Tami Simon: You’re listening to Insights at the Edge. Today my guest is Dr. Mark Hyman. Mark is a four-time New York Times bestselling author, and is currently a medical editor at The Huffington Post and on the medical advisory board at The Dr. Oz Show. He combines the best of conventional and alternative medicine with a blend of science, integrity, intuition, and compassion. He has written the bestselling books The UltraMind Solution, The UltraSimple Diet, and UltraMetabolism. With Sounds True, Mark has created the audio program UltraCalm: A Six-Step Plan to Reduce Stress and Eliminate Anxiety, along with a self-guided learning course called The Detox Box, a safe, medically informed detoxification program to boost your health and immune system.

In this episode of Insights at the Edge, Mark and I spoke about the basics of detoxification when it comes to feeling healthy and alive. We also talked about the importance of making healthy choices in creating our home and workplace as a “safe zone.” We talked about why so many people are currently discovering that they’re allergic to gluten and dairy, and how the changes that we need to make in our lives are not just personal, but also require collective solutions and social support. Here’s my conversation with Dr. Mark Hyman.

Well, Mark, I have to be honest, I’m a little nervous about talking to you about the topic of detoxifying. Because often, when I have in-depth conversations with people, I end up being very influenced by their ideas. And I’m quite nervous that this conversation is going to—“inspire” might not be the right word, but require me to do some kind of detoxification, and I don’t really want to do that. But let’s have the conversation anyway. I’m sure you deal a lot with people in this kind of situation, so what do you say at the beginning to help the nervous person even open up to this idea of detoxifying?

Mark Hyman: Well, I say, Tami, every day you’re detoxifying, whether you know it or not. Your body is in a constant process of doing that. You’re breathing and excreting carbon dioxide, you’re drinking in fluids and urinating them out, you’re taking in food and you’re excreting [it], you’re sweating through your skin.

So you’re always detoxifying, you just don’t think about it. But it’s one of the most important things your body does to keep you healthy. Sometimes it just needs a little nudge. That’s all we’re really talking about, nudging your body’s own vital processes and trying to find things that really don’t work for you and letting go of some of those.

TS: OK, nudging seems OK. I think my concern, when I hear a word like “detoxifying,” is that I’m not going to be able to have alcohol, caffeine, sugar, a lot of the other things that are part of my diet right now. That doesn’t sound like a nudge.

MH: [Laughs] It doesn’t, does it? But the way I encourage people to think about it is you spend your whole life just living your life, moving along, going through the things that you do, without much thought about how you might feel if you changed things a little bit, even for a few days or a week. [You don’t think about] what you might feel like if you just took away the things that may be impairing your health, and putting [in] things that help you thrive and see what happens.

Most of my patients will say, “Dr. Hyman, I didn’t know I was feeling so bad until I started feeling so good.” And I really want people to understand how close they are to feeling well. Most people don’t connect their behavior—what they eat, what they drink, what they do with their bodies or not, how much they sleep, how they deal with stress—they don’t connect that with how they’re [actually] feeling or any conditions or diseases or symptoms they might have. So there’s a big disconnect, even in very well-educated, intelligent people.

So all I invite people to do is to do an experiment. See what it feels like to change things for a little bit. I’m not talking about [stopping] everything for your whole life—you know, going into a monastery and renouncing all your earthly belongings and eating rice for the rest of your life. [Laughs] I’m just talking about a little holiday from your normal routine, a retreat. It’s something that’s been embedded in almost every culture throughout the eons. Every culture has a time of retreat, of renewal, of repair, of pausing, whether it’s Yom Kippur or Passover in Jewish tradition, whether it’s Lent, whether it’s Ramadan. There’s always something that is embedded in our traditions that allows us to stop and pause, think, reflect, renew.

And that’s something that we’ve lost in our culture. We just go at a hundred miles an hour, and many of us bear the insult of that pretty heavily in fatigue and chronic disease and sluggishness and brain fog and everything from acne to constipation. So these are all things that don’t have to be part of the normal human condition. And you don’t know better unless you try to stop and see what happens.

TS: OK, well, lay out for me the detoxification basics. Just, “this is what you need to know.”

MH: Well, I think, you know, it’s quite simple, really. It’s just taking out the bad stuff and putting in the good stuff, and letting your body do the rest. So it can be done in any variety of ways, but I try to make it just as least painful as possible. And most people freak out and think they’re going to go through a horrible series of symptoms [when they detoxify], have what they call a “healing crisis.” But I don’t really believe in that. I think you can do it in a way that’s remarkably powerful.

For example, I’m taking a group to a Caribbean island this week, and we’re going to do a healing week. It’s designed to restore and renew the body. So we include a lot of things. It’s about not only what we exclude, but it’s more about what we include. People think about detox this way, but I don’t think about it that way. I think about, what can we include? So, in the morning we include a beautiful walk in the morning on the beach. Now, you can’t always do that on the beach, but morning light has a powerful restorative effect on your pineal gland, which resets your autonomic nervous system, resets the stress response, helps your sleep rhythms. It’s great for your adrenals.

And then we have a little bit of a shake. We have a juice, like a vegetable juice shake in the morning that gets us going. And then we do a yoga class. Then we’ll have a little session where we’ll just have a conversation about healing and life and whatever I feel like talking about that day. [Laughs] And then we have lunch, and lunch is usually fresh vegetables, salads, whole combinations of delicious foods. And then we, again, take some pause in the afternoon and rest. Maybe people take a nap, just restore themselves a little bit, read, reflect. There’s an energy healer that I brought with me to do some energy healing.

And then we do a restorative yoga class. It’s not a big yoga class like we had in the morning, it’s more of a meditation and relaxation. It’s very passive. And then we do a sauna or steam or Jacuzzi, and sweat, and we do some electrolytes—which are basically different kinds of nut milks and things that are really very delicious. We’ve got a great chef to come with us. Now, of course, not everyone can do this like I’m explaining it, but these are the kinds of things we include. And then we have a very simple dinner, you know, maybe some vegetable protein or animal protein, a little brown rice, vegetables. And then we have a quiet evening, maybe do something fun together. We did a fire ceremony, and that was it.

The things that are left aside are daily habits of addiction to media, addiction to our Blackberrys and iPhones, computers, and emails, our addition to entertainment. You know, Americans are the most entertained, least informed people on the planet, and I think we sometimes just need to stop all that for a little bit to rest our nervous system. We leave aside the stimulants and the sedatives, so caffeine and nicotine and sugar and alcohol. And the other thing that I often do is I have people let go of the [foods] that are really inflammatory. [That includes] gluten and dairy and a few other allergens that can often be a problem and people have no idea because they’re eating them all the time, so there’s a baseline level of feeling unwell. So we pause and let the body—[we] see what happens when we remove those things.

And that’s pretty much it. It’s not too complicated, just eating some real foods, eating more fresh foods, getting rid of sedatives, getting rid of stimulants, getting enough rest. It’s just restoring your system. It’s like a recharge.

TS: You know, when I hear you describe it, and I imagine being in the Caribbean and having this great cook, and not having my technology devices with me, I feel very happy.

MH: [Laughs]

TS: It all seems like it’s going to roll fabulously. But what do you suggest for the person who has an inkling that they need to go through some kind of detox but they’re right in the middle of their life? They don’t have that kind of luxury.

MH: Well, I seem to do it pretty regularly myself. I call it “having my spa day.” So I, basically, will still do my work, but I structure my life on those days so that I can do things that are more restorative than depleting. So I’ll make sure I get enough sleep, I’ll make sure that I’ll do a yoga class, for example, I’ll eat really clean food, and I’ll just try and take care of myself within the scope of what I can do.

And it becomes sort of a habit, actually. It’s sort of how I live most of the time now. I think I probably work too much, but other than that, you know, I just don’t find myself gravitating toward sweets and sugar and alcohol and caffeine, though I like green tea. And I don’t find myself looking at a lot of these things that I think I used to use to help me manage my energy. Because if I use external props to manage my energy, then it’s something that will ultimately catch up with me and I’ll have to pay for it. I’ll have to pay back that energy with, usually, an illness or a collapse of exhaustion.

So I think it’s not that hard to do in your daily life. People do it. It takes a little bit of planning, a little bit of forethought, a little bit of structure. I’m really a big fan of planning, in terms of thinking about how you’re going to create your week and create your day, and to never be in a food emergency, how to stock your pantry and how to stock your fridge and what to shop for and how to have an emergency food pack with you. So you’re never really stuck in a place where you’re going to be making the wrong choices. And if you set the system up in advance, it’s not that hard to do it [for a week], or even for a longer period.

TS: OK, now, you talked about a couple of categories: the stimulants and the sedatives. What do you think is a healthy relationship to those two categories?

MH: It depends on the person. Some people have one cup of coffee and they’re bouncing off the wall for three days. Other people can have a triple espresso and go right to bed. That has to do with their capacity for detox. And that’s not a metaphorical capacity, that’s based on your genetics and your enzymes and how fast or slow they are at getting rid of these compounds. Same thing with alcohol, some people can tolerate it, some people can’t. I think everybody’s individual.

For me, I would probably say I like to have coffee as a drug once in awhile, if I’m feeling like I want to really focus or working on writing an article and I just want to have an extra little buzz, I’ll use it. Alcohol—I would say I don’t really drink on a regular basis, but occasionally I’ll go out and have some tequila with some friends, or sake if I go out to a Japanese restaurant. And I really enjoy that. So I think that I don’t do it on a regular basis, but probably two or three times a month. And everybody’s different. It really depends on the overall balance of your life.

TS: I’m liking these recommendations, much more than I had anticipated.

MH: [Laughs]

TS: I want to go back a little bit, because you said, you know, it’s different for different people, how their body naturally flushes out different substances. Can you explain that, how that works?

MH: Yes. Well, you know, everybody is genetically unique, and with the genomic revolution, we’re understanding that our biochemistry is all different, that our genetics are all different. And that the variations in our genes determine our health. Some people are fabulous detoxifiers, and others are horrible detoxifiers.

For example, for myself, I know that—I had mercury poisoning and I was very sick. I lived in China, and I [ingested] a lot of mercury from various sources. And when I did my own genetic testing, I found that I was a really crummy detoxifier. There are certain genes that have to do with glutathione—this is a master detoxifying molecule in your body—and I just can’t do it as well as most people. And so, if I’m exposed to a good amount of toxins, I’ll feel it, I’ll accumulate it, and I’ll not be able to excrete it.

So I’m very careful about not taking in, you know, extraneous toxins. I don’t eat swordfish, I don’t eat tuna. I make sure I use everyday foods that up-regulate those enzymes, like the broccoli family, vegetables. I used arugula as a salad because it has that property, watercress. I’m always looking to find where I can get my medicine from my food. And so I’m able to understand how to regulate that.

I think different people have to tune into what’s going on with their body. This is pretty unique, but if you tune in and you listen—and that’s why I love the idea of a week-long renewal and reboot. If you do that, you will know at the end what you’re new baseline is. And what happens there is you find a sense of possibility. “What is it like to feel good?” And then, you can make a choice. “If I add this or that back, how do I feel?” And you begin to notice and observe and listen to your body, because it’s the best barometer of what’s going on with you. It’s the best barometer of how to actually function in a way that drives choices that you’re in control of.

Instead of being a victim of your feelings, or your bodily sensations, or experiences, you can actually make a choice. And I don’t think most people have that awareness that they have that choice. And that’s really why I’m a big fan of detoxification and of this sort of reboot and renewal experience. [It] gives people a taste of, “Oh my God, I can feel like that? My joint pains can go away? My migraines can go away? My irritable bowel [syndrome] can go away? I’m not stuffy and runny everyday in my nose? My skin’s clearing up, I have more energy, I’m sleeping better, I lost weight.” All these things change very quickly. It doesn’t take months or years, it literally [takes] days or weeks.

TS: Now, this idea of having a choice. I think a lot of people don’t have the experience—for example, when you wake up in the morning, and there’s this sense of, “I need caffeine.” It doesn’t feel very choice-filled, let alone people who love sugar or all kind of things. So help me get to the place where I’m actually making choices all day long.

MH: Well, if you’re a heroin addict or you’re addicted to cigarettes, it isn’t a choice because it’s an addiction. And many of us are addicted to substances that are legal, like caffeine or alcohol or sugar, which is one of the biggest addictions in America.

People don’t think of it that way, but, I mean, look at the biology of sugar. It actually is the same as the biology of morphine or heroin or cocaine—it binds to the same receptors in your brain and stimulates that reward experience. And it’s short-lived, and then you need it again, and you need it again, and you need more and you need more, and then you develop a tolerance. In fact, over time, people who are obese and have become sugar addicts have less pleasure from the food and just need it to stay normal, like someone who’s a heroin addict isn’t getting high anymore, they’re just not feeling bad. I think that’s something most people aren’t aware of.

And it is possible to shift that. I’ve written a lot about this and I talk a lot about it. I think there’s a way to reset your metabolism very quickly. I did a workshop once and there was a woman [there]. She said, “Look, I’m a sugar addict. There’s no way I can ever stop. I’ve tried [and] I go crazy. I don’t know what to do. I’m really scared about being here. You have got to help me.” She was kind of freaking out. So I said, “Just do what I suggest, which is to eat in a certain way that balances your blood sugar, balances your biochemistry.” And two days into that she’s like, “Oh my God, I can’t believe it, I don’t have any cravings. I feel fine. I’m not always looking for it, I’m not in that place of being imprisoned by my cravings.”

That’s a powerful insight for people, and it doesn’t take a long time. Two or three days at the most. And sometimes you can mitigate that, and I talk and write a lot about how to reduce those symptoms of withdrawal. But it’s real, and if you say to yourself, “I’m so dependent on this compound to just feel good, is that something I want to choose?” And it might take a little work, but it is possible to overcome that.

TS: So can you give me the basics, Mark, on how I start to shift if I’m addicted to sugar?

MH: Yes. I’ve written about this in my latest book, called The Blood Sugar Solution. And essentially, I have 10 tips for cutting cravings and stopping food addiction.

The first one is to eat in a way that balances your blood sugar. So that’s having protein in the morning, and it can be any animal or vegetable protein. It can be a protein shake, it can be eggs, it can be tofu, whatever. Nuts, nut butters. Having protein is very key in the morning. It resets your brain chemistry. Having protein with every meal is also important, and having good-quality fats.

So I always say if you combine to create the perfect plate, and that will balance your blood sugar. So 50 percent, other than breakfast, should be non-starchy vegetables—asparagus, broccoli, green beans, or any greens. One-quarter should be lean animal protein or vegetable protein—a little chicken or fish or beans or tofu. And one-quarter could be a starchy vegetable, like a winter squash or black or brown rice. And if you eat that way, and you do it consistently, and then you have a little snack mid-morning, mid-afternoon, maybe a handful of nuts, that will keep your blood sugar even and prevent these spikes.

There’s also some other tricks, [like] using fiber beforehand. I use a special seaweed and konjac root, it’s a Japanese root. It’s very viscous, and it absorbs a lot of water. So if you take that [like 15 minutes] before a meal with a glass of water, it will help mitigate your appetite and reduce spikes in sugar and insulin. Eating early and eating often, as I said, is important, smaller frequent meals. Also, I use mineral broths, which can be very helpful in alkalinizing, help reducing those cravings, and [there are] a few other suggestions that I have.

But those are a few of the—it’s not rocket science. You have to go cold turkey, though, you can’t just have a little bit. You can’t have artificial sweeteners, because [those] trigger the same taste in the brain as sugar, and [they] set up a neurochemical reaction that drives insulin production, fat storage, [and] cravings, [and] screws up your metabolism. Dealing with stress is important, getting enough sleep is important. All those things are key. I mean, people who don’t sleep enough crave more sugar. I knew that was true when I worked in the ER. If I was up all night, I’d just be looking for the cinnamon buns in the morning.

TS: And why is that?

MH: It’s because when you don’t sleep enough, the ghrelin, which is the hunger hormone, increases, and the PYY, which is the break on your appetite from your stomach, that’s another hormone, it actually reduces. So you have too much of a hunger hormone and not enough of the appetite-suppressing hormones that get produced in the body as a result of sleep deprivation, even in healthy people.

TS: Now, you know, you said something that I’d never heard before, that [as a substance,] sugar works in the body, in terms of how it binds to receptors, in a similar way to heroin. Did I hear you correctly?

MH: Yes, absolutely. It’s quite astounding when you look at the research. Kelly Brownell is a friend and colleague of mine. He’s at the Rudd Center for Food Policy and Obesity research. He’s done a lot of work on food addiction, and, actually, he has a whole food addiction quiz, [with] which you can identify whether or not you are one of those people who does have a food addiction.

He also talks about some of the biology of it and the research. And when they’ve looked at brain imaging, they found that people who are overweight and obese and sugar addicts have lower dopamine receptors, they’re more likely to crave things that boost dopamine. [They found] that they stimulate these receptors in the brain that are triggering binging, [and] they develop a tolerance to it. And actually, they experience real withdrawal, like an addict.

There have also been some fascinating studies where they’ve used drugs that block opioid addiction. So, for example, when I worked in the emergency room, [when] patients would come in with a heroin overdose, we’d give them a drug called Narcan, which blocks the opiate receptors, so the heroin can’t do its job of making you, you know, sedated or whatever it does, and it saves somebody’s life.

Well, if you give that to a sugar addict, their cravings will stop and they’ll lose weight because they’re not going to receive any pleasure from the sugar anymore. It blocks that effect. So it’s very interesting to see that. And looking at brain imaging studies, we see all these patterns that are the same.

TS: OK. So if I was trying to break a heroin addiction—I mean, God forbid—I wouldn’t try and do it on my own. You know, I’d need quite a lot of help. Yet I can break a sugar addiction on my own?

MH: Absolutely. You’re not going to go into serious death throes [laughs] when you cut out sugar. But you might feel poorly for a day or so. And by doing the things that I just said, and by giving yourself that time, you can get off it, and very quickly.

If you start the first day, going cold turkey, and you start with the right food, and you eat frequently enough, and you have the right foods throughout the day, and you cut out all sugars and grains, you’ll see very quickly, your body will reset. The hormones and the genes that get turned on and the neurochemistry [are] very quick to reset. Basically, the food industry has hijacked our brain chemistry, it’s hijacked our taste buds, and it’s hijacked our kitchens. And we need to take them back.

TS: In your own experience, or with people that you’ve worked with—whether they’ve given up sugar or done a detoxification where they’ve let go of caffeine for a period of time—what have you noticed in terms of the emotions that come up for people in the process? And how do you understand those emotions being released when a substance is no longer engaged?

MH: I think that’s a very important point, Tami. The reason that people get into behaviors that are addictive, like sugar or alcohol, is because they’re often triggered into that by some emotional experience—stress, trauma, or pain. And it makes you feel better temporarily, so you go back after it over and over again. But eventually it doesn’t work anymore.

So part of the process—and I talk a lot about this—is self-exploration and asking yourself questions about what’s really going on for you. For example, when you’re about to eat something, you should say, “What am I feeling right now? And what do I need? Am I feeling tired, do I need a nap? Am I angry, do I need to deal with that? Am I lonely, do I need a hug? Am I hungry, do I need something to eat?” Most of the responses we have to our feelings in this culture are to go to the fridge or to go to the fast-food place or to eat something, instead of just take a moment and say, “What am I feeling, and what do I need?” and identifying that in a very conscious way.

There [are] some wonderful, wonderful books—Julia Cameron has written a book called The Writing Diet, talking about how you can use words to help you process and metabolize your feelings that often are around your life and food, and things that don’t work for you. So we often use food to stuff our feelings, but we can use words to heal our feelings, and I think people often find journaling very, very helpful.

TS: Now, I’m imagining that many of our listeners probably know a great deal, at least, about some of the basics of what proper nutrition might be. They probably get it, the kinds of foods you’re recommending, and they may have even heard [about] having protein in the morning, and certainly that they should eat more broccoli and kale, etc. [So] this information, they get it. But yet, they’re not making these changes. Month after month after month, they’re still not making the shift, or if they do, it’s for a very brief period of time and then they just go back to their previous patterns of eating. So what do you think is actually at the bottom, Mark, of people having the information but not making the changes?

MH: Well, I think our culture doesn’t support it. We’re constantly pushed and pulled in the direction of not taking care of ourselves, of becoming numb, of being influenced by the defaults in our environment. One of the things I’ve been very focused on in the last year is, how do we change our community? How do we change the support in the world that we live in to foster the things that we know support health and create a life that’s abundant and rich?

I did sort of a social experiment with a large church in Southern California where we invited them to do a healthy living program together in community. They had a 30,000-member church, but they had 5,000 small groups. So it wasn’t really a mega-church, it was thousands of mini-churches. And in that experience of working together, of supporting each other, of helping each other, they were able to really transform. And instead of having donuts and ribs for breakfast, they had really good food. And instead of not engaging in activities that were healthy, they learned how to shop together and cook together and support each other and have dinners where they invite each other over. It became part of the culture of what they did. Many of us don’t have that support, and I think it’s possible to create that and build that in your community with friends or colleagues.

Even at work—you know, I think you go into work and it’s not a safe zone. There’s often cookies and candy and sodas everywhere. I met someone the other day [who] created a potluck club for lunch. They got a bunch of people together and they’d all make healthy meals. They had 14 or 15 people, so every two weeks they had to make a lunch for 15 people, and it works great. They basically got free lunch [laughs] and only had to cook once every three weeks. It was a communal thing and they shared it together. Those are the kinds of changes that we can build into our life that can really transform our experience—that our life in constructed in a way that supports health rather than sabotages it.

TS: Yes, that’s a strong statement. I think that it might leave people questioning, “Well, what’s the next step?” You mentioned the idea of bonding with other people in the workplace, that’s good. What else would I do? What are my next steps to make this a community affair?

MH: I think that each of us has to find our own community, but it’s something that we’re naturally drawn to. Edward Wilson, in his new book The Social Conquest of the Earth, talked about how it’s in our very nature to want to join a group, to be part of a tribe, and to work together toward common ends, whether it’s fighting other tribes or whether it’s surviving. It’s sort of an evolutionary adaptation. [He calls it] “group selection.” And it’s really sort of a quantum jump in our thinking from the survival of the fittest as an individual struggle to survival of the fittest as a group endeavor.

I encourage people to find out what their group is, [whether it’s] their church, their synagogue, their yoga group. Is there some way for them to collectively come together? Or maybe it’s just one friend, maybe it’s just a couple of people, maybe it’s just people in your family who are engaged with you in trying to create a different way of supporting each other. Those are the things that, I think, stand out to me.

You know, I was on the phone this morning, a conference call, with the Veterans Administration in New Orleans, where the entire health care system has been demolished. There’s no hospital, the clinics have been destroyed, so they’re having to decentralize health care and create community-based models where people support each other to get healthy. And actually, that’s something that I think people should think about even engaging in directly. I write a lot about that in my books, about how we can begin to create community, ways you can do it online or in person, and start to change our culture to sort of stand up and say, “I’m not going to take it anymore. I’m going to create a very local, very immediate, very real, very connected life that allows me to really support being fully alive and [take] care of myself in way that our culture really doesn’t support.”

TS: OK, I’m going to ask a question: a group of people come together in a business for a birthday party, and we’re not going to serve cake or cookies. What are we going to serve?

MH: [Laughs] You can serve cake or cookies! It’s really about what you do the rest of the time. It’s not the 5- or 10-percent-of-the-time things you do, it’s the 90-pecent-of-the-time things you do. And I think there’s always time in life for celebration, for feasting, for indulgence, for the spectrum of life experience that we have as humans. But I think we have to not have a birthday party every single day, basically. [Laughs]

TS: OK. Now, there [were] two other substances that you mentioned earlier in our conversation that I want to track back to, that you often leave out when you’re helping people go through a detox vacation program so they can get in touch with this more alive sense of being. You mentioned gluten and dairy. Let’s go into each of those, because I know these are two substances that there [seems to be] a lot [of] questioning about now: “Am I allergic to gluten? Am I allergic to dairy?” How would people know, first of all, do they have to be tested? Or would I just know because I was observing myself?

MH: Your body’s the best barometer of what’s good for you or not good for you. And if you listen to your body, even if you don’t like what it’s saying, it will usually tell you what you need to know. So that’s the first thing.

The second thing is that, unfortunately, our food production system has produced our staples in a way that are quite different than we had even 100 years ago or 50 years ago. So, for example, the wheat we’re eating is not the wheat your great-grandmother made bread with. Even [for] your grandmother, the wheat’s been hybridized and the person who did that, actually, won the Nobel Prize as part of the Green Revolution for feeding a hungry planet, which is a good thing. But the dwarf wheat is much more hearty, it’s much more pesticide and draught resistant, but the starch molecules are very, very starchy. So you’ve got a large starch molecule, and you’ve also got different gluten proteins. It’s a different genetic plant than traditional wheat. So you’ve got foreign proteins that are much more likely to cause inflammation.

Same thing with cows. The structure of a casein molecule in dairy is different than in heirloom cows or [cows] 100 years ago. So these have created a lot of inflammatory responses in people, and combining that with our high-sugar, low-fiber diet, [and] with drugs that damage the intestines like acid-blocking drugs and anti-imflammatory drugs and our over-use of antibiotics, all of a sudden we have a perfect storm for this explosion of food sensitivities and allergies, particularly gluten and dairy.

So I always encourage people to give those a break for a week or two and see what happens. Do you feel better? Do you have more energy? Does your stomach feel better? Did you get rid of your acid reflux or irritable bowel or migraines or asthma? Does your eczema go away, do your sinuses clear up? All these things can get better. Does your joint pain go away? Does your depression left, can you sleep better? These are the things that happen.

I do workshops with five-day detoxes with people at Kripalu, and people are amazed, at the end of five days, how dramatic the changes are in their body. By just taking a pause and putting in things that are going to create healing and support detoxification and reduce inflammation in the body, [and] getting rid of those things that are burdening the system and creating potential inflammation like gluten and dairy.

Again, it’s one of those things where you don’t know the horse is standing on your foot until it gets off. So I just tell people, “See what it’s like. Try it. If it doesn’t work for you, that’s fine. If it changes your life—I mean, you can get rid of symptoms you’ve had for a decade. You have a choice. Do you want to feel crummy or do you want to feel good? It’s up to you. I don’t have any judgment about it, but you should at least know you have a possibility of feeling good.”

TS: Do you also recommend that people are tested for food allergies?

MH: Well, there’s a lot of different kinds of testing. A lot of it is problematic. I think gluten testing is probably important for people who have conditions that are bothering them. I think the average person may not find anything with them, but if they’re not feeling well—and I have a population that comes to see me that doesn’t feel well—many, many of them, probably up to 30 percent of them, have some type of gluten sensitivity or inflammation related to that.

So I test for celiac. If anybody is problematic in their health, and if anybody is at risk based on my evaluation, I’ll test. I have a very low threshold for checking. But I’m not just looking for celiac, I’m looking for the spectrum of reactions to gluten. There is some more sophisticated testing coming up that I’ve been using, but it’s not something that’s really useful or available to everybody at this point. It’s really more for really solving tough clinic cases. I think, you know, just try and get off it for awhile, and see what happen, then trying it again and seeing what happens is a really great test.

I had this patient, she was off gluten, she felt great, all of her stomach pains got better, her irritable bowel, her allergies, and her energy and everything. [She said,] “I feel good, you know, I’m going to try it again.” So she had it again, and she ended up in the emergency room with severe pain, because when you stop it and you feel better, and then you start it again, your reaction will be worse. So your body will have a pretty good response to something that is not agreeing with it, and you can use that as a barometer for what to do.

TS: I want to go back, Mark, to what I think is really, in some ways, the emotional crux of our conversation. We talked about the power of social support and the cultural context in which we live, and how, for many people, they won’t have that support built into their life, but they can begin to create it. OK. But still, most of us find ourselves on our own, knowing we need to make certain changes. As I’m listening to you, I know the experience I’m having, and I’m imagining the experience that listeners may be having. I’m know there are certain things that I consume that I’d be better off—I’d feel more alive, more heart-based, more open if I did not eat things.

MH: Like what? [Laughs]

TS: OK, and there are other things I need to eat. I know this, and yet making these changes part of the reason it’s hard is because there’s emotional material I’ll need to work with in my life in order to do this. I’ll have to change a lot of things in my life, actually, to do this. I’ll have to face a lot of things. And you mentioned, you know, you can write things down, “why I’m craving this or why I don’t want to eat this.” But, you know, this is hard. It’s really hard work. And I know you’ve worked with lots of people. And so I want to hear more about what you find works to help people really face the emotional aspect of changing their diet.

MH: Well, you know, I really work with people a lot around this, because you can’t change the levers of biology unless you can change the levers on behavior. I know how to tune somebody up from a biological point of view, but it’s useless if they’re not going to do it.

So it’s a big part of our practice. And I have people at my practice who are coaches, I have nurses who work with [people] as coaches, nutrition coaches. And I act in that way with my patients and really try to find out what is it that’s meaningful for them, what is in their way, what are their obstacles, what are the things that are embedded in the structure of their lives that makes it difficult to do the things that are good for them. We explore all these things, and it’s different for everybody. So it’s very personalized.

And then there are some people, they really have very deep, embedded emotional patterns that are very hard to undo. I really encourage them to work with somebody. For example, I created an online course [that] is launching in the fall, which is basically providing life coaching as part of the healing process. So it helps you work through the biological transformation at the same time you’re working through the emotional blockages and the emotional toxins that are in your way.

I completely agree with you, it’s part and parcel of the process. But often, I say, it’s very hard to wake up, it’s very hard to get connected to your feelings if you’re constantly disconnected from them because you feel lousy or because your body’s inflamed or because you’re toxic or because you have nutritional deficiencies. It’s much easier to be meditating and enlightened and aware and awake if you aren’t mercury poisoned or your B12 levels are OK, or if you have enough vitamin D in your system, or if you’re not eating something that’s causing your brain to be inflamed, like gluten.

TS: Now, you see all kinds of people in your practice. I’m curious what the most common issues are that you discover that people are facing, that they’re surprised by. Like, “Really? I had no idea that’s really the source of my problem.”

MH: I do think that people don’t connect food with their health in a real way. They go, “Oh, I know if I eat a cheeseburger and fries and a soda, it’s probably not good for me.” But they don’t really connect the fact that they might have disease or symptoms that are connected to things they’re eating. And it’s sort of striking to me, to see that. Nothing is better in life than to actually get people to eat real food for a week or two, get off the major allergens for a week or two, and see the transformation that happens quickly. So when I can do that for people, I feel that’s a real service, to be able to actually guide them into an experience of wellness that isn’t that far off, and it’s simply through changing what they eat.

So food is always the biggest thing [first]. Sometimes it’s other things, though. Often gluten is a big factor they’re not aware of. Sometimes people have heavy metal toxicity they’re not aware of. A lot of times people are nutritionally deficient, they’re not aware of that. Many people have pre-diabetes and diabetes, and they’re completely unaware of that. And 90 percent of people who have this are not diagnosed, they’re just coming in blind. I think that’s a big part of, I think, what’s driving a lot of disease in our culture, this phenomena of pre-diabetes.

TS: I’ve never heard of that before, can you explain what that is to me?

MH: This is actually a problem that affects one out of every two Americans. Ninety percent are not diagnosed, and it’s the continuum from a little bit of belly fat to imbalances in your blood sugar to pre-diabetes to full-blown type 2 diabetes.

What happens is, when you eat sugar or processed foods, you drive up your insulin levels. Insulin is a fat storage hormone. Then you become resistant to the effects of insulin and you pump out more and more insulin, and your body becomes dumb to it and you need more and more, and you just produce more belly fat, and it’s a vicious cycle. It’s a condition that’s driving most of the health care costs and most of the disease in our society.

I think it’s a shame, because it’s mostly a lifestyle-driven disease, and conventional practitioners don’t know much about it and don’t diagnose it and don’t know how to treat it. We’re trained more about how to fix malaria than how to treat obesity-related illnesses when [we] graduate medical school. It’s pretty much a shame.

TS: How do you diagnose pre-diabetes when people come and see you?

MH: Well, I have a really simple quiz, a questionnaire I set up. I ask a set of questions, you know, do you have belly fat? Do you have a family history of diabetes or obesity or early heart disease? Are you of non-white ancestry, do you have African American, Latin American, Asian, Indian, Native American—all of these have much higher risks. Do you have a little high blood pressure? Has your doctor told you your sugar’s a little high? Do you have high triglycerides, low HDL? Do you have other problems, like infertility? Have you had heart disease yourself? These are all questions I’ll ask people as a survey.

And then I’ll do some testing, and I’ll measure some very simple blood tests. It’s a sugar drink, so I give people a sugar drink and then measure their blood and check their insulin and their blood sugar an hour, two hours later. Most doctors just check blood sugar, which is very late to go up in the game. You first want to check insulin early on, and that will give you a clue as to what’s really going on. So that’s the way I’ll diagnose it, and it’s pretty easy to diagnose, if you know what you’re looking for.

TS: And when you said that it’s endemic in our society today, what kinds of statistics do you have for that?

MH: Oh gosh, Tami, it’s horrible. You know, one out of two Americans, I think, has pre-diabetes or diabetes. Type 2 diabetes affects one in ten Americans, one in five African Americans, and one in four Medicare patients. It will affect one in three children born today. One in three children born today will have type 2 diabetes, if we continue our current trends. One in three Medicare dollars is spent on type 2 diabetes. I just talked to the VA, we have 6 million veterans, and 2 million—a full one-third—are diabetic.

So this is a huge problem, and it’s costing us $3.5 trillion to take care of this globally. It’s spreading around the world: 80 percent of the world’s type 2 diabetics are in developing countries, and half of them are not diagnosed. China and India are No. 1 and 2 now for type 2 diabetes, where a generation ago there wasn’t any. So we’re in a serious situation, and we have to address it.

TS: Now, in your program that you created with Sounds True, The Detox Box, which is a self-guided approach to detoxifying, you made a really interesting statement that I’d love for you to comment on. You write that, “Contemplative exercises can have every bit as much impact on your body’s ability to detoxify as the finest supplement or the most rigorous exercise program.” And I’m curious to see if you can explain that.

MH: Absolutely. You know, thoughts are things. Thoughts are real, thoughts are substances that affect you. They have weight and they can be harmful. We’re learning some extraordinary things about thoughts and what they do and the way of framing the world and the way of thinking about ourselves in the world.

In the world of epigenetics, which is maybe a little technical, but the idea is that you have a set of genes that you got from your parents. You have 23 pairs of chromosomes, 46 genes. You can’t change that, but you can change your books of life, you can change where the bookmarks are and which chapters are read and which pages are read in your book of life. And these are things we call epigenetic tags—you tag your genes to turn on or off different genes that create the expression of who you are in this moment. Your thoughts modify your gene expression. Your thoughts and your feelings control which genes get turned on and off and how that regulates health or disease.

So learning how to work with that and transform that both on an emotion level, on an intellectual level, on an energetic level—these can all be extraordinary transformational experiences. And they’re a key part of detoxifying.

TS: Now, Mark, just to end, I’d love if you would be willing to talk a little bit about your own process of becoming “congruent,” if you will, with all the things you know. I mean, how has that gone for you? Is it hard? Have there been any, like, “Oh my God, I know this but I just can’t do it”? You know? “Everything’s kind of lining up with all this information that I know and how I actually live my life.”

MH: Yes. That’s a great question. Well, like most people I was pretty stubborn, and didn’t make any changes until I had to. I always say people don’t change because they have NEP syndrome, which means “not enough pain.” So I didn’t really change until I had enough pain. And I had some basic tools—I was a yoga teacher before I was a doctor, and I was a vegetarian for many years, and I always exercised, but I really ran myself into the ground.

I worked as an emergency room doctor and I just really killed myself and got very, very ill. And I was fueling myself on coffee. I’d have a quadruple espresso, half a pint of Ben and Jerry’s ice cream, and a giant chocolate chip cookie, and I would go to work at 11:00 at night and work all night. It would last me until about 5:00 in the morning. Hopefully I could take a nap for an hour, and then I’d get back and finish my shift. And that was how I managed. And then I would stay up the whole day and I wouldn’t sleep, and I just wouldn’t listen to my body. I didn’t listen to the basic rhythms of life and thought that MD stood for “medical deity,” and it meant I didn’t have to follow the same rules of biology as everybody else.

So I was sort of forced to, because I developed chronic fatigue syndrome, and I had to completely reset my whole life. I had to pull back from everything. My whole body broke down, so I had to change my diet. I just had to reset my whole system. And as I’ve come out of that, I realized I healed myself in that process. But I’ve had to live in a way that supports myself, and sometimes I do better, sometimes I do worse.

Sometimes I’m tired, I’m run-down, [and] I’ll just go have something that’s really junk or garbage-y, and sometimes I’ll go have a giant latte and a chocolate chip cookie. Sometimes I’ll do that, [because] I just feel like crap and I want to get a little energy boost and I have a long day ahead of me and, you know, I just have to deal with it like everybody else. But on a day to day basis, I try to structure my life so that I can have things around me that support me and they become more second nature.

I also create my house as a safe zone and my work as a safe zone, so it’s very tough for me to make the wrong choices. I make it really hard because—you know, before this show, I was hungry. I was actually out late last night, and usually I don’t do that, but I was at a really fun event in New York, and I knew I had to do this show and I was getting a little hungry. So I went downstairs, and the worst thing I could find to eat was some macadamia nut butter and some 80 percent dark chocolate, which I dipped in the [nut butter]. That was my decadence, and it was delicious! Since I’m not used to eating a lot of that stuff, it actually was super sweet and super delicious.

TS: So you’ve been on a chocolate high this whole call, Mark?

MH: Oh, totally, yes. [Laughs] I didn’t have much, I just had like a little square, I just dipped it in there and it was really good. And I think people would go, “Ah, that’s gross, I don’t want that, I want my cookie.” And sometimes I’ll go for that, but if you just create the defaults in your environment—my house, I can’t find anything. If I’m going hunting and gathering, I’m only going to find stuff that’s going to support me, not stuff that’s going to harm me.

The more you can build that in your life, the better it is. And I try to schedule in yoga and exercise, meditation. It’s not always easy, but I know that it helps me, and I want to be able to enjoy life. I’m, at heart, a hedonist, and I want to really feel good and enjoy the things that are available to enjoy in life, and I can’t do that if I feel like crap.

TS: Mark Hyman, the healthy hedonist. I like it.

MH: [Laughs]

TS: Thank you so much for this conversation, and thank you so much for all the good work you’re doing.

MH: Thank you.

TS: Dr. Mark Hyman has created, with Sounds True, a program called The Detox Box, a safe, medically informed detoxification program to boost your health and your immune system. He’s also recorded with Sounds True and audio program called UltraCalm: A Six-Step Plan to Reduce Stress and Eliminate Anxiety. Thanks so much for being so real, and so helpful. I really appreciate it.

MH: My pleasure.

TS: SoundsTrue.com. Many voices, one journey. Thanks for listening.