How to Restore Your Body’s Energy and Heal from Within: Dr. Martin Picard Explains

Mark Hyman, MD

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.

Martin Picard
Energy has been the missing dimension of medicine.

Dr. Mark Hyman
If your mitochondria stop working, you're dead in seconds. Doctor Martin Picard is a professor of behavioral medicine at Columbia University, he directs the mitochondrial psychobiology group, how your psychology affects your biology, where

Dr. Mark Hyman
he explores how our minds and our mitochondria connect.

Dr. Mark Hyman
As the chair of energy and health at Columbia Aging Center, he leads NIH funded studies linking stress, energy, and healing, and works with scientists around the world to transform our understanding of health. What are the mitochondria and how we should be thinking about them from the perspective of how they're integral to our entire communication network and our energy network that runs our body?

Martin Picard
The potential energy inside your body, it's equivalent to a lightning bolt. And somehow, we don't combust and we don't burst into flames. If you mess up with the energy, like, just a little bit, you can actually alter the human experience. You can alter your state of mind.

Dr. Mark Hyman
You're saying we shouldn't be focusing so much disease, we should be focusing on what's creating health.

Martin Picard
You look at which diseases are there evidence for that mitochondria are impaired in some way. And turns out every disease, the reason stress is bad for us, the reason stress makes us tired and ends up damaging our organs and ends up aging us faster is because it steals energy from the things that keep us healthy.

Dr. Mark Hyman
So people listening, go, okay, I have some of these conditions.

Martin Picard
Where do I start? I'd start by saying you're not broken and there are no parts I think to be fixed or surgically removed or transplanted. There are things that we know can unleash the healing potential of the body.

Dr. Mark Hyman
Wow, what a conversation. Well, Martin, welcome to the Doctor. Hyman Show. I came to you. I'm excited, I am to have you here.

Martin Picard
Thank you. I'm excited to be here.

Dr. Mark Hyman
You are a really deep thinking scientist. You're going into the weeds on how to understand the human body in a new way. You're at Columbia University. You published many papers that are revolutionizing our thinking about how the body works. And, you know, you're not a practicing doctor, but you're a scientist.

And what's striking to me as I've read your work is that you come to the same conclusions about the nature of nature, the nature of biology, the nature of how our bodies work as I have as a practicing physician for over forty years. And I have observed things clinically that I knew were true, but the science hadn't fully caught up with. And and before the podcast, we were talking about my book, Ultramind Solution, which I wrote in 2008, which was based on what I was seeing in my practice, which we call anecdotes, but I think it's more like anic data. And and and I was observing how particularly in terms of mental health and the Ultramind solution, how energy metabolism was such a key part of so many conditions of the brain, from depression to bipolar disease to schizophrenia to Alzheimer's to autism to ADHD, and on and on and on. And I'm like, I know this is true in my cells, in my bones.

I know it's true, and I can't wait till science catches up with it. And guess what? It has. And it's so exciting. I mean, you know, I I got to meet you through a friend of mine, Jan Bazooki, who basically had a son with bipolar disease.

And she had read my book. They watched a broken brain series that I had as a documentary, and they got this moment, and they put him on a ketogenic diet, which really shifted his metabolic function in his brain, and that led him to fully recover from bipolar disease. If people want to learn about it, they can go to metabolicminds.com. She's recently given you over a million dollar grant to do work at Columbia to dig deep into the role of mitochondria and mental health. But mitochondria, we're gonna talk about because that's your gig, is is mitochondria.

And probably people don't know what those are, but I I wanna have you explain it a little bit. But, you know, just at a high level, you know, in in functional medicine, which is what I do, the the framework is really about the science of creating health. So people say, what is functional medicine? I say, it's not about diseases. In fact, I don't really care that much about diseases.

I care about the science of creating health. And when you create health and you engage the body's repair, renewal, regenerative mechanisms, the body can heal. When you change the circumstances, you talk about subtracting versus adding. In medicine, we add drugs and all kinds of stuff as opposed to subtracting, like taking away bad food, you know, taking away too much stress and so forth. That there's a way to take out the bad stuff and put in the good stuff that allows the body's own system to repair and heal.

And that's the fundamental premise of the future of medicine. What I would say, we're in this incredible moment in science where we're understanding the nature of nature. We're understanding the laws of biology. And if I said to you, what are the laws of biology? The average person, they go, I don't know.

Evolution, maybe. If I said, what laws of physics? Oh, there's thermodynamics. There's gravity. There's therm you know, quantum physics.

There's all these law they're not not equations, but there are equations, and it's a knowable thing. But for laws of biology, we're just beginning to understand what those are. You know, Einstein said, I don't want to know the spectrum of this or that element. I want to know the thoughts of God and the rest are details. So in a sense, we're we're actually being able to see the mind of God.

And if you don't believe in God, whatever thing you believe in, the way we're created, nature of nature, is is just it's so exciting to me. And so reading your work, I'm just jumping out of my chair because I'm like, wait. Wait. Wait. This is what I've been saying for thirty years.

And this is so cool. And I wanna explain how it it how in your particular field, which is really understanding how our bodies take energy from food and oxygen and turn it into the energy that runs our body. How we turn the energy of the sun that's transmuted through plants and animals, and the plants that the animals eat into the storage form of energy that then we burn just like the sun creates a tree, and then we can burn the wood and create the fire. That's what's happening in our bodies. And that process is so important to so many diseases, not just mental health, but to diabetes and metabolic health.

Really important. Everything is connected. And so mitochondria are are one of those fundamental physiological systems that we talk about in functional medicine that we have to understand and treat. And what's so ironic is that in traditional medicine, we learn about it, the Krebs cycle, which is, you know, first year biochemistry class, which essentially is how we make energy from food and oxygen and turn it into ATP. And and that's it.

And then we're like, oh, biochemistry is not important. Let's talk about real disease. And we forget about it all. We don't know how to diagnose it. If there's a problem, we don't know how to treat it if it's a problem, and we don't really understand how to how they work.

And I personally had chronic fatigue syndrome when I was 36, which is how I learned about all this, and I felt my mitochondria not working. I want you to sort of help us understand now that we sort of laid the groundwork of we're gonna talk about the science of health, and we're gonna talk about the fundamental role of mitochondria in our health, and how to understand it, how to diagnose problems with it, and how to treat it. I want you to sort of explain for the layperson, what are the mitochondria, what the flaws are in our current thinking, the limitations, and what how we should be thinking about them from the from the perspective of how they're integral to our our entire communication network and our energy network that runs our body.

Martin Picard
Before talking about mitochondria, want to say a few words about Yes.

Dr. Mark Hyman
Here. Go. Energy.

Martin Picard
I I'm so happy to be here chatting with you about this and to find someone who has come to, you know, a a conclusion that energy is really what drives everything in the body. Yeah. It's also what drives our minds. Yep. Right?

And our ability to to interact with another human being and with the world and our ability to to do and to feel and to you know, our conscious self is really emerges from the flow of energy. And the if you think about it, the main difference between a dead body, right, just a cadaver, and a thinking, feeling conscious person that actually has experiences, It's not the cells. It's not the molecules. It's not the genes or the, you know, the organs. Everything is still the same.

But when the body is alive, the main difference is energy is flowing through it. Right? It's the flow of energy that actually brings everything into into into life. So without energy flowing, the genes, right, like the the beloved genome, and there's been so much written about, like, the genes control our lives, the blueprint of life, and Yeah. Yeah.

You know, genes is your is your destiny. Without energy flowing, genes are just like this and the genome is just an inert repository of information. There's, like, there's potential there, but the potential is only manifested once you flow energy through it. So energy is so fundamental to to what we are, and you talked about, you know, the laws of physics. There are good laws of physics.

They're they're formal descriptions of how the world works. You know, they're equations, and you can use them for predicting stuff. And we don't have similar, you know, and and equivalently useful laws in biology, especially not around, like, how energy behaves in the body. And I think energy has been the missing dimension of medicine. Right?

Medicine has been focused, maybe obsessed with molecules, the three dimensions, right, of space, x y z, and then little molecules and genes and and organs. And and if something doesn't exist in that dimension, if you can't see something on a scan, if you can't see something on blood work, then, you know, it's probably not real. It's probably, you know, in your head or probably not worth, you know, taking paying attention to it. So I think energy has has been the missing dimension, right, which really, I think it's a fourth dimension.

Dr. Mark Hyman
I mean, because we can't measure it fully. Yes. And and there are ways we do in functional medicine. But, like, this one we can't really fully measure, doesn't mean it doesn't exist. Correct.

And this then we ignore it, and it's ridiculous in medicine.

Martin Picard
And it's a major challenge. Like, once you when you can't see something and you can't measure something, then either you're forced to kind of believe, right, and and think that it's there, or you see the effect of that thing on something else. That's what, you know, the the physics of fields field physics works like this a little bit where you can't see a field, like an electromagnetic field. You can't see it. To know if it's there, you need to kinda put something in the field.

You put a piece of metal. And then if you see the piece of metal being attracted, you know, oh, there's a field. Yeah. Right? So you know the effect and the you know the existence and the properties of a field by measuring its effect on something else.

I suspect that's what health is. Health is, you know, a field like state where you might not be health is not a thing. Right? It's not a thing you can

Dr. Mark Hyman
It's a dynamic process.

Martin Picard
It's a dynamic process. It's a dynamic state that is energetically sustained. Right? Yeah. And we've come to a definition of of or, you know, an operationalization in scientific terms, a way of describing something so that you can measure it and you can, you know, eventually do experiments around it and then develop technologies to to to quantify it and to track it.

So the definition we have of health is that it's a field like state, right, that emerges from the flow of energy through a structure, this this thing.

Dr. Mark Hyman
Human body.

Martin Picard
The body is the structure. As energy flows through this, a field emerges. Just like electricity flowing through a coil generates an electromagnetic field. Right? The the the you're gonna have a coil if you have, like, a copper wire wrapped around a solar a cylinder, that's a a coil by itself, it does nothing.

Right? But if you flow electrons through it, you put electricity, now boom, you have a field. And then with that field, you can power an electric car. Right? You can, like, propel a car.

You can do all sorts of things.

Dr. Mark Hyman
One of the things that was shocking reading your work was that you said that the amount of, like, energy, the potential released in the process of making energy in the cells is like a lightning bolt. It's like the equivalent of, like, a a lightning bolt Yeah. In our bodies happening all the time.

Martin Picard
That's how much energy is stored. Right? The the potential energy of inside your body is equivalent to if you kind of take all of it that exists there inside your mitochondria, it's equivalent to a lightning bolt. It's it's amazing. And and somehow, we don't combust, and we don't, you know, burst into flames for for good reason.

Dr. Mark Hyman
Well, what's interesting when you do the math, and this is kind of what's interesting to me, is that basically, just at a high level, these mitochondria are these little tiny bacteria looking like things that I don't know if I'm just gonna get up for a sec because I can you show you show me you gave me this as a present, and this is like this is so cool. This is basically everybody, this is a mitochondria.

Martin Picard
This is

Dr. Mark Hyman
it. It's what it looks like. It looks like a bacteria. And, basically, it's an ancient symbiotic relationship between bacteria that entered into these cells that then use that bacteria to make energy. And the DNA from the bacteria is different than your DNA.

It's your mother's DNA. It's mitochondrial from your mother. And it's very it's a very fragile organelle, and there's anywhere from hundreds to thousands and even tens of thousands in the brain, which has the most In each cell. In each cell. Right.

So you know? And you've got 40,000,000,000,000 cells, and you've got, I don't know, how many tens a thousand the math, I don't even know the number. But the the idea is that that, you know, you've gotta run your body. And every every second, you have 37,000,000,000 chemical reactions in your body, all of which require energy. And so when you think about the fundamental sort of source of life, it's really energy.

When you take a cyanide pill, you know, like in the movies when the CIA guys have to kill themselves, they they die in seconds. Why? Because it poisons the mitochondria. It blocks the mitochondria. And so that's how important it is.

If if your mitochondria stop working, you're dead in seconds. Yeah. Right?

Martin Picard
And another thing from the the CIA, the, you know, the truth serum, which was discovered in the Yeah. Mid nineteen hundreds. Truth serum, the key ingredient that would, like, you know, mess your mind so much that you'd be too weak to lie, right, or to make stuff up. That was the idea. That special ingredient was a poisoned mitochondria as well.

Dr. Mark Hyman
Was it phenobarbital? What was it?

Martin Picard
It was a it was a barbital. It was amytol. Amytol. It was like

Dr. Mark Hyman
a it was a barbiturate. Right?

Martin Picard
Yeah. So it poisons complex one with where which is where energy and electrons enter into the electron transport chain. I used that in my PhD as a poison, you know, for for mitochondria to do experiments. And then I then I learned, oh, shit. This is what people were using to to mess up with the human mind.

Yeah. Right? So if you mess up with the energy with cyanide, then you can kill the whole body. If you mess up with the energy, like, just a little bit, you can actually alter the the human experience. You can alter your state of mind.

And I suspect that's what's happening as well with food and, you know, why the ketogenic diet is is is beneficial because it changes your energy. And just changing your energy just a few percent could be enough to actually change how you feel, right, and and how how you interact with the world around you.

Dr. Mark Hyman
And what's so exciting is that scientists and academic centers are now getting this. Like, you've got I've had a number of people on my podcast like Savani Sethi from Stanford who's doing metabolic research on psychiatry and mitochondria. You know, we have Chris Palmer who's been on the podcast talking about brain energy as a way of treating psychiatric illness. Whatever you're talking about in medicine, whether it's diabetes or autism or Parkinson's or depression or bipolar disease or kids of RAM, I mean, the list goes on. It's all connected to energy.

And and it is in the functional medicine framework, one of the key physiological systems as part of this network of web of systems that underlies all disease. And you're saying we shouldn't be focusing so much disease, we should be focusing on what creating health. And that's one of one of your key papers that I read, and we'll link to it, was really about this whole idea. And I read it, I was like, oh my god. This is crazy.

This is what I've been saying for thirty years. Like, what's going on here? How is this happening? The paper is is really important because it's it sort of lays out a framework for, you know, why do we care more about disease and health, and how do we begin to think about, you know, the the body as a as a system that we can actually optimize through removing things that are harming it and adding things that help it. Your work is just so critical in that way, and I I think one of the one of the problems I think people have and I and I honestly admit, I I I also had this belief until I started really diving into your work was that, you know, mitochondria basically take food and oxygen, and they combust them like an engine, and they produce energy that runs everything in your body like

Martin Picard
a Transform.

Dr. Mark Hyman
And yet, you're saying you're discovering us way more than that. It's like a it's like a core hub of communication and communication and regulation. And so maybe, you know, before we get down into sort of the weeds a little bit, tell us the expanded view of mitochondria. Because it's not just like like a car engine that consumes gas and oxygen and puts energy through your tires to go run your car. It's it's more than that.

Martin Picard
Yes. It's not a machine. It's not a machine. It's not a machine. Before we talk about mitochondria, we talked so much so far about energy.

What the hell is energy? And, yeah, I mean, it's a tough one because even physicists don't agree on what energy is. You know, the great communicator Richard Feynman, a physicist who did so much for for humanity was an amazing communicator. He said, you know, the we actually don't know what energy is. Right?

We we have equations. We have, you know, things that describe how how it works, how it behaves.

Dr. Mark Hyman
Equals m squared.

Martin Picard
Yeah. Equals MC squared is an important one, but we don't actually know what energy is. So I think currently, in in science, the the most agreed upon and maybe the most widely useful definition is energy is the potential for change. Ah. Right?

So energy is not a thing. And I suspect that's why among other

Dr. Mark Hyman
other It's state.

Martin Picard
It's a

Dr. Mark Hyman
Dynamic state.

Martin Picard
It's the potential for change that can feed different states. Right? Like, when you flow electricity in a a little coiled, you know, piece of wire and you have a field that emerges from there, energy is the electricity. Right? Electricity is one form of energy.

So energy is not a thing, but it takes many forms. It's a potential for change that can materialize or or take different forms. Electricity is one form. And then as the electricity, one form of energy flows through the the copper wire, now it transforms. And then it transforms into an a different kind of energy, which in this case is the electromagnetic field.

Right? And then you can use that, for example, in the the motor of an electric car to then propel the car forward. Now as the car gains speed, it acquires kinetic energy. Yeah. Right?

Different form of energy.

Dr. Mark Hyman
Yeah. It's physics one zero one.

Martin Picard
Potential and kinetic energy. Right? Potential, kinetic, electrical energy, thermal energy, the heat of the heat of your body, right, is is a form of energy. Light is a form of energy. You know, what beams down from this nuclear reactor in outer space is Like,

Dr. Mark Hyman
red light therapy. I have a I'll show you my my little, you know, wellness clinic downstairs, but I I have a red light therapy, which then works fine.

Martin Picard
Of energy?

Dr. Mark Hyman
Inform energy that helps your mitochondria work better and repair

Martin Picard
and heal. Energy is the potential for change that manifest in under as different forms. Right? And what mitochondria do is they don't produce energy. Right?

They produce ATP. They produce hormones. They and we we can talk about this.

Dr. Mark Hyman
Mitokines. I never learned about mitokines.

Martin Picard
Mitokines. Yes.

Dr. Mark Hyman
Like cytokines are those inflammatory molecules of your immune system. Heard about during COVID, the cytokine storm, but kines are basically communication molecules. Like, they're they're messenger molecules that the body uses to regulate everything. And so cytokines are something new I never heard about, which are these communication signaling molecules that are in your mitochondria that regulate all kinds of functions, which I want you to tell me

Martin Picard
about. The function of the of the cytokines, a function of of the expanded view of mitochondria now that's emerging is one of connection, like you were saying.

Dr. Mark Hyman
Connection. Tell me more.

Martin Picard
Right? Like, earlier, you you talked about how everything in the body is interconnected. Yeah. Right? What interconnects everything?

What is the glue? There's this famous experiment where you take metronomes, right, that goes

Dr. Mark Hyman
Like, when you're playing your piano. Yeah.

Martin Picard
Yeah. Exactly. So if you take a bunch of them, let's say you put four on a piece of wood, and then you have them desynchronized. Right? And then you put that piece of wood on two cans of Coke, two aluminum cans.

What happens if you wait just a few minutes is that the metronomes will all come into sync with one another. So somehow there's information about the the the phase of one metronome that is shared through this conductive medium, right, which is, like, they all sit on the same piece of wood, and then they sit on two cans on a table, and then you can see it moves, you know, ever so slightly. Yeah. And so there's energy, right, the potential for change in one metronome, the movement of one metronome that is exchanged with the other one and the other one and the other one. They're all interconnected.

And at the beginning, you look at this, it's a whole mess. You know, they're they're all asynchronous, desynchronized. Yeah. And then within a few minutes, they start to be synchronous. And then you can ask, how did this happen?

And from a physics perspective, it's very simple. There's energy from one that was transferred to all of the other ones, and then energy is is transferred through through all of them through this conductive medium that is this little movement. If you were to put the four metronomes on a table that is, you know, fixed, they they would stay out of sync. But if you put them on the same on the same malleable surface. Right?

Dr. Mark Hyman
Energy is transmuted through the surface. Exactly. So So how did that apply to human health and biology? Because I think maybe people are a little lost what

Martin Picard
you're saying. The point is

Dr. Mark Hyman
smart guide. I'm I'm getting a little lost. So help me out here.

Martin Picard
The conductive medium that allows the metronomes to come into sync

Dr. Mark Hyman
Yeah.

Martin Picard
And to, in the end, all behave like a a unified whole

Dr. Mark Hyman
Yeah.

Martin Picard
Is the transfer of energy. Yeah. So then you can ask, well, what's the what's the conductive medium in the human body? And that's energy. Energy and metabolism, specifically.

Right? Metabolism is the conductive medium that connects every cell in your body. So when we talk about mitochondria and and their their ability to transform energy, food, and oxygen. They transform this into first an electrical charge. Inside the mitochondria become charged like little batteries.

This is where the lightning bolt, you know, bolt calculations come from. And then they start to talk to one another. And mitochondria are these, you know, like an intracellular brain, pretty much. Mitochondria can receive information from hormones, from metabolites, and from

Dr. Mark Hyman
Immune system, from the microbiome.

Martin Picard
Yes. Right?

Dr. Mark Hyman
Yes. Toxins.

Martin Picard
Thousands. Thousands of little inputs. Right? Mitochondria behave like a little intracellular brain, so every cell

Dr. Mark Hyman
Kinda looks like a brain ish thing.

Martin Picard
Yeah. This is one form. There are many many different forms, and this comes, you know, from the tree, which is really crystallized energy from the sun.

Dr. Mark Hyman
Yeah.

Martin Picard
Right? And then mitochondria are in the business of taking that form of energy, right, biochemistry, the food you eat, and then dematerialize this, literally. Deconstruct it. Deconstruct it, but you take it from material biochemistry into an immaterial electrochemical gradient.

Dr. Mark Hyman
So basically, what you're saying is you're like, you eat a food piece of food. It's like stored energy from the sun Mhmm. In some version. Right? Yep.

That's something what it is. They're growing the plants and eating the plants themselves or eating the animals that ate the plants. And then that energy is transmuted, broken down, and turned into electrical energy and other forms of energy that actually drive every sting in the body.

Martin Picard
Exactly. If you think about the the range, like, the the human body and just life in general is so beautifully complex. There's the degrees of freedom to use technical language. Right? You have one thing and then how many branches, how many different ways can it go Yeah.

Is is, you know Yeah. Yeah. Yeah. The number of cells we have, the number of genes we have, the number of proteins come. Yes.

You know, the the number of metabolic reactions that happen. Every enzyme is basically a little degrees of freedom. A little opportunity for, you know, do I do this? Do I do that?

Dr. Mark Hyman
Well, I just wanna stop you there because what you said is just I don't wanna lose it. It's so important. Disease is the loss of resilience and metabolic resilience and freedom. Mhmm. And so what you're talking about is how do you create a resilient system in the body at every level, mitochondria and everything else, so that the body can actually function better?

And that those degrees of freedom and resilience are what create health. I I personally really, unfortunately, understand mitochondria on a cellular level myself because my mitochondria have been so screwed up so many times that I've had to really understand how to recreate a healthy energy system in my body. And I do that with my patients, and it's it's it's kinda miraculous.

Martin Picard
The miraculous thing about it is is what we see in nature every day. Right? Like, the our ability to heal and to and to build and sustain health is what we see in nature. Right? Like, you you take a plant, you cut something, and then it grows back.

And and the the ability to to heal and to transform is is just part of what life does.

Dr. Mark Hyman
On a personal level, and some of you may know this who are listening, I personally had a kind of a catastrophic illness nine months ago from the recording of this podcast. I was completely capacitated. I was I was in bed. I couldn't move. I lost 20 pounds.

I was weak. I couldn't walk, and I was in a totally low energy state, let's call it. And and I had to claw my way back over the last nine months and was able to use the science that you're talking about at 65. And I did not know this was possible, because I was kinda scared, to be honest with you. I was scared that, oh, shit.

I'm 60 Am I gonna be able to recover? I'm not 35. Can I recover and get back to function? Can I can my mitochondria, my health recover? And I wasn't treating a disease per se.

I was just in this totally broken down state that happened after surgery and inflammation, infections, whatever happened to me. And this weekend, was in Aspen, and I hadn't really been doing a lot of cardio, doing strength training in the gym. And I was able to get on a bike, not an electric bike Yeah. And ride up a mountain 11 miles. You might have caught your working.

9,600 feet of elevation. And I did it a couple of days in a row, and I could do it again today. And I'm like, holy cow. The body has the capacity to repair. I wasn't treating a disease.

I was helping restore my health and and engaging what I know as a functional medicine doctor about the science of creating health. This is really the laws of biology. And and one of the things that you talk about, which I think is was a new idea to me, one of the one of these fundamental laws of biology that you've uncovered called the energy resistance principle. And most people probably have never heard of it. Most doctors haven't heard of it.

I've steeped in this stuff, and I never heard of it until I've heard your stuff. I think it's something that you you kind of discovered. Hopefully, you get the Nobel Prize. I'm counting on it. I wanna go to the ceremony if you do.

Promise me you'll send me an invite. And it explains a lot about what happens when we get sick, when we're under stress, and how those things affect our ability to produce energy, and what the body does in response to those insults. And the insults can come from everywhere. So when I think about myconia, I think that they're like the canaries in the coal mine. You know, the canary in coal mine was a canary.

They put a coal mine, and if it died, the this this coal miners knew the air was bad. Get the hell out of there. So the the mitochondria are the first kind of sensitive little organelles inside our cells that are responding to these inputs from psychological stress. You call it psychobiology, which I love. Right?

They respond to toxins, which we're all exposed to. They respond to things that are happening in our microbiome. They respond to inflammation from any source. When you get the flu, why do you feel achy and tired and weak? Because the virus is messing up your mitochondria.

You know? Right? And so you have all these insults that can happen from various different sources, from mental stress, from physical stresses, from infections, from toxins, from your microbiome, from hormonal dysregulation. And so all those things modify the function of the mitochondria in such a way that reduces energy, which is why we're all walking around tired, why we have brain fog, why we feel like crap. It's not in our head.

Well, it is in our mitochondria. So well, I mean, yes, of course, it can be stress and so forth, but I want you to kinda under help us understand how how these mitochondria receive all these signals, what happens to them, why they stop working, and why it's sort of this universal phenomena underneath so many illnesses. You know, in functional medicine, I think thirty four years ago, Jeffrey Blank came up with this idea of mitochondrial resuscitation. How do we resuscitate our mitochondria? And it and it's it's really profound, and it's what I've been doing myself.

Martin Picard
Can you kinda help us understand how we how we think about these mitochondria, how they're impacted by the environment, how we can then start to begin to care for our mitochondria better and use the science that you're talking about in this energy resistance principle to understand what's happening and then what to do about it. I think the reason why energy is and and mitochondria are implicated in so many diseases we did an analysis a few years ago, and the it was it was called the rise of mitochondria in medicine. Right? And and you look at which diseases are there evidence for that mitochondria are impaired in some way. And turns out every disease

Dr. Mark Hyman
Pretty much. Pretty much.

Martin Picard
So why is that? These are your question. I think fundamentally, the answer to that question is because you are energy. You're not a machine that is powered by energy. You literally, you you, Mark, me, Martin, the experience of you, the experience of me is energy.

And I don't mean that in some, like, woo woo way.

Dr. Mark Hyman
Yeah. I'm an energy healer. You know, like yeah. Right. Right.

It's not

Martin Picard
There might be something to that, but the

Dr. Mark Hyman
Well, there is.

Martin Picard
You fundamentally right? When if you stop breathing and the energy stops flowing through your body, then your body just will remain what your body is. Right? That is not who you are. You are the energy that is flowing through it.

And and somehow it feels like something. When energy flows through the body, when it transforms, it it feels like something. And that's the so the basis of of what we are is really energy. And that's why mitochondria are so important because mitochondria are the portal. They're, you know, the conduit through which energy flows and then through which it's like the first step of transformation that brings you to life, right, and that that moves your body into life.

So it's that structure. That piece of structure is like the for the the analogy of the solenoid, right, the the cord, the the copper wire, that that's a mitochondria. Without mitochondria, you you could flow electricity. You would never get a field out of it. So mitochondria are so important and perhaps are like the cannery in the coal mine because they are the first site of energy transformation.

So if if energy isn't flowing right, then then you feel that very acutely because that's affecting what you are. Like the virus, the example you gave, like, if you're if you have a a bad case of flu, you feel terrible. And then you said it's because, you know, the virus is affecting your mitochondria. I don't know if that's true, but what we know for sure is that when you're fighting a virus like this, what happens is your immune system is gonna start burning a ton of energy. And there's this fundamental energy principle, which is energy constraints, right, or energy trade offs.

What happens is for reasons that nobody understands, no scientist has kind of come up with a satisfactory answer, There's a fixed energy budget that we have access to. So the the this thing, this organism needs to manage an economy of energy. Right? And if you measure someone's energy expenditure over twenty four hours, right, on day one and then on day two and day three, and you do this over long periods of time, it's pretty fixed.

Dr. Mark Hyman
You mean you mean they're like the resting metabolic rate? Or do you mean

Martin Picard
Resting is when you're not doing anything. Yeah. Right?

Dr. Mark Hyman
How much them walking around and doing your life.

Martin Picard
If you measure energy expenditure, not just resting, but including everything you do. Right? And then that in would include, for example, your bike ride up the up the mountain. I'm sure you burnt more energy.

Dr. Mark Hyman
Definitely. I was so hungry that night.

Martin Picard
So there are days when you spend more energy, but then there are days when you spend less energy. Right? And overall, if you integrate over long periods of time, it kind of averages out. Yeah. And there's this remarkable discovery a few years ago by Herman Ponser.

He went to work with Hadza's in Africa.

Dr. Mark Hyman
Yeah. I've been there.

Martin Picard
And he measured how much energy do these people burn. Like Yeah. They walk all day. Like, some people some of them up to, like, 20,000 steps. Right?

Looking for food and so very active lifestyle. So the and they're they're very lean. They don't tend to have metabolic disorders, and so he thought maybe, you know, it's because they expend so much energy. Right? Turns out, the energy expenditure of hunter gatherer with someone who's, like, foraging all day is the same as a sedentary couch potato whose job is to type

Dr. Mark Hyman
Really? How is that?

Martin Picard
How is that? Exactly. This is that's a it's a mystery. It's a bit of a mystery for there are many evolutionary reasons why that could be the case. Imagine you're, you know, a caveman back, you know, tens of thousand hundreds of thousands of years ago.

And then if the energy budget was not fixed, right, and then you could have, you know, one guy who's like, I'm gonna not I'm not gonna sleep, and I'm gonna just be very active, and then I'm just gonna eat more food. Right? Because if your energy budget was not fixed, the solution to getting more energy would just to eat more food. Yeah. We know it's not that's not how it works.

If you eat more, then you end up hurting yourself. Yeah. And then you end up wasting energy digesting food that you don't need and then storing excess fat and Yeah. And so on. So the the an expression of the fact that we have a fixed energy budget is the fact that you can't just eat more to have more energy.

So somehow your energy budget is constrained.

Dr. Mark Hyman
But you can change it, can't you? If you exercise, if you build more muscle, if you actually increase your v o two max, which is the amount of oxygen you can burn per minute, that's related to how much calories you can burn per minute. Yep. That can change.

Martin Picard
What happens if you start exercising to increase your v o two max, your energy expenditure, let's say, is 1,500 calories per day. Right? And then you start working out, so then you expand, you know, you go sit on the treadmill or, you know, your your cycle ergometer, you see 300 calories. So you burn 300 calories. So then on that day, you'll be 1,500 plus 300, so you'll be at 1,800.

So say, see, I I'm I can go over my budget. But then if you do this a few times a week for multiple weeks, what ends up happening is that 300, your body is gonna save it somewhere else. So the the 1,500 is is gonna end up shrinking. It's called metabolic compensation. So the the organism is gonna find ways to be more efficient.

Yeah. So that that 300 doesn't come on top of your 1,500. It it's absorbed into it. And that's why exercise is not a good way to lose weight for most people.

Dr. Mark Hyman
No. I would say you can't exercise your weight on a bad diet.

Martin Picard
Yeah. And that's in part because as you exercise, the body is like, oh, I can't afford this. Like, I have a fixed budget. What can I do to accommodate this? And and I think, I suspect, a significant proportion of the health benefits of exercise is that energy saving, that that metabolic compensation.

The body basically becomes more efficient. And to become more efficient, it needs to do less of the things that are not useful. It needs to be more less frivolous with its energy budget. So if you have bad mitochondria that are not working really well, you get rid of them through mitophagy.

Dr. Mark Hyman
I I'm confused because, you know, when I've I looked at the literature, for example, with metabolic health and diabetes. The mitochondria of diabetics or even first degree relatives of diabetics don't work as well. There's something called p c g one alpha, and that is sort of a molecule within the the mitochondria that regulates energy. And and so it's less in people who had type two diabetes and in their first degree relatives even if they don't have diabetes. Right.

So so it seems to me, you know, there's a variation in the quality of our mitochondria across humans, and there's also a variation in what you can do to actually improve their ability to produce energy. Am I wrong?

Martin Picard
Transform energy. So p g c one alpha regulates the amount of mitochondria. So if p g c one alpha goes down, then you the that happens if you stop exercising, right, or if you're bedridden for some reason or if you break an a leg and it's in a cast, right, the muscles are gonna atrophy. It's also gonna lose mitochondria, and PGC one alpha goes down. Now if you start to exercise again and the muscle contracts and it needs more energy, then the cell, the muscle cells are gonna say, shit.

This this this is costing me a lot of energy. I need to build, you know, the machinery to to support that energy flow, and then it makes more mitochondria by turning out p g c one alpha. So p g c one alpha regulates the amount of mitochondria, and there's a few reasons why

Dr. Mark Hyman
And you can get more efficient mitochondria.

Martin Picard
Right? You yes. There's much more root wiggle room in the amount of mitochondria you have. Like, if you go from being sedentary to training for a marathon, for example, you can double the amount of mitochondria in your muscle. Double.

Dr. Mark Hyman
So then does that mean you you're burning more energy?

Martin Picard
It doesn't. It means you can your max, your ceiling, right, is higher, but your your budget at rest doesn't change.

Dr. Mark Hyman
I thought when you train and you increase your v o two max, which essentially is the amount of oxygen and calories you can burn per minute, that your resting metabolic rate will increase. At doing nothing, you'll burn more calories doing nothing.

Martin Picard
It it doesn't. Really? Or if it does, it's it's minimal. And there's actually evidence that shows it actually decreases. So if you increase your v o two max, you make more mitochondria in your muscle, then it means you can push harder.

Right? You can go more intense.

Dr. Mark Hyman
Your upper limit is

Martin Picard
higher. Yes. Your upper limit is higher, but your resting either stays the same or in some cases, in for some physiological system

Dr. Mark Hyman
more efficient.

Martin Picard
Actually, yes. Exactly. So if in your trained state, right, if you're the mark from a few months ago, your heart rate was probably pretty high at baseline. Yeah. And then if you're, you know, picking up steam, making more mitochondria, increasing your v o two max, going on out on the bike Yeah.

Yeah. Your resting heart rate actually decreased.

Dr. Mark Hyman
That's what happened. It was like when I was sick, it was it was in my seventies, and now it's in the fifties.

Martin Picard
Yeah. So 20 beats. Like, think about how much energy nothing is free in biology. Right? Think about how much energy the heart burns every beat.

It's like this whole contraction and then this whole relaxation. Everything costs energy. Now you're saving 20 beats per minute, and then compound this or number of minutes in a day. Yeah. Number of minutes in a month.

Like, you're saving so much energy by having a lower resting heart rate. That's in part what people think is the basis for metabolic compensation. So you start working out, and the body actually becomes more efficient.

Dr. Mark Hyman
So let's take this back to kind of practical. We didn't quite explain the energy resistance principle. I wanna I wanna explain that. I wanna and then I wanna tie it back to how this matters to real people with struggling with real issues, whether it's something like brain fog or fatigue Yeah. Or depression or Diabetes.

Diabetes. Like, how how do we then begin to apply this in new science? And even, you know, how how do we understand the role of I call it the mind body effect, but also the body mind effect.

Martin Picard
So the the core idea of the energy resistance principle and the the ERP for short, the the energy resistance principle is meant to be a formal description of how energy behaves in biology, and it's a bridge between physics and biology in a way. And we think there's a a little formula that's very simple and oversimplistic, but it's I think it's the first formal equation that bridges physics and biology and and describes how energy flows and how energy transforms inside our bodies. And the the first kind of assumption for the ERP is that you are energy. Fundamentally, like we said earlier, what you are is this energy that's flowing, and you can lose a piece of your body. Energy is still flowing.

You still feel like yourself. But if you've changed the way energy flows, you haven't changed the physical structure of your body, but you've changed. Right? So at the end of the day, when your energy is not flowing great and you're you know, it's really time for bed or you're past your bedtime, you're not the best version of yourself. You're literally a different kind of person.

Or if you take, you know, amethystole or some, you know, other So

Dr. Mark Hyman
your energy like that's why you're tired at the end the day because your ability to produce energy goes down?

Martin Picard
There's something energetically that changes, and and we feel this as fatigue. But what seems to happen, there's a new paper that came out a few months ago in Nature showing that the pressure to sleep, which is basically a fancy word for saying I'm tired. I'm tired. That study was done in flies. It was, like, you know, a lab experiment.

But what they showed is that what drives a fly to want to sleep, so the pressure to sleep, which is probably equivalent to the fatigue you feel at the end of the day, arises in your mitochondria. Yeah. And the way it arises is because energy is basically facing more resistance. It's like you're flowing water through a through a pipe, right, or through a hose. If you squeeze a hose, right, you increase a pressure.

You increase a resistance. Energy flowing in the body just works just like that, and it works just like in a simple electrical system. To come back to our electrical analogy, you have electrons flowing, and if you have a battery, negative pull, electrons flow, and then they reach the positive pull. Right? So that's a simple energetic circuit, and we have great formulas in physics to describe how this works, Ohm's law or the power law, and then you know from those those laws.

If you want to transform the flow of electrons, electricity into light, into movement of a car, an electric car, into powering your or not, your your laptop, what you need is resistance in the circuit. Energy that that flows without resistance doesn't do anything. But the the the equations in physics tell us you need some resistance so that the flow of electrons can actually be transformed to power And not too much. And and to work. Exactly.

So the energy resistance principle says you, your existence as an energetic process requires resistance, but you need to live at a sweet spot of resistance. Not enough resistance. Like, if you're, you know, a photon beaming in outer space that never hits anything, no transformation. At some point, the photon hits a green leaf, and then the green leaf offers resistance to the flow of energy. Right?

That energy electromagnetic energy hits a green leaf, and then it's transformed into something else, a

Dr. Mark Hyman
different formative.

Martin Picard
Yes. Photosynthesis. And then at some point, the electromagnetic energy of the photon gets converted into biochemistry.

Dr. Mark Hyman
Okay. What you're saying is mind blowing, and I thought about this so long. Basically, what's happening, everybody listening is sunlight, sun energy. You can feel the energy. If you go on the sun, you can feel it.

Mhmm. That is transformed by plants into energy and food. Yeah. And it's kind of a miracle. And the body is kind of the reverse.

So mitochondria are the human kind of

Martin Picard
They do the opposite.

Dr. Mark Hyman
Like, they're the kind of complement of the photosynthesis. Yeah. Right?

Martin Picard
They close the life cycle. But the way photosynthesis works, right, the way you transform light into food is through resistance. Yeah. You need to slow down the photon. Right?

You bring it down to zero. It goes So

Dr. Mark Hyman
how do you get the right resistance? Because too much resistance kind of shuts things down, and not enough resistance doesn't allow you to actually produce enough energy to thrive. Exactly. Right? Yes.

So can you kinda walk us through what are those things that cause too much resistance, and then how do we fix that?

Martin Picard
So the resistance so that happens and I think is tuned in your mitochondria. And that's precisely why you make more mitochondria with p g c one alpha or why you make fewer mitochondria by decreasing p g c one alpha among other things. So this the the body, we can think as this electrical circuit that goes from the electrons flow from negative to positive, right, through maybe a motor or through something that does work. What your body is is basically like an energetic circuit, like an electrical circuit. And the electrons, the the negative pole on the battery is food, and then the positive pole that accepts the electrons is oxygen.

Yeah. So the food and the oxygen are like the two poles in this electrical energetic circuit. So this is an energetic circuit as well, and the the circuitry, the copper wire, is your metabolism.

Dr. Mark Hyman
It's kinda cool because plants take in sunlight and carbon dioxide, and they turn into energy. They store it. We eat it. We reorganize it and breathe oxygen, and then we burn the calories in our mitochondria to produce energy that runs everything. And that fundamental system, what you're saying, I get it right, is essential for the functioning of the human body, and if it's not going well, can explain most chronic diseases at some level or another.

Martin Picard
Correct. Because if the energy is flowing with not enough resistance, then transformation is not possible. Right? If you if the green leaf couldn't stop the photon, there would not be photosynthesis. So in the same way, if your metabolism couldn't slow down the the the flow of electrons from food, you know, this little nut that you eat, right, the the the the fat that you

Dr. Mark Hyman
that I have for breakfast.

Martin Picard
So they they need to if they don't face enough resistance, then basically, you burst into a flame. Yeah. Right? That's what fire is. Fire is you have electrons that are stuck on a piece of paper, a piece of wood, a piece of, you know, whatever, and then it jumps on oxygen.

So if you warm up carb something carbon based, right, hot enough, then the electrons will just find oxygen. Boom. They jump on it, and you get a you get a spark, you get a flame. So fire is the the uncontained, unrestricted acceleration of ox of electron, boom, onto oxygen.

Dr. Mark Hyman
So help us understand, like, this this energy resistance principle from a practical human perspective. Because I I think we're getting a lot into the physics, which is cool, but I I wanna make sure people understand how this relates to them. Because people are saying, well, that's interesting, but I didn't really tune in to listen to physics lesson. I wanna know you know, my my joke is everybody's favorite radio station is WIFM. What's in it for me?

So I wanna get into the what's in it for me now, which is how when things go wrong does it cause human disease, and then how do we fix the mitochondria? Because, you know, I was saying earlier, in medicine, it's pretty much ignored after first year biochemistry. And yet in functional medicine, we have, I think, somewhat crude tools to assess the functioning of mitochondria through looking at Krebs cycle metabolites, energy production, metabolites in the urine, or doing v o two max testing, or there's newer things that actually allow you to look at various various of the steps in the pathways and how they're functioning, you know, cytochrome c, and then all the all the complex one into four, all the all the all the stages. So I I think the way I think about it just to explain to people is mitochondria is like kinda put energy in, and it's kind of this is not actually happening. I like, put energy in from oxygen and energy in from food, and it kinda goes through like an assembly line.

And there's steps on the assembly line that all have to be working to at the other end, come out with something called ATP, which is energy. And then the waste product is carbon dioxide, which we breathe out and the plants consume. It sounds like we're we're just like one organism whether we like it or not. And it also produces water, which we pee out, and also produces some free radicals, which can get out of control. But the mitochondria have their own built in antioxidant systems to protect against this rusting or free radical injury.

But when those go awry, you end up with more mitochondrial damage and more trouble with your mitochondria and and less ability to produce energy, and that leads to all the diseases, like the mental health issues, the metabolic diseases, like diabetes, the cardiovascular issues, and psychiatric even like neurodegenerative issues like Parkinson's, Alzheimer's, autism. So kind of walk us through how how we start thinking about when measuring what's going on. Like, are there clinical tools? And and there's one that you talked about, this g d

Martin Picard
GDF fifteen.

Dr. Mark Hyman
15. Yeah. Which is a new blood test, a biomarker that can help you understand how this energy resistance principle is working. Are you good or bad? And and what other tools can we use to measure?

And then, you know, how do we get to start treating people differently by going upstream to treat the mitochondria? And and just for those listening, everybody knows I wrote a book on longevity called Young Forever. And in that book, I talk about what science is uncovering around what call the hallmarks of aging. These fundamental things that explain the pace and the rate of aging and chronic disease. And they're they're upstream to diseases.

In other words, they're they they are things that go wrong that are fundamental to all age related diseases, and yet we're treating all the diseases except we're treating Alzheimer's. We're treating diabetes. We're treating cancer. We're treating diabetes, which is kind of the wrong approach.

Martin Picard
Yeah. Because they all converge on the hallmarks of aging.

Dr. Mark Hyman
Right. And so the hallmarks of aging, I wrote about, and and one of the key hallmarks is mitochondrial dysfunction. And a lot of the longevity therapies work on what I call the longevity switches. These are the these are the things that regulate in part mitochondrial function, the creation of new mitochondria, the the the the effectiveness of their producing energy. And so whether it's the the mTOR and things like rapamycin or insulin signaling or AMPK, which is basically regulating blood sugar or sirtuins, which regulate mitochondrial biogenesis, DNA repair, they're all kinda connected to mitochondrial function.

And so we're learning different ways to intervene, but earlier in the process. And and in my book, I talk about how the homeworks of engineering are good, and they're useful framework, but they don't go far enough because they don't ask the question, why? Functional medicine is the medicine of why. Why are the mitochondria not functioning?

Martin Picard
Yes. And what connects those hallmarks of aging? They're so central to not only how we age, like you're saying, but to to so many diseases. And the reason is because beneath under underneath all of the hallmarks of aging is energy. And anytime I hear the term mitochondrial dysfunction, I get an emotional response.

Dr. Mark Hyman
Oh, why?

Martin Picard
My hair rises because it's it's so misleading. And and it kind of locks us into this old idea, mitochondria are powerhouses. You gave a nice story of how mitochondria kind of are this little ATP producing, you know, engine. I would give a different picture that says mitochondria is kind of the the meeting point where you have food, electrons from food, and then oxygen. And what mitochondria do is they basically allow their reunification.

Right? They were separated. The plants in photosynthesis broke water apart. Electrons and stuck onto c o two, and then they made carbohydrates, and then the oxygen, you know, liberated. And then those two are kinda longing for each other for forever.

And then until they meet back inside your mitochondria. When they meet in your mitochondria, boom. You get water back again.

Dr. Mark Hyman
Kind of a miracle.

Martin Picard
It is amazing. And that's what energizes your mitochondria, yes, to make ATP. ATP synthesis is one of, like, at least three dozen functions. So anytime I hear mitochondria function, I I Wow.

Dr. Mark Hyman
Because it's reduced to just ATP for most people. Yes. It's like

Martin Picard
And yes. And if you say mitochondrial dysfunction, it means there's one way in which mitochondria can be dysfunctional, and that assumes that kinda there's one function, which is not the case. So mitochondria, these little living creatures, and they're a portal. They're an energetic portal where bio the the biochemical type of energy gets dematerialized, and then it makes all of your, you know, other life possible. Heat is generated, reactive oxygen species, other form of energy, probably light, you know, biophotons released from from mitochondria and other other kind of signals that then inform the whole, you know, of the organism.

Dr. Mark Hyman
Yeah. By the way, everybody, you know those sparklers you get at fourth of July with the the the, like, bright sparklers? That's phosphorus. That is what ATP is, adenosine triphosphate. It's got three phosphate molecules, and that's kinda what's happening, these sparklers inside your cells Interesting.

And your light beings.

Martin Picard
Yeah. I never thought about that. So with the energy resistance principle, you wanted to kind of go into the practical Gotcha. Yeah. Applications for this.

Dr. Mark Hyman
What's in it for me?

Martin Picard
Yeah. What this what this is referring to is how with how much ease can energy be flowing. Right? The the the food and the oxygen coming into mitochondria to make water again and then energizing the whole system. How easily is that flowing, or is this flowing with great resistance?

So that's what the the ERP is about fundamentally. We feel that. And and the the the energy resistance principle paper and the the other piece we're we're writing, and that's in in the book energy that I'm working on, talks about what it feels like when energy resistance isn't flowing well. And it turns out that all of the hallmarks of aging and all of the classic hallmarks of diseases, including inflammation, damage, molecular damage to to DNA, telomere shortening, epigenetic aging, all of those are downstream of energy resistance. So when energy can't flow easily and it it flows with great resistance, like you have too much pressure, right, in a hose, at some point, it's something's gonna blow up.

Or if resistance is too high in in an electrical circuit like your your computer, it starts to overheat. Right? And as things heat up, there's what's called dissipative loss. So then the the structure of your body starts to to dissipate, to break down, and then that's Disease. That's disease.

Right? So all of all of those hallmarks of of disease can be traced down to energy not flowing easily. And you mentioned NAD earlier. What NAD does is basically it's an electron transducer. Right?

So the more NAD, the more the less resistance there is.

Dr. Mark Hyman
I mean, basically but what we call we call the producing of energy in the body, the electron transport chain. So, basically, you're transporting electrons down this chain through all these chemical steps that require nutrients and cofactors, everything from co q ten to b vitamins and so forth, NAD, all these different steps. And that creates an enormous opportunity for intervention, for helping people recover from an impaired energy production process.

Martin Picard
If there's a deficiency in some of those cofactors. NAD is upstream of the electron transport chain. It's what gives the electrons from the Krebs cycle that you mentioned into the electron transport chain, and then from there, they're channeled and onto oxygen. And some people seem to be deficient in NAD. And

Dr. Mark Hyman
Well, that goes down as you get older.

Martin Picard
It goes down as you get older. I see patients in the clinic with mitochondrial disease and non in ND, but I'm in the clinic half a day a week, and I see people with genetic defects in their mitochondria.

Dr. Mark Hyman
Yeah.

Martin Picard
Right? So the mitochondrial DNA that we get from her mom, they have a mutation. Yeah. And they feel tired all the time. Many of them have multisystem disease.

So Yeah. Many of their organs are not working as we know mitochondria everywhere. And some of them have tried NAD, you know, infusions and and feel like it it's helping them. And and I've seen some some of them being, like, pretty angry that this is not reimbursed. Right?

Yeah. It's not traditional medicine. It's functional medicine.

Dr. Mark Hyman
Right. Exactly.

Martin Picard
What are the practical implications Yeah. For for of the energy resistance principle is we should be treating energy. Yeah. Right? You're not a machine.

You are energy. And then the way energy flows through your physical body is what determines whether you can heal, whether you feel vitality.

Dr. Mark Hyman
You need energy to heal.

Martin Picard
Yeah. You need energy to heal, but you need energy to flow in a certain way. If it flows with too little resistance, you'll combust and maybe you you feel manic or you feel like, you know, you're you're not quite grounded. And then if energy flows with too much resistance, then it probably feels like a drag, and that's what we experience as as fatigue and as chronic fatigue syndrome. And what we experience negative symptoms of depression, for example.

Right? The the apathy and anhedonia and and so on. And it turns out there there's a marker, like a blood marker of excess energy resistance in the body, and that's this protein you mentioned, GDF 15.

Dr. Mark Hyman
GDF 15. What does it stand for?

Martin Picard
Growth differentiation factor 15.

Dr. Mark Hyman
And you can measure in a blood test?

Martin Picard
You can measure in a blood test. We discovered a couple years ago, you can measure it in saliva.

Dr. Mark Hyman
Is this commercially available?

Martin Picard
It's not commercially available.

Dr. Mark Hyman
So you have to be a research scientist?

Martin Picard
You do. The Mayo Clinic has a clinical test for GDA fifteen that they use to diagnose mitochondrial disease. Yeah. GDA fifteen, interestingly, was discovered in completely separately in different fields of medicine. So it was discovered in mitochondrial disease.

Like, if you wanna know, does this person have mitochondrial disease or not? They're always tired. They have this symptom, neurological issues, cardiac issues.

Dr. Mark Hyman
And these are rare genetic mutations that are un very rare and that that are well recognized in medicine. They're usually diagnosed by muscle biopsy. Right. And and they cause people to have a lot of these symptoms of system failure and fatigue. But but but there's a spectrum of problems with the mitochondria that occur in otherwise healthy people that are influenced by these different insults that we get from living in this modern world, the stress, the psychological stress that's transduced through the mitochondria, the toxins, the change in our microbiome.

Our nutrition plays a huge role in the function of our mitochondria. Mean, I that's why ultra processed food is so bad because there's no nutrients in there, and it creates a lot of inflammation. Why?

Martin Picard
Why does it create inflammation? Good question.

Dr. Mark Hyman
I mean, I have no theory, but I would love to hear yours.

Martin Picard
We think it comes down to energy. The source of inflammation, if you go down the chain, inflammation, the way we talk about inflammation nowadays, which I think is a misnomer, is cytokines. If you're cytokines and we say, ah, there's inflammation, inflammation traditionally would was redness, heat, and swelling.

Dr. Mark Hyman
And pain.

Martin Picard
And pain. Hallmarks of of inflammation. And as part of the this inflammatory process, cytokines can be used, right, by the the cells that are injured. Like, if you break the the skin epithelium, for example, they'll start to secrete cytokines. The immune cells will start to secrete cytokines.

So it's part of the process, but the inflammation itself is not the cytokines. The cytokines are this universal language of cell cell communication. Yeah. It's how cells talk to each other. You know?

It's like the words that we use to talk to each other, this is like the repertoire of cytokines.

Dr. Mark Hyman
Yeah. That's the key. The body's a network, and it communicates through these messenger molecules that range from hormones to neurotransmitters to peptides to cytokines to cytokines mytokines

Martin Picard
to Mhmm.

Dr. Mark Hyman
Myokines to I mean, every every kinda Yeah. Communicable communications. It's so fascinating, and it's happening at fantastical speeds constantly in the body. And when those communication systems are awry, that's when disease arises.

Martin Picard
If everything is going well in your body and your cells are you're working coherently, coherence, I think, is a a key concept that isn't a part of medicine, but, you know, needs to be part of our the future of medicine. If we think about health energetically, you you you get to coherence and to, you know, resonance and pretty quickly. But if everything goes well in the body, every cell, you know, lives harmoniously, you know, as part of this social contract. Like, every cell works with every other cell, and no one cell is gonna go on their own to in the in a selfish way that cancer is. But if every cell is okay and and is is functioning harmoniously, the whole organism, you don't need to secrete cytokines.

Right? Because the the cells are are are working the way they should. When something's wrong, then you if you're a cell and you're experiencing excess energy resistance because your mitochondria are not working properly, maybe maybe there's a a toxin that that came in, you need to let other cells know. Right? Because if you die and then the whole organism is gonna suffer from this.

So the right thing to do if for this social collective, that's the body, if one cell is struggling energetically, it lets other cells know, and then other cells can can help support it. That's the basis of physiology. And if one organ is in need of more

Dr. Mark Hyman
energy Compensation.

Martin Picard
Right. So that's what cytokines are there for. And many cytokines seem to be secreted in response to an energetic issue, an energetic deficit. Like, even after exercise. Exercise is not bad for you.

We know exercise is good. You contract your muscles very vigorously if you climb 9,000, you know, feet of vertical.

Dr. Mark Hyman
No. No. It was it was about 3,000 vertical feet, but it was 9,600 feet of elevation.

Martin Picard
Okay.

Dr. Mark Hyman
And it was 11 miles straight up. So my mitochondria were working overtime.

Martin Picard
Overtime. And then during the exercise, there's

Dr. Mark Hyman
I felt so great after. I actually got more energy, which is so weird.

Martin Picard
Yeah. What did it feel afterwards?

Dr. Mark Hyman
I felt great. I wasn't tired.

Martin Picard
Where in your body did you feel

Dr. Mark Hyman
I didn't feel sore or tired or anything. I just felt energized and alive,

Martin Picard
and my brain was on fire, and I had I just felt good. So the energy resistance principle says, what you were experiencing like this after exercise that leaves you feeling, you know, good and energized and you're on fire, this is a decrease in energy resistance. That's what it feels like when energy is flowing in your body and it's effortless. Right? That might relate actually to the psychological state of flow.

Right? When you're in a state of flow and things are easy and things are just flowing, there might be a literal energetic parallel in your mitochondria. That energy is just flowing. And if you don't overdo it, after exercise, that's what you feel. Right?

And your heart rate is a little higher and your your blood vessels are dilated and and things are flowing, you know, and that's very comfortable. And and that's, again, I suspect that's what happens in the state of mania in bipolar. Right? Because people that are when they're in the the the manic phase Yeah. They they don't feel tired.

Right? It's crazy. They stay

Dr. Mark Hyman
all day for, like, ten days in a row, and they're Yeah.

Martin Picard
You don't feel like sleeping? I think they're Yes. There there's other kind of psychological and kind of delusions that come with this, which I think says something about the need to slow down the energy flow in your mitochondria. But when energy is too high, right, that there's there's something maladaptive to that. So that's why energy resistance principle says there needs to be a sweet spot.

Dr. Mark Hyman
You got a Goldilocks principle.

Martin Picard
Correct. Exactly. And when energy is too high, then, you know, it feels uncomfortable. And I suspect there we might have the direct ability to feel when energy resistance creeps up. So if you contract your muscles, right, like, you you lift a weight that's too heavy for you and then it starts to burn Yeah.

Right, what is that burning?

Dr. Mark Hyman
It's lactate.

Martin Picard
It's not.

Dr. Mark Hyman
It's

Martin Picard
not. That was debunked. I was I was the theory when I was a student.

Dr. Mark Hyman
What is it then?

Martin Picard
We don't know. We don't know.

Dr. Mark Hyman
You run out of energy, though.

Martin Picard
What's that?

Dr. Mark Hyman
You run out of energy.

Martin Picard
There's still energy that you you can still contract, but, you you know, you feel the the burning.

Dr. Mark Hyman
Well, I'm doing pull ups. Like, there's one point I just can't get another pull up in. Right? What is that?

Martin Picard
Well, I think that's a mixture of, you know, you there's acidity and there's, you know, buildup of product, and so muscle fatigue is is one thing. What I'm talking about is the burning sensation. Right? The burning sensation you can get if you're deconditioned and, you know, you're going up the stairs or or something like that. We used to think it was lactate or lactic acid, then there was a theory about acidity and, like, the pH changing.

It seems like it's probably neither of those. What I suspect it is is you're actually feeling the energy flowing through your mitochondria. And when energy resistance increases, yes, you may lactate, and, you make other things, but maybe we can actually experience the change in in energy resistance. Same thing with an infarction, like a heart attack.

Dr. Mark Hyman
Heart attack. Yeah.

Martin Picard
Right? When blood can't flow to the to the heart anymore, like, the the pain of this my dad went through this a few years ago.

Dr. Mark Hyman
Oh, I'm sorry.

Martin Picard
He said it was horrible. He he recovered really well. But the pain and he described this as, like, a pressure. Yeah. Like, 200 pounds on his chest.

Dr. Mark Hyman
An elephant sitting on your chest. That's right.

Martin Picard
Yeah. And then there's referred pain, and the heart has no pain fibers. There's no you know, if you if you open someone's chest and you poke the heart, like the brain, if you take the scalp off

Dr. Mark Hyman
Right.

Martin Picard
There there's no pain receptors on the brain or on the heart. But somehow we can feel, and it's I I've never experienced this, but, you know, the the pain of angina or of a heart attack, that could just be energy just can't that that's not able to flow. Right? Energy resistance is is too high.

Dr. Mark Hyman
So people listening, go, okay. I have some of these conditions. I have depression, or I have maybe I have Parkinson's, or maybe I have someone in my family with autism, which is not so common, or maybe, you know, I have diabetes, or maybe, you know, I have any one of these conditions that may be related to the mitochondria. Where do I start? Like, what what tests should I do?

What therapies are available? How are we thinking about this wrong? And I know you're not a doctor or clinician, but as best you can, describe what we're learning about how to assess and treat mitochondrial problems.

Martin Picard
I'd start by saying, like I said earlier, you're not a molecular machine. You're not broken. And there are no parts, I think, to be to be fixed or surgically removed or or transplanted. There are things that we know can unleash the healing potential of the body. Right?

Like, resting is really important. And when you exercise and then you make more mitochondria, you don't make more mitochondria during exercise. You make your new mitochondria when you're resting. Right? So and that's a a key element of energy resistance principle.

You need to increase your resistance when you're, you know, biking or you're out of breath. Anything that's out of anything that makes you out of breath, it means you're increasing energy resistance in your body. And then when you relax, right, that's when adaptation happens. So it's the you increase resistance, then you decrease resistance. And that's, you know, the great thinkers, you know, the creative writers will tell you, like, you need to, like, obsess with something, but then you need to let go.

You go you go for a nap or you you shower, and then the idea come. Right? It's when you relax it's when you relax that you get the benefit from having, you know, the increased resistance. So the the the chronic exhaustion, you know, maybe the burnout of chronic stress, I suspect come from having chronically high energy resistance. And then if you think about this as the basis of of health, energy flowing through your system, right, is what you are, how do you care for this?

How do you support this so that the organism can heal itself? Right. That is, I think, should be the basis for medicine. Yeah. As as I think part of the the core philosophy for functional medicine.

Right? How do you

Dr. Mark Hyman
Restore function.

Martin Picard
Yes. How do you restore function? How do you how do you allow the organism to heal itself? To do what nature just naturally does, what life naturally do. And and I think that's there I think key pieces that we know are generally true across people, but I I just wanna preface this by saying every person is different and know, you know, the kind of science that we do and the science that's out there that's driving culture is very much a science of averages.

The things that we end up believing and kinda taking as evidence based, this is all, like, group averages. So if you wanna know if something works, the the gold standard in science is you gather a couple 100 people. You expose some of them to the treatment. You expose some of them to to a sham or placebo, and then you see on average, did I move the average? Right?

Did I move the needle? So you measure something in your group of a 100 people. And then after eight weeks of this treatment, if the average is up by you do your power analysis. If it's up by more than x percent, then it's significant p value less than point o five, then they say, ah, evidence based. This works for people.

And then that goes to the FDA. The FDA says, okay. Approved. This thing is evidence based. But when you actually peel off the surface of a trial like this, of a research study, you find that there's some people in this study, they responded.

Like, they're they're they're cured. Whatever they came in with that was a problem is gone. Right? And they're amazing. Their life is transformed.

These are the people who should be receiving that intervention. But in the same trial, as you you peel the surface, there are people who didn't respond. Yeah. These are nonresponders, you know, typically that are called in in research studies. And then there are always people who actually are worse.

People who were injured or who were hurt by this treatment that now is, you know, approved as evidence based and as, you know, beneficial or or salivary. So there everything we tend to talk about is, like, average, and and there are things that are generally true across averages, but there are things that I think we we underestimate the the value or the power of individuality. And and that's where, you know, a really good physician and a person centered approach is is really critical.

Dr. Mark Hyman
Yeah. I think you're right. It's all about, like, looking at the individual because everybody's a little different. And and I think that looking through the lens of mitochondria is an important lens. And and we talk about this in functional medicine.

One of the new lenses we look through. How do we see the same things through new lenses? It's like putting on glasses, and all of a sudden you can see everything differently. And so when I see a patient, I'm thinking mitochondria. I'm thinking, are they working?

How well are they working? What's impairing them? How do I help their mitochondria work better? How is that gonna help them feel better? And so I know you're not a doctor, a clinician.

Me or doctor, PhD doctor, but you're not a clinician. Where where should people start in terms of thinking about assessing mitochondrial function? Because I use various tests. I know they're a bit crude. Maybe this new GD, you know Yeah.

EDF fifteen is actually a test we might use to look at this energy resistance in the body and find out if we're in the Goldilocks range. What can we do to assess the function of mitochondria, or do we just sort of infer it because based on the diseases? And then what are the therapeutic interventions? Because people like Chris Palmer are using ketogenic diets to improve mitochondrial function and mental health. People like Suzanne Goh are using mitochondrial supplements like CoQ10 or sulfate or carnitine to help autistic kids with mitochondrial dysfunction that she measures on a functional MRI machine.

Like, where is this all going? How do we get this in the clinic? Because the bench to the bedside is just takes decades. And I'm, like, impatient because I see people suffering. And I'm like, you know, like, how do we how do we take this and practicalize it, if that's a word?

Martin Picard
Mhmm. Yes. How do we touch human lives with this wonderful scientific knowledge?

Dr. Mark Hyman
Yeah. Yeah. That's why I want you to spend the rest of time talking about that because we're kinda doing a lot of science stuff, and I wanna get if you can, and if you can, just tell me. I'll Mhmm. Like, I'll I'll I'll kinda help you.

But I think this is something that I'm so passionate about because, like I said, I've suffered from it. I see so many patients suffer, and I see these therapies work.

Martin Picard
So in many cases where I think that would be classified as mitochondrial dysfunction, I I would not use the term mitochondrial dysfunction. There's an impairment maybe in the way mitochondria work, but someone could have mitochondrial impairment because the mitochondria are not making the hormones they should be making Mhmm. Or mitochondria are not making the ATP they should be making, right, which I think is what the the function dysfunction typically refers to. Or mitochondria are not able to receive the signals they should be receiving or producing the signals they should be producing to turn on this gene or or that gene. So with this, what can we do with this?

And I think it it brings us down to energy flow. Right? Like, is your organism able to flow energy through the mitochondria the way it it should? And I think that's why perturbing the system, like doing stress test I think you've used v o two max as as a way of, like, testing the the system and seeing how the mitochondria are they capable? V o two max is basically a test of how how much energy can you flow how quickly can you flow energy.

So that's, I think, one way when you can where that allows you to get an overall read on the organism's ability to support energy flow. Mhmm. GDF 15, I suspect I've never been a fan of, like, a single protein or a single, you know, marker because the system is so much more complex than than a single thing driving everything. But it seems like it's it's a convergence point. It's a signal of energy resistance, and energy resistance is that point of consilience.

Right? If if energy can't flow properly, then you create an you create inflammation, you create reactive oxygen species, and you create heat excess heat, and then you create disorder that leads to disease and and aging. So energy resistance, I I'm starting to believe is really the the crux or kind of the

Dr. Mark Hyman
So measuring that's important.

Martin Picard
The Rosetta Stone. Yes.

Dr. Mark Hyman
You try to get this test commercially available. That's one key way to look at it, and then see whether what you're doing from a lifestyle or supplement or other intervention perspective is actually working.

Martin Picard
Yes. If you can yes. Having a way to quantify, to measure energy resistance in the body would be game changing.

Dr. Mark Hyman
But we have it. Mayo Clinic doesn't. Like, if I'm a doctor, can I send my blood my patients to Mayo Clinic now?

Martin Picard
I think so. Yeah. Yeah. I think so. Yeah.

They've they've used it only, I think

Dr. Mark Hyman
For these severe diseases?

Martin Picard
For for mitochondrial diseases, yes, these, like, rare genetic disorders.

Dr. Mark Hyman
Yeah. They don't they don't think too much about the continuum of disease from asymptomatic to full blown, you know, full blown pathology or yeah.

Martin Picard
Correct. But there's this new study in The UK, the UK Biobank. It's over 50,000 people where the proteins in the blood were measured, and then they were looking, what's the best marker for diabetes? What's the best marker for dementia? What's the best marker for bipolar?

What's the best marker for cancer? And then you can go down the list. They have 900 clinical phenotypes. And then there's 3,000 proteins. And then they're asking, okay, which of these proteins is the best marker for disease one and disease two and disease three?

Right? And then you go down the list. GDF 15 is by far the best marker for most diseases.

Dr. Mark Hyman
Most diseases?

Martin Picard
Most diseases. So it's a pan disease. Right? The technical term is a pan disease biomarker. Why the hell is that?

The energy resistance principle says it's because all of these diseases have an energetic ideology.

Dr. Mark Hyman
That's amazing. So we gotta get this test commercially available like ASAP.

Martin Picard
That that'd be very useful, I think. That protein marker, we know also is goes ballistic in pregnancy, and it actually be driving nausea. Right?

Dr. Mark Hyman
Morning sickness. That, right, in your research.

Martin Picard
Yeah. So there's a a new paper that came out showing that morning sickness in first trimester pregnancy is driven by excess of GDF 15.

Dr. Mark Hyman
So that's too much energy resistance. Correct. And how do you fix that?

Martin Picard
In in this case, the energy resistance comes for the placenta. Right? This is you know, we think is the placenta trying to protect the mom against the baby's really low energy resistance. So the of core principle in in, like, the way energy works in the world is that it will flow down the path of least resistance. So if you have water streaming down a river, and then the the the terrain, you know, goes up here and goes down here, where's the water gonna go?

Down. Right? Because it's a passive least resistance. And for the water to go up, they would need to be, like, pushed or there'd be a lot of resistance. So energy flow is the same way in the body.

So if there's something in the body that has really low energy resistance, energy is gonna go that direction. We think that stem stemness, you know, stem cells, the developing embryo, like the the fetus, it's probably really low energy resistance. But then if the if the mother wasn't protected against that, right, if there wasn't kind of a shell of high energy resistance around it, then all the energy from the mom would be going to the baby, and then that'd be actually bad for for the mom. So what the the solution that the that the human species found is to shelter the baby into a little pocket. Yeah.

And there's this thing called the placenta that filters, you know Yeah. Energy and and everything else from from the the mom into the baby. And then there's a tiny little, like, cable that connects the baby to to the mom. Right? They're not, like, fused.

There's there's there's kind of a a limited channel for communication and for for for feeding. So GDF 15 comes from the placenta. The placenta makes tremendous amount of GDF 15, you know, hundreds or thousands of orders of mag of of fold more than than

Dr. Mark Hyman
the rest of say

Martin Picard
I'm a

Dr. Mark Hyman
doctor, and I I have a patient who's got fatigue or any one of the conditions that I earlier mentioned, and I measure this g d fifteen. What do I do about it? Like, clinically, what do I do? Like, what what are the therapies that are currently available from lifestyle, from stress management, from diet, from exercise, from supplements, from medications? Like, what's out there that can be used?

Because I I've I've, you know, been using these principles of mitochondrial resuscitation for a long time. But I'm just wondering from your perspective as an expert in this, like, what's what's here now, and what's coming down the pipe?

Martin Picard
What can we use to decrease energy resistance and allow energy to flow more freely in the body so the body can heal itself? Yeah. Moving, physical activity. Right? You increase energy resistance, and then you relax.

Dr. Mark Hyman
Exercise.

Martin Picard
Exercise, but then good periods of rest. And you we need to cherish the rest period as as much as we cherish the intent.

Dr. Mark Hyman
Yeah. My aura ring said rest today. I'm like, alright. Fine. I won't exercise.

Martin Picard
This is so important. I I I learned to feel this. I call this mitoception. Right? Like, you know, interoception?

Dr. Mark Hyman
Yeah. Right? It's like awareness of your mitochondria.

Martin Picard
Exactly. If you tune into your energy to your mitochondria, then you can know, yeah, you should be resting. Right? And I've learned to feel this through injuries, not not through great sensitivity to my to my subtle energy. But through exercise, learned you know, I started running a few years ago.

But if I run every day, then I get injured, you know, in, Achilles or knee or, like, so if I run every other day for me, that's that's the right dose. Right? Yeah. And I don't run 20 miles. I run, you know, for, I don't know, twenty minutes, and that's to me, that's, like, the right dose, the right intensity.

So mitoception, kind of feeling into your mitochondria and using these energetic signals that we all get at the end of the day. And at the end of the day, you can actually sit down, maybe, you know, pop your journal open and ask, like, what brought me energy today? What really energized me? What inspired me? And then then you do the other the the the flip side, you say, what drained me today?

Like, that conversation with that guy was really draining. I don't wanna do that again. What things in your life, right, are sucking your energy? And I would say, things in your life are increasing energy resistance Yeah. In your body?

So so you can learn to become sensitive, right, to that and kind of train your awareness, your energetic awareness, And I call this through mitoception. So that's one thing I I through this practice

Dr. Mark Hyman
Yeah. It's so interesting because I used teach these workshops around, you know, kind of healing repair. And one of the exercises I had people do was go through and create a list of energy drain and energy gain. What are the things that drain your energy and get rid of them? What are things that help you gain energy and add those things?

It's interesting. It's what you're talking about.

Martin Picard
Yeah. That's it's I think it's profound because that's actually the best way you have, right, to keep a tab not on how your the machine of your body is is working, on how you, the energetic process, is doing. And emotions, right, and our states of mind, emotions really are energy in motion. Right? We feel emotions when energy is stuck somewhere, when it flows.

Right? Emotions are are energetically charged, and they mean so much. Like, the the content of of your mind is the best instrument you have. Right? And kind of feeling into how you feel is the best instrument you have to know whether the content of your life is aligned with who you are as a person.

Dr. Mark Hyman
That's beautiful said. That's beautiful said. But you're also in your work of psychobiology, as you call it, talk about how states of stress will actually directly be transduced or communicated to the mitochondria that then change the way they work in a detrimental way. And it's not just like an idea. It's actually biology.

Martin Picard
Yes. Your your mind can actually change your mitochondria. And this was a hypothesis ten years ago. Now we know this is true. And we've done a few studies in the lab and and and brains of of people after they they pass away and on whom we had information before they died about how they felt about life, about themselves, about the the world around them.

And we found that people who felt more optimistic, who felt more connected to other human beings or something greater than themselves, people who felt like they had a purpose in life, they have more mitochondria in the prefrontal cortex. And more more specifically, a mitochondria that seem to be an enhanced or that seem to have a greater ability to transform energy.

Dr. Mark Hyman
That's fascinating because I call myself a pathological optimist.

Martin Picard
Yeah. That's I it's probably good.

Dr. Mark Hyman
I've been through a lot of hardship in my life, both physical, emotional, and psychological, and and yet I always come out optimistic. Whether it's foolish or not, I don't know. But the joke is optimists live longer even if they're wrong.

Martin Picard
I I think it's true. And, you know, these difficult life experiences is really what shape us. Yeah. And they shape us energetically.

Dr. Mark Hyman
So how is this being used clinically in medicine now? Like, where where are the pockets? I mentioned a few like Brian I mean, like, Suzanne Go or Chris Palmer or Simone Seti and other places. Where where are you seeing this actually emerge in a clinical practical sense for people?

Martin Picard
I don't think it's there yet, but I hope in five years it will. And I think right now, we're still thinking about mitochondria as little machines, little powerhouses. We still think about the body as a machine that we need to fix, that we need to, you know, supplement with something. I think there's a deeper reality that where the mind plays a much bigger role than we anticipated. You know, I mentioned moving, right, exercise and then resting as essential for building that finding that sweet spot, helping your body find this Goldilocks zone of energy resistance requires that you push it, and then you let it rest.

Same thing mentally, psychologically. Like, we need to have something to work towards. The mind needs resistance as well. Too much resistance if you put too much resistance on the mind, then you feel stifled, and you feel you know, if you do this to a child, then I think you traumatize, you know, a child. The art the art of education is really to tailor the right, you know, pattern of resistance.

You need to say no sometimes, but you need to also let the energy of that, you know, young creature flow. So too much resistance in the mind, not good, feels terrible. Nobody likes a job where they can't, you know, be themselves and and do what they wanna do. And but then not enough resistance, you know, feels ungrounded and and probably feels like, you know, psychotic disorders or

Dr. Mark Hyman
That's good sense. Remarkable because these metabolic therapies, you say they're not quite in the clinic yet, but I I would kinda disagree with you because, you know

Martin Picard
Metabolic therapies are. No. No. I like ketogenic diet, you mean?

Dr. Mark Hyman
Yeah. Ketogenic diets or even mitochondrial supplements that are used to improve mitochondrial function, whether co q ten or NAD or NMN or the B vitamins or

Martin Picard
If there's a deficiency in the mitochondria, those things can be lifesaving and and life changing. The ketogenic diet, I've I've tried it myself. I I've met and and feel so grateful to have had people share their experiences with me, their lived experience of going through terrible times of schizophrenia or or bipolar than going on a ketogenic diet and seeing their lives completely transformed. Yeah. And finding the energy, finding the capacity to do things in a way that they hadn't in years.

This is, like, remarkable. And I think that that works in part because the ketogenic diet reduces energy resistance in the body. If you have ketones in your blood, ketones enter the brain, and then they're oxidized. They get you know, the the electrons on the ketones get to oxygen with less resistance than the electrons on glucose. There's glucose has to go through this crazy path, very indirect, to get on in on oxygen.

Dr. Mark Hyman
So burning fat actually can help the mitochondria work better. I I've had patients with Alzheimer's who I was treating and helping them improve, and then they would have a dip, and I would I put this woman on a ketogenic diet, and it was like the lights came on.

Martin Picard
Mhmm.

Dr. Mark Hyman
And I was like, holy crap.

Martin Picard
Yes. I've seen that many times now. This is remarkable. And, yeah, I've experienced also greater clarity of of mind from not having sugar. And I think I'm one of those, like, lean hyper responders, I think they're called.

If I eat too much sugar, too much fat, I can't put on weight. Like, I'm pathologically, you know, doomed to be lean, which which is pretty bad because then if there's too much food substrates, too much sugar or fat in my blood, then it and it ends up being deposited ectopically, right, in my liver and my muscles and maybe other places. So I I'm not I don't have a great tolerance to, like, excess food. And and I've noticed, like, if I fast for, you know, like, intermittent fasting Yeah. Yeah.

For, like, sixteen hours

Dr. Mark Hyman
Yeah.

Martin Picard
I feel much better. And then so it goes back to mitoception, like, feeling what's right for you. And my my hunch is once we have a GDF fifteen, you know, marker of energy resistance accessible and available to people, it's gonna be most useful not as a one time thing where you go to your doctor, you get GDA fifteen measured, and then, you know, then, you know, oh, my energy resistance is higher than it's supposed to be for someone my age. What can be most useful is when you have your GDF fifteen measured every day. Maybe you have a continuous monitor, like a CGM, but for energy resistance.

And then

Dr. Mark Hyman
Is that realistic? Is that coming?

Martin Picard
I I think it's coming in a few years. But then you could know for you. Right? For you, Mark, if you eat this thing, when you have your almonds in the in the in the morning, your energy resistance drops by 5%, which is amazing. Right?

If you eat this, like, cheesecake for lunch

Dr. Mark Hyman
Goes up.

Martin Picard
It goes up 15%. Bad news.

Dr. Mark Hyman
That's why you feel crappy. If you go good for a second while you eat the cheesecake, and then a little bit later, feel like crap.

Martin Picard
Yeah. Exactly. I might have to I think it it boils down to to changes in energy resistance. And if you go for for if you're exercising, right, during the exercise, energy resistance would creep up. And then after the exercise the exercise, it would go down.

And then as you make more mitochondria because the more mitochondria you have in your body and in in your muscles, the more flow channels there is for energy. Right? Every mitochondria is a a little, you know, channel. Fascinating. So then you can live at lower level of energy resistance.

And then if there's lower resistance, like lower, like, blood pressure, for example, then the heart doesn't need to work as hard. Right? And then your whole organism can live in a more a more comfortable way and a more energetically efficient way.

Dr. Mark Hyman
So this is almost like kind of a unified field theory for human health in a sense. Right?

Martin Picard
I think it is. Yeah.

Dr. Mark Hyman
It's like what when you keep going upstream, upstream, upstream, why why why why why? This is the the medicine of why it's functional medicine. You you come to a conclusion that there's these fundamental biological processes. And I know your folks on mitochondria, but I think there's other things that are really playing a role here, my microbiome and nutrient sensing and and other things that immune dysregulation. And there there are these in functional medicine, there's these lenses.

Like, there's seven, basically, lenses we look through, and we basically look at what are the things that in in the simplified terms, like energy gain and energy drain, where it's too much we need get rid of or too little that we need to get. That's kind of the principle. And it affects these seven physiological network systems. Right? Your microbiome and gut, your immune system, your energy system, which is your focus, your detoxification system, your transport and circulation, and communication systems, and your structural system.

And they all are influenced by mitochondria, but they they all are influenced by each other. Yep. And there's a network phenomena.

Martin Picard
The glue between them, I would say, is energy. Energy flow is what connects all of them. Mitochondria is part of it. It's kind of the the the hardware. Right?

It's like the a microchip, a distributed microchip that through which energy flows to power the immune system to, you know, feed the gut and and to interconnect everything.

Dr. Mark Hyman
So what you're saying essentially is that sort of the the future of medicine is mitochondrial medicine, in a sense. Like, it's really understanding how that plays a role in so much chronic disease.

Martin Picard
I think the future of medicine is understanding energy.

Dr. Mark Hyman
Energy. Which is comes down to mitochondrial health.

Martin Picard
Right? Maybe I can tell the story that you talked about earlier, like, fighting a virus. And last year, over New Year's, on on December 31, I was I I was starting to feel a little, like, scratchy throat, and I went to the New Year's dinner. But then I came home early, went to bed feeling terrible. And and that night was, like, terrible.

Next day, I felt I felt depressed. Yeah. Like, my my immune system was probably in full force. I had fever, like, pretty high fever. And then my state of mind changed, and then I thought, shit.

Should be writing about this. I'm writing a book on energy.

Dr. Mark Hyman
Yeah. Yeah.

Martin Picard
When's it coming out? Spring twenty twenty seven.

Dr. Mark Hyman
Okay. It's a while.

Martin Picard
So, yeah, I was thinking, I should be writing about this. Like, this is this is my immune system burning energy so much that it's draining my will to live. And it was drain I couldn't have motivation. I couldn't, like, care about the things I normally care about. I couldn't you know, I thought I could just prop myself up in the bed, like, pull my laptop and write about what I'm feeling, my experience of being energetically depleted by this virus.

I think I wanted to record this, but I but I don't I care enough. And now think about this in my normal state of mind. Like, this is crazy. This was such an opportunity to capture this human experience of, like, being drained of energy. What was happening is not that my mitochondria were broken or that, you know, I was missing a supplement or something.

What was happening was that the the immune system, we know this from a lot of good work, was consuming so much energy. Right? You have immune cells that have recognized the virus, and now they need to multiply. So you have one immune cell that knows what the problem is.

Dr. Mark Hyman
Cells are running a marathon.

Martin Picard
Yes. And and, you know, on on overdrive, and then the the body is warm, right, if you have a fever, that that costs energy. And then just, like, going to the bathroom. Like, you're moving every muscle contraction was painful, and this is all, like, really adaptive. This is the the brain saying, shit.

We're running here this free

Dr. Mark Hyman
Slow down rests.

Martin Picard
Yeah. Right. There's something that's costing a lot of energy. We're going we're gonna go bankrupt if we if we don't shut things down. Right?

And then the brain has this amazing ability to shut down testosterone, for example, which is which costs a lot of energy. Yeah. Shut down your thyroid hormones, which also can

Dr. Mark Hyman
That's interesting because when I was really sick, my testosterone went down dramatically. My thyroid

Martin Picard
saving. Energy conservation.

Dr. Mark Hyman
Yeah. My thyroid hormones shut down. And I was like, I felt horrible, and I just had to rest.

Martin Picard
We understand this as energy conservation. Right? The brain is receiving the signal from the immune system, cytokines, g d f 15 is is one of them, but not only g d f 15. Goes to the brain, the brain says, shit. Something in the body, the brain might not know what is causing energy, but it's receiving the signal through the cytokines.

Something is over consuming energy big time. If we don't do something, we're gonna die, like, literally. So then the brain says, okay. Will to live, down. Motivation, down.

Desire to interact with other human beings, down. Sensitivity to pain, alledonia, right, or to your skin, way up so that this this this thing, this guy doesn't move. Right? Yeah. Make sure this guy doesn't go running, for example.

Right? So then you make the whole body uncomfortable. The brain could be engineering all of this. Yeah. The same thing with aging.

The brain could be shutting down testosterone and thyroid hormones and all of the endocrine deficits. We know even, like, hair graying, like, could be a way of saving energy because it costs energy to put pigment, put color in

Dr. Mark Hyman
your hair.

Martin Picard
So what was happening there in this, like, terrible experience, and it lasted about forty eight hours where I I felt like I I was actually scared. I didn't go to the hospital, but I felt scared because I I don't remember feeling that terrible. And but that terrible feeling was nothing else, I think, than my brain feeling like we're running out of energy. Like, I was running out of energy. The the flow of energy that I am was compromised.

And if if I didn't have the resources, which are my mitochondria and my little fat stores and, like, other glycogen that I had stored, you know, places Yep. Then I could have died. Right? And maybe that same infection or that same situation, if I was 90 years old, that might have been the enemy. Right?

But because I'm I have more mitochondria than than

Dr. Mark Hyman
More resilient.

Martin Picard
Yeah. More resilience. Right? So the mitochondria are these flow channels that are there to support the demands of of energy flowing, and my heart was much beating much faster. Right?

So, again, not my mitochondria broken or, like, needing something, but it was the energy was being diverted. And I think that's what chronic stress is. The reason stress is bad for us, the reason stress makes us tired and and ends up damaging our organs and ends up aging us faster is because it steals energy from the things that keep us healthy.

Dr. Mark Hyman
Okay. So so let me get this straight, Martin. What you're basically saying is the Goldilocks effect is is important. But at a deeper level, our bodies need to have the stress response in order to become more resilient. Correct.

So when you exercise or lift weights or when I was riding my bike up the mountain, like, was huffing and puffing. I was it was hard. Right?

Martin Picard
You should.

Dr. Mark Hyman
Yeah. And that was increasing stress in my system. Correct. But it was temporary. And there's this concept we talked about on the podcast called hormesis, which is basically a stress that doesn't kill you Mhmm.

But makes you stronger. That's why calorie restriction increases longevity. That's why things like various inputs that are even supplements may increase the kind of little stress in the body. I had this theory that the molecules in plants, these phytochemicals that we consume when we eat colorful fruits and vegetables, are actually the plant's defense mechanism, but they're little mini poisons.

Martin Picard
Mhmm.

Dr. Mark Hyman
And then our bodies use them to say, oh, let me build a more resilient system.

Martin Picard
Mhmm.

Dr. Mark Hyman
And so so ultimately, what you're saying is that, you know, the energy resistance, when it gets high, can actually induce longevity pathway.

Martin Picard
It's a danger. If energy resistance creeps up in your body, it's dangerous. So then the if it stays elevated forever. Right? Right.

So then in response to that, the body will will mount responses, we call stress responses. Like, when you adapt after exercise, you make more mitochondria. That's that's a stress response. Yeah. But then the result of having the product of having more mitochondria in in your body and your muscles is lower energy resistance.

So then you can spend you spend an hour exercising, huffing and puffing at high energy resistance, and that's uncomfortable.

Dr. Mark Hyman
Two hours, but yeah.

Martin Picard
And then you you spend twenty two hours Yeah. At lower energy resistance. That's a net gain.

Dr. Mark Hyman
This is such a key point because it's not that energy is bad or good. It's just it's just understanding how to play with it so that you're not in a constant state of energy resistance, which is what happens when you're chronically ill.

Martin Picard
Exactly. And the the key point here, and we talked about the the Goldilocks, you know, level of energy resistance. That's an oversimplification. What really needs to happen is you increase energy resistance, right, and then you decrease energy resistance. So it's like a pendulum.

Or maybe it's more like in three dimension. It's more like an infinity sign. But there's there you go to high energy resistance, you exercise, but then you spend some time in low energy resistance.

Dr. Mark Hyman
But you need that in order to actually create resilience and Health. Exactly. So that's that's the key here. I think people need to walk away with this. We can start to look at how we're doing.

And and ultimately, what we're saying is this a GDF fifteen, if we could continuously measure, like, glucose monitor would go up if we're doing stressful things like hyperbaric oxygen or doing exercise or a sauna or a coal plunger. All these things people do to kind

Martin Picard
Or or an interaction with with another person where, like, it moves your energy that might actually increase energy resistance.

Dr. Mark Hyman
Yeah. But then ultimately, then it once it stops, you become more resilient, and you activate these longevity pathways. Yep. That's amazing.

Martin Picard
You know, for example, during the day, you'll study, right, or you'll learn something, you you listen to a podcast, but then what really when that knowledge really sets in and kind of gets incorporated into the corpus of your knowledge and into who you are as a as an energetic organism is during sleep. Right? And sleep is maybe the it's a daily period of very low energy resistance. When you sleep, energy resistance Right? It's like the you measure how much energy the the body burns during the day.

It's like this. And then then you have a meal, and then you actually burn a bit more energy to digest your food. Then if you go on a bike ride, you get a big spike. Then when you go to bed, there's this beautiful decrease, this hypometabolic state. And then stress hormones, right, the the same hormones that kind of mount these hormetic responses like cortisol and testosterone, they go down when you sleep.

And then that's when repair happens. That's when healing happens. So it's in the period of low energy resistance. Right? And then before you wake up, you start to have those hormones that go up again.

And then waking up is a stressor. Waking up is a stressor, and then it costs energy. You can see this. We've done studies of sleeping people, and when they wake up, there's this beautiful spike of energy resistance or energy expenditure, which is driven by the energy resistance. But this runs through, like, everything in nature.

Like, the sun rises and it sets. Right? And then it's it's like, trees, you know, they have leaves and then they fall and

Dr. Mark Hyman
the Yin

Martin Picard
and yang.

Dr. Mark Hyman
It's like the ancient Chinese figure out. The yin and yang.

Martin Picard
Right? The way your heart works Yeah. You know, contracts Breath. Breath out. Yes.

Dr. Mark Hyman
Day and night.

Martin Picard
Yes. Sleep Breath.

Dr. Mark Hyman
Wake. Right? Yeah. It's actually true. And that's that's really a key principle of life, which is on, off, on, off, on, off constantly.

And getting a balance right is important. And unfortunately, most of the way we live in society today is just on, on, on, on, on. And that's why we have such a burden of chronic disease. So wow. What a conversation.

I mean, this could go on for hours. I I just wanna kind of summarize what we talked about because it's a lot. And I think that, you know, what your work is is discovering and and you sort of came up with this energy resistance principle. Right? This is your

Martin Picard
It it came up with a wonderful friend of mine who's who was my teacher when I studied holistic medicine, and and I had a part time practice in back in Montreal for five years when I was doing my PhD learning about mitochondria in on you know, during the week, and then one day a week on Fridays was. So no Friday no mitochondria on Friday, and that's where I was seeing clients in the clinic. And this connected me with, you know, that level of human experience and people describing

Dr. Mark Hyman
Yeah.

Martin Picard
You know, not being well and, you know, dis ease, not necessarily because of, like, a a disease diagnosis, but, like, just the dis ease that traditional medicine has no, you know, answer to. So that was kind of my So

Dr. Mark Hyman
we're we're kinda looking in the wrong place for the answers. And what what your work is really helping elucidate is that by thinking upstream, by thinking of what are the common links between all these diseases that we see, that we've talked about, that are affecting us so desperately from mental health issues to metabolic issues to neurodegenerative issues to immune issues. I mean, all of it. That that there's kind of a sort of a common link, and the common link is energy. And that many of us know on a symptomatic level that we don't have enough energy.

And that we now understand what are those things that impair energy production, and their poor diet, stress, lack of exercise, lack of sleep, inadequate nutrients that run our energy system, toxins, allergens, microbes, microbiome. These are just the fundamental things that our our mindset can yeah. They they they deplete our energy if we don't do them right. And that that if we actually learn about how they function and how the mitochondria work, we can actually start to improve our energy by taking away the things that impair it and adding in the things that help it. And and there's a laundry list of things that do that.

The the beautiful thing that you're talking about is is finally soon being able to have a clinical biomarker, a blood test, that is is sort of universally applicable to understand where you are in the cycle of energy gain or energy drain in in simple layman's language.

Martin Picard
Yep. High or low energy resistance.

Dr. Mark Hyman
High or low energy resistance. And and and then we can modify our lifestyle, our way of being, our diet, our supplements, our sleep in order to actually help improve the and help us get to the Goldilocks of energy resistance. Right. Too much is bad. Too little is bad.

And that that the future of medicine will be, I think, increasingly be able to understand how we measure mitochondrial function, how we measure energy. Right? The GDF 15, which is I think one. I think there there I think there probably will be others. And and how we then can sort of use this to treat a whole range of different diseases.

And and where this is happening already, because you say it's not quite clinically there, I think I think I disagree with you. Think it is clinically there. I mean, Metabolic Minds is an organization that funds research at Mayo Clinic and other institutions like yours to help understand the role of mitochondria and mental health. You know, the autism work of Suzanne Gogh, the metabolic health work of of Simone Seti and others around diabetes and metabolic health. These are these are changing how we think about health completely.

And this kind of like I I kind of joked about the unified field theory, you know, which is physics that Einstein was trying to get to, but there are these these natural laws of biology that we haven't discovered. And I I I my gut feeling after having this long, long conversation is that this energy resistance principle is one of those things. It's one of these fundamental laws that you've uncovered that can help us explain a whole range of things. Right? Pierre Laplace said that a small number of general laws can explain an enormous number of complicated and complex phenomena.

Through a small number of general laws of physics, we can launch a spaceship to Mars. It's complicated. Human biology is far more complex than that, and is is kind of unknowable, but but there are there are, like, directionally things that we can do to optimize that. And I've been doing this clinically for years. It's crude, I would admit.

We're kind of looking through kind of like almost like, you know, the the first X-ray. You know, you can barely kind of see anything. And now we have these high resolution three Tesla imaging machines where you can see everything. I think we're gonna get there. I think, you know, hopefully, we don't have to do muscle biopsy and everything, but find out their mitochondria.

But I think the the the there's a lot of doorways to to activate this, and I think there's a lot of things that we can do from a lifestyle and diet and supplement perspective that that help with these pathways. And I've written a lot about it. I've talked a lot about it. You're you're leading the science in the way on this. I think it's it's an incredible field.

So everybody listening understands energy. They know I don't feel good. I have low energy or high energy. There's a reason, and there's a pathway to understand how to assess it and to treat it. And I've written a lot about this in my books.

I talk about a lot, but I think personally, I've experienced this on a cellular level, so I understand it. And I've treated thousands of patients this way. And I've seen really miraculous things happen that are beyond our our comprehension with our current model of medicine. And so I'm just so grateful for your work. I'm so grateful that you're leading this.

You're a young guy, which is great because you have a lot of years ahead of you to kind of help us kind of unpack all this.

Martin Picard
Lots to do.

Dr. Mark Hyman
And then turn into something that's going to really help humanity at scale, and and to to really change the way we think about health and medicine, and to move us from this disease centric model to a health centric model. So I just wanna thank you for your work. I want I want people to learn about it. I am going to link to all these articles in the show notes. So I want you to really kind of if you're listening, wanna geek out a little bit, go in there.

You can throw the paper in chat. GPD have it summarize it for you and say, meet this in eighth grade reading level, you know, or, like, whatever you want. And and I think your book is coming out, which is gonna be all about energy in 2027. I'm gonna keep an eye out for that. We'll certainly promote it.

I love that you're creating the science of health program at Columbia, at your Columbia University. This is not, you know, some crazy hippie in some clinic in, you know, like, in Berkeley. This is actually in the halls of academia where and I'm not thinking as hippies in Berkeley, trust me. But I mean, I was one once. But I I think that that's so it's so inspiring to me that that scientists are saying, wait a minute.

We got this wrong, and we're thinking about disease wrong. And we need to shift our thinking and and look for root causes and look upstream and look at how we begin to reimagine medicine from the perspective of health, not disease. So, Martin, thank you for coming all the way to Austin to talk to me. I think we're gonna keep up with your work. I have you back on the podcast when we get your book coming out.

And and again, just congratulations and I've been learning so much from you already. So thanks for being on the podcast.

Martin Picard
Thank you. My pleasure.

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. It's important to have someone in your corner who is a trained, licensed health care practitioner and can help you make changes, especially when it comes to your health.

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