The UltraWellness Blog by Mark Hyman, M.D.

Dr. Hyman's Haiti Journal - Day 8: The Next Tsunami

marc@stockman.com () — Sun, 24 Jan 2010 07:38:39 -0500

Please note: This blog is a reprint of an article that appeared on Huffington Post a few weeks ago.

How can we measure the resiliency of the Haitian people who are the poorest in the western hemisphere with 55% living below the extreme poverty line of $1 a day? On a good day in Haiti, nearly half the population doesn't know when or where the next meal will come; in good times, 47% don't have any access to the most basic health care; 45% of the population doesn't have clean water and 80% are without basic sanitation. People fear going to the nation's main hospital, which we have worked to bring to life over the last week, because at its best, it provided inadequate care in facilities with marginal electricity and water, and received no funding. When we arrived there, we found no basic medical supplies to restock the meager supplies we could fit into our bags and our small plane.

How can we measure the resiliency and capacity to endure of these people who have endured for 200 years? Perhaps it is in the strength of the 85-year-old woman found yesterday in the rubble 10 days after the quake still breathing, with a pulse and blood pressure and who after some intravenous fluids, started producing urine again. Or the little boy who a day after being found in the rubble after a week was running around our medical camp hugging the nurses and doctors who brought him back from near death? Or the 13-year-old who ran to the top of the 3-story building as it collapsed under her, riding it down to the ground suffering "only" a massive laceration to her thigh that her mother attempted to stitch without anesthesia with a needle and thread. There is barely a whimper from the hospital campus where we reduced fractures with only a little pain medication and where gaping, infected and necrotic wounds are re-bandaged daily without sedation. There is only the occasional wailing from a broken heart.

Yesterday was the first day the coordination and supplies came together on the hospital campus -- with nine hospital and 3-4 NGO operating rooms working 24 hours a day now, with X-ray and ultrasound and proper surgical instruments and supplies, and medical personnel, with food, water, and tents to house the patients who crawled with broken pelvises and hopped with the newly amputated stumps dangling from the hospital wards to the open air with each shake of the ground. Finally after days of transporting patients in and out of buildings, after the U.S. Army Corp of Engineers repeated inspections, it was clear that patients were more afraid of being inside than outside. But it is very difficult to run surgical intensive care units in the open air or sweltering tents without electricity or water. And patients die.

But what we see inside the walls of the hospital, which has concentrated resources, NGOs, food, water, supplies, people, however inadequate they may be, however limited our abilities to care for patients, however strained our ability to track medical records, to know which patient had which treatment and when, however great our need for better communication and coordination, the General Hospital is the most well-organized run health care facility in Port-au-Prince right now. Compared to the needs and demands of those outside its walls, those in tent cities, or lying in the streets who bathe, eat, drink and defecate all in the same few square feet, and are at risk of tetanus, or diseases of overcrowding such as meningitis, diarrhea, typhoid, hepatitis, measles, diphtheria, whooping cough or tuberculosis, or the millions displaced or whose lives are upside down, General Hospital is the now the Mayo Clinic of Haiti. But the load of new surgical cases at the General is diminishing though we still have to clean and eventually close the hundreds of stumps and wounds we have treated already. Local doctors at the hospital express concern that we have seen all the patients to be seen, and are worried about sending patients off the USS Comfort or other mobile hospitals coming in. But they have not accounted for the second wave.

The Second Wave: The Forgotten Thousands

There will be a second wave, there must be a second wave and it must come now or it will be too late. There have already been too many tragic deaths in the immediate aftermath of the quake, but now there will be thousands of unnecessary, preventable deaths from the consequences of the lack of medical care from infection, gangrene and tetanus. There is simply a lack of infrastructure.

There are few ambulances or EMTs in Haiti and I have only seen one or two in the streets. There is barely fuel, with prices shooting up to $800 USD a gallon at one point, in a country where a good wage is $100 a month, where 900 gallons of diesel to run the hospital generators were stolen from the back gate before the military arrived. The initial effort by FEMA providing $36 million for search and rescue was critical to save lives. Now 11 days later, there is a need for emergency medical response teams to find and scoop and transport the thousands remaining strewn about the city. According the USAID daily report, there was only $50,000 spent on emergency medical response to date.

It is dire, even the dogs are hungry. They chewed to the bone a leg of a dead man sticking out of the rubble.

Last night flying back on a C 17 Air Force transport, I spoke to Miami firefighters who surveyed the city and reported that they saw no search and rescue teams any longer, only two ambulances and two pieces of heavy equipment. But when they walked through tent cities and streets and they found hundreds of patients who needed to get to a hospital for emergency care but had no way of getting there, now way of being identified and were not aware of available resources or hospitals. Cell phones work only occasionally, there is a breakdown of communication infrastructure. One hospital they visited remained nearly empty with doctors roaming the streets looking for patients.

The immediate burden on the hospital campus has been addressed, but there are thousands tucked in corners of alleyways, under tarps, in tent cities all over Port-au-Prince and surrounding areas that have not had medical care, still with open fractures, gaping wounds, crush injuries that are stuck without knowledge of where medical facilities are, or any way to get transported and afraid to leave their meager belongings unattended on the sidewalk or by their tent or tarp.

Yesterday I heard about Jackmel, a nearby city, where 30 critical victims needing amputations or emergency surgical care have been trapped by damaged roads and isolated since the quake with no food, water, and medical care waiting for 11 days to get evacuated. I worked yesterday with General Keen to find a way to get those patients mobilized. And those are only the ones I have heard about, how many more are there? There are thousands more unattended who now are at risk of unnecessary death from gangrene and infection and tetanus, thousands more who could have their limbs or lives saved if we can get to them in time.

Coordination between the military, government and volunteer resources is happening but slowly. A clear plan needs to be developed immediately to deploy volunteer EMT's, translators and security and transport with a map of all existing medical resources, functioning communication to immediately find and bring those patients to medical care. Fliers, radio announcements, trucks with loudspeakers can be deployed through the city to flush out the patients needing care.

Third Wave: Discharge Planning, PTSD, and Rehab

Then there is the third wave. Once we treat and stabilize the patients, there is nowhere for them to go. Their homes are piles dust and rust, their families gone. Who can tend to them, feed them, change their bandages? Where can they live, who will transport them back to the doctor or hospital for follow up visits? We can't send them back to the street. I spent two hours yesterday with Navy doctors Richard Sharpe and Larry Ronan from the USS Comfort to find an open space to put post-operative patients. We are at capacity. And all the hospitals in the country are full.

Soon, very soon, there is the need for rehabilitation, helping the thousands with lost or broken limbs get back on their feet or foot again. There are no physical therapists, no facilities, and no place for them to go for care. As the immediate surgical needs are slowly addressed, the psychological needs explode magnified by each minor aftershock. There are no psychologists here. The Center for Mind Body Medicine that has worked on PTSD in Kosovo, Gaza and New Orleans is mobilizing a team of 500 to go to Haiti over the next months coordinated with Partners in Health. But more will be needed.

Coordinated planning is needed to provide food, water, sanitation, dressing changes and skilled nursing care, and it is needed now in large temporary tents properly staffed by local Haitians providing jobs and care, closing the ecosystem of health and recovery. Plans are being developed to move people out of Port-au-Prince to begin to rebuild and restore the city infrastructure, utilities, and housing. The local Haitian medical community has to be supported and restored to care for the traumatized for the long term. The partnership model of Partners in Health training and employing local community health workers providing jobs and bolstering the Haitian economy, which they have done now in a dozen locations in Haiti, employing 5000 Haitians is essential if we are to avoid a hit and run NGO disaster relief that will only leave another disaster. Last night we scrambled to find a way to take over the Israeli field hospital and care for the 150 patients still there when they leave on Wednesday.

The Silver Lining: Empowering the Haitian People

They have done their job, but rebuilding Haiti will not take a week or a month or a year, but decades of sustained and coordinated effort needed when the disaster relief is over. Haitians must be empowered to take back their country and create what they have always deserved. They were the first liberated from slavery in the early 1800s but yet to be lifted from extreme poverty.

Aside from my day job, I am a volunteer for Partners In Health (PIH), which has been working on the ground in Haiti for over 20 years. The organization works to bring modern medical care to poor communities in nine countries around the world. The work of PIH has three goals: to care for patients, to alleviate the root causes of disease in their communities, and to share lessons learned around the world. Based in Boston, PIH employs more than 11,000 people worldwide, including doctors, nurses, and community health workers. The vast majority of PIH staff is local nationals based in the communities they serve. They can partner with other organizations and the local Haitian government and communities to effectively and for the long-term support the emergence of the enduring, resilient and openhearted people from two centuries of darkness. Donate at http://www.pih.org.

Mark Hyman, MD

To see more of Dr. Hyman's photos from Haiti go to:

http://www.flickr.com/photos/drhyman/sets/72157623158256281/

Beware: Some of the images are graphic.

Dr. Hyman's Haiti Journal - Day 6: Catastrophe to Chaos

marc@stockman.com () — Sat, 23 Jan 2010 10:15:38 -0500

Please note: This blog is a reprint of an article that appeared on Huffington Post a few weeks ago.

It is nine days after the quake, and last night three gaunt Haitian medical students, their school destroyed, came up to me in the dark as I walked past the nursing school with 150 nurses still buried in the rubble, the smell of rotting flesh floating in the hot, heavy evening air. They have helped out for the last week at the hospital but had no food to eat and only a little water to drink. Their homes were destroyed and most of their families were dead. Yet they showed up to help. They came to me to ask if they could get a job, a way to feed themselves and what family they had left. But the hospital's personal system is not functioning yet. Our first priority has been saving lives.

I went to get them food; high-energy biscuits (dry cookies) that were dropped off by the World Food Program too feed 5000 people on the hospital campus for five days. The food has been dropped off, but is locked behind three doors and there is no clear distribution system yet. It took me two hours to get them food and then find some more food for the new group of surgeons, doctors and nurses that arrived from Children's Hospital in Boston for Partners in Health. The three medical students slept out on the ground, with home to go back to, and with food in their stomachs for the first time in a week.

The first day we arrived at the abandoned hospital save for Dr. Lassegue and Mrs. Thompson, the director of the General Hospital and his administrator. Our small group of seven, the first to arrive, built five operating rooms and with the help of a few other small groups who arrived the next day, we created a functional, if primitive, surgical hospital. We have now seen every one of the 1000 or so patients that were strewn about the hospital grounds under the hot sun, amidst flies and maggots, and we have operated on about 200 of them.

But yesterday was a watershed. There were no drapes, supplies, gloves, masks, and surgical bandages when we started in the morning two days ago. But yesterday we received a flood of supplies and people. To build the hospital infrastructure with 1,500 employees, volunteers and workers with systems for personal, supplies, food, water, sanitation, power in less than a week is monumental task. When it has to be done in a system that at its best was a disaster makes it near impossible, but in Haiti, every day, the people live and do the impossible surviving wounds, trauma, and burdens unimaginable to most the rest of the world. We now have hundreds of doctors and nurses from around the world, aid workers and supplies. Dr. Paul Auerbach, emergency physician from Stanford University is doing a super human task of organizing the entire medical and professional staff in flux moment to moment into a cohesive unit, creating order from chaos. He is working closely with Dr. Telemark, the chief of surgery of the hospital. It is the beginning of creating order from chaos.

The next phase will be coordinating the activities - logistics, infrastructure, and organization. After the setback from the second quake, yesterday we made progress. Claire Pierre and I and Dr. Benjamin from Mount Sinai, met with the Minister of Health and the head of disaster relief. There are poor communication systems all across the country, most destroyed by the quake, with email or cell service often down. So we drove to their new headquarters in an automotive parts building to explain the needs of the patients and hospital. I have been coordinating with General Keen and Colonel Gibson and the Joint Task Force Surgeon, Dr. Ellison, to get support from the military for medical evacuation and logistics and support. I explained to the minister that the military was willing to give their full support but needed a helicopter-landing zone near the hospital and approval for full logistical support for humanitarian aid.

I pulled out my iPhone and gave the General's email address to the Minister of Health and he composed an email giving him full permission to help. I read the email and wept with relief, knowing we could save hundreds more patients. He feared displacement of the people camped in the nearby stadium. In every open space in the city, 3 million Haitians sleep outside on the street afraid of being in the buildings. After the quake two days ago, fresh amputees hopped on one leg out of the post-operative wards fearing their lives. But the President and the Minister welcomed the Navy helicopters to land at the Palace grounds close to the hospital to evacuate patients from the hospital to the USS Comfort, a 1,000 bed hospital ship. The Palace is collapsed like a big meringue pie.

The next morning a man came in with a traumatic head wound and with the new team from Mount Sinai headed by Michael Marin, he had 3 intravenous lines started and his head wound covered and then we quickly transferred him to the waiting FLA (front line ambulances) from the 82nd airborne. I jumped in the back of the dark, hot sweatbox of the ambulance carrying 4 stretchers and loaded with patients, continued to help him breathe with an ambu-bag. We made our way 500 yards to the Palace grounds and offloaded him to the helicopter. I hung his intravenous fluids on a carabineer and kneeled over another patient trying to hold on the door as the helicopter lifted off and whisked us off for the 5-minute flight to the USS Comfort hospital ship. We landed on the deck, a team of navy sailors took him to the emergency area where a team of doctors and nurses were waiting on the ship capable of taking 1000 injured patients. After making a quick assessment of the ships surgical capabilities, I jumped back on the chopper, a bag of peanut covered M&M's in my pocket, given to me by a sailor who thought I looked hungry. I was. In the heat of temperature and activity, eating and drinking are secondary which is good, as I don't have to worry about where I will go to the bathroom.

But today, Day 9, there is no sanitation at the hospital campus, and Captain Ramos, who is in command of the 70 soldiers from the 82nd airborne, who have been there for three days, is worrying about the health of his men and women. General Keen came yesterday and I asked him for sanitation, but there are no port-o-potties available in the country and only a few latrine kits. And disease is breaking out - not just wound infections, but also tetanus and meningitis are breaking out on the hospital campus.

A group of Spanish rescue workers have begun removing the 150 dead nurses from the nursing school. One worker came into speak to Dr. Lassegue about where to place the corpses. They were placing them in large garbage bags and wondering how we could identify the bodies. The bodies were often in parts and only a few had identification on them. How do we name the lost? The woman's whose house we are staying at, Micheline Rampy, had lost a close friend, Allain Rolan Rocourt, who died in the first moment of the quake as a beam fell on his neck. He was found still sitting at his desk. He had a funeral, but what about the lost and nameless bodies piled by the thousands shoveled by front loaders into dump trucks, what about the nurses in the bags in the morgue with no names?

Now the hospital has supplies and people, and we have created a functional hospital within a week. But there are still thousands who have not been seen laying in the streets, fractures and wounds unattended with no transport that will bring a second wave to the hospital. The Haitians with resources and money, and local businessmen and women are mobilizing 10,000 people with transportation to go out into the communities to find the lost and wounded and bring them to get care. But as of yesterday all the hospitals are full in the country, and this morning when I arrived back at the hospital, the Palace landing zone was closed for patient transport because of a food drop for the tent city in front of the Palace.

There were two more small aftershocks this morning and all the patients ran, hopped or were dragged from the building screaming. In the hot sun the intensive care patients felt safer than in the buildings even though they risked death from dehydration. And though more tents were put up yesterday, there are still too many in the sun. All the buildings are again empty after enormous efforts to get the inspected and patients moved back inside - and we struggle to find open ground on the hospital campus to put more tents. Larry Ronan, MD from the USS Comfort came to find a place to put a mobile post-operative ward. But the only place was the ground greasy with fat and body fluids from the hundreds of dead bodies that lay there just a few days before. How can we place a post-op unit in front of the morgue where the stench still hangs thick in the wet Caribbean air?

Yet we are only at the first phase of the catastrophe. Next we have to find a way to care for the patients discharged from the hospital who will need care for months, and those who will need rehabilitation after losing their limbs. And there will need to be help for the estimated half million homeless, half million who will have to be displaced from their homes in the streets and tent cities to rebuild Port au Prince. It may be even more because almost all of the three million in this city are sleeping in the streets and parks, afraid to go back in their homes. Every other building has collapsed in the city. There is a saying that the Haitians are not afraid of war or earthquakes or hunger, but they are terrified of rain. And soon the rains will come.

Once the immediate life-threatening needs are met, the psychological trauma and support and re-building of communities will need to happen. As we drove through the rubble of the city to the hospital this morning, a woman was screaming and writhing on the cement in an alley, grieving and expressing the anguish felt by millions here and around the world.

Friends and people are calling and asking how they can help. This country needs help and not just now but for a long time. If you can volunteer for an organization that has a coordinated infrastructure and have useful skills, they will need help for years. But the most important thing that is needed is money and lots of it to help care wounded and traumatized.

The organization best connected and on the ground for 20 years before the earthquake and who will be here for the long haul in Haiti is Partners in Health that has worked closely with the Haitian government to build 10 hospitals all over the country and build community health infrastructure. Most of the other NGO's will come, provide relief and leave. But the Haitians will need help for a long time!!

So please donate to Partners in Health now at http://www.pih.org. We need $10 million or more just to rebuild this hospital. If every American gave $10 we would have $3 billion dollars to help this country. I have never met a people so full of heart and resilience and kindness and who have suffered so much. The pain they suffer here is beyond anything I have seen yet there is barely a scream or whimper from any of the patients, even the children as we change their dressings or move their twisted torn bodies. Today, amidst the mangled limbs, tetanus, and chaos (which is a step up from the catastrophe of the last week), a young woman caring for her mother, stopped to paint her toenails bright red and smile. And a little boy ran alongside me, smiling, and drinking a little water finally.

Mark Hyman, MD

To see more of Dr. Hyman's photos from Haiti go to:

http://www.flickr.com/photos/drhyman/sets/72157623158242455/

Beware: Some of the images are graphic.

Dr. Hyman's Haiti Journal - Day 5: Shaken Again

marc@stockman.com () — Sat, 23 Jan 2010 10:13:24 -0500

Please note: This blog is a reprint of an article that appeared on Huffington Post a few weeks ago.

Days 4 & 5

I slept through the aftershock this morning, a small 6.1 earthquake that has had no real impact because everything that could be destroyed was already destroyed. But the aftershocks that will ripple through the lives of the Haitian people will last for decades. They will for Mitch, who I met the first morning at the hospital grounds. He was laying in the back alley, unattended for four days except for a small bandage around his knee. He called out softly in English for me to stop, to help him. He had not eaten nor drank water since the quake and was still smiling at me. He lost his entire family -- a wife and three children -- and home. He was alone with no one to care for him, unlike some of the other patients who were tended to by their less-wounded family members, bringing what food and water they could.

I kneeled down and opened his dressing. A quart of foul pus spilled out from his knee, which was shattered and crushed. Pier, my wife, is an orthopedic surgeon. She came over and said he needed to be the next surgery case.

But the volume of trauma and mangled limbs is staggering.

I saw him a few days later, finally inside the make-shift pre-op area -- still with almost no water, food, antibiotics nor pain medication. He smiled again when he saw me and grabbed my hand.

I brought General Keen from U.S. Southern Command, who is leading the military relief and support effort for the Haitian people. I showed him the hospital which, seven days after the quake, still had no food or water for the patients (nor the doctors, nurses and staff). We still didn't have stable power and were operating in dark rooms, the batteries of our flashlights dimming or dead. We still operate with hacksaws. Supplies are trickling in, but we have more doctors and staff now than supplies. This morning surgeons were operating without gowns or gloves. And without lights, again.

Later, one of the patients we operated on the first day -- a woman with a beautiful smile, pony tail and an orange t-shirt -- was septic and having seizures that wouldn't stop. Maggots crawled out of the stump of her recently amputated leg. We (Partners in Health) are working to get the hospital up and functioning with food, water, supplies, power, sanitation, and security (we made significant progress after I emailed my contacts at the State Department -- General Keen showed up after), but we have no communications internally and little organization. I ran over to the Norwegian team's tent to find a bottle of seizure medication. They had finally set up after a week, getting their supplies and opening one mobile operating suit. The anesthesiologist gave me a bottle of phenobarbital. I looked down on the operating table and saw the surgeon cutting off a man's leg above the knee. I realized it was Mitch, my friend from my first day, who now -- seven days after the earthquake -- was finally in the operating room.

My heart cracked and the tears came all day. Through the exhaustion, a of lack sleep and food, I had spent four days of getting to know these extraordinary people. Their spirit is indefatigable despite 200 years of natural and political disaster. With each story, the tears came: the young man asking for a job so he could bring food to his wife and children, who hadn't eaten in a week; the well-known Haitian musician who, rather than escape a crumbing building, rushed up to the third floor to rescue a baby. He carried the baby in his arms, but lost most of his fingers as he protected the baby. George Boutin, my father-in-law, didn't have the heart to remove his mangled fingers and hand. He reconstructed them so the musician could, perhaps, play music again. Maybe. Perhaps. Hopefully one day.

Today, the local hospital staff (nurses and workers) came back, at least those who were alive. They came even though their families were dead, even though they still slept on the street because their homes were in rubble, and even though most hadn't eaten food for days. After 10 straight hours of operating in hot and dark rooms, the dark skinned nurses looked pale and weak. They worked without food or drink all day. In a back room of the main storage area I found a few cases of water meant for 5,000 people. I brought a few to the operating room to refuel the staff at 8 p.m. last night.

General Keen arrived to inspect the scene. The military are here to create life, support life, to save lives, to bring relief in a country where there is no local infrastructure. The NGO's (non-governmental organizations) and United Nations struggle to get organized in the chaos. Their kindness and compassion made me cry again. They are organized and willing and focused. They are not here to provide security or make us safe, because there has not been one incidence of violence. There are only those gently, graciously asking for water or food or supplies or shelter from the sun.

This hospital was a disaster before the disaster. The Americans built the national public hospital in the 1930's and there has been no support or funding from the Haitian government since then, except a small budget to pay salaries. I know we can raise the $30 million to rebuild the hospital, but wonder if it will be properly allocated because of the chaos in the government.

There is no remaining organization in Haiti to help us get the power back on or provide food and water for patients in the hospital. There is no one to get us medical supplies, or sanitation for the 4,000 people on the hospital compound, or get some of the overload of 1,000 surgical patients lifted to other sites. But General Keen's 82nd airborne is organized, compassionate and capable of helping us build the National Hospital into what it was meant to be -- the nation's center for caring for the poor.

But today, when I got back to the hospital, all the patients that we had moved into the hospital's remaining buildings were outside -- strewn all over the hospital grounds. The aftershock shook them and frightened them. Those who had just had their legs cut off jumped on one foot out of the buildings. Others had their families drag them out for fear of getting caught in another collapsed building. The trauma is so deep and vast that even after we had the buildings cleared by the U.S. Army Corps of Engineers and announced it to all the patients, most were still to afraid to enter the buildings. As a result, many died from dehydration in the heat and sun. After five days of trying to rebuild the hospital, we had to start all over again.

But we did, and the people kept smiling back at me as I walked by.

Please donate to Partners in Health at http://www.pih.org. They are integrated with the Haitian health care system and can create a sustainable system from the ashes and sorrow.

Mark Hyman, MD

To see more of Dr. Hyman's photos from Haiti go to:

http://www.flickr.com/photos/drhyman/sets/72157623158238557/

Beware: Some of the images are graphic.

Dr. Hyman's Haiti Journal - Day 4: Hacksaws and Vodka

marc@stockman.com () — Sat, 23 Jan 2010 10:10:51 -0500

Please note: This blog is a reprint of an article that appeared on Huffington Post a few weeks ago.

The country has one doctor for 11,000 people. Electricity and running water are available in Port-au-Prince for two hours -- on a good day. The chief surgeon at the General Hospital (the largest public national hospital) told me that patients often die in the operating room because the generator fails -- on a good day. Under these circumstances, a small group from Partners in Health, led by Paul Farmer, is trying to resurrect the city's most important hospital from the rubble.

I have been there with a small group of seven surgeons, doctors and nurses who performed the first surgery. That was four days after the quake shook for 15 seconds -- flattening the city and over half of the buildings, including the hospital where 150 nurses remain buried in the nursing school. The sickly, sweet stench of death and rotting flesh fills the air as I walk by.

Two orthopedic surgeons, my wife and father in-law, started the first amputation without water, electricity, or disinfectant. They used a rusty hacksaw we washed with vodka, lit by camping headlamps in an empty room with a few boxes of supplies we had packed into our plane. Over the last two days, we created five operating areas to care for the 1,200 patients who are still lying on the ground outside in the hospital's courtyard. They desperately need surgery to repair their crushed and broken bones, now festering and infected in the humidity and sweltering Haitian sun. The nurses and hospital staff are either dead or at home caring for their families. In the United States we have ten staff for every patient at most hospitals. There now are only a few local staff left for thousands of patients. They, too, are dead. They, too, have lost their homes. Today some began to return to work, their families gone or injured, their homes in piles of rock and debris.

ASSESSING NEEDS AND GETTING ORGANIZED

This morning we stopped at a hardware store on our way to the hospital to find three rusty hacksaws. We are still operating with headlamps and no electricity, oxygen, suction, or cardiac monitoring equipment. It is a week after the earthquake and supplies have spilled into the country from around the world, but much is still at the airport or in processing somehow. This hospital -- the main hospital -- is not getting the supplies. President Clinton brought what he could today to help but we will run out tomorrow.

There is peace and calm and a sense of gratitude pouring from every bed and every pair of eyes that look at me as I walk by. There is no danger here, no issue of security. There is no need for assessment. There is need for action. We must treat the patients who still can survive, before they need the morgue instead of post-operative care.

At the highest level we need organized and immediate logistical support. We must get everything and everyone to where the need is greatest, especially here at the nation's main hospital. I received an email from the disaster department (Health and Human Services) stating that they heard from the United Nations that we are fully operational. We are operating, but it is not "operational" yet. People and supplies want to find their way to us (and other places in need) but the dots are not connecting.

SOME PROGRESS

We did have our successes today, under the guidance of Dr. Benjamin, a Haitian-American surgical care intensivist from Mount Sinai. He came down with us on Friday. We turned one of the few remaining safe buildings into a post-operative intensive care unit. At 10 a.m. this morning it was finally clean. By 6 p.m. tonight it was filled with over 50 post-operative patients. They were finally able to be moved from a cramped preoperative room, filled with putrefying wounds, where they had been languishing without care at night.

In three days we have gone from a nearly deserted hospital to a partially-functioning surgical hospital (as well as we can without water or electricity or supplies). Haitian-American surgeons and nurses showed up today to help care for these patients over night, which is the first time there will be any care at night. Our small team of seven has performed 75 operations over the last three days -- they now lay behind me, exhausted and asleep. And I can barely keep my eyes open as I write this after nearly three days with no sleep and little food or water.

There are miracles. One girl, whose bed was the back hatch of a Toyota pickup truck, was unstable after we removed her right leg, which had been crushed by the rubble. We left her last night, uncertain if she would survive. But she did. And a sixteen year old girl delivered twins -- stillborn in the middle of the night, alone in the dark, groaning from the labor pains and the stabbing pain of her crushed and broken leg.

THE SONGS OF DARKNESS

The preoperative area is dark after sunset, still without electricity as both our main generators broke tonight. There are not enough doctors or nurses to staff it. Patients wait and pray. That is all they can do.

All the NGOs (non-governmental organizations) left because we had no security, even though there has not been one single act of violence or chaos despite the lack of food, water or care for most of the patients. After they left, as I walked into the room to check on the patients, I heard the songs of darkness. The patients and their families sang songs of prayer for strength and courage to bear the burden of suffering through the night. The singing, in unison by patients and their families, filled the darkness. My heart and soul filled with light.

How can a people be so full of love and patience and kindness? And be that way in the midst of unimaginable loss and suffering?

REBUILDING HAITI'S TRAINING HOSPITAL

I received this email from my new friend, Evan Lyon, MD, faculty at the Brigham and Women's Hospital and a volunteer for Partners in Health. He has worked in Haiti for 10 years. We are trying to coordinate and rebuild the hospital, together with the hospital administration, to create a sustainable, durable institution. This was the Massachusetts General of Haiti, the training site for nearly all its doctors and nurses, and now we have to rebuild it. Today, one of the medical students asked President Clinton how he could help him continue his education, desperate to learn and come back to Haiti to care for his people. We need to help those students finish their training and come back.

Here is what Evan wrote me....

"For over 10 years, Zanmi Lasante has been one of the largest and most attractive training sites for graduating medical students. The majority of our doctors and nurses, our pharmacists and lab technicians, have trained at the Hopital Universite de l'Etat d'Haiti. Until less than a decade ago, all doctors trained in Haiti graduated from the national medical school. This university hospital helped to train them all. We have been honored to receive many of the top graduates of the national university at Zanmi Lasante for their first year out of medical training for a year of social service. Our best medical staff comes from their number and they are leading partners in health's efforts to respond to the disaster.

The university hospital sustained massive damage; at least 50 percent of the campus cannot be used. Many buildings are destroyed. All are cracked. Some are safe to work in. The adjacent nursing school was completely destroyed. We are working to help the general hospital back to its feet in the dusty shadow of the nursing school where the bodies of many, many second year nursing students remain trapped in the rubble. It will be weeks or months until the rubble is cleared. The smell of death is everywhere. Many of the dead are our sisters and brothers in health, in the difficult work to relieve suffering.

The devastation and sadness of the earthquake are beyond comprehension. Certainly far beyond this single doctor's heart to see.

Today we worked to get the university hospital on its feet again. Dr. Lassegue, the hospital's director, and his staff have been ubiquitous at the hospital and are leading efforts to care for the injured. Partners in Health is working closely with the hospital to provide care, and to direct relief efforts from international aid agency's from around the world. We had five operating rooms operational today. Surgeons had been operating with daylight and flashlights but the electricity is now restored. Over 40 operations were performed today. We estimate over 1,000 are already assessed and awaiting surgery on the campus. People are laying on mats on the ground, on the ground, in shade where it can be found, under sheets strung from the trees.

Inpatient wards are coming together. We hope to increase to 10 operating rooms in the next 48 hours, with 24-hour service now that the electricity has been restored. The hospital must stand again.

As Dr. David Walton and I left the hospital compound this evening, we saw the lights of a large front-end loader working near the morgue. Three dump trucks sat at the ready. Where thousands upon thousands of bodies had laid just days ago, perhaps 40-50 bodies remained: swollen, alone, pushed to the side of the pavement and slippery with blood and body fluids. As we walked past the morgue and the largest pile of bodies, we noticed the one man was wearing a Zamia Asante shirt when he died. I cannot begin to understand why this small detail made a scene of unspeakable sadness even sadder.

We are with all Haitians. This man was with us and is now gone."

Please donate to Partners in Health at http://www.pih.org. They are integrated with the Haitian health care system and can create a sustainable system from the ashes and sorrow.

Mark Hyman, MD

To see more of Dr. Hyman's photos from Haiti go to:

http://www.flickr.com/photos/drhyman/sets/72157623158232953/

Beware: Some of the images are graphic.

Dr. Hyman's Haiti Journal - Day 1: Beyond Horror

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 20 Jan 2010 14:31:45 -0500

Please note: This blog is a reprint of an article that appeared on Huffington Post a few weeks ago.

This isolated, serene Caribbean island floated in a calm sea dusted by soft white clouds. We circled patiently, waiting to land for hours at 25,000 feet, watching the sunset across the wing of the Gulfstream jet carrying two orthopedic surgeons, a nurse anesthetist, a critical care nurse, and two Haitian intensive care doctors working at Mount Sinai in New York. We were accompanied by Paul Farmer, the founder of Partners In Health, his student in his Global Health and Inequities program at Harvard, and Claire Pierre, a physician born and raised in Haiti.

A kind-hearted, generous man donated his plane to carry us and surgical supplies against innumerable obstacles to finally land in Haiti just as dark set upon this country and people crushed by the worst earthquake devastation in history. My wife and I woke up the Thursday morning after the quake and knew we had to go down right away.

Effortlessly and within less than 24 hours we were on a plane and hours later, miraculously, were on the ground.

Then we landed amidst the chaos -- no immigration, no customs. We were greeted instead by tears and relief and hope from the local Partners In Health volunteers who lost family, friends and co-workers. We unpacked the plane and loaded up three trucks full of supplies and doctors and slowly wound our way through the rubble and chaos.

Building after building lay in ruins and people sat, stood, or lay on the sidewalks and streets, afraid to go back into their homes and buildings for fear of another tremor and collapse.

In the park at the center of Port au Prince, thousands of people slept outside -- sitting talking, laughing, living while death was all around them. There was peace and calm and cooperation and acceptance among the people, even laughter and smiles on the patients in the face of no homes, no water, no food, nothing at all to soothe them except their humanity. Haitians danced and sang in the streets celebrating life and the human spirit's capacity to survive. There was nothing to be happy about, and an unimaginable tragedy to mourn. We drove by the collapsed palace and ministries of health. No one was spared. There were 150 nurses still trapped in the rubble of the nursing school building on the grounds of the General Hospital, the epicenter of medical care in this ravaged city.

We arrived at the largest hospital in the country, the General Hospital, and were greeted by Dr. Lassegue, the director, a balding man with a wide toothy smile. He had not slept in three days, or barely eaten or drunken water. Yet he was smiling, happy to see us, happy to be able to serve and help.

There was no electricity, patients lying all about outside on the ground, or on bed outside with traumas, wounds, infections all unattended in their own feces and urine without food or water. Waiting. Waiting for someone to come, to help. Yet there was relative calm and peace as patients waited with their families attending to them -- how can these people endure the unendurable?

Here in Haiti, where there is one doctor for every 11,000 people, the top hospital now has only about 10 doctors and 10 nurses and a few residents with no orthopedic surgeons to handle the sea of broken bones. There are 1,500 hundred patients laying about the courtyards of the hospital -- afraid to enter the buildings that normally have the capacity for 700 -- with almost 1,200 of those patients needing urgent surgery four days after the quake with wounds festering and the sweetish, fetid smell of Pseudomonas bacteria in the air. The nurses have either died or are home caring for their loved one. There was little care and no operations happening even days after the earth shook their worlds apart.

Haiti is poor, broken down and traumatized, with natural disasters following political disasters and on and on. But the Haitians are not poor or broken down. Their spirits are rich and resilient and kind.

At the hospital we exited our air-conditioned land cruiser into the thick, rancid stench of decaying flesh. Around the corner from the indefatigable Dr. Lassegue was the morgue -- a vast open parking lot of putrefying bodies, bloated and swollen and rotting. Hundreds upon hundreds were piled and strewn across the concrete -- thrown into piles and hoisted up by their limbs into pickup trucks or by bulldozers into large dump trucks to be buried in mass graves.

The smell and taste and vision of the sea of dead rotting bodies was something unimaginable, beyond horror -- a vast and sick landscape of death after only 15 seconds of earthshaking.

Then we emptied the trucks and sorted the surgical supplies into the operating rooms and triaged the patients with headlamps -- attending to the sickest, those needing amputations, deciding who would be first in the morning as the light came up. We hoped for water, electricity and more supplies to help us save the wounded but there are none here at the hospital yet -- perhaps they are still at the airport or circling over this island of people with the biggest and most patient hearts I have known.

Tomorrow we will start the first surgery here after the earthquake. The first amputation with nothing but a hacksaw and headlamps and a bottle of vodka to sterilize the equipment and a few rusty instruments to start. But we will do it because it has to be done and there is no one or no where else to do it.

And now I go to sleep on the cement floor of the operating room, thankful, peaceful and exhausted but happy to be here.

If you want to support this effort to rebuild the main hospital in Port au Prince and support the Haitians to reclaim their lives and their place, donate where the greatest need is now and bring immediate relief to those most in need. Donate now to Partners in Health.

Mark Hyman, MD

To see more of Dr. Hyman's photos from Haiti go to:

http://www.flickr.com/photos/drhyman/sets/72157623282853642/

Beware: Some of the images are graphic.

Dairy: 6 Reasons You Should Avoid It at all Costs

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 13 Jan 2010 18:44:04 -0500

Got milk?

These days, it seems like almost everybody does. Celebrities, athletes, and even former president Clinton's head of Health and Human Services, Donna Shalala, are all proud to wear the white "milk mustache." After all, everyone knows that you need milk to be healthy ...

Dairy is nature's perfect food -- but only if you're a calf.

If that sounds shocking to you, it's because very few people are willing to tell the truth about dairy. In fact, criticizing milk in America is like taking on motherhood, apple pie, or baseball. But that's just what I'm about to do.

Based on the research and my experience practicing medicine, I typically advise most of my patients to avoid dairy products completely. I like ice cream just as much as the next person, but as a scientist I have to look honestly at what we know. In today’s blog I will explore many of the documented ill-effects of dairy, and give you six reasons you should avoid dairy at all costs.

The Reason I Have Problems with the USDA Food Pyramid

I’m aware that my advice to avoid dairy flies in the face of the new, "up-to-date" food pyramid from the United States Department of Agriculture (USDA). The USDA's pyramid recommends drinking 3 glasses of milk a day. What's wrong with that? Well, for one thing, it's not a recommendation that's based on strict science.

Some of the "experts" who helped create the pyramid actually work for the dairy industry, which makes the US Department of agriculture’s recommendations reflect industry interests, not science or our best interests.

In fact, Walter Willett, M.D., Ph.D -- the second-most-cited scientist in all of clinical medicine and the head of nutrition at Harvard's School of Public Health -- is one of the pyramid's most vocal critics. He's even called its guidelines "udderly ridiculous." That's not something a Harvard scientist says lightly.

But Dr. Willett is right. The pyramid just isn't based on key scientific findings about health. Just take a look at some of the pyramid's recommendations -- and why I disagree with them.

1. Consume a variety of foods within and among the basic food groups while staying within your body's energy needs.

Sounds sensible -- but which food groups? If you choose dairy, meat, fats, and carbohydrates, the "perfect" meal could be a cheeseburger, milkshake, and fries with ketchup (potatoes and tomatoes are the two top vegetables consumed in America). Generic advice like that is pretty meaningless and potentially harmful.

2. Control your caloric intake to manage body weight.

Again, that sounds good, but as I wrote in my book UltraMetabolism, even the best-trained nutritionists and dietitians can't come close to correctly estimating their own caloric intake in a day. Also consider this: Is it okay to consume all of your calories from cola or ice cream as long as you stay within my caloric needs? Of course not. So this is more useless advice.

3. Increase intake of fruits and vegetables, whole grains, and nonfat or low-fat milk products.

Well, fruits, veggies, and whole grains are great. Milk -- not so much. I'll get back to that in a minute.

4. Choose carbohydrates wisely.

Who could argue with that? But how do they define "wisely"? The real advice here should be to cut down sugar intake from 185 pounds per person per year (what we currently consume) to less than a pound, avoid flour products (except as a treat), and stick to whole-food carbohydrates like vegetables, fruit, whole grains, beans, nuts, and seeds.

5. Choose to prepare food with little salt.

That's not bad advice. But it doesn’t make sense if most of what you eat is packaged or processed foods that you don't actually prepare. For most Americans who eat half of their meals outside their homes, this isn't helpful. A better recommendation would be to avoid packaged, processed, canned, prepared, and fast foods (unless you know exactly how they are made).

6. If you drink alcoholic beverages, do so in moderation.

Sounds good -- but if you're usually drinking two bottles of wine a night, then one seems like moderation! I think a better suggestion is to limit your alcohol consumption to half a drink a day or 3 glasses a week (the amount that seems to have the most health benefit).

7. Don't eat unsafe foods.

Of course you shouldn't leave your egg salad out in the hot sun or toss your salad with hands that just handled raw chicken coated with salmonella. But the food pyramid guidelines don't mention pesticides, hormones, antibiotics, or genetically modified foods, despite scientific evidence of their harm. Shame on the USDA!

You can see now why I have big problems with the food pyramid! Its guidelines try to sound sensible -- while still protecting the interests of the food industry, the agriculture industry, and all of the lobbyists paying for the elections of the Congress. That way everybody's happy ...

But I'm not, and you shouldn't be either. The public just isn't served by this watered down, confusing, and useless pyramid. Worse, some of the recommendations are downright harmful --like the one to drink more milk and dairy products.

The Truth about Dairy

According to Dr. Willett, who has done many studies and reviewed the research on this topic, there are many reasons to pass up milk, including:

1. Milk doesn't reduce fractures. Contrary to popular belief, eating dairy products has never been shown to reduce fracture risk. In fact, according to the Nurses' Health Study dairy may increase risk of fractures by 50 percent!

2. Less dairy, better bones. Countries with lowest rates of dairy and calcium consumption (like those in Africa and Asia) have the lowest rates of osteoporosis.

3. Calcium isn't as bone-protective as we thought. Studies of calcium supplementation have shown no benefit in reducing fracture risk. vitamin D appears to be much more important than calcium in preventing fractures.

4. Calcium may raise cancer risk. Research shows that higher intakes of both calcium and dairy products may increase a man's risk of prostate cancer by 30 to 50 percent. Plus, dairy consumption increases the body's level of insulin-like growth factor-1 (IGF-1) -- a known cancer promoter.

5. Calcium has benefits that dairy doesn't. Calcium supplements, but not dairy products, may reduce the risk of colon cancer.

6. Not everyone can stomach dairy. About 75 percent of the world's population is genetically unable to properly digest milk and other dairy products -- a problem called lactose intolerance.

Based on such findings, Dr. Willet has come to some important conclusions:

• Everybody needs calcium --

• Calcium probably doesn't prevent broken bones.

• Men may not want to take calcium supplements.

vitamin D

• Dairy may be unhealthy.

If all that isn't enough to swear you off milk, there are a few other scientific findings worth noting. The Federal Trade Commission (FTC) recently asked the UDSA to look into the scientific basis of the claims made in the "milk mustache" ads. Their panel of scientists stated the truth clearly:

heart disease

irritable bowel syndrome

Simply put, the FTC asked the dairy industry, "Got Proof?" -- and the answer was NO!

Plus, dairy may contribute to even more health problems, like:

Allergies

Due to these concerns, many have begun to consider raw milk an alternative. But that isn’t really a healthy form of dairy either ...

Yes, raw, whole, organic milk eliminates concerns like pesticides, hormones, antibiotics, and the effects of homogenization and pasteurization -- but to me, these benefits don't outweigh dairy's potential risks.

From an evolutionary point of view, milk is a strange food for humans. Until 10,000 years ago we didn't domesticate animals and weren't able to drink milk (unless some brave hunter-gather milked a wild tiger or buffalo!).

If you don't believe that, consider this: The majority of humans naturally stop producing significant amounts of lactase -- the enzyme needed to properly metabolize lactose, the sugar in milk -- sometime between the ages of two and five. In fact, for most mammals, the normal condition is to stop producing the enzymes needed to properly digest and metabolize milk after they have been weaned.

Our bodies just weren't made to digest milk on a regular basis. Instead, most scientists agree that it's better for us to get calcium, potassium, protein, and fats from other food sources, like whole plant foods -- vegetables, fruits, beans, whole grains, nuts, seeds, and seaweed.

So here is my advice for dealing with dairy.

5 Tips for Dealing with Dairy

• Don’t rely on dairy for healthy bones.

vitamin D

• Get your calcium from food.

• Try giving up all dairy.

sinuses

headaches

irritable bowel syndrome

• If you can tolerate dairy, use only raw, organic dairy products.

• If you have to feed your child formula from milk, don't worry.

Still got milk? I hope not! Remember, dairy is not crucial for good health. I encourage you to go dairy-free and see what it does for you.

Now I'd like to hear from you ...

Do you agree or disagree that dairy is bad for you?

Have you experienced any problems consuming dairy?

What changes -- for better or worse -- have you experienced if you've tried eliminating dairy?

Please let me know your thoughts by leaving a comment below...

To your good health,

Mark Hyman, MD

Gluten: What You Don't Know Might Kill You

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 05 Jan 2010 15:39:49 -0500

Something you’re eating may be killing you, and you probably don’t even know it!

If you eat cheeseburgers or French fries all the time or drink six sodas a day, you likely know you are shortening your life. But eating a nice dark, crunchy slice of whole wheat bread -- how could that be bad for you?

Well, bread contains gluten, a protein found in wheat, barley, rye, spelt, kamut, and oats. It is hidden in pizza, pasta, bread, wraps, rolls, and most processed foods. Clearly, gluten is a staple of the American diet.

What most people don’t know is that gluten can cause serious health complications for many. You may be at risk even if you don’t have full blown celiac disease.

In today’s blog I want to reveal the truth about gluten, explain the dangers, and provide you with a simple system that will help you determine whether or not gluten is a problem for you.

The Dangers of Gluten

A recent large study in the Journal of the American Medical Association found that people with diagnosed, undiagnosed, and "latent" celiac disease or gluten sensitivity had a higher risk of death, mostly from heart disease and cancers.(i)

This study looked at almost 30,00 patients from 1969 to 2008 and examined deaths in three groups: Those with full-blown celiac disease, those with inflammation of their intestine but not full-blown celiac disease, and those with latent celiac disease or gluten sensitivity (elevated gluten antibodies but negative intestinal biopsy).

The findings were dramatic. There was a 39 percent increased risk of death in those with celiac disease, 72 percent increased risk in those with gut inflammation related to gluten, and 35 percent increased risk in those with gluten sensitivity but no celiac disease.

This is ground-breaking research that proves you don’t have to have full-blown celiac disease with a positive intestinal biopsy (which is what conventional thinking tells us) to have serious health problems and complications -- even death -- from eating gluten.

Yet an estimated 99 percent of people who have a problem with eating gluten don’t even know it. They ascribe their ill health or symptoms to something else -- not gluten sensitivity, which is 100 percent curable.

And here’s some more shocking news ...

Another study comparing the blood of 10,000 people from 50 years ago to 10,000 people today found that the incidences of full-blown celiac disease increased by 400 percent (elevated TTG antibodies) during that time period.(ii) If we saw a 400 percent increase in heart disease or cancer, this would be headline news. But we hear almost nothing about this. I will explain why I think that increase has occurred in a moment. First, let’s explore the economic cost of this hidden epidemic.

Undiagnosed gluten problems cost the American healthcare system oodles of money. Dr. Peter Green, Professor of Clinical Medicine for the College of Physicians and Surgeons at Columbia University studied all 10 million subscribers to CIGNA and found those who were correctly diagnosed with celiac disease used fewer medical services and reduced their healthcare costs by more than 30 perecent.(iii) The problem is that only 1 percent of those with the problem were actually diagnosed. That means 99 percent are walking around suffering without knowing it, costing the healthcare system millions of dollars.

And it’s not just a few who suffer, but millions. Far more people have gluten sensitivity than you think -- especially those who are chronically ill. The most serious form of allergy to gluten, celiac disease, affects 1 in 100 people, or 3 million Americans, most of who don’t know they have it. But milder forms of gluten sensitivity are even more common and may affect up to one-third of the American population.

Why haven’t you heard much about this?

Well, actually you have, but you just don’t realize it. Celiac disease and gluten sensitivity masquerade as dozens and dozens of other diseases with different names.

Gluten Sensitivity: One Cause, Many Diseases

A review paper in The New England Journal of Medicine listed 55 "diseases" that can be caused by eating gluten.(iv) These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores(v), and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Gluten is also linked to many psychiatric(vi) and neurological diseases, including anxiety, depression(vii), schizophrenia,(viii) dementia(ix), migraines, epilepsy, and neuropathy (nerve damage).(x) It has also been linked to autism.(xi)

We used to think that gluten problems or celiac disease were confined to children who had diarrhea, weight loss, and failure to thrive. Now we know you can be old, fat, and constipated and still have celiac disease or gluten sensitivity.

Gluten sensitivity is actually an autoimmune disease that creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different "diseases." To correct these diseases, you need to treat the cause -- which is often gluten sensitivity -- not just the symptoms.

Of course, that doesn’t mean that ALL cases of depression or autoimmune disease or any of these other problems are caused by gluten in everyone -- but it is important to look for it if you have any chronic illness.

By failing to identify gluten sensitivity and celiac disease, we create needless suffering and death for millions of Americans. Health problems caused by gluten sensitivity cannot be treated with better medication. They can only be resolved by eliminating 100 percent of the gluten from your diet.

The question that remains is: Why are we so sensitive to this "staff of life," the staple of our diet?

There are many reasons ...

They include our lack of genetic adaptation to grasses, and particularly gluten, in our diet. Wheat was introduced into Europe during the Middle Ages, and 30 percent of people of European descent carry the gene for celiac disease (HLA DQ2 or HLA DQ8), which increases susceptibility to health problems from eating gluten.

American strains of wheat have a much higher gluten content (which is needed to make light, fluffy Wonder Bread and giant bagels) than those traditionally found in Europe. This super-gluten was recently introduced into our agricultural food supply and now has "infected" nearly all wheat strains in America.

To find out if you are one of the millions of people suffering from an unidentified gluten sensitivity, just follow this simple procedure.

The Elimination/Reintegration Diet

While testing can help identify gluten sensivity, the only way you will know if this is really a problem for you is to eliminate all gluten for a short period of time (2 to 4 weeks) and see how you feel. Get rid of the following foods:

www.celiac.com

For this test to work you MUST eliminate 100 percent of the gluten from your diet—no exceptions, no hidden gluten, and not a single crumb of bread.

Then eat it again and see what happens. If you feel bad at all, you need to stay off gluten permanently. This will teach you better than any test about the impact gluten has on your body.

But if you are still interested in testing, here are some things to keep in mind.

Testing for Gluten Sensitivity or Celiac Disease

There are gluten allergy/celiac disease tests that are available through Labcorp or Quest Diagnostics. All these tests help identify various forms of allergy or sensitivity to gluten or wheat. They will look for:

When you get these tests, there are a few things to keep in mind.

In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be "false positives." That means the test looks positive but really isn’t significant.

We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems.

So now you see -- that piece of bread may not be so wholesome after all! Follow the advice I’ve shared with you today to find out if gluten may be the hidden cause of your health problems. Simply eliminating this insidious substnace from your diet, may help you achieve lifelong vibrant health.

That’s all for today. Now I’d like to hear from you ...

Are you one of the millions that have been lead to believe gluten is perfectly safe to eat?

How do foods that contain gluten seem to affect you?

What tips can you share with others about eliminating gluten from your diet?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

References

(i) Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009 Sep 16;302(11):1171-8.

(ii) Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93

(iii) Green PH, Neugut AI, Naiyer AJ, Edwards ZC, Gabinelle S, Chinburapa V.
Economic benefits of increased diagnosis of celiac disease in a national managed care population in the United States. J Insur Med. 2008;40(3-4):218-28.

(iv) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review.

(v) Sedghizadeh PP, Shuler CF, Allen CM, Beck FM, Kalmar JR. Celiac disease and recurrent aphthous stomatitis: a report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):474-478.

(vi) Margutti P, Delunardo F, Ortona E. Autoantibodies associated with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57. Review.

(vii) Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of mood disorders--a general population-based cohort study. J Affect Disord. 2007 Apr;99(1-3):117-26. Epub 2006 Oct 6.

(viii) Ludvigsson JF, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of schizophrenia and other psychosis: a general population cohort study.
Scand J Gastroenterol. 2007 Feb;42(2):179-85.

(ix) Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6.

(x) Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review.

(xi) Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review.

(xii) Green PH, Jabri B. Coeliac disease. Lancet. 2003 Aug 2;362(9381):383-91. Review.

Breast Cancer: How to Reduce Your Risk Now

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 30 Dec 2009 14:13:37 -0500

Today, I would like to introduce you to my colleague at The UltraWellness Center in Lenox Massachusetts, Dr. Elizabeth Boham. She is a physician who practices Functional Medicine and is a Registered Dietitian. Among other things, Dr. Boham works every day with women who come to see her to help them decrease their risk of breast cancer. She wrote the following blog to give you some simple steps you can take to substantially decrease your chances of getting breast cancer.

--Dr Mark Hyman

Breast cancer is a serious concern, especially if you already suffered from the disease and are now afraid of a recurrence. If you are worried, it’s understandable. The incidence of breast cancer is skyrocketing ...

Last year over 200,000 new cases of invasive breast cancer and 60,000 cases of non-invasive breast cancer were diagnosed. A woman’s risk of getting breast cancer has jumped from 1 in 20 in the 1960s to 1 in 8 today. Tragically, more than 40,000 women died from breast cancer alone last year.

Why has there been such a huge escalation in the rates of this frightening disease? What’s the cause of this epidemic and what can we do about it?

Getting to the bottom of these questions is of personal interest to me. When I was 30 years old, I was diagnosed with an aggressive type of invasive breast cancer. At the time I thought I was healthy ...

Before I went to med school my background was in nutrition and exercise physiology. I was an athlete, an avid exerciser, and was careful with my diet. I was young, had no family history of breast cancer, nor any signs of chronic illness.

So when I was told I should have a mass in my breast removed, the last thing I thought it would be was cancer. I couldn’t understand how an otherwise healthy woman, like me, could get cancer. What did I do wrong? What could I do to reduce my risk of recurrence?

Looking for answers to these questions sent me on a journey through my medical training and eventually to an education in Functional Medicine. What I discovered on that journey is that there are ways you can prevent breast cancer and reduce your risk of recurrence. In today’s blog I will share what I have learned. I will explain some of the underlying root causes of breast cancer and provide 9 tips to help you reduce your risk.

What Functional Medicine Teaches Us about Breast Cancer

In traditional medical training you don’t learn about the impact that things like diet, toxins, and digestion have on your overall health. Certainly the connections between how your gut functions, your toxic exposure, and your risk of breast cancer is not something most doctors are taught.

To find real answers to my questions about breast cancer I knew I would have to dig deeper. When I finally found functional medicine, the answers it offered were like a revelation to me.

Functional Medicine teaches us that imbalances in the 7 key systems in the body can lead to a host of diseases, including breast cancer. By analyzing which of these systems are out of balance and learning how to optimize them, you can decrease your risk of getting breast cancer or suffering a recurrence.

When it comes to breast cancer specifically, there are many pieces to the puzzle, but one of the keys is balancing your estrogen levels. High levels of estrogen consistently correlate with breast cancer in most scientific studies. The first step to creating and maintaining estrogen balance is to overcome insulin resistance.

Insulin is the hormone released from your pancreas after a meal. It sends signals to your cells telling them to absorb sugar from your blood -- which is a critically important job. However, this finely orchestrated system is sent spiraling out of control by our modern diet.

Sugar is the main culprit. When you eat too much of it, in the form of high-fructose corn syrup, highly-refined and processed carbohydrates, or the multitude of other forms it comes in, your body sends out more insulin than it can properly use and you develop insulin resistance.

What most people DON’T realize is that as your insulin levels increase your estrogen levels increase as well. That means your risk of breast cancer goes up every time you eat too much sugar!

However, the havoc that insulin wreaks doesn’t stop there.

Insulin resistance also increases the amount of body fat you have. As your body fat increases, so does an enzyme in your fat called aromatase. Aromatase turns hormones made in other organs in your bodies (such as your adrenal glands) into estrogen. That means your estrogen levels are raised even more, making your risk of breast cancer that much greater.

This point is especially important for postmenopausal women. Percentage of body fat is the number one risk factor for breast cancer in this population.

Excess insulin causes other problems that contribute to you risk as well: it may stimulate the growth of tumors in your body and increase systemic inflammation which is a leading factor in cancer of any kind.

There are medications available that can help counteract these conditions. You can take aromatase inhibitors which are designed to prevent the aromatase in your body fat from converting your hormones into estrogen or you can take medications to balance your insulin and blood sugar.

However, you can achieve the same effect naturally by choosing real, whole, organic foods, exercising daily, and maintaining a healthy body weight.

As important as it is, insulin imbalance isn’t the only culprit that can lead to breast cancer. Environmental toxins have a major impact as well. The most damaging environmental toxin when it comes to breast cancer is estrogen and substances that mimic it.

From birth control pills and hormone replacement therapy to eating meat and drinking milk from cows given growth hormones, we are all exposed to excess estrogen.

The problem is compounded by the fact that other environmental toxins like some pesticides and compounds found in plastics mimic estrogen and stimulate the estrogen receptor in an unhealthy way.

Obviously, estrogen isn’t a “toxin” in the sense that DDT is. But too much of it can be nearly as deadly and we are exposed to extraordinary amounts nearly every day. At the end of this blog I will explain how you can eliminate this toxic burden.

Another critical part of your body you need to focus on if you want to limit your risk of breast cancer is your digestive system.

What is the connection between your gut health the health of your breasts?

Your flora -- or the good bacteria that live in your gut.

These little symbiotic helpers not only strengthen your immune system and help you digest the foods you eat, they also help detoxify the estrogen made in your body after it’s been used. If your flora aren’t in balance, the estrogen your body needs to eliminate gets reabsorbed. This increases your estrogen level and exposes your body to unhealthy estrogen breakdown products.

It’s interesting to note that many studies link increased use of antibiotics to an increased risk of breast cancer. This may be because excess antibiotic use kills off the good bacteria in your gut.

Now you know some of the main contributing factors to breast cancer. Next let’s review what you can do to balance your estrogen levels, heal from insulin resistance, limit your toxic exposure, and support the flora in your gut.

10 Tips to Reduce Your Risk of Breast Cancer

Following these steps will help you limit your risk of breast cancer:

1. Choose whole foods.

UltraMetabolism

2. Get 3-5 hours of exercise per week. This also helps increase your insulin sensitivity and allows you to more easily control your percentage of body fat.

3. Increase your fiber intake. Your goal is 35 gm per day. High-fiber foods include vegetables, fruits, beans, nuts, and whole grains such as brown rice and ground flax seed.

4. Have protein at every meal or snack of the day. Good protein sources include; fish, lean poultry, beans, nuts, eggs, and soy. Make sure you include a few vegetarian options in your daily protein intake.

5. Maintain a healthy weight. This is the best studied, most agreed upon step a woman can take to decrease her risk of breast cancer.

6. Get a good night fatigue. Sleeping well helps with weight control, insulin sensitivity, and supports your immune system. All of this is important for preventing cancer.

7. Choose organic and hormone-free meat, milk, and produce. This reduces your exposure to unwanted pesticides and hormones.

8. Avoid excess toxic exposure. Choose organic products for your lawn and garden, avoid dry cleaning, don’t use plastic bottles, and limit your intake of medications (like Tylenol) that get processed in your liver.

9. Take probiotics. Take 10 to 20 billion organisms on an empty stomach twice a day, once in the morning and once in the evening.

10. Limit your alcohol intake to no more than 1 drink per day and 5 per week—less is better. Remember 1 drink is 5 ounces of wine, 1.5 ounces of hard alcohol, or 12 ounces of beer.

These are just a few simple things you can do every day to reduce your risk of getting breast cancer. There are many others techniques you can use and I may explore some of them in future blogs. But by taking just these few steps you not only enhance the health of your breasts, but you start down the path of UltraWellness -- a path that promises nothing less than a lifetime of vital health, optimal weight, and mental acuity.

Now I’d like to hear from you ...

Have you struggled with breast cancer and if so, what has worked and what hasn’t?

Do you have any additional recommendations that might benefit others who are struggling with breast cancer?

Please leave your thoughts by adding a comment below.

To your good health,

Elizabeth Boham MD, RD

The Diabesity Epidemic Part III: Treating the REAL Causes Instead of the Symptoms

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 22 Dec 2009 13:57:51 -0500

There is one driving factor that contributes, above all else, to the epidemic of diabesity and other chronic illnesses we see today. By addressing this one problem you may reverse many of your health problems, even if you don’t do anything else. In today’s blog, the last in my three-part series on diabesity, I will tell you what that problem is and how you can effectively treat it. Here’s a hint: You won’t find the solution in a pill bottle ...

Remember, in the last week’s blog on diabesity, we learned what doesn’t work to treat the condition -- namely conventional, outdated approaches to medicine that focus on treating symptoms with medications instead of addressing the underlying causes of illness. Now that we know what doesn’t work, I want to spend some time in this week’s blog explaining what DOES work.

If we want to effectively treat this epidemic of diabesity, we must start focusing on the underlying causes that are driving these problems in the first place. You see, ALL of these phenomenon we see in diabesity are the result of the same thing: Imbalances in the seven underlying key systems in your body that are at the root of all health and illness.

Today you will learn what those seven systems are and how you can use this exciting new field of medical research and practice known as functional medicine to help you prevent and even reverse Diabesity.

Introducing the 7 Keys

In the last 20 years an emerging body of scientific knowledge points to a number of factors that are the true drivers of diabesity and most chronic disease. While genetic predisposition may play a role in diabesity, what we now know is that it is the ways in which your lifestyle and environment wash over your genes to create changes in your moment to moment biological functioning that leads to health or disease.

These changes in gene expression or function are what result in the symptoms we see in diabetes. But your symptoms -- your high blood sugar, high blood pressure, high cholesterol, and the rest -- are NOT the cause of diabesity. They are simply clues to help us find the real underlying causes.

The fundamental causes of diabesity are imbalances in key systems of the body that results in insulin resistance, problems with blood sugar control, and all the other complications and associated problems. There are seven fundamental systems in your body. These keys form the basis of Functional medicine. I also call them the 7 keys to UltraWellness.

Understanding these basic systems, how they get out of balance, and how to get them back in balance, allows us to create a personalized medicine program for each person. This is the medicine of the future.

To heal from diabesity, or overcome any of the other chronic illnesses you suffer from, you must rebalance the 7 key systems in your body that are at the root of health and illness. They are: optimize nutrition, balance your hormones, cool off inflammation, fix your digestion, enhance detoxification, boost energy metabolism, and calm your mind.

Imbalances in these underlying key systems are at the heart of all chronic illness, including diabesity. Today I want to focus on one of the most important keys -- Key #1: Optimize Nutrition -- and explain how it contributes to diabesity.

*****************IMPORTANT ANNOUNCEMENT****************

Nutrition is just one of the seven keys to preventing and reversing diabesity. I’ll be exploring the other six during a special webinar in which you’ll discover how to overcome diabesity and reclaim a normal life. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you—whether you are overweight, have been diagnosed with diabetes or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

*******************************************************

Key #1: Optimize Nutrition

The main driving factor of our diabesity epidemic is our nutrient-poor, calorie-rich diet. It has led to a nation of overfed but undernourished people. In fact, there are so few nutrients in our diet that we now have an epidemic of nutritional deficiencies that promote the development of diabetes in including vitamin D, magnesium, chromium, zinc, and antioxidant deficiencies.(i),(ii).

The solution is simple. Whole, real, fresh food that you have to cook is the most potent medicine to prevent, reverse and treat diabesity.

First let’s look at some of the major dietary shifts that have driven the diabesity epidemic, and then we will explore the exciting new science of nutrigenomics which promises to help us fix the problem for good.

The #1 dietary shift that leads to diabesity is sugar in all its forms.

The average American today eats 150-180 pounds of sugar per year. That’s over half a pound of sugar a day! And I’m not eating that much, so that means some of you are eating a lot more!

We evolved eating 22 teaspoons of sugar per year.(iii) So we are no longer eating in harmony with our genes. In the last 30 years our sugar calories increasingly come from high-fructose corn syrup. This mostly in the form of liquid calories from sodas, soft drinks, sweetened beverages.

In fact, Dr. Walter Willett from the Harvard School Public Health stated at a recent White House meeting on Prevention and Wellness at which I also spoke, that the two most important factors driving our obesity epidemic are sugar-sweetened drinks (iv) and the number of hours of television watched per day.(v) These correlate more with obesity than any other factors in the research.

We need to stop eating (and drinking) so much sugar. It’s killing us.

The #2 dietary shift that leads to diabesity is our low-fiber diet.

As our sugar consumption has increased, our fiber consumption has decreased. We now eat less than 8 grams per day. Yet our Paleolithic ancestors ate 100 grams of fiber per day.(vi) This is another indication of how we are no longer eating in harmony with our genes ...

Fiber is important because it slows the absorption of sugar into the bloodstream from our gut and reduces cholesterol. It mostly comes from fruits, vegetables, nuts, seeds, and beans.

Those who eat a refined, processed, diet that comes from boxes, packages, or cans get less fiber than those who eat whole, real foods. The lack of fiber in our diet has enormous implications for our health. It causes heart disease, diabetes, obesity, cancers and many other chronic diseases.(vii) In fact, studies show that adding high levels of fiber to the diet is as effective as diabetes medication without any of the side effects.(viii)

And the #3 dietary shift that leads to diabesity is our epidemic of nutritional deficiencies.

A number of nutrients are particularly important to prevent and treat diabesity. These include vitamin D,(ix) chromium,(x),(xi) magnesium,(xii) zinc,(xiii) biotin,(xiv) omega-3 fats,(xv) and antioxidants such alpha lipoic acid.(xvi)

These nutrients are necessary for proper control and balance of insulin and blood sugar. When these are deficient, our biochemical machinery slows down and grinds to a halt. And these happen to be the very nutrients most of us are deficient in.

What’s critical to understand is that the solution to the whole diabesity epidemic can be found at the end of your fork! What you put on your fork is the most powerful medicine you have to correct the fundamental underlying causes of chronic disease and diabesity. That is true for one simple reason: Food is more than calories; it is information. Here’s what I mean ...

We generally think of food as a way to get energy; a means to feed our bodies the fuel they need to function. However, new science has shown that food literally speaks to your genes. The information your body receives from the foods you eat turn your genes on and off.

This provides your body with instructions about how to control your metabolism from moment to moment and day to day, every time you take a bite of food. This is the science of nutrigenomics, or how food talks to your genes, and it is the nutritional approach that underlies this program. Food is more than calories – food is information.

By feeding your body the right information, you can turn off the genes that lead to diabesity and turn on the genes that lead to health. The key lies in the quality and type of food you eat, not necessarily the calories you consume or the ratio of protein, fat, and carbohydrate in your diet.

Dr. Dean Ornish proved that you could reverse blockages in clogged arteries and increase blood flow in the heart by simply changing the quality of the food you put in your body and engaging in some simple lifestyle changes. He also showed that you could beneficially affect over 500 genes turning off the disease-causing genes and turning on the health promoting genes by changing diet and lifestyle in just three months. This is more powerful than ANY medication ever invented.

So what should you eat? The optimal diet to prevent and treat diabesity includes:

This is commonly known as a Mediterranean diet. It is a diet of whole, real, fresh food. It is a diet of food you have to prepare and cook from the raw materials of nature. And it has broad-ranging benefits for your health.

Our common ideas about food only being a source of energy are very limited. Nutrigenomics and its role in diabesity is the future of medicine. It will help us both understand and successfully treat this burdensome condition that affects over 1 billion people worldwide.

That is only one of the seven keys you need to prevent or reverse diabesity ... but now I’d like to hear from you ...

Are you ready to take the steps needed to treat the underlying causes of your health condition?

Do you want to learn more about how food is medicine and what the other keys to treating diabesity are?

Have you tried any of the techniques in the blog? How did they work for you?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, MD

P.S. Nutrition is just one of the seven keys to preventing and reversing diabesity. I’ll be exploring the other six during a special webinar in which you’ll discover how to overcome Diabesity and reclaim a normal life. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you—whether you are overweight, have been diagnosed with diabetes or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

References

(i) Kligler B, Lynch D. An integrative approach to the management of type 2 diabetes mellitus. Altern Ther Health Med. 2003 Nov-Dec;9(6):24-32; quiz 33. Review.

(ii) Kelly GS. Insulin resistance: lifestyle and nutritional interventions. Altern Med Rev. 2000 Apr;5(2):109-32. Review.

(iii) Cordain L., et al. 2005. Origin and evolution of the Western diet: Health implications for the 21st century. Am J Clin Nutr. 8 (2):341–54. Review.

(iv) Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001 Feb 17;357(9255):505-8

(v) Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003 Apr 9;289(14):1785-91.

(vi) Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med. 1985 Jan 31;312(5):283-9. Review.

(vii) Robson AA. Preventing diet induced disease: bioavailable nutrient-rich, low-energy-dense diets. Nutr Health. 2009;20(2):135-66. Review.

(viii) Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med. 2000 May 11;342(19):1392-8.

(ix) Reis JP, von Mühlen D, Miller ER 3rd, Michos ED, Appel LJ. Vitamin D Status and Cardiometabolic Risk Factors in the United States Adolescent Population. Pediatrics. 2009 Aug 3.

(x) A scientific review: the role of chromium in insulin resistance. Diabetes Educ. 2004;Suppl:2-14. Review.

(xi) Lau FC, Bagchi M, Sen CK, Bagchi D. Nutrigenomic basis of beneficial effects of chromium(III) on obesity and diabetes. Mol Cell Biochem. 2008 Oct;317(1-2):1-10. Epub 2008 Jul 18. Review.

(xii) Chaudhary DP, Sharma R, Bansal DD. Implications of Magnesium Deficiency in Type 2 Diabetes: A Review. Biol Trace Elem Res. 2009 Jul 24.

(xiii) Masood N, Baloch GH, Ghori RA, Memon IA, Memon MA, Memon MS. Serum zinc and magnesium in type-2 diabetic patients. J Coll Physicians Surg Pak. 2009 Aug;19(8):483-6.

(xiv) Albarracin CA, Fuqua BC, Evans JL, Goldfine ID. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev. 2008 Jan-Feb;24(1):41-51.

(xv) Flachs P, Rossmeisl M, Bryhn M, Kopecky J. Cellular and molecular effects of n-3 polyunsaturated fatty acids on adipose tissue biology and metabolism. Clin Sci (Lond). 2009 Jan;116(1):1-16. Review.

(xvi) Shay KP, Moreau RF, Smith EJ, Smith AR, Hagen TM. Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochim Biophys Acta. 2009 Oct;1790(10):1149-60. Epub 2009 Aug 4.

The Diabesity Epidemic Part 2: The Continuum Concept and Why Conventional Medicine Actually Makes Things Worse

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 16 Dec 2009 16:20:30 -0500

If you are diabetic, overweight, or suffer from insulin resistance, metabolic syndrome, or any of the other conditions conventional medicine associates with "elevated blood sugar," I want to share a startling new discovery with you: Lowering your blood sugar may increase your risk of death.

These are the findings from an extraordinary new study that was recently published in The New England Journal of Medicine, and in this blog, the second in my three-part series on diabesity, I am going to tell you all about that study and its profound implications for the treatment of obesity, diabetes, and other related conditions.

In last week’s blog you were introduced to the concept of diabesity, and learned that conventional treatments typically don’t work to treat it. Today we’ll see WHY those treatments don’t work and look at the REAL way to treat the problem. Let’s start with one of the most fascinating medical studies published in recent times ...

The ACCORD Study: Revolutionizing Our Understanding of Diabesity

In 2008, an extraordinary study was published in The New England Journal of Medicine. It is called the ACCORD study,(i) and it is one of the most profound pieces of literature that exists regarding why conventional treatments for diabetes simply do not work.

In the study 10,000 patients with diabetes were designated to receive intensive or regular therapy to lower blood sugar. These patients were monitored and their risks of heart attack, stroke, and death were evaluated. The patients who had their blood sugar lowered the most had a higher risk of death.

Let me repeat that, because I really want you to understand it: The patients who had their blood sugar LOWERED the most had a HIGHER risk of death. How could this happen if, as we believe, elevated blood sugar is the cause of all the evils of diabetes? Why would lowering blood sugar lead to worse outcomes?

Amazingly, the study had to be stopped after three and a half years because it was evident that the aggressive blood sugar lowering led to more deaths and more heart attacks. This completely explodes the way conventional medicine understands and treats diabetes. It’s a revolutionary study. Yet for those of us who have been working to understand the REAL causes of diabesity, it isn’t all that surprising.

How could LOWERING blood sugar INCREASE your risk of death?

The reason is simple: Elevated blood sugar is actually a symptom of underlying metabolic, physiologic, and biochemical processes that are out of balance ... and lowering blood sugar with medications does not address the underlying issues that gave rise to the high blood sugar in the first place. This may surprise you, but many of the methods used to lower blood sugar such as insulin or oral hypoglycemic drugs actually make the problem worse by increasing insulin levels.

Type 2 diabetes is a disease of too much, not too little, insulin. Insulin is the real driver of problems with diabesity. That means you don’t simply need more insulin in your blood to lower your blood sugar. Instead, what you need to do is treat the underlying causes that gave rise to the high blood sugar and insulin in the first place. And that is insulin resistance.

Insulin Resistance: The Real Cause of Diabesity

Insulin resistance occurs when your diet is full of empty calories and has an abundance of quickly absorbed sugars, liquid calories,(ii) and carbohydrates (like bread, pasta, rice, and potatoes). When this happens, your cells slowly become resistant to the effects of insulin. You need more and more to do the same job of keeping your blood sugar even. Thus you develop insulin resistance.

High insulin levels are the first sign of a problem. The higher your insulin levels are, the worse your insulin resistance. As a result your body starts to age and deteriorate. In fact insulin resistance is the single most important phenomena that leads to rapid and premature aging and all its resultant diseases including heart disease, stroke, dementia, and cancer.(iii),(iv)

As your insulin levels increase it leads to an appetite that is out of control, increasing weight gain around the belly, more inflammation and oxidative stress, and myriad downstream effects including high blood pressure, high cholesterol, low HDL, high triglycerides,(v) weight gain around the middle, thickening of the blood, and increased rates of cancer, Alzheimer’s disease, and depression. These are all a result of insulin resistance and too much insulin. Elevated blood sugar is not the source of the problem.

Understanding this has a profound impact on the whole way we think about diabesity. It’s not simply a matter of shifting our focus from one type of medication to another. This completely alters the fundamental way we understand the disease.

In fact, in some sense, diabesity isn’t a "disease" at all. It’s simply a continuum that stretches from optimal health to full-blown illness. Let me take a few moments to explain this, because it is essential for you to understand if you want to fully realize the potential of this new paradigm to prevent or reverse diabesity.

The Continuum Concept

Most medicine is based on clear-cut, on-or-off, yes-or-no diagnoses. Most conventional doctors are taught that you have a disease or you don’t, you have diabetes or you don’t. There are no gray areas. This approach is not only misguided, it is dangerous, because it misses the underlying causes and more subtle manifestations of illness.

Practicing medicine this way completely ignores one of the most fundamental laws of physiology, biology, and disease: The continuum concept. There is a continuum from optimal health to hidden imbalance to serious dysfunction to disease. Anywhere along that continuum, we can intervene and reverse the process. The sooner we address it, the better.

**************IMPORTANT ANNOUNCEMENT*************

I’ll be discussing the continuum concept, the REAL causes of diabesity and how to prevent and reverse the condition and reclaim a normal life during a special upcoming webinar. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you—whether you are overweight, have been diagnosed with diabetes or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

*************************************************

When it comes to diabesity most doctors just follow blood sugar, which actually rises very late in the disease process. Conventional medicine tells us if your blood sugar is 90 or 110, you don’t have diabetes; if it is over 126, you do have diabetes. But these distinctions are completely arbitrary, and they do nothing to help treat impending problems.

I remember one patient, Daren, came to see me with mildly elevated blood sugar. I asked Daren if he had seen his doctor about this. He said, "Yes". I then asked "What did your doctor say?" Daren’s doctor told him, "We are going to wait and watch until your blood sugar is more elevated, then we are going to treat you with medication for diabetes."

Given our current level of scientific understanding of diabesity, I find this concept of watching and waiting until more serious disease occurs unfortunate, misguided, and in some cases it’s deadly.

It is also why diabesity is so woefully and inadequately diagnosed and treated. Millions of Americans are suffering needlessly from chronic symptoms. Nearly half of all diabetics are undiagnosed. Nearly ALL of the 100 million Americans with pre-diabetes are undiagnosed.

Why? Most doctors just don’t know how to diagnose it, or what to do about it, because there is no good drug treatment.

The truth is the road to diabetes starts as early as childhood.(vi) We now know that there is an epidemic of type 2 diabetes in children as young as eight years old,(vii) and pediatric diabetic specialists who used to only care for type 1 diabetes, now find their offices are overwhelmed with cases of type 2 diabetes.

By the time you get diagnosed with diabetes you have had problems with insulin and blood sugar that could have been detected twenty to thirty years earlier. That is, if you knew where to look, which most doctors are not trained to do.

Insulin resistance and diabesity is often accompanied by:

These clues can often be picked up long before you ever get diabetes and may help you prevent the disease entirely. Why is this important? Because insulin resistance can cause SUBSTANTIAL health risks even in the absence of full blown diabetes.

In part one of this blog series I reviewed some of the common complications of diabetes. But what most people (including most doctors) don’t realize is that insulin resistance or pre-diabetes can be just as bad and can lead to nearly ALL of these complications even in the absence of a technical diagnosis of diabetes.

In fact, many people with pre-diabetes never get diabetes, but they are at severe risk just the same. We could eliminate many of the long-term complications of diabesity if we simply addressed these symptoms and diagnosed the problem much earlier in the process—that is to say, much earlier on the continuum.

This leaves us with a couple of questions:

causing

fundamental underlying problem

It is only by answering these questions and addressing the real causes of diabesity -- the factors that are leading to this problem with insulin resistance -- that we will effectively treat this terrifying disease.

Any hope we have for resolving this pandemic must use a new approach to the diagnosis and treatment of diabesity. That approach is called functional medicine. And I am going to explain what it is and how you can use it to help you heal from diabesity in the next blog in this series.

By applying this new form of medicine to your health problems you may overcome diabesity and become vibrantly health once again.

Now I’d like to hear from you ...

Are you taking insulin and if so, how has it helped, or not, with your diabesity?

What do you think about conventional medical approaches to treating this problem?

What do you think about the continuum concept? Has your experience with diabesity reflected this continuum?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, MD

P.S. I’ll be discussing the continuum concept, the REAL causes of diabesity and how to prevent and reverse the condition and reclaim a normal life during a special upcoming webinar. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you – whether you are overweight, have been diagnosed with diabetes or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

References

(i) Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545-59.

(ii) Chen L, Appel LJ, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Mitchell D, Batch BC, Svetkey LP, Caballero B. Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Am J Clin Nutr. 2009 May;89(5):1299-306.

(iii) Bhashyam S, Parikh P, Bolukoglu H, Shannon AH, Porter JH, Shen YT, Shannon RP. Aging is associated with myocardial insulin resistance and mitochondrial dysfunction. Am J Physiol Heart Circ Physiol. 2007 Nov;293(5):H3063-71.

(iv) Ryan AS. Insulin resistance with aging: effects of diet and exercise. Sports Med. 2000 Nov;30(5):327-46. Review.

(v) Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation. 1997 Oct 21;96(8):2520-5.

(vi) Nelson RA, Bremer AA. Insulin Resistance and Metabolic Syndrome in the Pediatric Population. Metab Syndr Relat Disord. 2009 Nov 29.

(vii) Silverstein JH, Rosenbloom AL. Type 2 diabetes in children. Curr Diab Rep. 2001 Aug;1(1):19-27. Review.

The Diabesity Epidemic Part 1: How Diabetes and Obesity are Ravaging America Today

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 09 Dec 2009 15:37:49 -0500

Do you fear for your health or feel exhausted all the time? Are you overweight? Or do you just have too much belly fat? Do you suffer from diabetes, monitor your blood sugar all the time, have serious blood sugar and insulin imbalances, or have elevated cholesterol, blood pressure, and triglyceride levels? If so, you may find this remarkable story of one my patient’s very interesting.

One evening, after a lecture in New York, a man approached me about becoming my patient. He was rotund, with a round, ruddy face, a booming voice, and a gentle manner. Everything about him was large -- his appetite, his belly, and his heart.

Sam was nearly 60 years old, and his love of everything big was waning as he felt the encroachment of death. As we talked, he described years of feeding his fat, drinking a pint of heavy whipping cream every night before bed to keep his weight up.

In the end, the big presence that Sam’s 300-plus pound corpus gave him was not worth the infirmities he suffered. He was diabetic. His insulin was over 200, normal is less than 20. He also had dangerous cholesterol levels, angina, sleep apnea, a sluggish thyroid, and was doggedly fatigued, short of breath at nearly every step, had nasal congestion, swollen legs, dry skin, and yeast grew all over his body.

Sam may sound like a hopeless case, but the truth is that everything Sam had done to his body he did himself and could undo. I told him that if he did everything I suggested he would lose weight, feel better, and all his symptoms would go away.

Enthusiastic, though somewhat skeptical, he left my office determined. Three months later when I spoke to him again, he lost 30 pounds, had more energy, his nasal congestion was gone, his fluid-filled, swollen legs were better, and all of his cravings were gone -- he never felt hungry, and he found the program I prescribed to him easy to follow.

Fourteen months later I saw him again and repeated his blood tests. I was shocked when he weighed in. He had lost 110 pounds without being on a strict deprivation diet. He simply changed his eating and his lifestyle. His diabetes was CURED. His blood sugar dropped from 130 to 74 (greater than 126 fasting denotes diabetes). His HDL and LDL cholesterol and triglycerides were normal without any medication. And he was exercising vigorously three to four times a week.

After a lifetime of uncontrollable appetites, Sam finally found balance and health without suffering. Yes, he changed his diet and lifestyle, but he was able to continue taking pleasure in food. Most importantly, he looked and felt twenty years younger.

Now, I know Sam’s story is an extreme one. You may or may not be suffering from problems as severe as those he faced. Even so, I’m sure you can relate to some of what Sam experienced if you are overweight, have high blood pressure, elevated cholesterol, have problems with your blood sugar, or have been diagnosed with type 2 diabetes ...

You may feel twenty years older than you are, and, deep down, you may even be terrified by the possibility of additional health complications like heart disease, stroke, dementia, nerve damage, blindness, and amputation or even cancer. Like so many others that suffer with this condition, you just want to live a normal life and get back some of your energy and vitality; you want to turn back the clock and reverse your diabetes ...

You can do that. I know most people are skeptical when a doctor tells them they can reverse diabetes, but over the course of this three-part series of blogs I’m going to show you how. You can have the same experience Sam did, and you don’t have to suffer or starve to make that happen.

Later in this blog series, I will tell you how you can do that. Today, I want to explain what I mean by the term “diabesity”. If you have diabetes you have it. But you don’t have to have diabetes or even have symptoms to be suffering from diabesity. In fact most people who have it don’t know they are suffering from a deadly condition that is 100% reversible.

**************IMPORTANT ANNOUNCEMENT*************

I’ve received so many questions about diabesity that I’ve decided to hold a special webinar during which you’ll discover the 7 keys to overcoming diabesity and reclaiming a normal life. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you—whether you are overweight, have been diagnosed with diabetes, or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

****************************************************

Many Names, One Disease -- Defining Diabesity

You may be one among millions of people who are suffering from a health problem that is now epidemic in our country. Your doctor might have diagnosed you with one of many seemingly different diseases. He may have said you have:

What he likely didn’t tell you is that ALL of these conditions are basically the same thing—just with varying degrees of severity. The underlying causes of ALL of these conditions are the same. And because they are all the same condition, the treatment for all of them is also the same.

That is why I have set aside these conventional diagnoses in place of a new name that more accurately defines the health problems you may suffer from. That term is diabesity.(i) Diabesity is the condition of metabolic imbalance and disease that ranges all the way from mild blood sugar imbalance to full blow diabetes.

Whether you are suffering from a little extra weight around the middle or you have been diagnosed with insulin resistance or even type 2 diabetes, the fundamental underlying biological causes of ALL of these conditions are the same. This is what I’ve discovered in over 20 years seeing thousands of patients.

Diabesity, in its various forms, affects over 1 billion people worldwide. It is a massive global problem, and our current approach to prevention and treatment is obviously not working because millions more are affected every year in a dramatic increase of a condition that was once very rare.

Diabesity is also the leading cause of most chronic disease in the 21st century.(ii) Those with diabesity are at an increased risk of heart disease (iii), (iv), stroke, dementia(v), cancer(vi), high blood pressure, blindness, and kidney failure. Nervous system damage also affects 60 to 70 percent of people with diabetes and can lead to a loss of sensation in the hands and feet, slow digestion of food in the stomach, carpal tunnel syndrome, sexual dysfunction, and other nerve problems.

So this is VERY real and VERY serious for those who suffer from the condition. Given all of this, one would think the questions on everyone’s mind would be: Why is this happening? What has caused this diabesity epidemic? Why are our current approaches to treating the problem failing so miserably? And what new approaches could we take that would more effectively treat the problem?

Few in medicine today are asking these questions, yet their answers are disarmingly simple.

The Problems with Diabesity Treatment -- Symptoms, Not Causes

The reason our current approach to treating diabesity fails is because it focuses on treating the symptoms or risk factors of the disease rather than the causes. All of our attention is on treatments that:

But we never ever ask the most important question: Why is your blood sugar, blood pressure, or blood cholesterol too high and why is your blood too sticky and likely to clot? Put another way: What are the root causes of diabesity?

Answering that question must be the focus of our diagnosis and treatment of this disease if we are going to solve this global epidemic.

In truth, diabetes, elevated blood sugar, blood pressure, and cholesterol are simply downstream symptoms that result from problems with our diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities. These are the real causes of diabesity. Unfortunately, few are taking the time to treat them.

Using medication or surgery to treat symptoms like imbalanced blood sugar, high cholesterol, high blood pressure, and the other complications of diabetes is like mopping up the floor while the sink overflows.

In medicine today we have a choice. We can continue to mop up this overflow, or we can deal with the source of the problem and turn off the faucet—that is, treat the root problems that are causing your illness. In this three-part blog series, I am going to show you how to turn off the faucet so you can heal from your diabesity and achieve optimal health.

The real solution for diabesity is a comprehensive diet and lifestyle program. And in this series of three blogs I am going to teach you how you can integrate such an approach into your life to heal from your symptoms. I will show you why conventional treatments typically fail, what you can really do to treat diabesity, and explain how healing the 7 key underlying systems in your body is the real solution to the problem.

By following this system you may see many of your lifelong health symptoms evaporate in a matter of weeks or even days in some cases, and you may -- for the first time -- achieve vibrant health.

Now I’d like to hear from you ...

Do you believe you can be healed from diabesity?

Have you tried conventional medical treatments? How have they worked for you?

Are you ready to try a radically new approach that may help you heal once and for all?

Let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

P.S. I’ve received so many questions about diabesity that I’ve decided to hold a special webinar during which you’ll discover the 7 keys to overcoming diabesity and reclaiming a normal life. My tech team tells me that only 500 viewers can watch at once, so if it’s something that interests you—whether you are overweight, have been diagnosed with diabetes or are worried about developing it -- you may want to reserve your spot now before all of the spots are filled.

References

(i) This term was first coined by Shape Up America, former Surgeon General C. Everett Coop’s foundation.

(ii) http://apps.nccd.cdc.gov/DDTSTRS/FactSheet.aspx (National Diabetes Fact Sheet 2007)

(iii) http://www.cdc.gov/diabetes/statistics/cvd/fig5.htm

(iv) Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002 Dec 4;288(21):2709-16.

(v)Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology. 1999 Dec 10;53(9):1937-42.

(vi)Key TJ, Spencer EA, Reeves GK. Symposium 1: Overnutrition: consequences and solutions Obesity and cancer risk. Proc Nutr Soc. 2009 Dec 3:1-5.

The Super Fiber that Controls Your Appetite and Blood Sugar

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 13 Oct 2009 14:57:12 -0400

Imagine eating 12 pounds of food a day -- and still staying thin and healthy. That may sound crazy, but it’s exactly what our hunter-gatherer ancestors ate for millennia! And they didn't have any obesity or chronic diseases like heart disease, diabetes, cancer, or dementia.

Of course, I wouldn't advise anyone today to eat 12 pounds of food, because the food in our society lacks one major secret ingredient that our ancestors ate in nearly all their food -- fiber!

Fiber has so many health benefits that I want to focus on it in this week's blog. I’ll explain some of its benefits and give you 9 tips you can begin using today to get more fiber in your diet. I’ll also tell you about my favorite “super-fiber” that can help you increase your total fiber intake overnight.

But before I tell you about what fiber can do for you, let's a look a little more at the history of fiber.

Why Bushmen are Healthier than the Average Westerner

Dr. Dennis Burkitt, a famous English physician, studied the differences between indigenous African bushmen and their "civilized" western counterparts. The bushmen seemed to be free of the scourges of modern life -- including heart disease, cancer, diabetes, and obesity.

Dr. Burkitt found that the average bushman had a stool weight of 2 pounds and the "civilized" men had a stool weight of only 4 ounces - that's 87.5% smaller! The difference was in the amount of fiber they ate.

Today, the average American eats about 8 grams of fiber a day. But the average hunter and gatherer ate 100 grams from all manner of roots, berries, leaves and plant foods. And the fiber is what helped those ancestors of ours stay healthy. Just take a look at all the good things that fiber can do for your body.

You need fiber to keep you healthy from top to bottom, as well as to provide food for the healthy bacteria that work within you to promote health.

In fact, fiber can actually prevent obesity and all the chronic disease of aging. This is because fiber slows the rate at which food enters your bloodstream and increases the speed at which food exits your body through the digestive tract. That keeps your blood sugar and cholesterol in ideal balance -- and quickly eliminates toxins from your gut and reduces your appetite.

There's good science to back this up. Research shows that fiber can lower blood sugar as much as some diabetes medications, lower cholesterol, and promote weight loss.

It's clear, fiber is a great ally in the battle of the bulge.

But it's also a hero in more serious battles.

For example, one recent study showed how butyrate made by gut bacteria from certain types of fiber acts as a switching molecule that turns on an anticancer gene -- and turns OFF colon cancer. In fact, fiber has been shown to reduce the risk of colon cancer by as much as a third and breast cancer by almost 40 percent.

It also lowers cholesterol and reduces the risk of heart disease by as much as 40 percent. And if you have diabetes, adding fiber to your diet may even help you use less insulin. Plus, it's a great natural cure for constipation and irregularity.

Now that you know how beneficial it is, let’s look at how you can begin taking advantage of fiber’s health benefits.

Getting Enough Daily Fiber

You should shoot to get 30 to 50 grams of fiber into your diet every day. The type of fiber you choose is important, too.

Most people think that bran is the best type of fiber to eat. But bran (wheat fiber) is mostly insoluble and doesn't get digested. Think of it as more of a scouring pad for your intestines. That's good for getting you regular, but it just can't help your health the way that soluble fiber can.

You'll find soluble fiber in fruits, vegetables, beans, nuts, seeds and most whole grains. The bacteria in your gut metabolizes the soluble fiber in these foods, and that's when the benefits start.

Soluble fiber can help lower cholesterol, blood sugar, and insulin, prevent cancer, balance hormone levels, remove excess estrogen and reduce the risk of breast cancer, make vitamins and minerals, provide food for the colon cells, and more. So it’s easy to see just how crucial soluble fiber is to good heath!

In just a minute, I'm going to tell you how to increase your fiber intake. But first, I want to tell you about some recent discoveries regarding an ancient fiber source that can help you lose weight, lower your cholesterol, reduce your appetite and lower your blood sugar more effectively than ANY other fiber. It’s called glucomannan, but I call it super fiber!

Glucomannan: The Benefits of Super Fiber

Glucomannan (GM) is a soluble, fermentable, and highly viscous dietary fiber that comes from the root of the elephant yam, also known as konjac (Amorphophallus konjac or Amorphophallus rivieri), native to Asia. The konjac tuber has been used for centuries as an herbal remedy and to make traditional foods such as konjac jelly, tofu, and noodles. More recently, purified konjac flour, or GM, has been used as a food stabilizer, gelling agent, and supplement.

What makes this fiber so super is the fact that it can absorb up to 50 times its weight in water -- making it one of the most viscous dietary fibers known.

That means that GM can help you shed pounds. In many studies, doses of 2 to 4 grams of GM per day were well-tolerated. This amount also resulted in significant weight loss in overweight and obese individuals.

GM works by promoting a sense of fullness. Plus, it pushes more calories out through your colon, rather than letting them be absorbed. It also lowers the energy density of the food you eat. In other words, it bulks up food in your gut -- creating a lower calorie content per weight of food you eat.

And since fiber has almost no calories but a lot of weight, adding it to your diet lowers the energy-to-weight ratio of the food that you eat. Studies show that the weight of food controls your appetite, so the fiber increases the food's weight WITHOUT increasing calories -- a critical factor in weight control.

This powerful fiber may also control your appetite in other key ways.

For example, it sends signals to your brain that there is a lot of food in your gut and tells it to slow down on stuffing food in there.

GM also leaves your stomach and small bowel slowly because it is so viscous. By slowing the rate of food absorption from the gut to the bloodstream, GM reduces the amount of insulin produced after a meal, which also controls your appetite.

It may also increase the level of hormones in the gut (such as cholecystokinin), which is another way to control your appetite.

And finally, you lose more calories through stool because GM soaks up all those extra calories!

GM can also help your health in other ways. In addition to weight reduction, GM has been studied for its effects on constipation, serum cholesterol, blood glucose, blood pressure, and insulin resistance syndrome.

With all those benefits, there's no doubt you should eat more fiber. No, you probably won't be eating 12 pounds of food like your ancestors did! But you can increase your fiber intake, just by being smart about what you eat. Here are some simple suggestions for increasing fiber in your diet.

9 Tips for Increasing the Fiber in Your Diet.

1. Get the flax.

2. Load up on legumes. Beans beat out everything else for fiber content!

3. Bulk up on vegetables. With low levels of calories and high levels of antioxidants and protective phytochemicals, these excellent fiber sources should be heaped on your plate daily.

4. Go with the grain. Whole grains like brown rice or quinoa are rich in fiber, too.

5. Eat more fruit. Include a few servings of low-sugar fruits to your diet daily (berries are the highest in fiber and other protective phytochemicals).

6. Go nuts. Include a few handfuls of almonds, walnuts, pecans, or hazelnuts to your diet every day.

7. Start slowly. Switching abruptly to a high-fiber diet can cause gas and bloating. Increase your fiber intake slowly till you get up to 50 grams a day.

8. Consider a good fiber supplement. If you're have trouble getting your fill of fiber, choose a supplement that contains both soluble and insoluble fiber and no sweeteners or additives.

9. Choose GM. By now, you know that my favorite kind is glucomannan (GM), or konjac. Many companies sell it in capsule form. Although I don't normally recommend specific brands, I like the one produced by Natural Factors called WellBetX. You can take 2 to 4 capsules with a glass of water, 30 to 60 minutes before eating. Don't take any medications within 1 hour before or 2 hours after taking it because the fiber may absorb the medication.

As you can see, fiber has big benefits for your health -- from encouraging weight loss to preventing chronic diseases. I hope you'll start adding more of this important compound into your diet today!

Now I'd like to hear from you ...

Have you noticed any ill-health effects from having a low fiber intake?

How much fiber do you think you currently eat every day?

What high-fiber foods do you enjoy?

What steps are you taking to get more fiber in your diet?

Please let me know your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

References

Howarth NC, Saltzman E, Roberts SB. Dietary fiber and weight regulation. Nutr Rev. 2001;59:129-139.

Burton-Freeman B. Dietary fiber and energy regulation. J Nutr. 2000; 130(2S Suppl):272S-275S

Vuksan V, Sievenpiper SL, Xu Z, et al. Konjac-Mannan and American Ginseng: Emerging alternative therapies for type 2 diabetes mellitus. J Am Coll Nutr. 2001;20(5Suppl):370S-380S.

Bourden I, Yokoyama W, Davis P, et al. Postprandial lipid, glucose, insulin, and cholecystokinin responses in men fed barley pasta enriched with beta-glucan. Am J Clin Nutr. 1999;69:55-63.

Baer DJ, Rumpler WV, Miles CW, Fahey GCJ. Dietary fiber decreases the metabolizable energy content and nutrient digestibility of mixed diets fed to humans. J Nutr. 1997;127: 579-586.

Chen H-L, Sheu WH, Tai T-S, Liaw Y-P, Chen Y-C. Konjac supplement alleviated hypercholesterolemia and hyperglycemia in type 2 diabetic subjects--a randomized double-blind trial. J Am Coll Nutr. 2003;22(1):36-42.

Vuksan V, Jenkins DJ, Spadafora P, et al. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999;22(6):913-919.

Walsh DE, Yaghoubian V, Behforooz A. Effect of glucomannan on obese patients: A clinical study. Int J Obes. 1984;8:289-293.

Reffo GC, Ghirardi PE, Forattini C. Glucomannan in hypertensive outpatients: Pilot clinical trial. Curr Ther Res. 1988; 44(1):22-27.

Livieri C, Novazi F, Lorini R. The use of highly purified glucomannan-based fibers in childhood obesity. Pediatr Med Chir. 1992;14(2):195-198.

Vita PM, Restelli A, Caspani P, Klinger R. Chronic use of glucomannan in the dietary treatment of severe obesity. Minerva Med. 1992;83(3):135-139.

Cairella M, Marchini G. Evaluation of the action of glucomannan on metabolic parameters and on the sensation of satiation in overweight and obese patients. ClinTer. 1995;146(4):269-274.

Arvill A, Bodin L. (1995). Effect of short-term ingestion of konjac glucomannan on serum cholesterol in healthy men. Am J Clin Nutr. 1995;61:585-589.

Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from konjac-mannan in subjects with the insulin resistance syndrome: Results of a controlled metabolic trial. Diabetes Care. 2000;23(1):9-14.

Gallaher DD, Gallaher CM, Mahrt GJ, et al. A glucomannan and chitosan fiber supplement decreases plasma cholesterol and increases cholesterol excretion in overweight normocholesterolemic humans. J Am Coll Nutr. 2002;21(5): 428-433.

Burley VJ, Paul AW, Blundell JE. Influence of a high-fibre food (myco-protein) on appetite: Effects on satiation (within meals) and satiety (following meals). Eur J Clin Nutr. 1993;47:409-418.

Hill AJ, Blundell JE. Macronutrients and satiety: The effects of a high protein or high carbohydrate meal on subjective motivation to eat and food preferences. Nutr Behav. 1986;3:133-144.

Astrup A, Vrist E, Quaade F. (1990). Dietary fibre added to a very low calorie diet reduces hunger and alleviates constipation. Int J Obes. 1990;14:105-112.

Pasman WJ, Saris WH, Wauters MA, Westerterp-Plantenga MS. Effect of one week of fibre supplementation on hunger and satiety ratings and energy intake. Appetite, 1997;29:77-87.

Liu S, Willett WC, Manson JE, Hu FP, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr. 2003;78(5):920-927.

Maximizing Methylation: The Key to Healthy Aging

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 07 Oct 2009 16:25:41 -0400

Taking just a few vitamins CAN optimize the function of ALL your body's systems. It’s true. But you have to know what to take and you have to know why these supplements work ...

That’s why, in this week’s blog, I am going to discuss one of the most important biochemical processes for long-term health and how you can keep it running at its very best with supplements and other measures.

Unfortunately, many people suffer from one or more of the 8 factors that negatively impact this biochemical process, so problems in this area are widespread though many don’t realize they are suffering.

The good news is that there are MANY things that you can do right now to optimize this critical biochemical process that may have a dramatic impact on your health. In today’s blog I will review the 8 factors that can lead to problems in this area, and outline 12 tips that will help you optimize this essential part of your biology.

But first, I'd like to tell you about two of my patients with seemingly unrelated health problems that were actually caused by a breakdown in this biochemical process. And I want to share a study done on Chinese babies who had a birth defect known as spina bifida.

You'll be amazed at how all three -- my two patients and these Chinese babies -- were affected by the exact same thing ...

What an Elderly Golfer, a College Professor, and Chinese Babies have in Common

One of my patients, Mr. Roberts, was an 88-year-old businessman who didn't let his age slow him down. He still golfed three times a week, worked two days a week, flew around the world in his private jet, and was "romantic" once a week with a wife 30 years his junior. He also loved his 6 ounces of Grey Goose vodka every night.

Of course, he did have some health problems. Mr. Roberts had been treated well for mild heart disease. His doctor even recommended 800 mcg of folic acid and 250 mcg of vitamin B12 -- megadoses by any standard.

Mr. Roberts also had a check-up at the Mayo Clinic and was told that he was healthy, despite having mild anemia and large red blood cells. Yet he still complained of mild fatigue and trouble with his short-term memory. Plus, I noticed a slightly wide gait common in someone with poor balance.

Then there was Mr. McNally, a Boston college professor who was 50 years old, fit, and lean but wore a worried look as he walked into my office.

He recounted the sad tale of his 7 brothers. Four had died of a heart attack and three others had had bypass operations at a young age. Concerned about his own fate, he ate a low-fat diet, exercised regularly, didn't smoke, had normal blood pressure and cholesterol levels, and took antioxidants and a multivitamin. Perhaps his only vice was the multiple Starbuck's grande lattes he downed each day. Living under a constant state of impending doom, Mr. McNally came to me asking for a stress test to see how his heart was doing.

Strange as it may seem, these two men reminded me of my time in China. When I lived in Beijing, a study was done on a group of women in Harbin, the northern most industrial city in the Gobi desert, just north of Beijing. It seemed that there was an unusually high rate of birth defects in the area, specifically spina bifida.

The Chinese have a tradition of holding weddings during the Chinese New Year in February. In Harbin, many of the babies born 9 months later had birth defects. This study sought to determine what the link was and found that the major factor was the lack of fresh greens or vegetables in the Gobi desert in the middle of winter.

Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very important in common. They all have inadequate levels of specific vitamins, either acquired or genetic, and their methylation systems are not working properly as a result. I'll explain more about what "methylation" is in a second. First let’s analyze the similarities in these cases.

Take Mr. Roberts. Our romantically active 88-year-old took high doses of B vitamins. But he still had very high levels of homocysteine and methylmalonic acid -- indicators of folic acid and B12 deficiency.

Mr. McNally had similar problems. Our college professor had a genetically sluggish metabolism of homocysteine which caused extremely high levels of this toxic amino acid to build up in his blood. This was the likely cause of all the heart disease in his family.

Again we see a similar set of problems in those Chinese babies. Their mothers were conceiving in the middle of winter -- when their folate intake was low from the absence of fruits and vegetables. This is what triggered such a high rate of birth defects.

The common link in all three of these cases is a problem with methylation. Let me tell you more about that that actually means.

Methylation is a key biochemical process that is essential for the proper function of almost all of your body's systems. It occurs billions of times every second; it helps repair your DNA on a daily basis; it controls homocysteine (an unhealthy compound that can damage blood vessels); it helps recycle molecules needed for detoxification; and it helps maintain mood and keep inflammation in check.

To keep methylation running smoothly you need optimal levels of B vitamins. Without enough B vitamins methylation breaks down, and the results can be catastrophic. In these cases we see more birth defects like spina bifida (as with the Chinese babies), more cases of Down's syndrome, and more miscarriage.

A breakdown in methylation also puts you at higher risk for conditions like osteoporosis, diabetes, cervical dysplasia and cancer, colon cancer, lung cancer, depression, pediatric cognitive dysfunction ( mood and other behavioral disorders), dementia, and stroke. And like Mr. Roberts and Mr. McNally, you may be at higher risk for cardiovascular disease.

To avoid all of these problems, the key is to maximize methylation. That means avoiding the things that cause your methylation to break down, testing to find out how well your methylation is working, and including the things that support proper methylation. Let’s look at how to do that.

8 Factors that Affect Your Methylation Process

8 major factors negatively impact methylation. They are:

1. Genetics.

2. Poor diet. The word "folate" comes from "foliage." You need to eat plenty of leafy greens, beans, fruit, and whole grains to get adequate levels of vitamins B6 and B12, betaine, and folate. Egg yolks, meat, liver, and oily fish are the main dietary sources of vitamin B12 -- so long-term vegan diets can be a problem. Plus, certain compounds can raise levels of homocysteine and deplete the B vitamins. These include excess animal protein, sugar, saturated fat, coffee, and alcohol. Irradiation of food depletes nutrients, so foods treated this way may be lower in B vitamins, too.

3. Smoking. The carbon monoxide from cigarette smoke inactivates vitamin B6.

4. Malabsorption. Conditions like digestive diseases, food allergies, and even aging can reduce absorption of nutrients.

5. Decreased stomach acid. Aging and other conditions can reduce stomach acid -- and therefore absorption of vitamin B12.

6. Medications. Drugs like acid blockers, methotrexate (for cancer and arthritis and other autoimmune diseases), oral contraceptives, HCTZ (for high blood pressure), and Dilantin (for seizures) can all affect levels of B vitamins.

7. Other conditions. These include hypothyroidism, kidney failure or having only one kidney, cancer, and pregnancy.

8. Toxic exposures. Some toxins can interfere with vitamin production.

Watch out for these factors and you will go a long way toward protecting your methylation.

Measuring Your Own Methylation Process

To find out if your methylation process is optimal, ask your doctor for the following tests:

1. Complete blood count.

2. Homocysteine. This is one of the most important tests you can ask for. The normal level is less than 13, but the ideal level is likely between 6 and 8.

3. Serum or urinary methylmalonic acid. This is a more specific test for vitamin B12 insufficiency. Your levels may be elevated even if you have a normal serum vitamin B12 or homocysteine level.

4. Specific urinary amino acids. These can be used to look for unusual metabolism disorders involving vitamins B6 or B12 or folate, which may not show up just by checking methylmalonic acid or homocysteine.

12 Tips to Optimize Your Methylation Process

Just as there are many causes of poor methylation, there are lots of things that support its proper functioning. Here's how to maximize methylation -- and prevent conditions like heart disease, cancer, dementia, depression, and more.

1. Eat more dark, leafy greens.

2. Get more Bs in your diet. Good food sources include sunflower seeds and wheat germ (vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6 and folate); leafy dark green vegetables; asparagus, almonds, and whole grains (folate); and liver (all three).

3. Minimize animal protein, sugar, and saturated fat. Animal protein directly increases homocysteine. Sugar and saturated fat deplete your body's vitamin stores.

4. Avoid processed foods and canned foods. These are depleted in vitamins.

5. Avoid caffeine. Excess amounts can deplete your B vitamin levels.

6. Limit alcohol to 3 drinks a week. More than this can deplete your B vitamin levels.

7. Don't smoke. As noted above, smoking inactivates vitamin B6.

8. Avoid medications that interfere with methylation. See notes on this above.

9. Keep the bacteria in your gut healthy. Take probiotic supplements and use other measures to make sure the bacteria in your gut are healthy so you can properly absorb the vitamins you do get.

10. Improve stomach acid. Use herbal digestives (bitters) or taking supplemental HCl.

11. Take supplements that prevent damage from homocysteine. Antioxidants protect you from homocysteine damage. Also make sure you support methylation with supplements like magnesium and zinc.

12. Supplement to help support proper homocysteine metabolism. Talk to your doctor to determine the best doses and forms for you. Here are a few suggestions:

• Folate (folic acid):

• Vitamin B6: Take 2 to 5 mg a day. Some people may need up to 250 mg or even special "active" B6 (pyridoxyl-5-phosphate) to achieve the greatest effect. Doses higher than 500 mg may cause nerve injury.

• Vitamin B12: Doses of 500 mcg may be needed to protect against heart disease. Oral vitamin B12 isn't well absorbed; you may need up to 1 or 2 mg daily. Ask your doctor about B12 shots.

• Betaine: This amino acid derivative is needed in doses from 500 to 3,000 mg a day, depending on the person.

By working to optimize your methylation you can protect yourself from virtually all the so called "diseases of aging." When you do, you will be well on the road to lifelong vibrant health.

Now I'd like to hear from you ...

Do you have symptoms of poor methylation?

What are you doing to optimize this process?

Do you take B-vitamin supplements? Have you noticed any results?

Please share your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

5 Simple Steps to Burn Fat without Eating Less

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 23 Sep 2009 18:58:31 -0400

There is now a way you can boost your metabolism without changing how much you eat. It's true. You can rev up your metabolic engine, feel more satisfied when you eat, burn more calories, and lose more body fat -- all without even changing how MUCH you eat.

Recent studies show how three key changes can help you accomplish your weight loss goals without changing the amount you eat. They are:

1. Meal timing and meal frequency --

2. Meal composition -– Specifically the role of protein in controlling appetite centers in your brain, increasing caloric burning, and reducing belly fat and weight.

3. Drinking green tea -- Which turns up your fat burning thermostat.

All three of these things have one very important concept in common: thermogenesis -- the creation of heat in your body. When you increase the thermogenesis in your body you literally turn up your metabolic fire.

Thermogenesis has nothing to do with the amount of calories you consume. It's controlled by a number of different interconnected control systems in the body designed to keep us healthy. By optimizing these systems you can turn up your metabolic fire without turning down the foods you love.

Today I will explain how the three key factors outlined above affect thermogenesis and give you a 5-step plan to increase your metabolic fire. Let's start by taking a look at the first thing that increases thermogenesis -- when and how often you eat.

Meal Timing and Frequency

Whether you eat all your day's food at once or in several meals throughout the day shouldn't affect your weight -- it's all about calories in, calories out, right?

No!

In fact, a recent study published in the American Journal of Clinical Nutrition (i) looked at the effects of regular meal frequency on fat burning (your internal thermostat), insulin sensitivity, and cholesterol in healthy obese women. The researchers compared people who ate small, regular, frequent meals (about 6 a day) to people who ate less regular meals a day.

What they found is that those people who had more regular meal patterns showed startling differences. They had increased thermogenesis -- a faster, hotter, metabolism -- from what is called the thermic effect of food (the TEF factor). This TEF factor makes you feel full. It somehow triggers the brain to feel satisfied and reduces your appetite.

When you eat regularly throughout the day, you get a slow, steady burn effect from the food. But when you eat erratically -- by skipping meals, snacking frequently, eating away from home, or eating late -- like so many of us do, your body gets mixed signals.

This irregular eating pattern leads to a lower energy expenditure (EE), or calorie burning, than regular meals. In fact, during the periods that you don't eat, your body's metabolism slows down to conserve energy. And it's not just your weight that can suffer as a result ...

In the same study, the authors found that those who ate irregularly had higher levels of cholesterol and higher levels of insulin, which is the major fat storage hormone. The more insulin that your body makes after meals, the fatter you will be. And, as you know, insulin imbalances can also lead to a host of health problems including insulin resistance and type 2 diabetes.

Meal timing makes a difference, too.

Studies show that eating breakfast (ii) and not eating late (iii) can both lead to reductions in body weight, independent of calories. (For more on this, see Chapter 5 in UltraMetabolism on the Sumo Wrestler Myth).

What's so amazing about all this is that it has nothing to do with the content or type of food you eat. Simply changing when and how often you eat can have dramatic effects on your weight!

But, of course, what you eat makes a difference too ...

Meal Composition

Now let's look at the effect of changing the composition of the meal. What happens if you change the ratio of fat, protein, and carbohydrates, but not the amount of calories you eat?

Recent studies have clearly shown that low-fat diets don't work. End of story. What about low-carb diets?

These do work IF you give up carbs -- the most important source of health-giving compounds in our diet, including fiber, vitamins , minerals, antioxidants, phytonutrients, and more. So weight loss from a low-carb diet comes at high price: poor health!

Low-carb diets also give you constipation, bad breath, hemorrhoids, headaches, and even muscle weakness and pain.

That leaves the question of protein. What happens when you increase the amount of protein in your diet?

Before I go on, let me clarify that when I am talking about increasing protein I mean nuts, seeds, beans, whole grains, omega-3 eggs, wild fish, and lean poultry or other meats. I am by NO means talking about a steak and cheese diet!

That said, protein, it seems, is more thermogenic. It burns hotter than other food sources -- so at the end of the day, you have burned off more calories than you store when you eat more protein. Don't just take my word for it. Science backs this up.

In one study, for example, the participants who got 36 percent of their daily calories from protein burned 71 more calories a day than those who ate low-protein diets (15 percent of calories). (iv) This may not seem like much -- but over a year, it's equivalent to an extra 7.4 pounds of weight loss!

This works because amino acids, the building blocks that form protein, send messages to areas in the brain that signal you are full. This is called the mTOR signaling pathway. (v) But protein has even more benefits ...

Eating good quality protein not only helps you lose weight, but lose it in the right places - your hips and belly. A higher protein diet can help you lower your waist circumference, waist-to-hip ratio (one of the most important measurements in your body which predicts heart disease, cancer, and death better than almost anything), and intra-abdominal adipose tissue (otherwise known as belly fat)!

There are just a few caveats ...

People with kidney failure have to be cautious with increasing their protein intake. And those with concerns about osteoporosis should focus on plant sources of protein (like nuts, seeds, beans, and whole grains), because the high acid content of animal protein may cause bone loss.

We’ve now covered meal timing, frequency, and composition. Next let’s look at what you drink.

Green Tea

Tea is the most widely consumed beverage in the world -- and I'm not talking about Lipton's tea here, which is the bottom of the barrel in terms of quality. I am talking about real, brewed green tea which is part of a fantastic class of compounds called polyphenols -- powerful plant chemicals or phytonutrients that interact with human biology to keep us healthy.

The polyphenols green tea contains are called catechins, and this group of chemicals has such wide effects that it would be impossible to discuss them all in one blog. So for now, let's look at just their metabolic effects.

The same issue of the American Journal of Clinical Nutrition I mentioned previously also reported on the effects of green tea on metabolism. (vi) Researchers specifically focused on the effects of catechins on metabolism in this double-blind, controlled study and found they were two-fold.

First catechins increased thermogenesis, or calorie burning. People who drank 690 milligrams of catechins in the form of green tea daily for 12 weeks had lower body weight, body mass index, waist circumference, total body fat, and subcutaneous body fat. That's WITHOUT changing their calorie intake.

The second effect was green tea's antioxidant properties. Not only did the green tea and catechins increase calorie burning, but they prevented the damaging effects of free radicals on metabolism by reducing oxidized or rancid fats. Other studies show how rancid fats and oxidation may interfere with metabolism.

To sum up, this research shows that green tea can affect weight loss in two ways -- by increasing thermogenesis and by reducing the damaging effects of oxidative stress on metabolism.

So what can you do to incorporate these research findings into your life, lose weight, and increase your metabolism without changing the calorie content of your diet? Just follow these simple steps.

5 Steps to Lose Weight Without Changing What You Eat

1. Start the day right.

2. Boost your protein intake. Have some protein with every meal.

3. Stay regular. Eat regular meals every day. That's breakfast, lunch, dinner, and one or two snacks.

4. Don't go to bed too full. Finish eating 2 to 3 hours before bed.

5. Make a cup of tea. Drink 1 to 2 cups of good quality green tea every day. Steep one tea bag for 5 minutes in hot water and enjoy!

Follow these steps and you will not only lose weight without changing what you eat, but you will be well on your way to lifelong vibrant health.

Now I'd like to hear from you ...

What happens to you if you skip meals?

Have you noticed that eating carbs for breakfast increases your appetite throughout the day, or that having that omelet in the morning is more satisfying?

Have you experimented with low carb or low fat diets? Share your experience with us.

Please let me know your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

References

(i) Farshchi HR, Taylor MA, Macdonald IA. Beneficial metabolic effects of regular meal frequency on dietary thermogenesis, insulin sensitivity, and fasting lipid profiles in healthy obese women. Am J Clin Nutr. 2005 Jan;81(1):16-24.

(ii) de Castro JM. The time of day of food intake influences overall intake in humans. J Nutr. 2004 Jan;134(1):104-11.

(iii) Keim NL, Van Loan MD, Horn WF, Barbieri TF, Mayclin PL. Weight loss is greater with consumption of large morning meals and fat-free mass is preserved with large evening meals in women on a controlled weight reduction regimen. J Nutr. 1997 Jan;127(1):75-82.

(iv) Whitehead JM, McNeill G, Smith JS. The effect of protein intake on 24-h energy expenditure during energy restriction. Int J Obes Relat Metab Disord. 1996 Aug;20(8):727-32

(v) Cota D, Proulx K, Smith KA, Kozma SC, Thomas G, Woods SC, Seeley RJ. Hypothalamic mTOR signaling regulates food intake. Science. 2006 May 12;312(5775):927-30.

(vi) Nagao T, Komine Y, Soga S, Meguro S, Hase T, Tanaka Y, Tokimitsu I Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr. 2005 Jan;81(1):122-9.

Mercury Detox – A 3-step Plan to Recover Your Health

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 16 Sep 2009 14:02:14 -0400

After my last blog, I'm sure many of you are depressed and discouraged about mercury and its toxic effects. The bad news is today I am going to review more of mercury’s toxic effects and expand on what I learned at the medical conference on mercury I mentioned in my last blog ...

But the good news is I will provide you with a clear, 3-step plan to help your body detoxify from mercury and recover your health. I have used this same plan successfully and safely with hundreds and hundreds of patients over the last 10 years -- and it’s the same process I used myself to overcome mercury toxicity!

But first, let's review the rest of the data presented at "The Impact of Mercury on Human Health and the Environment" conference that I began discussing last week.

Mercury and Autism: Part One

Last week, I talked a little bit about the link between mercury fillings and autism. Now I'd like to discuss mercury's effects on this condition in greater detail.

Boyd Haley, Ph.D., from the University of Kentucky Medical Center, is a vociferous opponent of dental amalgams. The toxicology literature and decades of his own research fuel his fervor.

The National Institutes of Health (NIH) funded his research for 25 years until he began to seriously call into question the safety of dental amalgams, the use of thimerosol (another form of mercury) in vaccines, and their correlation with autism.

His work is now funded by the private Wallace Foundation, run by the son of President Truman's vice-president, Henry Wallace, who died of ALS and who had been frequently exposed to mercury-containing fungicide on grain.

Dr. Haley believes that fish is not as big a contributor to mercury toxicity in humans as amalgams because methylmercury is generally excreted quickly while mercury vapor from amalgams is not.

At the conference he reported on the dramatic rise in autism rates. The numbers were stunning -- over 900 percent in less than a generation in California and 714 percent nationwide. The dramatic increase in autism rates in California was due in part to the introduction of the hepatitis B vaccine in 1990 and an increase in the overall vaccination schedule.

In 1999, thimerosol was removed from these vaccines as parents gained increased awareness of the danger it poses. You see, thimerosol is quickly converted to ethyl mercury in the body, where it moves rapidly from your blood to your brain. In the first three quarters of 2004 -- five years after thimerosol was removed from vaccines -- the data showed a decline in the incidence of autism in California for the first time.

Dr. Haley has observed that the lowest level of mercury is found in the birth hair of the most severely affected autistic children (i).

Interestingly, the 4 to 1 ratio of autism in males to females may, in part, be due to the effects of testosterone on mercury excretion. Antibiotics also prevent excretion of mercury, and antibiotic use is higher among autistic children.

Dr. Haley also reported on data showing a synergistic effect of heavy metals. For example, the dose of lead and mercury that would cause death in 1 out of 100 people is magnified when you are exposed to both lead and mercury, leading to a lethal dose 100 percent of the time when combined, even at low levels. You can find more information on this at Dr. Haley's website: www.trustfoundation.org.

As compelling as Dr. Haley’s presentation was, it is only the beginning of the story that connects mercury exposure to autism ...

Mercury and Autism, Part Two

Jane El Dahr, M.D., is the Chief of Pediatric Allergy, Immunology, and Rheumatology at Tulane University Health Sciences Center. She also discussed the possible link between thimerosol in vaccines and autism. (The data she presented is available at www.safeminds.org).
In California, rigorous standards for reporting autism have been put in place because social benefits are tied to accurate diagnosis -- so the increases there are very likely to be accurately recorded.

During the first 25 years this reporting was put in place, 6,527 cases of autism were reported. But then the rates skyrocketed. It took only 3 years during the 1990s to add another 6,596 cases. From 1987 to 1998 there was a 273 percent increase in autism cases in California!

In response, the Centers for Disease Control (CDC) and the American Academy of Autism released an "Autism Alarm" stating that 1 in 166 children in the US have autistic spectrum disorder (ASD). Currently, one-sixth of all children under the age of 18 have a developmental disability. That means nearly 20 percent of the population may suffer from this problem and may not be able to be productive members of society as a result.

Much of this could be due to mercury toxicity.

That's not just a guess -- it's based on the analysis of the actual doses of thimerosol received by children after the change in the vaccination schedule mentioned above. In people with a genetic susceptibility, such as a defect in the enzymes responsible for detoxifying heavy metals, prenatal and early postnatal exposure to mercury leads to neurologic damage resulting in autistic symptoms (ii).

Acrodynia, or "pink baby syndrome," from exposure to calomel or mercury in teething powder has similar symptoms to autism, providing us yet another link between mercury exposure and autism.

Other potential sources of early exposure in fetuses or infants include maternal amalgams, fish consumption, eardrops, and nasal drops. But vaccines may be more problematic than all of these. They present a significant source of mercury exposure in Rho-gam, influenza vaccines during pregnancy, and childhood immunizations.

It has been found that the maximum exposure from these vaccines in the first six months of life is 187.5 micrograms of mercury -- far exceeding limits set by the World Health Organization (WHO) and The Environmental Protection Agency (EPA).

According to the EPA, the "safe" daily level of mercury exposure for a 5 kilogram, 2-month-old infant is 0.5 micrograms or 0.1 micrograms per kg. But these limits are set for methyl mercury primarily from fish, not for ethyl mercury from vaccines. The typical 2-month vaccination schedule for a baby includes DTP, Hib, and HepB. Combined, these vaccines contain 62.5 micrograms of mercury.

That's a whopping 125 times the EPA limits for a single day exposure!

Like lead, there may be NO safe level -- and children are more susceptible to toxic effects than adults.

Dr. El Dahr said that there appears to be correlation between immune system malfunctioning in both autism and mercury toxicity. These specific immune abnormalities have been found in 30 to 70 percent of autistic children.

So what do we do about all of this mercury in our children and the resulting health problems?

Mercury in Children: Assessment, Diagnosis, and Treatment

Stephanie Cave, M.D., is on the clinical faculty of Louisiana State University Medical School, and since 1996 has treated over 2,300 children with autistic spectrum disorder. Her recent book, What Your Doctor May Not Tell You About Children's Vaccinations, outlines the data and debate in this highly charged field.

Dr. Cave reported on the increased incidence of autism in the last 30 years -- up from 1 out of 10,000 children to 1 out of 150 children and 1 of just 30 males in the United States.

The major toxicity from mercury that contributes to this epidemic, she said, is its ability to severely inhibit enzyme function and structural integrity.

At the conference, Dr. Cave critiqued a well-publicized study in the Lancet, which concluded that there was no toxic effect from thimerosol. She pointed out numerous problems with this study, including the fact that it used various amounts of thimerosol exposure and only involved 33 people.

Another study published in the Journal of the American Medical Association also reported no increased risk of autism with thimerosol (iii). But the problem with this study was that the authors were affiliated with the state-run Statens Serum Institute. Eighty percent of the Institute’s profits are from vaccines! The methodology was also called into question because of inconsistencies in their reporting system (iv).

Yet another study had even more ominous findings. A case control study of 221 children with autism and 18 controls found that after a DMSA challenge test, vaccinated autistic children had THREE times the level of mercury in their urine compared to controls (v).

The question that remains is how these kids with ASD should be treated. Dr. Cave reviewed her approach ...

Besides taking a developmental history, she does a thorough laboratory evaluation, testing for numerous things. Her treatment protocols include casein- (from dairy), gluten-, allergy- and seafood-free diets, removal of amalgam fillings, and detoxification support.

Key to the treatment is careful detoxification of heavy metals after repletion of cellular nutrients, repair of gut dysfunction, and enhancement of liver detoxification chemistry. Supplements and treatments may include multivitamins and minerals, essential fatty acids, magnesium, digestive enzymes, Coenzyme Q10, and antioxidants like selenium, zinc, and vitamins C, E, and A.

She also suggests bowel ecology restoration which may include anti-fungal drugs, antibiotics, herbs, probiotics, and glutamine.

Enhancement of liver detoxification is facilitated by Epsom salt baths, magnesium sulfate creams, and oral, intravenous, or topical glutathione.

Mercury and other heavy metal detoxification is achieved after a DMSA provocation challenge of 20mg/kg with a 10-hour urine collection. DMSA is given at a dose of 10mg/kg every 8 hours for 3 days, with 11 days off. The cycle is repeated 4 times, followed by another provocation challenge test.

The results of this protocol were impressive. Dr. Cave presented a number of cases where these treatments showed significant benefit and reductions in autistic symptoms!

But autism isn’t the only disease related to mercury toxicity. There are many others.

Mercury and Adult Illness: From Alzheimer's to Heart Failure

We’ve now seen the devastating effects that mercury toxicity can have on kids. The effects on adults are no less severe.

Robert Nash, M.D., is a practicing neurologist and the Chairman of the American Board of Metal Toxicology. At the conference, he reviewed mercury-associated diseases, mechanisms, controversies, and therapeutic options.

He suggests the toxic effects of mercury spread across a broad spectrum of diseases including autism, Alzheimer’s disease, ALS, multiple sclerosis, Parkinson’s disease, neurodevelopmental diseases, nephrotoxicity, and cancer.

The mechanism of mercury toxicity in the adult brain may be related to proteins involved in mercury excretion, including glutathione, glutathione transferase, metallothionine and ApoE. Mercury depletes glutathione and ascorbate (vitamin C), and inhibits thiamine (B1) and pyridoxine (B6).

Mercury can also affect the central nervous system by concentrating in the spinal fluid, and the kidneys by reducing concentrating capacity. And it inhibits nerve growth, and passes easily through the placental barrier. The chemical can also reduce nerve function and communication, which can lead to the development of neurofibrillary tangles -- a common feature of Alzheimer's. In fact, recent findings suggest that the gene Apo E 4 may increase the risk for Alzheimer's because it has an impaired ability to bind with mercury and transport it from the brain.

Dr. Nash suggests that most, if not all, abnormal biochemistry in the Alzheimer's brain can be mimicked by mercury. He further concludes that, biologically, the case of mercury as a cause of Alzheimer's disease is more complete than that for thimerosol-related causation of autism.

According to Dr. Nash mercury toxicity and retention is enhanced by factors found in the diet, antibiotics, other toxicants such as cadmium and lead, and genetic susceptibilities. So no level of mercury exposure from amalgams can be considered without risk!

In addition to the compelling evidence linking Alzheimer’s to mercury toxicity, research shows it may also be linked to cardiovascular disease.

Two studies have reported increased risk of heart attack while another has shown no risk. And the data presented on heart failure from unknown causes is very compelling as well. Biopsy samples found 22,000 times the level of mercury in people with heart failure from unknown causes compared to controls whose heart failure was caused by virus, heart attacks, or high blood pressure (vi).

One of my patients had this exact problem. She had no reason for heart failure -- but at 62, she was facing a heart transplant. When I discovered that she had mercury toxicity and treated her, she began to thrive again. Her cardiac function dramatically improved by 130 percent!

Despite all this bad news about the effects of mercury, Dr. Nash concluded on an optimistic note ...

First, he suggested that there appears to be a subset of the population that cannot effectively excrete mercury and is at greater risk than the general population. This susceptibility is likely due to genetic differences, diet, exposure to other toxicants, antibiotic use, etc.

Given that susceptibility, he argued that mercury is a risk factor in many diseases -- but can be safely measured. And he said that the body can be detoxified of mercury, mitigating some of its toxic effects. Of course, more studies should be done to shed light on this important topic. But we are on our way to finding answers to this important health concern.

I know some of what I have reviewed these last two weeks was pretty science heavy. But I wanted to take the time to share this fascinating research with you because I believe it's so important. I want people to know that just because this topic is mostly ignored by conventional medicine and dentistry, it isn't any less critical or relevant to our health or our children's health.

More importantly: It CAN be treated!

In my practice, I have seen the benefits of detoxifying from mercury. My patients have recovered from dementia, chronic fatigue, fibromyalgia, Parkinson’s disease, heart failure, multiple sclerosis, depression, autoimmune diseases like colitis and rheumatoid arthritis, and many other problems. Of course, that doesn't mean that mercury is THE cause of these conditions, but simply one of the many causes that has to be considered.

So now that you understand the powerful effect mercury can have on your health, let's review how you know if you have mercury toxicity, and then how to treat it.

Diagnosing and Treating Mercury Toxicity

The first thing to understand is that identifying mercury problems and detoxifying from them (or any other kind of heavy metal poisoning) has to be done VERY carefully and under the supervision of a physician trained in the techniques of metal detoxification, but it can be done safely and effectively with an educated doctor’s assistance.

What follows is a 3-step plan to find out if you are suffering from mercury poisoning and detoxifying from it. Understand that this approach has to be done carefully and systematically to make sure you get your body ready for removing the metals.

Step 1: Getting Ready for Detoxification

This process can take a few months, and I can't stress enough how important this preparation step is. It is accomplished by optimizing your nutritional status and detoxifying ability. Once this is done you will begin mobilizing and binding the metals in your body and excreting them through your urine, bile, stool, and sweat.

Here is what I recommend to my patients.

1. Optimize your gut function.

food allergens

dairy

gluten

2. Optimize your nutritional status for detoxification. Use healthy fats ( omega-3 fats, olive oil, and flax oil), amino acids (which boost all your liver's detoxification capacity), and minerals, particularly zinc and selenium (which help your body detoxify metals).

3. Enhance your liver's detoxification pathways. Take folate and vitamins B12 and B6 and eating sulfur-containing foods such as broccoli, collards, kale, daikon radish, garlic, onions, and omega-3 eggs, as well as supplements such as alpha-lipoic acid and n-acetylcysteine.

4. Use herbal support for detoxification. These include chlorella, cilantro, garlic, and milk thistle.

5. Start sauna therapy. Make sure you take adequate electrolyte and mineral replacements to prevent dehydration and mineral loss from the sweat.

6. Optimize elimination routes for metals including your urine, stool, and sweat. Use fluids, fiber, and saunas.

Step 2: Integrate Additional Steps to Support Detoxification

At this stage you can integrate the following to support your detoxification even more:

• Chlorella. Start with 1 pill three times a day and then build up to 3 pills three times a day for 3 months if tolerated -- take 30 minutes before meals and at bedtime.

• Supergarlic 6000 by Metagenics (or an equivalent product). Take 1 twice a day.

• Hepatothera forte (or an equivalent product). Take 1 capsule twice a day by Prothera (Selenium, n-acetylcysteine, lipoic acid, milk thistle).

Step 3: The Metal Detoxification Period

www.iaomt.org

This can be done slowly over time, but must be done VERY carefully and only under a trained biological dentist's supervision to avoid burdening yourself with more mercury during the removal process.

• Get a test to assess your total body load of mercury. This is called a challenge or provocation test. The easiest and safest way to do this is to take 500 mg of DMPS in one dose first thing in the morning after emptying your bladder, followed by a 6-hour urine collection. DMPS is a prescription drug and is not FDA-approved in the US, although it has been approved and used for decades in Europe.

The other option is to use DMSA, which is FDA-approved. It pulls out a lot less mercury and needs to be taken at a dose of 30 mg/kg for the challenge test. I find this is not as effective to get a true reading on what is in the body.

• Use binding agents to pull the mercury out of your body. There is a lot of controversy about the best way to do this. But after helping people detox from heavy metals for 10 years, I've found the safest and most effective treatment is oral DMSA.

It is taken as follows: One 100 to 250 mg capsule of DMSA orally three times a day before meals. Take it for 3 days. Then take 11 days off. Do this for 6 months. Then recheck your level of mercury through the challenge test.

• Do saunas daily -- especially on those days when doing DMSA.

• Consider getting intravenous vitamins and antioxidants for 3 months while undergoing this process this to administer glutathione, phospholipids, vitamin C, and B vitamins to boost detoxification. This is harder to get, but can help the process work better and help you feel better throughout the process.

• Drink enough filtered water and fluids to make urine clear.

• Make sure you have bowel movements twice a day. This is very important or you will reabsorb mercury from the gut. You can add ground flax seeds to shakes or foods, or take one to two 150-mg magnesium citrate capsules twice a day if you are not going regularly. You can also try even stronger laxatives if you have to such as senna or cascara.

• Consider whey protein to boost glutathione if you are not allergic to dairy.

Understand that I am simply sharing my experience and knowledge with you here. I recognize this is a controversial area. Unfortunately, there are no large controlled studies looking at this problem. I am working on getting studies on this and other areas of systems medicine and functional medicine funded so we can have better answers. For now, we have to go with what we know and the experience and knowledge of many physicians over many years of doing this.

Realize that we DO know how to help you detoxify effectively and deal with the effects of low level mercury toxicity! While it may be difficult you MUST find a doctor skilled at dealing with heavy metal toxicity to undergo the protocol above safely.

What I have outlined in this blog are only my guidelines. They may be the same or similar to what you find others are using. What is essential is that you get assistance. I DO NOT recommend you detox from mercury without a doctor’s supervision!

But I DO recommend you find out if mercury toxicity is a problem for you. It is an essential step to achieving lifelong vibrant health.

Now I'd like to hear from you...

Are you surprised by the links between mercury and conditions like Alzheimer's disease?

Do you agree with childhood vaccinations? Why or why not?

Have you tried detoxifying from mercury? What was your experience?

Please let me know your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

References

(i) Holmes AS, Blaxill MF, Haley BE. Reduced levels of mercury in first baby haircuts of autistic children. Int J Toxicol. 2003 Jul-Aug;22(4):277-85.

(ii) S Bernard. Autism: A novel form of mercury poisoning. Medical Hypothesis. 2001:56 (4): 462-471.

(iii) Hviid A. Association between thimerosal containing vaccine and autism. JAMA. 2003; 290: 1763-1766.

(iv) Rimland B, Bernard S. Letters. JAMA. 2004; 291:180-181.

(v) Bradstreet J. A case-control study of mercury burden in children with autistic spectrum disorders. Journal of American Physicians and Surgeons. Volume 8 Number 3 Summer 2003.

(vi) Frustaci A, Magnavita N, Chimenti C, Caldarulo M, Sabbioni E, Pietra R, Cellini C, Possati GF, Maseri A. Marked elevation of myocardial trace elements in idiopathic dilated cardiomyopathy compared with secondary cardiac dysfunction. J Am Coll Cardiol. 1999 May;33(6):1578-83.

Mercury -- How to Get this Lethal Poison Out of Your Body

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 09 Sep 2009 14:39:53 -0400

If you are heavy, it could be making you sick and tired and age prematurely. And I don't mean heavy with fat ...

I mean heavy with heavy metals -- like mercury!

Unfortunately, toxic mercury problems are common. Along with polar bears, beluga whales, ducks, otters, panthers, and all river fish as well as most large ocean fish, we humans are poisoning ourselves with mercury at ever increasing rates.

There's no doubt about it, mercury is the most alarming, disease-causing source of environmental toxicity that I see daily in my practice. Many of patients have toxic levels of mercury -- and they're not alone. I personally suffered from mercury toxicity and chronic fatigue syndrome --which I cured myself from, in part by getting rid of the mercury in my body. So I know about this first hand.

I became toxic because I polluted myself by growing up on tuna fish sandwiches, eating sushi, living in Beijing, which heats all its homes with coal -- the major source of environmental mercury load -- and having a mouthful of amalgam -- a.k.a. mercury -- fillings.

All of these exposures, combined with genes that prevent me from effectively detoxifying metals in my body, led to a slow and significant poisoning of my cells and mitochondria. And the effects were obvious ...

I felt weak, tired, and couldn't think, I had muscle pain and twitches, insomnia, digestive problems, food allergies, depression, and anxiety. And it was only by discovering high levels of mercury in my hair and urine -- and slowly detoxifying myself -- that I was able to get better.

I have seen this over and over in my patients, too. From chronic fatigue and fibromyalgia, to depression, anxiety, obesity, dementia, Parkinson’s disease, cancer, heart failure, and heart disease, the message is clear ...

We are being poisoned!

This is such an important public health and personal issue for so many people that I'm going to use this blog and next week’s blog to fully explain the extent of mercury issues and give you a comprehensive plan for reducing your exposure and healing from mercury toxicity. I'll show you the science behind mercury toxicity, share some stories about my patients who have suffered, and talk about the way we need to deal with this major health problem.

First, I'd like to share with you what I learned at one of the most important international conferences on mercury yet to be held. It was called "The Impact of Mercury on Human Health and the Environment" and was presented at Tulane University School of Public Health and Tropical Medicine in New Orleans.

There, a unique international group of policymakers, environmental scientists, toxicologists, biochemists, journalists, academic physicians, practicing pediatricians, neurologists, and dentists gathered.

We were there to make sense of the environmental impact, toxicology, basic science, public policy and health implications of one the least studied and perhaps greatest potential threats to our long-term health -- mercury. And I want to share some of what I learned at that conference with you.

Mercury Levels Are on the Rise

Barry Kohl, Ph.D. is an adjunct professor in the department of Earth and Environmental Sciences at Tulane University. At the conference he provided a unique overview of the impact of industrialization on environmental mercury levels through a description of the levels of mercury in the ice core extracted from the pristine Freemont Glacier in Wyoming.

There were small peaks in mercury concentration in the ice core from the 1815 Tambora volcanic eruption in Indonesia, the 1850-84 gold rush in California where mercury was used for smelting, the eruption in 1883 of the Sumatran volcano Krakatau 10,000 miles away, and the more recent Mount St. Helens eruption in 1980.

Overall, the changes in environmental mercury levels have been dramatic. Over the past 100 years, there has been a 30-fold increase in mercury deposition, 70 percent of which is from human sources.

In fact, there was an exponential peak in mercury occurring in the last 40 years due to major industrialization. Much of this mercury comes from coal-fired industrial plants and from chlor-alkali plants that use mercury in the process of making chlorine used in plastics, pesticides, PVC pipes, and more.

One note of hope was the reduction in industrial mercury emissions from 220 million pounds to 120 million pounds a year over the last 10 years. But that's small consolation when we're talking about a substance that is toxic in parts per million, not in millions of pounds.

And the more mercury we are exposed to, the more we are likely we are to be toxic.

Risk Increases with Dose

Harvey Clewell from the ENVIRON Health Sciences Institute, Ruston, Louisiana, reviewed the epidemiologic studies from the Seychelles and Faroe islands. He showed that your risk of toxicity increases with higher doses of mercury.
Now, there are different types of mercury. Nearly all human exposures to one type, methylmercury, come from fish.

In the Seychelle Islands, there seemed be little effect on kids from mercury; however their fish consumption was predominately from low-risk small reef fish that don't contain much mercury.

On the other hand, in the Faroe Islands people eat whale blubber, which contains high levels of mercury -- over 3 parts per million. There, high levels of mercury were found in umbilical cord blood and correlated with reduced performance in neurologic testing in 917 mother-infant pairs.

The health effects from methyl mercury upon infants and children depend on the dose. Severe symptoms start with exposure to doses of 100 mcg/kg/day, mild symptoms with more than 10 mcg/kg/day, and sub-clinical symptoms with less than 1 mcg/kg/day. These symptoms include late development in walking and talking and decreased performance on neurological tests.

Dr. Clewell also reviewed the limitations of various forms of testing for mercury.

Methylmercury (also called organic mercury) is found predominately in red blood cells, which is what doctors check when they do a blood test for mercury. But unless you’ve been eating fish with mercury recently, you won't see your total body level of mercury.

Plus, mercury is lipophilic, meaning that it concentrates in fatty tissues, especially in the brain, which is made mostly of fat. That means that blood levels aren't an accurate measurement of total body burden of mercury.

Inorganic mercury from dental fillings (amalgams) is found in plasma but is rapidly cleared and stored in your tissues. Inorganic mercury is also converted from methylmercury by the body and is the main form of mercury in brain, which can lead to dementia, autism, ADHD and more.

All of these are reasons you need to get comprehensive testing done to assess you total mercury load. I will review the test you need in a moment, but first I want to talk about how mercury gets in your body and what it does to your body and brain.

Health Effects of Mercury

We get mercury in our bodies from many different sources including mercury vapors in ambient air, ingesting it via drinking water, fish, dental amalgams, vaccines, occupational exposures, home exposures including fluorescent light bulbs, thermostats, batteries, red tattoo dye, skin-lightening creams, over-the-counter products such as contact lens fluid and neosynephrine, and more.

You absorb about 80 percent of inhaled mercury vapor and nearly 100 percent of the mercury in fish through your gut.

One this mercury is in your body it is then primarily distributed in the kidneys and brain and can be readily transferred to the fetus via the placenta.

The only way it can get out of your body is via urine, feces, expired air, and breast milk.
The major reason it is toxic to human biology is because mercury has the ability to bind to sulfur-containing molecules in the body (found in nearly every enzyme and in the mitochondria), as well as other chemical binding sites in the cells.

We've learned a lot about how this mercury effects us and our children from reported exposures to mercury over the last 100 years. These include epidemics such as the Minimata Bay exposures in Japan, acrodynia or pink disease in children from calomel (HgCl) used in teething powder, "mad hatter syndrome" or erethism, and methylmercury fungicide grain seed exposures in Iraq and Pakistan.

The symptoms and diseases these exposures have caused are varied and mimic many other conditions. Nervous system toxicity can cause erethism ("mad hatter syndrome" as mentioned above) with symptoms of shyness, laughing, crying, and dramatic mood swings for no apparent reason; nervousness; insomnia; memory problems; and the inability to concentrate.

Other neurologic symptoms may include encephalopathy (non-specific brain malfunction), nerve damage, Parkinsonian symptoms, tremor, ataxia (loss of balance), impaired hearing, tunnel vision, dysarthria (slurred speech), headache, fatigue, impaired sexual function, and depression.

Kidney toxicity leads to proteinura (protein in the urine) and acute renal failure.

Gastrointestinal symptoms include nausea, vomiting, diarrhea, and colitis.

Skin toxicity causes allergic dermatitis, chelitis (cracked corners of the mouth), gingivitis (gum disease), stomatitis (sores in the mucous membranes of the mouth) and excessive salivation.

Clearly, mercury toxicity is VERY serious business!

Dentistry and Mercury

One of the more controversial sources of mercury toxicity is dental fillings. Silver dental fillings, or amalgams, contain inorganic mercury. Mercury exposure from amalgams is estimated to be between 3 to 17 micrograms per day from chewing, brushing, grinding, and even slow corrosion.

Questions have arisen about whether or not this amount is toxic ... I am going to clear up the confusion here.

A recent study in the Journal of the American Medical Association found no significant neurologic or behavioral changes in children who had mercury amalgam (silver) fillings, compared to kids who had composite (white) fillings placed. But there were significant problems with that study ...

First, the duration of the study was short and the effects subtle. Second, they failed to emphasize the significance of the fact that the kids who had the silver fillings had much higher levels of mercury in their urine than the kids with white fillings.

This is one of the most important details of that study, because it proves that mercury fillings in your mouth release mercury vapor and this is absorbed into your body, ending up in your urine -- and getting deposited in your organs, including your brain, where it accumulates over time.

Whether your fillings are new or old, the mercury in them is constantly absorbed into your body. And even if you stop being exposed to that mercury, it sticks around. It takes up to 18 years for the body to clear half of the dose of mercury from the body. Once mercury is in the body it comes out only VERY slowly.

In fact, people with amalgam fillings have significantly elevated blood mercury levels, 3 to 5 times more mercury in the urine, and 2 to 12 times more mercury in their tissues than those without amalgam fillings.

However blood and urine mercury levels don't necessarily relate to the mercury load in your body tissues or severity of clinical symptoms.
Research on sheep and monkeys with dental amalgams has shown that blood mercury levels remained low -- even though their tissue mercury levels were raised.

Urine mercury levels aren't much better as an indicator of your total mercury load. They mainly reflect the cumulative dose of inorganic mercury in the kidneys and there exists only a very weak correlation with levels in other target tissues.

Another speaker at the conference, Mike Robichaux, a practicing dentist, reviewed his experience with removal of amalgams fillings. He showed a remarkable video of mercury vapor being released from a 25-year-old tooth. You can watch it on the website of the International Academy of Oral Medicine and Toxicology.

But other dentists aren't so concerned. In fact, the American Dental Association still says it is safe to use mercury or silver fillings. That's something I've always wondered about, since the Environmental Protection Agency (EPA) considers old mercury fillings that have been removed from the body toxic waste that has to be disposed as such.

Let me put this another way. It's apparently all right to put mercury fillings in your mouth -- but not to throw them out in the garbage!

The danger of amalgam fillings has been confirmed by research from around the world.

At the conference, Anders Lindvall, M.D., from the Foundation for Metal Biology in Sweden, reported his work on the health effects of dental amalgams and presented a review of the controversial literature on dental amalgams and human health.

Many of his patients reported a symptom complex consistent with chronic fatigue syndrome that they believed were related to dental amalgams. So in 1990, Dr. Lindvall began a study at Uppsala University Hospital in Sweden to diagnose and treat 796 patients with suspected amalgam-related illness and to develop and evaluate diagnostic tools to assess toxicity from dental amalgams. (i)

Besides conventional measures of quality of life and symptoms, unique laboratory assessments were used to determine the presence and immunological toxicity of metals.

One was PIXE, an accelerator-based test on single blood cells that assesses intracellular levels of trace elements, which showed that, in lymphocytes (white blood cells), mercury is found in the nucleus, particularly in places where zinc is low.

The other was MELISA, a test of lymphocyte reactivity to metal compounds. Information about the MELISA test is available at www.melisa.org. (ii)

Dr. Lindvall's patients were treated with antioxidants (B complex vitamins, vitamins C and E, and selenium); infections and jaw dysfunction were addressed; and selective removal of any incompatible dental material was performed using low-emission amalgam removal techniques and bio-compatible materials to replace the amalgams.

The cost of these procedures was covered by national health insurance.

Laboratory follow up at one year showed over 70 percent of patients reported significant improvement in symptoms after amalgam removal!

Unfortunately, this study had some problems too ...

The clinic was closed after the study was published, so there was no further access allowed to the records, which contained over 1,000 untreated patients who could have served as a control group. And since 1999, amalgam dental restorations in Sweden are no longer covered by insurance.

But Dr. Lindvall's study still suggests that silver amalgams can cause health problems -- and that removing the fillings can help relieve these problems.

And other studies have had similar effects.
Research has found that patients with chronic fatigue and autoimmune thyroiditis show improvement in their health status after their amalgam fillings are replaced with composites. (iii)

In another study, 71 percent of people with autoimmune diseases, including multiple sclerosis, improved after amalgam removal. Low-dose exposure to inorganic mercury may be a contributing factor in the development of autoimmune diseases. (iv)

Animal and lab studies suggest that exposure to metallic mercury may cause nerve cell damage and promote the production the plaques found in the brains of Alzheimer’s patients. (v)

Plus, we know that mercury levels in the human placenta correlate with the number of maternal amalgam fillings -- and a substantial amount of mercury from amalgams reaches the fetus.

Worse, mercury from dental amalgams in pregnant women may also contribute to development of autism in their children. In one study, mothers of 94 autistic children had statistically more amalgam fillings during pregnancy than 49 mothers of healthy kids. (vi)

In contrast to their higher mercury exposure during pregnancy, these autistic children had reduced mercury levels in their first haircut (mercury exposure can be measured in human hair). This may reflect a reduced capacity to excrete mercury from their body, which in turn may lead to elevated brain mercury levels.

And approximately 20 percent of the general public may experience sub-clinical central nervous system and/or kidney function impairment due to amalgam fillings.

When taken collectively, the research forces us to question the safety of dental amalgams. In my view, there is no doubt about it … they are a danger.

But before you start yanking out your fillings, there is something else to consider ...

Genetic Variations in the Ability to Detoxify

Some of us are very good at detoxifying mercury and other toxins, while some of us store toxins like a toxic waste dump. Genetic variations (called polymorphisms) make some people more prone to metal toxicity.

One gene in particular is very important because it's related to the body's production of glutathione, our most powerful detoxifier and antioxidant. Your body can only excrete mercury when it's bound with glutathione.

The polymorphism of the gene that controls the enzyme glutathione-S-transferase (GSST) prevents excretion of mercury. That is the gene problem I have that led to my mercury toxicity.

When that happens, the mercury stays in tissues and does damage. Plus, mercury also binds to key enzymes that help us produce glutathione -- in effect helping itself accumulate in our bodies.

Research also shows that people suffering from symptoms like fatigue, irritability, mood disorders, poor concentration, headaches, and insomnia due to their amalgam fillings are more likely than their peers to have the apolipoprotein E 4 (ApoE 4) gene. (vii)

ApoE 4 is known as the " Alzheimer’s gene." It also promotes heart disease. ApoE 4 reduces detoxifying activity. This means that people with this gene can't get rid of mercury from their brains, contributing to its toxic effects on this organ.

I know this all sounds very depressing. And it is. But the good news is that there are things you can do to reduce your exposure -- and identify if you have toxic levels of mercury.

So let me sum up what we learned in this week's blog and offer some suggestions for reducing your exposure.

10 Truths and Tips about Mercury Toxicity

2. The main ways that humans are exposed to mercury are from contaminated fish and dental amalgams or silver fillings.

3. Mercury can affect nearly all your organs, especially the brain, heart, kidneys, and guts.

4. Many chronic diseases may be caused or worsened by mercury, including neurologic disease, ADHD, autism, heart disease, autoimmune diseases, and more.

5. Some of us are genetically better adapted to detoxify mercury than others, leading to variable effects within the population.

6. You should reduce your exposure by avoiding large ocean fish (like tuna, swordfish, shark, and tilefish) and river fish. Eat only small wild fish. If it fits in your pan, it is probably okay.

7. Blood tests are relatively worthless for analyzing mercury toxicity, unless you have had a significant recent exposure or eat a lot of sushi or tuna.

8. Hair tests only check for mercury from fish, not from fillings so they only give you a partial picture.

9. The only way to find out your total body load of mercury is to take a medication with sulfur molecules that binds to the mercury like fly paper. This is called DMSA or DMPS.

This test should ONLY be done by a trained physician and involves taking one dose of this medicine, followed by a 6- or 24-hour urine collection to see how much comes out. (In my opinion, the most reliable testing is done by www.doctorsdata.com).

10. If you are toxic and sick, you may consider addressing your dental health by seeing a biological dentist who can safely help you deal with mercury in your mouth.

Going to see a conventional dentist who drills out your fillings without any precautions or protection can lead to serious health consequences. I strongly advise against it. However, amalgam filling removal CAN be done safely and effectively done by a dentist trained in the correct techniques.

That’s all for this week. Next week, I'll give you more advice on how to safely eliminate the mercury in your body if you find you are toxic. Finding out if you are poisoned by mercury, limiting your exposures, and getting the mercury out of your body is absolutely critical if you want to achieve lifelong vibrant health.

Now I'd like to hear from you...

Do you think mercury toxicity is a legitimate health concern or a bogus problem?

Do you have any symptoms of mercury toxicity and what have you done about them?

Have you asked your doctor about mercury toxicity and if so, what was his/her response?

Are you exposed to many sources of mercury? What could you do to reduce your exposure?

Please let me know your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

References

(i) Lindh U. Removal of dental amalgam and other metal alloys supported by antioxidant therapy alleviates symptoms and improves quality of life in patients with amalgam-associated ill health. Neuroendocrinology Letters. 2002; 23(5/6):459-482.

(ii) Stejskal V. Metal-specific lymphocytes: biomarkers of sensitivity in man. Neuroendocrinology Letters. 1999;20:289-298.

(iii) Sterzl I., et al. Mercury and nickel allergy: Risk factors in fatigue and autoimmunity. Neuroendocrinology Letters. 1999; 20: 221-228.

(iv) Prochazkova, J., et al. The beneficial effect of amalgam replacement on health in patients with autoimmunity. Neuroendocrinology Letters. 2004; 25(3): 211-218.

(v) Stejskal, J. and Stejskal, V. The role of metals in autoimmunity and the link to neuroendocrinology. Neuroendocrinology Letters. 1999; 20: 351-364.

(vi) Holmes, A.S., et al. Reduced levels of mercury in first baby haircuts of autistic children. International Journal of Toxicology. 2003. 22(4): 277-285.

(vii) Wojcik, D.P. et al. Mercury toxicity presenting as chronic fatigue, memory impairment, and depression: Diagnosis, treatment, susceptibility, and outcomes in a New Zealand practice setting (1994-2006). 2006. Neuroendocrinology Letters. 27(4): 415-423.

Vitamin D -- Why You Are Probably NOT Getting Enough

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 02 Sep 2009 15:50:45 -0400

What vitamin do we need in amounts up to 25 times higher than the government recommends for us to be healthy?

What vitamin deficiency affects over half of the population, is almost never diagnosed, and has been linked to many cancers, high blood pressure, heart disease, diabetes, depression, fibromyalgia, chronic muscle pain, bone loss, and autoimmune diseases like multiple sclerosis?

What vitamin is almost totally absent from our food supply?

What vitamin is the hidden cause of so much suffering that is so easy to treat?

The answer to all of these questions is vitamin D.

Over the last 10 years of my practice, my focus has been to discover what the body needs to function optimally. And I have become more interested in the role of specific nutrients as the years have passed.

Two recent studies in the journal Pediatrics found that 70 percent of American kids aren't getting enough vitamin D, and this puts them at higher risk of obesity, diabetes, high blood pressure, and lower levels of good cholesterol. Low vitamin D levels also may increase a child's risk of developing heart disease later in life.

Overall, 7.6 million, or 9 percent, of U.S. children were vitamin-D deficient, and another 50.8 million, or 61 percent, had insufficient levels of this important vitamin in their blood.

Over the last 5 years, I have tested almost every patient in my practice for vitamin D deficiency, and I have been shocked by the results. What’s even more amazing is what happens when my patients' vitamin D status reaches optimal levels. Having witnessed these changes, there's no doubt in my mind: vitamin D is an incredible asset to your health.

That is why in today’s blog I want to explain the importance of this essential vitamin and give you 6 tips on how to get optimize your vitamin D levels.

Let’s start by looking at the massive impact vitamin D has on the health and function of every cell and gene in your body.

How Vitamin D Regulates Your Cells and Genes

Vitamin D has a huge impact on the health and function of your cells. It reduces cellular growth (which promotes cancer) and improves cell differentiation (which puts cells into an anti-cancer state). That makes vitamin D one of the most potent cancer inhibitors -- and explains why vitamin D deficiency has been linked to colon, prostate, breast and ovarian cancer.

But what's even more fascinating is how vitamin D regulates and controls genes.

It acts on a cellular docking station called a receptor that then sends messages to our genes. That's how vitamin D controls so many different functions -- from preventing cancer, reducing inflammation, boosting mood, easing muscle aches and fibromyalgia, and building bones.

These are just a few examples of the power of vitamin D. When we don’t get enough it impacts every area of our biology, because it affects the way our cells and genes function. And many of us are deficient for one simple reason ...

Your body makes vitamin D when it's exposed to sunlight. In fact, 80 to 100 percent of the vitamin D we need comes from the sun. The sun exposure that makes our skin a bit red (called 1 minimum erythemal dose) produces the equivalent of 10,000 to 25,000 international units (IU) of vitamin D in our bodies.

The problem is that most of us aren’t exposed to enough sunlight.

Overuse of sunscreen is one reason. While these product help protect against skin cancer -- they also block a whopping 97 percent of your body's vitamin D production.

If you live in a northern climate, you're not getting enough sun (and therefore vitamin D), especially during winter. And you're probably not eating enough of the few natural dietary sources of vitamin D: fatty wild fish like mackerel, herring, and cod liver oil.

Plus, aging skin produces less vitamin D -- the average 70 year-old person creates only 25 percent of the vitamin D that a 20 year-old does. Skin color makes a difference, too. People with dark skin also produce less vitamin D. And I've seen very severe deficiencies in Orthodox Jews and Muslims who keep themselves covered all the time.

With all these causes of vitamin D deficiency, you can see why supplementing with enough of this vitamin is so important. Unfortunately, you aren’t really being told the right amount of vitamin D to take.

The government recommends 200 to 600 IU of vitamin a day. This is the amount you need to prevent rickets, a disease caused by vitamin D deficiency. But the real question is: How much vitamin D do we need for OPTIMAL health? How much do we need to prevent autoimmune diseases, high blood pressure, fibromyalgia, depression, osteoporosis, and even cancer?

The answer is: Much more than you think.

Recent research by vitamin D pioneer Dr. Michael Holick, Professor of Medicine, Physiology, and Dermatology at Boston University School of Medicine, recommends intakes of up to 2,000 IU a day -- or enough to keep blood levels of 25 hydroxy vitamin D at between 75 to 125 nmol/L (nanomoles per liter). That may sound high, but it's still safe: Lifeguards have levels of 250 nmol/L without toxicity.

Our government currently recommends 2,000 IU as the upper limit for vitamin D -- but even that may not be high enough for our sun-deprived population! In countries where sun exposure provides the equivalent of 10,000 IU a day and people have vitamin D blood levels of 105 to 163 nmol/L, autoimmune diseases (like multiple sclerosis, type 1 diabetes, inflammatory bowel disease, rheumatoid arthritis, and lupus) are uncommon.

Don't be scared that amounts that high are toxic: One study of healthy young men receiving 10,000 IU of vitamin D for 20 weeks showed no toxicity.

The question that remains is: How can you get the right amounts of vitamin D?

6 Tips for Getting the Right Amount of Vitamin D

Unless you're spending all your time at the beach, eating 30 ounces of wild salmon a day, or downing 10 tablespoons of cod liver oil a day, supplementing with vitamin D is essential. The exact amount needed to get your blood levels to the optimal range (100 to160 nmol/L) will vary depending on your age, how far north you live, how much time you spend in the sun, and even the time of the year. But once you reach optimal levels, you'll be amazed at the results.

For example, one study found that vitamin D supplementation could reduce the risk of getting type 1 diabetes by 80 percent. In the Nurses' Health Study (a study of more than 130,000 nurses over 3 decades), vitamin D supplementation reduced the risk of multiple sclerosis by 40 percent.

I've seen many patients with chronic muscle aches and pains and fibromyalgia who are vitamin D deficient -- a phenomenon that's been documented in studies. Their symptoms improve when they are treated with vitamin D.

Finally, vitamin D has been shown to help prevent and treat osteoporosis. In fact, it's even more important than calcium. That's because your body needs vitamin D to be able to properly absorb calcium. Without adequate levels of vitamin D, the intestine absorbs only 10 to 15 percent of dietary calcium. Research shows that the bone-protective benefits of vitamin D keep increasing with the dose.

So here is my advice for getting optimal levels of vitamin D:

2. Take the right type of vitamin D. The only active form of vitamin D is vitamin D3 (cholecalciferol). Look for this type. Many vitamins and prescriptions of vitamin D have vitamin D2 -- which is not biologically active.

3. Take the right amount of vitamin D. If you have a deficiency, you should correct it with 5,000 to 10,000 IU of vitamin D3 a day for 3 months -- but only under a doctor's supervision. For maintenance, take 2,000 to 4,000 IU a day of vitamin D3. Some people may need higher doses over the long run to maintain optimal levels because of differences in vitamin D receptors, living in northern latitudes, indoor living, or skin color.

4. Monitor your vitamin D status until you are in the optimal range. If you are taking high doses (10,000 IU a day) your doctor must also check your calcium, phosphorous, and parathyroid hormone levels every 3 months.

5. Remember that it takes up to 6 to 10 months to "fill up the tank" for vitamin D if you're deficient. Once this occurs, you can lower the dose to the maintenance dose of 2,000 to 4,000 Units a day.

6. Try to eat dietary sources of vitamin D. These include:

• Fish liver oils, such as cod liver oil. 1 TBSP (15 ml) = 1,360 IU of vitamin D

• Cooked wild salmon. 3.5 oz = 360 IU of vitamin D

• Cooked mackerel. 3.5 oz = 345 IU of vitamin D

• Sardines, canned in oil, drained. 1.75 oz = 250 IU of vitamin D

• One whole egg = 20 IU of vitamin D

You can see now why I feel so passionately about vitamin D. This vitamin is critical for good health. So start aiming for optimal levels -- and watch how your health improves.

Now I’d like to hear from you ...

Have you experienced any symptoms of vitamin D deficiency?

Do you think you are not getting enough sun?

Have you experienced any health benefits from getting more sun or correcting a vitamin D deficiency you may have had?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

5 Simple Steps to Cure IBS without Drugs

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 26 Aug 2009 14:00:36 -0400

Imagine having a condition with symptoms so severe that you can't leave the house, yet your doctor calls it a "functional," or "psychosomatic," disease -- meaning that it's all in your head.

Frustrating? Absolutely.

But it's a very real problem for the 60 million people -- that's 20 percent of Americans -- who have irritable bowel syndrome (IBS). These people are plagued by uncomfortable and often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain.

I have lots of patients with IBS, some of whom have suffered for decades without relief. Their previous doctors couldn't find the cause of the illness, so they were told to just get more fiber or take Metamucil, or were prescribed sedatives, anti-spasm drugs, or antidepressants.

That is NOT the answer. I've found a better way. And in today’s blog I am going to share 5 steps you can take right now to cure IBS without drugs.

But first I want to tell you about a patient of mine ...

Alexis and Her Lifelong Irritable Bowel

At age 45, Alexis had suffered from IBS for 33 years -- almost all of her life! Her major symptom was sudden, painful, cramping diarrhea. She was doing the best she could to prevent it. She didn't consume dairy, didn't drink or smoke, and took Citracel every day. Yet nothing helped.

She would go to the bathroom 4 to 5 times before she even left the house in the morning. And she couldn't go out of the house at all without knowing where all the closest bathrooms would be in case she had what she called "s--- attacks."

That wasn't Alexis' only problem ... She also felt full and bloated after every meal, which starchy foods made worse.

An upper endoscopy had shown that she had gastritis, or inflammation of the stomach, and she had taken many antibiotics over the years. She also had severe premenstrual syndrome (PMS), with irregular periods, breast tenderness, sugar cravings, headaches, and agitation.

She also had unusual symptoms like rectal itching (often a clue to yeast infections or food allergies). And she was tired all the time.

Alexis tried to eat healthy, but her diet was less than ideal. She had a bran muffin and coffee in the morning and a salad for lunch. But her "drug of choice" was sugar -- in the form of cakes, ice cream, Jell-O, diet sodas, and other junk food. Not surprisingly, she was also about 20 pounds overweight.

To help Alexis, all I really did was identify and treat the UNDERLYING CAUSES of her digestive problems! To understand how I did that, you first have to understand a little bit about how the gut works.

How Gut Imbalances Can Lead to IBS

Imagine a tennis court. That is the surface area of your small intestine, where food is absorbed. Your small intestine is also the site of about 60 percent of your immune system. And this sophisticated system gut-immune system is just one-cell layer away from a toxic sewer -- all of the bacteria in your gut.

If that lining breaks down -- from stress, too many antibiotics or anti-inflammatory drugs, intestinal infections, a low-fiber, high-sugar diet, alcohol, and more -- look out! Your immune system will suffer and you can develop all sorts of digestive problems -- including IBS.

Let's talk a little more about all that bacteria. You've got about 3 pounds of it -- 500 species -- in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.

If the bad guys take over -- or if they move into areas that they shouldn't (like the small intestine which is normally sterile) -- they can start fermenting the food you digest, particularly sugar or starchy foods.

This is called small bowel bacterial overgrowth -- and it's a major cause of IBS.

The major symptom it causes is bloating, or a feeling of fullness after meals. What causes this bloating? The overproduction of gas by the bacteria as they have lunch on your lunch!

Small bowel bacterial overgrowth can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.

Bacterial overgrowth is a real syndrome and was recently described in a review paper published in the Journal of the American Medical Association. The condition can be treated. In fact, a major paper was recently published in the Annals of Internal Medicine that showed using a non-absorbed antibiotic called rifaximin for 10 days resulted in a dramatic improvement in bloating and overall symptoms of IBS by clearing out the overgrowth of bacteria.

That's great news for many IBS patients. But, unfortunately, not all patients with the same diagnosis are created equal. There's more than one factor that leads to IBS. Another major cause of IBS is food sensitivities.

A landmark paper, was recently published in the prestigious British medical journal Gut that found eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms. Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.

So the research tells us that these are the two main causes of irritable bowel -- food allergies and overgrowth of bacteria in the small intestine -- but there may be others, including a lack of digestive enzymes, parasites living in the gut, zinc or magnesium deficiency, and more.

And this is precisely why it is so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS -- the solution is most certainly not a one-size-fits-all one. But solutions can be found if we look carefully at the underlying causes and treat them.

Which leads me back to Alexis ...

How I Helped Alexis Heal from IBS

I prescribed Alexis a non-absorbed antibiotic, an antifungal drug for her yeast problem, and had her eliminate the foods to which she was allergic. I believe in treatment that addresses the underlying cause of the problem. If there is a bacterial or yeast infection, then medications are often the best treatments. The key is to effectively treat the cause. If medications do that, then I use them.

Then I gave her supplements of healthy bacteria to normalize her gut and zinc to help with her digestive enzymes (chronic diarrhea can result in zinc deficiency).

I also gave her extra fiber to feed the healthy bacteria, fish oil to reduce gut inflammation, a multivitamin, and herbs to balance her hormones (which are greatly affected by abnormal bacteria).

What happened then may shock some, but I wasn’t surprised. It is the same result I have seen in patient after patient when the principles of functional medicine are applied ...

Alexis came back to see me two months later, and she was a different person. Not only did she lose 20 pounds, she had not had a "s---- attack" and was having normal bowel habits for the first time in 33 years! She also had more energy, and her PMS vanished.

She looked and felt 10 years younger and was free of the suffering she had endured for over three decades.

Do you suffer like Alexis did? It doesn't have to be that way. We have the understanding and tools to deal with this chronic problem and the suffering it causes one in five people. There is no need to wait for any more studies. I have been treating IBS in my practice for over 10 years with dramatic success.

In fact, just recently, one of my patients told me that, for the first time in his life, he didn't have any more stomach pains or digestive problems. He had previously been so bad that he had to have a phone installed in his bathroom!

To take advantage of these discoveries today, simply follow these five steps.

5 Steps to Curing IBS

1. Get tested.

Immunolabs

2. Test yourself. If you can't afford the test mentioned above, then just eliminate the most common food allergens for 12 weeks -- that's dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them to see if they cause symptoms. This is an effective way to isolate the foods that may be causing you problems.

3. Get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin (Xifaxin) and take two 200 mg tablets 3 times a day for 7 to 10 days. This is often the best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome.

4. Repopulate your digestive tract with good bacteria. I don't usually recommend brands, but when it comes to probiotics the quality varies so much that I suggest taking two specific brands. Take one packet of VSL3 or other high potency probiotic twice a day for 1 to 2 months. This probiotic has over 450 billion organisms per packet. I also recommend a probiotic called S. boulardii take two capsules twice a day for 2 months. This is a special probiotic that helps to further normalize gut function.

5. Read more about the condition and your options. My favorite book on this subject is Digestive Wellness by Elizabeth Lipski.

By taking these steps and seeking out the underlying causes of IBS, you can dramatically improve your health and overcome your digestive disorder.

Now I'd like to hear from you...

Do you have IBS? How long have you had it and how has it been treated?

Have you noticed whether stress, certain foods, or other factors affect your symptoms and how?

Have you tried any of the recommendations in this blog? How have they helped?
Do you have any other suggestion for successfully treating IBS?

Please let me know your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

Resveratrol—Eat Whatever and Live to 120?

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 18 Aug 2009 12:40:33 -0400

"Live to 120 years old by eating as much as you want and drinking lots of red wine!"

That's the intriguing finding of a recent study from Harvard researcher David Sinclair and his group.

The only catch is that you'd have to drink about 1,500 bottles of wine a day to get those results. Of course, that would kill you pretty quickly -- before you'd have a chance to reach age 120! Still, those are important findings ...

In fact, Dr. Sinclair thinks they're so important that he started a company to produce a pharmaceutical derivative of the active compound in red wine, resveratrol.

Although his findings have merit, I think he is misguided in his attempt to find a "magic pill" that will allow you to eat whatever you want and live forever. The body is much more complex than that.

This week, I'm going to explain why a magic pill WON'T work -- and provide ten tips that really WILL help you live longer and prevent all the diseases of aging.

Why "Magic Pills" Don’t Work

Don't get me wrong. Dr. Sinclair is on the right track. But I believe he's focused on the wrong thing. In looking for that "magic pill," he's not taking into account the bigger picture.
That approach will always fail.

Sure, there has been a lot of fanfare about this new "drug" resveratrol that can extend your life span and let you eat whatever you want and have the fitness of a trained athlete without any exercise. But that's wrong on a couple of counts ...

First, resveratrol isn't a drug at all. It's a natural plant defense molecule, or " phytonutrient," that's found in grapes (and therefore red wine), as well as in peanuts, berries, and a Chinese herb called hu zhang.

Second, all the excitement reinforces the idea that a single molecule (whether from a drug or a plant) can solve all our health problems. In functional medicine we look at ALL the systems of the body. We need to consider resveratrol as just ONE of many healthful plant compounds.

You see, resveratrol is just one of thousands of polyphenols, which make up just one class of phytonutrients. These phytonutrients act in many ways, the most important of which is as a genetic control system, turning on and off genes that help us stay healthy.

This is the science of nutrigenomics -- which describes how food is information that tells our bodies what to do, not just a source of calories we need for energy.

I believe that all the excitement about resveratrol is misguided. Everyone is looking for a quick fix, and scientists (especially ones who start pharmaceutical companies to market their discoveries) are looking to make a quick buck.

There is nothing wrong with either. But in order to find the real secret to longevity and to healthy aging and fitness, we need to look at how this compound works and learn from that how to keep ourselves healthy.

The secret lies in our mitochondria.

Mitochondria: The Real Secret to Healthy Aging and Lifelong Fitness

Mitochondria are the little organs in every cell that turn oxygen and food into energy.

For now, let's examine two recent studies that shed light on these mighty little organs that hold the key to health, weight loss, and longevity.

In the first study, published in Nature, Dr. Sinclair and his colleagues gave one group of mice a diet high in fat (60 percent of calories). What happened then was interesting ...

In middle age they all became obese, got diabetes and fatty livers, and died early.

Another group of mice were fed the same diet, but also received resveratrol at a dose of 24 mg/kg of body weight. That's the equivalent of the amount of resveratrol found in about 750 to 1,500 bottles of wine a day! What happened to those mice was even more interesting ...

They still got fat -- but lived longer and did not develop diabetes. They were also more agile and had more endurance than the rats that didn't get the resveratrol. Interestingly, their cholesterol profiles didn't improve -- BUT they didn't get heart disease, showing that cholesterol is not the big evil we think it is.

Let's take a closer look at what these findings really mean.

In this study, resveratrol produced changes associated with longer lifespan and produced the following biologic effects:

• It reduced levels of insulin-like growth factor-1 (IGF-I), a molecule related to the growth hormone that promotes cancer growth.

• It increased AMP-activated protein kinase (AMPK), a signaling system in the body that controls insulin sensitivity and can prevent diabetes.

• It increased peroxisome proliferator-activated receptor coactivator-1 (PGC-1) activity. This is a critical signaling system that turns on genes that improve blood sugar control and improve mitochondrial function.

• It increased the numbers of mitochondria, which boosts the capacity to turn food into energy and burn calories.

• It improved motor function, making the old rats more agile.

• And finally, the resveratrol helped prevent the effects of aging by modifying 144 out of 153 metabolic pathways that are controlled by genes.

This all sounds good. And it is! But the most important thing that these findings tell us is ignored by Sinclair and his colleagues.

They tell us that aging and disease are controlled in large part by SUGAR and insulin function in the body!

In a moment I will explain how you can use this information to reverse disease, lose weight, and live longer and healthier. But first, let me tell you about the second study, which in some ways was even more dramatic.

That study, which was published in Cell by Johan Auwerx from the Institute of Genetics and Molecular and Cell Biology in Illkirch, France, tested much higher doses of resveratrol in mice. These doses were 18 times higher than those in the first study. That's 400 mg/kg of resveratrol -- equal to about 360 daily capsules of resveratrol for a 130-pound person!

Imagine achieving the fitness of a trained athlete, staying thin, preventing diabetes and heart disease, and living to 120 years old -- all while eating a high-calorie, high-fat diet (and taking 360 pills a day of resveratrol)! That's the equivalent of what happened to the rats.

Specifically, the rats fed the high doses of resveratrol along with their high-calorie, high-fat diet showed the following effects:

• They didn't develop pre-diabetes or metabolic syndrome.

• They increased the number of energy-producing mitochondria in their muscle cells.

• Their metabolic thermostat was turned up and they increased fat burning by increasing thermogenesis.

• They increased their endurance and aerobic capacity (without exercise).

• They maintained their cells' sensitivity to insulin, resulting in better blood sugar control.

Plus, they had enhanced muscle strength, reduced muscle fatigue, and improved coordination. And resveratrol increased the activity of PGC-1 alpha, which in turn controls genes that affect blood sugar control -- with no bad effects on their organs.

This seems incredible! But it's all very plausible if you understand the root causes of obesity, aging, and disease. Those causes are blood sugar control and the health, number, and function of your mitochondria.

It's unlikely that taking ONLY resveratrol -- even at high doses -- will allow us to live a life of sloth and gluttony and be disease-free forever. But what these studies do tell us is VERY important.

When we view these findings from a systems perspective -- understanding ALL the influences on blood sugar control, insulin, and our mitochondrial function -- we can create a lifestyle and program that works to keep us healthy, thin, and young.

Recently, I was at a conference on longevity and aging and had a chance to converse with Dr. Leonard Guarente from the Massachusetts Institute of Technology. In 1995, Dr. Guarente discovered a gene called SIR-2 in yeast that controls longevity. He was a teacher of David Sinclair, who authored one of the recent studies on resveratrol I discussed above.

I asked Dr. Guarente what REALLY was at the root of the effects of this master gene that controls longevity (called SIRT-1 in humans). Resveratrol works through this gene. His answer was quite simple. It was ...

... SUGAR!

This gene has its master effects on aging by improving how the body controls sugar and insulin sensitivity.

This isn't really surprising. All the effects of aging are increased by worsening blood sugar control -- even before you get diabetes. People with diabetes have smaller and more poorly functioning mitochondria and get cancer, heart disease, and dementia at far greater rates than the general population.

So if we could fix our blood sugar control and boost our mitochondria, we could live longer and disease-free.

Considering this, let's look at the big picture again ...

Taking a magic pill just won't do the trick. That's especially true if you factor in all the other real-life insults that affect us, such as poor diet, stress, environmental toxins, and a sedentary lifestyle -- all of which affect blood sugar control and mitochondria.

Instead, you need to know ALL the factors that DAMAGE your blood sugar control and mitochondria. And you need to know ALL the factors that IMPROVE or boost your blood sugar control and mitochondria.

These are just the back-to-the-basics principles of functional medicine that I’ve been talking about for years -- identify the bad stuff and take it away; identify the good stuff and add it.

So what can you do to live longer and stay disease-free -- other than drink 1,500 bottles of wine or take 360 pills of resveratrol a day? Here is just a partial list!

Ten Tips to Help You Live a Longer and Healthier Life

1. Balance your blood sugar.

fiber

2. Eat protein with every meal. This helps balance your blood sugar. Include nuts, beans, fish, lean animal protein, and omega-3 eggs in your diet.

3. Increase your intake of omega-3 fats. These improve blood sugar control by working on the same cell-signaling mechanisms as resveratrol. Eat wild fish (salmon, sardines, black cod, and herring) or take omega-3 fatty acid pills (1,000 to 2,000 mg of EPA and DHA a day).

4. Eliminate or dramatically limit flour products. That means anything with sugar from any source.

5. Find ways to relax every day. This prevents diabetes and controls your blood sugar by reducing levels of cortisol, the stress hormone.

6. To boost your mitochondria, you will need to exercise and build muscle. Try interval training, a technique of exercising fast (like sprinting) for one minute and then more slowly (like fast walking) for three minutes. Repeat this in cycles totaling 30 minutes twice a week.

7. Eat foods with phytonutrients. There are many protective ones other than resveratrol, including those found in green tea, pomegranate, and all dark, colorful fruits and vegetables.

8. Consider supplements that help protect and boost your mitochondria. These include Coenzyme Q10 (100 to 200 mg a day), acetyl-l-carnitine (500 to 1,000 mg twice a day), alpha-lipoic acid (100 to 200 mg twice a day), D-ribose (5 g once or twice a day), magnesium (150 to 300 mg twice a day), B-complex vitamins (daily), and NADH (5 to 10 mg a day).

9. Live clean and green. Limit your exposure to heavy metals, pollution, and other environmental toxins -- all of which poison your mitochondria.

10. Learn how to detoxify. Support your body’s detoxification system and your liver function.

This is just a start of what you can do.

Just remember -- you will need to take a comprehensive approach to health, leveraging the latest research to help you improve your metabolism, stay thin, and live longer. There are no quick fixes. But addressing your whole system will give you a huge advantage!

Now I'd like to hear from you ...

What do you think about the constant drive to find a "magic pill" to cure all our health woes?

Have you experienced any instances of looking at the big picture of your health versus trying to solve all your problems with a "magic pill"? What were the results?

Have you tried taking resveratrol supplements? Did you notice any effects?

What are you doing to improve your mitochondrial function?

Have you experienced any health or weight loss benefits by getting your own blood sugar and insulin under control?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

3 Simple Steps to Eliminate Heartburn and Acid Reflux

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 12 Aug 2009 14:04:35 -0400

Are millions of us born with a genetic defect that makes us produce too much stomach acid?

Do we just have a major evolutionary design flaw that requires us to take powerful acid-blocking drugs to prevent heartburn and reflux?

I believe that the answer to all of these questions is a resounding "no."

In this week's blog, I'll explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes.

The Truth about Acid-Blocking Medications

At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or GERD (gastroesophageal reflux disease, also known as heartburn) affects a whopping 25 to 35 percent of the US population!

As a result, acid-blocking medications are the third top-selling type of drug in America today. Two other drugs to treat reflux, Nexium and Prevacid, are in the top 10 best-selling drugs and account for $5.7 and $4.0 billion in sales annually!

Things have certainly changed since I was in medical school.

In those days, GERD wasn't even considered a serious disease. Instead, people had heartburn or ulcers, but that was pretty much it.

And when acid-blocking drugs first came on the market, even the pharmaceutical representatives warned us how powerful these drugs were. They told us not to prescribe them any longer than 6 weeks and only for patients with documented ulcers.

What a difference a few decades make!

Now, these drugs are given like candy to anyone who ate too many hot dogs at a ball game -- and one drug, Prilosec, is now available without a prescription.

No wonder these drugs are so popular. Their manufacturers have created the illusion that we can eat whatever we want with no consequences, just by popping a pill.

They even have commercials showing a family rushing to stop their father from eating a big sausage with fried onions and peppers -- and he tells them not to worry because he took his acid-blocking pill!

I know someone who used to work for the makers of Pepcid. He told me that when it first became available over the counter, teams of drug company representatives would stand at the gates of county fairs and southern barbeques and hand out free samples.

Talk about sending a bad message!

In reality, acid-blocking drugs are a double-edged sword.

Let's look at some of the recent research on the dangers of these drugs.

Acid blocking drugs obviously block acid that can cause symptoms of heartburn and reflux. But your body actually needs stomach acid to stay healthy.

We know that stomach acid is necessary to digest protein and food, activate digestive enzymes in your small intestine, keep the bacteria from growing in your small intestine, and help you absorb important nutrients like calcium, magnesium, and vitamin B12.

So what happens when you take acid-blocking drugs?

There's evidence that these medications can prevent you from properly digesting food, cause vitamin and mineral deficiencies, and lead to problems like irritable bowel syndrome, depression, hip fractures, and more.

Studies show that people who take acid-blocking medications for the long term can become deficient in vitamin B12, which can lead to depression, anemia, fatigue, nerve damage, and even dementia, especially in the elderly.

The research also tells us that taking these drugs can cause dangerous overgrowth of bacteria in the intestine called Clostridia, leading to life-threatening infections.

For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain, and diarrhea (many of the common "side effects" noted in the warnings for these drugs).

This can cause irritable bowel syndrome.

And a recent study in the Journal of the American Medical Association found that chronic use of acid-blocking drugs leads to an increase in the development of osteoporosis and increase in hip fracture because blocking acid prevents the absorption of calcium and other minerals necessary for bone health.

And all this is only part of the problem! There have even been some reports that these drugs may increase the risk of certain cancers.

These are serious problems -- and it's pretty clear that in this case, the "cure" of acid-blocking drugs is worse than the "disease" of GERD. But that's of little comfort when you're suffering from heartburn.

So if drugs are not the answer, what is? We need to find the real causes of reflux and heartburn -- get rid of them! And we need to use the right foods, nutrients, and lifestyle therapies to heal the problem.

What Causes GERD?

Fried food, alcohol, caffeine, and soda can all trigger reflux. Spicy, tomato-based or citrus foods may also cause problems for some people. Smoking also increases the risk of reflux. Being overweight and having your belly fat push up on your stomach can prevent it from emptying, triggering reflux.

Having a hiatal hernia (where your stomach pushes up through your diaphragm) can also cause trouble and can be diagnosed by x-ray. Eating large meals and eating before bed are two other main reasons for reflux.

But there are other causes that are often overlooked. Food is supposed to go down, not up, when you eat.

That's why there are two main valves, or sphincters, that control food going in and out of your stomach -- the one at the top (or the lower esophageal sphincter) and one at the bottom (the pyloric valve).

When you're stressed, the valve on the top relaxes and the valve on the bottom tightens up.

The result? Food goes up, not down. So stress contributes to reflux.

Magnesium deficiency is another cause of reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.

While controversial, I believe that a common infection can cause not just ulcers but reflux as well. This bug is called H. pylori and can be identified by a simple test. It needs to be treated even if you don't have an ulcer.

Food sensitivities or allergies can also cause reflux. Common culprits include dairy and gluten-containing foods like wheat, barley, rye, and oats. Plus, overgrowth of bacteria in the small bowel or yeast overgrowth in the gut can cause reflux.

These are all treatable conditions that you don't need powerful acid blocking drugs to fix.

To properly diagnose the causes, you may need to do the following.

3 Steps to Permanently Overcoming Heartburn and Acid Reflux

Step 1: Treat the Bugs if You Have Them

yeast overgrowth

irritable bowel syndrome

Step 2: Change Your Diet

eliminate dairy and gluten

www.celiac.com

Step 3: Try Some Natural Remedies to Help Soothe the Gut

magnesium

As you can see, there's no need to suffer from heartburn and reflux -- or to take expensive and dangerous acid-blocking drugs.

I hope the changes I've suggested here will soothe your stomach and have you feeling healthy in no time!

Now I'd like to hear from you...

Do you have heartburn, reflux or GERD? What seems to trigger it?

Have you taken acid-blocking drugs? What was your experience?

What changes have worked for you in preventing and treating these problems?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

Calm Your Mind, Heal Your Body

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 04 Aug 2009 13:29:49 -0400

When it comes to your health, there is one factor that is more important than almost any other ...

If it is missing from your life, it causes or worsens 95 percent of all illness. It has been associated with dramatic reductions in disease and increased longevity.

And it is more important than cholesterol, blood sugar, blood pressure, or any other risk factor in determining whether you will live a long and healthy life. But it doesn’t come in a pill, and it can’t be found in a hospital or in your doctor’s office.

What is this critical factor that determines so much about how healthy or how sick you are?

Your attitude, your social networks, your community, and your spiritual beliefs.

Put another way, the health of your mind and spirit and your sense of connection to your community has an immense impact on the health of your body. In fact, aside from eating breakfast, biggest predictor of longevity is psychological resiliency -- being able to roll with the punches that life throws at us.

We’ve known about this in medicine for a long time. I was recently browsing through my library and found an old book that I read in college called Mind as Healer, Mind as Slayer, written by a friend and leader in the field of mind/body medicine, Kenneth Pelletier. He is a clinical professor of medicine at the medical schools of the University of California, San Francisco and the University of Arizona.

His book was published in 1977. I wish I could say that a lot has changed since that book was published. Sure, we have filled in the gaps and learned more about the mechanisms through which the body affects the mind and the mind affects the body, but the basic truths remain the same.

There is a dramatic and powerful connection between your mind and body, and between your body and your mind. In fact, it really should not be called a connection because it is just ONE bidirectional system.

Unfortunately, few doctors accept or understand this fundamental reality about biology. So, in most doctors’ offices, you aren’t going to learn about the connection between your body and brain or how to use that connection to help you heal.

However, in this blog I am going to give you the tools to do that. I am going to explain how the body and mind are intimately connected and give you 10 tips you can use to calm your mind and heal your body.

Calming your mind is the last of the 7 keys to UltraWellness; today you are going to learn how you can relax your way to vibrant health and optimal weight.

An Epidemic of Stress-Related Disorders

According to Hans Selye, M.D., the man who coined the word "stress" and first mapped out its biological effects, "The modern physician should know as much about emotions and thoughts as about disease symptoms and drugs. This approach would appear to hold more promise of cure than anything medicine has given us to date."

Selye’s words are as true today as they were on the day he wrote them.

We are seeing an epidemic of stress-related disorders in our society, including depression, anxiety, autism, attention deficit disorder, memory disorders, and dementia, and these disorders are making the pharmaceutical industry highly profitable.

You see, Americans live on caffeine and Prozac. We use substances to manage our moods. In fact, the four top-selling items in grocery stores are all drugs that we use to manage our mood and energy: caffeine, sugar, alcohol, and nicotine.

But how do we really deal with the root of this problem? You use the MOST powerful pharmacy in the world -- which is right between your ears!

A little later, I will tell you how to use your brain to fix your health problems. First, I want to share a story that illustrates the power the mind has to harm or to heal.

The Power of the Mind-Body Connection

Tom, a long-term patient of mine, came to see me after his wife died. He suddenly developed heart failure. His heart just wouldn’t pump. It was flooded with grief molecules, hormones like adrenalin, noradrenalin, and cortisol.

His case is far from being the only documented case in which grief caused cardiovascular problems. The New England Journal of Medicine recently published a study about how grief or emotional trauma can cause heart failure -- literally a broken heart.

Rather than giving Tom drugs for "heart failure" as I was taught in medical school, I suggested he get healing touch, a form of energy and emotional healing. Sounds a bit out there, huh? Well, he followed my advice and dramatically recovered. Touch, not medication, healed his heart.

I think we can all learn a lesson from Tom and other cases like his.

In school, we all learned how to read and write, but we never learned how to use our minds to help us with the most important survival skills of all: staying happy and healthy!

Other cultures differ in their training. Herbert Benson, M.D., of Harvard Medical School, has demonstrated the amazing power that trained Tibetan meditators use to control their physiology by slowing their metabolism, changing their heart rates and brain waves, and raising or lowering their body temperature.

He even documented on film an ancient practice called tumo, the generating of internal heat, performed by initiated Tibetan monks. The monks are wrapped in icy cold sheets and must use their internal heat to dry them, possibly by actively burning something called brown fat. As a result, they can sit naked on a snowy mountaintop all night and not freeze, keeping warm with their internal heat.

That’s something most of us don’t have any consciousness of, or control over. Imagine if you could turn on fat burning and lose weight with your mind!

That is how powerful our mind and our beliefs can be.

But in the West we aren’t even taught how to cope with the day-to-day frustrations of life. We live under constant chronic stress and we are not trained to address this stressful psychic load that is the burden of the 21st century.

This is unfortunate, because stress is killing us.

Just consider these facts:

• Low socioeconomic status is associated with poorer health outcomes and higher risk of death from all causes. This is not because of poor health habits, but because of feelings of powerlessness and loss of control.

• Internalized racism and stress are associated with high amounts of belly fat.

• Stress hormones damage the hippocampus -- the memory center in the brain -- causing memory loss and dementia.

• In a study of people who volunteered to have cold viruses injected into their noses, only people with a high level of perceived stress got colds.

• Women with metastatic breast cancer survived twice as long if they were part of a support group.

• Belonging to a group -- a religious group, a bowling club, a quilting group -- reduces risk of death from all causes and increases longevity, despite health habits.

• In a study of doctors, those who scored high on hostility questionnaires had a higher risk of heart attacks than those who smoked, were overweight, had high blood pressure, or didn’t exercise.

So, if you don’t think the mind has the power to influence your body, think again.

The good news is that you can change your beliefs and attitudes and their effects on your mind and your body. You may need to learn a few new skills, like stress reduction techniques, but it can be done.

However, our beliefs and attitudes aren’t the only things that matter. Our mind and brain function is also influenced by what happens in our bodies. By addressing the 7 Keys to UltraWellness, "mental" problems can often be cured—without changing our beliefs.

The effects of beliefs and attitudes are important. There can be no question of that. But the effects of imbalances in our core body systems on our mental state and brain function are just as important and are mostly IGNORED by traditional medicine.

The systems in your body that affect mood and brain function include hormones, immune system, gut, detox system, energy system, nutritional status, and other environmental inputs.

For example, I saw a man yesterday who was completely stressed out and anxious. He had palpitations and drank four martinis a night just to calm down. He also had severe muscle cramps and eye twitches.

These are obvious signs of magnesium deficiency. But stress, alcohol, caffeine, and sugar all deplete magnesium. He was trapped in a vicious cycle.

What he needed wasn’t Valium or Prozac, but rather to address why he was magnesium-deficient and then fix it through detoxification, treating his yeast overgrowth, cutting out alcohol and caffeine, and supplementing with the relaxation mineral, magnesium, to calm his nervous system.

That, in combination with other tools for calming the mind and the body, will help him reset his nervous system. By using these tools together, he’ll be taking advantage of both the body-mind effect and the mind-body effect, thereby optimizing his treatment.

You can do the same thing. By employing the following techniques, you can leverage the power of your brain and body to calm your mind and bring healing.

10 Tips for Calming Your Mind

Here is what we know about how to influence the mind-body and the body-mind system. Consider these essential survival skills. You cannot thrive without them!

1. Address the Underlying Causes of Stress --

2. Relax -- Learn how to ACTIVELY relax. To engage the powerful forces of the mind on the body, you must DO something -- you can’t just sit there watching television or drinking beer.

3. Learn New Skills -- Try learning new skills such as meditation, deep breathing, yoga, biofeedback, and progressive muscle relaxation or take a hot bath, make love, get a massage, watch a sunset, or walk in the woods or on the beach.

4. Move Your Body -- Exercise is a powerful, well-studied way to burn off stress chemicals and heal the mind, so just do it! It has been proven to be better than or equal to Prozac for treating depression.

5. Optimize Your Nutrition -- Clean up your diet from mind-robbing molecules like caffeine, alcohol, and refined sugars and eat regularly to avoid the short-term stress of starvation on your body.

6. Supplement -- Take a multivitamin and nutrients to help balance the stress response, such as vitamin C; the B-complex vitamins, including B6 and B5 or pantothenic acid; zinc; and most important, magnesium, the relaxation mineral.

7. Try Herbs -- Use adaptogenic herbs (herbs that help you adapt and balance your response to stress) such as ginseng, Rhodiola rosea, Siberian ginseng, cordyceps, and ashwagandha.

8. Use Heat Therapy -- Take a hot bath or a sauna to help your body deeply relax and turn on the relaxation response.

9. Change Your Beliefs -- Examine your beliefs, attitudes, and responses to common situations and consider reframing your point of view to reduce stress.

10. Find a Community -- Consciously build your network of friends, family, and community. They are your most powerful allies in achieving long-term health.

In the last seven blogs, I have introduced you to a set of new ideas and concepts that have the power to transform your health personally and to transform health care as a whole. It is no small job in either case, but it is essential to stem the impending tsunami of ill health and economic burden facing us, our children, and our children’s children.

The solution is a fundamental change in our worldview about health—a view that helps us get to the core of illness, learn self-care, take control, and empower ourselves to transform our own health and turn our "sick care" system into a health care system.

Each of us can contribute and make small changes that will have a big effect as we move toward vibrant health and vitality as individuals, and as a society.

Take control of your health today using the techniques I have outlined in this series of blogs, and you will become part of a growing movement that is working toward fundamentally changing the way we understand the body and practice medicine in this country.

Now I’d like to hear from you ...

What examples of the mind-body and body-mind effect have you experienced?

What do you do to relax and calm down?

What changes in your health do you notice when you’re relaxed?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, M.D.

How to Give Yourself a Metabolic Tune-up

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 28 Jul 2009 19:53:28 -0400

Are you tired and worn out?

Do you have sore muscles, fatigue, and brain fog?

If so, you might have metabolic burnout!

Imagine if you could find a way to tune up your metabolism, increase your energy levels, think clearly, and feel less achy.

Imagine if you could prevent diabetes, heart disease, Parkinson’s disease, and dementia.

Imagine if you could heal fibromyalgia and chronic fatigue syndrome.

Imagine if you could get to the roots of aging, slow the whole process, and eliminate most age-related diseases.

These aren’t just fantasies.

All these things are possible—if you give yourself a metabolic tune up.

You might have heard of the rats fed high doses of resveratrol, the plant compound found in red wine. But did you know that those rats lived 30 percent longer than their peers – the equivalent of an additional 120 human years -- even though they ate a bad diet.

In fact, they became fitter and lost weight even while eating a poor-quality, standard American diet.

How could they eat high amounts of bad food and not exercise, yet still become fitter, AND live 30 percent longer than the average rat?

One word: MITOCHONDRIA -- the source of your energy.

The resveratrol protected and improved the function of the mitochondria through its effects on special master-aging genes.

So what are mitochondria and what do they have to do with having more energy, losing weight, and living to be 120 years old without any disease?

Today you will learn the answer to that question. And I will provide you with 8 tips you can start using today to give yourself a metabolic tune-up and boost your energy metabolism.

The key to more energy lies in providing your mitochondria the right environment to thrive. When you do, you can boost your energy metabolism. Doing this is the 6th of the 7 keys to UltraWellness, and it is absolutely essential if you want to obtain optimal health.

So let’s look at what mitochondria are and what they do.

What Are Mitochondria?

Mitochondria are the little factories in our cells that take the foods we eat and the oxygen we breathe and convert them into energy. That energy is called adenosine triphosphate, or ATP, and it is used to support every function in our body.

Each cell holds hundreds or thousands of mitochondria; they are found in greater amounts in active organs and tissues such as the muscles, heart, and brain. In fact, we have more than 100,000 trillion mitochondria in our bodies, and each one contains 17,000 little assembly lines for making ATP.

Why are these are these little energy factories so important to your health?

The answer is simple: Mitochondria are the place where metabolism happens.

When your mitochondria aren’t working properly, your metabolism runs less efficiently or can practically shut down.

Problems occur because these powerful energy producers are VERY sensitive to damage.

And when they are damaged, you suffer all the symptoms of low energy—fatigue, memory loss, pain, rapid aging, and more.

Fatigue is the most common symptom of poorly functioning mitochondria, and it is the reason we tend to poop out as we age. We add constant insult and injury to our mitochondria, and this causes them to break down and stop producing energy.

The main way your mitochondria are damaged is by uncontrolled oxidative stress. That may sound complicated, but in reality we are all familiar with “oxidative stress” even if some of us don’t know what the term means.

Oxidation is the rust on our cars, the brown color that appears on an apple when cut and exposed to air, the rancid vegetable oil in our cupboards, even the wrinkles that form on our skin.

What most of us don’t realize is that our own tissues are rusting, our own fats are going rancid, and our brains are melting as we go about our daily life.

What starts this process is some insult—too many calories, smoking, a sunburn, exposure to toxins, anti-nutrients, sugar, and more—that tips the balance, starting a chain reaction of cellular and tissue damage that leads us down the long road to weight gain and chronic illness.

The ultimate outcome of oxidative stress and the resultant loss of energy is death!

But the good news is that we can counteract the damage by giving ourselves a metabolic tune-up.

Let me explain ...

What Is a Metabolic Tune-up?

Dr. Bruce Ames, a renowned scientist from the University of California, Berkeley, has spent the last decade discovering how we can give ourselves a metabolic tune-up.

In one study, he gave two compounds to old rats who were tired, wouldn’t get on their treadmill or swim very far, and couldn’t find the cheese in the maze. These compounds make mitochondria run better, boosting metabolism.

They are alpha-lipoic acid and acetyl-L-carnitine.

Overnight, these old rats became young rats. They got onto the treadmill, swam long distances without fatigue, and could easily find the cheese in the maze, just like their young, healthy counterparts.

How could that happen?

Well, Dr. Ames simply gave the cells the raw materials they need for optimal function. That’s it!

You can do this too, and the process is very simple ...

First, find the things that damage your metabolism and mitochondria, then eliminate them.

Second, give your body the things that help mitochondria function optimally.

Here’s how you do that.

8 Tips for Giving Yourself a Metabolic Tune-up

The first step to giving yourself a metabolic tune-up is locating and eliminating the causes of damage to the mitochondria:

Eat less processed food, junk food

• Detoxify by getting rid of environmental and internal toxins.

• Cool off the inflammation in your body.

• Balance your hormones.

Once you’ve done that, you need to boost your mitochondrial function and provide the mitochondria with the correct environment to thrive:

• Eat whole, real, colorful plant food. That’s eight to 12 servings of fresh vegetables, fruits, beans, nuts, seeds, and whole grains every day. These foods are full of antioxidants and phytonutrients.

• Take mitochondria-protective and energy-boosting nutrients such as acetyl-L-carnitine, alpha-lipoic acid, coenzyme Q10, N-acetyl-cysteine, NADH, D-ribose, resveratrol, and magnesium aspartate.

• Increase your intake of omega-3 fats to help build your mitochondrial membranes.

Taking care of your mitochondria and giving yourself a metabolic tune-up will allow you to increase your energy, lose weight, and age well. It is a cornerstone of creating lifelong vibrant health.

Now I’d like to hear from you ...

Have you experienced burnout and fatigue? What was that like?

What do you think about the idea of giving your metabolism a tune-up?

Do you believe that supplements can help you optimize biological function?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

Is There Toxic Waste in Your Body?

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 21 Jul 2009 15:17:16 -0400

Your body may be a toxic waste dump.

Worried?

You should be ...

We are exposed to 6 million pounds of mercury and the 2.5 billion pounds other toxic chemicals each year.

80,000 toxic chemicals have been released into our environment since the dawn of the industrial revolution, and very few have been tested for their long-term impact on human health. And let me tell you, the results aren’t pretty for those that have been tested ...

How can we not be affected by this massive amount of poison?

According to the nonprofit organization Environmental Working Group , the average newborn baby has 287 known toxins in his or her umbilical cord blood.

If a newborn is exposed to that many toxins, imagine how many you have been exposed to in your life ...

Do you think this may be why so many of us are sick and fat today?

The simple truth is that we are living in a sea of toxins and it is destroying our bodies and brains.

The two most important things you need to know to cure disease, create health, and lose weight are:

nutrition

Unfortunately, you probably aren’t going to learn much about them from your doctor. Most physicians today are still hopelessly ignorant in these areas. They were simply never taught about nutrition and detoxification in medical school.

However, there are many things you can do to reduce your toxic exposures and enhance your detoxification. Today I want to share some information your doctor probably won’t focus on in your next visit, even though it is at the very root of your health. I am going to outline a simple 10-step plan you can use to enhance your detoxification.

Enhancing detoxification is the 5th key of the 7 keys to UltraWellness. If you want to lose weight and get healthy, you need to clean up the toxic waste in your body. Today you will learn how.

The Role of Toxins in Health and Disease

The role of toxins and detoxification in health has been largely ignored by medicine.

Thankfully, scientists and practitioners are starting to recognize its importance in health.

I recently spoke about detoxification at the 13th International Symposium on Functional Medicine. The presentation was called Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points. Leading experts from all over the globe came together to present the data on the role of toxins in health and offer suggestions for how we can detoxify.

If you want all the scientific background on detoxification, I recommend reading the proceedings from that meeting. You will find extensive data on the impact toxins have on our health and how critical detoxification is for long-term wellness.

The reality is that many of you probably have symptoms of chronic toxicity but don’t realize that you’re toxic.

The following is a list of the common symptoms of chronic toxicity. If you suffer from any of the following, detoxifying might be critical for you to get healthy and feel good again:

Premenstrual syndrome

Difficulty concentrating

Trouble losing weight

But how do you detoxify? And what does that word even mean? Let’s look a little more closely at what detoxification is.

What are Toxicity and Detoxification?

When you hear the word "detox" you might think drug detox or alcohol detox or wheatgrass enemas. That’s not what I am talking about.

I am referring to the science of how our bodies get rid of waste. If waste builds up, we get sick. And the key is to figure out how to enhance your body’s capacity to detoxify and get rid of waste while minimizing your exposure to toxins.

This is so important, because many diseases of our society are actually related to toxicity.

Here are some of the diseases you may suffer from if you are toxic:

Attention deficit disorder

Depression and other mood disorders

Digestive diseases like Crohn’s disease, ulcers, and colitis

Menstrual problems

With so many conditions on that list, it might seem that everyone is toxic.

That may be true to differing degrees ...

Problems with detoxification form one of the roots of illness -- and signify one of the core systems in the body that must be working well for you to be healthy. If you feel lousy, it’s likely you’re toxic.

It is important to understand why we are toxic and how we can detoxify. I will explain how you can detoxify a little later, but first I want to tell you about where toxins come from and how we are overloaded.

To understand toxicity, you must understand the concept of "total load."

Total load is the total amount of stressors on your system at any one time -- it’s like what happens when a glass fills over with water. It takes a certain amount of water to fill the glass and then, after a certain point, you put more in and it overflows.

When our detoxification system is overwhelmed, it gets overloaded. That’s when we start developing symptoms and getting sick, but it may take years of accumulated stress and toxins to get to that point.

Here are some, but not all, of the factors that can contribute to your total toxic load:

• Exposure to heavy metals like mercury and lead, petrochemicals, residues, pesticides, and fertilizers.

• Food allergies, environmental allergies, molds, and toxins from molds.

• Eating a standard American diet.

• Mental, emotional, and spiritual toxins -- isolation, loneliness, anger, jealousy, and hostility, all of which translate into toxins in our system.

• Medications can sometimes be toxins. Often we need medications, but the reality is that most of us are overmedicated and use medications to treat problems for which there are better solutions, such as lifestyle and diet.

• Internal toxins -- things like bacteria, fungus, and yeast inside our gut as well as hormonal and metabolic toxins that we need to eliminate.

That’s a lot of toxins for our bodies to manage.

You may wonder: Why aren’t we all sick, given this incredible load of toxins?

The answer is simple.

It is because each of us is genetically and biochemically unique. Some of us are good at getting rid of toxins and waste, and others are not.

I am not. That is why I developed chronic fatigue syndrome.

I became overloaded with mercury and couldn’t get rid of it because I am missing a gene for GSTM1 -- a critical detoxifying enzyme for mercury. But by learning to support my system and how to detoxify, I was able to cure myself of a seemingly incurable condition.

What I learned is that there are five key steps to optimal detoxification. They are:

1. Identify and Get Rid of Toxins --

2. Fix Your Gut -- Gut imbalances are a key source of toxins for many.

3. Get Moving -- This help your blood and lymphatic circulation do its job.

4. Get Your Liver and Detox System Working -- If your detoxification system isn’t working properly, this is a serious problem and needs to be addressed. A great place to start is the 10-step approach outlined below.

5. Detox Your Mind, Heart, and Spirit -- This is just as important as detoxing your body, and it’s an area few of us ever think about as a source of toxins.

To completely detoxify your body you need to work through each of these steps carefully, and that can take some time. But you can start today by following this simple 10-step plan.

10 Simple Steps to Enhance Detoxification

Proper detoxification is so essential for health that you need to start enhancing your body’s ability to detoxify today. Here is how to do it:

1. Drink Clean --

2. Eliminate Properly -- Keep your bowels moving, at least once or twice a day. And if you can’t get going, then you need some help. This can include taking two tablespoons of ground flax seeds and taking acidophilus and extra magnesium citrate capsules. If you have any chronic diseases or problems, you have to be careful about taking supplements and should work with your doctor.

3. Eat Clean -- You should also eat organic produce and animal products to eliminate the toxins, hormones, and antibiotics in your food.

4. Eat Detoxifying Food -- You should eat 8 to 10 servings of colorful fruits and vegetables a day, particularly family of the cruciferous vegetables (broccoli, collards, kale, cabbage, Brussels sprouts, kohlrabi) and the garlic family (garlic and onions), which help increase sulfur in the body and help detoxification.

5. Minimize Drugs -- Avoid stimulants, sedatives, and drugs, such as caffeine and nicotine, and try to reduce alcohol intake.

6. Get Moving -- Exercise five days a week with focus on conditioning your cardiovascular system, strengthening exercises, and stretching exercises.

7. Avoid the White Menace -- This includes white flour and white sugar.

8. Sweat -- Sweat profusely at least three times a week, using a sauna, steam, or a detox bath.

9. Supplement -- Take a high-quality multivitamin and mineral supplement.

10. Relax -- Relax deeply every day to get your nervous system in a state of calm, rest, and relaxation.

Simply following these steps will help to correct problems caused by toxicity, maximize your body’s own detoxification capacity, and help you safely eliminate toxins stores in your body.

Depending on your symptoms, genetic predispositions and environmental exposures, you may need different levels of nutrients and types of treatment, but this is an excellent way to get started on detoxification today.

Remember, getting rid of toxins and learning how to optimize your detoxification system is essential for creating lifelong vibrant health.

Now I’d like to hear from you ...

Why do you think we live in such a toxic world?

Do you think the government should do more to regulate toxins? If so, what kind of legislation should be put in place to protect us?

Have you suffered from toxic exposures? What were they and how did they make you feel?

Do you have any other suggestions for detoxification?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

Is Your Inner Tube Making You Sick?

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 15 Jul 2009 12:22:01 -0400

There might be something wrong with your inner tube, and it could be making you sick and fat.

You may not even realize you have a problem ... but if you have health concerns of any kind or you are overweight, your inner tube could be the root cause.

Of course, I’m not talking about a beach toy. I mean the inner tube of life -- your digestive system!

It is likely that you suffer from (or have suffered from) some type of digestive disorder -- irritable bowel syndrome, bloating, constipation, diarrhea, heartburn, reflux, gas, and other things too gross to mention in print.

And you are not alone. More than 100 million Americans have digestive problems.

Two of the top five selling drugs in America are for digestive problems, and they cost us billions and billions of dollars.

There are more than 200 over-the-counter (OTC) remedies for digestive disorders, many of which can create additional digestive problems.

Visits for intestinal disorders are among the most common reasons for trips to primary care physicians.

And that’s not even the worst news.

Most of us (including most doctors) do not recognize or know that digestive problems wreak havoc in the entire body, leading to allergies, arthritis, autoimmune disease, rashes, acne, chronic fatigue, mood disorders, autism, dementia, cancer, and more.

So having a healthy gut means more than simply being free of annoyances like bloating or heartburn! It is absolutely central to your health. It is connected to EVERYTHING that happens in your body.

That’s why I almost always start helping people treat chronic health problems by fixing their gut, which is what I want to help you do today.

Today , you will learn how you can find out if you have a problem with your gut (though many of you won’t need me to tell you -- your gut will speak for itself!), and I will give you 7 simple steps you can take today to heal your inner tube of life.

Fixing your digestion is the 4th key of the 7 Keys to UltraWellness or functional medicine, and it is absolutely essential that you heal this critical system in your body if you want to achieve optimum health.

Why your gut is so important? Let me explain ...

How Your Gut Keeps You Healthy or Makes You Ill

The health of your gut determines what nutrients are absorbed and what toxins, allergens, and microbes are kept out. It is directly linked to the health of your whole body.

Intestinal health could be defined as the optimal digestion, absorption, and assimilation of food. But that is a big job that depends on many other factors. Let’s look at a few of them …

First, there are bugs in your gut that form a diverse and interdependent ecosystem like a rainforest. In fact, there are 500 species and 3 pounds of bacteria in your gut which form a HUGE chemical factory that helps you digest your food, regulate hormones, excrete toxins, and produce vitamins and other healing compounds that keep your gut and your body healthy.

This ecosystem of friendly bacteria must be in balance for you to be healthy.

Too many of the wrong bacteria, like parasites and yeasts, or not enough of the good ones, like Lactobacillus or Bifidobacteria, can seriously damage your health.

So keeping a healthy balance of bugs in your intestines is one factor to good gut health.

Second, there is your gut-immune system. Your entire immune system -- and the rest of your body -- is protected from the toxic environment in your gut by a lining that is only ONE cell-thick layer. If spread out, this lining would take up a surface area the size of a tennis court, and the entire thing is covered by a sewer!

If that barrier is damaged, you can become allergic to foods you may normally be able to digest perfectly well, you will get sick, your immune system will become overactive, and it will begin producing inflammation throughout your body.

Filtering out the good molecules from the bad molecules and protecting your immune system is yet another important factor in gut health.

Third, there is your second brain -- your gut’s nervous system. Did you know your gut, actually contains MORE neurotransmitters than your brain? In fact, the gut has a brain of its own. It is called the "enteric nervous system" and it is a very sophisticated piece of your biology that is wired to your brain in intricate ways.

Messages constantly travel back and forth between your gut-brain and your head-brain, and when those messages are interfered with in any way your health will suffer.

Fourth, your gut also has to get rid of all the toxins produced as byproducts of your metabolism, which your liver dumps into bile. If things get backed up when you are constipated, you will become toxic and your health will suffer.

And last but not least, your gut must break down all the food you eat into its individual components, separate out the vitamins and minerals, and shuttle everything across the one cell-thick layer mentioned above so it can get into your bloodstream and nourish your body and brain.

Your gut has quite a lot to manage. Even in perfect world it is hard to keep all of this in balance. But in our modern world there are endless insults that can knock our digestive systems off balance; it is that much more difficult to maintain excellent digestive health.

How to Know if Your Gut is Out of Balance

To fix your digestion, you first need to understand what is sending your gut out of balance in the first place. The list is short:

• Overuse of medications that damage the gut or block normal digestive function -- things like acid blockers (Prilosec, Nexium, etc.), anti-inflammatory medication (aspirin, Advil, and Aleve), and overuse of antibiotics, steroids, and hormones

• Undetected gluten intolerance, celiac disease or low grade food allergies to foods such as dairy, eggs, or corn.

• Chronic low-grade infections or gut imbalances with overgrowth of bacteria in the small intestine, yeast overgrowth, parasites, or even more serious gut infections

• Toxins like mercury and mold toxins, which damage the gut

• Lack of adequate digestive enzyme function, which can come from acid-blocking medication use, or zinc deficiency

• Stress, which can alter the gut nervous system, cause a leaky gut, and change the normal bacteria in the gut

What happens then is obvious. You get sick.

But what’s important to understand is that many diseases that seem to be totally unrelated to the gut -- such as eczema or psoriasis or arthritis -- are actually CAUSED by gut problems. By focusing on the gut, you can get better. Here is an example …

Can Eczema Start in the Gut?

Allison, one of my patients who suffered from eczema -- a weepy, red, oozing, scaly, itchy rash -- all over her body is perfect example of what can happen when your gut is out of balance and the extraordinary level of healing that can occur when you fix your digestion.

This woman, who saw doctor after doctor, put salves, lotions, and potions on her skin and gave her steroids and antibiotics. But none of them ever addressed the underlying cause of her problem.

Allison was 57 years old and had been suffering from severe, unrelenting eczema for eight years. She ate a high-sugar diet and had a history of frequent vaginal yeast infections.

When I saw her, I checked her gut and found she had a leaky gut -- that one-cell thick lining in her intestines was breached and wasn’t working properly. She had developed 24 IgG food allergies, and her stool had no healthy bacteria and an overgrowth of yeast from years of taking antibiotics. She also had very high blood levels of antibodies against yeast.

So I helped her heal her gut. I asked her to stop eating the foods she reacted to, told her to stop feeding the yeast in her gastrointestinal tract by cutting out sugar and refined carbohydrates (which they thrive on), and killed the yeast in her gut with antifungal medications and herbs. Then I helped her rebuild her ecosystem of healthy bacteria with probiotics and provided here with healing gut nutrients that allowed her intestinal lining to resume its normal function.

The result?

Her eczema disappeared for the first time in eight years -- and it stayed away!

You can experience the same thing Allison did. You may be able to heal from many of your chronic symptoms simply by fixing your digestion. Here is how you do it.

7 Steps to Optimal Digestive Health

To heal your inner tube of life you simply need to:

Eat whole unprocessed foods.

fiber

2. Eliminate food allergies. If you think you have food sensitivities, try an elimination diet. Cut out gluten, dairy, yeast, corn, soy, and eggs for a week or two and see how your gut feels and what happens to your other symptoms.

3. Treat any infections or overgrowth of bugs -- Parasites, small bowel bacteria, and yeasts can all inhibit proper gut function. You must treat these infections if you want to heal.

4. Replenish your digestive enzymes. When you don’t have enough digestive enzymes in your gut, you can’t properly covert the foods you eat into the raw materials necessary to run your body and brain. Take broad-spectrum digestive enzymes with your food to solve the problem.

5. Rebuild your rain forest of friendly bacteria. Take probiotic supplements. They will help you rebuild the healthy bacteria so essential to good gut health.

6. Get good fat. Take extra omega-3 supplements, which help cool inflammation in the gut.

7. Heal your gut lining. Use gut-healing nutrients such as glutamine and zinc to repair the lining in your gut so it can resume its normal function.

Fixing your digestion may take some time, but it can be done. And it is absolutely essential if you want to achieve vibrant health. So work on your inner tube of life using the steps above and watch as your symptoms (and those extra pounds) disappear.

Now I’d like to hear from you ...

Did you realize how important your gut is to your overall health?

What steps have you taken to fix your digestion? How have they worked?

Why do you think the pharmaceutical industry develops and actively advertises drugs that are known to inhibit proper gut function and thus compromise health?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, M.D.

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• Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6.

• Wilders-Truschnig M, Mangge H, Lieners C, Gruber HJ, Mayer C, März W. IgG Antibodies Against Food Antigens are Correlated with Inflammation and Intima Media Thickness in Obese Juveniles. Exp Clin Endocrinol Diabetes. 2007 Dec 10

• Thomas T. MacDonald and Giovanni Monteleone Immunity, Inflammation, and Allergy in the Gut, Science 25 March 2005 307: 1920-1925

• Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004 Oct;53(10):1459-64.

• http://digestive.niddk.nih.gov/statistics/statistics.htm

• Benarroch EE. Enteric nervous system: functional organization and neurologic implications. Neurology. 2007 Nov 13;69(20):1953-7. Review.

• Sandler RH, Bolte ER, Chez MG, Schrift MJ. Relief of psychiatric symptoms in a patient with Crohn's disease after metronidazole therapy. Clin Infect Dis. 2000 Jan;30(1):213-4.

• Lin, H. Small Intestinal Bacterial Overgrowth: A Framework for Understanding Irritable Bowel Syndrome JAMA. 2004 292: 852-858

• Pimentel M, Park S, Mirocha J, Kane SV, Kong Y. The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med. 2006 Oct 17;145(8):557-63.

• Av SP. Hepatic encephalopathy: pathophysiology and advances in therapy. Trop Gastroenterol. 2007 Jan-Mar;28(1):4-10. Review.

• Jansson-Nettelbladt E, Meurling S, Petrini B, Sjölin J. Endogenous ethanol fermentation in a child with short bowel syndrome. Acta Paediatr. 2006 Apr;95(4):502-4

• Sandler RH, Finegold SM, Bolte ER, Buchanan CP, Maxwell AP, Väisänen ML, Nelson MN, Wexler HM. Short-term benefit from oral vancomycin treatment of regressive-onset autism. J Child Neurol. 2000 Jul;15(7):429-35.

• Parracho HM, Bingham MO, Gibson GR, McCartney AL. Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children. J Med Microbiol. 2005 Oct;54(Pt 10):987-91.

• Wakefield AJ, Puleston JM, Montgomery SM, Anthony A, O'Leary JJ, Murch SH. Review article: the concept of entero-colonic encephalopathy, autism and opioid receptor ligands. Aliment Pharmacol Ther. 2002 Apr;16(4):663-74.

• Aytac U, Dang NH.CD26/dipeptidyl peptidase IV: a regulator of immune function and a potential molecular target for therapy. Curr Drug Targets Immune Endocr Metabol Disord. 2004 Mar;4(1):11-8. Review.

• Mentlein R. Dipeptidyl-peptidase IV (CD26)--role in the inactivation of regulatory peptides. Regul Pept. 1999 Nov 30;85(1):9-24. Review.

• Ek J, Stensrud M, Reichelt KL. Gluten-free diet decreases urinary peptide levels in children with celiac disease. J Pediatr Gastroenterol Nutr. 1999 Sep;29(3):282-5.

• Liu Y, Heiberg T, Reichelt KL. Towards a possible aetiology for depressions? Behav Brain Funct. 2007 Sep 14;3:47.

• Wakefield AJ, Ashwood P, Limb K, Anthony A. The significance of ileo-colonic lymphoid nodular hyperplasia in children with autistic spectrum disorder. Eur J Gastroenterol Hepatol. 2005 Aug;17(8):827-36.

• Uhlmann V, Martin CM, Sheils O, Pilkington L, Silva I, Killalea A, Murch SB, Walker-Smith J, Thomson M, Wakefield AJ, O'Leary JJ.Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol. 2002 Apr;55(2):84-90.

• Kawashima H, Mori T, Kashiwagi Y, Takekuma K, Hoshika A, Wakefield A. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci. 2000 Apr;45(4):723-9

• Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review.

Is Your Body Burning Up with Hidden Inflammation?

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 08 Jul 2009 15:00:51 -0400

Could something as simple as a quick and easy blood test save your life?

Absolutely.

It is called a C-reactive protein test, and it measures the degree of HIDDEN inflammation in your body.

Finding out whether or not you are suffering from hidden inflammation is critical, because almost every modern disease is caused or affected by it.

If your immune system and its ability to quell inflammation in your body are impaired, watch out. You are headed toward illness and premature aging.

Fortunately, addressing the causes of inflammation and learning how to live an anti-inflammatory lifestyle can dramatically improve your health.

Today, I am going to review what the primary causes of inflammation are and give you a simple, 7-step approach that will help you cool the fires raging out of control in your body.

Cooling off Inflammation is Key #3 to UltraWellness and in this blog -- the third in this 7-part series on the 7 keys to UltraWellness -- I am going to teach you how to do just that.

The first step is to understand what inflammation is and why it can become so dangerous.

Inflammation: The Good, the Bad, and the Ugly

Everyone who has had a sore throat, rash, hives, or a sprained ankle knows about inflammation. These are normal and appropriate responses of the immune -- your body’s defense system -- to infection and trauma.

This kind of inflammation is good. We need it to survive -- to help us determine friend from foe.

The trouble occurs when that defense system runs out of control, like a rebel army bent on destroying its own country.

Many of us are familiar with an overactive immune response and too much inflammation. It results in common conditions like allergies, rheumatoid arthritis, autoimmune disease, and asthma. This is bad inflammation, and if it is left unchecked it can become downright ugly.

What few people understand is that hidden inflammation run amok is at the root of all chronic illness we experience -- conditions like heart disease, obesity, diabetes, dementia, depression, cancer, and even autism.

A study of a generally "healthy" elderly population found that those with the highest levels of C-reactive protein and interleukin 6 (two markers of systemic inflammation) were 260 percent more likely to die during the next 4 years. The increase in deaths was due to cardiovascular and other causes.

We may feel healthy, but if this inflammation is raging inside of us, then we are in trouble.

The real concern is not our response to immediate injury, infection, or insult. It is the chronic, smoldering inflammation that slowly destroys our organs and our ability to function optimally and leads to rapid aging.

Common treatments such as anti-inflammatory drugs (ibuprofen or aspirin) and steroids like prednisone -- though often useful for acute problems -- interfere with the body’s own immune response and can lead to serious and deadly side effects.

In fact, as many people die from taking anti-inflammatory drugs like ibuprofen every year as die from asthma or leukemia. Stopping these drugs would be equivalent to finding the cure for asthma or leukemia –- that’s a bold statement, but the data is there to back it up.

Meanwhile, the real effects of statin drugs like Lipitor in reducing heart disease may have nothing to do with lowering cholesterol, but with their unintended side effect of reducing inflammation.

But is taking medication the right approach to addressing the problem of inflammation?

No. It is DOWNSTREAM medicine.

Here’s how UPSTREAM medicine thinks about inflammation ...

How to Locate the Causes of Hidden Inflammation

So if inflammation and immune imbalances are at the root of most of modern disease, how do we find the causes and get the body back in balance?

First, we need to identify the triggers and causes of inflammation. Then we need to help reset the body’s natural immune balance by providing the right conditions for it to thrive.

As a doctor, my job is to find those inflammatory factors unique to each person and to see how various lifestyle, environmental, or infectious factors spin the immune system out of control, leading to a host of chronic illnesses.

Thankfully, the list of things that cause inflammation is relatively short:

• Lack of exercise

• Stress

• Hidden or chronic infections with viruses, bacteria, yeasts, or parasites

• Hidden allergens from food or the environment

• Toxins such as mercury and pesticides

• Mold toxins and allergens

By listening carefully to a person’s story and performing a few specific tests , I can discover the causes of inflammation most people.

It’s important to understand that this concept of inflammation is not specific to any one organ or medical specialty. In fact, if you read a medical journal from any field of medicine, you will find endless articles about how inflammation is at the root of problems with the particular organ or area they focus on.

So what’s the problem?

There is almost no communication between specialties. Everyone is treating the downstream effects of inflammation, but addressing the causes of inflammation that are upstream could help people who have multiple problems that are really linked together by this common root cause.

Take, for example, a man who came to see me recently. He wanted to climb a mountain and asked for my help to get healthy. He was 57 years old and took about 15 medications for six different inflammatory conditions: high blood pressure, pre-diabetes, colitis, reflux, asthma, and an autoimmune disease of his hair follicles called alopecia.

Yet when I asked him how he felt, he said "great". I told him I was surprised because he was on so many medications.

Yes, he said, but everything was very well controlled with the latest medications prescribed by the top specialists he saw in every field—the lung doctor for his asthma, the gastroenterologist for his colitis and reflux, the cardiologist for his high blood pressure, the endocrinologist for his pre-diabetes, the dermatologist for his hair loss.

But did any of those specialists ask him why he had six different inflammatory diseases and why his immune system was so pissed off? Was it just bad luck that he "got" all these diseases -- or was there something connecting all these problems?

He looked puzzled and said "no".

I then searched for and uncovered the cause of his problems: gluten. He had celiac disease, an autoimmune disease related to eating gluten, the protein found in wheat, barley, rye, spelt, and oats.

Six months later he came back to see me. He had lost 25 pounds, had no more high blood pressure, asthma, reflux, or colitis, and said he had normal bowel movements for the first time in his life. His hair was even growing back. And he was off nearly all his medications.

7 Steps to Living an Anti-inflammatory Life

So once you have figured out the causes of inflammation in your life, gotten rid of them, the next step is to keep living an anti-inflammatory lifestyle. But how do you do that?

Here is what I recommend. It’s a disarmingly simple but extraordinarily effective way to achieve UltraWellness:

1. Whole Foods --

high-fiber

trans fats

phytonutrients

2. Healthy Fats -- Give yourself an oil change by eating healthy monounsaturated fats in olive oil, nuts and avocadoes, and getting more omega-3 fats from small fish like sardines, herring, sable, and wild salmon.

3. Regular Exercise –- Mounting evidence tells us that regular exercise reduces inflammation. It also improves immune function, strengthens your cardiovascular systems, corrects and prevents insulin resistance, and is key for improving your mood and erasing the effects of stress. In fact, regular exercise is one among a small handful of lifestyle changes that correlates with improved health in virtually ALL of the scientific literature. So get moving already!

4. Relax -- Learn how to engage your vagus nerve by actively relaxing. This powerful nerve relaxes your whole body and lowers inflammation when you practice yoga or meditation, breathe deeply, or even take a hot bath.

5. Avoid Allergens -- If you have food allergies, find out what you’re allergic to and get stop eating those foods—gluten and dairy are two common culprits.

6. Heal Your Gut -- Take probiotics to help your digestion and improve the balance of healthy bacteria in your gut, which reduces inflammation.

7. Supplement -- Take a multivitamin/multimineral supplement, fish oil, and vitamin D, all of which help reduce inflammation.

Taking this comprehensive approach to inflammation and balancing your immune system addresses one of the most important core systems of the body.

In the future, medicine may no longer have specialties like cardiology or neurology or gastroenterology, but new specialists like "inflammologists".

But by understanding these concepts and core systems that are the basis of healthy living now, you don’t have to wait.

Now I’d like to hear from you ...

Have you had your C-reactive protein tested?

Do you think inflammation may be at the core of your health condition?

Why do you think so many doctors practice downstream medicine instead of catching problems early with upstream medicine?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

Are Your Hormones Making You Miserable?

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 01 Jul 2009 16:24:58 -0400

Are your hormones out of balance?

Does your life feel like a song played badly out of tune?

If so, the problem may have to do with imbalances in your hormones, which are wreaking havoc on your body and mind.

There is one hormone in particular I am going to focus on today, and it could be at the root of your problems.

I will share with you 12 tips you can start using immediately to begin rebalancing your hormones and bring your life back into tune.

But first, ask yourself these questions:

• Do you crave sugar or salt?

• Are you overweight and putting on more and more belly fat?

• If you are a woman, do you have premenstrual syndrome, painful or heavy periods, and a low sex drive?

• Are you depressed? Do you sleep poorly?

• Do you feel tired but wired?

• Do you need coffee to wake up in the morning and a few glasses of wine to calm down at night?

If you answered "yes," your hormones may be out of balance, and you are not alone ...

In fact, this is how most Americans feel because we are living out of harmony with our natural biological rhythms. This is because small molecules in our bodies that we depend on to keep us in balance are running haywire.

These messenger molecules are involved in almost every function of the body, and they are critical to our well-being.

They are our hormones -- messenger molecules of our endocrine system -- and neurotransmitters -- messenger molecules of our brain and nervous system.

Understand how and why these systems get out of balance and you will go a long way toward understanding why Americans are so tired, depressed, and overweight!

Our hormone and neurotransmitter system is another one of the core systems of the body that we must address to achieve vibrant health. That is why Balancing Your Hormones is Key #2 to UltraWellness.

In today’s blog -- the second in this 7-part series on the 7 Keys to UltraWellness -- I will explain why your hormones get out of balance, how to get them back in balance, how they work, and why so many of you feel miserable because of them.

The Four Major Hormonal Epidemics in America and Why They Are Making Us Miserable

All of our hormones and neurotransmitters work together as one dynamic system to help us maintain optimal health and keep us happy, focused, and peaceful. They are like a finely orchestrated symphony that must work together to keep everything in balance.

The command and control center for this process is in your brain. It is made up of the hypothalamus and pituitary glands.

This center sends signals to distant parts of the body to control everything from your stress response through the adrenal glands to your blood sugar balance through the pancreas to your thyroid hormone via the thyroid gland, to your sexual behavior and function through the reproductive organs. It also controls growth, sleep, mood, and much more.

In addition to these hormonal messengers you also have important brain chemicals called neurotransmitters, which send messages throughout your body to every cell, organ, and tissue and help you do everything from moving your arm to feeling happy or sad.

When your neurotransmitters or hormones are out of balance, literally everything in your body goes haywire.

There are four big epidemics of hormonal problems in Americans today that are sending millions of people out of balance: too much insulin (from sugar), too much cortisol and adrenaline (from stress), imbalances of sex hormones such as estrogen and testosterone, and not enough thyroid hormones.

Although all 4 of these hormone epidemics are important, today I want to focus on the most common -- and therefore the most problematic -- of these conditions: too much insulin.

Insulin Resistance: Awash in a Sea of Sugar

Let me tell you the story of a man who came to me. His story may be all too familiar to you ...

James was a 46 year-old Wall Street executive who came to me for a cardiac stress test. He was a hard-driving, don’t-look-up type of guy who was convinced he was dying of heart disease.

Every afternoon, he would experience the sudden onset of sweating, a racing heart, anxiety, and shortness of breath -- in other words, he thought he was going to die!

He was also thick around the middle. After taking one look at him and listening to his story, I said, "You don’t eat breakfast, do you?"

"And you feel tired after eating, so that is why you skip food during the day -- to keep sharp for work," I continued. "And when you feel like that, you go to the vending machine for a soda and get a quick sugar fix, and in a few minutes you feel better."

Shocked, he asked, "How did you know?"

I explained to James that he was fighting with his genes and was insulin resistant, leading to wide swings in blood sugar that were responsible for his symptoms.

He couldn’t regulate his blood sugar because he pumped out too much insulin. And this was leading to every one of his symptoms ...

When you eat too much sugar, flour, and white rice, your insulin levels spike.

When this happens, your cells become resistant to its effects. So you pump out more and more insulin, become even MORE resistant to its effects, and end up in the vicious cycle of insulin resistance.

Insulin resistance can cause energy and mood swings -- AND it can take you down the slippery road toward high blood pressure, heart disease, obesity, cancer, brain aging, dementia, and more.

But James is not alone in his problem with blood sugar control ...

Between 80 and 100 million Americans suffer from insulin resistance. It is not exactly the same in everyone, but the ultimate consequences can be similar.

Most people with insulin resistance have extra fat around the middle.

(Quick Tip: Check your waist-to-hip ratio -- the measurement around your belly button divided by the measurement around your hips. If it is greater than 0.8, you likely have insulin resistance.)

You may be tall, thin, short, fat, or any combination of these and still have insulin resistance.

The only way to know for sure is to take an insulin response test, which measures blood sugar AND insulin while you are fasting and 1 and 2 hours after you consume a 75-gram sugar drink.

Just measuring blood sugar alone isn’t enough. You HAVE to measure insulin -- this is something that many doctors miss.

Insulin resistance is not a genetic defect, an error in our evolution, or a mistake by God. It is the result of the simple fact that we have strayed from eating in harmony with our genes. In other words, we do not fit into our genes.

Historically, we ate the equivalent of only 20 teaspoons of sugar a year as hunter–gatherers.

But just 200 years ago, we started consuming about 10 pounds of sugar per person per year -- a 5,000% increase over our evolutionary ancestors!

As if that weren’t bad enough, we now we eat 150 pounds per person per year, or about 1/2 pound each day -- that’s the equivalent of drinking 6 cans of Coke or eating 8 Snickers bars per day.

What’s worst, the average child consumes 34 teaspoons of sugar a day!

That means that we are now eating 75,000% more sugar today than our ancestors did.

This is ridiculous -- no wonder so many of us are sick, fat, tired, and depressed!

We evolved in a world without supermarkets, convenience stores, or fast food restaurants. We had to work for our food and had limited access to refined foods or excess calories.

In fact, our genes are pre-agricultural -- we only started farming 10,000 years ago and only started refining flour about 200 years ago with the advent of the steam engine-powered flourmill.

With the advent of 15,000 low-fat foods (which are also high-sugar, high-calorie foods) on the market over the last 15 to 20 years, we have created an epidemic of increasing obesity, diabetes, and heart disease. The scientific foundation for the low-fat movement was shaky from the start, and the consequences of that movement were the exact opposite of its intentions -- we are now the most unhealthy generation.

Madison Avenue got ahead of medical science to the detriment of us all.

How Does All This Sugar Harm Our Health?

Well, our bodies normally produce insulin in response to food in our stomachs, particularly sugar. When we eat too much sugar we produce FAR too much insulin, and this leads to a variety of health problems.

We once thought that insulin’s only role was to help the sugar enter cells so it could be metabolized, transforming the stored energy of the sun (in plant foods) with the oxygen we breathe into the energy we use every day to run our bodies.

We were wrong.

Insulin has many other effects on the body. And when there is too much of it, the results can be catastrophic.

Here is what too much insulin really does to your body and health:

• Insulin acts on your brain to increase appetite, specifically an appetite for sugar. Try as you might, as long as your insulin levels are high you will fight a losing battle for weight loss.

• It increases LDL cholesterol, lowers HDL cholesterol, raises triglycerides, and increases your blood pressure. Insulin resistance causes 50% of all reported cases of high blood pressure.

• It makes your blood sticky and more likely to clot, leading to heart attacks and strokes.

• It stimulates the growth of cancer cells.

• It increases inflammation and oxidative stress and ages your brain.

• It even increases homocysteine because sugar consumption decreases vitamin B6 and folic acid.

• Insulin also causes sex hormone problems and can lead to infertility, hair growth where you don’t want to grow it, hair loss where you don’t want to lose it, acne, low testosterone in men, and more. It also leads to mood disturbances.

Fortunately, balancing blood sugar and correcting insulin resistance are well within our reach.

Scientific advances of the last few decades show us how.

While some medications can help with insulin resistance, such as Glucophage, Avandia, and Actos, they have side effects and are only a Band-aid unless they are used along with a comprehensive nutrition, exercise, and stress management plan like the one described below.

Resetting Your Metabolism for Optimal Blood Sugar

My goal is to make your metabolism more efficient, to make your cells more intelligent and cooperative, not resistant. In other words, you will need much less insulin to accomplish the task of balancing your blood sugar.

You can achieve this by resetting your metabolism of sugar and insulin.

To do this you have to eliminate the things that are knocking you out of balance, and provide your body the things it needs to reestablish optimal balance and thrive.

Here is what to do:

high-fructose corn syrup

• Don’t drink liquid calories in juice and soda. Your body doesn’t feel full from them, so you eat more all day.

• Stop consuming all processed, junk, or packaged foods. If it doesn’t look like the food your great grandmother ate, stay away.

• Stop eating trans or hydrogenated fats.

• Slow the rate of sugar uptake from the gut by balancing your meals with healthy protein (nuts, seeds, beans, small wild fish, organic chicken), healthy carbs (vegetables, fruit, beans, whole grains), and healthy fats (olive oil, nuts and seeds, avocadoes, fish oil).

• Eat plenty of soluble fiber (30 to 50 grams a day).

• Eat smaller, more frequent meals.

• Make your cells smarter by giving them an oil change with omega-3 fats, which help fix cell membranes so that they can more readily receive the messages from insulin.

• Move your body: Exercise improves your cells’ ability to work better, respond to insulin better, and burn sugar faster.

• Relax! Stress reduction also helps improve blood sugar control.

• Make your cells more efficient by increasing specific nutrients, such as chromium, vanadium, magnesium, vitamin E, biotin, the B vitamins, zinc, bioflavonoids, and some newer compounds including alpha lipoic acid, arginine, and carnitine.

• Herbs may also be of benefit. These include Panax ginseng, ginkgo biloba, green tea, fenugreek, gymnema sylvestre, bitter melon, and garlic.

Just balancing this one hormone -- insulin -- can have wide-ranging effects on all your other hormones and brain chemicals and is a great place to start on your path to vibrant health.

Just try these suggestions for 1 week and see how you feel -- you may be shocked at how quickly your body can recover.

Now I’d like to hear from you ...

What do you think can be done to cleanse our food supply of so much sugar?

Do you believe the corn industry’s ads on the safety of high-fructose corn syrup?

How can we protect our children from consuming massive amounts of sugar?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

How to Optimize Your Nutrition for Vibrant Health

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 24 Jun 2009 17:29:55 -0400

Confused about what "good nutrition" is?

You shouldn't be -– we know what works and what doesn't.

In a moment, I will share 5 simple tips to help you optimize your nutrition and achieve vibrant health, but first let me clear up a few misconceptions.

Despite the "conflicting" scientific studies and media reports designed to confound rather than enlighten, there is no confusion about what constitutes good nutrition.

If we were to gather the world's top nutrition scientists and experts —- free from food industry influence -- there would be very little debate about the essential properties of good nutrition.

Unfortunately, most doctors are nutritionally illiterate. Worse, they don’t know how to use the most powerful medicine available to them: food.

Common sense and scientific research both lead us to the conclusion that if we want healthy bodies, we must put the right raw materials into our bodies: real, whole, local, fresh, unadulterated, unprocessed, and chemical-, hormone-, and antibiotic-free food.

There is NO role in our diets for foreign molecules such as trans fats and high-fructose corn syrup, which interfere with our biology at every level.

If you want junk out, put junk in. Enough said.

If you want a whole, healthy body, put in whole real food.

Today I will explain how you can do that ...

This is the first in a 7-part series where I will give detailed explanations about each of the 7 Keys to UltraWellness. Key #1 is Optimize Nutrition, and in this blog I will explain what constitutes a healthy diet, give you some tips to help you optimize your nutrition, and clarify whether or not supplements are truly a waste of money.

The Basics of a Healthy Diet

What I am about to share might be shocking ...

Carbohydrates are the single most important food for long-term health and well-being.

This may be surprising given the low-carb movement, and "carbophobia" in our country, but it's true.

Of course, I don't mean the over-processed, refined, sugary, white foods we commonly think of as carbohydrates, such as donuts, bread, bagels, muffins, colas, juices, and most junk food.

And I don't mean the cheap, super-sweet, government-subsidized high-fructose corn syrup that is driving our epidemic of obesity and chronic disease.

The carbohydrates I am talking about are the real, whole, nourishing plant foods that the human species has thrived on since from the dawn of evolution.

Most of the food consumed by humans since the beginning of time has been carbohydrates. In fact, plant foods are comprised mostly of carbohydrates: vegetables, fruits, beans, whole grains, nuts, seeds, herbs, and spices.

These foods contain slowly released sources of sugar that prevent surges of blood sugar and insulin. Too much insulin causes heart disease, diabetes, cancer, depression, and even dementia.

Carbohydrates contain almost all the vitamins and minerals our bodies need to operate normally and optimally.

They also contain fiber, which helps normalize our digestive function and slows the absorption of sugar and fats into the body, keeping us balanced.

The bonuses in plant foods are phytonutrients -- colorful healing compounds made by plants to protect themselves, but that also protect us against aging, obesity, brain damage, and more.

For example, broccoli and the cruciferous vegetable family contain powerful detoxifying compounds that protect us against environmental toxins.

Green tea contains anti-inflammatory, antioxidant, and detoxifying properties.

Resveratrol from red grapes boosts our energy production and protects our cells.

These are just a few examples of the thousands of phytonutrients in the plant foods that should be the foundation of our diet.

Michael Pollan, the author of The Omnivore's Dilemma, summed up all nutritional research in 3 simple principles:

"Eat food. Not too much. Mostly plants."

In fact, you need know nothing else to be vibrantly healthy.

That's it. Eat real whole food as it came from the earth: fresh vegetables, fruits, beans, whole grains, nuts, seeds, herbs and spices, eggs, and lean animal protein like fish and chicken.

Imagine what your great-grandmother would recognize as food, or what might have been on her dinner table. Just food. There is really no such thing as junk food –- there is just food, and then there is junk.

Whole foods that contain phytonutrients, vitamins, minerals, omega-3 fats, and fiber all directly, immediately, and specifically interact with our genes, controlling moment-to-moment changes in our physiology and biochemistry.

Food literally talks to our genes. Food is not just a source of calories, it is also a source of INFORMATION.

The key is to send the right information to your genes by eating whole, real, food -- mostly plants. Specific nutrients or plant compounds bind to receptors in cells, translating messages from the foods we eat or vitamins we take in into instructions that are carried out by our cells through their effect on our DNA.

That is why food can heal or harm. You make that choice every day by what you put on your fork.

That means if you eat whole, real, fresh food, you don’t need vitamins. Right?

Well, maybe ...

Do We Need Vitamins or Not?

I agree that you don’t need vitamins and that they are a waste of money.

But that is true ONLY if you eat wild, fresh, whole, organic, local, non-genetically modified food grown in virgin mineral and nutrient rich soils, and not transported across vast distances and stored for months before eaten.

It is true ONLY if you work and live outside, breathe only fresh unpolluted air, drink only pure, clean water, sleep nine hours a night, move your body every day, and are free from chronic stressors and exposures to environmental toxins.

Then you don’t need vitamins.

But, of course, this describes absolutely no one on the planet! Therefore, in reality, we ALL need vitamins.

Most people don’t understand the role of vitamins and minerals in our bodies. I certainly didn't when I finished my medical training.

I thought if we just got enough of a nutrient to prevent some horrible deficiency state like scurvy (vitamin C deficiency), then we didn't have to worry about getting more than that.

I also believed that if you ate "enriched food" like white flour with a few vitamins added back in, or milk with vitamin D added in, additional vitamin supplementation was a waste.

What most people don't realize is the same thing that I didn’t realize when I first started practicing medicine: The real reason our food supply must be "enriched" is because it has been so processed that it is "impoverished" to start with.

So why can’t you just eat "nutrient-rich" food, instead of eating "nutrient-poor" food?

Today, even with our "enriched food," more than 92 percent of Americans are deficient in one or more vitamins. That doesn't mean they are receiving less than the amount they need to get for optimal health. That means they receive less than the MINIMUM amount necessary to prevent deficiency diseases.

In a study published in the Journal of the American College of Nutrition, researchers found that 6 percent of those tested had serious vitamin C deficiency and 30 percent were borderline low.

A report in the journal Pediatrics found that obesity and malnutrition can coexist. Obese, overfed, and undernourished children with cognitive disorders were found to have scurvy and severe vitamin D deficiency or rickets. These deficiencies damaged their brains. You never think of an overweight person as malnourished, but they are!

A USDA survey showed that 37 percent of Americans don’t get enough vitamin C, 70 percent not enough vitamin E, almost 75 percent don’t get enough zinc, and 40 percent don’t get enough iron.

I would say that 100 percent of us don't have enough of the basic nutrients to create optimal health or give ourselves a metabolic tune up.

There are many reasons why the foods we eat no longer contain the nutrient levels we require for optimal health. Crops are raised in soil where nutrients have been depleted. Plants are treated with pesticides and other chemicals so they no longer have to fight to live, which further diminishes their nutrient levels and their phytonutrient content—not to mention the toxic exposure we receive from such chemicals.

Animals are cooped up in pens or giant feedlots instead of roaming free and eating the nutrient-rich wild grains and grasses they once consumed. Since cows' stomachs are adapted to grass instead of corn, they must take antibiotics to prevent them from exploding.

To complicate this further, all of us are exposed to hazardous toxins and chemicals that poison our bodies; we live with too much stress; we don't sleep enough; we don't exercise enough; and we are inflamed -- making the nutritional demands on our bodies even greater.

The question is not how much of a certain nutrient or vitamin we need to not get sick, but how much we need to be optimally healthy! In fact, lower amounts recommended by the government may NOT be enough.

Most people can get what they need by taking the following essential supplements every day:

magnesium

Vitamin D

Fish oil

folate and vitamins B6 and B12

I have tested thousands of patients for vitamin and nutrient deficiencies and found that by correcting them, people feel better, their mood, mental sharpness, memory, and ability to focus improve, they have more energy, and they even lose weight. It also helps prevent disease.

In my 20+ years of practicing medicine with thousands of patients, I have seen depression, anxiety, bipolar disease, autism, ADHD, mood swings, Parkinson’s disease, and dementia go away or dramatically improve when people get the right nutrients.

In today's world, everyone needs a basic multivitamin and mineral supplement. The research is overwhelming on this point.

So what are the takeaways here? What do you need to do to optimize your nutrition?

Here are some simple steps you can begin taking immediately:

1. Eat whole, real, fresh, organic, unprocessed food.

2. Eat a lot of fruits and vegetables full of colorful phytonutrients. That means eating five to nine servings of fruits and vegetables a day. Choose a wide variety and you will do much to support your health.

3. Eat foods with plenty of fiber. Think whole grains like brown rice, quinoa, and millet and vegetables like celery, asparagus, and leeks. Fiber is essential for balancing blood sugar and maintaining a healthy bowel.

4. Eat foods containing omega-3 fats. I recommend eating protein at every meal, and some of the best sources of protein have an abundance of these healthy fats, which are essential for building every cell membrane in your body. Try cold-water river fish like salmon, sardines, and halibut; eat omega-3 eggs; and eat plenty of nuts like almonds, macadamias, and walnuts.

5. Take the essential supplements outlined above every day. They are the basic workhorse team needed to support every biochemical reaction in your body.

Now I’d like to hear from you ...

What do you think about the quality of our food supply?

Do you think supplements are effective?

Do you have any tips for others on how to more easily eat real, whole foods?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

The 7 Keys to UltraWellness: Discover Why You are Sick and How You Can Heal

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 17 Jun 2009 12:14:29 -0400

"I didn’t know how bad I was feeling until I started feeling better."

That is what my patients tell me every day. They go from being ill or just okay to experiencing UltraWellness.

Most people don’t know how poorly they feel until they feel better. In fact, most of us don’t recognize that fatigue, digestive problems, aches and pains, allergies, headaches, and more aren’t just annoying symptoms. They are early clues to impending diseases that can disable and kill us.

Most heart disease starts in the womb. You can detect brain changes in teenagers that can predict the development of Alzheimer’s disease. Blood tests in children can predict who will develop diabetes later in life. Most cancers take more than 30 years to grow to the size where they can be detected.

How can we address problems that we don’t even know we have?

There is an answer. It lies in the revolution that is happening in medicine today. That revolution is called functional medicine. I call it UltraWellness, and that is what you are going to learn about today ...

How I Found the Real Cure for Chronic Illness

One in three Americans has some type of chronic disease -- and most of the rest of us are headed toward one. Most of us don’t feel as well as we should or could if only we understood how to care for and feed our bodies the way they were designed.

Conventional medicine helps at the very end stages of disease. If you are very sick, have an emergency, break a bone or have a raging infection, then, yes, conventional acute care medicine is the right solution. As former emergency room doctor and the husband of an orthopedic surgeon, I am glad we have this care when we need it.

But when I worked in the emergency room, I felt I was saving people just before (or sometimes after) they were washed DOWNSTREAM and over the waterfall to their death.

I began to wonder what led them to this point -- what happened UPSTREAM in the process of disease and illness. What were the real causes of disease? If I could answer that question, then I thought I might be able to help prevent disease in the first place.

The early influences on my thinking—from Asian philosophy, to nutritional biochemistry, to the study of ecology and ecosystems -- all helped me form new and different view of health and disease.

I am one doctor who is part of a movement that is on the cutting edge of an entire shift in our scientific model of disease. It is called systems medicine, or functional medicine.

It provides a way of understanding all the influences on our biology that are at the root of illness and how our lifestyle and environment interact with our genes to create the imbalances or balances that are the real determinants of disease or health.

This medical view does not reduce symptoms and diseases to their component parts and traditional specialties, but studies the entire ecology of the body and its environment.

I have practiced this model for over 15 years and seen miracle after miracle, day after day. People don’t only get relief from symptoms, they get truly well. That is why I have called this approach to health UltraWellness.

It is the answer to the crisis we find ourselves in -- an increasing epidemic of chronic disease and an impending economic collapse as more of our resources are put toward caring for the chronically ill.

Today, medicine is in a serious predicament. The way we understand health and disease no longer reflects biological reality or the biological laws of nature. We need to understand that diseases are not fixed things that you catch or that just show up out of context, but are related to the environment, your diet, genes, and lifestyle.

We need to understand that the body is an ecosystem and is part of a larger ecosystem. Understanding how all the parts relate and what disturbs our ecological balance is more important than naming the disease, blaming the name for the problem, and thinking a drug will fix the disease.

I call this the "naming and blaming" game.

For example, depression doesn’t just show up without cause or reason. It is related to a web of forces that we can influence and affect.

What systems medicine, functional medicine, and UltraWellness are about is "thinking and linking." That means seeing all the patterns and relationships that make sense of your whole story -- your lifestyle, stresses, genes, environment and how they interact with your biology to create imbalances that lead to disease.

Our current way of thinking is outdated, wrong, and will not help us address our declining health as individuals or as a society.

That’s why we are making no progress and even backsliding when it comes to addressing chronic disease.

Let’s look at the data.

Chronic diseases affect 133 million Americans. That means in the average family of three, at least one person has a chronic disease. We are seeing an epidemic of autoimmune (24 million Americans), allergic (50 million Americans), and asthmatic (30 million Americans) diseases in this country. In addition, 20 percent of Americans (about 60 million people) have irritable bowel syndrome.

In fact, the rates of nearly every modern disease -- autoimmune diseases, allergic diseases, digestive problems, heart disease, cancer, obesity, diabetes, and dementia—are increasing. One in three children born today will have type 2 diabetes. One in two people over age 85 will develop dementia.

These problems are increasing in the population at a dramatic rate. And they affect everyone, either personally or through the suffering of someone close to them.

But it doesn’t have to be this way. We have all the information we need right now to end or greatly reduce the suffering of so many. The answer lies within the 7 keys to UltraWellness.

I know this, because I watch miracles happen every day ...

The Promise of UltraWellness

Every day in my office, I see patients who feel alive again after expecting to suffer their whole lives from chronic problems like bad digestion, headaches, fatigue, arthritis, allergies, hormonal problems, obesity, heart disease, and depression.

But within a few months—even weeks—their lives open up again. This week alone, I spoke to a 27-year-old woman who could not lose weight and was constantly tired. She finally lost 20 pounds effortlessly by getting treating her mercury toxicity.

And there was the 78-year-old woman who felt she was on her way out with symptoms of fatigue, memory loss, joint pains, and bad digestion. She now works out every day and is full of energy, simply by treating her nutritional deficiencies and getting back in balance.

And the 30-year-old woman with PMS, migraines, stomachaches, acne, and polycystic ovarian syndrome who is completely better after getting her system back in balance.

And the 47-year-old woman with chronic sinus infections and fatigue who hasn’t had a problem all winter.

And that was just part of one day!

The reality is that most of us don’t know how bad we feel until we start feeling better. We accept chronic symptoms as a necessary part of life. That is just not necessary. We have solutions today that you are not hearing about.

I have learned so much in the last 20 years of seeing patients, studying the scientific literature, combining my knowledge and observations with other doctors who are also practicing systems and functional medicine, and applying it in my practice. And I am committed to sharing that information with you because it works.

It is not perfect, nor can it address 100 precent of health problems 100 percent of the time, but it is a better mousetrap!

This is the promise of UltraWellness -- the opportunity to cure or dramatically improve chronic problems that are poorly addressed by conventional medicine, and to discover vital, vibrant good health at any age.

There are 7 fundamental new principles or concepts that help me navigate to the underlying causes of disease and that will help you achieve UltraWellness.

These concepts are my new roadmap in the landscape of health and disease and I will share them with you so you can take advantage of them today.

This is the future of medicine now. It will help you transform your health, and will contribute to the transformation of our "sick care" system to a healthcare system!

First, we must understand how everything in our environment interacts with our genes to create health or disease, especially our diet and nutritional status. Air, water, microorganisms, exercise, trauma, psychosocial factors, environmental toxins and radiation also affect our genes and our health.

Second, we must understand how our hormones and brain chemistry influence nearly every aspect of our health, why they get out of balance, and how to get them back in balance.

Third, we must understand how most of us have smoldering hidden inflammation that will kill us until we learn how to control it.

Fourth, we must understand that our digestive system is at the core of our health, why it breaks down, and how to repair it.

Fifth, we must understand how toxins and problems with our detoxification or waste management systems lead to chronic health problems and how to optimize this detoxification system.

Sixth, we must understand the importance of energy -- how we make it, why we lose it, and how to create more of it.

And finally, we must understand how the mind interacts with the body and how the body interacts with the mind to influence and affect each of our other systems.

Understand that these are really not all separate systems. They are part of a web of function and physiology that is at the root of both health and disease.

This revolutionary new way of thinking about health and disease will guide you toward something many people have given up on experiencing -- UltraWellness.

Often when I explain this to people for the first time they remark on how simple and obvious this seems. Why didn’t anyone explain it like that before?

That’s very true.

And it reminds me of T.H. Huxley's reaction to the reading of Darwin’s The Origin of Species: "How extremely stupid not to have thought of that."

Now I’d like to hear from you ...

Do you have annoying, seemingly harmless symptoms like those mentioned here?

How has conventional medicine treated them?

Which, if any, of the seven keys to UltraWellness have you already tried?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

How To Fix Obama's Health Plan Before It's Too Late

blog-editor@marmaladesoul.com (Blog Editor) — Wed, 10 Jun 2009 15:49:52 -0400

The Chinese word for crisis is comprised of two separate words, "danger" and "opportunity" -- and this describes the exact situation we face with the healthcare crisis in our country.

As a nation we are at the precipice of change for our healthcare system.

But if we make the wrong choices and simply provide universal coverage to an outdated 19th and 20th century model of medicine, this crisis will lead us into danger.

However, there are different choices we can make now that will lead to profound opportunity -- one that may provide real solutions to our healthcare crisis.

Today, I will outline a 9-point plan for real healthcare reform. This plan takes into account all of the changes we need to make -- including the fundamental shift in the type of medicine we practice -- if we are going to truly resolve the health catastrophe in this country.

Hope for a Brighter Future in Medicine

Despite the looming dangers we face as we work to change medicine, I have hope.

Over the last few months, I have been privileged to participate in events at the nexus of change that have all focused on fundamentally changing our disease-based healthcare system to one focused on creating health and wellness.

These ideas are not yet at the center of the healthcare debate, but they must be -- and they can be.

In February of this year, the Institute of Medicine held a Summit on Integrative Medicine and the Health of the Public at the National Academy of Sciences. Six hundred key leaders and stakeholders in healthcare including educators, scientists, community leaders, practitioners, lawmakers, policy makers, and insurance leaders attended it.

It was a broad coalition that came together with a common purpose to change not only the way we practice medicine, but also the type of medicine we practice.

I believe the medicine at the core of healthcare reform must be founded on the clinical model and framework for practice developed by the Institute for Functional Medicine, a nonprofit organization of which I am a member. The Institute's mission is to support the widespread adoption of functional medicine.

This new way of thinking about health and disease is the biggest secret in healthcare today, yet it is the most effective model to address the current drivers of cost and chronic disease. To spread the word, the Institute recently published a detailed white paper called "21st Century Medicine: A New Model for Medical Education and Practice."

The same week the white paper was published, I testified on integrative and functional medicine before Senator Edward Kennedy’s Senate working group on healthcare reform, alongside other leaders in healthcare including Drs. Dean Ornish, Mehmet Oz, and Andrew Weil. The full testimony is available for the Committee on Health, Education, Labor, and Pensions, "Integrative Care: A Pathway to a Healthier Nation."

I also met with key policy makers in the White House. and was heartened by their openness and willingness to find a way to true healthcare reform.

More recently, at a retreat center on the edge of a Minnesota pond, I was privileged to be part of a think tank sponsored by the National Institutes of Health on "whole systems research."

It was an international gathering of systems biologists, mathematicians, physicists, geneticists, physiologists, psychologists, researchers, and doctors from a dozen countries and diverse backgrounds—Palestinians and Jews, Chinese and Iraqis, French and Germans -- all exploring very important but neglected questions that hold the solution to our epidemic of chronic disease.

In this isolated place, the thinkers with their fingers on the pulse of the future all suddenly came to the same conclusion. The way we do research doesn’t help us understand how things really work as a whole, integrated system.

In other words, the current model of studying one drug, chemical pathway, or gene for one disease doesn’t give us useful answers to how we get sick and how we can get well.

What everyone at the conference understood at that moment is the same truth we need to come to as a nation ...

The old, conventional model of medicine and scientific research is simply outdated. It must give way to a new way of thinking about health and illness and a new method for medical practice.

A 9-Point Plan for Real Healthcare Reform

I believe that real healthcare reform is now possible because of a perfect storm where alignment of economic, scientific, and moral imperatives provides us an opportunity to do well as a nation by doing good, through fundamentally changing the kind of medicine we practice.

But to achieve that goal will require the collective imagination, intention, focus, and action of healthcare providers, consumers, industry, and policy makers.

A coordinated effort across government agencies and industry sectors focusing on health and wellness, incorporating what we already know, is urgently needed. We also need leadership at the highest levels of the White House to successfully create a culture of health and wellness and transform our healthcare system.

The 9-point plan below, while not at the center of the healthcare debate, is essential to create real change and avert disaster.

Just as horse-and-buggy makers gave way to the automobile, and 8-track tape manufacturers gave way to the iPod so must conventional medicine give way to a new way of practice.

Yes, some industries will fade, as funds are allocated toward policies and initiatives that prevent and treat chronic disease through dietary, lifestyle, and community interventions instead of expensive drugs and medical technologies. But other industries that promote health and wellness will flourish in their place.

These policies and initiatives are necessary for healthcare reform that addresses the true causes of our chronic disease epidemic and exploding costs. These are the changes that must be made if we are going to fix our broken healthcare system:

2. Improve research by comparing existing drug- and procedure-based medicine to changes in lifestyle, diet, and other functional and integrative approaches.

3. Transform medical education by including nutrition, lifestyle, and environmental factors as core components of the education of health professionals and physicians.

4. Establish an Institute for Functional Medicine at the federal level that would develop the educational curriculum for medical schools, residencies, postgraduate education, and other health professionals.

5. Improve food policy, agriculture policy, and school and community environments to encourage health by prohibiting food that is known to promote obesity and disease and providing whole, real, fresh foods for our children. Obese teenagers have the same risk of premature death as heavy smokers. We wouldn’t feed our dogs cola, burgers, and fries -- so why do we feed them to our children?

6. Conduct projects in community health centers that demonstrate how offering inexpensive, nutritious meals (including takeout), recreational facilities, lifestyle counseling/education (like cooking classes), and healthcare based on functional medicine at one location can dramatically improve health outcomes.

7. Impose limits on pharmaceutical and unhealthful food advertising. More than $30 billion is spent on marketing junk and fast food to consumers, including $13 billion targeted at children, and more than $30 billion is spent by the pharmaceutical industry on marketing drugs to physicians (about $30,000 annually per physician). Direct-to-consumer drug advertising also drives prescribing practices based on preferences induced by commercials rather than science.

8. Develop a system of electronic medical records that facilitates 21st-century, systems-based, functional medicine. We shouldn’t simply transfer 19th- and 20th-century medical records-keeping systems to an electronic format.

9. Create a White House Office on Wellness, Health Promotion, and Integrative Health as a way to develop an ongoing vehicle for coordination of strategy and policy. It should focus specifically on coordinating and developing policies and programs for lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.

These changes won’t take place overnight, and they won’t be easy. But they can happen.

However, the only way they will happen is if the average person—that means you—gets involved and votes for change every day with your fork, with your feet, and with your voice.

We are facing a watershed moment in the history of medicine, one where changing the very way we understand and treat disease is finally possible.

But we all must work together to effect such a tremendous change in our medical system.

As Margaret Mead said, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

We now have all the information we need to cure or dramatically improve chronic problems that are poorly addressed by conventional medicine and to discover vital, vibrant, good health at any age.

And we can finally transform our "sick care" system into a healthcare system that promises vibrant health and vitality to every man, woman, and child in this country.

The answer lies in functional medicine –- the future of medicine, available now.

Now I’d like to hear from you ...

What do you think of my 9 point plan?

Do you have any other suggestions?

How do you think functional medicine can help improve healthcare?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

Obama's Health Plan: What Matters the Most is Missing

blog-editor@marmaladesoul.com (Blog Editor) — Tue, 02 Jun 2009 16:34:03 -0400

Want to know the real truth about healthcare in this country?

Even if President Obama and Congress get everything else right in healthcare reform, it won’t matter ... that is, unless we address the underlying causes of illness that drive both skyrocketing healthcare costs and the proliferation of chronic disease.

But we can’t get there with our current model of medicine, and that’s what nobody is currently talking about, not even President Obama.

But there is a solution ...

Thankfully, an innovative approach currently exists that can not only prevent but also more effectively TREAT chronic disease ... more about that in a moment.

To effectively reform healthcare in the U.S., we must change not only the WAY we practice medicine, but also the TYPE of medicine we practice.

We must improve financing and delivery of healthcare, as well as our fundamental scientific approach to chronic disease -- an epidemic that now affects 133 million Americans and accounts for 78 percent of healthcare costs.

Healthcare costs are now approaching 20 percent of the U.S. gross domestic product -- approximately $2.5 trillion, or $8,160 per person annually. This is more than what the federal government spends on national defense, homeland security, education, and welfare combined!

Unless real change is made we are facing an impending collapse of our economy as more of our resources are put toward caring for the chronically ill.

This is a national security issue that threatens our standing in the world. As President Obama has stated, "Healthcare reform is no longer just a moral imperative, it is a fiscal imperative."

Fortunately, there is a new model of medicine that offers the real change we need. This new medicine is personalized, preventive, predictive, participatory, and patient-centered.

It is proactive rather than reactive. And it addresses the causes of disease and optimizes biologic function in the body’s core physiologic systems, rather than just treating symptoms.

This model exists TODAY – it is based on systems biology and is called functional medicine.

Why We Need to Change Healthcare Now

Our current model of medicine is unsustainable because it cannot stem the rising tide of chronic disease.

Relying only on reforms in coverage or access, financing, electronic records, malpractice, medical errors, coordination of care, and research on new drug therapies -- while retaining the conventional acute-care model -- will be untenable in the long run.

To be sure, such reforms are necessary, but not sufficient to avoid the collapse of our healthcare system, which may soon dwarf our current financial crisis if the Medicare trust fund runs out in 2016 as projected. According to the "Status of the Social Security and Medicare Programs" annual trustees report just published, the program is actually bankrupt right now. It's taken in less money than it has paid out two years running.(1)

This is not being alarmist; this is simply facing reality.

Here's the problem: These reforms do not alter the fundamental approach to prevention and treatment.

If we focus on improving the way we practice the medicine of the past, we will still have the medicine of the past. If we improve the wrong type of care, then we will simply be doing the wrong things better.

Conventional acute-care medicine is disease-, drug-, and procedure-based and is designed for acute illness, trauma, and end-stage disease for which it is the best form of treatment in the world.

As a result, our current medical education focuses on sickness rather than health; journals publish about disease management not what causes disease.

However, disease-based, acute-care medicine is the WRONG model to address chronic illness, because it doesn’t address WHY people are sick or the underlying mechanisms and biologic causes of their illness.

This is why we spend more money than any other industrialized nation on healthcare yet are near the bottom of the list for all major health outcomes. This is why we are witnessing a decline in life expectancy for the first time in history.

The Right Solution for the Problem of Chronic Disease

Functional medicine, on the other hand, is a system of personalized care that directly addresses how our environment and lifestyle influence our genes to create imbalances in our core biologic systems that, over time, manifest as disease. It is this kind of medicine that is needed to create real success in 21st century medicine.

Functional medicine is not a new treatment, test, or procedure -- it is a new "operating system" or method for problem solving and processing complex clinical information.

It is a fundamentally different way of thinking about the origins and mechanisms of illness. It encompasses all the TOOLS of healing and medicine, both conventional and integrative. And it provides a common language, a map or GPS system for navigating through the puzzle of chronic illness.

Simply put, functional medicine identifies why our underlying biology is imbalanced and corrects those imbalances. Then our body's natural healing intelligence takes over and automatically fixes what's ailing us.

This is the future of medicine and it's available right now.

A growing coalition of practitioners, educators, and scientists is dedicated to advancing this model. I am part of that coalition.

We at The Institute for Functional Medicine have introduced 20,000 physicians and healthcare providers to functional medicine since 1991, and we wrote the Textbook of Functional Medicine in 2005 to describe both the underlying science and the practical clinical strategies and tools that comprise this new model.

This is not just an elegant theory –- it works in practice ... something that I am very familiar with since I have been practicing functional medicine for over 10 years.

Let me illustrate how this works with real patients I have treated in my practice.

A Woman with Multiple Chronic Diseases

Deborah, a 46-year-old woman, having seen a dozen doctors over a dozen years, came to me with 29 different diagnoses, including depression, hypertension, obesity, polycystic ovarian syndrome, migraines, heavy menstrual bleeding, asthma, sinusitis, irritable bowel syndrome, reflux, fibromyalgia, osteoarthritis, and psoriasis.

Each disease was treated with the best available conventional treatment. But she was still sick, despite 9 medications.

Of course, she didn't have 29 separate diseases. She had imbalances in a few of her core underlying biologic systems -- digestive, immunologic, and hormonal -- that gave rise to all her symptoms.

The underlying cause of all her "diseases" was an autoimmune response to gluten, leading to autoimmune thyroid disease and severe vitamin D deficiency because of low absorption of nutrients from the foods she consumed.

Six weeks after eliminating gluten from her diet (wheat, barley, rye, etc.), improving her diet, and replacing thyroid hormone and vitamin D, her 29 diseases were completely gone -- along with 21 pounds ... not a bad side effect!

A Boy with Attention Deficit Disorder and Asthma and Allergies

Clayton was a 12-year-old boy who had been diagnosed with severe attention deficit hyperactivity disorder (ADHD) and behavior problems and had poor school performance who was on Ritalin for years. He also had illegible handwriting, or dysgraphia.

He also had apparently "unrelated" problems of asthma, allergies, hives, stomachaches, headaches, insomnia, muscle cramps, and anxiety and a history frequent infections and antibiotic use.

He had seen 5 specialists (lung, gastroenterologist, allergist, psychiatrist, and neurologist) and was on 7 medications for allergies, asthma, pain, and ADHD. No one asked how everything was connected, or how his diet of junk food and sugar made him sick.

His immune system was activated, his digestion not working, and he was nutritionally deficient in zinc, omega-3 fats, magnesium, and vitamin B6.

We simply normalized his biologic function by removing impediments to health (junk food diet, food sensitivities, overgrowth of yeast, and lead) and providing the ingredients necessary for optimal biologic function -- a whole-foods diet, additional nutrients including vitamin B6, magnesium, zinc, omega-3 fats, and probiotics.

In two months he returned without any physical or psychiatric symptoms and was off all his medication. His mother brought a sample of his handwriting, which had gone from illegible to normal, simply by getting his brain working again by getting his body in balance.

A Once in a Lifetime Opportunity for Real Reform ...

This model of care is the basis for the type of medicine that must be at the center of healthcare reform. I live in the trenches as a practicing doctor, treating real people who are suffering from real problems.

These problems have real solutions, which are being overlooked -- solutions that hold the key to saving our healthcare system from self-destruction.

Functional or systems medicine needs to be the "Intel inside" that drives the type of medicine that is practiced as we create a new healthcare system.

Real healthcare reform is now possible in a perfect storm where the alignment of economic, scientific, and moral imperatives provides an opportunity for us as a nation to do well by doing good through fundamentally changing the type of medicine we practice.

It will require the collective imagination, intention, focus, and action by healthcare providers, consumers, industry, and policy makers. But we can do it, and we must do it now.

In the words of the ancient sage, Rabbi Hillel, "If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?"

Now I’d like to hear from you ...

What steps do you think will be necessary for successful healthcare reform?

How do you think healthcare reform will be achieved?

What do you think is the biggest obstacle we will face in reforming healthcare?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

(1) http://www.ssa.gov/OACT/TRSUM/index.html