack of accountability and transparency in medicine. It's called unaccountable where hospitals won't tell you in how transparency can revolutionize health care and another book you wrote called the price we pay. What broke American health care and how to fix them.

I mean, why are we spending twice as much as any other nation getting half the results. So, I'd love to kinda hear how you went from being like a, you know, revered surgeon at Johns Hopkins where the sort of the birthplace of modern medicine with William Olser to kinda calling calling out what's really wrong with the system.

Dr. Marty Makary
Well, it's great to see you, Mark. You know, I think I it hit me at a certain point. I went as far as you can go in academic medicine, all the regalia, all the societies and honors and promotion and tenure. And it hits you at a certain point. I don't know if it's after I wrote 200 scientific articles or 250, but you realize no one's reading these things.

Yeah. The system is so broke And the problem is we have a lot of smart people in a system where they're just collecting their paycheck every 2 weeks, putting their head down. This shouldn't be. This should, you know, this isn't right. And we feel like we're cogs in the wheel, And people are afraid to get off the hamster wheel, take risks, and call things out.

So in the book, the price we pay, we, my research team brought attention to this issue of price gouging and predatory billing, which is the term we called these kind of crazy bills that get thrown at people, they want a price that are not giving a price. And it ruins lives. And now we have this massive trust problem where some 62% of Americans say they have avoided care or delayed care for fear of the bill. Yeah. So you can have the cure for pancreas cancer now, but if 62% of the population, it doesn't trust you, that pills only 38% effective, not a 100% effective.

Dr. Mark Hyman
No. It's true. I mean, I I literally had direct experience. I had any issues, so I needed an MRI. And I went to Chinatown, New York City.

I got one for 400 bucks. Had to get one in, in Berkshire and and where I live in the Massachusetts. And and it was 25100 bucks for the same MRI, same machine. I just went and had back surgery and had hyperbaric oxygen. I I went to this hospital and I said, I wanted to get it.

And I said, okay. But it's $5000 a session. Like, jeez. And I talked to the the head and everything goes well, if you do it this way, not through Medicare, and you do it through, you know, an off label use. It's a $175.

So, like, a 175, 5000 exactly the same procedure. How does that happen in medicine?

Dr. Marty Makary
Yes. Exactly. Right. So this is the game. I call it the game in the book, the price we pay.

And we found that the game is designed to maximize profits. It's not designed to be honest with patients. And so, the book actually led to some real legislation and an executive order from the White House that was entirely bipartisan that now requires hospitals to start posting cash prices for common shoppable services. And the secret insurance discount, that the insurance companies have with hospitals

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Will all be public. All of that is gonna start to happen this year. And, that is because we felt firmly, like, we gotta do something.

Dr. Mark Hyman
All the doctors lobbying organizations out there are just fighting for

Dr. Marty Makary
more money for doctors. And that's the common trade association thing. Yeah. That's not bad. That's what I'm saying.

You know, we're not getting cut on Medicare, but this health care system is more than just fighting for more money for your own special interest.

Dr. Mark Hyman
And yet and yet the average consumer is kind of just, you know, at the effect of all this and has no power and they cost our escalating and, you know, we spend so much money in health care and we're getting less and less and the outcomes are worse and worse. And we don't have in line incentives. And so It's kind of kind of messed up. You know, I I I think you you also, talk about in your book blind spots some really interesting things that that, we screwed up in medicine or things that we're not looking at. And, you know, when I remember I gave a lecture at Cleveland Clinic, once, and it was it was just a whole audience of, you know, doctors and scientists.

And it was it sort of gave some case presentations, and I presented a case around autism that I treated where we really helped to reverse the case using very intensive lifestyle dietary changes fixing the microbiome, which was as an issue for 98% of these kids have really screwed up guts. And he says, well, you know, you know, this is just an anecdote and, you know, where's the evidence? And I'm like, this I said, look, you know, can you help me explain how the microbiome affects almost all known health from heart disease to cancer, diabetes, to dementia, to autism, to allergies, to immunity, to depression, add to eczema, to asthma, and if I'm allergic to chronic I mean, I literally could go on forever. Right? How can you explain that with your current set of facts and theories.

Like, boy, it can't. Like, so when you have a set of facts that present themselves to you when the science changes, you have to change your thinking and your practice yet. We don't do that. It's just so evident to me that despite knowing now that so many of our diet, our disease are diet related or there's so many related to the microbiome, which is controlled by our diet, or that so many diseases are related to environmental toxins. Doctors don't learn about this.

They don't put it in their practice, and it's sort of this this kind of blind spot. Can you kinda talk about who came up with this idea of blind spots and why the microbiome is such a blind spot and we'll get into more of them?

Dr. Marty Makary
You know, maybe we need to be treating more diabetes with cooking classes instead of just throwing insulin at people. We have the most over medicated generation in the history of the world. Right? And so we can keep treating high blood pressure with first line after second line, or we can start talking about sleep quality and stress management. And this is the new movement now in medicine.

It's a real tension. To address these giant blind spots. The microbiome is one of them. Food, medicine, general body inflammation, all the stuff that you've been teaching the public and the medical community about for a long time now. The microbiome may be this central organ health but it has no center at the NIH.

There's a little tiny unit, and I talked to the person who runs it and they're massively underfunded. Right. But the microbiome trains the immune system, digests food, produces vitamins, it's involved in mood because some of the bacteria produce serotonin. It even regulates estrogen, it deconjugates estrogen into an active form. And so

Dr. Mark Hyman
you sound like a functional medicine doc there, Marty.

Dr. Marty Makary
I think hard. I wanna be one, but, know, I don't have the expertise on which foods, vitamins, but what I'm interested in as almost a a journalist within the medical profession is we have new exciting research that relates to every disease process, every specialty and it gets almost no attention. Yeah. And, this one study by the Mayo Clinic, I think maybe the most significant study the last 10 years, in my opinion, that got almost no attention. They looked at 14,000 kids and compared kids who got antibiotics in the 1st couple years of life compared to kids who did not.

Dr. Mark Hyman
Yes.

Dr. Marty Makary
And the kids who got antibiotics in the 1st few years of life went on to have higher rates of chronic diseases. They had a 20% higher rate of obesity, a 21% higher rate of learning disabilities.

Dr. Mark Hyman
Mhmm.

Dr. Marty Makary
A 32% higher rate of attention deficit disorder. All these things are on their eyes. 90% higher rate of asthma Almost a 300% increase in celiac disease. Yep. All these diseases are going up.

We're messing up the microbiome. That was the mechanism believed to the end, which how the antibiotics worked. To induce the increased risk of these diseases. And how can you look at that and say, yeah. No.

No. Let's ignore that. There's nothing there. We may have

Dr. Mark Hyman
because there's no pill, Marty, to fix it. There's no. There's no statin for the microbiome.

Dr. Marty Makary
No pharma company CEO gets rich. But it's amazing now. The research on the microbiome

Dr. Mark Hyman
is is blowing me away. And they published this study in the Mayo Clinic

Dr. Marty Makary
seatings, which is in our world of research. It's a little bit of a flag that no one else would take it.

Dr. Mark Hyman
Right.

Dr. Marty Makary
I think it's probably the most important, significant study in the last 10 years.

Dr. Mark Hyman
Wow. Okay. Tell us about it.

Dr. Marty Makary
So, I mean, I mean, the fact that you have all these chronic diseases. I mean, We all the stuff, all the stuff that is increasing attention deficit disorder, learning disabilities, we scratch our heads. People come in and we diagnose them with celiac. And they say, doc, how could this possibly happen? And we come up with some non answer.

Like, well, it's unknown or, you

Dr. Mark Hyman
know, genetic. Genetic.

Dr. Marty Makary
And no. We have I mean, there's a study here telling us 300% increased risk when you alter the microbiome with antibiotics early in life. And it's other things that see sections, it's ultra processed foods. It's high refined carbohydrates. So we have yet to really understand what's going on here.

The rise in colon cancer and young healthy people.

Dr. Mark Hyman
Right.

Dr. Marty Makary
Turns out that there's an association with the microbiome. There's, an association with polyps and antibiotic use. There's an association with c section delivery being born by c section and going on to have a colon cancer before age fifty was an association just published in JAMA surgery. So you have this incredible body of literature emerging on this central organ system that is highly actionable that we can talk about that we can study. And it kinda lives in this corner because What specialty is it?

And what NIH center is it? Is it infectious diseases? GI? Is it oncology? Is it primary care?

Is it functional medicine? And it has no home because we've created these Right. Silos. Right?

Dr. Mark Hyman
Well, that's really the fundamental issue with medicine, right, is this is the sub specialization, the specialization that dividing the body into parts and geography and specialization based on that, but it has no scientific rationale. Like, when you actually look at how the body is truly organized as one integrated ecosystem. And it's not a bunch of separate different parts that have no relation to one another. They're all doing

Dr. Marty Makary
It's so connected. It's it's, yeah,

Dr. Mark Hyman
and it's it's really connected. And and the microbiome isn't is, I would say, the best example of that. And in in the functional medicine world, it's always been the place we start. When anybody comes in with almost anything, we get optimized or nutrition and we fix their gut. Now when I say fix the gut, most traditional doctors, well, I don't know what you mean.

Like, take a laxative. You're constipated take mo a modem if you have diarrhea, if you have a parasite, take a drug. Like, people don't know in the medical world how to optimize the microbiome. That's why it's ignored.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
It's not taught. It's people don't understand how to regulate it, and it's possible. And it's doable. And that's what we do every day in functional medicine.

Dr. Marty Makary
It's inherited the microbiome. So you pass on the skeleton of the microbiome to, offspring antibiotics and C section save lives. We've we've both seen that. Yeah. But they're massively overused, and they're messing up the microbiome in ways.

We don't even appreciate and people are being given options without really knowing what is potentially happening because of this. Now I don't know what causes autism. Other smarter people may have ideas. But the researchers that did this study, and they're not no name researchers. Talking to Marty Blazer, who I think is the world expert

Dr. Mark Hyman
on micro on the

Dr. Mark Hyman
micro mouse.

Dr. Marty Makary
Missing microbes. Great book. He, told me that while there they did not find an association with altering the microbiome and autism, they believe there is an association there. They think maybe they haven't sampled enough children or something. Now I don't know if he's right, but if he's right, that is a massive signal in the data that we should be following.

Dr. Mark Hyman
Well, I

Dr. Mark Hyman
know it's true. I mean, it's not it's not surprising. When you look at the data on autism, almost all the kids have some kind of gut issue. They have bloating. They have distension.

They have sticky smelly poops.

Dr. Marty Makary
Really? I did not Yeah.

Dr. Mark Hyman
It's it's it's really common. I mean, it's it's really out there, and and it's in the literature. And I can tell you if you talk to parents with kids with autism, they all have gut issues. And it's not, and it was sort of a it's not a a sort of a kind of a a sort of a red herring finding. It's a core finding.

And and about 75% have altered immune systems and inflammation. And if you look at the brain of kids with autism, they're bigger on MRI. This is worked on by Martha Herbert at at Harvard. And and there's also, if you look at kids who've died from from accident or something who had autism, their brains are all full of inflammation. They're microglia just which is the immune system of the brain are all just on fire.

And when you look at the history and I've treated many, many, many dozens of kids with autism over the years, the stories are almost sort of universally similar. The kids you know, have borne by C section. They're not breast fed. They get lots of colic.

Dr. Mark Hyman
They

Dr. Mark Hyman
get antibiotics. They got eczema. They get earaches. They it's like and then they get piled down with tons of vaccines. Not saying vaccines cause autism, but, like, It's just a lot for these kids' immune systems, and then something flips.

Dr. Marty Makary
I I'm chuckling a little bit. I mean, I love what you're saying, but I'm chuckling because I, had this kid come in a teenager who had the classic, sort of irritable bowel, lip chronic abdominal pain, no one knows what it is, has had a 1,000,000 tests done. It doesn't show anything definitive. And I decided to take a lot of time. It was something we're not incentivized.

Do. It took a lot of time.

Dr. Mark Hyman
I mean, you took more than 8 minutes with

Dr. Marty Makary
the patient. I listened to the patient. I didn't look at the EHR. And it turns out that the kid hit that had that same profile. Born by C section, constant antibiotics unnecessarily, it sounded like throughout their early childhood, especially in the 1st 3 years when the microbiome is being formed and had eaten terrible food their whole life.

And then the mom tells me this, you know, this condition, which we just give this diagnosis of irritable bowel, how could this possibly happen to my son? Well, you know, we I don't I wasn't there when you got all these choices, but you've also been feeding the kids shit for the last 12 years. And and so we're shocked. And then we have this massive whack a mole at medical industrial system that's gonna order millions of tests and put the kid on some kind of IVIG or some kind of Keytruda. Yeah.

It's like Yeah. Can we talk about root causes?

Dr. Mark Hyman
Root cause. Exactly. You know, I was I was in the intellectual problem. I mean, I I gave a lecture about 500 people on Aspen Institute last week. And I asked talking about something, I think, similar to this.

I said, how many of you in the audience have never had antibiotics and not a single person raise their hand? Right? So and if you look at, for example, there's work done on Bifidobacterium and Fantis, which is a really key important keystone species that proliferates in an infant is supposed to be there, but if the mother's taking antibiotics, it will it's very sensitive. It will get wiped out. And this is important for the development of immun tolerance for the allergy, autoimmunity, eczema, inflammation, asthma, all these conditions.

And and there's actually a company that's been funded. I think 100 of 1,000,000 of dollars called it. I think it's, even in the company about the product, Vivo, e v ivo, and it's basically a baby probiotic that you can give to the baby. And the thing that's unique about it is that it colonizes because when you take any probiotics as an owl, they don't really stay. They kinda go through.

They they have an impact, but it's like tourists going through an economy. This is actually building a house. Yeah. And it's it's quite amazing how it prevents a lot of these conditions.

Dr. Marty Makary
So that's what we need research on.

Dr. Mark Hyman
There's a lot.

Dr. Marty Makary
The the thing is that there's

Dr. Mark Hyman
a lot, like, if you if you Yeah. You know, this is we won't practice any faith medicine. Like, have you looked at the evidence? There's like 10,000,000 articles on pubmed. Have you actually read all of them and you actually know what you're talking about because this this sort of veil of evidence based medicine often is a sort of a smokescreen for people not knowing, all the data and saying it it just because they don't know it.

It means it's not true. And I think that's unfortunate because they're like you said, when you start to look at the research of the microbiome, you found so much.

Dr. Marty Makary
I saw a trial in China where they're treating autism with, combination of bacteria therapy or basically probiotics. Fecal transplants and Shepherd Pratt with affiliated with my hospital, John Hopkins, is doing a trial with probiotics and bipolar to treat bipolar. So it's like, this is, you know, we how much have we spent on cancer? And we what have we gotten for it? Almost nothing.

Yeah. The ROI is almost 0. I mean, the top paper at ASCO, the cancer meeting, was like, oh, if we use Avastin for GBM of the brain, you can get another

Dr. Mark Hyman
Couple months.

Dr. Marty Makary
Couple months. No added cure. Right? So, anyway, I I love what you're saying a 100%. So so I wanna go into, like,

Dr. Mark Hyman
a a a kind of

Dr. Mark Hyman
related by the little bit of a touchy subject, which is the subject of vaccines. And it's one of those subjects that is so confusing to me as a doctor as a scientist because Science is about asking questions.

Dr. Marty Makary
They can't ask questions about it.

Dr. Mark Hyman
It's about having hypothesis and proving it negative. Right? That's kind of the

Dr. Mark Hyman
basic scientific method. And if you question

Dr. Mark Hyman
anything at all, about any vaccine. You're immediately able to be an anti vaxxer. And you can't say, well, is this vaccine safe? Is that vaccine safe? What are the risks and and benefits of each one individually?

What about them combined? And and and it's it's just the weirdest thing. It's like, heresy. And I experienced this personally, like a Cleveland Clinic when I was there, somehow I I because I I people thought I was an anti vaxxer, they they the pediatric department, like, very upset.

Dr. Marty Makary
Get that label.

Dr. Mark Hyman
And and and and I literally had to write a letter like, no. I'm not. I've been vaccinated. My kids are vaccinated, but it's important to actually ask questions about this because if there's signal somewhere that there's an issue, we should look at it and And you wrote a very, a very courageous paper that was published, that you coauthored in in it was published in, journal medical ethics, and it was talking about whether or not we should be giving vaccine boosters to young adults going back to school. And you basically said that in a survey of all the data, I'll let you unpack it, but the punch line was that the risk of getting it was worse than the risk of not getting it.

And and, I wonder, 1, can you tell us about that study? And, 2, what has been the reaction? And have you been now labeled in any vaccine?

Dr. Marty Makary
Yeah. Sure. Okay. I've gotten that label a little bit for, questioning the booster vaccine in young healthy people, especially who have already had COVID. The question is with the vaccine booster in young healthy people, is there a benefit And there was so much controversy.

And I saw how at the FDA, it was pushed in with the political might of, you know, a top down order that it, made me ask some questions. 2 the 2 top vaccine experts that the FDA were fired directly fired, by their superior for questioning the COVID vaccine approval for young, healthy people. That is the booster, the booster, not the original. So the CDC never released the data. And only data we had was observational.

The clinical trial data on the booster, it was basically just reamed through. They didn't go through the normal process. So then when you look at the risk of myocarditis, not to mention the other claims that are out there of people being messed up or injured or not the same after the vaccine, again, high risk people early in the, pandemic, it was very clear. The the benefits outweigh the risks. But when you get down to young, a young healthy twelve year old girl, does she really need 6 COVID vaccine doses in 3 years?

Dr. Mark Hyman
We basically said

Dr. Mark Hyman
Well, yes, because the journey needs to make a profit.

Dr. Marty Makary
Well, they they weren't too happy with me. Moderna,

Dr. Mark Hyman
constantly has

Dr. Marty Makary
people at their company trying to reach out to me. Yeah. And, so the what is the risk of myocarditis of the COVID vaccine in a young health of the COVID booster in a young health person. I I ask that every time I'm engaged on this topic with someone who's like, how dare you not support the vaccination with the COVID booster in young, healthy people? What is that risk of my record?

I just It's 1 in 22100 to 1 in 28100. Heart injury from myocarditis. One person in a study of about, 2000 died in an ICU. Come off. 22 others were admitted to an ICU.

The New England journal. This is New England Journal. It's not like I'm making. So on a societal level, is there a net benefit or a net harm to giving the COVID booster to a young healthy population? It would it's a net harm.

If we actually do the math, It's in that harm. Very small harm, but to mandate it, to force, you're gonna create never vaxxers by doing that.

Dr. Mark Hyman
Right.

Dr. Mark Hyman
I mean,

Dr. Mark Hyman
in your in your study, you basically could have, like, over forty thousand people, young adults, so and found you to prevent one COVID hospitalization. You would have to trade that for 18.5 serious adverse events from the mRNA vaccines, including the, myo and pericardotis.

Dr. Marty Makary
We don't even have that hospitalization. That's based on data where we don't know if the hospitalization is for COVID or with an incidental COVID positive test.

Dr. Mark Hyman
Yeah. But you're talking about, like, you have to vaccinate, you know, 40,000 people to prevent one hospitalization, but you get 18 serious centers. You

Dr. Marty Makary
gotta burn the village to save it.

Dr. Mark Hyman
That's the problem. And so what's been the reaction to this this this article that you published and to this view? Because it's it's like you can't have this conversation. It's like you you're not allowed to have this conversation in medicine. And so how how Have you been able to still have a position at Johns Hopkins?

Dr. Marty Makary
They've been great, actually. Hopkins, the school of medicine has been terrific. My Dean, asked me to present to all the other department leaders. Along with 1 or 2 other infectious diseases, experts. And my Dean said, I know you have a slightly different perspective on COVID and the vaccine booster in young healthy people.

So I'd like the the department leaders at

Dr. Mark Hyman
Johns Hopkins to hear both perspectives, and we had a wonderful dialogue. I mean, I've been I've been active there as a surgeon and public health researcher for over

Dr. Marty Makary
20 years before COVID. So they knew you were in a nut job. Yeah. They knew I'm a reasonable guy, and I work hard. And I mean well, and I love this country.

So I didn't get that kind of anonymity based accusations you see on Twitter. To

Dr. Mark Hyman
convince them?

Dr. Marty Makary
I don't know. You know, you have people privately come up all the time to me. I don't know if you had this happen. We're like, Marty, I love what you're saying. I love you.

Keep going. I can't say anything, but you keeps that's perfect.

Dr. Mark Hyman
Right. Right.

Dr. Mark Hyman
I'm like,

Dr. Marty Makary
what are you afraid of? You know, too many people are afraid of speaking up. It's still happening in so many years

Dr. Mark Hyman
of medicine. Like, I do. I was like, how many doctors I raise in an audience? How many doctors here take, neck vitamins and, like, almost everybody raise their hand? How many doctors recommended their patients and, like, you know, half the hands go down?

So, exactly. Alright. You know, the other thing you talk about, you know, this whole idea of of of, the GLP 1 agonist. And they've been around for a while. Some of them were than others.

And, you know, we're we're in this moment where we are in a metabolic crisis in America. 93% have poor metabolic health, which means they have some degree of insulin resistance, pre diabetes on the spectrum, even if they're normal weight, because they eat too much crap and sugar and ultra processed food, you know, 42% are obese. And and these drugs seem like a panacea. Wow. This is a miracle drug.

Get this shot once a week and, like, lose weight and everything's gonna be great. I'd love to hear your thoughts on on this perspective of of kind of widespread use, Medicare coverage you're talking about, ensures covering it. You know, there's a new study after a new study coming out, and I just wanna give a little little background on this, showing that and and here's my belief. And I don't I don't really have any evidence back it up, but it's like, I see a new study almost every day about the benefits of of these GLP 1 agonists coming out in major journals. It works for heart disease.

It works for depression. It works for this. It works for that. You know, it seemed like everything. You know, in my head, I'm, like, thinking, is it the GLP 1 agonist or is the weight loss?

Right? And in in in in a bariatric surgery study, they they looked at, for example, what the difference was because, you know, bariatric surgery can cure diabetes in 2 weeks. And they basically did bariatric surgery in one group and then No biometric surgery on the other group, but they fed an exact same diet that the bariatric surgery group ate. They also reversed her diabetes in 2 weeks. No difference.

Dr. Marty Makary
Yeah. Sometimes out of the operating room, in the recovery room, we noticed the requirements go down. Right.

Dr. Mark Hyman
Right. But but but I'm saying it's even without the surgery Without

Dr. Marty Makary
the surgery.

Dr. Mark Hyman
So so is it the GLP 1 or is the weight loss? And and there was a a guy who met recently named Sammy who started coming called Verta Health, which uses ketogenic guides to reverse diabetes. And he said they they've actually done the study where they've actually looked at this, and they found it wasn't really the GLP 1. It was just the weight loss and the improvement in metabolic health as a result of it. So I'd I'd love to hear your perspective on that because You know, it's hard to to learn how to eat right, and it's hard to how to do it.

And and, yes, everyone wants that easy fix. And the news is appropriate for some patients, but, you know, I know people who wanna lose £10 for the bikini, and I'm, like, thinking this is a good idea. So can you tell us your perspective on that?

Dr. Marty Makary
Well, one thing that that is a theme in blind spots and a theme in in the research I learned was that if somebody put something out there with such absolutism, when the scientific evidence is really inconclusive or there's a lot of opinion, We just don't know what the long term effects of GLP 1 are. For example, they just haven't been around long enough. How can you say with such absolutives and that there's no long term downside? We may see a benefit in the short term with some of these chronic diseases. But we may be accelerating frailty, which is basically

Dr. Mark Hyman
Loss of muscle mass.

Dr. Marty Makary
Loss of muscle mass. And that is, as you know, the number one predictor of longevity is muscle mass. And that's why we want people to be active when they're older. So, We we don't have that data and people are acting as if it didn't matter. It'll go the way we want it to go.

There are bacteria in the microbiome that produce GLP 1. Yeah. And maybe we should be talking more about Probiotic. Having a a very healthy yeah. Maybe we you already make some.

So it's like, how can we not crush that? We're on a path of having every eight year old in America on 3 or 4 medications. It's scary.

Dr. Mark Hyman
Maybe their children or when they're adults?

Dr. Marty Makary
When they're children. Yeah. I mean, already half of America are taking chronic medications and the average number is 4. Once you get over 65, it's like you gotta have these boxes to remember what to take. And, look, medication save lives.

You and I have seen that. That's that's part of the medicine we're trained in. But We're gonna convert America's children into a generation of patients. Maybe we need to talk more about school lunch programs than putting every kid on Ozempic. And that is not a conversation that we're having.

We're just sort of celebrating Hey. Highfive. We found a way to, you know, create a GLP 1 agonist. We'll see about these new generation GLP 1 drugs that have a blocker on the muscle receptor supposedly. They're gonna they're gonna enter clinical trial soon.

Yeah. But I So to prevent the muscle loss. To to, yeah, prevent it or reduce it. Maybe, and I I I believe in impeccable objectivity changing positions as the data evolves. Right now, I have serious concerns about just giving out GLP ones like candy.

First side effects.

Dr. Mark Hyman
Why is there just beyond the muscle loss?

Dr. Marty Makary
The acceleration of frailty, the muscle loss, there some people don't do well with the profound loss of muscle. So, you know, there have been studies that have looked at weight. And it turns out that fluctuating weight all the time is worse for

Dr. Mark Hyman
you than staying overweight.

Dr. Marty Makary
That's right. That's right. So are people gonna be I'm doing better now, and I don't need it. I need. I'm going on this vacation.

I'm coming back. It's like, that's not that's not good medicine.

Dr. Mark Hyman
No. And I and I I don't have, that many patients on these jpy 1 agonists, but you know, I'm seeing side effects. Like, 1% pancreatitis the other day.

Dr. Marty Makary
Yeah. No one side effects.

Dr. Mark Hyman
And

Dr. Mark Hyman
this is a 900% increase in the risk of pain. I mean, I never see pancreatitis unless you have somebody with a serious problem. And see from a drug like this, it's very concerning. That's you're a pancreas surgeon. So you get on point of the pancreas.

Dr. Mark Hyman
I love

Dr. Marty Makary
the pancreas.

Dr. Mark Hyman
You love the pancreas. So this is is is concerning to me. And I think, the perverse incentives in medicine are driving this kind of crazy trend. Yeah. And and in in your book, you also talk about sort of the the blind spot around around the way we do research and the profit motive in research.

And I I, you know, when I entered medical school, I thought science was this sort of ethereal thing, which

Dr. Mark Hyman
was pure and independent and and completely

Dr. Mark Hyman
objective and just, like, you know, just had this kind of halo around it. And what I realized is that science is really freaking corrupt and that, that and and then what I was at a as a a passover dinner with my with my, one of my cousins and their husband. I was like, what do you do? And he's like, well, you know, I I I I I am a I'm a contract research organization a run contract. I'm like, oh, really, what's that?

He says, well, that's where pharma companies pay us to find experts in different domains and then fund the drug studies, do the studies, write the paper And then we pay them to put their name on it.

Dr. Marty Makary
Like a super pack.

Dr. Mark Hyman
Yeah. And I'm like, really? Leaving this is not right. Corruption. It's so cro can you so can you speak to that in in this and the challenges around around the the sort of the peer review process, the weaknesses in that, the the how do we address this whole phenomena?

Because it's, you know, it's it's, there's so much conflict of interest in medicine, and it leads to, like, the massive funding. So for example, if the amount of money It was now going into GLP 1 research. We're going into food as medicine research. Right? We would be showing phenomenal outcomes if we did the right kind of research.

Right? So how do we how do we deal with this?

Dr. Marty Makary
I do think everyone that goes into medicine is going in it for amazing reasons. And one thing that unites everybody in medicine is everyone has a sense of compassion that drew us into this calling. So we've got good people, but we walk into a bad system, and it's not a system we design. It's system we inherited, but we shouldn't defend it. It's entirely broken.

We have a bloated NIH that funds

Dr. Mark Hyman
research worse than the government

Dr. Marty Makary
funds, the postal service. We have silos. Pretty bad. We have there's a small group of people making all the decisions. At the very top, these are folks where we need term limits, the folks where they decide what's important or not important, and it's based on their understanding of the world.

Medical school education at every school in the United States is controlled by nineteen people that serve on the board of a private company that determines the curriculum of every medical school in the country. And if you wanna do something creative, talk about food or inflammation, You gotta get back

Dr. Mark Hyman
to mind. Company that's that creates the licensing exam, or is this

Dr. Marty Makary
Double AMC, they run, yeah, the US Emily. Yeah. And so these, you know, I've talked to Dean's of medical schools that have said, Marty, I'd love to talk about this stuff. All this stuff you talk about, all these stuff that are in the blind spots, modern medicine, and they say, we can't because the students know exactly what their learning objectives are for the boards. Yep.

And if we teach something else, they're gonna skip that class and I'm gonna focus on memorizing and regurgitating the 55 enzyme names they have to spit on on an exam. Why are we forcing our youngest, brightest, creative, most altruistic minds? To regurgitate the names of enzymes that you can look up on a smartphone.

Dr. Mark Hyman
Right. Right.

Dr. Marty Makary
And so we have this system now where a small group of people are controlling medical education, a small group of people control where the NIH dollars go. And who are funding the big questions central to health? For example, there's a new practice that's taking off of cutting the tongue under infraenulum.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
The friendulum under the tongue. Sometimes they'll even do the side of the tongue or the friendulum under the inside of the upper lip. Sounds it's crazy to me. I have ENT docs that say there's a subset of kids that may benefit from

Dr. Mark Hyman
the rounded tongue tied, like fully tongue tied.

Dr. Marty Makary
If it's truly a foreshortened tongue, they believe there's there could be a benefit. It's never been proven, but they do believe there's clinical benefit. But then they say going to the upper lip and the side is crazy. They also say we need a good study on it. Well, there's a group of people out there that are calling every kid tongue tied, doing it routinely.

Who's gonna this desperately needs a randomized control trial. Who's gonna fund it? Pharma, no way, NIH, not one of their silos, American Academy of Pediatrics, unlikely. And so this practice will

Dr. Mark Hyman
go on. Freemium fenulum cutting.

Dr. Marty Makary
May maybe sometimes it is the advocacy groups, the philanthropists that fund research. Most of our research at Johns Hopkins on my team, which is it's a we call it the redesign of health care. It's on All the major topics in medicine that we are not talking about that we should be talking about. And we our rapid response team, when the opioid epidemic hits, we go to work in days. When COVID hits, we go to work in days.

The old NIH, you know, take a couple years, work on formatting a grant. They're funding these tiny incremental little I don't even call them discoveries, like findings, Yeah. Like, is it interesting what the average size of stones are on the street? No. Is it research?

I guess. Yeah. But we're funding these little dumb things, and then the big questions go unfunded. So we think the solution is philanthropic funding, reorganizing the NIH, term limits at the NIH, and a small

Dr. Mark Hyman
For the for the director of the NIH?

Dr. Marty Makary
Or For all, all people who are in decision making leadership, power over grants at the NIH. And grants, I, my opinion, when I say, we, these are my opinions, the grant should be funded when one reviewer loves the idea and then it goes into a pool and you could give out the grants randomly to when one person thinks that's a big idea that could be interesting, why do you have to have a consensus among the old guard establishment that, yes, we're gonna fund another study on stents.

Dr. Mark Hyman
And there's unconscious bias. You know, like, I I was talking to Francis College, who's a wonderful man. Really kind, good, harded man, brilliant guy, you know, who is the director of an age. And I said to him, and I I think I've talked about some podcast before. I said, Why didn't you use COVID to educate the American public about the importance of nutrition in optimizing your health to prevent COVID?

Because 63% of the hospitalizations in deaths from COVID were because of poor diet. Yeah. And we know that we are 4% of the population in the world and 16% of the cases in deaths. He's like, oh, well, we couldn't do that because it would basically blame the victim, and we don't wanna do that. And in another meeting, I was like, no, it's not their fault.

It's it's just because we have a toxic food system. Right. Talk about that as the and and then at another meeting, he got up and said, well, there's no we don't really know that much about nutrition, and there's no national and student nutrition at at the NIH. And many other countries have this, and nutrition is the biggest cause of all the diseases we see today. Period.

Like, no argument. All the science says this.

Dr. Marty Makary
Yes.

Dr. Mark Hyman
And I and and and he got up and said, we don't really know much, and there's not much data. And at the same meeting, doctor Dardis Mazafarian was there, who's the, was the dean of the Tufts School of Nutrition Science And Policy is now the head of Fuddhist Medicine Institute there. He said, well, like, for instance, Doctor Collins, I I beg to differ with you, and and then he went to this long, kind of, scientific unpacking of the literature that we do know.

Dr. Mark Hyman
You should

Dr. Mark Hyman
tell. I was like, wow. You know, it's it's it's not necessarily been, malevolence. Sometimes it's just, oh, ignorance. You know, but I'm like, wow.

Yeah. And and I also in terms of the the medical school stuff, it it you're right about the licensing exam, and I think one of the things we're working on in in Washington, my nonprofit called a food fix campaign, is to change the licey exams because that's what der term is a curriculum. And my my daughter's in medical now, and and I'm like, if you learn about this now, if you learn about the micro learning about the inflammation. Like, all the things that matter, she's not learning about. And she's all I know is that I have to pass the test, and I just have to study what's up for the test.

And that's it. Right. And I have the practice test. I have the questions, and I have Yep. And it's It's like if there was 5% of the questions on nutrition and chronic disease, that would force the change in the curriculum.

If there was 5% of the questions on the microbiome or on inflammation and health or in, like, any of these things

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
On mitochondrial function and how to treat mitochondrial. This is another black hole. Right?

Dr. Marty Makary
Yes. Yes.

Dr. Mark Hyman
Blind Spot. I don't know if you're talking about

Dr. Mark Hyman
that. Yeah.

Dr. Marty Makary
It's a big blind spot energy in micro mitochondrial. I mean, it's essential to connected, you know, sort of universal theory behind health is that there are these basic principles of mitochondrial health, inflammation, nutrients. We have such a nutrient poor diet. All the stuff you've been working on. But next time you see Francis Collins, you can remind him that the h in NIH stands for health.

Dr. Mark Hyman
I know. I said, and I said, that's what I say. We don't have nationals who are healthy. We have national institutes of diseases. That's right.

It's amazing. So how how do you think that that we can kind of reform the system besides just changing the term limits and besides, you know, do we get pharma money out? Do we do we try to sort of have special barriers that prevent them from manipulating the science and the papers. You know, I mean, it's like half the time what it says in the abstract isn't actually what it says in the data. Most people just read the abstract.

Like, there's all kinds of monkey business going

Dr. Mark Hyman
Yes.

Dr. Mark Hyman
Right? It's a rookie business.

Dr. Marty Makary
Yes. Well, I, first of all, I think we insist on rules of transparency for clinical trials. Number 2, if you're gonna opine about a topic, do a clinical trial. The amount of opining around topics that the NIH throws out there. Oh, we don't have good data on this.

Well, you control the $80,000,000,000 budget over there at NIH. We saw this all during COVID. All the COVID controversies could have been settled immediately by them doing the proper clinical or randomized control trial on that question. All those questions, masking toddlers, natural immunity, the booster 6 do the trial. You know, isn't spread airborne from or from touching services?

In the summer of 2026 months into COVID, the NIAad and Doctor Fauci sorry. I said something I shouldn't have said there. I mentioned his name. He was telling teachers. It's okay.

I mean, he's very some people love him.

Dr. Mark Hyman
Some people hate him. I try

Dr. Marty Makary
to be objective, but it's so he was telling teachers to wear gloves and goggles in class. Do the freaking study. If you think it's spread by service transmission and you don't believe it's airborne, do the study. You got the $80,000,000,000 budget at the NIH. So one is in he

Dr. Mark Hyman
actually admitted that. He says, I just made this stuff up. I just made up the 6 feet thing. I just made up the mass thing. Like, I just made this stuff up.

I'm like, wow. Okay. Well, thanks for telling us.

Dr. Marty Makary
I think one of the biggest propagators of mis information during the pandemic was the United States government itself. And it's not new, the food pyramid.

Dr. Mark Hyman
And And it wasn't just trump saying put, bleach in your veins. It was more than that.

Dr. Marty Makary
Yeah. I like that. Yeah.

Dr. Mark Hyman
It was the actual NII. It was the actual CDC.

Dr. Marty Makary
And it's not new. Peanut allergies, same thing we get people the wrong guidance. There's so many recommendations that, people should be able to ask questions. I'm not saying be cynical. I'm not saying don't trust your doctor, but people should be able to ask questions.

So if pharma does a study, Regardless if that study goes their way or not, we should get the results immediately. Okay. That is a basic new principle of transparency we need to adopt in the United States. When PACSlovid just as an example, the antiviral used, made by Pfizer to treat COVID. When that came out, the government recommended that for everyone.

They promoted. It was one of the biggest public health campaigns in the last year and after the pandemic. A study came out in the New England Journal of Medicine just a number of months ago that showed zero benefit in people under 65, none, zilch. The study now that's studies go different ways, and that's the way science is the but the study ended nearly 2 years prior. If you look at the actual tables, the results were the study was done.

Why did the public not see it

Dr. Mark Hyman
for nearly

Dr. Marty Makary
2 years? Because it didn't go their way. When the COVID vaccine booster goes their way, they tell you before anything's even published. Just a press release, and it's a CEC. Yeah.

Dr. Mark Hyman
Yeah. They got a full page eye in the New York Times.

Dr. Marty Makary
Yes. So this is the type of trial level transparency we need. Yeah. And we gotta do it now because otherwise, we need we need better funding and academics. We need more civil discourse in medicine.

We need less cancer culture.

Dr. Mark Hyman
Yeah. Yeah. It's so true. It's so true. You know, well, I'm just like, we totally agree on everything here.

One of the things that, shocked me that I found out, you know, because as a doctor, you think, okay. Well, the literature is published. It's it's they're publishing all the data on particular drug or particular intervention that they're that they're studying. And it turns out that that pharma has to present all their data to the FDA, but they don't have to publish all the data. And and typically, they only publish the positive data.

They don't publish any of the negative trial data.

Dr. Marty Makary
That's right.

Dr. Mark Hyman
And so the public has no clue that there's all these other studies that contradict the one study that showed there was positive, and the FDA is is a captured agency because it's like a revolving door for pharma and farmer leadership. And and so like, it was sort of shocking to me as I sort of even as a doctor that I found that sound like, what do you mean? They don't they don't publish all the data. Like, they just hide all the negative data.

Dr. Marty Makary
Yeah. You can do that. Yeah.

Dr. Mark Hyman
Yeah. And that's how it is. So Yeah. So for people listening, it's it's you know, you've gotta be smart on your own, and you've gotta be your own advocate, and you've gotta be proactive about your health, and you've gotta not just take things at face value, and you gotta do a little digging. And now with the AI, it's gonna be easier and easier with doctor to use to be Doctor Google, but

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
Not always right, but it's at least a good start. You know, one of the things y'alls talk about in your book was this whole idea of of blood tests that are not being ordered that everybody needs. And I thought that was really intriguing because I just cofounded a company called function health. To which is a health platform that allows you access to your own health data and lab testing without having to go through a doctor insurance company and you get, you know, for 4.99, you get over a 100 and 10 biomarkers would be $15,000 retail. And there's been huge consumer interest.

We're like 60,000 members in the 1st year. And we we had 10,000,000 biomarkers. Fascinating. And and it's and we're we're doing a lot of tests proactively. Now you and I know when went to medical school, we're like, only test to confirm a diagnosis that you've already made through history.

Right? Diagnosis history history history. And yet you're saying maybe we should be reconsidering this because there may be things that we can do proactively and practice more proactive preventive predictive medicine than reactive medicine. Can you tell us about what you're thinking there and what these tests are?

Dr. Marty Makary
Yeah. So, a buddy of mine will, just graduated from medical school at I don't know if I should say that in school, but it's in the south. And he basically, said he got 2 hours of, teaching on all of nutrition and cholesterol and lipoproteins, basically. And in those 2 hours, and he got 8 hours on a bunch of nonsense that he can't, you know, the disparity is unbelievable. The, 2 hours on nutrition, he said it would have been better not to have those 2 hours because there was so much misinformation in him.

All it was was He feels good. Yeah. Exactly. Oh, go forth. Preach to the world.

You know, check their total triglycerides. Turns out lipoprotein a and apoprotein b are very good predictors, at least better than the current old crude predictors.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Of people that have early heart disease looking for general body inflammation. The tests aren't great, but I get a highly selective C reactive protein. Said rate, not very good, but something. So trying to measure general body inflammation the deposition of the types of lipoproteins that result in that plaque buildup. And when you put that together Are

Dr. Mark Hyman
there lipoprotein fractionation?

Dr. Marty Makary
Yeah. Lipoprotein fractionation, the the high density particles, l p a.

Dr. Mark Hyman
So looking at the quality and number of the particles, not just the weight, which is what you got on a regular cholesterol test, which in my view should be banned.

Dr. Mark Hyman
It should yeah. It's such

Dr. Marty Makary
little useful information. It's misleading.

Dr. Mark Hyman
It is.

Dr. Marty Makary
Yeah. And when somebody has an early heart attack in their 40, or early fifties, and it shocks everybody. Sometimes we'll go back and get that test, and it turns out their LP little a was up or the APO protein was up, even though the other numbers showed that things were okay. Yeah. Next time somebody gets to set a lab test, I usually tell them, make sure that you've got that tested for at least once.

Lp at least once. It's a lot genetically driven. 99% of cholesterol is made by your own body. And so these are some basic things that people can test for. And I I'm really fascinated with the micronutrients and allergy testing, and I and that's something where you've got more expertise than I

Dr. Mark Hyman
do.

Dr. Mark Hyman
Yeah. Right. True. You mean you mean, like, true allergy IgE, or you mean like more food sensitivity testing?

Dr. Marty Makary
Food sensitivity because And nutritional testing. Nutritional testing because we've had this dogma from the American Academy of Pediatrics starting 24 years ago. That don't feed young kids, any peanut butter related, stuff, milk. Yeah. Eggs.

There was this 1, 2, 3 saying. You I don't know if you heard of this, like, your kids should get, milk at age 1. You can introduce a little bit of eggs at age two and then peanut butter at age three. Well, you got it so backwards. Yeah.

Peanut butter should get introduced a little bit, not in place of breast milk, but a little bit at age at 4 months, 5 months, 6 months. Soon as the kid can eat, there's the studies have even shown that 5 months prevents peanut allergies more than introducing it at 6 months, 4 more than 5, And so it there's a strong association with what we call oral tolerance. And that's what the American Academy of Pediatrics got perfectly backwards. When they told lactating and and pregnant mothers, total peanut abstinence for you and kids 0 through 3. They didn't prevent peanut allergies with that recommendation.

They cause them.

Dr. Mark Hyman
So we have evidence based medicine or other things we wanna say we prove, and we for the things we have no evidence on, we say that we say them with such authority that they they act like they have evidence, but they don't.

Dr. Mark Hyman
Well, that's the thing. If you're gonna

Dr. Marty Makary
put out a strong recommendation, others say, you know, this is based on just me shooting from the health care. I don't know. Or reverse it once the study comes out, showing that it was wrong with the same vigor that you put it out. When the study came out in the New England Journal 2015, what's that? 9 years ago, showing peanut avoidance causes an eightfold increase in peanut allergies.

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
Say, gosh, we got this so wrong as an academy. We need to tell the world. Instead, they kinda fade out, you know, get the low fat diet wrong for 60 years. It kinda fade out, you know. Get hormone replacement therapy wrong.

Just kinda fade out. Where's the humility?

Dr. Mark Hyman
Yeah. Yeah. Right? Oh, shoot. We got it wrong.

Like, let's let's make a call, like, let's let's set directly straight. Right. Yeah. It's crazy. And, you know, the test you mentioned, the the APO B

Dr. Mark Hyman
Mhmm.

Dr. Mark Hyman
Which is early measure of of small dense particles and all the bad particles that cause heart disease and LPA, which is a a marker that's genetic, but also is increased your risk. The particle size and the number of life approaching fractionation since high sensitive CRP. These are all tests that are just part of the standard function health profile. Yeah. And we also test all the nutritional stuff.

We're finding that 51% have abnormal APO B. We'd find that 4089 percent have abnormal lipoprotein particle size and number. We find that 46% have elevated CRP. This is in a health board population, and 67% have a deficiency in 1 or more nutrients.

Dr. Mark Hyman
And this is not at the

Dr. Mark Hyman
level that would be optimum for health, but the minimum to prevent a deficiency disease. So a ferritin of 16, not an optimal ferritin of 45, for example, or a vitamin d of 20, not, you know, of optimal vitamin d of 50. And and so we've been fighting this in the population and And so I'm a big advocate of of tests don't guess and of knowing your numbers and of actually being proactive about optimizing them because they may not cause an immediate issue, but, there was a a brilliant scientist, Robert Heaney, who who's an out of debt, who was a vitamin d researcher, and he wrote a article a long time ago called long latency deficiency diseases. And it was fascinating because he talked about, well, if you have, like, you know, acute you know, folate deficiency, you know, you'll get megaloblastic anemia, which is for Temanema. But if you have, like, low grade, like, low folate, you might get dementia.

Or if you have, like, you know, a little bit low on an optimum vitamin d, very low, you'll get rickets if it's acute deficiency, but if it's a little over your lifetime, you'll get osteoporosis, long latency, deficient disease. And he goes over nutrient like this. And it was it was fascinating to me to really change my thinking about being more proactive because you're optimizing the body's systems, and they all have to be functioning. And and it's it's amazing to me how many doctors don't even think about this, don't know about it, aren't educated about it. And, I mean, even asking my daughter, you learn about lipoprotein fractionation in medical school, which is, like, should be the goal standard.

I mean, I I mean Yes.

Dr. Marty Makary
I shouldn't

Dr. Mark Hyman
be telling these tales, but I was at Cleveland Clinic and there's a there's a doctor there who wonderful man, but he, you know, he's older and he throughout the executive health program. I don't think he's there anymore, but I met with him and I said, listen, you know, you should update the executive health program to include the life approaching fractionation. Yes.

Dr. Mark Hyman
Because there's a much better representation of cardiovascular. You have something with a normal perfectly normal cholesterol under 200. They're LDL under a 100. They're triglycerides normal.

Dr. Marty Makary
HTL looking

Dr. Mark Hyman
like 4550, everything looks great, but they could have the worst particle and and size and density that you could imagine and be at very high risk. And he's like, well, you know, we only like to introduce things after we have a lot of research. I say, well, This has been around for 40 years. I've been doing this test personally for 30 years. Yes.

Ronald Krause developed this at, you know.

Dr. Marty Makary
It's been around.

Dr. Mark Hyman
Yeah. And and he's one of the most brilliant lipidologists in the world. I'm like, you know, this is so slow to adopt actually the science into what we know. And and people are suffering because of it. And that's kinda why I think, you know, some of these things can be solved from the inside, but like you said, some of this has to be solved from the outside.

And we need, you know, we we need philanthropy. We need you know, better policy regulations. We need better, you know, reimbursement around medicine that pays for the things that actually work like food as medicine. You know, we, you know, we need to have companies from the outside changing things from the inside. So it's pretty it's it's it's kind of an exciting moment, but, like, you're like, know, like, you know, the wizard of Oz when the curtain gets pulled back, you're that guy.

Like, you're the guy pulling back the curtain and there's, like, this little old guy back there with no pants on. Yeah. And it's it's, it's quite amazing what you've done. Well, you know,

Dr. Marty Makary
I go around. I talked to so many experts. And I ask them, is there dogma in your field that is wrong or has been proven wrong or you believe is wrong, but it's still heralded out there as science when it's really just the way we it's been done. It's just sort of custom. And they start unloading and they start telling you things.

And actually, the lipidology community

Dr. Mark Hyman
has evolved entirely independent of the cardiology community. So the cardiologist kinda claimed lipid

Dr. Marty Makary
science at a certain point But the lipidology community is like, Hey, wait a minute. We've been studying this for a long time with hyperlipidemia, and they have very different views on things. So for example, lipoprotein a testing was recognized in the lipidology community of saving lives, as you mentioned. Yeah. But not in the cardiology community because all their tests just use the crude LDL.

Right. So I went to the, head of the cardiology lipid center at Hopkins, and I asked him. I said, I've been reading about LP a, Seems like it should be this subject of a massive universal public health campaign Yeah. To get everyone to get it done. It'd be a lot better than trying to get a defibrillator in every bathroom in the mall,

Dr. Mark Hyman
you know, which is actually

Dr. Marty Makary
a real campaign Hopkins chair champion. And so lives for sure, but Saves lives, but, like, here's something that's so that RTC is the number one cause of death. So he acknowledged. Yeah. There's some new research, and we we did put it in our new guidelines.

I'm like, you know what? It was I read those guidelines, American Casualty. It was a footnote. Yeah. Like, where's the enthusiasm?

Where's the vigor? Where's the it's just like molasses sometimes.

Dr. Mark Hyman
Yeah. Well, because there's no good drug for it. Right? I mean, there's platinum freezes. There's certain supplements at work.

Sometimes the piece, CSK inhibitors lowered a little bit.

Dr. Marty Makary
Yeah.

Dr. Mark Hyman
But it's it's, you know, it's it's a harder to treat problem. And and we're very, very cited about testing things for which we have great drugs because the pharmaceutical companies, you know, make it easy for us. They do all these studies. They kept their drug risks calm. They they have great commercials and tell the patients what to ask for

Dr. Mark Hyman
her. Yeah.

Dr. Marty Makary
There is a drug in phase 3 clinical trial. That this targets lipoprotein little a. So we'll see what the results of that show. But I wonder if, you know, those are the people you wanna just be more aggressive on, maybe. Yeah.

Totally. Track. Maybe you get the cardiac, CT angio on them instead of just the calcium score. You know, those are the ones. Well, with function health, we had a

Dr. Mark Hyman
young thirty five year old who did the test, and he had high APO B. He had high LPA. He had really horrible lipid particles. The rest of his cholesterol, normal cholesterol profile looked pretty good. And, you know, he was 35, and we sent him for a CCTA, but cor coronary your entry game with the with the CT scan, but we added the AI interpretation with a test call clearly.

I don't know if you've heard of this test. Have you? No. It's really amazing because you actually can see soft plaque inflamed plaque, not just calcified plaque, and you get a much better read on every artery. And Shot a plaque?

Dr. Marty Makary
But You found a plaque. Yeah.

Dr. Mark Hyman
And he

Dr. Mark Hyman
and, yeah, and this guy's 35, and he's headed for heart attack. And he had no clue because he was dandy, he's healthy, he's fit. He exercised. He's great. It's like some genetic thing going on.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
And and so, you know, we're often kind of walking into our futures without any idea of what we're heading into because, you know, we're not taking advantage of the latest science.

Dr. Mark Hyman
And and, I mean, I wrote a book like more than 20 years ago where I was talking about APO B and LPA

Dr. Mark Hyman
and CRP and testing insulin. Mean, insulin's another one of those tests. You know? Yeah. You know, thank god.

Quest now has a test. It's called the insulin resistance score, which uses mass spec to measure insulin C peptide, which is a I mean, your pancreas guy, I don't tell you, but it's a yeah. And telling your audience, it's it's it's the precursor of the insulin molecule. And and when you get this ratio, it it's as good as what we call uglycemic clamp test, which is the gold standard. It's a very invasive test that you do in the hospital for insulin resistance, but it's as good as that test.

And it's cheap and it's something umbrish you get because it is the biggest driver of cancer, heart disease, dementia, and and even it's linked to depression and fertility, acne, and a bunch of other stuff. Uh-huh. Even low sex drive and erectile dysfunction and, I mean, you name it. And that it nobody's doing that test.

Dr. Marty Makary
So I

Dr. Mark Hyman
I mean, I ask quest, like, how many people are getting lipoprotein fractionation, like, less than 1%. How how many people are testing insulin when they were doctors order insulin? It has less than 1% of our test. I'm like

Dr. Marty Makary
Tell them we don't need AI. We just need I. We just need some Oh my god. Yeah. Basic.

Dr. Mark Hyman
Well, I actually I I actually talked about this. I don't know if it's not right. Maybe in your wheelhouse, you can tell me, but, I've I've kinda come up with this new concept. What I call MI. And not MI like heart attack, but MI like medical intelligence.

Dr. Mark Hyman
Uh-huh.

Dr. Mark Hyman
Which is something we don't have. It it we have a single doctor that you rely on for his own experience, however smart they are, whatever they've learned, whatever course they went to, whatever school they went to, whatever residency they went to. Like, that's what you're getting. And and they haven't certainly read all of 10,000,000 papers on PubMed. They certainly haven't read every textbook and article about every disease and and you're and you're kinda relying on there and good will and intelligence and kindness to figure out what's going on.

And and, you know, we do a pretty good job most of the time, I would say. But, you know, I feel like we're entering this moment in health care where we're gonna be able to draw through technology, all the world's scientific literature that it consume every single textbook, you know, up to date, all the the latest met medical knowledge, patient reported data, all their lab data, all their omix, all their imaging, all their biosensors and wearables, all their medical history to track it over time, you know, when Lee or I could call this dense dynamic data clouds of information that give you personalized predictive models of where you're headed and what to do about it. To me, you know, having that be able to sort of inquire to that that that your own data set, about what what's really going on and see those patterns and correlations that, you know, the average doctor is gonna miss. I mean, would you rather have your dermatology exam by, you know, an AI, computer or by a dermatologist. Like, I went to a dermatologist and I'm a doctor.

I know I had a precancerous lesion, and and he completely missed it. And he was like the head of, you know, I don't know, dermatology, the major academic, you know, medical school. And I was like, I wanna go to the top guy and

Dr. Marty Makary
give it down professor and chairman.

Dr. Mark Hyman
And you, you know, he looked at me, like, turn me around, looked at his eyeballs. I'm like, no magnifying glass. No light. I'm like, goddamn. I'm no I know better than this.

I was like, And I was like, so walked out, so disappointed. And I'm like, you know, so what do you think of this idea? And could this really change things? Because then all of a sudden, all the things you're talking about will bubble up. Like, the the the the the pharma, and and the medical industrial complex won't be in charge anymore because you've got, you know, free access to data and information that's been locked away.

Dr. Marty Makary
I tell all our Johns Hopkins students and residents that what will make you a great doctor is knowing your limit It's your humility. It's saying, I don't know when that's the right answer. And that was the right answer during COVID a lot of times. We didn't hear it. And so when I talked to a pediatrician and asked them about peanut allergies, you'll have somebody who will just recite a catechism.

Well, according to the guideline of the American Academy, you know, somebody else will think independently and creatively, and they'll say, You know, there is a guideline out there, but there's this study, and I've heard doctors suggest this. And my this has been my experience. And I'm not sure, or this is what one mentor thinks. This is what that is a creative. That's a doctor you want.

Doctor who thinks independently and isn't just, you know, falling in line with some dictum that says everyone obey and and and get in place. When we, as a medical profession, have use good scientific studies to make broad health recommendations, we shine. We help a lot of people. But when we wing it, when there's broad health recommendations made by a small group of people who are just ruling on a on an opinion, and making it sound absolute like at scientific data, we have a terrible track record. We ignite epidemics.

We ignited the opioid epidemic saying opioids were non addictive.

Dr. Mark Hyman
Yeah. Pain is the 5th vital sign.

Dr. Marty Makary
Pain is the 5th vital sign. These are manufactured peanut allergy epidemic, you go down and down the down the line. Even you could argue the low fat contributed to obesity rates,

Dr. Mark Hyman
the low fat. I'm not gonna argue that. I think that's pretty much a fact. Yeah. That's you

Dr. Marty Makary
don't need AI. Just die for that.

Dr. Mark Hyman
Yeah. No. It's true. And and and then we stuck and don't wanna say that we made a mistake either.

Dr. Marty Makary
That's the key. That's the key. And patients are very forgiving if you're honest

Dr. Mark Hyman
Yeah.

Dr. Marty Makary
In real time. Yeah.

Dr. Mark Hyman
I was talking to a friend about that about that. You know, if you're a doctor and you're telling the patient the truth and you say, I don't know or I fucked up, Like, they're less likely to sue you.

Dr. Mark Hyman
Yeah. Then

Dr. Mark Hyman
if you're just trying to hide hide what's going on. Right? And we're kinda trained to kind of circle ranks and hide and not telling each other. And I'm I'm so impressed by you. You're actually out there saying something.

I've been saying forever, but I'm like, kind of, you know, on the fringe. You're you're in the center of the belly of the beast.

Dr. Marty Makary
I've, I've ushered so many people to the afterlife in the ICU, and, you know, I've done a lot of cancer care that I'm constantly reminded how life is short in these folks that are just afraid of what somebody's gonna think. If you just speak in your honest opinion, I don't think that's healthy, and that's what we need more of.

Dr. Mark Hyman
And so so in in the policy realm, because you've you've mentioned how your book really helped shift some policy around cost transparency.

Dr. Mark Hyman
Yeah.

Dr. Mark Hyman
You know, what are the other big levers besides term fixing the NIH and putting in a national assumed nutrition and funding the right research and getting rid of all the the kind of old cronies in there that just kinda don't want the to get the kind of new science out there What what actually can we do, on a policy level? Cause I I'm curious. I I have a nonprofit that works on food policy. I mean, I'm actually going to be doing a hearing in front of the Ways Means Committee, September 18th, in front of the health sub communities in charge of all Medicare and reimbursement. You know, and I and and and, like, you were talking about, like, for example, about diabetes, and I had had, spent the option with Sammy who who started for the health.

Dr. Mark Hyman
And

Dr. Mark Hyman
they they really deeply studied that they could save $6000 per patient after cost by putting them on this program to reverse diabetes and they reversed diabetes, which is not something the ADA even basically recognizes as something you can do. And if if Medicare implemented this, it overnight, it would save a $100,000,000,000. Yeah. Looks like that. Boom.

Because there's sixteen and a half million people on Medicare, who have diabetes.

Dr. Marty Makary
So Sammy's the endocrinologist that started Verda?

Dr. Mark Hyman
No. Sammy is a is a is an entrepreneur.

Dr. Marty Makary
Okay.

Dr. Mark Hyman
Who

Dr. Mark Hyman
is an elite athlete who found that he had metabolic syndrome because he was using all these sports goos that are full of sugar to fuel his endurance athlete, performances. And so he was like, what's going on here? And then he basically trained and did a cross, the ocean road from California, Hawaii doing a keto diet and show that you could you could do it. And He rode from California, Hawaii. Robo with his wife.

Wow. Like, robo. Nice part. I mean, I don't think it's not safe, but it was hardcore. He said, like, twenty foot seas.

It was, I'm pretty rough. But but the point is that, you know, I'm having this hearing, and and I I I imagine it's gonna be very tough to to get Medicare reimbursement for a program like that, even though the data's so clear, even though they've shown that it proves all lipid parameters, it's like it's sort of the opposite of what you think by being eating only fat. Right?

Dr. Marty Makary
It's, the policy world is tricky because There are so many things we can do without the government that we're not doing. For example, the Verde company that you mentioned, and I had met with the endocrinologist too as one of the, I think, co founders or something. And he showed me that data. It was super impressive. Finney.

I I think that was gonna be. Super impressive data. Just like you said, this is clearly something we should be doing, and it fits the whole what we've known and seen on the ground as doctors for many years, and that is the hard part of treating chronic diseases, not telling people what to do. It's helping them do it. Its behavior changes, checking in with them.

It's being their friend. It's going along the walk with them. If I tell I see somebody smokes on their chart. I don't do what I used to do and tell you, oh, yeah. You should stop smoking.

You're gonna die. Now I ask them, you know, some people

Dr. Mark Hyman
go outside and have a cigarette. I'll tell you to do a talk. Almost.

Dr. Marty Makary
I almost do that. I'd say some people really don't wanna quit. They don't wanna talk about it. And other people really want to. Where do you stand?

And whatever answer you say is okay with me. Most people say, I don't wanna talk about it. And they're you're not gonna affect them no matter what. But then you meet somebody that says, I just had a granddaughter. I'm dying to quit.

We should put all of our energy in to help them with medication, behavior, all And that's what Virgil's doing. It's saying, if you want someone to help and go down this walk with you and help pick foods and and manage your diabetes instead of just pumping insulin and We're gonna be there for you. And those are the solutions that the in the private sector, employers that pay for health care, what we call, erisa plans, employer sponsored health care plans. They're saying know, I'm gonna make Verda available to my employees at this company. I'm gonna make Teladoc.

I'm gonna make and they're piecing together what we call these point solutions. So now you can be creative and come up with a foodist medicine program You don't need to wait for Medicare and there are 50 bureaucratic red tape steps. And you can go go to work right away. And that's the exciting thing. That's why I'm so optimistic about some ray of hope in this broken health care system because employers are are standing up, and they're they're saying yes to the challenges.

So they're in

Dr. Mark Hyman
the financial incentives are online. The pioneer that they the privately insured large corporations who are footing the bill.

Dr. Marty Makary
They are, but at the same time, They see the demand for this. And if there's demand, they wanna make those employees happy because they wanna attract employees. Fertility services. Is there an ROI on it? No.

But they know there's demand for those fertility services. So that that is now enabling smart people to say, hey. This makes sense medically in terms of improving health. Let's do it. Let's try it.

Let's do a pilot. Let's and it's happening fast. Like, we don't have to wait, you know, these diabetes alternative, these companies now. They're not anti dialysis. Sorry.

I meant dialysis. So in dialysis, we have a system where just kinda let people go into renal failure, then we put them on the machine. Well, what about actively getting them to avoid dialysis before they become dependent on it? Yep. So there's a couple companies now.

They're not the big ones. And they are actively working with people in that pre dialysis phase of their life. And if they can avert one pace

Dr. Mark Hyman
patient becoming dependent, it pays for itself. So this is the exciting stuff right now in in

Dr. Marty Makary
medicine.

Dr. Mark Hyman
It's true. I mean, I I I've, you know, with aggressive lifestyle intervention, you can reverse renal insufficiency. You can. And I and I had a patient who was, like, you know, typical insulin resistance and cardiovascular disease and hypertension and kidneys starting to fail as Gf far was just the measure of kidney function was going down and kidney level tests were going up. And, you know, I put him on

Dr. Mark Hyman
a program and he lost weight. He did amazing. Got the inflammation down.

Dr. Mark Hyman
And his kidney's normalized. The protein went out of his urine. And his nephrologist was like, what the hell did you do? I've never seen this before. This doesn't happen.

It's not possible. Like, well, what's going on? Like, and we don't see it because we don't know to tell people what to do. Like, we just don't have the knowledge or education, and it goes back to your licensing exam. That's one of the things we're working on is also changing the licensing exams, getting, ACCME to change those requirements.

Graduate medical education, we spent $17,000,000,000 a year from the federal government paying for these residency programs and fellowship programs. We have no strings attached about how that money is used or what they're teaching or anything. Like, and so we can put some guardrails on that. Yeah. You know, it's is this amazing.

Your your your work is tremendous. I'm I'm super excited about it. Marty McRe from Johns Hopkins written so many books as late as one of his blind spots when medicine gets it wrong and what it means for health. You will not be sorry to read these books. You will educate yourself.

You become empowered. And I think what you're doing is speaking out telling through the speaking truth of power and actually empowering patients to learn how to become, agent have agency over their own health and do us right for themselves and not be just at the sort of whims of a paternalistic system that has immense, financial perverse incentives and commence corruption, and it's not giving us what we need to know. So thank you for speaking out. Thank god you're there in doing this work. I'd love to have you on the podcast.

Any final words or thoughts and advice for listeners about how to navigate all this?

Dr. Marty Makary
Was great to see you, Mark, keep up the great work. So, you know, I felt like there's so much new research that is directly speaking to these blind spots in medicine that people should know about it, not just in the medical community, but If my colleagues are fascinated by some new research that I'm presenting to them in a lecture, some of that research has direct implications for everyday folks out there. And so that's why I put this book together. So I hope people enjoy it.

Dr. Mark Hyman
Well, thank you. You can find it everywhere you get books. It's out there now. And you can go to Marty, and Macri and just check take out his work. His website is macrimd.com.

Dr. Marty Makary
Marty MD. Yep.

Dr. Mark Hyman
Oh, Marty MD. Okay. Martmd.com. I should let you say what do you have social media? What is that?

Dr. Marty Makary
I'm on Twitter. It's a bit of a nasty place, but I I try to encourage people on it and, LinkedIn a little bit, but, great to be with you. So thanks so much, Mark. Okay.

Dr. Mark Hyman
I can't wait to have you back for your next book. And, like, I think there were, like, four thousand tops we didn't cover. So get the book, check it out, and, and Like,

Dr. Marty Makary
to push the field.

Dr. Mark Hyman
Yeah. Let's go. Thanks so much, Marty.

Dr. Marty Makary
Great. Thanks.

Dr. Mark Hyman
Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at doctor Mark Hyman, and we'll see you next time on The Doctor's Faramcy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more.

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