Bonus Episode: Reversing Fatty Liver at the UltraWellness Center

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 fifteen-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
Coming up on this episode of The Doctor Hyman Show.

Dr. Todd Lapine
So even though we call it nonalcoholic fatty liver, what they're actually doing is to be becoming like an a brewery. The the bacteria in the gut and the food that the person's eating is actually having a low grade, production of alcohol, which is like dripping alcohol into the person's liver twenty four seven.

Dr. Mark Hyman
We jump into today's episode, I wanna share a few ways you can go deeper on your health journey. While I wish I could work with everyone one on one, there just isn't enough time in the day. So I built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the HymanHive, for live q and a's exclusive content and direct connection. For real time lab testing and personalized insights into your biology, visit Function Health.

You can also explore my curated doctor trusted supplements and health products at doctorhyman.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad free with Hyman Plus. Just open Apple Podcasts and tap try free to start your seven day free trial. Hey, everybody. It's doctor Mark Hyman, and welcome to our series about chronic disease where we focus on a functional medicine approach that's quite different and highlights the things that we do with the Ultra Wellness Center in Lenox, Massachusetts.

A practice I've had for twenty years. We've got five doctors, three physicians assistants, I think five to seven nutritionists. We do deep dives on people to find out root causes of all sorts of issues. Stuff that you just don't get when you go to your regular doctor, and it's stuff that we should be doing because the science is here. It's just not getting into practice.

So we've got a great topic today and a great story that we're gonna share with you around a common problem. Unfortunately, way too common, is fatty liver disease. And joining me today is my friend and colleague, doctor Todd Lapine. We've been working together since the mid nineties, believe it or not. Still are going at it.

A long time. I think we have over probably a hundred and twenty years of collective experience in functional medicine at our practice. Really incredible group of physicians and and providers and helpers and a great team. And and we help people deal with stuff when they've done everything else and tried everything else and they can't get the answers. And we think about things differently, and we use the lens of functional medicine to think about how do we understand the root cause of disease.

And today, our topic is going to be something all too common, which is fatty liver disease. It used to be called nonalcoholic fatty liver disease, and now it's changed the name because before we used see this in alcoholics because they drink too much, it would mess up their liver. And we see this in in about forty to fifty percent of the American population, which is kind of terrifying. You know, it's seventy to ninety percent of people who have prediabetes or type two diabetes. It's the most common liver disorder in The United States.

And now that the new name for it is metabolic associated fatty liver disease. Metabolic meaning your metabolism is busted, meaning you have high blood sugar, high insulin, and you're on that trajectory to prediabetes and type two diabetes. And it's it's scary because it's not affecting just adults, it's affecting kids. And that's what's terrifying to me. There's I saw this guy once taught at a at a conference on childhood obesity and I was there.

And I and there was this guy who was a hepatologist. And I'm like, what are you doing here? You're like a liver specialist, liver surgeon. Like, what what are you doing here? He's like, well, a lot of kids who are young and drinking soda have fatty liver disease and we do liver transplants on '15 year olds.

Dr. Todd Lapine
Oh my god.

Dr. Mark Hyman
And I'm like, oh my god, really? And so this is a real problem. It's mostly undiagnosed, mostly untreated because there's no quote drug for it. But there's a lot of things we can do when we think through the lens of functional medicine. And I personally have seen this so much, and I've seen it reverse so quickly using a really intelligent approach of getting with the root causes.

So, Todd, I want you to start by walking us through what are the factors from a root cause perspective that are driving this epidemic which is affecting probably one in two Americans. I mean, you know, anybody who's overweight probably has this. Right? Seventy five percent of Americans are overweight. About two thirds of people who are skinny also have metabolic issues.

So maybe it's like, you know, when you look at how do you define it because most people aren't getting liver scans and we'll talk about the diagnosis of it. You know, if you have a MRI or you have a fatty liver scan, and I'll tell you, you can actually you can actually see the amount of of fatty liver, but most people don't have that. And and and you really want a liver fat less than 2%. And over that, you're starting to get into trouble. So, Todd, what are the things that from a functional medicine perspective we think about?

How do we start to diagnose these problems? What are the clues that you haven't? Kind of walk us through that thinking about You

Dr. Todd Lapine
you you you actually read my mind, Mark, because, basically, I was gonna bring in two topics, which is basically just, you know, to sort of wrap your head around what's happening when you get fatty liver disease. I want you to think of soda and the big gulp sodas, which are laden with high fructose corn syrup, and then you also think of foie gras. So the French have a wonderful, delicious, fatty delicacy called foie gras. And the way that they make foie gras is that they force feed ducks, grains, and they literally just shove it down their throat for days at a time, and eventually, they overwhelm the liver's ability to process food. So there's a metabolic overload.

And what happens is those calories can't be burned. They get stored as fat. And that's what's really happening with people who have fatty liver disease is that it's a metabolic mitochondrial traffic jam is what's happening. And yes, you see this more commonly in people who are overweight, people who are consuming too many calories, but you can also see it in people who are not overweight. So there's multiple ways of looking at what is going on in patients who have fatty liver.

Sometimes it's picked up because somebody does some liver tests or a chem panel, and they notice that the liver tests are slightly elevated. One of the tests that is a really sensitive marker is a liver test called gamma glutamyl transferase or GTT, And that is one of the most sensitive markers that you can pick up fatty liver disease very early on. And, again,

Dr. Mark Hyman
it's not that in your routine panel. Right? If you go to

Dr. Todd Lapine
the No. Doctor It's it's actually it's it's interesting. You're you actually bring up a good point because the reason why it's not brought up is because so many people have abnormal GGTs that they don't do it anymore routinely because they say everybody's got elevated GGT. And Well, I know. Yeah.

Right. You don't. Right. That's good. So and and the other aspect of that is that an elevated GGT is actually a sign of glutathione deficiency.

And glutathione, as we as we've all heard, is one of the major antioxidant systems in the body. So when you have an elevated GGT, it tells you that there's it's like the check engine light's coming on in the liver saying something's wrong here. And that can be an early sign to tell you that a person has fatty liver disease. And again, like you were saying, one out of three Americans have metabolic syndrome, which is what you get years before you develop diabetes. So catching this early is really, really critical because if you let it go long enough that you're saying, you're going to be doing liver transplants in teenagers, and that's not where we need to be headed.

So it's really one of those conditions that you have to think about. And as a physician, you don't wanna be fooled because somebody can have it and not actually be overweight or markedly obese. So you really have to have your your, your antennas up to try to pick it up early.

Dr. Mark Hyman
You know, there are other diagnostic tests we do because the GGT and liver function tests are telling you that you have a problem but they don't really necessarily tell you why. It's a good screening tool and it should be done for everybody. And we do this at the Ultra Wellness Center. But the other big thing we look at carefully is insulin resistance and there are some really interesting ways to actually diagnose this phenomena which can happen, you know, obviously when you have diabetes, type two diabetes, when you have pre diabetes, but even before that, you can have low grade insulin resistance that can still cause problems. And so how do we diagnose this problem of insulin resistance?

Dr. Todd Lapine
You bring up we just actually just had a topic with one of my, my colleagues about that, and and you typically can I think the gold standard, in my opinion, for checking for insulin resistance is the glucose tolerance test, which measures both glucose and insulin levels simultaneously? And some people will say, we'll check your hemoglobin A1C, and if normal, they say, oh, you don't have insulin resistance. But you actually can have insulin resistance even with a normal hemoglobin A1C. And I recently had a patient who had a normal fasting glucose and a normal fasting insulin level. And when I did the glucose tolerance test, the person was maybe ten pounds overweight, but I just had a sneaking suspicion based upon the history that there was probably some insulin resistance.

And when I did the insulin glucose tolerance test, the patient's insulin level maxed out at. The gold standard is really the glucose tolerance test, which is really like a stress test for your pancreas. If you want to know what's going on with the heart, you get on the treadmill. This is like a treadmill for your pancreas.

Dr. Mark Hyman
Good. It's a really good test. We've done it for decades. But, you know, I don't I don't know if you're aware, Todd, but there's a newer test that's been developed by Quest that uses mass spectrometry to measure insulin and c peptide, and that is as good as the glucose tolerance test, if not better. And it's it's sort of even equivalent to what they use in research called the euglycemic clamp test.

So Oh, yeah. It's really it's really sensitive. And now we can, with a simple blood test without drinking the equivalent of two Coca Colas, which we used to do, actually measure this. And again, one of those things that is not getting picked up by your traditional doctor, but there's all this emerging diagnostics available to help us understand this problem. What what are some of the other things, you know, we would look at that help us sort of diagnose this and that that sort of see there's a problem besides looking at your liver function test, looking at your blood sugar insulin, fasting or the insulin resistance score.

There's somebody I read once had high levels of blood alcohol Yeah. But they didn't drink at all. It's because they had this auto brewery syndrome

Dr. Todd Lapine
Yep.

Dr. Mark Hyman
Where the sugars are being fermented by the bacteria in their small bowel because they had gut issues.

Dr. Todd Lapine
Yeah. And you can actually you can actually get the the auto brewery syndrome from both yeast because when we make alcohol, we basically take sugar, grapes or whatever, and then you add in yeast, and they ferment it. And the the waste product is actually alcohol. That's why alcohol is a toxin because it's a it's a it's a waste product, and that can happen both from yeast and also from bacteria. So you can get it from both of the organisms which can produce alcohol, and that is one of the risk factors for developing fatty liver.

I did a deep dive on this. I did a series of seminars with a good friend of mine, David Brady, and we did it on diabetes or metabolic syndrome and all the implications thereof. And as you mentioned, we used to call this nonalcoholic fatty liver disease. And back in the day, I used to work at the VA hospital and used to see a lot of patients who were alcohol abusers and alcoholics. And that was one of the main things that you would see where people would get fatty liver disease.

Now, the interesting thing is the gut microbiome, and this is in the literature, this is really quite fascinating, there's specific bacteria, and there's probably multiple ones, but one of the biggest ones is when you measure the gut microbiome and you see high levels of Klebsiella. Klebsiella is a gram negative bacteria. It's found naturally in people. But when you have overabundance of Klebsiella, Klebsiella bacteria actually produce alcohol. So even though we call it nonalcoholic fatty liver, what they're actually doing is they're becoming like a brewery.

The bacteria in the gut and the food that the person's eating is actually having a low grade production of alcohol, which is sort of like dripping alcohol into the person's liver 20 fourseven because they're eating highly processed foods, highly glycemic foods. And a lot of times when you see these patients, these are patients who like, they walk around like, I've got brain fog. Well, have brain fog because they're having low levels of alcohol 20 fourseven in their body. So that's another thing that you can that you can have to think about in terms of, diagnostics, is to look at the gut microbiome and also leaky gut.

Dr. Mark Hyman
I think people hear fatty liver. They go, oh, I'm gonna eat fat. I'm gonna get fatty liver. It's actually the opposite. You kinda hinted at it, you know, to get these duck to have or goose to have a fatty liver.

And by the way, foie gras is means, fatty liver in French, basically. And and what they do is they force feed them like corn, and then it it that that turned into fatty liver. But what we're seeing now is this increase in high fructose corn syrup in our population Yes. Which can be anywhere from 55 to 75% fructose. Now Yep.

You know, people say it was the same as regular sugar, and in many ways it is. But the one significant difference is that high fructose is what drives fatty liver. It won't cause your blood sugar to go up or your insulin to go up directly, but indirectly, it would lead to fatty liver and insulin resistance over time. So this is a big factor in why these kids who are drinking, like, big gulps or, you know, two liter bottles of soda a day are getting fatty liver.

Dr. Todd Lapine
Yep. Absolutely. You break you you you actually just you know, that's a nice segue into, the next, aspect of fatty liver that I wanna talk about. And fructose, as you mentioned, is one of the big drivers in high fructose. So we find fructose in in in fruits.

So if have an orange or an apple and it's in season, there's a small amount of fructose. And the liver can only process so much fructose. What happens is when you overwhelm the liver's ability to metabolize fructose, you deplete ATP. So ATP is the fuel that our mitochondria use to generate energy or enter that's how the we power ourselves of our body. And what happens is you actually get mitochondrial dysfunction when you overwhelm the liver with too much fructose because the the incidence of fatty liver rises to two to three times when you have a high fructose diet.

So, yeah, mitochondria is another aspect. And the way I also remember that is that when we burn our calories, where do we burn our calories? We burn our calories in the mitochondria. They have the the the the back on the fireplace of the of the cell. So you you wanna, you know, put the log in your fireplace and burn it.

Well, my analogy to patients is that when you have dysfunctional mitochondria, it's like having a log that doesn't fit into the fireplace. So you start stacking the wood on the side, and that's essentially the buildup of adipose tissue throughout the body, especially in the liver and the visceral fat, And that's where it is, it's coming from.

Dr. Mark Hyman
And I think we'll back to the diet and the causes. But you know, in terms of just diagnosis, you know, you can look at your liver test and it could be a lot of things. You can be taking too much Tylenol, you can be doing other things. So or drinking too much. So so there's other factors that we now know that that we can look at like c reactive protein which measures inflammation, nonspecific But or there's some really cool kind of diagnostic tests that are derivative from irregular blood work.

And for example, there's something called the fib four test, which is a fib four index. And it basically can help you identify issues without biopsy. So it looks at platelets as well as your liver function test, AST, L ALT. And there's another test called NAFLD, your name is Shunsh, NAFLD fibrosis score. And that fibrosis score takes into six variables that are easy to measure, your age, your body mass index, your blood sugar.

Right? You have impaired fasting glucose, your AST, ALT, which is your liver test, your platelets and your albumin. And that gives you an idea through well, not a lot of invasive testing what's going on. So there's another way you can screen for it. And that can be done, you know, through regular lab work.

And then there's imaging tests, which can be very helpful. I mentioned the MRI, there's there's ultrasound and there's also called the FibroScan which sort of checks this pulse wave into the liver and sees how the wave goes and the elasticity of the liver. And if it's, you know, fatty, you can tell. If there's some fatty liver, you can tell. If there's a more serious, versions of this, you can tell if there's like more scarring.

So it's a really it's a really interesting way to kind of measure problems. It only takes a few minutes. And of course, there's the MRI. So there's a lot of ways to sort of figure this out. And it's important for people to understand that most traditional doctors don't really measure this, don't look at these things, don't send people for these tests.

And if you're a hepatologist, you do. But otherwise Right. Your most primary care internal medicine doctors just don't have a clue about how to really diagnose this. And then they're like, what are you going do about it? Right?

Let's talk about some of the causes of fatty liver. Kind of hinted about fructose and diet.

Dr. Todd Lapine
One one other thing, Mark. I just wanted to that you talk about the diagnostic test. One test that I have been using a lot in my patients, which measures six biomarkers, is a test called FibroSure, and that's available by mainstream labs. And that's another way of they have an algorithm where they're checking the various biomarkers and they put it into the algorithm after the blood draw, and that can help you to risk stratify how bad the fatty liver disease is. That's another another one.

Dr. Mark Hyman
Yeah. So you you know, there's other reasons to have liver damage like environmental toxins, you know, deficiency of certain nutrients like choline. But and and obviously you can look indirectly at lipids because you don't see lipid abnormalities when you have a fatty liver like small particles or high triglycerides because Yep. Liver can't process all the less triglycerides. And and so, you know, we can kind of start to measure something stool testing, looking at the gut and and kind of get a pretty good sense of like what's causing it.

I think, you know, when you look at our current diet, I mean, 60% of it is ultra processed food. There's a lot of, fructose in that through a high fructose corn syrup in most of them. There's starches in those. Yeah. There's also things that damage they've got lining like emulsifiers.

And so you have a whole perfect storm, plus we live in a toxic stew of chemicals and pesticides and herbicides and plastic, microplastics, you name it, heavy metals, all that stuff puts a load on the liver. So it's no surprise that we have this. And I wonder, you know, when you're seeing a patient with this, how do you start to think about, you know, what to do with this person? What's the sort of recommended treatment? Because like I said, there's no drug for treating this.

If there was, you know, it would be a multibillion dollar drug I'd buy stock in it. And we don't have one. So you have to use a functional medicine approach to really kill a fatty liver, which by the way is really reversible unless you've already gotten to the point of cirrhosis and scarring, is the end stage of this. This why kids need liver transplants. They get cirrhosis just like an alcoholic from the sugar.

Dr. Todd Lapine
And that that's why like anything, like any any condition, the earlier you can catch it, the better. And you're exactly you're hitting the nail right on the head because this is something that you want to be preemptive. You don't want to wait till there's fibrosis and scarring and there's going to be irreversible damage. You want to catch this way before it happens. And obviously the first thing you're going to do is dietary changes.

Like you're saying, there's a lot of different things that can contribute to disruption of the gut microbiome, disruption of the gut barrier, and we call that leaky gut. There's different tests that you can do that can determine if you have leaky gut. Always remember, this is another thing that I like to emphasize to my patients, is the connection between the gut and the liver. So all of the blood from the gut, guess where it goes? It doesn't go into the circulation.

It actually goes from the gut into the portal system up to the liver to be filtered out before it goes into the systemic system. And that's where patients who have Clinically, we used to see patients with hepatic encephalopathy because their blood wouldn't be able to get filtered through the blood, and that causes all kinds of mental conditions. So having a healthy gut so that the blood that's then flowing into the liver is not gonna be as pro inflammatory with all of these lipopolysaccharides, the the coating of the gram negative gut bacteria, which provoke inflammation and then aggravate, like like adding gasoline to fire.

Dr. Mark Hyman
So so basically diet would be starting with, you know, a low, or no ultra processed food. Right? Getting rid of high fructose corn syrup in your diet. I think if people listening can do one thing, this is, you know, again, we focus on food as medicine at the Ultra Wellness Center. We focus on how to treat many chronic conditions with food.

And and you can dump huge amounts of liver fat by simply cutting out the starch and the sugar, particularly the high fructose corn syrup which is in every packaged processed food there is. Mean it's not something you have in your cupboard, Right? It's an industrial food product.

Dr. Todd Lapine
And Added ketchup and yeah. Yes. Added added to many foods. I mean, you start reading labels, and again, we always talk about that, like, the best food is food that doesn't have a label. Right?

It's not it's not manufactured. It's not franken food. It's not processed food. It's real food. And, you know, in addition to the, you know, the the the fructose content, processed carbs so that, you know, when we wanna fatten up cattle, what do we do?

We feed them grains. And highly processed, grains is another thing which is basically acting just like sugar, in the diet. It increases insulin and glucose levels, which in turn, you know, drive the the whole metabolic path dysfunctional metabolic pathways.

Dr. Mark Hyman
I mean, it's interesting also, you know, I remember reading a study where they did this in mice, but it was also in human trials, where they gave the mice, alcohol to cause fatty liver. Yeah. But at the same time, they gave something called MCT oil, which is medium chain triglycerides. It's a special kind of fat that's absorbed directly, not through your lymph like most of your fat is, but actually directly into the liver. And it has a lot of benefits to the liver.

It helps get rid of liver fat, it helps reduce inflammation, it helps mitochondrial function, it helps improve insulin sensitivity, it's sort of all your organ fat. But here you here you are treating a fatty liver with a fat, and it it works pretty darn well. Pretty interesting to see those studies, I thought. I was like, wow, these are basically, even though they're giving a liver toxin, it still works. I was like, wow.

Dr. Todd Lapine
And and the, the interesting thing is as we I use MCT quite a bit in my patients, and MCT is basically readily available to mitochondria for metabolism. So it's like a clean fuel. It's very, very clean. And it's also been shown to improve cognitive function in patients with know, dementia or early Alzheimer's

Dr. Mark Hyman
Yeah.

Dr. Todd Lapine
Because it's a cleaner fuel. It just is, it just burned through the mitochondria much cleaner than, other food.

Dr. Mark Hyman
So what other foods should we be thinking of that support the liver, and help and help deal with the the the issues

Dr. Todd Lapine
that

Dr. Mark Hyman
can

Dr. Todd Lapine
be Another one in which and and in preparing for this, another one that which you're familiar with is fatty fifteen, which is the another name for docohexanoic acid. And there's some studies showing that a lot of people are deficient in docohexanoic acid because of the decrease in dairy consumption. That's one of the big sources of fatty fifteen, and and that has been shown to actually help with mitigating the effects of fatty liver. Other things that can be done are flaxseeds. There's a great paper which I just stumbled upon, and they all they did was just use ground up flaxseeds.

And there's probably multiple mechanisms for why that happens because it changes the gut microbiome, gives good fatty acids. And there was a significant improvement with adding flaxseeds to people's diet. We sure oftentimes will do that for people with ALA, alpha linolenic acid deficiency. Another thing that can be used for patients with fatty liver is tocotrienol, which is made from annatto. So it's a special form of vitamin E, and that also is very effective.

And then, as I mentioned before, glutathione. But it's basically it's derivative from the annatto seed, and it's highly concentrated gamma vitamin e. So it's a it's a it's a form of tocotrienol, and then there's some really good studies on that having a benefit in patients with fatty liver. And then the other thing is supporting glutathione. And remember, people who have fatty liver oftentimes have elevated GGT, and that is a sign of oxidative stress.

So anytime you can mitigate oxidative stress, you're also gonna be supporting the resolution and improvement in fatty liver disease.

Dr. Mark Hyman
And so the supplements that you can take, you can actually take supplements that help boost glutathione, right? Yep. Like N acetylcysteine or milk thistle is an herb, often use these in people with fatty liver disease, and lipoic These are things that you can actually help use to repair the liver once it's been damaged. So you start with diet, right? You start with low sugar starch diet with more good fats, lots of fiber, you talked about flax seeds, MCT oil.

But you can layer in things that really help the liver repair and heal and boost the glutathione levels which helps it helps it get rid of the inflammation in the fatty liver. So and lipoic acid, milk thistle, they're they're great. And even herbs like turmeric or curcumin can be very helpful.

Dr. Todd Lapine
Yeah. And the other the other thing and I always, you know, give credit to Jeff Land to, bring into my awareness of the role of glycine. So glycine is what's called a conditionally essential amino acid. And when you make when your body makes glutathione, it's made it made from three different amino acids. It's made from glutamine, glycine, and cysteine.

And there's an interesting paper that looked at the combined use of lysine with NAC or N acetylcysteine, and those are basically the building blocks of glutathione. And in this particular paper, they basically said this is an anti aging combination. It decreases inflammation, improves mitochondrial function. It helps with healthy aging. It's just a it's a real winner.

So any anytime you can support glutathione production is good. You mentioned alpha lipoic acid. So the other important thing is that glutathione goes between what's called the oxidized form and the reduced form. So it's it's like a battery that get has to sort of get charged. And the reduced form of glutathione is the active form.

And in order to recycle your glutathione, you need the things like alpha lipoic acid and also vitamin C. And I think that's, to some degree, Linus Pauling, who was big on vitamin C, I think vitamin C has many, many different functions in the body, but I think vitamin C actually helps to recycle your glutathione which helps with the aging process.

Dr. Mark Hyman
And you know, there's so much you can do to really heal this and it's something I've treated, I know you've treated many times and many patients at the Ultra Wellness Center that we see who have, you know, that along with other metabolic issues. They usually have pre diabetes, they usually have abnormal lipids that are high triglycerides, low HDL, they usually have high CRP and inflammation. And we created a holistic approach to these patients using diet and lifestyle, exercise, stress reduction, sleep optimization, all those things. But then you you sometimes need some of these additional supplements and nutrients like choline, you can get from food for example, but also you can take it. Like eggs have it, grass fed meats have it, Sometimes soy has it actually from lecithin.

And Christopher's vegetables are great for boosting glutathione, that's a broccoli family. Omega three rich foods help reduce inflammation. But Yep. Today you need more stuff. Like you can take omega three supplements.

You can take, you know, the tocotrienols and the the certain forms of vitamin E that can help. You can take MCTL, you can take N acetylcysteine and glycine and things that help boost glutathione. You can milk this and a lot of acid, and berberine, one that helps improve liver fat and and help blood sugar regulation.

Dr. Todd Lapine
Yeah. Berberine. Berberine is actually I always tell my patients that Berberine is really almost like a a natural form of metformin. Actually very, very similar effects, as metformin. What you're really saying

Dr. Mark Hyman
is And the diabetes To diabetes.

Dr. Todd Lapine
Yeah, diabetes drug. And what you're really saying is that all these things that you're mentioning are what we call nutraceuticals as opposed to pharmaceuticals. So yes, I still prescribe medications. I trained as an internal medicine, and I send patients to surgeons, and I give patients thyroid and insulin and blood pressure medicines, whatever, when needed. But getting out the prescription pad is the last thing that I do now.

I don't wanna use the prescription pad, but I can use the prescription pad. If I need an elephant gun, then I'm gonna, you know, use the elephant gun. But a lot of things that we that we can do are relatively inexpensive. They're very safe. There's science behind it.

So it really makes sense to be using diet, combining that with supplements. I always one of the other my pet peeves is that tell people that I've never cured anyone with a pharmaceutical drug, and I've never cured anyone just with a supplement. Supplements really complement a healthy diet. So if you don't have a good foundational diet, supplements are not You have to really have a healthy foundational diet, then you complement that with, the nutraceuticals.

Dr. Mark Hyman
Supplements, they're called supplements. Supplement your diet, not they're not replacements, right? So I think this is so important. And so, you know, there's a few other things we do with these patients. You know, get them exercise, get them to optimize their sleep, manage stress, get rid of toxins because, you know, if you have a dietary induced fatty liver, it's going to be exacerbated or worsened by exposure to pesticides and plastics.

And one of the things that really commonly affects insulin resistance is BPA, which is Oh. Ubiquitous. It's a it's a bisphenol A, it's one of the most ubiquitous toxins. It's not all plastics, lined cans, packages, boxes. And we we were all like credit card receipts, ATM receipts, you know, your your gas station receipts if you get those.

I don't touch those so I can avoid it, you know? Yep. And and, those are often just these hidden exposures exacerbate things. So we help people reduce their exposure to toxins and improve the microbiome, and and then we kind of follow them and see how they do. But we see usually com complete resolution most of the time for these patients.

Dr. Todd Lapine
The other thing, you mentioned BPA, is a lot of times they'll say this is BPA free. But what they do is they actually put other chemicals that are cousins to BPA. So just because it's BPA free and it's still in plastic is not necessarily

Dr. Mark Hyman
Yeah.

Dr. Todd Lapine
That's that's sort of the big thing is they they have, like, a weird this is BPA free plastic bottle or whatever. That doesn't mean squat.

Dr. Mark Hyman
It's true. I mean, it's it's it's a tricky, slippery slope.

Dr. Todd Lapine
It's all marketing. It's it's all marketing because people, they they're aware that, okay. You b p if you have BPA in your product, people aren't gonna buy it. So we have a BPA plastic, BPA free product. So you're buying

Dr. Mark Hyman
It's this another petrochemical toxin.

Dr. Todd Lapine
Exactly. Exactly. Got it on the van lining. Yeah. And it's you've got be, you know, you're you've got to be a savvy consumer and a you know, you have to do your own homework because when you go into the the the the regular, you know, mainstream grocery stores, the way that I look at it is most people are being slowly poisoned.

I mean, literally, it's when you look at the processed food in this country with the preservatives, the food coloring, the food additives, highly processed foods. People are literally being, you know, slowly poisoned in this country. And, you know, Robert Kennedy is is bringing awareness to this, which is I really, you know, about about making America healthy again because we have an epidemic of autism in this country. We have an epidemic of obesity in this country. We have an epidemic of metabolic syndrome.

And you know, we're not gonna be the leading country no matter what our military is if we have a bunch of sick population.

Dr. Mark Hyman
One of the things that this traditional medicine really sucks at is dealing with chronic illness. Unless you have a pill for it like a high LDL, which by the is I don't think the main cause of heart disease but like statins, we don't do anything. Like we don't diet go down the diagnostic rabbit hole like we just talked about with all the different kinds of diagnostics. And most of these are available through conventional medicine. They're just not used by traditional doctors unless you're a liver specialist dealing with someone with more end stage liver problems.

By the time it's Yep. That bad you can pick it up. And so at the Ultra Wellness Center, you know, have five physicians and three physician's assistants, seven nutritionists on a great team, all working to help people understand root causes and get to the bottom of what's going on with them. And then teach them after we've discovered through, you know, advanced diagnostic testing what's going on, we teach them how to do all the things they need to do, whether it's optimize their diet, heal their gut, get rid of toxins both through reducing your exposures but also through helping the body eliminate them. Optimizing nutritional status and dealing with all those factors that that are modifiable and obviously lifestyle stuff, so that we can actually help people get back to wealth.

And it's really it's you know, we've been doing this together for God almost thirty years now, Todd. Think next year might be thirty years. It's like

Dr. Todd Lapine
We're thirty years young. Right.

Dr. Mark Hyman
And it's it's really remarkable how people recover and do well when they have the right insights. And everything we talked about today is science backed, is based on the scientific literature. It's just not stuff that's gotten into practice. It often takes a decade or two or three or sometimes more for stuff from the bench and the scientific discovery to its implementation in clinical medicine. That's all we're doing.

We're kind of accelerating that gap and we're thinking about the body as a system through the lens of functional medicine. So anybody listening, if you have friends or family who have issues, chronic disease, we'd love you to come see us at the Ultra Wellness Center. Just go to ultrawannacenter.com, you can learn more about what we're doing. Send over to the patient, talk to our team and they'll walk you through what you what you need to know. But, you know, we we love doing this and we really help so many people.

And and again, people are just desperate. And I probably get, like you do, probably 10 to 15 emails and texts a day of, I got this, my friends got this, my sisters got that, my uncles got this, can you help, can you help, can you help? Because they're not getting the answers from Mayo Clinic or Cleveland Clinic even, which is a great institution, but just limited unless they're going to the Center for Functional Medicine. So we really we really have this chance to do better.

Dr. Todd Lapine
You're you're absolutely right, Mark. I mean, the the the the I think the masses of people are waking up to realize that, you know, when you have these chronic conditions now mainstream medicine is really good. You break your bone. You have a a stroke or heart attack. You can sort of do aggressive interventions.

But for chronic disease, I'm going to say that mainstream medicine is actually dangerous. I think that the pharmaceutical approach of adding pill after pill to suppress this, and then you got a side effect for that. So you had another prescription medication. It's polypharmacy. I'm going to venture to say that a lot of what regular doctors are doing, not that they're intending to create iatrogenic, which is physician induced illness, but a lot of stuff that we're seeing nowadays are iatrogenic illness.

People are trying to treat these chronic complex lifestyle conditions with pharmaceuticals, and they're lowering the cholesterol, they're lowering the blood sugar, but they're not actually addressing the root cause.

Dr. Mark Hyman
That's what we do at Telstra Wellness Center and we'd love you to check it out. And, Todd, thank you for joining us today and we'll see you again when we're gonna keep doing these case studies and talk about chronic disease and how we deal with it differently. So we'll keep you hopefully thinking about things differently and get you on a path to wellness. Alright.

Dr. Todd Lapine
Thanks, Mark. Enjoyed it.

Dr. Mark Hyman
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. 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.

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