Supplements: Useful Or Useless?

a lot of supplements out there are not great because they're not giving the right type of nutrients within the supplement [Music] welcome to the doctor's pharmacy i'm dr mark hyman and that's pharmacy with an ffar macy a place for conversations that matter and if you've ever worried if you should take vitamins if you're nutritionally deficient or if it's all a bunch of huey this podcast is going to be very interesting to you because it's with my friend colleague at the ultra wellness center the medical director here dr elizabeth bowham on this special episode of the doctor's pharmacy we call house call and we dive deep into issues around functional medicine and how to treat difficult problems that aren't getting better using traditional care so welcome liz thank you mark thanks for having me liz is a doctor's doctor she is a md she's an rd nutritionist and she's an exercise physiologist and she's one of the leading thinkers uh teachers and faculty and functional medicine around the world she's taught in south africa london and all over the united states she's a key part of our faculty at the institute for functional medicine and she's been my colleague here forever at the ultra wellness center we've worked together before that at canyon ranch for 20 plus years now it's amazing and i don't think you look any different than you did 20 years ago neither do you maybe a few more gray hair so welcome welcome we're going to talk today about nutrition and nutritional deficiencies and nutritional testing and why uh we should be concerned about these so liz from a traditional medical point of view we were trained that you should be able to get all your nutrients from food that supplements are often a waste of money and just create expensive urine uh how do you address that you know i i remember and in my training it was the same right like i was trained to to say let's focus on food for first right which we always do we always want to focus on food first and not to really you know supplements aren't going to be that helpful and don't use them and you know i remember i remember when i first took a multivitamin a good multivitamin so this was after my nutrition training after i was in rd after i was it was probably when i was at canyon ranch and you weren't even a nutritionally trained md yes so you did a fellowship in nutrition as a doctor so you know i i you know i was always trying to get all my nutrients from food and teaching my patients to get all my their nutrients from food and so i remember taking a really good quality multi all of a sudden going wow oh i have all this energy that i didn't realize i didn't have right it was it made a huge difference for me and i think in a lot of ways multis are almost the least important supplement we give but it for for me and for so many of my patients sometimes even a multi can be can make a huge difference and i think what what is really important to pay attention to with supplements is that when we use them in a personalized approach when we're testing when we're we're using them based on what that individual person needs not just saying okay everybody take this which sometimes that's helpful too but but really figuring out for that individual person what are they deficient in where do they need to focus that can make a huge huge difference for how they feel it's so true and i think you know we're we're taught that we should really get everything from food but there's been a lot of problems with our food supply that's true you know we aside from us eating mountains of processed food which has got no nutrients except things that are fortified right yeah enriched why are they enriching because it's impoverished to start with right and on top of that the way we grow our food in soil that's depleted because of industrial farming techniques because of the fertilizers and chemicals that literally destroy the microbiome of the soil which is needed to extract nutrients from the dirt from the soil that the plants can use which then we eat we've seen 50 reduction in nutrient levels like magnesium and other minerals in our vegetables over the last 50 years so if you're eating broccoli today and you made it 50 years ago it's a different food it's a difference shipping them over long distances the average apple you eat has been in a storage house for a year right and they're they're refrigerated kept in storage they're transported so they lose nutrition and we're also living a lifestyle that depletes our nutrients yep we're drinking too much alcohol smoking eating processed food which by the way in order to we'll talk about in order to actually metabolize your food the way your food is metabolized is requiring vitamins and minerals to run that as cofactors for all those enzymes right to run the food through your metabolic factory you can't i like the assembly line if you don't have the nutrients you can't run the food through right and so you get more depleted and then we have all these drugs we take that deplete our nutrients yes medications uh and then yes so we have all these reasons why we're nutritionally deficient so talk to us about what are we seeing in america and then we'll talk about what we're seeing here at the ultra wellness center because we we don't just guess here we test yes and uh it's shocking honestly to see the level of nutritional deficiencies and what who you think would be a well-nourished healthy person so tell us about the kinds of nutritional efficiencies we're seeing at scale in america and why they're so important i mean if you just look at what people are eating we're seeing that 68 of americans are not getting enough magnesium and so 68 are not meeting the rdi the recommended dietary intake and we have to remember that that rdi was set for just sufficiency so you know not having a deficiency in magnesium so which what that means is those recommendations are not set at what is optimal either for that individual person so they're just the minimum requirement in a sense so 68 of us are not getting enough magnesium 40 are not getting enough zinc 78 are not getting enough folate maybe even 90 plus percent are not getting enough of the omega-3s in their diet so we're seeing significant nutritional deficiencies and that's leading to so many issues in terms of chronic disease and also just feeling awful right so what's fascinating to me is you know when i started learning about all this you know i learned about nutrition medical schools like okay vitamin c prevents scurvy and vitamin d prevents rickets and vitamin a prevents you know blindness and b vitamins prevent this and that and i never really understood why they were important other than preventing deficiency diseases which is sort of why we first learned about them was from these diseases and and then i began to understand this and being the thing about you know what do vitamins and minerals actually do in the body right and there's there's 37 billion billion chemical reactions that happen in the body every second 37 billion billion i don't even know what that is it's like a cause a billion kaba jojo you know i don't know it's a lot and every single one of those chemical reactions requires helpers and the helpers are co-factors are vitamins minerals yeah right and and one of the other shocking things i learned was that our dna one third of our dna codes for enzymes so enzymes are catalysts that convert one molecule to another so all these chemical reactions i talked about all need catalysts or enzymes one third of our entire genetic material is coding for these enzymes and there's variations in how they work that make one person require more or less of a different nutrient right so some for example is you need more b vitamins if you have certain variation you might need more folate or b12 or b6 and if you take the normal amount quote the rdi which is not the optimal amount to create health it's the minimum amount necessary to prevent a deficiency disease yes so how much vitamin c do you need to not get scurvy probably 60 milligrams how much vitamin c do you need to optimize your immune system to not get covered probably 4 000 milligrams right and it's different for each person like you're saying based on our genetic makeup right and and everything else going on in our body not just our genetics but what other diseases we're dealing with what other how we digest and absorb our nutrients i mean so many things impact our nutritional needs yeah it's so true your gut microbiome determines yeah what's going on with your nutritional levels and you may not be producing the vitamins in your gut like vitamin k or biotin because you have a bad gut so exactly it's so fascinating to me and and really functional medicine our focus is on nutrition as the first line of therapy and it's both using food as medicine but also understanding the role of key nutrients and playing a role in how they function so you and i have been in this field for a long time and and and you know it's easy to be sort of a little bit arrogant and think that you know the traditional doctor well you know people eat food they don't need vitamins a waste of time waste of money but we we get kind of humbled by seeing actually what happens when we test people and i think despite doctors saying this you know when you look at the data i think i think 72 percent of doctors recommend supplements their patients and 79 take them themselves so whatever they're telling you it's interesting that you know and yeah we see studies that show oh vitamin d doesn't affect heart disease or cancer and and omega-3 fats don't really benefit heart disease or cancer prevention so we see these studies that are conflicting all the time you know i think i think those that that happens for so many reasons right why those studies are conflicting one is because we're um we're putting everybody in that same group so we're not personalizing the approach and so it depends on people's health status how they're digesting absorbing how their their nutritional status in general are they deficient to begin with what are their genetic needs so that really impacts how somebody shifts or or improves from when we give them those nutrients so i think that one of the biggest issues with research is we're not looking at individual variations and snips in somebody's makeup their genetic variations that impact what they need right and so so it just sort of lumps everybody into one category yes so someone for example had like a vitamin d receptor gene that made them require high dose of vitamin d and you took 100 000 people and you saw them taking vitamin d well you think they're taking enough but it might not be enough for that person and if you actually took that subset and you studied them and you gave them the right amount to get their blood levels optimally it might be different it will absolutely be different so we know with fish oil for example if people are eating a couple servings of good fatty fish a week then fish oil supplements might not be as helpful for them but when people aren't eating that then fish oil supplements make a huge difference and help lower triglycerides and decrease risk of heart disease so we know that it really is dependent so much on your individual diet as well as all those other things we've spoken about that's true i always say if you don't have a headache and aspirin doesn't do anything right if your omega-3 levels are already good you take omega-3 and it doesn't it doesn't do anything right right so i think the studies are challenging and often like you said they're in in in it's hard to distinguish you know what the overall health of the patient is and so if these patients are eating crappy diets if they're smoking they're drinking they're not exercising taking a vitamin is not going to help them you know they're not that powerful right in that sense right if you clean up everything and then you add them in they can be extremely effective and powerful so that's not to say that if you're overweight and unhealthy you shouldn't take supplements because i think they will help but it's they work much better if you clean up house first comprehensive program right so um let's talk about how we learn in our practice the ultralinear center about what people's nutritional status is how do we how do we figure that out well so we do we we look at it from multiple different angles right first it starts with a physical exam you know what is their waist-to-hip ratio how are they holding on to weight in their body then we look to look for signs of nutritional deficiencies maybe their hair is dry or their skin is dry or they have different um they have spots on their nails which could indicate zinc deficiency you know we look at their diet intake wait wait the nutritional physical exam i just want to pause because you teach that course as at the institute for functional medicine and it's it's fascinating when you learn as a doctor what the clinical signs are of vitamin deficiencies right so we know the obvious ones that for example if you have scurvy you get no gum issues right if you have the vitamin divisions you get little cracks in your mouth called kelosis yeah if you have white spots on yours might be zinc deficiency if it's bumps on the back of your arms you know or dry skin we think about vitamin a a lot we think about zinc yeah um and my favorite test is a vitamin d test you know what that one is yes tell us about it so when you're if you if you bang on somebody's leg and they have pain then that could be a sign that they're low in vitamin d yeah so if you take your thumb and you press right now ready to go press right now on their shin bone and if it's tender then it means you're probably vitamin d deficient because it makes your bones soft now i take vitamin d so my bone doesn't hurt at all when i press on it you're pressing right now yeah mine doesn't hurt either there you go i'm taking my vitamins you're taking my vitamin d yeah so you could do a simple test so there's a lot of things clinically you can figure out that are signs of nutritional deficiency that's the first and i think that's really important to to look and examine because biomarkers are not perfect which are lab tests but they can be very helpful but they're not perfect at determining everybody's nutritional deficiencies for example magnesium we know that magnesium is we talked about it's a very common deficiency but sometimes the you know serum magnesium and red blood cell magnesium can be normal and somebody can still be deficient in magnesium and would benefit from more magnesium whether it's dietary or supplement wise well that's the other thing we take a detailed history so by actually questionnaires you can determine what your nutritional deficiencies are so i wrote my book ultramined i literally had questionnaires in there how do you know if you're zinc deficient vitamin d deficient magnesium deficient fluid deficient you know so forth and you can you can actually do these questionnaires and you're going to get pretty sense if you're deficient or not and then you look at their diet too you know you look to see what they're eating and what they're not eating you know when somebody's a vegan you're you're thinking more about okay i've gotta i've gotta really look for b12 i've gotta really look for uh issues with iron i've gotta really think about zinc and the omega-3 fats because they're more common deficiencies you know yeah if you're if you're not eating anything iodine you know right so there's things we have to think about depending on what their diet is like and their digestive system so if we do a comprehensive approach and the biomarkers can be really helpful too um they're not perfect but blood tests or what other tests yeah so we can look at blood we look at urine we do this panel called the ion panel and it's this all over nutrition panel gives us so much good information it tells us about amino acid levels those are the the components of protein in the blood building blocks of protein yep and it tells us he tells us about omega levels omega-3 levels omega-6 levels it tells us about mineral levels it tells us about all those steps of the mitochondria in the you know steps of the krebs cycle which need nutrients to work properly like you were talking about those cofactors the vitamins and minerals that help those reactions work so we can take our food and turn it into atp or energy so when we have deficiencies in certain nutrients we'll see shifts in this panel called the organic acid testing which you know that's really helpful it's a urine test it's a urine test so that's really important so what you're saying essentially is that we use a lot of different kinds of testing yes because your typical doctor will check your blood levels but if you check your blood levels of folate or magnesium think oh it's fine you're not necessarily fine so each nutrient requires a very different approach depending on the nutrients so vitamin d yeah you can check your blood level of vitamin d you ought to check the right one but it's pretty good yes right you can check your blood levels of omega-3s pretty good right but you want to check in the right way yes some like folate or b12 or magnesium not so much not so good right and and i think you know you mentioned magnesium it's a really good point so a lot of doctors will check magnesium now if it's low on a regular blood test it means you are in big trouble you're really like you're really low and then you can check red cell magnesium which is a little bit better yep but the true test is something called a magnesium loading test yeah which which is what so you give you give magnesium and then you collect urine for a period of time so that magnesium you know depending on the level of sufficiency that somebody has in their body that will impact how much magnesium that spills over into their urine so it's not until we do very often but it's now you really want to know you got to give someone a load of magnesium if they pee it out they're good if they hold on to it and nothing comes out in the urine they're pretty low hey everybody it's dr hyman thanks for tuning in to the doctor's pharmacy i hope you're loving this podcast it's one of my favorite things to do and introducing you all the experts that i know and i love and that i've learned so much from and i want to tell you about something else i'm doing which is called mark's picks it's my weekly newsletter and in it i share my favorite stuff from foods to supplements to gadgets to tools to enhance your health it's all the cool stuff that i use and that my team uses to optimize and enhance our health and i'd love you to sign up for the weekly newsletter i'll only send it to you once a week on fridays nothing else i promise and all you have to do is go to dr hyman dot com forward slash picks to sign up that's drhyman dot com forward slash picks p-i-c-k-s and sign up for the newsletter and i'll share with you my favorite stuff that i use to enhance my health and get healthier and better and live younger longer now back to this week's episode and you know and you were mentioning folate and b12 i see this all the time people come in with a b12 level that their doctors did and it's normal and so then they go okay they i don't need b12 but but many times that's not really telling us about functional markers of b12 or what what is sufficient for that individual person so we'll do things like methylmalonic acid and homocysteine they're more functional markers of the b vitamins they give us a lot more information than just a serum level of a vitamin so in other words is it is it doing what it's supposed to do in the body and if it's not you're going to see a backup of these other compounds that we don't normally test exactly no doctors structure b12 folate they're fine you may not be fine yes and i've seen many patients who are not fine and who have very severe deficiencies and different types and often you can tell if someone needs a certain type of a nutrient looking at their genetics and their blood tests you can tell they need this form or that form of the nutrients so it becomes very sophisticated in an approach of functional medicine i mean i think that's a great example of where where a lot of supplements out there are not great because they're not giving the right type of nutrients within the supplement so for example if a supplement is um you know less expensive they may use folic acid in the multivitamin and folic not everybody because of their genetic makeup can utilize folic acid and use it for what the body needs folic acid for folate for yeah so folic acid is a synthetic form of folate they may increase risk of problems yes increased risk maybe with cancer right so not everybody can take folate and in the form of folic acid and utilize it if they have a shift in this if they have a genetic variation called the mthfr gene and there's others as well and so those are things we look at as well and when we use vitamins we use really good quality ones ones that are more the body is more able to utilize like a methylfolate form and that makes a huge difference for people yeah and in so many aspects to actually picking the vitamin right it's not just the form of the nutrient but is it is it the form that's bioavailable is it absorb what is in with it that can prevent its absorption you know what what exactly is it so you can say oh i need magnesium i'm just going to go to the store get some magnesium it's usually magnesium oxide which is really cheap magnesium it's in most supplements but doesn't really get absorbed very well and may not be effective right so that right magnesium oxide and also magnesium citrate right they're more likely to pull water into the gut and so they will they'll loosen up the stools for some people they need that and that's good but it's not as well absorbed as like a chelated form of magnesium like magnesium glycinate which is much better absorbed into the body so depending on what you're using your magnesium for you know you want to make be making sure you're choosing the right one yeah this is so what's different about here at the ultra wellness and what we do in functional medicine is that there's a really deep understanding of the role of nutrition and nutrients in health and and what's so important about these is it's not that they're single function compounds right so you know if you take a drug it usually hits one pathway it does one thing right yep when you take magnesium it affects 300 different enzymes and has many many other functions in the body it's phenomenal magnesium is is an amazing mineral and it's so good for us in so many ways and when people are magnesium deficient we see all sorts of issues from depression anxiety muscle cramps hypertension asthma um uh restless leg syndrome diabetes more insulin resistance so magnesium is supposed to forget constipation oh my goodness i forgot constipation headaches yep right migraines yeah twitchy muscles when people get twitchy eyes yeah i had a lot of twitchy eyes in residency i love magnesium yeah so it helped my twitchy eye so people get treated for all these problems right they get treated for constipation they get treated for and we and this the sort of ironic thing about magnesium is that it's used all the time in medicine as a last resort right so when a woman comes in who's in uh preterm labor and their uterus is contracting like crazy yeah they get iv magnesium if a woman is high blood pressure in pregnancy they come in they're about to have a seizure they give them iv magnesium why because it works better than anything else yeah if someone's having a cardiac arrest and arrhythmia when all the other drugs fail they give my magnesium as the last step because it helps to relax the heart muscle so it's the i call it the relaxation mineral so anything that's twitchy irritable or tense whether it's anxiety insomnia constipation muscle cramps twitchy blood vessels high blood pressure twitchy heart which is you know palpitations you know twitchy emotions which is anxiety but all these things are related to insufficient magnesium and they're treated you know they'll take xanax for anxiety you know take a laxative for constipation take a migraine pill for your headache take you know this or that for this or that and it's it's unfortunate because it it just this is such a simple solution and we know it's a vicious cycle right we know that chronic stress when we're under chronic stress that that causes our body to excrete more magnesium in the urine so we become more deficient in magnesium so we chronic stress who's got that i know right so then you become more deficient in magnesium stressless time right now and then you get more anxious and then you use up more of your magnesium so we know that when we're we're dealing with chronic stress we're using up our magnesium we're excreting more magnesium and we need even more magnesium because that was what helps us feel calm and uh so so it's it's we'll go through all the things that actually cause us to lose magnesium so i mean we stress stress it's a big one huge i remember i just interrupted i remember one study i read of of kosovo and they did magnesium studies and they found that people in kosovo under all that war and stress they had really huge amounts of excretion of magnesium whereas people who weren't in that environment didn't yeah right we know that people who take like uh proton pump inhibitors acid blockage acid peptide like protonix and prilosec and nexium and all those drugs yeah that's like decreases your magnesium absorption so you know just just depending on your medication that can deplete your body of magnesium diuretics yep blood pressure pills but you need magnesium to control your blood pressure you're taking a pill that causes you to lose magnesium right again that vicious cycle that we see all the time yeah alcohol alcohol deplete your body of magnesium and all the b vitamins so i think that's important smoking well nobody's into smoking sugar yeah and my favorite of all of them coffee yeah right coffee causes magnesium loss so you live in american lifestyle where you're drinking coffee drinking alcohol lots of stress you have uh you know probably a pretty crappy diet and then you take a proton pump inhibitor you're taking acid acid blockers diet and then on top of that you're eating a very low magnesium diet so talk about how that plays a role you know magnesium is in so many of our foods magnesium's in our well not the foods we actually eat well yeah but it's in our nuts and seeds our beans and legumes our vegetables greens greens yep our vegetables and um it's in whole grains like quinoa and buckwheat so it's in a lot of our food but when you take for example brown rice and you make it white rice you deplete you about 90 plus percent of the magnesium is released or is lost in that processing and so and they don't spray that back on you know they'll spray back on some b vitamins but not the magnesium so when people are eating refined and processed foods they're getting a more magnesium deficient diet so eve and sometimes people don't even realize they're getting refined and processed foods i mean sometimes people like i have a healthy diet but they they forget about that piece of toast at breakfast or the crackers at lunch that are made up of have white flour in them and that are are more magnesium deficient so and as we get older we can't really eat as many calories as we used to so we're more likely to have problems over time as well so i think i think you know the diet is so magnesium depletion deficient our lifestyle is so magnesium depleting and so we're kind of getting it from both ends yes uh and we see this is one of the most common problems in our practice that is undiagnosed and it you know the patients think we're geniuses because all these problems they've suffered from just go away and they're like wow how did you know you know it's not that hard it's just a good medicine and we know i mean this is not functional medicine it's just medicine and it's often being missed and let's talk about the patient you had and talk about what happened with this patient because i think putting a face on this is going to be very helpful so i had a 68 year old woman who came in to see me and you know she was really struggling with chronic pain she had anxiety she had hypertension so she had elevated blood pressure she was pre-diabetic um she had restless legs so she couldn't she had poor sleep and her legs were like you know she couldn't really calm down at night because her legs were sort of twitchy um like we were talking about and um she had constipation so she had all these anxiety blood pressure yes so you know yeah yeah so she came in from the average patient we see here at the ultimate center right and of course we did a comprehensive program for her but so many of her symptoms were pointing to low magnesium so we did a comprehensive program we we changed her diet she's like one of those people who who felt like she was on a really good healthy diet but when you look deeper especially for her level of activity she was wasting calories right she was wasting calories on that piece of toast at breakfast and crackers at lunch and a little bit of cake at dinner right so she wasn't eating you know she had a lot of vegetables in her diet she had a lot of good healthy foods in her diet but she also had some of these other things that just took away from the nutrient density of her diet so i always work with all my patients on nutrient density because i think that's such an important point right you want to have you want to be choosing the foods that have the most nutrients per calorie and and especially as we get older or depending on our level of activity we really can't waste a lot of calories on foods that that have a have poor nutrient content or low nutrient density right and my first book we call the nutrient-to-calorie ratio yeah which is how many nutrients per calories you're getting so broccoli has a lot of nutrients very few calories yes coca-cola has a lot of calories but no nutrients right right so for her we we worked on shifting her diet we did an elimination diet for her because that she also needed you know to pull away some common inflammatory foods but we then shifted instead of you know choosing a piece of toast at breakfast we had um we had her have some sweet potatoes with her with her omelette and then at lunch instead of having crackers we put some quinoa on her salad ways that you get more nutrients per calorie and more magnesium right because we we and we also gave her magnesium though you know she she was at a point where she was so low yeah her tank was low and we needed to supplement so you know we gave her um we gave her both the type of magnesium that helped increase her bowel movements because she was constipated and we gave her the magnesium glycinate that's better absorbed so we gave her both and it was it was really helpful she had improvement in her blood pressure she definitely had improvement in that restless leg so she slept better she had improvement in her pain her pain decreased significantly she had improvement in her headaches you know so it's it's really it's a magical mineral and you know if i saw her today because you know um we're doing more iv magnesium now at the ultra wellness center you know we have a a combination of called ultra calm which has iv magnesium in it you know we can we can use that right away to see okay is this going to help with somebody's headaches or help them feel more calm people in my office with headaches or migraines and literally give them a shot of magnesium and that's like that goes away instantly yeah that's very powerful and that's i mean i was joking that's what we do like in a cardiac arrest and the heart's not going we have intravenous magnesium we can have magnesium for preterm labor or for you know preventing seizures with high blood pressure i mean it's so powerful and it's one of my favorite things it makes i've had iv magnesium have you had it it's so it makes you feel like warm and relaxed and calm it's like it's the most amazing thing it's like instant it's like instant volume without all the side effects yeah and you know and it's safe for most people you know it's really safe for most people people with um kidney issues so renal insufficiency on dialysis you know kidney issues you have to be careful you want to be really working we always want to work with your doctor but you have to be more careful but for most people you know it's it's a safe mineral that we can use you also talked about briefly the different forms of magnesium so this is another aspect of nutritional therapy that we do in functional medicines it's very customized so yes this person might do better with magnesium glycinate because they may have more detoxification issues they might not have constipation they might be prone to diarrhea you can use this for if you have more constipation issues you might use magnesium citrate if they're more neurological issues you might use magnesium three and eight which has a better neurologic profile so it's a very personalized customized approach and we make sure the nutrients don't have junk in them fillers impurities that the potency is there we use very you know rigorous evaluation of the companies we use to actually figure out what supplements right i mean you mentioned like so often people go oh i need magnesium and they just grab one and they take it and then they start getting diarrhea and then it didn't help and then you're like and they're like oh this is crummy because it's just not the right it's not the right form it's not a good quality yeah and we didn't even talk about menstrual cramps and all that stuff you know i mean you know another patient i had she was a 30 year old woman who was really struggling with pms so she was for the week before her period she was really irritable she was um feeling more angry and sad um she had more cramps with her period she had lots of cramps that were keeping her in bed for a couple days when she got her period and um you know and magnesium was really effective for her we could give magnesium for the you know i gave it to her all the time she didn't need the citrate form so i just gave her a magnesium glycinate and that really that really helped her throughout her whole month just feeling more calm and it helped decrease the amount of pms she had and then when she was getting her period we gave her even a little more magnesium glycinate and that helped with the cramping too and so and she just felt she just felt better i mean we know that magnesium deficiency is associated with depression you know we know that it impacts this nmda receptor in the brain probably and that may be the connection with depression and so when we give magnesium we can decrease the amount of depression and for some people i mean it's not it's not the cure-all for all depression but for some people it's even better than an antidepressant you know depending on what's going on well point it's very personalized and while magnesium weight for some person may not work for another person i just want to share a story i remember this magnesium patient i had she was a doctor she was a radiation oncology resident at mayo clinic seeing the best doctors in the world she had incapacitating migraines yeah i mean just was on narcotics and any vomiting medication used for chemotherapy and she was constantly going off work and just struggling and she wasn't like a sort of emotionally unstable person who was she was having these debilitating migraines so i took our history i'm like okay what else is going on because this is what we do in functional medicine it's not it's like oh let's focus on your migraines now let's focus on the rest of you because that's where the clues are so what did she have the usual she had severe constipation i said i said uh you have regular bowel movements she goes yeah i got regular albums i say half and you go she goes once a week i'm like i said that's not regular she was regular for me i'd go every week and and and she just thought that was normal right she had palpitations which is the irritability of the heart she had anxiety she had insomnia she had muscle cramps she had all these things that were like neon flashing lights of magnesium deficiency and if you go to a medical textbook you will read that those are the symptoms but somehow it's nutrition so doctors just don't pay attention i don't understand so i'm like all right let's just try magnesium see what happens and i gave her a lot and i said take enough so make sure you go and she needed like over 2 000 milligrams a day was a lot most people need you know 200 400 right you know 600 uh it was a lot and she started going to bathroom her palpitations went away her insomnia went away or anxiety and her migraines in a way and she could go back and do her career as a radiation oncologist amazing and you're like wow that was easy but it's really finding out how to navigate to that issue which is exactly what we do in functional medicine it's so different than traditional care we we have a different roadmap that focuses on the cause and not just the symptom right constipation is a symptom muscle cramps are symptom headaches are a symptom you know depression's a symptom it's not the cause and in in not everybody it's magnesium right for each of these problems absolutely but it it it's important to figure out how do you navigate to the root cause and that's what we do in functional medicine and we do it through a very detailed set of questions history which we have you fill out and then we do another detail set of questions in person but now we do it all on zoom too so we have virtual care anybody from anywhere in the world can see us here at delta wellness center and then we do appropriate testing so rather than guest we test and it's extraordinary how much nutritional deficiencies we see i just recall patient recently as a vegan i was struggling with his health he was 20 years old and i was like oh my god like this is a very wealthy well-to-do guy from a good family and i'm thinking this guy's not malnourished he's eating food he had no omega-3 fats he was severely b vitamin deficient he was severely vitamin deficient he was magnesium efficient he was iron deficient he was selenium deficient i was like whoa and your body can't heal right you know when you're deficient in so many things your body's not going to heal you know that digestive system is not going to heal your skin's not going to heal yeah we talked about like the magnesium in 300 different enzymes but each one of those they're they're multi-functional substances that are designed to support your body's normal functions which is very different than drugs right right and there are some have to be careful with you can od on right you can take too much vitamin d you can take too much vitamin a selenium too much vitamin a yeah uh but certain things too much iodine too much iodine some people take iron really high doses yeah so you can get into trouble but a lot of stuff is water-soluble vitamins like the b vitamins people's coming with their bleach 12 they're taking b12 their b12 levels are off the roof and the doctors oh your b12 toxic i'm like no no your body just pees out what you don't need it's non-toxic it's fine right exactly exactly so a lot of times if serum b12 is high because somebody's on a supplement i might still keep them on that b12 if it's really appropriate for them like they have uh their methylmalonic acid was once too high needing meaning that they needed b12 or maybe they don't absorb b12 well we've talked a lot about parietal cell antibodies in the past in other podcasts and we know that impacts how you absorb b12 so sometimes they still need to stay on b12 even if their levels look okay of serum b12 so and sometimes they might not be able to absorb it in their gut so they might need it under the tongue or they might do shock injections yeah right so it's very personalized very customized and it's really you know it you know when when when there's this whole backlash against vitamins in the research i think it just makes people feel like nothing works and i think when you're looking at these large populations these large studies the effects kind of get washed out and it's unfortunate um the other issue is people get hooked on the nutrient of the day yes right and then you can get into trouble so we saw that with what we call the carrot study which was there was a awareness that people who ate more carotenoid-containing vegetables like carrots and sweet potatoes had less lung cancer so they did a study well let's take people who are at high risk of lung cancer who are smokers yeah and let's give them lots of beta carotene yep which is one of hundreds of carotenoids it's naturally found in food yes and it it sort of belied a lack of understanding of how these nutrients work they work as a team so antioxidants which is beta-carotene is only effective if there's other antioxidants so it's like passing a hot potato you need vitamin c and vitamin e and lipoic acid and glutathione and the carotenoids all of them work together and if you just do one you're going to kind of increase the hot potato but there's nowhere to hand it off to and then these patients actually got more cancer right some people oh taking vitamin b vitamins or beta-carotene causes cancer well not exactly it's just more complications right yeah so i think we have to be careful with these with these sites and and when you look at smaller studies you look at interventional studies they often show in the right patients it can be profoundly effective and you know and i know with our patients they are profoundly effective in terms of how they can be so helpful for energy how they can be so helpful for depression how they could be so helpful for um their digestive system how they could be so helpful for healing in the body and skin and um so we we see it every single day in our practice how powerful these nutrients can be yeah and when used appropriately yeah and i think it's just not taking mega doses it's taking the right amount for you to optimize your health and that's the other issue is it's not just the minimum amount for the rda people say on the bottle it says 200 of the rda that's dangerous i'm like no that's the minimum amount you need so you don't get scurvy or rickets that's not going to help you create optimal health optimal health right yeah i mean even the in the rdi it says you know you know you need maybe you know 30 units of vitamin d so you don't get scurvy but you can take up to 4 000 and there's this whole idea which is i love it just this long latency deficiency disease so we know if you acutely don't have vitamin c you get scurvy or if you acutely don't have vitamin d you get rickets but what happens if you don't have vitamin d at a high enough level over your lifetime you get cancer you get osteoporosis you get muscle loss that whole triage theory right that bruce ames has really done research on and shown that if if you know we know that if with the when the body is insufficient in a nutrient right you may not have um a deficiency like of vitamin c causing scurvy but if you have insufficiency for long periods of time the body is going to use it has this triage theory going on which is what dr bruce ames who's one of the real pioneers and researchers in nutrition and nutritional science has shown that you know the body then uses the vitamin c what it really needs it for acutely but then may not have enough to do some of those you know lower level functions in the body so you then maintain cleanup yeah so over years and years and years you start to get chronic disease and you don't feel as good yeah yeah i love his concept of a metabolic tune-up and that you know just a moderate amount of the right nutrients for your life stage and age really helps you get a metabolic tune-up and avoid a lot of the consequences of unhealthy aging which is pretty cool yeah and i certainly know they've helped me i know they helped you and i think that they will help so many patients but it's important to understand what your particular issues are what your needs are and and that's really what we do here at the ultra wellness center is help people figure out what their issues are because everybody's different it's personalized nutrition it's precision nutrition and personalized medicine and by doing that through the way we approach patients holistically through systems approaches through the kinds of diagnostics and testing we do we really can get an incredible set of of data that help us to get people better when when they're not getting better from a lot of other approaches absolutely it's the future of nutrition right it is well uh if you've been listening and you're interested in coming to see us we'd love to see you here at the el chowano center just go to ultrawellnesscenter.com and you can now see us virtually through zoom which means you don't even have to get out of your bed and you can come right and see us we'll even send someone to your house to draw your lab test if you want so you don't have to leave your house and we'd love to help you and anybody you love so check us out at the ultrawellnesscenter.com ultrawellnesscenter.com and if you love this podcast please share with your friends and family on social media leave a comment we'd love to hear from you and tell us about your experience with nutritional deficiencies and supplements we'd love to hear about it and of course subscribe wherever you get your podcast and we'll see you next time on the doctor's pharmacy thank you mark

Channel: Mark Hyman, MD

Views: 141,431

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Id: 1llv5GVmjks

Length: 42min 57sec (2577 seconds)

Published: Mon Jul 20 2020