Office Hours: ADHD Is a Whole-Body Problem What to Look at Beyond the Brain

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a sixteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Mark Hyman
When I think of someone with ADHD, it's not a brain problem, it's a system problem. These are not brain disorders. They're systemic disorders that affect the brain. So basically, when you have depression or ADHD or autism or any of these behavioral or psychiatric conditions, it's a brain on fire. And so a lot of times the reason for the brain on fire is the gut.

It it's quite simple. It's your body is connected to your brain. Everything that's happening south of the border of your neck is affecting what's going on in your head. Hey everybody. Welcome back to Office Hours.

Today we're doing things a little differently. I'm here with Emma, one of the producers of the Doctor. Hyman Show, and we're digging into a topic that I think is gonna surprise a lot of people. Emma, what are we gonna talk about today?

Emma (Producer)
Last week, you had a conversation with Jenniferie on an incredible episode about the impact our nervous systems have on ADHD management. One thing we wanted to dive a little deeper on is the functional medicine lens of ADHD and how other symptoms of our body may heighten symptoms. So Mark, first question to you is, what other systems in our body may impact ADHD symptoms?

Dr. Mark Hyman
Well, everything affects everything. That's how the body works. The body is a network, it's a system, everything's connected to everything. So when I think of someone with ADHD, it's not a brain problem, it's a system problem. There was an incredible scientist, Martha Herbert, who's a mentor of mine from Harvard who was a neurologist, a pediatric neurologist, who talked about autism or even the whole spectrum of, you know, ADHD, learning disabilities, dyslexia, all the way to Asperger's and autism, the whole phenomena of neurodevelopmental disorders, is really affecting one in six kids now, is a staggering amount of kids.

And it's getting worse. And what she said was that these are not brain disorders. They're systemic disorders that affect the brain. And so everything is going to affect how that brain functions. What that child eats, or the person with ADHD, because grown ups have it too.

Their exercise, level of stress, sleep, their nutrient status, their balance of hormones, their gut microbiome, toxic load, food sensitivities, gluten, a whole spectrum of things will affect the brain. And so trying to treat the brain by just giving Ritalin or a stimulant and not really dealing with the root causes is a problem. And I think what we're now understanding is the gut plays a huge role in overall health, and particularly in neurologic diseases, psychiatric diseases, and really the whole spectrum of anything that drives inflammation. And by the way, everything that's going on in the brain in someone with ADHD or autism, is inflammation. When they've taken children who had died, who had autism, and they did autopsies on their brain, they found that they had inflamed brains.

Literally, they had elevated levels of activation of what we call microglial cells, which are the brain's immune system on MRIs. Martha Herbert documented this. Their brains are larger, meaning they're swollen, literally swollen. So I think we have to look at what is driving the inflammation and the gut is a huge, huge factor in that.

Dr. Mark Hyman
This episode was brought to you by Function. Get access to over 160 lab tests annually at functionhealth.com/mark.

Emma (Producer)
So I want to know specifically, what does the gut actually have to do with our ability to focus?

Dr. Mark Hyman
Well your your microbiome is information. You've got three pounds of bacteria in there. You've got probably 40,000,000,000,000 bacterial cells. You've got probably a 100 to a 150 times as much DNA as your own DNA. It's making proteins, metabolites.

Probably a third, and this has been estimated up to a third of everything in your bloodstream, of the metabolites in your bloodstream come from the microbiome. And so if your bugs are making bad molecules that are inflammatory or disregulate your neurotransmitters or brain inflammation, it's gonna have an effect on you. And if there's a leaky gut for various reasons, because of dysbiosis, people have, you know, by c sections, lots of antibiotics, or lack of breastfeeding, and breastfeeding is so important to develop the gut microbiome because 25% of the calories in breast milk is not absorbed by the baby, it's meant to feed the microbiome. You know, we see that, we see lots of antibiotic use. And so there's this whole setup that these kids get of dysregulated gut microbiomes that generates inflammation, and that generates leaky gut, food sensitivities, and systemic inflammation that's causing their brains to malfunction.

Emma (Producer)
Interesting. So there is this large connection between your gut and your brain kind of speaking with one another. So can we go back and start at the beginning? How exactly is my gut talking to my brain?

Dr. Mark Hyman
Through many, many, many pathways, there there's there's something called the second brain in the gut, which is the enteric nervous system. The enteric nervous system is essentially the nervous system that is in your digestive system. And it's independent, it's communicating constantly up and down to your brain. And so any kind of inflammatory signals from the gut get transmitted up to the brain through the enteric nervous system. And vice versa, stress will definitely communicate down through that system into the gut and can cause digestive issues.

We all know that you know, we get you know, stress causes diarrhea or we got you know, different kinds of stress related gut symptoms, gut feelings. That it's a bidirectional pathway. I think you know, we have to understand that unless we unless we really address that whole ecosystem through both nervous system regulation and optimizing the microbiome, we're not gonna be able to really help people with with a whole host of conditions, especially ADHD.

Emma (Producer)
Are you able to explain a bit more in detail kind of how the gut brain axis works? Like what's the vagus nerve and like where is my immune system connected in all of this?

Dr. Mark Hyman
I mean, I think you know, it's interesting how it all connects. Right? You've got the vagus nerve which is basically the main nerve running from your brain down, innervating all of your GI tract. You've got 60% of your immune system in your gut. You've got all these microbial metabolites being absorbed and you know, signaling different things in your body.

And so we basically are are in this constant dance between your gut and your brain and everything that's happening in there. And so when you're when your diet's crappy, when you don't have healthy microbiome, when you're not making healthy short chain fatty acids, when you're eating foods that are very irritating to the gut or not eating enough fiber, which most people don't eat, you're gonna end up with leaky gut or damage to the gut bearing integrity with inflammation throughout the body, with dysregulated signaling to the brain. And and so basically, conversation is happening between the brain and the gut getting really dysregulated. I'm just giving you a quick story of a case that I had, which was a young girl, she was nine years old and she had severe behavioral issues. Kind of ADHD, but like even worse.

She was just very disruptive, always aggressive, getting kicked out of class all day, on the bus home, she'd have to stop the bus 10 times just to deal with her. At home, she would, you know, tear up pictures of her sister and just be very kind of almost sociopathic, I would say. And and we did a work up. And she didn't have any digestive symptoms, but she she had severe overgrowth of bad bugs in her gut. And she had severe growth of fungus, yeast overgrowth in her gut.

And we were able to document this through validated tests. We didn't guess, we actually measured it. And so, rather than give her some ADD drug, or give her some, you know, behavioral therapy or you know, counseling or cognitive behavioral therapy or any kind of treatment that was meant to change her behavior, what I did was I gave her an antibiotic and I gave her an antifungal to clear out those bad bugs. And then I rebuilt her gut microbiome with probiotics. Things like zinc, extra fibers, prebiotic fibers, and omega three fats and gamma linoleic acid, is really helpful for gut healing.

And And a whole bunch of other things. But the point is she went from being this violent aggressive girl to being this perfectly normal kid. And her ADD was gone. And so that taught me, that was years ago, it taught me that there's this massive connection between the gut and the brain and behavior and mood and and cognition and attention and so many things. So it's it's quite amazing when you start to dig in and see what's happening in in in people who have these problems.

And the truth is that most psychiatrists never look at your gut. They will look at your poop. They won't look at your breath test. They won't look at, in fact, any anything related to what's going on in your gut. And so they're just thinking about what's happening in the brain as if it was divorce from the rest of your body, which it's not.

Emma (Producer)
And I wanna get deeper into more about kind of what your protocol would be, your approach to individuals that for sure have ADHD. But I wanna kinda circle back to that story. You talked mentioned testing there. Are you able to shed some more light on what the tests were that you ran? Or maybe parents that have children, what maybe should they keep in mind and potentially get themselves or their child tested for?

Dr. Mark Hyman
There's a there's a lot of testing that's done in the functional medicine space that's not considered validated by traditional medicine. And that's, you know, unfortunate that traditional medicine hasn't taken it seriously. But I can tell you after being in the space for now thirty years, I started practicing functional medicine in 1996, which is a long time ago. I literally just had my office party and all the staff was there. We had, there's a whole bunch of us that have been together for thirty years, twenty years, twenty five years.

And you know, I was talking to my nurse who literally has been with me since 1996. And I I I said, you know, without you being willing to go and figure out all these weird lab tests, we never we never would have moved the field forward. So I look at stool testing, and I will look at everything that's going on in the gut, digestive enzymes, fat absorption, levels of inflammation markers, short chain fatty acids, which are really important to tell you a lot of what's happening in the brain. I look at the microbiome itself, I look at what's growing, whether it's healthy bacteria, I look at whether it's parasites or worms or yeast or other things. And then I I understand what's happening to that whole ecosystem.

And it's not really looking for a pathology, like yes, you might find a parasite and that can be considered a pathology. But most the time, it's really looking at the whole ecosystem. It's this thing's out of balance or imbalances, called dysbiosis, as opposed to symbiosis, which is working together, you've got this dysregulated microbiome. We also look at urinary markers of metabolites, because everything in your gut gets absorbed. And so if a bacteria or fungus are making metabolites, we we track those like the arabinitol or other markers, and we can see very normal, and we can treat those.

We can also do breath testing to see what's going on with their different gas production, whether it's hydrogen, methane, or sulfide, which all can have severe effects on the level of inflammation of the gut and the cognitive symptoms. Across the spectrum of you know, people not just with ADHD. So we look at a lot of different things. And we also look at you know, nutritional status, because that plays a big role in health, particularly in in ADHD kids. They have a lot of nutritional deficiencies like like most people in America.

Emma (Producer)
But Mhmm.

Dr. Mark Hyman
They they they're really particularly susceptible to things that are are are challenging.

Emma (Producer)
Nutritional deficiencies is something I think I I have in my questions to to dive deeper into with you as well. I wanna go back specifically to gut microbiome in individuals with ADHD. So what's the difference about the microbiome in people that have ADHD?

Dr. Mark Hyman
Well, it tends to be more inflammatory. It tends to be lower in certain species. And it seems to be having, you know, a more of inflammatory kind of profile. And it it may not be producing the most of the short chain fatty acids that you need, it might affect dopamine function, know, the microbiome like Bifidobacterium is is important in in regulating dopamine, and that can be problematic in these kids. And they also, know, may have differentiated sort of things related to gluten, where they'll get increased zonulin levels, which are a marker of gluten damage to the gut, which leads to leaky gut, they can get, you know, in ADHD they've seen zonulin levels being associated with social functioning, with you know, you know, basically behavior and OCD and ADD.

And there's also fungal, fungal issues. A lot of Candida can be a big factor. I've seen many, many kids with significant fungal overgrowth in the gut because of antibiotics, because of poor diet, because of sugar, all these reasons. These kids develop fungal overgrowth. And that also may be an issue.

They're actually doing fecal matter transplants, or what we call FMTs, basically poop transplants, in people with autism, with ADHD, and it's pretty amazing. So I think kids who've had a lot of antibiotics, you know, have a higher risk of getting ADHD. So we know that gut plays a huge, huge role in the overall regulation of the brain and mood, cognitive function.

Emma (Producer)
Mhmm. I know we briefly touched on it at the beginning, but I'd love to dive deeper into how specifically the microbiome affects our attention.

Dr. Mark Hyman
How it affects our attention? Well, I think anything that it causes brain inflammation will affect cognitive function. And so, I think it all hasn't been fully mapped out. But I do think that, you know, with decades of clinical experience from functional medicine world, and from this sort of emerging research that's on the microbiome, We really see there's a massive behavior diet microbiome loop that's modifiable, that can be changed. We know that antibiotics play a huge role in triggering issues with kids.

We know there's, you know, significant patterns in the microbiome that can be associated with cognitive issues around ADHD or autism. So we're just, this whole field is really emerging fast. But I can tell you, without even knowing all the details, because really we're able to study so much more at so much greater depth than we ever have before, given our current diagnostic tools, and stool testing, and genetic testing, what's going on in the gut. I can tell you as a doctor, seeing real patients in my practice for thirty years, using an approach that really resets the gut, even if we don't know exactly what's happening in there, has a massive impact across the board on brain function, on mood, on attention, on memory, on everything. And so, I think the story is still being unwound, but but the the reality is that there's more and more emerging data on the role of diet, on the role of dysbiosis and gut issues with these kids.

And with adults. And so I think there's a real sort of amazing doorway to treat these people by checking on what's going on. You know, people don't actually have to have gut symptoms. They might just have behavioral symptoms or cognitive symptoms and they don't actually know that it's going from their gut.

Dr. Mark Hyman
I know I'm not the only one that has ever walked into a room and forgotten why it was there, or stared at my computer screen knowing I needed to focus but can't. Here's what I want you to know. Brain fog isn't a character flaw. It's not a lack of discipline. It's not something you should simply accept.

Most of the time, brain fog is linked to your biology. Blood sugar issues, thyroid dysfunction, low iron, even low vitamin d. But you don't know there are things to correct unless you measure them. And that's why when someone comes to me struggling with focus, energy, or mental clarity, I start by looking on the inside. That's exactly why we built Function.

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Emma (Producer)
I know there you also mentioned inflammation. What about, like, neurotransmitters and the role that that kind of plays on our attention and the connection to the gut? Can you go more into that as well?

Dr. Mark Hyman
Sure. I mean, you know, you're you're you're you have a lot of neurotransmitters in your gut. And and basically, you know, not all of it is going to your brain, but it regulates the nervous system in the gut.

Emma (Producer)
Can I pause you? Yeah. Can we back up even further? Like, can you just describe simply what are neurotransmitters as well?

Dr. Mark Hyman
So neurotransmitters are essentially communication molecules that help your nervous system have a conversation regulate everything So in your they control thoughts, feelings, moods, behaviors, motor function, pretty much everything. And it can be everything from you know, GABA, which is a neurotransmitter, to serotonin, to dopamine, to norepinephrine, to epinephrine. They have, these are multifunctional molecules that are really important, That regulate mood, cognition, behavior. So acetylcholine is one, which is very common. It's an excitatory neurotransmitter.

Nitric oxide is another. Glutamate is another that regulates things. Histamine, melatonin. All these, there's a lot of different ones. But they're very, very powerful.

And these, the, they're made, a lot of these are made in the gut. So they have very different effects on different things, but these are all regulating your nervous system. And there's, you know, really important strategies to optimize the gut health as a way of optimizing the neurotransmitters.

Emma (Producer)
Got you. Okay. The other thing I feel like we should talk about here is the gut barrier. So are you able to explain what intestinal permeability is?

Dr. Mark Hyman
So generally your gut is is a is a organ that absorbs and filters the food you're eating, and lets the nutrients in, and keeps the foreign proteins out. It also, you know, there's a bacterial microbe in microbiome in there that's helping you digest your food, making vitamins, regulating inflammation, reducing your risk of cancer, or conversely making things worse. And also you've got also bacterial toxins in there your body has to protect itself from. So there's a barrier lining the gut. And your gut's basically one cell thick.

And it's it's like, think of it like you're basically one cell away from a sewer. And the gut has these little cells called intestinal epithelial cells that are joined like Legos, with these things called tight junctions. So think of them like interlocking Legos. It join the cells together very tightly, they're called tight junctions. When there's dysbiosis, when there's certain foods like gluten, people react to, and in everybody gluten will cause some degree of this, and I think American European wheat for various reasons, we can talk about.

But basically, these tight junctions tend to loosen, and you get these spaces between the cells. So instead of food going through the cells, they're supposed to go through the cells, nutrients are supposed to go through the cells, they go between the cells, and what also happens is different foreign particles leak in. They go basically food proteins or bacterial toxins leak in, and right underneath the lining of your cells is your immune system. 60% of your immune system is here because that's where you're interfacing with the world in the outside world most of the time. And so when you start to get all this foreign literally crap being exposed to your immune system.

It goes, what's this? It's not me. And it starts to create this inflammatory cycle. And it can drive so many diseases. That's why the microbiome has been linked to everything from ADHD, to autism, to Alzheimer's, to Parkinson's, to depression, and then obviously to cancer, to heart disease, to obesity, to you know, autoimmunity, to allergy, asthma, eczema, you name it.

And and it's because when you get a leaky gut, which is so common because of low fiber, because of our ultra processed diet, because of the overuse of antibiotics and acid blockers, and the use of c sections and lack of breastfeeding, all of these cumulative reasons, role of toxins and so many other things, we end up with these leaky guts to some degree or another. And those create, to some degree or another, a systemic inflammatory response and that inflammatory response is affecting the brain. It's creating an inflamed brain. So basically, when you have depression or ADHD or autism or any of these behavioral or psychiatric conditions, it's a brain on fire. And so a lot of times the reason for the brain on fire is the gut.

And so restoring gut health is so important. That means removing the irritating foods and there's a whole system in functional medicine called the five r program, which is remove the bad stuff, You know, replace things that are missing, reinoculate probiotics, repair the gut lining, and restore the whole nervous system in the gut. So there's a whole way to do that, but it's a system. And the functional medicine is really good at helping people practically apply it. And what's beautiful about it is that even though we don't have all the science yet on how everything affects everything, and how these microbiome changes affect cognitive function specifically.

We know some, but not not in great detail. We can still get these people better by focusing on repairing the gut ecosystem.

Emma (Producer)
I know you've also done a really in-depth episode on office hours, kind of going into this kind of gut microbiome, how to heal the gut. So we can also link that in the show notes as well too. I wanna go deeper into diet. We've kind of tiptoed around it, and I wanna go deeper into it. So this is probably a silly question, but could the modern diet be making ADHD symptoms worse?

And if so, can you kind of just explain to me in more detail about how that is? You're laughing as I ask that

Dr. Mark Hyman
question. Yeah. I mean, look. Our modern diet, our ultra processed diet is pretty much the cause of most chronic diseases we see across the spectrum to some degree or another. There's other causes.

There can be toxins, there can be infections, there can be mold, there's other reasons. But the diet is such a big factor. It influences ADHD in multiple ways. One, by regulating the microbiome. You basically are not just feeding yourself, you're feeding your microbiome.

So if you're feeding it processed food and no fiber and sugar, you're gonna end growing bad bugs in there that cause inflammation and leaky gut and cause these behavioral symptoms. When you you know, look at the opposite, if you use fermented foods, probiotic foods, prebiotic foods, phytochemically rich foods, when you cut out the starch of sugar, cut out the ultra processed food, it changes the microbiome and it changes the behavior. It changes the brain function. So it really, it's really an essential part of repairing any kid. And I I had a kid who was 12 years old, but will probably would show his show his before and after handwriting picture, which people can see if they're watching on YouTube or You can basically see his mother brought his homework to me before I did anything.

And then he was We did a full work up. And this kid was really a mess. This kid had been kicked out of kindergarten. He was so disruptive. He was on ADD medication for years and years.

He was socially disruptive. He had all these other health issues that seemed peripheral, like he had asthma, he had headaches, he had stomachaches, he had, you know, insomnia. I mean a whole bunch of stuff that was completely ignored by a psychiatrist. And he was treated by a psychiatrist, by an allergist, by a lung doctor. I think he had, I don't know if he had irritable bowel, might have seen a GI doctor.

He was on all these drugs. He's done seven different drugs at like 12 years old. You know, and I'm like, wait a minute here. There's something connecting all this together. And so when we unwound his story, he ate only processed food.

He never ate a vegetable in his life. He you know, had all these symptoms that were kind of inflammatory issues. So I basically looked at his gut microbiome, I looked at food sensitivities, I looked at his toxic load, I looked at his nutrient status. And what I saw was a kid who was massively nutritionally deficient. I mean it was low zinc, low magnesium, low b six, and folate, and all these all these things that were so important that he never, I mean folate, the word comes from foliage.

So you have to eat greens. This kid was not eating greens. And so the this kid had such a dysregulated microbiome, and he also had a leaky gut. He also had a lot of food sensitivities. He had elevated gluten antibodies, so was basically he was reacting to gluten.

Plus he was reacting to dairy. And so we got him off all that ultra processed food. We got him on whole foods. We got him off the gluten, dairy, and sugar, and processed foods. I restored his microbiome by resetting it because we kinda hit a lot of yeast overgrowth.

So I gave him any fungal, because we found fungal overgrowth in his testing. He had lead, and I get rid of his lead through chelation. I optimize his nutrient status with magnesium, zinc. I mean, had lots of low grade, low magnesium, zinc, b six, folate. I gave him probiotics, I gave him fish oil, omega threes.

He was super low on omega threes, lot of these kids are. And so basically, in two months, the mother brought him back after changing his diet, fixing his gut, giving him optimizing his nutrient status, getting rid of the bad bugs in his gut. He he was completely better. He had no no symptoms from any of the things that we talked about. And more importantly like his brain was working, And he didn't have ADHD, he didn't have trouble focusing, he didn't have behavioral issues.

And it and the handwriting you can see before and after was was the thing that made me write the Ultra Mind Solution. Mhmm. When I which when I saw these handwriting change from before I treated him to after I treated him. Within two months, it went from illegible at 12 years old to perfect penmanship at 12 years old. And I'm thinking, wow.

How did this happen? Like how how did this actually happen in the brain? The brain went from chaotic and disorganized and just synchronous to coherent and synchronized and orderly in how it was functioning. And and it was reflected in his handwriting. And a lot of these kids have what we call dysgraphia, which is basically bad pit.

Right? It's a meta gorgon bad area. But it but it it taught me a lot about how diet and the gut health and nutrient status play a role in these kids with severe ADHD.

Emma (Producer)
Okay. So you mentioned some nutrient deficiencies, and I'd love to kind of go further into that. Can you double down on what specifically you often see, what nutrient deficiencies you see, when the impact that the adequate nutrition can be, and when supplementation might also be a beneficial thing to explore.

Dr. Mark Hyman
Look. If kids are eating ultra processed food, they're nutritionally deficient. At Function Health, we're seeing that over seventy percent of the average person who's doing function health lab testing, which is generally a health forward population, seventy percent have a deficiency. Not an insufficiency, a true deficiency based on the reference range from Quest of one or more nutrients. That's shocking.

It should be shocking to people. It's not to me because I've I've been doing this for a long time, but to see actually the hard data at scale on hundreds and hundreds of thousands of people, I'm like, damn. Like, we are all walking around with these undiagnosed nutritional deficiencies that are affecting the quality of our health.

Emma (Producer)
So sorry. You said they're also health focused as well too. So, these people are mindful of the foundations. So do you think that speaks to, like, the quality of our food as well too?

Dr. Mark Hyman
For sure, but you know people, yeah, it can be gut health, lots of things. But I had a I had a recently a couple of patients who were not health focused. They never heard of doctor Hyman. And and they had they were obese. They were you know, three hundred pounds, three hundred thirty pounds with the guy.

The one was two fifty I think. And obviously ate a lot of food, but they were very malnourished. Very low omega three's, very low vitamin e like extremely low, very low folate, very low magnesium, very low zinc. And so we saw a very low iron, the woman had very low iron. A lot of a lot of these things are people are walking around and they have no idea.

So I think for me, I I I think it's important to test nutrient status, which is why Functional Health as I designed the panel, which I designed, was to really look at a whole suite of different health issues, but really also do a deep dive on nutrients. So nowhere else you're going get vitamin d, omega threes, omega, you know, your your full methylmalonic acid homocysteine which measure b six, folate, b 12, looking at red cell magnesium, looking at zinc, obviously vitamin d. So a lot of things we we can see what's going on at the common nutrient level. Iron, we're looking at everybody in iron. So we're a lot of of these nutritional deficiencies.

And so, you know, they affect cognitive function of magnesium is required for for neurotransmitter regulation, and particularly for relaxation, nervous system relaxation. And you know, this kid I was mentioning to you with ADHD is irritable, he was hyper, he had insomnia, he had headaches, he had cramps, he had stomach issues, constipation. These are all magnesium deficiency symptoms. So it doesn't take a rocket scientist if you know what the symptoms are, to diagnose magnesium deficiency, even you know, without a lab test. The lab tests are a little squirrely too, but I think we really have to not just focus on the brain, when we think of people with these attention disorders.

We have to focus on the body as well. And this is why when I wrote the book, Ultra Mind Solution, the subtitle was fix your broken brain by healing your body first. So you know, people people do all the therapy they want. But like, if you for example, if you're trying to manage pain and you're standing on a giant nail, you know, you can get kick a lot of narcotics. The treatment is taking out the nail.

Right? And then if you have pain, can deal with it. But like, I think a lot of what at times happens in medicine is we're using all these psychiatric tools to treat a problem that's not psychiatric. Now sometimes it is. Sometimes it's a combination.

But sometimes it's just biological changes. And there's a whole field of biological psychiatry. Now there's departments of nutritional metabolic psychiatry at Harvard, Stanford. They're treating very severe illnesses like schizophrenia and bipolar disease with dietary interventions that are very aggressive around ketogenic diets. But I I've seen, you know, how these things work and they're it's quite impressive when you when you actually are in the weeds with people and you work with people, you see the changes happen pretty quickly.

Emma (Producer)
I'm kind of taking us a bit of left field here, you saying that kind of made me think how much of the ADHD experience is biological and the rest kind of due to lifestyle and diet. Like, how much do you see that kind of overlap?

Dr. Mark Hyman
Look, think there's a spectrum of humans, right, and different traits and behaviors and proclivities and skills and like, I you don't have to pathologize all of it. But I think if people's life are really affected, if if you know, if you rule out everything else, like there may sometimes still be some behavioral or attention issues. And that may be more kind of hardwired or or more permanent. But I never start there. I always assume that there's stuff to fix.

And the way functional medicine works is it's pretty simple. It's doing a very deep survey from history, lab testing, on what's out of whack. And then it just corrects everything. So rather than like going, oh well, it's just vitamin d, just get vitamin d, but don't change his diet. No, you have to change the diet, you have to get the vitamin d, you have to exercise, you have to treat the gut microbiome.

If there's toxins, you have to deal with that. If there's infection, you have to deal with that. And so it's the opposite of traditional medicine, which is just do one thing. Take this one drug with this one disease with this one outcome. It's not how the body works.

If you're trying to grow a plant in your garden, you can't just provide water but no soil or sunlight. Or you can't just provide sunlight but no soil or water. Right? You need to provide all the the foundational ingredients for health. And and this is basically what we do in functional medicine.

It's basically a detective job and each person is different. You know, sometimes it's quite quite simple, sometimes it's much more complicated, and it can take a long long time to unwind some of these things.

Emma (Producer)
Okay. So say I came to you today and I was like, hey, Mark, I just got diagnosed with ADHD. What would you say to me? Where would you tell me to begin? What kind of plan would you lay out before me?

Dr. Mark Hyman
As a as a young woman or as a kid?

Emma (Producer)
Let's say as a young woman because as we mentioned with Jenna, there's a lot of women around my age that are often getting diagnosed. Right?

Dr. Mark Hyman
Yeah. I mean, it's it's an adult thing too. I would I would take a very detailed history. So when you come to see us at the Ultra Wellness Center, do have a 32 page questionnaire, which is annoying. But it it it tells me everything about you.

I wanna know every little symptom. I wanna if your eyes twitch. I wanna know if you, you know, have dreams or don't have dreams. Like for example, if you don't have dreams, it could be a b six deficiency, right? So there's little clues in everything.

Or if your butt's itchy, it could be yeast overgrowth. Like there's all these little things we know. I want to know mold exposures, whether you've had a tick bite, how much sushi you ate, whether you got dental fillings, how you were born, what environment you grew up in, what are traumas were. I mean, want to know everything. And so first, I unpack all that.

And then I go, okay, based on that, what do I want to look at? The clue mean, if you say, well gee, I had a bunch of tick bites or gee, I live in a moldy house or yeah, I eat tuna every day. I'm going to go down and find out what's going on. I'm going to do heavy metal testing, and check for mold, and check for ticks. I'm also going to look at nutritional status.

I'm going to look at your microbiome. I'm going to look at your immune health. I'm going to look at food sensitivities and allergens. And and I'm going look at your metabolic health and insulin resistance, and all the things that really matter that help give me a good comprehensive picture of what's happening with you in this moment. And based on those findings, know, I will have a map.

I will know, okay, for you Emma, there's these you know, five things that are the priorities. You know, your your low in magnesium, you've got bacterial overgrowth in your gut, you've got a lot of mercury because you love tune every day, and you know, you you you also have have a low vitamin d and low zinc. And so I'm going go, okay, I'm going to I'm going to fix all these things. And I'm going to do it systematically by first starting with diet and lifestyle, and then adding in some nutrients, correcting the gut issues, and then getting rid of what things that might be irritants like toxins or mold or allergens or infections. And it's it's just a systematic process.

And sometimes it's, you know, it's you know, I sometimes it's unusual. Like I had a kid with a severe OCD. And it was developed after he got a strep infection. And there's actually something called PANDAS, which is Pediatric autoimmune neuro something something something. I forgot the exact nomenclature, but essentially it's a neuropsychiatric condition that's triggered by an immune response to the strep after you've had it and treated it.

And there's antibodies you can measure, you can check for this, but it's ongoing inflammatory thing. So I actually treated this kid with ozone, which sounds really crazy, but it was can't just throw more antibiotics at it, doesn't really work that well. And it was incredible, the kid completely resolved. So I think you know, we have to sometimes think out of the box when we're looking at things, but you really have to treat everybody individually. That doesn't mean like everybody with OCD has that problem.

I mean that was his particular thing. And this is the other problem with medicine is, we label people based on symptoms, not on causes. So you can have 10 people with ADHD, they can have 10 different causes. 10 people with autism, 10 different causes. 10 people with OCD, 10 different causes.

So you have to be a detective and find out what is the cause for this particular person.

Emma (Producer)
And then your protocol for each of them would be completely unique. So your protocol Yes.

Dr. Mark Hyman
And then it be very personalized. So basically functional medicine is highly personalized medicine. And it's it's it's basically a simple algorithm, which is take out the bad stuff, put in the good stuff. There's too much of something that's causing your body your body to react badly and there's not maybe not enough of something your body needs to function properly like light or water or sleep or the vitamin d or whatever it is. So basically my job is to be a detective and find out what you have too much of that I need get rid of and what you don't have enough of that you need to get.

And this is very simple like equals m c squared framework. But you know, behind it is like the whole you know, human human complex biology. It's it's it's quite astoundingly complex. So you know, just finished writing a book which is gonna come out next year which is essentially about the whole map of the human body and how it actually works. Which is a very different frame than Vesalius who was the vivisection and basically discovered that there were all these organs and basically medicine got organized according to organs, not according to how the body functions.

And so, like we're talking about the microbiome, you know, you've got the gut, but nobody's thinking that it's affecting the brain, but it's totally connected. Right? So that's like, can't you just look at the gut? Are you are you gonna get the brain? The brain is where, you know, your mental health is or your thoughts are, but it's not.

It's it's it's systemic. So I think I think it's just really it's a real paradigm shift.

Emma (Producer)
Before we close out here, I wanna hit you with some rapid fire questions. So essentially just quick short answers, kind of first thing that comes to mind. How does that sound to you?

Dr. Mark Hyman
Sure.

Emma (Producer)
The first one here is, can caffeine help with ADHD or does it make it worse?

Dr. Mark Hyman
It depends on the person. I mean, sometimes it helps focus, but it also can if people are tend to be more irritated or stressed out, it can activate that. And it depends on your caffeine metabolism because basically, some people have fast metabolism of caffeine, other people have slow metabolism. And so it's really about, it's like finding out what really is going on with you. I don't have a hard rule about it.

Emma (Producer)
Why do people with ADHD seem to crave sugar and carbs?

Dr. Mark Hyman
Well, you know, when you crave sugar and carbs, usually means there's something going on. It's either one of two things. One is you're you're you're primed for it through eating a lot of starch and sugar, which does also cause a lot of brain dysfunction. So you're kind of sugar, eating sugar makes you crave more sugar. And it has, it does so through the way it affects your insulin production, which you make more insulin, then you become insulin resistant.

Then you start changing your neurotransmitters and your immune cells and you start to create this hyperphagia, which means you're just hungry all the time. And people know this. If you have if you have like, you know, pancakes for breakfast, you're really starving by 11:00. But if you have like a protein shake or a bunch of eggs and bacon for breakfast, you're fine till lunch. It's because it it it creates these huge swings in blood sugar.

So when your sugar's crashing, you're going to crave more sugar. And that's the instability of blood sugar that causes that. The second thing is the gut. And the microbiome affects your appetite. I mean, we know g o p one drugs are affecting essentially peptides in the gut that regulate appetite and so forth.

But it goes much further than that, and in fact the microbiome, when you have overgrowth of bad bugs, they're hungry. So fungal overgrowth will tend to cause more sugar and carb cravings. And we see that a lot. So they might have fungal overgrowth and not be aware of it. And then when you treat it, when they fungal, it goes away.

And I've seen people do that and also even lose a lot of weight.

Emma (Producer)
So then you you talked about breakfast there. If I was to skip breakfast, will that make ADHD symptoms worse?

Dr. Mark Hyman
Yeah. Potentially. I think, you know, you really you really wanna stabilize your blood sugar and your brain function. And when you when you eat protein, fat and fiber in the morning, it basically stabilizes your blood sugars, it stabilizes your immune system. And you know, kids are eating cereal and sugar for breakfast, which is basically what what Americans do, they eat dessert for breakfast.

Sugar, sweetened cereals, pancakes, french toast, muffins, bagels, pop tarts, I mean you name it. Every everything, yogurt, I mean there's more sugar per ounce of most sugar sweetened yogurts, quote fruit flavored yogurts than there isn't a can of coke. So I think I think people need to understand that they can't eat sugar for breakfast. They can't eat dessert for breakfast. And that they eat protein, and they eat fiber, and they eat fat.

It basically stabilizes the brain, the mood, cognitive function, and everything else.

Emma (Producer)
What about food dyes? Can they make ADHD symptoms worse?

Dr. Mark Hyman
Food dyes, yes. There is some evidence that removing additives and colors will affect behavior. And there's some published data on this in The Lancet and others, where they basically took kids and you know, who had ADHD and they gave them either naturally like colored red liquid to drink, or they gave them like artificial dyes. And the kids with artificial stuff just had way worse behavior outcomes. So we we know these things do affect these kids.

Emma (Producer)
Can menopause make ADHD symptoms worse?

Dr. Mark Hyman
I mean when when when we go through menopause, their hormones are changing, their metabolism is changing, their adrenal are affected, their thyroid's changing. And so yes, brain function can change a lot. And women get brain fog, lack of focus, attention, but it may not be quote ADHD, it just may be perimenopause that's worsening any cognitive symptoms. So the goal is really, really to find out what's going on and optimize a woman's health through all basic foundational things, affect their quality of their hormonal function, and affect the way they go through perimenopause and menopause. So if you're eating healthy, if you're exercising, if you're getting enough sleep, if you're dealing with stress, if you're optimizing nutrients, if you're optimizing your microbiome, often you can kind of sail through it.

Hormones can be a useful adjunct and I think hormones can be really helpful. But a lot of times the dysregulation of hormones that's causing cognitive function is related to the reason why they're having it. It's not just worsening ADD.

Emma (Producer)
What do you think is worse for ADHD? A bad diet or bad sleep?

Dr. Mark Hyman
Bad diet. Okay. I mean listen, don't sleep, you can't focus. But that's not ADHD, that's just fatigue. Right?

Mhmm. But a bad diet will very much disregulate your brain. And we see this over and over in clinical trials and observational data that that the neuropsychiatric problems are very much related to the food we're eating. There was a study that I talked about in Food Fix, where they took kids who were in a juvenile detention center who eating all these bad processed foods, and they swapped out healthy foods. And then in this juvenile detention center, the violent crime went down by ninety seven percent.

The use of restraints went down by seventy five percent. Suicide in these teenage boys went down by a hundred percent, meaning there were no suicides, which is the third leading cause of death in that age group. And that's just from changing their diet. And they had them you know, locked up so they could control Amazing. What they Yeah.

It was quite, it was quite amazing to see. So I think you know, diet plays a huge role and we know a lot of this from prison studies too. When you give prisoners healthy food, they calm right down. If you reduce violent crime by 56%, they add a multivitamin, they reduce violent crime by 80% in the prisons. It's pretty impressive.

So I think I think bad diet, I would say, is the answer to that question.

Emma (Producer)
Those are all the rapid fires I have for you today and kind of all the main questions I had for you about ADHD. So I know we've covered a lot. We've talked about the microbiome. We've talked about inflammation. We just talked about sleep.

We've talked about lots about food, blood sugar. What's kind of like the one idea you want everyone to take away from our conversation today?

Dr. Mark Hyman
It's quite simple. It's your body is connected to your brain. So everything that's happening South Of the border of your neck is affecting what's going on in your head. And if you're suffering from whether it's a psychiatric problem, or an attention problem, or you're on the spectrum of autism, fixing the physiological problems that are often associated with these problems will often help dramatically. If not sometimes completely get rid of these problems.

I've seen real miracles. Like they're not miracles, they're just applying the science. But you know, different people respond differently. I've had you know, some kids with autism completely get better. I've had other people who improve.

I've had others that had weird forms of autism where I couldn't find anything wrong, but they're still, their brains weren't working. So probably a genetic thing that was a it's some kind of you know, inherited issue. So I think I think it's important to really understand that that there is a lot that you can do if you start finding out what's going on under the hood. And the fur the best place to start is Functional Health. It's just a dollar a day.

It's $365. You get a really deep dive. You can see a lot of what's going on hormonally, metabolically, nutritionally, toxin levels, inflammation. I mean, lot of things. So I think it's really a powerful first step.

But then there's more. There's always more. So you can always work with a good functional medicine doctor, come to the Ultra Wellness Center. But we we really, we don't want people to suffer unnecessarily. And I think this is for me the driving force of my career, my life, which is knowing what I know and do it and seeing what I've seen over thirty years.

People getting better using the principles of functional medicine. And so many people are suffering needlessly and you know, I can't get rid of all suffering in the world. But like if if there's problems we have solutions to and we do with functional medicine, then then people should not have to suffer. And that's really that's really I think what I want people to understand. If you're struggling, it's worth digging.

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it with someone else you think would also enjoy it. You can find me on all social media channels at doctor Mark Hyman. Please reach out, I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the doctor Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at doctor Mark Hyman for video versions of this podcast and more.

Thank you so much again for tuning in. We'll see you next time on the doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests.

This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed health care practitioner and can help you make changes, especially when it comes to your health.

This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.