The Brain-Body Fix: How Magnesium, Omega-3s, & Vitamin D Transform Your Health - Transcript

Dr. Mark Hyman
Coming up on this episode of The Doctor Hyman Show. About twenty percent of the population is living with over magnesium deficiency. This is full blown magnesium deficiency, and that's like one in five people. That's a lot of people.

Subclinical or insufficiency, not true deficiency which you'd see in a lab test, but insufficiency can affect up to eighty percent of the population. Now before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, there's simply not enough time for me to do this at scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive.

And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at DrHyman.com for my website store for a summary of favorite and thoroughly tested products. Probably eighty percent of Americans are in deficient or have insufficient levels of vitamin D, levels that don't protect them optimally from the things that you wanna have vitamin D protect you from, whether it's osteoporosis or depression or cancer or to boost your immune system so you don't get things like the flu or COVID. I mean, if you have a high vitamin D levels, your reduction in flu is 75%. That's more than the flu vaccine. So it really is a powerful nutrient.

It's very safe at the recommended doses. It's easy to take. There's no side effects. It's very cheap. And it's such an incredibly important vitamin for optimizing your health in every way, including longevity.

So let's talk about vitamin D a little bit. Now people think they should be avoiding the sun to get not get skin cancer, but, vitamin D actually protects you against skin cancer, believe it or not, and reduces the risk of melanoma dramatically in many other cancers, not just not just skin cancer. It actually reduces overall mortality by seven percent. So just having good vitamin D levels reduce the risk of death by seven percent. And vitamin D, you know, we used to get from sun running around naked, hunting, gathering.

And also, if we were living in colder climates, we would eat fish, wild fish, like, herring and sardines and mackerel. And these these fatty small fish have pretty high levels of vitamin D. Also, mushrooms. So if you're foraging and going for mushrooms, there's a lot of, like, porcini mushrooms have the highest levels of vitamin D, but it's still hard to get enough. We're not getting these foods anymore.

So, you know, we saw such a with the industrial revolution, this incredible advent of, rickets and vitamin D deficiency. And it's one of the, you know, major areas where we've seen a public health improvement by getting awareness of vitamin D. Now it's been fortified in milk. Milk doesn't necessarily have vitamin D. It does actually doesn't have vitamin D.

It only has vitamin D because it's added in to the milk. So if you think you need vitamin D to get your I mean, milk to get your vitamin D, that's not actually true. You don't you don't get a vitamin D from milk only because it's added. Now most of the problem with vitamin D is that doctors don't understand how to diagnose it. They might even order the wrong test.

They don't know the right treatment. They don't know the doses. They don't understand its importance. And they see the reference levels on lab tests, which are typically like twenty nanograms per deciliter. Now that is ridiculously low.

And I think if you look at what's optimal, it should be over 45 or 50. And so many, many people are in this sort of borderline area of less than 20 or 20 to 50, where they do need more vitamin D. Now most doctors think, oh, you don't have Ricketts. You you don't have vitamin deficiency or your your number's like, you know, 20 or 30. You're fine.

And they're actually wrong. And the question is, what's the dose you need to not get Ricketts? It's probably like thirty units a day. It's not not what we need for optimal health. What we need for optimal health might be more like five thousand units a day.

I mean, even the, government's upper limit is, you know, four or five thousand a day is a safe dose. You're not gonna get into trouble with that. Some people are, you know, very good at absorbing it. Others aren't. Some people need actually up to ten thousand units a day.

There was one study where they gave, healthy young adults ten thousand units of vitamin D for three months, and there was no toxicity from that. Now, you can get toxicity if you take a lot more. I mean, and it can cause a problem. But it's it's far lower than that, you know, we we we think. And in fact, your level has to be over 250, even though the reference range on the labs is up to a hundred.

You know, it doesn't really get become toxic until about two fifty. So the real question is, you know, how much should we be taking on a daily basis? And I think they're depending on you and your vitamin D level, your sun exposure. I mean, I have a friend who lives on the beach and, you know, goes out surfing every day, and his vitamin D level is about 45, which is pretty good with no vitamin D supplementation. But I rarely see that unless she's living in Mexico on the beach all the time.

But if you if you if you aren't, you probably need between two to five thousand units a day of vitamin D. You know, what's really concerning is when you look at the data, you know, it's it's 80 of us who are insufficient or deficient. This is either frankly deficient, let's say less than 30, which is now the reference range on most labs, some still say 20 and those who are between 20 and 50. So I think that's important because vitamin D deficiency is linked to many cancers, high blood pressure, heart disease, diabetes, depression. We call it seasonal affective disorder or SAD, Fibromyalgia.

I mean, people have muscle aches and pains. These are often from low vitamin D levels. Bone loss, obviously osteoporosis. Even autoimmune diseases, multiple sclerosis, found in much higher levels in northern latitudes and where there's low vitamin D. And so vitamin D is really important for for everything, including autoimmune disease.

And it's really not hard to do. I mean, you really, you know, could could make a dramatic difference by just getting people's levels of vitamin D up to forty five nanograms per milliliter. And that would literally lead to four hundred thousand fewer premature deaths a year. That is no joke. There was one study that showed that if your vitamin D levels were low, you were seventy five percent more likely to end up in the hospital or in the ICU from COVID.

If your if your vitamin D levels were over 50 from one big Israeli study, there was no death, like zero. Now that may be not true if you keep doing the study, and it may be a little bit bigger. There may be occasional deaths, but the point is here that vitamin D is highly protective. So, you know, I I think, you know, we probably should have a vitamin D mandate in this country. Now when my patients get their levels up, they feel better, they have more mood improvements, they their muscles recover better, their thyroid works better, their energy's better, their their whole system works better.

And so it's a really important thing to make sure you get. So how does your body, like, make vitamin D? Now we obviously never had to take supplements when we were hunting and gathering and evolving because we're outside most of the time. And and in fact, 80 to a hundred percent of the vitamin D that we need is created because of exposure to the sun. And and when you get a little bit of a sunburn, you know, we call a minimal erythromal dose, which means basically the dose that makes your skin a bit red, when you get a sunburn, that might produce between ten to twenty five thousand units of vitamin D in our bodies, which is great.

The problem is most of us don't get that kind of sun exposure. And a lot of times we use a lot of sunscreen, which is not necessarily bad. Well, it depends on which sunscreen you're using, but they block a lot of the benefits of getting vitamin d. So you might be out in the sun but using sunblock and then not getting vitamin d. Now if you live in a northern climate, you're for sure not getting enough sun and vitamin d, especially in the winter.

And you're probably not eating a lot of the, you know, porcini mushrooms and baccarat herring and cod liver oil. Right? Also, the other problem is as we get older, our our skin does not convert the sun into vitamin D in the way that we did when we were younger. So the average 70 year old creates only 25% of the vitamin D that a 20 year old does. Also, depending on your skin color, if you're have dark skin, if you're African American, you basically will produce far less vitamin D, and you need a lot more sun exposure.

So most African Americans are very deficient in vitamin D. I'll also recommend that that everybody supplement. Now yeah, I I think it's one of those basic supplements that everybody should get. It makes such a difference, and you should have a level between 45 to 75, let's say. And the only way to know what that is is to test.

You need to test and find out what's going on. And and you can guess, but you you often will be off. Some people need two thousand units. Some people need five thousand or ten thousand units to get their vitamin levels up to, you know, the ideal level. And and you can do that through your doctor or, you know, I cofounded a company called Function Health.

You go to functionhealth.com. You can join the wait list and get testing that actually helps you to get your actual levels, to know what you're doing, to check it over time. I think if you use the code young forever, you can get in and and actually get off the wait list. So try that and see how you how your vitamin d levels are, but it's important to know. And and and and often doctors say, oh, don't worry.

Just take just take the vitamin d, but you really wanna know what your levels are. Also, if you wanna get, you know, sun exposure, the best is ten to two in, obviously, the summertime, ten to two 10AM to 2PM, full body sun exposure for twenty minutes. That that will I mean, you can cover your face or put some luck on your face, but you really wanna have full body exposure. I mean, it only works in the summer and only works if you live, you know, below Atlanta. So I recommend taking vitamin D and probably two to five thousand of vitamin d three.

It's important to take vitamin d three, not vitamin d two. Most doctors will prescribe vitamin d two, which is unfortunate, but make sure you get the right vitamin d. And, again, it it depends on your age, your your genetics, where you live, how much time you're in the sun, time of year. But if you're, oh, in the summer, I don't need it. But it's actually not true you need it during the summer unless you're out there all the time.

So check your vitamin D levels and find out what's going on. Now what about, protecting yourself from skin cancer? That's important. Right? You wanna make sure you don't get skin cancer, particularly on your face.

So I think, you know, if you wanna go out in the sun, great. Use sunscreen on your face. If you wanna you're worried about getting a sunburn and you're really out there a lot, you can use high SPF sunscreen. But, you know, you're gonna get vitamin D from your supplements, you should be okay. The high SPF, you know, it it kinda gives people a sense of security that you can go out there and just burn up.

But you wanna be careful. You don't you don't wanna do that. You wanna make sure you just, you know, moderate your sun exposure, avoiding the high high ultraviolet radiation exposures that you can get from prolonged sun exposure. So, basically, use sunscreen. And also, by the way, you wanna use sunscreen that doesn't have crap in it, and we'll talk about that in a minute.

So over the counter sunscreens are fine, but but they're often full of crappy harmful ingredients. EWG found 80% of the 1,700 products they looked at that were sunscreen had inferior sun protection or had, like, really weird ingredients like oxybenzone or other parabens. I had a woman once who was in my practice, and she had super high levels of toxins in her urine from parabens. And she's like, a super health nut. And I'm like, what are you what are you doing?

What are you exposed to? What plastics or chemicals? She said, oh, well, you know, I use a ton of sunscreen all the time every day. And so she had high levels of these toxic petrochemical plastics in her urine that were coming from the sunscreen. A lot of it wasn't getting out of her body, so it wasn't great.

Also, you should be worried about sunscreen with vitamin A. If you use vitamin A, it actually can make make the skin cancer more likely. So I would be particularly careful of that. But the bottom line is choose, you know, good average low SPF sunscreen. Don't rely on it for total protection.

Cover your face mostly. And and and you'll you'll be able to go out and enjoy the sun. So what are the seven strategies I use to get, you know, safe sun exposure? Well, don't don't be afraid of the sun on your vacation. Don't obviously get overexposed.

Right? Because, you know, getting overexposed doesn't just ruin your vacation and give you a sunburn. It can lead to long term issues with skin damage and skin cancers and more wrinkles, which nobody wants. So try to get at least twenty minutes of sun exposure every day. It's first thing in the morning ideally, which the morning sunlight helps trigger your brain to release chemicals and hormones like melatonin.

It kinda resets your circadian rhythms. It helps mood, healthy aging. Use sunscreen, but only when you need it. And particularly use the safe sunscreens. You can check out Skin Deep, which is a database from database from EWG, and it's great.

Be proactive about protection. So don't, you know, overdo it. Right? Try to get shade, umbrella, tree, you know, hat. I mean, protect your clothing.

That's fine. If you want to don't get skin cancer, which I don't wanna get. Make sure you cover up. Sunglasses are important. You don't actually get sunburn in your eyes, but you're you get cataracts from prolonged sun exposure without UV blocking sunglasses.

So that's important. Don't get burned. Burning is really bad because that leads to more risk of skin cancer. Choose a skin cancer that has optimal UVA protection. Don't do tanning beds.

Get vitamin d, which will help reduce your risk of skin cancer. And, you know, there's good evidence that it's some block prevents squamous cells, but not necessarily basal cells. So make sure you get skin checks, get your skin checked for cancer on a regular basis every year, make sure you get a good dermatologist to look at it, and they can get things when they're early, and and they're really not a problem. You don't die from skin cancer except melanoma, which is not necessarily sun related. Basically, that twitches, spasms, cramps, or is irritable in your body is likely in full or in part related to inadequate magnesium levels.

Things like heart palpitations, anxiety, depression, insomnia, blood sugar issues, hormone imbalances, irritability, aggressiveness, PMS, menstrual cramps, preterm labor, muscle spasms, tremors, vertigo, ringing in your ears, tinnitus, chronic pain, muscle weakness, kidney stones, angina, high blood pressure, constipation, acid reflux, headaches, hearing loss, being sensitive to loud noises, immune dysfunction, seizures, right, which is irritability of your brain, cognitive decline, and all these muscle cramps are related to potentially low magnesium levels. So if you have any symptoms, you gotta be thinking about magnesium. So why is it a problem? Well, about twenty percent of the population is living with overt magnesium deficiency. This is full blown magnesium deficiency, and that's like one in five people.

That's a lot of people. Subclinical or insufficiency, not true deficiency, which you'd see in a lab test, but insufficiency can affect up to eighty percent of the population. Now why is this important? Well, unlike drugs which work with one pathway and one particular reaction in the body, magnesium and most vitamins and minerals, by way, work on hundreds and hundreds of different pathways, and and magnesium is involved in over 600 enzymatic reactions in your body. Now enzymes help convert one molecule to another, critical for everything, and it basically influences every single one of our biological systems, which is why it can cause symptoms all over the place, from your brain to your heart to your your gut and constipation to menstrual issues and cramps and muscles.

I mean, it's literally everything. And in in low levels or suboptimal levels impact every area of our health, increase our risk for chronic disease. So it's not just kind of this annoying symptoms like muscle cramps. It it it puts you at big risk for serious illnesses. Now it really probably should be considered a public health crisis, but most physicians don't test for it.

It's not on your regular blood panel you get every year. If they do agree to test for it, they'll likely run it, we'll call it serum magnesium test. That's what I learned in medical school. But it's not really the indicator of what's happening in your body. It's like, this joke I often tell when I'm giving lectures.

You know, this guy dropped his keys, on the street, and his friend comes over and sees him looking under this lamppost. He goes, well, why what are you looking for? What are you doing? He says, well, I'm looking for my keys. He said, where'd you drop them?

He said, I dropped them down the street, but he said, why are looking over here? He says, well, the light's better here under the lamppost. So that's how medicine is. It's easy to test your magnesium, but it's not the right way to find out if you're low or not. I mean, if it's low on serum magnesium, you're really, really low.

By the time it gets low, you're in trouble. Now in a perfect world, I'd have the chance to see millions of patients, but the truth is I'm just one doctor. Over thirty years of seeing millions of biomarkers and tens of thousands of patients, I've come to understand that much is being missed by conventional health care. We often wait until we have symptoms of diseases, then we get tested, but the transition from wellness to illness can often be detected decades before any symptom or diagnosis. I want people to have access to their own health data and the ability to engage in self care and lifestyle practices that I believe can optimize their health and reverse the trajectory of chronic diseases that now affect six in ten Americans and accounts for over $4,000,000,000,000 in healthcare costs.

And that is why I recently co founded Function Health, where I'm the chief medical officer. Function is a revolutionary way to understand and manage your health through lab testing that you're often not getting through your healthcare system. All the results are delivered in an easy to use dashboard that tracks your numbers over time and gives you actionable insights for every biomarker. The best test, which is really not practical, is something called a magnesium loading test, which is a twenty four hour urine test. And you basically give people magnesium IV, and then you collect the urine for twenty four hours and you see what spills out.

And if they don't spill out anything, it means they're alone magnesium. If they spill out a lot, it means their body's good and they can get rid of what they don't need. The next best test, and what we do with Functional Health, is called the red blood cell magnesium level. Now this is not as good as the magnesium loading test, but it's pretty good. And it gives you a sense if you're insufficient or low.

And people should be over five, and often we see levels much lower than that. Okay. So what does magnesium do? Why should you care? As I mentioned, I call it the relaxation mineral.

I think about Epsom salt. Right? That's magnesium sulfate. You soak in a hot bath, your muscles get relaxed, you don't have soreness. It just basically relaxes everything.

And again, it controls over 600 different enzyme reactions. It helps in the production of ATP, which is the thing that makes you move and grow and do everything you do. It's basically the energy of life. And it's it's really the key to making energy in the body. And and often when you see low magnesium, and I've had this before, it, it can be, something that's found in chronic fatigue syndrome, fibromyalgia.

Often if if you have insulin sensitivity, issues, in other words, you're insulin resistant, and your blood sugar is not good. It could be low magnesium. And magnesium is very much involved in blood sugar regulation. Also, it's involved in regulation of vitamin d in the body, the activation and transport of vitamin d. It's important you're not not just for muscle health and contraction and relaxation of muscles, but also, bone strength and bone density.

It's also critical in making hormones such as, testosterone, progesterone, estrogen. It's important in the sense this neurotransmitters in your brain. It's involved in calming and relaxation, and inhibits the release of what we call excitatory neurotransmitters. It's also involved in DNA repair. It's involved in, fluid and electrolyte balance, right, with calcium, sodium, potassium, and which and hydration, which is why it's often an electrolyte.

So it's really important for electrolyte replacement. It's critical for heart. Right? I mean, a heart having a healthy heartbeat, blood pressure, high blood pressure is basically tightness of the arteries and and the blood vessels, and so magnesium is used in relaxation. We actually, when when we have patients with with really severe diseases, this was so interesting.

When I treated as doctor, it was kind of a last resort drug. Right? It's a it's a mineral, but it was a drug that we used when things didn't work, or nothing else worked, for example. So, if you're in every ICU, in every cardiac unit, in every emergency room. It's on the crash cart, which is basically what we use when we resuscitate a person who basically has their heart stop and stop breathing.

And when none of the drugs work, the last thing we give to stop cardiac arrhythmia, which is the rapid beating of the heart that can kill you, we use intravenous magnesium. We use it to treat preterm labor. If someone comes in in early labor, we give them IV magnesium. If someone has high blood pressure in pregnancy, called preeclampsia, and that causes seizures, we give them intravenous magnesium, and we only use it when everything else has failed. But it shouldn't really be like that.

We also use it for bowel prep. If you're constipated, it's basically one of the best treatments, milk and magnesium. You heard of that. And, it also is used to prep for colonoscopies such as magnesium, magnesium citrate, which makes you really go. So it's used in everything in the body.

We use it in medicine a lot. It's just kind of one of those things that doctors don't really think about as a problem for people when they come in with all these symptoms. So the question is, why are we deficient? Right? Well, seventy five percent of Americans aren't eating enough magnesium in their diet.

Where does it come from? Dark greens, beans, nuts, seeds, seaweed, people don't eat that. You know, it's declining soil quality. It's resulted in almost a 50% decline in magnesium in fruits and vegetables over the last fifty years. There's been, a dramatic decline.

So I think it's really concerning. Also, you know, about twenty five percent of kids are magnesium deficient, which is very concerning to me too. It's critical for their bodies and to grow. Another thing is ultra processed foods deplete magnesium. So 60% of our diet is ultra processed food, 67% of kids' diets.

Food processing reduces magnesium in the food by up to 80%. Also, we if we eat a lot of high starch and sugar foods, which is our standard American diet or SAD diet, those foods deplete magnesium. So the more sugar you eat, the more starch you eat, the more you lose magnesium and increases the rate of excretion of magnesium, and that's not good. So you eat sugar and starch, pee out magnesium. Also, the recommended levels are are to prevent deficiency diseases.

The RDA, what we call the RDA, is about three hundred to four hundred twenty milligrams. It's just too low. It's said to prevent deficiencies, but it's not really about optimal health. And about half the population doesn't even get the minimum amount you need to prevent deficiency. And globally, it's a huge problem, as well.

In a study of healthy, university students in Brazil, they consumed, an average of about two hundred and fifty milligrams of magnesium and forty two percent have low levels in healthy, quote, healthy college students. Also, there's a number of groups that are high risk for magnesium deficiency. So if you're in one of these groups, you got to pay attention. If you're pre diabetic or diabetic, if you're low in magnesium, it increases the risk of various things like eye damage or retinopathy, neuropathy, nerve damage, kidney disease, and blood vessel disease. It's really critical in regulating our blood sugar.

For women, it's involved in estrogen regulation, metabolism, detoxification, and deficiency is present in about eighty percent of pregnant women and fifty five percent of women with hormone related issues. Think about that. You know, I mean, you're pregnant and eighty percent of women are deficient, it's one of the biggest causes of preterm labor is low magnesium levels. So if you have low, preterm labor or you have high blood pressure in pregnancy, like I said before, we treat you with intravenous magnesium. So why not take magnesium?

Also, you can get constipated when you're pregnant too. So it helps with all that. Eighty four percent of postmenopausal women with osteoporosis had low magnesium. So this is just a rampant problem. As you get older, you're not so good at absorbing things.

There's another group that has risk. So you don't absorb it, you excrete more magnesium. If you have certain age related diseases that cause low magnesium, certain medications, we'll talk about in a minute, can lower magnesium levels and make you peel magnesium. Often things that are used to treat high blood pressure, like diuretics. If you look at hospitalized patients, sixty five percent of people who are critically ill who are admitted to the ICU or intensive care unit were magnesium deficient.

And with COVID nineteen, we saw also those who had the highest magnesium intake had the lowest levels of inflammation and had 70 lower odds of developing severe symptoms. So just taking magnesium can reduce the inflammation if you get COVID and reduce your risk of having severe COVID by seventy percent. That's amazing. And this is completely safe. Unless you have kidney failure, it's an incredibly safe mineral to take.

Now, the other thing you should know is is, you know, most doctors don't think about it unless you're in extreme situation, like like we talked about, whether you have preterm labor and arrhythmia or having seizures from pregnancy or high blood pressure in pregnancy. We just don't think about it, But we should. And again, as I mentioned, if it's tested, it usually is a serum magnesium, which doesn't reflect the whole body. It's only about 1% of the magnesium in your body. 99% is in your tissues, your bone, muscle.

The body has really tight regulation methods for magnesium, and it pulls from the reservoirs in your bone or muscle if you want if you're needing to keep levels stable. So if your whole body is depleted, it's going to be hard to replenish. And, normal serum magnesium levels are about 1.8 to 2.3, but I think anything under two is linked to increased health risks, and optimal levels should be over two. So if you're getting a serum magnesium, it should be over two, but I don't like that. I like the red blood cell magnesium.

So functional medicine looks at this a little bit differently. We look at, you know, comprehensive testing, look at what's going on with all the biomarkers, and we look at red blood cell magnesium. It's way more accurate reflection of whole body magnesium. It measures intra cellular magnesium, which is where often it needs to be to do the job. It reflects the magnesium content of muscles and bones.

It has a longer half life. It's less prone to fluctuations from your diet, and it correlates with clinical symptoms. So it's a really good biomarker that is part of the function panel that you're not getting when you go to your regular doctor. We're sure it's not on your annual panel and it's probably not on any panel that they do at all if you're going to measure magnesium. The other things you can kind of look at in relation to magnesium that are part of the functional panel include kidney tests like creatinine and BUN, vitamin d levels, because low levels, are often associated with it, with low levels of magnesium absorption, just like calcium absorption.

Calcium levels are also interacting, potassium levels, low levels of potassium, or calcium can be an indicator of low magnesium. If you're high in sodium and other, clearly, you might have a low magnesium. If your blood sugar's high, your your insulin's high, your a one c, your average blood sugar's high, blood sugar sugar is is a sign of low magnesium. So a lot of things you can look at to kind of get a clue that you might be magnesium deficient. Another hormone that's important you should look at is a parathyroid hormone.

We also think it's important to look at that, And magnesium can be involved in in the release of parathyroid hormone from the parathyroid gland in the neck. And if your parathyroid levels are low, you're gonna have low magnesium. So it's important to look at all this stuff, look at your EKG, look at your heart function. So there's a lot of ways to look at magnesium, but key is red blood cell magnesium to start. What are the root causes of having an abnormal, magnesium or low low magnesium?

Well, our diet. Right? Our SAD diet or standard American diet, as I mentioned, salt and sugar make you pee out magnesium and starch. Phosphorus also, that's in in soda. Right?

Colas, particularly food additives. And they're all these things are used in ultra processed foods, and that causes us to peacefully pee out magnesium. Coffee and alcohol also make us lose magnesium. And too much calcium from supplements, not a good idea either. Stress, another one.

Chronic stress is a big factor. Because, obviously, when you have a magnesium, your nervous system is relaxed, your body's calm. When you are stressed, you actually pee out magnesium. Those, living in Kosovo during the War in One study, had higher cortisol levels, which is a stress hormone, and lower magnesium levels. Also, if women have heavy periods, it's another, factor that can cause low magnesium malabsorption issues.

We have celiac, inflammatory bowel disease, colitis, Crohn's. If you have diarrhea, you lose magnesium. If you're, and have diabetes and you're peeing too much, you lose magnesium or kidney damage, you'll have magnesium issues. Also, you sweat a lot, like you do saunas, exercise, go in a hot climate, you're gonna, without electrolyte replacement, get into low magnesium states. Again, over supplementation with calcium, you don't want to do that.

And then a few other things can cause you to have, magnesium issues. One is, having aluminum from antacids and cookware, food additives, drinking water, deodorant, all that will potentially affect your magnesium. Drugs, a lot of drugs, as I mentioned, affect magnesium levels. So these are common drugs like diuretics, which are used in high blood pressure, which is often a low magnesium issue, certain antibiotics, steroids. As I mentioned, the cortisol will make you lose magnesium, used for inflammatory disorders.

Acid blocking drugs we use for reflux are horrible because they block acid which you need to absorb minerals such as magnesium. And other deficiencies of nutrients like vitamin b six or vitamin d or selenium often will cause us to have a low magnesium. Alright. So what are the things we talked about? Let's just kinda go over those.

What are the things we should be worried about that can be related to magnesium deficiency? Well, cardiometabolic disease, type two diabetes, as I mentioned. In one small study, they looked at the intracellular magnesium status of patients with diabetes and it was depleted over thirty percent of patients. And now this problem affects ninety three percent of the population to some degree or another. Heart disease, another big category.

If you have a coronary artery disease, and this is the Rotterdam study, looked at ten thousand people, reported a thirty six percent greater risk of death from heart heart attacks and a fifty four percent greater risk of sudden cardiac death in those with low serum magnesium levels. So that's really concerning. So if you have low magnesium, you're fifty four percent greater to die, from a sudden death, thirty percent greater risk of having a heart attack. That's bad. If you have high blood pressure, often a clue that you might be low in magnesium because magnesium relaxes blood vessels and improves flexibility.

If you have palpitations, a rapid heartbeat, again, magnesium could be the cure. Heart attack, strokes, and a blockage in your arteries. Again, studies show that this was a cross sectional study published in nutrition metabolism and cardiovascular disease showed that otherwise healthy Koreans with the lowest serum magnesium had two times the risk of having calcium buildup in their heart, which is a huge clue that there's atherosclerosis or plaque development. And also it's involved in calcium metabolism. There's too much calcium, not enough magnesium, it's a problem.

You've had a stroke, you know, those with, highest versus, lowest magnesium intake had a forty percent reduction in all cause mortality versus the lowest intake. So basically, if you had high intake of of magnesium and end up with a stroke, you're gonna have a forty percent reduction in your risk of of death after. That's pretty good. It's low magnesium in linked to cataracts. It's linked to headaches, obviously.

In fact, the American Academy of Neurology gives magnesium a level b rating as as probably effective for the prevention and treatment of migraine. So often when someone comes in with a migraine to the emergency room, I would give them intravenous magnesium because it relaxes all the spasming blood vessels in their head and helps them relax. Osteoporosis, often we see it low in osteoporosis as we mentioned. We see a problem with chronic fatigue and fibromyalgia, mood disorders, anxiety, depression, ADHD. Autism often is very low in these problems.

Sleep issues if you have insomnia and you can't sleep or other problems, that may be magnesium. It's one of the best sleep aids out there. People don't realize it. If take magnesium at night, you'll sleep well. And, Epsom salt baths do the same thing you can get through your skin.

If you have hormone issues like PMS, often a low magnesium issue or PCOS, fibromyalgia, as I mentioned, asthma, twitchy airways, chronic kidney disease, seizures, all these things can be a clue that they may be low magnesium. Now, what about high magnesium? Well, this is very rare, but there are certain things that can cause it if you have chronic kidney failure, adrenal issues, maybe, different kinds of tumors or problems to your adrenals, overtaking antacids with magnesium in them, severe dehydration because it changes your electrolyte balance and you lose a lot of potassium and sodium. And the symptoms of it having high magnesium are nausea, vomiting, fatigue, low blood pressure, trouble breathing, and even respiratory problems and heart attack because it slows everything down. So basically, when we give IV magnesium to women who are in preterm labor, we watch their respirations because it slows down your respirations, it slows down your breathing, it slows down your heart, it relaxes everything.

So the idea is if you have too much, it kind of relaxes things too much, and that's not good. Okay. So how do you how do you address this? How do you address and treat magnesium deficiency? Well, it just get rid of the causes.

Right? We just talked about that. Get rid of the the crappy diet, the sodas, the manage your chronic stress levels. Take a look at your medication. Are you taking acid blockers?

Are you taking diuretics? What are you taking? Do you have certain health conditions that need to be addressed, whether it's diabetes or heart disease or or other hormonal dysfunctions that can be addressed that actually will help you deal with this from the root cause. So, it's really important to look at the at the, at the causes and remove what's causing the magnesium deficiency. Maybe it's poor diet, maybe it's taking stuff that's causing magnesium loss.

So what should you do to actually improve your your magnesium levels and to address magnesium deficiency or insufficiency? Well, first, you want to eat magnesium rich foods. What are those? Well, dark green leafy vegetables, things like spinach, Swiss chard, kale, collards, all that stuff is great. Arugula, avocados, cold water fish, mackerel, salmon, nuts are high in magnesium.

Almonds, cashews, brazil nuts, pecans, walnuts, seeds like pumpkin chia seeds. Dark chocolate, my favorite one of my favorite sources of magnesium, actually. Whole grains can be helpful, nonchimos soy can be helpful too. I like tempeh. So the diet can be a big factor in replenishing magnesium.

Also, you want to find healthy ways to manage stress, right? So active relaxation, yoga, breath work, gratitude journals, riding your bike, working out, getting in the sauna, cold plunges. There's a million ways to actually improve your, stress response, whether it's a I use binaural beats with something called NuCom, which is some fun thing I've been trying, which basically puts you in a different neurotransmitter state, a different brainwave state. Also, make sure you replenish your electrolytes. If you're sweating, you're exercising, you're doing the sauna, make sure you use electrolytes that have sodium potassium and magnesium.

And then supplements. What about supplements? I think, you know, of all the supplements, of all the things that I use, one of the most important is magnesium, probably the second in vitamin D and third would be fish oil. But it's so important. And most people have such improvements pretty quickly when they take it.

And it can improve your sleep, it can reduce anxiety, it can reduce palpitations, it can we do muscle twitching, muscle cramps, I mean, so many things, constipation. Now, there's a lot of different forms of magnesium, so you should be aware with all the different forms. But, the dose should probably be between four hundred to a thousand milligrams of magnesium a day. Now, are many different forms with all different effects, so you have to figure out what you need. For example, my favorite basic one for everybody is magnesium glycinate.

It's broad spectrum, it works across a lot of things that help with sleep, with relaxation, anxiety, PMS, cardiovascular health, that's taken at night. Magnesium citrate, you can use if you have constipation, so that actually helps you go to the bathroom. Magnesium threonate, better for the brain, gets in the brain better. Anxiety and depression is is what I use those for. Some are also great better for muscles like magnesium taurate, which is great for muscle recovery, blood sugar regulation, heart health.

Magnesium malate, again, this is part of the mitochondria and energy cycle, so it helps energy and athletic performance. Magnesium sulfate, we use that, it's Epsom salt, so you can absorb it through your skin. You can try my UltraBath, which is two cups of Epsom salt and 10 drops of lavender oil, hot water, soak in that for ten to twenty minutes before you go to bed and you'll sleep like a baby. So basically, just to review, magnesium is so important. It plays a critical role in optimal health and longevity and chronic disease prevention.

Conventional medicine often focuses on treating the acute issues and not understanding the root causes. You really shouldn't be waiting for symptoms to appear to take charge of your health.

Andrew Huberman
The studies that look at EPA, essential fatty acids, and the gut microbiome. Those are the two things that to me, it's like, it's undeniable. I don't understand how anyone nowadays could even question the idea that getting proper lipid intake, know essentially

Dr. Mark Hyman
The brain is fat.

Andrew Huberman
Yeah these omega threes are so important. Mean in a double, several double blind placebo controlled studies that I've read, it appears that getting a thousand milligrams or more per day of EPA, so not just taking a thousand milligrams of fish oil but making sure that you're getting above that threshold of a thousand milligrams of EPA from quality sources, compares just with similar effect as SSRIs, prescription antidepressants, but without the side effects, right? Which is incredible and that if you are taking SSRIs, it allows you to take a much lower dose to still be effective. To me like incredible data and then the other one is that getting ferment, ingesting fermented foods one or two servings a day.

Dr. Mark Hyman
Sauerkraut for the brain.

Andrew Huberman
Yeah, sauerkraut for the brain or whatever given culture because what I learned and this is very new and emerging data, there's a guy at Duke, he's incredible, he was a nutritionist but then he has PhD nutrition, excuse me, and now he's a neuroscientist, his name is Diego Borges, not to be confused with the Argentine writer Borges, he's Ecuadorian and he found that there are neurons in our gut of the vagus nerve. These are neurons that live in the gut endothelium, and they sense three things. They fire electrical signals to the dopamine centers of the brain in response to fatty acids, right, they're when fats are you know, meats and things are broken down in the fatty acids, amino acids of other kinds, so from protein and sugar. Sure. And what, and so these neurons can easily be tricked into signaling the brain to release more dopamine and because dopamine is really the molecule of craving, into craving more of whatever activated those neurons.

And so if you give these neurons enough EPA or enough amino acids, so protein and essential fatty acids, the dopamine centers of the brain are just firing like clockwork, is going to enhance mood, motivation, energy, I mean dopamine in proper amounts is a beautiful thing. Too high obviously you don't want, but you're not gonna get it too high.

Dr. Mark Hyman
People don't get addicted to chicken breast, but they get addicted to sugar.

Andrew Huberman
Right, and I think that's, I actually think that's because they are, these neurons seem to be responding best to particular amino acids, they seem to want glutamine of all things, they seem to want the omega threes, and what's interesting is that even if they numb the taste so that people can't taste sugar, if people ingest sugar, these neurons

Dr. Mark Hyman
Sugar receptors in your gut, right?

Andrew Huberman
And they crave more sugar even if they can't taste the sugar. So I always thought that the dopamine release to sweet things was because it tastes so good. But the Borges lab results and some other work on dopamine more generally from my colleague Anna Lemke at Stanford shows that dopamine isn't so much about pleasure. We all, including myself, we're taught it's about pleasure. Dopamine is about craving more of whatever it is triggered dopamine release.

Dr. Mark Hyman
Yeah. Whether it's heroin or cocaine Right. Sugar.

Andrew Huberman
Or sugar. And so these neurons that trigger dopamine release, they are powerfully affected by these quality omega threes and by amino acids. And then what's really interesting is that they trigger the release of dopamine, but then you say well okay, that should be pretty simple, should, like you said people don't get addicted to chicken breasts and I wonder whether or not that's either because omega threes are too low, so these neurons are not, the full concert of these neurons isn't active, or it could be that for some reason that the other things that people are ingesting has messed up these neurons and so the whole brain body relationship is disrupted and it's, I guess Robert Lustig is his name at UCSF. Yeah

Dr. Mark Hyman
yeah yeah.

Andrew Huberman
And others are now showing that some of the emulsifiers in foods and other things like what they do to the gut endothelium, I never really understood how the gut brain thing worked, but what I realized is that these microbiota, they don't care about us. What they do is they they're trying to find conditions in the gut where the mucus is, pH of the mucus is just right. And that if people ingest emulsifiers and sugars, what happens is these and Borgeslav has shown this, that these that these neurons that are in the gut endothelium and can sense amino acids and can sense essential fatty acids, they actually start to retract their processes into the deeper layers of the gut. In other words, if you ingest the wrong things, pretty soon the neurons in the gut remodel the bad kind of neuroplasticity and you lose your gut brain sensing system. Wow.

And so it's not just a matter of giving it the right things, it's really about, for many people it's gonna be about repairing this system and allowing this portion of our nervous system to grow back. Now the nice thing about peripheral neurons is that they grow back. In it

Dr. Mark Hyman
Wait wait, I just gotta unpack that because what you said was just so profound right there. Basically, you're talking about uncoupling the the natural ability of our body to sense its environment and to self regulate in the right way to create health when we eat processed food that contains ingredients that screw up the gut microbiome or the lining. And the all of a sudden that the brain in the gut or whatever you wanna call it, the neurons in the gut start to change as a result of the crappy food we're eating and make us less able to seek out and want the foods that are good for us and tend to make us seek out and want the foods that are bad for us.

Andrew Huberman
Exactly.

Dr. Mark Hyman
That is a massive, like, brain state shift for me because I never really understood, you know, the the mechanics of how that happens. But it's clearly true when people are eating bad foods, they want more bad foods and they keep eating more and more of them, and there are many reasons for that, but the gut story is just fascinating.

Andrew Huberman
Yeah. These neurons, and really, you know, I tip my hat to the Borges slab, it it's it's cool you know science as you know can get really entrenched and that someone comes from a completely different perspective of you know his background in nutrition, and he described, it actually it's relevant story here, he had a friend who was, she was very overweight and she ended up having a gastric bypass surgery and she lost a lot of weight and her diabetes went away and but she also started craving runny eggs, know easy over runny eggs, but previously just the thought of runny eggs made her nauseous, made her want to vomit. And he heard that story and he realized that cravings themselves are modified by the conditions of the gut, how could this be? So he started exploring what are these neurons in the gut? Who are they, what brain areas are they talking to?

It's very clear that these neurons, they innervate the gut, they're part of the vagus nerve, connect to the brain areas that release dopamine and create craving. And so the health of these neurons in your gut is strongly going to impact what you want. And so what I love about the literature and I haven't had anything to do with the research I'm describing, I've spent a lot of time with that work. What I love about the work that he's doing and others are doing is that it really points to A, the brain body connection is mediated by neurons. B, that what we crave and what we seek really can change.

Think that a lot of people that are having a hard time shifting towards healthier eating or healthier relationship to light, as we talked about a few moments ago, it starts becoming reflexive because not just because it's better for us, but because our nervous system actually remodels itself in ways where the good stimulus starts to evoke dopamine release.

Dr. Mark Hyman
Yeah. I find that for so true. If I if I go off track, I just want more of the bad stuff. If I stay on track, I want more of the good stuff. Like, I naturally will crave the things that are good for me.

But I I think what's happened through through our radical dietary changes is we've gotten so far away from our natural sort of ability to seek out things that nourish us, and and and we've lost that. Animals have that. They're not gonna be running around eating things that are gonna make them sick and gain weight and cause damage to their gut microbiome or whatever. They but they're not thinking about it. Their body naturally will seek out, oh, I want this plant because it's got this nutrition in it or this one has this phytochemical.

They're not thinking that, but their body is telling them where to go, where to look, and what to eat. Mhmm. We've sort of really decoupled our ability to be in touch with our natural healthy cravings and have been hijacked by the food industry to desire all these foods that are driving us into worse and worse states of dysfunction, poor health, and poor brain states and poor brain function. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at doctor Mark Hyman.

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We'll see you next time on the Doctor Hyman show. This podcast is separate from my clinical practice at the Ultrawellness 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 education purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.

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