It Is Possible To Stop Or Reverse Dementia with Dr. Elizabeth Boham

Mark Hyman, MD

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Dr. Mark Hyman: If you have a diagnosis, then you need to start thinking about the cause. In dementia, it's a lot of things. It's like we talked about, it could be the metals, it could be the insulin resistance, it could be the nutritional deficiencies. Dr. Mark Hyman: Hello everyone. It's Dr. Mark Hyman and welcome to a special episode of the Doctor's Farmacy. That's pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. If you ever have memory issues, you better listen to this podcast because it'll help you a lot. This special episode is called, "House Call." Dr. Mark Hyman: In this series, I sit down with the UltraWellness Center's physician, Medical Director, Dr. Elizabeth Boham who's been my colleague in practicing functional medicine for decades now. She's one of the most extraordinary doctors I know. I go to her when I'm sick, and she has literally been the pillar of the UltraWellness Center in Lenox, Massachusetts, where we've seen thousands and thousands of patients from all over the world helping them with all kinds of problems that no one else can figure out. Dr. Mark Hyman: Today, we're going to talk about memory and dementia, which is a terrifying thing for people because, "Okay, you got a heart attack, whatever, you're still you, you get dementia, you're not you anymore." It's terrifying, and it's one of the most prevalent conditions rising and rising. We now see at a rate of about 5 million people in America with Alzheimer's, it's going to go to 14 million soon. It's global, it's a couple hundred million people around the world with this. It's pretty terrifying. The care of these patients is just so burdensome on the families. It's so costly. It costs more to take care of an Alzheimer's patient than it does to take care of someone with heart disease or cancer. People just don't realize that. So we're going to talk about this. How much do we really have an impact on this disease? Can we do anything about it? Dr. Elizabeth Boham: It's such a great question, Mark and such a great place to start, right? Dr. Mark Hyman: It's hopeless. As a neurologist, the classical joke about neurology is, "Diagnose and Adios." Right? You have Alzheimer's, nothing I can do, see you later, get your affairs in order, goodbye and have a nice rest of your life, and that's it. Dr. Elizabeth Boham: Actually we know there's so much we can do, right? There's so much we can do that impacts our health and our body and definitely our brain health. So we can have a huge impact by taking good care of ourselves, by making the right food choices, by exercise, by meditation, by getting good sleep. There's a lot of times that we can find some imbalances in the body when we look deeper that can have a huge impact on somebody's cognition and on their memory, and that's really exciting. Dr. Mark Hyman: It's so exciting, because for years we're told, "There's nothing you can do." Dr. Elizabeth Boham: Right. Dr. Mark Hyman: There has been literally billions of dollars spent on hundreds and hundreds of studies, but they've all failed. When these drugs work, the benefit is that maybe they'll delay getting into a nursing home by three or four months. That's a success. Right? Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Some of them just don't work at all, like the main drug we use, Arisept the studies show it doesn't even work at all. I mean, they might help a little bit. That's okay, but why have they failed? Because we're looking in the wrong place for the solutions, and we're not looking at the root causes, we're trying to deal with the problem after it's already happened or out at the downstream on the effects of it and not really dealing with the drivers of this problem. Dr. Mark Hyman: In functional medicine, we really look at that. What's been exciting to me over the last few years Liz is that there's been a number of studies that have come out that have shown that personalized approaches work, that lifestyle interventions work, the FINGER Study, which was published from Europe, show that by simple aggressive lifestyle interventions, diet, exercise, stress reduction, treating risk factors, like if you have prediabetes or whatever had a significant impact on slowing and even reversing memory loss. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: A new study just published this recent last October by Richard Isaacson in New York City show that you actually could by personalizing treatment for people's nutritional status, for their metabolic status, for their lifestyle treatments, you could literally stop or reverse memory loss, and Alzheimer's in these patients, which is just should be headline news, but you don't hear about it. Dr. Elizabeth Boham: That's what's so fun about doing functional medicine, because that's what our focus is, right? That's what we're looking to do. We're looking to personalize our treatment plan for that individual patient. We gather all of their history and figure out for that person, what may be out of balance for their body, what may be causing the inflammation in their body, what may be causing their problems with their cognition. We can then personalize and figure out where do they need to focus? What do we need to focus on with that person? It makes a huge difference for so many people in terms of how they feel. Dr. Mark Hyman: Years ago, I'm practicing functional medicine at Canyon ranch. I just was treating all these people for body issues, right? So for their gut or their heavy metals or their metabolic syndrome, they're prediabetes and nutritional deficiencies and folate and B12. I would find all these physical things wrong with people, and then I would treat them and then they'd report to me, "My memory's better. My depression is gone. My panic attacks aren't anymore happening. I have a belly to focus and pay attention better." Dr. Mark Hyman: I'm like, "What is going on here?" I wasn't focused on treating the brain, but as a side effect to fixing the body, the brain would get better, and that's when I wrote the UltraMind Solution, which is how the body affects the brain. It was like over 10 years ago, and we're just catching up with what I was observing back then. Even the literature back then, you could see there was evidence that this was true. Again, it just takes 17, 20 years for scientific advances to end up in clinical medicine, but functional medicine shortens that gap. Dr. Mark Hyman: I remember this one patient, and I want you to talk about your patients soon, but there's one patient I had who was so striking. He came in with his wife and he was a CEO of a major company. It was his family business. He wasn't able to function. He was 70 years old. He basically was depressed and cognitively impaired, memory loss, basically sitting at home in a corner, doing nothing and has had mood changes because a lot of times people with memory issues or dementia get a lot of mood changes. Their personality changes. Nobody wanted to be around him, his grandkids didn't. Dr. Mark Hyman: I'm like, "Well, I've never treated this before, but I'm going to just try to get you physically healthy and see how it affects your brain." Because at that time there wasn't a book on the end of Alzheimer's or any of the stuff. Although David Perlmutter talked a lot about how to treat the brain with neurology, and we really learned a lot from him. This patient, it turned out, he lived in Pittsburgh, he had super high levels of mercury, and he also had a lot of dental fillings, and in Pittsburgh, all my patients from Pittsburgh have super high mercury. Dr. Elizabeth Boham: Interesting. Dr. Mark Hyman: The reason is I believe is that it's the steel capital of America and they use coal for the steel plants and coal has mercury and lead. It's used on everything. They put it on the fields, they use coal ash for, instead of sand on the icy roads in the winter, they'll use coal ash. So it's everywhere. He also had prediabetes, which was undiagnosed. He wasn't really overweight, but he had a little belly and he also had severe irritable bowel for 30 years, and was on Stelazine, which is a anti-psychotic, like tranquilizer basically, which was strange. Dr. Mark Hyman: He also had severe foliate and B12 deficiency. He had high levels of homocysteine- Dr. Elizabeth Boham: He had a lot going on, huh? Dr. Mark Hyman: ... and methylmalonic acid. So he had gut issues. He had vitamin deficiencies that affect the brain. He had heavy metals. He had prediabetes, and he also had genetics that set him up for this. So he measured his genes, something called, "APOE." If you have APOE4, you're much higher risk for dementia, and you also can't get rid of metal. So he had APOE44, which is the worst risk. He also had genes that affect his folate metabolism like MTHFR. So he wasn't able to process the folate he was getting from his diet. So he was functionally deficient in these nutrients. Dr. Mark Hyman: He had terrible gut issues. So we looked at all these things and I just treated his diet to get rid of the insulin resistance. I treated his gut with the 5R program, which we've talked about on the podcast to reset his gut. I gave him the nutrients he needed in the right doses. I detoxified him from heavy metals and he literally came back to life and I've treated him for years and years, and his memory was good. His mood was good. He was able to go back to work and function running his company. You just don't see that with traditional medicine. Dr. Elizabeth Boham: I think you bring up a really important point that sometimes people want to know the underlying root cause. The one thing, right? They want to know what is the thing that's causing this problem? This cognitive decline, for example, or whatever problem that person has. Many times, it's a little bit of multiple different things that come together, right? So he had six different things that you were focused on and they were each contributing to his cognitive decline. So you have to work on all of those different pieces for him to start to feel optimally better. Dr. Mark Hyman: So his unique genetic susceptibilities made those things worse for him. Right? Dr. Elizabeth Boham: Absolutely. Right. Dr. Mark Hyman: So not everybody with prediabetes gets dementia. Not everybody with mercury gets dementia. Not everybody with gut issues gets dementia, right? When you add that all the up, it actually all makes sense. I think we are often really focused on the pathology and medicine, right? Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: We focus on the amyloid or the tau proteins, all these things that we see in the brains of people with Alzheimer's, but it turns out that those are so downstream as a consequence of all these other factors that nobody's treating. We know that memory issues and the brain issues, whether it's depression or autism or ADD or Alzheimer's are inflammation in the brain. There's amazing studies that people have terrible amyloid in the brain, but their genes for inflammation are different, and they don't actually produce inflammation, and they die completely cognitively intact with a brain full of amyloid. Dr. Mark Hyman: All these billions of dollars of drug studies on amyloid just have failed because we're just going downstream instead of upstream, which is what functional medicine does. Dr. Elizabeth Boham: Which is so fun to practice, right? Dr. Mark Hyman: It is. Dr. Elizabeth Boham: Where you're spending that time to really get to know your patient, get their personal history, figure out for them, what are the things we need to remove? What are the tax we need to take away to help their body heal? I think you're right. There's so many situations where we see people have huge improvements in their memory and cognition when we address what are their underlying root causes. Speaker 3: Hi, everyone. Hope you're enjoying the episode. Before we continue, we have a quick message from Dr. Mark Hyman about his new company Farmacy and their first product, The 10-Day Reset. Dr. Mark Hyman: Hey, it's Dr. Hyman. Do you have FLC? What's FLC? It's when you feel like crap. It's a problem that so many people suffer from and often have no idea that it's not normal or that you can fix it. I mean, you know the feeling, it's when you're super sluggish, your digestion's off, you can't think clearly, or you have brain fog or you just feel run down. Can you relate? I know most people can, but the real question is, what the heck do we do about it? Dr. Mark Hyman: Well, I hate to break the news, but there's no magic bullet. FLC isn't caused by one single thing. So there's not one single solution. However, there is a systems based approach, a way to tackle the multiple root factors that contribute to FLC. I call that system, "The 10-Day Reset." The 10-Day Reset, combines food, key lifestyle habits, and targeted supplements to address FLC straight on. It's a protocol that I've used with thousands of my community members to help them get their health back on track. It's not a magic bullet. It's not a quick fix. It's a system that works. If you want to learn more and get your health back on track, click on the button below or visit, getfarmacy.com. That's get pharmacy with an F, F-A-R-M-A-C-Y dot com. Speaker 3: Now, back to this week's episode. Dr. Elizabeth Boham: I had a 75 year old gentleman who came to see me and he was a professor. His brain was really important to him. He spent a lot of time up there in his brain and he noticed that it wasn't working as well. He was having a hard time with paying attention to when he was reading, he was getting lost when he was driving. He was really frustrated and scared. Dr. Elizabeth Boham: So we started to get his history from him. I got a good detailed history, and one of the first things I noticed, even outside of the history was we did his anthropometrics. So he comes into the office, right? Dr. Mark Hyman: What's that? Dr. Elizabeth Boham: He comes into the office and we measure his blood pressure. We measure his weight, but in our office, we also measure the waist to hip ratio. At the UltraWellness Center, we always are looking at that waist to hip ratio, right? So we get so much information when we look at somebody's waist to hip ratio, because if you're holding on to too much weight around the belly- Dr. Mark Hyman: Belly fat. Dr. Elizabeth Boham: ... that belly fat, that visceral adiposity causes a lot of inflammation in the body. It's a sign, it's a signal to us- Dr. Mark Hyman: That's all the organ fat. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: It's a different kind of fat than the fat on your butt, on your legs, right? It's really dangerous and drives so much inflammation. Dr. Elizabeth Boham: We can't just liposuction it away. Dr. Mark Hyman: No. Dr. Elizabeth Boham: Right? Because it's deep in there. Dr. Mark Hyman: Actually, that's so funny you mentioned that, because I have a slide that I use in my talks, which was of a study in the New England Journal of a woman who had 40 pounds of liposuction who was really overweight. They did a scan of her belly before and after, and they found that yeah, all the subcutaneous fat was taken out, but all the visceral fat was there, and none of her blood markers changed with loss of 40 pounds of fat. Not her blood pressure, not her inflammation levels, not her insulin, blood sugar, cholesterol, nothing changed. Dr. Elizabeth Boham: Right, because we know it's that deep visceral fat that's so pro-inflammatory in the body. Dr. Mark Hyman: What's visceral? Dr. Elizabeth Boham: It's the deep, it's the organ fat that's deep in our belly. We know that it's not just sitting there. It's an active endocrine organ. It's producing inflammatory markers. It's producing cytokines. It itself is increasing inflammation in the body. Dr. Mark Hyman: Your fat cells are not just here holding up your pants. They're actually dynamic, and they're producing hormones, they're producing inflammation and it's affecting everything in your body including your brain. Dr. Elizabeth Boham: Everything including your brain, and you were just mentioning earlier about how cognitive decline and memory loss is often an inflammatory disorder. So we did his waist to hip ratio, and for men in general, you want to be less than 0.9, your waist to hip ratio. Dr. Mark Hyman: I'm more severe. I'd say 0.8. Dr. Elizabeth Boham: Yeah, and it depends on somebody's ethnicity where how strict we want to be, but at least less than 0.9. He was like 1.04. He was holding on to too much weight around his belly. I said, "Okay, this is an area I know I have to focus on because even if somebody can't do tons and tons of a workup and tons and tons of testing, we know that that insulin resistance, that weight gain around the belly, that metabolic syndrome that's- Dr. Mark Hyman: The prediabetes. Dr. Elizabeth Boham: ... that prediabetes that's associated with that visceral adiposity. So that weight gain around our belly is associated with what we call "prediabetes or metabolic syndrome, insulin resistance." We know that that is associated with dementia or memory loss. Dr. Mark Hyman: Prediabetes causes pre-dementia. Dr. Elizabeth Boham: Yes. Dr. Mark Hyman: So you don't even have to have diabetes to have a problem. Dr. Elizabeth Boham: Right. Dr. Mark Hyman: If you have diabetes, your risk of dementia is four times greater than the average person, which is staggering. Dr. Elizabeth Boham: Staggering. So people- Dr. Mark Hyman: Especially since the fact that 75% of us are overweight, and 42% now are obese, and it's all connected. Dr. Elizabeth Boham: Right, and at least half of us have metabolic syndrome in this country. Dr. Mark Hyman: One out of two people in the country have prediabetes or diabetes. Dr. Elizabeth Boham: People are always like, "Oh, is there anything I can do to prevent this dementia?" Dr. Mark Hyman: Yes. Dr. Elizabeth Boham: This is an area that we really can attack. It makes a huge difference when you work to get down the waist to hip ratio. So what we did with- Dr. Mark Hyman: People don't connect the belly and the brain. I mean, the belly fat, the bigger your belly, the worse your brain off, brain is off. You're more likely to have Alzheimer's or you're actually literally shrink your brain. The bigger your belly, the smaller your brain. Dr. Elizabeth Boham: They're calling it Type 3 diabetes, is dementia or Alzheimer's disease because we know there's such a connection with how well the insulin works in the brain. So it's really critical that people understand that there's so much you can do by just improving your waist to hip ratio. Dr. Mark Hyman: [crosstalk 00:17:19] your professor's diet wasn't terrible, but- Dr. Elizabeth Boham: No, he didn't think it was terrible. Dr. Mark Hyman: ... it was high starch and sugar. Dr. Elizabeth Boham: Right. Well, we always ask, we always have people actually fill out their diet diary, but I always ask and people are, they're like, "Oh no, it's not bad. We're trying to be healthy." He had the money and he was educated, but for breakfast he might have that- Dr. Mark Hyman: He wasn't eating junk good, but he was- Dr. Elizabeth Boham: No, but he might have a piece of toast. He'd be like, "Well, it was wheat toast for breakfast, with my coffee." Then at lunch, he might grab a Turkey sandwich and had a salad. Then at dinner, he might have pasta with his fish or chicken. So he didn't have an awful diet, but for him, he had gained 30 pounds over the last 40 years or so. He had gained it as we mentioned in his belly, which is a sign to me that says, "Okay, he's more carbohydrate intolerant. He's got this metabolic syndrome, which means he's not tolerating these carbohydrates that well anymore." That's where we need to focus from a diet perspective. Dr. Mark Hyman: So just to be clear about carbohydrates, so like broccolis are carbohydrates, but you're not talking about broccoli. Dr. Elizabeth Boham: No. Dr. Mark Hyman: So plant foods are all carbohydrates. That's what they are. Dr. Elizabeth Boham: Yup. Dr. Mark Hyman: Any plant for whether it's orange or broccoli or a potato, but they're not all the same. Right? Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Certain carbohydrates are super bad for your blood sugar and insulin. I know those are great. I always just joke when I say, "Carbohydrates are the most important food for health and longevity." Why? Because we need a plant rich diet full of lots of colorful fruits and vegetables that are low in starch and sugar, but if people are eating potatoes and bread, which you think, "Oh, that's fine whole wheat bread," but actually that's worst for your blood sugar than table sugar, and sandwich bread and potatoes and pasta. It may not seem terrible, but if you are someone who's carbohydrate intolerant, which by the way affects about 70% of Americans, then the ones who were overweight, then you got to deal with that. Dr. Elizabeth Boham: Right. I always tell people, take away anything with flour in it even if it's gluten free flour, because some people are like, "What's gluten free?" If they've taken a grain and turned it into a flour, then like with pasta or bread, then it's something that's easily digested in your body and it causes your blood sugar spike, which causes your insulin to spike. Then that insulin causes us to gain weight around the belly. Remember that belly- Dr. Mark Hyman: It makes you hungry and crave carbs. Dr. Elizabeth Boham: That's for sure. Right. Dr. Mark Hyman: It makes you lazy. Dr. Elizabeth Boham: Yup. Dr. Mark Hyman: So we think people are lazy. They don't exercise. They're often feel like crap, so they don't want to exercise. It's like a vicious circle from the food causing you to be hungry and lazy, as opposed to the other way around the fact that you eat too much and you don't exercise enough causes weight gain, it's the other way around. Dr. Elizabeth Boham: Absolutely. Then that weight around the belly is causing inflammation in your body to go up. That inflammation then is turning into for some people dementia and cognitive decline, which was happening with this gentleman. So when we did further testing, we could see more things that went along with this waist to hip ratio being high. We saw that his blood sugar was fine, like his blood sugar was fine, but his fasting insulin was high. I always recommend people, "Have your doctor check your fasting insulin." Dr. Mark Hyman: Which by the way, most doctors never do they check your blood sugar. Dr. Elizabeth Boham: Right. So his fasting insulin was 15. Dr. Mark Hyman: Wow, that's high. It should be less than five. Dr. Elizabeth Boham: Yeah. We like it less than five, definitely- Dr. Mark Hyman: Not to brag but mine is two. Dr. Elizabeth Boham: So we knew it was way too high. We also saw the other things that we typically see in this situation, high triglycerides, low good cholesterol. He had a lot of things that high C-reactive protein. Dr. Mark Hyman: That's a mark of inflammation, right? Dr. Elizabeth Boham: Yup, which you can have your doctor check as well. All of this sort of came to say, "Okay, we've got to really focus on his prediabetes on his insulin resistance, metabolic syndrome, whatever we want to call it." Right. What we did is we shifted his diet and we pulled away those refined and processed carbohydrates. We just focused on the non-starchy vegetables for his carbohydrate sources you were mentioning. Dr. Mark Hyman: Yeah, and more fat. Dr. Elizabeth Boham: More fat, right. Dr. Mark Hyman: Yeah, let's talk about fat in the brain. Dr. Elizabeth Boham: We know the brain is fed by good, healthy fat. The fat also really helps with balancing blood sugar. Dr. Mark Hyman: The fat is like 60% of your brain is fat and a lot of it's the omega-3 fats, right? Dr. Elizabeth Boham: Yeah. So we really focused on giving him more. We gave him fish oil as a supplement, but we focused on him getting more omega-3s from his diet too, from ground flax seed, from the fatty fish like sardines, which I love, salmon and really focused also on just giving him more fat in his diet. That helped him. That is what helped him feel more satiated. Dr. Mark Hyman: Yeah, because we need fat, you feel full and you're not hungry and it causes craving. Dr. Elizabeth Boham: Right. He wasn't looking for food all the time. Dr. Mark Hyman: If people cut the starch and sugar and they don't eat the fat, they're going to be hungry all the time. Dr. Elizabeth Boham: Right. So that really just helped him balance his blood sugar. Over time, he lost some of that 30 pounds. He lost most of the 30 pounds. We got him exercising because we know that can improve BDNF, that brain-derived neurotrophic factor. Dr. Mark Hyman: It's like miracle grow for the brain. Right? Dr. Elizabeth Boham: Yeah. He's sedentary kind of guy so we got him moving and exercising and it was phenomenal just by lowering his insulin, lowering that waist circumference, getting him exercising, he saw great improvement in terms of his energy and his memory, which is most important to him. Dr. Mark Hyman: Remember those studies are like, just walking prevents Alzheimer's because it increases this BDNF brain-derived neurotrophic factor, which is stimulated by exercise. Dr. Elizabeth Boham: Yup, and we can also stimulate BDNF through intermittent fasting, which is interesting, a more ketogenic diet, which is that low carb, higher fat diet through meditation, through the good healthy fats, the omega-3 fats. So we can stimulate that BDNF- Dr. Mark Hyman: Meditation also does it. So you can either run or you can sit on your butt and both do it if you do the right thing. Dr. Elizabeth Boham: Right. Yeah, [crosstalk 00:23:38] mindfulness. Dr. Mark Hyman: It's so powerful. So we really have to focus in on this because traditional doctors don't measure insulin. This is the most common condition period in medicine today without a doubt and yet doctors don't know how to look for it and diagnose it or treat it, which is just stunning to me because this is just basic. This isn't even just functional medicine. Right? Dr. Elizabeth Boham: Right. Dr. Mark Hyman: The literature describes what this syndrome is, metabolic syndrome, it's type 3 prediabetes. You can use a tape measure your waist to hip ratio. You can look at your triglycerides. You can look at your good cholesterol. The good cholesterol goes down, the triglycerides go up. You can look at inflammation. You can look at insulin. If you wait until your blood sugar's up, it's too late. By the time your insulin- Dr. Elizabeth Boham: Yeah, it's so much harder to reverse it at that point. Dr. Mark Hyman: I had a patient who was like really overweight and she had big, big belly and it was like such an eye-opening case for me because not only did I do a insulin, I did a glucose tolerance test also with insulin. So you give someone a load of sugar, go on two Cokes and you measure their blood sugar and insulin before and after one in two hours and you see what happens. She had the most perfect blood sugar. She never went up over a hundred, her blood sugar was perfect. Her A1C which is the average blood sugar was normal, but her insulin was like 200. Not 15, not five, but 200. And I was like, "Whoa." She is just packing on this belly fat because the insulin, just everything she eats just turns to belly fat. Dr. Elizabeth Boham: As you mentioned, people just feel so tired and lethargic, so we need to really help them drop that insulin. Dr. Mark Hyman: Yes. So, it's just so easy to treat this patient, and I think with typical cases of memory issues, it's such a big factor. I think the food is such a big factor. I think the diet, there's a lot of research showing like Mediterranean diets for example help them in Alzheimer's, they call it "The Men Diet." It's just basically things like salmon, and greens, and chocolate and- Dr. Elizabeth Boham: Olive oil, and olives, and nuts. Dr. Mark Hyman: Olive oil and maybe we even had white, red wine in there. I think we have so much power and people feel afraid and powerless about memory loss and dementia, like, "Though I can prevent heart disease and diabetes if I eat better and exercise," but they don't get that the brain is just connected to the body and you have tremendous control and power over what happens if you deal with all these variables. Dr. Elizabeth Boham: Absolutely. Dr. Mark Hyman: So the other thing I want to sort of talk about was this other case you had. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: It was the woman who had memory issues, and brain was super foggy and wasn't having any energy and she gets sick easily. What was going on with her? Dr. Elizabeth Boham: Right. So she was around 60, and so she was scared. She was scared that she was struggling with her memory and she was having a hard time recalling things, remembering that person's name or what was she supposed to be just doing or why am I in this room? She's like, "I'm 60. This is really scaring me." So I got a good detailed history on her. I realized she's also been really sick a lot. She was getting all the colds and flus that were going on. Dr. Elizabeth Boham: I'm like, "Okay, now that's concerning, so we did some testing on her and we found out, and when I did an exam, when I did an exam, I saw that she had a mouthful of silver fillings." So I got concerned, as you were mentioning earlier, we know that mercury is a neurotoxin, right? It can cause damage to the brain. We also know it can cause damage to the immune system. It can decrease the functioning of our immune system. So we did this special test with her that looks at, it was a quick silver test that looks to see her mercury in her blood, how much of it was coming from the fillings. Dr. Mark Hyman: Yeah, it's so interesting, because there's such controversy about this and the dental groups go like, "There's no issue, it's safe," but it's so funny to me that if you go to a dentist and you have fillings and they remove them from your mouth, they have to put them in a special toxic waste disposal system, according to the EPA. So why is it safe to put in your mouth, but not to throw in the garbage. I don't get that. Dr. Mark Hyman: The truth is that we know that it off gases that you grind your teeth or you chew, and you would think it's stable, but it actually releases mercury slowly into the body and it can be absorbed and cause all kinds of issues. Now, some people are great at getting rid of it, but others are terrible. This kind of test, you just don't get at your doctor. Dr. Mark Hyman: They would look at hair, urine blood, we see what's going on, how you're detoxifying, it's such a big issue. We do challenge testing to see what your body load is of mercury. There's good evidence for this but again, this is not something that most doctors look at or do. That's what we do in functional medicine, so different at the UltraWellness Center where we treat all sorts of patients like this. We see when we start to pull the hood back and look underneath, we see an incredible array of things that actually are treatable. Dr. Elizabeth Boham: Right. So for her, her inorganic mercury, which is telling us how much mercury is coming from those amalgams was really high. So I said to her, "You know what? We need to work on getting these fillings, these mercury amalgams." Dr. Mark Hyman: They call them silver fillings, but they're actually mercury. Dr. Elizabeth Boham: Yeah. Right. Safely removed. So safely, which I think is important. You don't want to just yank them all out without using precautions. So like a dam, a dental dam in the mouth, oxygen- Dr. Mark Hyman: High speed suction. Yeah. I had a patient, well not a patient, a doctor who talks about this, who was a chronic fatigue doctor. He wanted to get the mercury out of his mouth, and he had a lot of it and he went to the dentist and they didn't do it, and he ended up getting heart failure from the mercury poisoning. Dr. Elizabeth Boham: Yeah. Dr. Mark Hyman: Which is actually documented in literature it's one of the causes of heart failure. So you have to do it safely. You have to go to a biological dentist or an integrative dentist. There's a website called iaomt.org where you can see people who've been certified to do it properly to make sure you don't just go and get ripped these things out, because it can be really bad for you. Dr. Elizabeth Boham: Yeah. You want to work with somebody I think on this, especially if it's a big issue for you, because you also want to make sure the body is supported to detoxify. The body has this tremendous ability to detoxify. It's set up to get rid of these toxins we're exposed to. As you mentioned, some people are better than others. Dr. Mark Hyman: I suck at it. Dr. Elizabeth Boham: Yeah, me too, but all of us can support our natural body's ability to detoxify by drinking good water, having regular urination, making sure we're having regular bowel movements, eating a lot of fiber sweating with sauna and exercise. Dr. Mark Hyman: Yeah, poop, pee, perspire. Dr. Elizabeth Boham: Yeah. Oh, I like that, poop, pee, perspire. Yeah. So you want to support that and for some people, depending on what their levels are like, so for this woman, her levels were really high and she wasn't well when she first came to see me. So we needed to support her a little bit more. We actually gave her some NAC, N-Acetyl Cysteine, which helps the body with production of glutathione- Dr. Mark Hyman: Which is the main detoxifier of the body. Yeah. Dr. Elizabeth Boham: I actually gave her glutathione. I gave her IV as well as liposomal glutathione to help her body detoxify and mobilize these toxins and to help her through that process of getting rid of the silver in her mouth. That really helps the immune system too. I always find that so fascinating right when I first learned about the connection with the detoxification system and the immune system. Dr. Elizabeth Boham: When you really support the detoxification system, then somebody's immune system works better. That was very helpful and we do those IVs all the time at the UltraWellness Center, and it really helps with mobilizing heavy metals and toxins from the body. Of course we focus on those cruciferous vegetables, the broccoli, cauliflower, cabbage, kale, which really also they have glucosinolates in them, which help the body with production of glutathione like that- Dr. Mark Hyman: Which is amazing plant chemicals that act like medicine in the body. Right? Dr. Elizabeth Boham: Right. It's phytonutrients that help the body with production of the glutathione, which is this amazing detoxifier, this substance that helps the body detoxify. Dr. Mark Hyman: Many who use fibers and binders and that gutsy don't reabsorb it. Right? Dr. Elizabeth Boham: Right. So for her, we actually, her levels were at a point where we definitely had to use some binders to get down safely, but when you're doing that, you want to work with a practitioner who really knows how to do that. Dr. Mark Hyman: Yeah, you have to be trained in functional medicine. We do this at the UltraWellness Center. We've known forever, and I personally had mercury poisoning. I talked about it before, but I had cognitive impairment. I couldn't focus. I couldn't concentrate. My memory was terrible. I literally was reading my kids a book at night and I couldn't remember what I was reading. I just could read out loud, but I actually couldn't understand it. I literally had a broken brain, and then it was the mercury. Dr. Mark Hyman: It's so impactful for so many people and I've seen this over and over again. Then you have to learn how to do it right. All the things you're talking about, we have a very specific methodology that basically takes out the bad stuff and puts in the good stuff. So you support the body's natural system, so fibers and right foods to help detoxify and the right nutrients like selenium and zinc, and all these things are really so necessary and N-Acetyl Cysteine, lipoic acid. We use all these supplements and diet and sometimes even medication to help get the body to rid itself of these metals, but it has profound effects. For me it did, and this patient that you saw. Dr. Elizabeth Boham: It was amazing. She stopped getting sick so often and then most important for her is her cognition really improved. That brain fog went away. She wasn't having a hard time when she'd walk into a room and forgetting what she was doing there. She was noticing that her recall was better and that she just felt more clear in the head. It was really exciting to see. Dr. Mark Hyman: Yeah, so true. I remember this patient I had who's like about 75, 80. She was a very prominent woman in her community, was on the boards of many boards, and fairly wealthy and was just struggling. She was told that she had early dementia and there was nothing she could do about it. Dr. Mark Hyman: I actually tested her and she had a normal B12 and folate, but she when we checked these things called homocysteine and methylmalonic acid, which are special tests that look at the function of these nutrients, they were terrible. So I gave her B12 shot and some high dose of folate, and she literally just came right back on line and her depression, her fatigue and her memory loss went away. Dr. Mark Hyman: About five years after I got a call from her, I'm like, I was like, "Oh boy, maybe she's not doing good," and I had her on my schedule and I talked to her and she's like, "Oh, Dr. Hyman, I just wanted to find out what do I need to do because I'm going to Bhutan trekking and I want to know what I need to take [inaudible 00:34:14]. Dr. Elizabeth Boham: Yay. Dr. Mark Hyman: I was like, "What?" I see this over and over. I think that we talked about a few things, like insulin resistance, we talked about heavy metals, but you know, dementia is simply the name of symptoms of memory loss. It doesn't tell you what's causing it. People say, "Oh, you have memory loss, you have dementia. That's what's causing it." No, that's just the name of the problem of you can't remember anything. Right? Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Functional medicine helps to figure out the why. If you have a diagnosis, then you need to start thinking about the cause. In dementia, it's a lot of things it's like we talked about, it could be the metals. It could be the insulin resistance. It could be the nutritional deficiencies. It could be Lyme disease. Like Kris Kristofferson had dementia and treated with Lyme disease treatment and got better. I've seen many cases like that. Dr. Elizabeth Boham: Yup, infections. Right. Dr. Mark Hyman: It could be mold in your environment. It could be other toxic influences. So there's, there's so much we know about this disease now. If we applied it, we could help so many of these millions of people who are suffering. I think people just need to understand that it's not just about getting the diagnosis and getting your affairs in order anymore. We actually have so much we can do. Dr. Mark Hyman: In the Cleveland clinic, we've been working with the memory center there, the Lou Ruvo Center. They're so excited about these ideas. They're implementing them. We're seeing this in academic centers right in New York City with Richard Isaacson, which were funded by Maria Shriver's father had dementia. So we're seeing this incredible advances, but it's just people aren't getting access to it. Dr. Mark Hyman: At the UltraWellness Center in Lenox, Massachusetts, where we treat these kinds of problems, we see incredible results. We check all these things. We check metals, we check your gut, we check your insulin resistance. We check your nutritional levels. We check for Lyme if needed, we check for mold. These are the things that your traditional doctor just doesn't do. Then we learn how to fix the diet. Dr. Mark Hyman: We talked about things like intermittent fasting or ketogenic diets or caloric restriction, all of these things can actually help the brain, and then we figure out what foods are good for the brain, like the fats and we apply that. Then of course, we'll actually treat the specific things as needed if people need different things, then we focus on sleep and stress and gut and diet. So it's really a comprehensive approach that you just don't get when you go to the doctor and you say, "I'm having memory issues." Dr. Mark Hyman: It's terrifying for people because they think there's nothing you can do. You just want people to have hope, but actually there is a lot you can do. Dr. Elizabeth Boham: There's so much we can do. Dr. Mark Hyman: I'm sort of skeptical that you can have an impact when people are pretty far gone, it's better to get it earlier, like when you're pre-dementia or even before that, but I just wanted to end with a quick story, which is of a nursing home in Cleveland, where the family got very focused on my book UltraMind Solution and Dr. Bredesen's book, The End of Alzheimer's talking about lifestyle, diet, various things with their patients. These were patients who had moderate to severe Alzheimer's and they were in a nursing home. Dr. Mark Hyman: They said they hired a chef, they got all the gluten and dairy out, all the sugar processed food. They fed them whole foods, and within two weeks, these patients were coming back online. They were talking where they hadn't been talking. They were having less need for restraints and less need for this and that and medications. Dr. Mark Hyman: They weren't cured, but their cognitive function got significantly better. I see this over and over again. So I just want people to really feel like it's not a hopeless case, that there is something we can do and that there's a way forward to think through this together. I think people are struggling. We do this all the time at the UltraWellness Center in Lenox, Massachusetts. We have a great team of providers, four doctors, two PAs, whole bunch of nutritionists and great team. We're really good at actually navigating through these complex stories and coming up with what to do and how to help people. Dr. Elizabeth Boham: I agree. It's just a fun place to work because we see so much improvement all the time and it's really fun to dive deep and figure out for that individual person, what is going on. Dr. Mark Hyman: Maybe it's a miracle. It's not a miracle. It's just applying good science. Dr. Elizabeth Boham: Yeah, absolutely. Dr. Mark Hyman: Functional medicine, for those that are listening is not a specialty. It's a way of thinking about complex diseases, using a systems approach and getting to the root cause and actually thinking about how the body is one integrated system. Because often you go to the cardiologist and neurologist and rheumatologists gastroenterologists, and they're all treating their body part, but it's one system. So functional medicine helps us really deal with that, and we see amazing, amazing results. Dr. Mark Hyman: So Liz, Dr. Boham, thank you so much for joining us on this week's episode of House Call, this mini episode of the Doctor's Farmacy. I'd love everybody to share with your friends and family on social media, I love them to leave a comment if you can, tell us what you think we'd love to hear from you, subscribe wherever you get your podcasts. I'll catch you next time on The Doctor's Farmacy. Dr. Elizabeth Boham: Thank you, Mark.