3 Things That Destroy Your Gut Health - Transcript

Speaker 1: Coming up on this episode of The Doctor's Farmacy. Dr. Mark Hyman: A third to half of all the molecules and the thousands and thousands of molecules floating around in your blood, come from the bugs in your gut. If they're bad bugs, they're going to create havoc, and if they're good bugs, they're going to keep you healthy. Dr. Mark Hyman: Welcome The Doctor's Farmacy. I'm Dr. Mark Hyman, and we are here with a new episode for our masterclass. A new way we can dive into popular health topics, including inflammation, autoimmune disease, brain health, sleep, and more. Today I'm joined by my guest host, my good friend, my business partner, Dhru Purohit, the host of The Dhru Purohit Podcast. We're going to be talking about the top things that are not food related that destroy your gut health. Welcome, Dhru. Dhru Purohit: Mark, we've done so many episodes on gut health, and we've talked a lot about food and how food plays a major role, both foods to eat and to avoid, and we might hint at some of those today. But we want to talk about the other categories and we have three that we've identified here. I'm sure we'll break down more. Give us the top three things that you see in your practice and through your own experiences, over the years of being a functional medicine doctor, three categories that are major contributors to poor gut health function. Dr. Mark Hyman: Well, I mean the first one is what we call dysbiosis, which, essentially, means an imbalance in the microbiome, in the gut. You've got maybe a 100 trillion cells in there, maybe 10 times as much your own cells, a 100 times as much your own DNA. And they're not just hanging out, they're doing stuff. They're producing all kinds of proteins and molecules. And if you have bad bugs, it creates bad downstream effects. And if you have good bug, it creates beneficial effects. Your microbiome produces vitamins and it produces all sorts of beneficial molecules like butyrate that can prevent cancer and so forth. But if the wrong things are in your gut, it can actually end up causing more havoc. Dr. Mark Hyman: We call this dysbiosis. So it's not necessarily an infection, but also infections can be a problem. If you have a worm or para or overgrowth of yeast or small bowel overgrowth of bacteria, those are forms of dysbiosis that are more extreme. But those all are related to disturbances in the equilibrium, in the garden that you have inside your gut. It's like any garden, you don't want too many weeds, you want the right plants, and so forth. So that's a huge area that I think has not even been on the radar of medicine, which is, how do we optimize our microbiome? Dr. Mark Hyman: Now, there's companies out there that are having microbiome kits at home. There's people talking about the gut. But in day-to-day medical practice, your doctor, if he's not trained in functional medicine, does not understand how to optimize the microbiome. Doesn't even know what to do to look at it and test it properly. They'll look for parasites, look for worms. They'll look for infections. Sometimes, they'll look for inflammation. Sometimes, they'll look for digestive enzymes, if they're super fancy, but it's really not a comprehensive view of the gut. Dr. Mark Hyman: The second is toxins. And I think this is something we don't really appreciate very well. I'm going to share a story later about how toxins have impacted a particular patient in a very profound way that disrupts the normal equilibrium in the gut. So if you have heavy metals, if you have pesticides, toxins, they create all kinds of problems. There's even things in food that are not food that are chemicals like emulsifiers, for example, carrageenan and other thickeners that are hidden in food that actually cause leaky gut and all kinds of gut damage. Dr. Mark Hyman: One of them is called microbial transglutaminase, and that is basically manufactured gluten by bacteria in a lab that they put in food to make it stick together. Because gluten is glue, that's why they call it gluten, because it's sticky, and it's a way to hold food together that otherwise fall apart because it's full of processed nasty ingredients. Dr. Mark Hyman: And the third is stress. So any kind of physical, psychological stress will cause a leaky gut. If you go in the ICU and if you're healthy, you get a leaky gut. It just happens, because of the level of stress. If you take soldiers on a forced march overnight, in the morning, they'll have a leaky gut. So stress has a huge impact. Dr. Mark Hyman: And by the way, your microbiome is listening to your thoughts. So it's involved in constantly dynamically changing depending on your relationships, your experiences, your feelings. And we don't understand even the profound nature of how the microbiome influences our health. And this was shocking to me. I was on a panel at Cleveland Clinic with a colleague named Stan Hazen, who's one of the top cardiologists there, but who's studied the microbiome on heart disease. And I said, "Stan, how many of the metabolites in our blood do you think come from the microbiome?" And I thought he would say like five percent, 10%. He's like, "I don't know, maybe a third to a half." Dhru Purohit: Wow. Dr. Mark Hyman: So think about it, a third to a half of all the molecules and thousands and thousands of molecules floating around in your blood, come from the bugs in your gut. And if they're bad bugs, they're going to create havoc. And if they're good bugs, they're going to keep you healthy. Dhru Purohit: Well, let's dive into each one of those a little bit more, and let's start off with dysbiosis. You mentioned one in particular, you talked about overgrowth of the wrong type of bacteria or even like fungal overgrowth, candida. Just give us a little bit of a big picture of how does that- Dr. Mark Hyman: How does that happen? Dhru Purohit: ... come up in the first place? Dr. Mark Hyman: Why are we having a pandemic of dysbiosis? That's basically the question. And the reasons are multitude. One is, we've over sanitized our world. So we're really not living in relationship to nature in the way we were. And the microbiome of the earth helps our microbiome. We are in this symbiotic relationship. So when we're over sterilizing, sanitizing, we end up creating imbalances in our gut flora. There's books written about this called Missing Microbes, The Epidemic of Absence, which are great books talking about how our modern life has really taken us out of an intimate relationship with nature. Dr. Mark Hyman: If you grew up on a farm, if you live in a developing country, you're much less likely to have an autoimmune disease or allergies or any inflammation, because of how those microbes have helped you regulate and normalize your immune system. Dr. Mark Hyman: And then there's all the gut busting drugs that we take. The antibiotic, just massive amount of antibiotics are used in this country, and overuse in animals as well. Acid blocking drugs that people are taking like candy. It's a third leading class of drugs after statins and psychiatric drugs, basically Prilosec, Prevacid, Aciphex, Nexium, all those drugs that you can buy with a counter, now, people are taking, horrible for your gut. Dr. Mark Hyman: They prevent you from producing stomach acid, which you need to digest food. And so you get all these imbalances and the pH goes up, which means you grow different bugs and you get overgrowth of different bugs. And one of the side effects of these drugs is irritable bowel syndrome. So you fix your reflux and your heartburn, but you get irritable bowel, which one do you want? Dr. Mark Hyman: And then there's obviously drugs like the non-steroidals, aspirin, which is irritating to the gut, Advil, Aleve, all those drugs that we take for inflammation, also, damage the gut. The birth control pill also changes the gut flora, steroids that people take. So there's a whole bunch of gut busting drugs that are really common that we use. And of course, C-sections, lack of breastfeeding, early introduction of the wrong foods. The hybridization of our food supply, the extra antigens, all these weird things we're eating, chemicals, toxins, all this stuff, pesticides in our food, additives, all those go to destroying our microbiome, and ends up causing this epidemic of gut issues. Dr. Mark Hyman: The number one reason for doctor visits is gut problems. It's huge. Irritable bowel, we think, oh, it irritable bowel, it's not serious disease, but it accounts for 10% of the healthcare costs of major corporations for insurance. It's a big a big deal. Dr. Mark Hyman: So I think we have to understand that we live in a gut busting culture and a gut busting world. And that's why we're seeing such challenging issues around gut health and all the downstream consequences for gut health, which leads to so many other chronic diseases. We know that the microbiome now is involved in heart disease, cancer, diabetes, obesity, autoimmune diseases, allergies, dementia, Parkinson's, autism, I could go on and on. Pretty much every disease in some way can be linked back to the microbiome. And if you don't believe, just go on PubMed, just Google PubMed, and they'll send you a link to the National Library of Medicine, just put in microbiome and whatever disease you have or whatever thing you want to learn, and you'll see, there's amazing amounts of data emerging. Dr. Mark Hyman: And this is all new stuff. When I was starting out in functional medicine, we knew the gut was a big deal, and we knew it made a huge difference when we worked with a gut, but all the data wasn't there. And now it's just mountains and mountains of data. We're learning so fast about how the microbiome works and all the different species and what they do. But we've ended up with most people having pretty messed up guts in modern world. Dr. Mark Hyman: And I mean, there was one study where they looked at the stool from kids in Burkina Faso, which is an African country and America. And they found that their stool was so different. The microbiomes were so different based on what they ate. Denis Burkitt was a famous scientist from the UK, decades ago, who studied the differences between the hunter/gatherer societies and their cousins, basically, who moved to the city in African cities, and the differences in their diseases. And they found that the hunter/gatherers didn't have all the chronic diseases of Western civilization, but the city dwellers did. And he found that these city dwellers, their stool weight was four ounces, the hunter/gatherer's stool weight was two pounds. Dr. Mark Hyman: Why? Because they were eating tubers and roots and roughage and all this fiber, and so they had giant poops. Whereas the city drillers were eating processed food and not a lot of vegetables and who knows what they're eating. And they had these tiny little poops, and it had a huge impact on chronic disease and their health. Dhru Purohit: On the topic of gut dysbiosis, before we get to toxins and stress and unpack those, what do you want to say about a lot of the microbiome testing labs that are out there? What can we know from them? What are their limitations? And are there any ones that you feel are more superior? Dr. Mark Hyman: Here's the deal as a functional medicine doctor, the microbiome typically means what bacteria or viruses or yeast or parasites are in there? What's in there? So it's basically like taking a population survey and seeing what you got, and it's helpful. I mean, there's certain keystone species we need like akkermansia and others that make mucus layers for our gut to prevent leaky gut and the biofilm layer. And there's really importance in knowing what the balance of overall flora are. Do you have more from acute [inaudible 00:10:49]? More bacteroides? So you kind of get a sense of what's the overall ecosystem, and that's helpful. And there are a lot of companies that are testing that. Dr. Mark Hyman: But correlating that with particular conditions or diseases, there's some degree that's happening, but it's still in its infancy. And I think there's a lot of over interpretation of tests. And I think we have to be really careful. As a functional medicine doctor, I look at the actual microbes, but I'm also interested in the function of the gut, not just who's living there, but what are they doing? And often the indirect measurements are way more relevant to me. Dr. Mark Hyman: For example, I look at digestive enzymes and absorption of food, and see if you're having fat malabsorption, because I know maybe of other issues. I look at the immune system in the gut, things like calprotectin, eosinophil protein X, the antibody levels of IGA. I look at is there's some kind of irritation or inflammation. I look at something called short-chain fatty acids, which are the downstream byproducts of bacteria consuming the food that we feed them. Dr. Mark Hyman: And there are certain of these short-chain fatty acids that are extremely beneficial, like butyrate. And if you're low on them, it's a problem. It means you don't have a healthy ecosystem. Or maybe you have high levels of propionic acid, which is another short-chain fat, but it's a bad one that can cause autism and cognitive issues. Or maybe you have high levels of an enzyme that's produced by bad bacteria called clostridia, called beta-glucuronidase that actually is linked to increases in estrogen and estrogenic diseases like cancer or fibroids. Dr. Mark Hyman: Or maybe you have problems with various kinds of kind of commensal bacteria that are a little bit pathogenic. You're not looking for a true infection, but you see, oh, this is a little bit too much of this nasty bug called klebsiella. It's been linked to arthritis. I know I have to deal with that, I'll change my patient's treatment based on that. Dr. Mark Hyman: And then, of course, we look at parasites and we look at things like lactoferrin and we look at all kinds of things that we can look at, yeast. So we start to look at the whole environment, and that to me is way more relevant. And the test that I use is called GI Effects from Genova. I don't really have any relationship with them. We've just been using them for decades in functional medicine. And I think it's a really important way to look at the gestalt of what's going on. Because just looking at little bits here and there, I think we'll be missing a lot of what's actually happening and more clinically relevant things to do now. Dhru Purohit: The reason I wanted to bring it up is that people always write in from your community, and are like, "Great. I always hear Dr Hyman talking about going and test your stool." And there's no shortage of companies that are out there that are offering to test people's stool and send them information. But it's a little bit science is what I'm hearing from you when it comes to the interpretation of how to do it. That's where a good functional medicine practitioner could be helpful in helping people navigate that journey. Dhru Purohit: Okay, let's go onto the next categories. We have toxins and we have stress. So let's talk a little bit more about toxins, and unpack exactly how can toxins contribute to an overall unbalanced microbiome? Dr. Mark Hyman: Toxins interrupt normal biology. They poison mitochondria. They jam up enzyme systems. They create inflammation. They create oxidative stress. They directly affect the microbiome, for example, like glyphosate. I was shocked, because I eat pretty healthy. I try to eat organic. I never eat GMO that I'm aware of, when I buy food. But I go out to eat, if I'm traveling. And you never know what you're getting, I could be getting canola oil, it's a GMO thing spray with glyphosate. It's on my salad dressing or they made my vegetables in or whatever. So I don't always know what I'm eating. And I check my urinary glyphosate levels, and they were like pretty high. They were in the 50th percentile. I thought I'd really good, but they weren't. And I was like, "Oh boy, this stuff's everywhere." And that is a microbiome destroying chemical, for example, heavy metals are another one. Dhru Purohit: Let's just pause on glyphosate, because I think some people hear that and they're like, "Shit, this guy watches everything that he eats and is paying attention and is the guy that's teaching people." So it was a little bit of like, I just didn't want to leave it hanging there. Is it kind of like we're all doomed? Or is it- Dr. Mark Hyman: No, no. Dhru Purohit: ... how are you mitigating that? Dr. Mark Hyman: Well, now I'm a little more careful when I go out, and I'm a little more cautious about what I eat. And I'm just more smart about it. But unless you're buying all the food yourself and cooking all of it yourself, you always don't know what's in stuff. Dhru Purohit: And it's also a reminder that all these other things that you do regularly, working out, sauna, et cetera, taking the right- Dr. Mark Hyman: Exactly. Dhru Purohit: ... supplements, those things are helpful to get rid of that buildup in your body. Dr. Mark Hyman: Yeah. And so the toxins just disrupt systems and these disrupt enzyme systems. They cause leaky gut. And they're pretty ubiquitous. And they can be quite profound. I mentioned in another podcast about a guy who had mercury poisoning, and this was my story. I didn't know what was wrong with me, but I had lived in China for a year, and was exposed to a lot of mercury through the air filter that I was cleaning out and ended up... In my life I've always eaten fish. I grew up on tuna fish sandwiches. I like swordfish. I had fillings. I just was exposed to a lot of mercury. Dr. Mark Hyman: And I was fine for a little bit when I got back. But then I was up in Maine and I was at some summer camp thing I was at, and ended up getting really a bad stomach bug. I don't know what it was, but my stomach just blew up like a balloon, extreme bloating and really severe discomfort. And then my whole system just cascaded down. And that's when my chronic fatigue started. That's when I started having severe cognitive issues, muscle injury issues, but my biggest symptom was my gut. Dr. Mark Hyman: All of a sudden couldn't eat anything. I was getting bloated. I didn't know it at the time, but I had small bowel overgrowth. I had parasites, but also had terrible dysbiosis. And I just didn't know why, and I couldn't figure it out. And it took me a couple years till I figured out it was mercury. And I had diarrhea and bloating and irritable bowel for like five years till I actually was able to get my mercury levels down to normal, and then my gut normalized. Dr. Mark Hyman: So often it's kind of weird things that can sometimes be causing it. And I think it's important that people have gut issues to start with the basics. But then you start thinking, if you see that you're really not getting better. Dhru Purohit: Okay, let's go onto stress now next, what do you want to talk about when it comes to stress? And what do you want people to know when it comes to how stress can significantly destroy our gut help? Dr. Mark Hyman: Stress is one of those things that is ubiquitous. We all experience it, and learning how to deal with it is an important life skill. Whether it's through meditation, yoga, hot and cold plunges, sleeps, whether it's massage, whether it's deep relational connection with somebody else, whatever it is that resets your nervous system. But many of us are just bombarded with chronic stress and it leads to changes in our health. And one of the ways it alters our health is through change in our microbiome. Dr. Mark Hyman: And the microbiome, literally, is listening to your thoughts. The bacteria know what you're thinking and they actually change. And when you are under chronic stress, it changes the bacteria to be more toxic. The bad ones grow, the good ones die. And you end up with more and more dysbiosis, which has all these downstream consequences. Dr. Mark Hyman: So we know that people say they get gut feelings. This is a real thing that my stomach's in butterflies or my stomach's in knots or whatever metaphor we use, because the gut is directly connected to your nervous system. And there's more neurotransmitters in your gut than there is in your brain, which is crazy when you think about it. And there's a whole separate nervous system called the enteric nervous system, which, basically, it means the gut nervous system. And it communicates with your brain, but it's bidirectional. Dr. Mark Hyman: So stress here will cause stress in your gut. Stress in your brain causes stress in your gut. Stress in your gut will cause stress in your brain. We used to think irritable bowel syndrome was because people were neurotic and that was what was causing the problem. But actually we found out that the inflammation from the irritable bowel because of dysbiosis in the gut creates inflammation in the brain, which makes you anxious and depressed. So it's kind of a bidirectional system. So stress will mess up your gut, but your gut can mess up your stress, if you know what I mean. Dhru Purohit: Yeah. It just reminds us that like there's so many things that can all build upon each other and lead to a whole host of gut challenges. There was recently a friend of mine that was on my podcast, her name is Nishtha Patel. She's a nutritionist that's based out of London. And she had shared that her daughter, who suffered with irritable bowel disease, and had a situation where it sort of showed up out of nowhere for her daughter. And in unpacking it, and that led her to a path of learning about functional medicine and becoming a fan of yours, and your podcast and everything. Dhru Purohit: For her daughter, what had happened is that they were on a trip. I think it was in the Mediterranean and they were jet skiing. And they were around this area where there was some- Dr. Mark Hyman: Oil spill. Dhru Purohit: ... either algae buildup or oil spill that was there. And her daughter fell off the jet ski, ingested a bunch of water, swallowed some sort of items, and pretty much her symptoms started to show up after that process. Which naturally, especially when you didn't know where this came from, leads to more stress, that stress builds on top of the dysbiosis that's there, and it all cascades. Dr. Mark Hyman: Yeah. It's true. It's true. I think you kind have to deal with all the things that disturb the gut. It's your diet. It's stress. It's sleep. It's exercise. It's the right environments. You're not exposed to toxins at an excess level. All of that is so important. And I think we're so bad in medicine at dealing with gut issues, it's just embarrassing, given what we now know and actually what we are doing. Dr. Mark Hyman: And unfortunately, with conventional medicine, you're either told to eat more fiber or do a FODMAP diet, if you have bowel. Now, they're treating back arterial overgrowth, but they just give you an antibiotic and they don't deal with anything else to restore the gut. Or they give you acid blocking drugs for heartburn, which makes more problems downstream. And it's really a crime, because we know so much about how to deal with these issues. Dr. Mark Hyman: I've written many, many blogs about your bowel and reflux and heartburn, and I encourage, check them out or I'll link to them in the show notes. But the reality is that we now know so much about how to handle these problems in a much more effective way through diet and lifestyle, and through dealing with looking for root causes and diagnostic tests that we just don't get at the traditional doctor. Dhru Purohit: Mark, you talked about your first sort of bout with gut issues when you had mercury. There's a second time that you had gut issues that came up more recently. Can you share about that? Dr. Mark Hyman: Absolutely. I basically have had the privilege or the curse or the blessing, I don't know, it depends how you look at it, of getting pretty much everything and having to figure it out. And I've shared about this before, but about five years ago, I had chip a tooth, it broke. I needed a crown. It didn't work. I needed a root canal, and the root canal went bad. And I had to take the tooth out. And the doctor, who was a friend of mine, the dentist, and he's was an integrative dentist, he says, "Look, I think, this is pretty infected. You should take an antibiotic." And he gave me clindamycin, which I know is a regular antibiotic. Dr. Mark Hyman: It's been around forever. But it is associated with a particular, super infection called C. diff, or Clostridium difficile, which kills about 30,000 people a year. And it's pretty nasty. And it's very hard to treat. Many of the traditional medicines, which you give other antibiotics to kill. It's like, you take an antibiotic, it causes a problem, you take another antibiotic to kill that, and you cause more... And then one of the best treatments is actually fecal transplant, believe it or not, it's actually 98% effective. Where you take the poop out of a healthy person and give it to someone with this infection. Dr. Mark Hyman: But that same time I had that, I also, a few weeks later, broke my arm, and I was in pain. And so I was taking like a non-steroidal anti-inflammatory, because I didn't want to take narcotics like morphine or whatever they were giving me. I mean, maybe I should have taken the morphine, I don't know. And I ended up having terrible gastritis, which messed up my gut. So my stomach was awful. I was in pain, nauseous. It was awful. And then I developed colitis. So some people C. diff and they just get the infection, and then it causes diarrhea stuff, and they get an antibiotic, it goes away. Other times it develops into colitis. Dr. Mark Hyman: So the walls of my comb were thick. They were red. They were inflamed. My markers of inflammation called calprotectin were through the roof. I mean, normal is like 20, 30, less, mine was like a 1,000 and it was bad. I developed ulcerative colitis as a consequence of taking this antibiotic, which was for a dental procedure that, in retrospect ,I probably wouldn't have taken and I would've used other things. That might be nasal rinses or ozone or something else, but it was kind of bad. Dr. Mark Hyman: And I think we had to be very careful when we take these medications, because they can create untoward side effects that have long term consequences. And so it took me a while to rebuild back my gut, but now I've been doing that and I feel much better. We're actually launching a product that I developed out of suffering from that called Gut Food soon, which is basically designed to rebuild your gut, like a multivitamin for your gut. Dhru Purohit: And it wouldn't be a Dr. Hyman or Doctor's Farmacy podcast episode if we didn't at least touch on a little bit of food. So we covered a lot of non-food contributors, again, stress, toxins, dysbiosis. But when it comes to healing the gut, let's give people a top three. So top three things that you think that support gut health and top three things, food wise, that you think take away from gut health. Dr. Mark Hyman: I mean, the top three things that are likely to cause problems for the gut are gluten, dairy, and refined starch and sugar. Like one, two, three, those are big. If you have gut issues, get rid of those and see what happens. If you want to go next step, a little further, try getting off fermentable starches, greens and beans, are a huge issue. And certain vegetables can be problematic. Dr. Mark Hyman: There was a very amazing book called Breaking the Vicious Cycle by Elaine Gottschall, years ago, written that talked out how to treat ulcerative colitis by using what she called a specific carbohydrate diet. So it took out all sugars that needed to be digested. So you didn't get this fermentation and this bloating and distension and inflammation. So those are the things you want to get rid of. Dr. Mark Hyman: The things you want to add are three key things that are in foods that are not specific foods, but they're in specific foods, which are probiotics, probiotics, and polyphenols. Probiotics and probiotic foods are things that provide fiber to the bacteria that they like, that we can't eat. I mean that we can't digest. So they're just food for them. And they're in all sorts of plant foods, some artichokes, regular artichokes, plantains, asparagus, chicory root. A lot of foods have these prebiotic fibers that can be consumed as part of our diet. And just fiber in general, high fiber diets, in general are good for the bugs in your gut. Dr. Mark Hyman: Then there's prebiotic foods which we just talked about, and then there's probiotic foods. So those would be sauerkraut, miso, natto, tempeh, just things that are fermented that have been around for a long time, that have been used to preserve food, but ended up actually having probiotics in them. And we barely eat any of those anymore. Pickles and pickled vegetables, even pickles, I grew up on pickles, but pickles count. Dr. Mark Hyman: And then the third polyphenols, which is kind of a new discovery that good bacteria like to eat these colorful compounds in plant foods, the reds, yellows, greens, purples, oranges, and the more you can include these polyphenols from a colorful rainbow color diet actually helps to fertilize the good bugs. Things like cranberry, pomegranate, green tea, turmeric, various kinds of compounds that we can get is just part of our diet, help to fertilize and help the gut. So, yes, it's cutting out the bad stuff and it's actually eating gut supporting foods. Dhru Purohit: All right, Mark, this is the part of the episode where we go into community questions. And the first question that we have here from our audience is, I struggle with chronic constipation, what are some things that I could be keeping in mind to alleviate my symptoms? Dr. Mark Hyman: Well, constipation is very common, and it's often, we call it irritable bowel syndrome C or constipation. There's irritable bowel syndrome D, which is diarrhea. But constipation is very common and it can be many reasons for it that are not food related. Hydration is a big one. People not drink enough water. Magnesium deficiency is a huge one. Now, magnesium deficient is sort of food related, but not necessarily. It's really because, one, our diet is so deficient magnesium, which comes from greens and nuts, which we eat very little of. And two, we do a lot of things that cause us to lose magnesium, caffeine, sugar, alcohol, stress, all cause you to leak magnesium. So getting enough, magnesium is important and magnesium citrate can be very, very helpful. Dr. Mark Hyman: And then there's other factors that can cause constipation that are based on dysbiosis like, yeast overgrowth is a big cause of constipation. Dairy is a big cause of constipation, even though for some people it can cause lactose intolerance and diarrhea, it can cause constipation for many people. In fact, it's the number one cause of constipation in little kids. And it's also the number one cause of anemia, which is kind of striking. Why? Because it's an irritating protein in a set of proteins in dairy that irritate the gut and cause bleeding in the intestines of little kids. Dhru Purohit: Wow. Dr. Mark Hyman: So think about that. I'm not making this stuff up. This is in the National Library of Medicine, PubMed, major journals. So constipation's really common, and it can be, also, caused by parasites or other issues. One case I had was really fascinating, she had a tick infection, Babesia, which caused a nerve paralysis in her gut, which is really unusual. So there's sometimes unusual causes, but usually constipation's really easy to fixed by upping the fiber, upping magnesium, upping vitamin C upping hydration. Dr. Mark Hyman: And for most people that'll work. I had a patient once who was a radiation oncologist. She was a resident, actually, at the time. And she had severe headaches, migraines, and she was a resident at the Mayo Clinic, she was a doctor at the Mayo Clinic, which is where everybody goes to figure out problems that no one can fix. And she saw everybody and no one could fix her. And she was taking all the preventive drugs and all these different drugs. And it was just stuck, she was on narcotics and Zofran and chemotherapy, anti-nausea drugs that would be used for chemotherapy. I mean, it wasn't working. Dr. Mark Hyman: And she came to see me and I said, "Okay, so you have migraines, but what else do you have? Let's talk." And so we went through a list and she had constipation that was severe. She had palpitation. She had anxiety. She had insomnia, she had muscle cramps. These are all magnesium deficiency symptoms. I said to her, "So how often do you go to the bathroom?" She says, "Well, I'm pretty regular." I said, "Well, how you go?" "Well," she was like, "I go every week." I'm like, "That's not regular." "Well," she says, "it's regular for me, I go every week." I'm like, "You should go every day or twice a day." She's like, "Really?" Dr. Mark Hyman: And it's amazing. People don't even know what's normal. And so I gave her enormous doses of magnesium, because it was what it took to get her to go to the bathroom. And her headaches went away. Her muscle cramps went away. Her constipation went away. Palpitations went away. All this, insomnia went away. And so really she had a magnesium deficiency problem. Dhru Purohit: All right, Mark, this is the next question from the community member, is there a connection between our gut health and reflux? Dr. Mark Hyman: Well, clearly, reflux is a gut problem. So it means that you essentially have acid coming up into your esophagus or in the back of your throat. And it can cause all kinds of problems. It can cause cancer in your esophagus. It can cause vocal cord issues. It can be uncomfortable. People have heartburn, call it heartburn. And you see all these commercials, "Oh, don't worry. You can eat your sausage and your peppers and onions. And don't worry, you just have to pop this purple pill and everything's going to be fine." And you remember those commercials, "I can't believe I ate the whole thing," and it was this guy using Alka Seltzer or whatever? Dr. Mark Hyman: So these are really common problems. And often they're treated very simply with traditional medicine, using acid blocking drugs. They're problematic because they actually cause you to block stomach acid, which is needed to digest your food. It's needed to actually keep the pH of your lower part of your intestine normal. And you end up with all these second problems. And the causes are often the medications we're taking, which can actually be an issue. But it can also be a bacteria called H. pylori. It can be because our diet is to process and junky. If I eat fried foods, if I eat junky foods, I can get heartburn. Dr. Mark Hyman: So it's not that my stomach's the problem, it's what I'm eating is the problem. So I've written a textbook chapter on this. I've written many articles about this, and it provided a guide on how you can get rid of reflux. But, essentially, a lot of it is common sense. It's getting rid of the trigger foods, so that's often fried foods, processed foods, spicy foods for some people, citrus food, tomato foods can be an issue for some people, smoking, alcohol, caffeine, all those things are worth taking off the table for a short period of time. Dr. Mark Hyman: And then seeing how that works. Checking for H. pylori's is really important. And also treating imbalances in your gut. Magnesium deficiency can be also a cause, because the sphincter are in the lower part of the stomach has to relax in order for you to actually let the food go down. So there's a lot of things you can do to help calm the stomach down. We use glutamine, zinc, carnosine, another form of zinc that can be very helpful, and licorice, deglycerized licorice, DGL, which is also very helpful. So there's a lot of ways to treat this. And almost all of my patients with reflux get better pretty quickly by follow a functional medicine approach. Dhru Purohit: All right, Mark, so those are the questions that we had for today's episode. So this is a great opportunity to do a little bit of a recap on the top things non-food related that contribute to dysbiosis inside of the gut and just overall poor gut health. Dr. Mark Hyman: Well, thank you Dhru for asking that, but people will think, oh, my gut is only problematic, because of food, but it's so many other things that we don't think about. It's imbalances in the gut flora that come from our gut busting lifestyle and medications, it's environmental toxins, and it's stress. And sometimes it's latent infections or things that we haven't even thought about. And so I encourage people to just not take it at face value that they have X or Y disease. I have reflux. I have irritable bowel. I have inflammatory bowel. These are just names that we give to people who share certain symptoms. They don't tell you anything about what to do about it or what the cause is. Dr. Mark Hyman: And that's why in functional medicine, we focus so much on the gut and we're so good at addressing gut dysfunction. So if you've been listening to this podcast and you know someone with gut issues or you have them, please share this with your friends or family. We'd love to hear from you about how you've helped yourself with gut issues that maybe weren't related to food. Subscribe wherever you get your podcast. And we'll see you next time on The Doctor's Farmacy. Speaker 1: Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that 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 services. Speaker 1: If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.