Dr. Mark Hyman on The Truth Behind Metformin, Gut Health, PCOS, Fertility Issues, Hormone Health & Ozempic

Mark Hyman
People are hungry for this information. People don't want to feel sick. People don't want to feel like crap. You know, people want to understand what's happening in their body. And you can see it.

I mean, you can see it happening with all the trends of wearables and biosensors and people trying to like Biohack. I mean, there's a whole movement around understanding that our current healthcare system doesn't have all the answers and that we need to be in charge ourselves. This is the pursuit of wellness podcast, and I'm your host, Mari Llewellyn.

Mari Llewellyn
Hi guys. Welcome. Welcome back to the Pursuit of Wellness podcast. Today I am over the moon to announce that we have Mark Hyman on the show. This is a dream guest for me.

I actually can't believe I was able to sit down and chat with him. He's such a lovely guy and he's doing such amazing things in the health industry. I'm so excited for you guys to hear this episode today. If you don't know Mark, he is an internationally recognized physician, leader, educator, speaker and podcast host, 15 time New York Times bestselling author, and the head of strategy and innovation at the Cleveland Clinic center for Functional Medicine. After battling heavy metal toxicity himself, Mark learned to heal himself and forged a career pioneering new frontiers of medicine.

He has co created Function Health, which is his new business, to give millions of people the privacy and accessibility to healthcare they deserve. And he serves as the company's chief medical officer. I have personally learned a ton about function. It is an incredible piece of software. Guys, you're going to hear more about it in this episode today, but I think it's going to change the industry.

Some things we talk about in today's episode, we talk about functional medicine versus western medicine, the shift in academics, knowing what's going on with your own body, hormonal health and pcos, identifying your diagnosis, the low down on metformin, using it for pcos and diabetes and longevity, natural methods for fertility complications Ozempic and fertility. I'm sure you guys have been hearing about people getting pregnant on Ozempic. We talk about that, the side effects of Ozempic, can it be effective? And Mark's overall take on wellness and how to live the best possible life for you. Also, guys, listen until the end of the episode because we dropped a very special code for Mark Hyman's new company function.

It has, I believe, over a 200,000 person waiting list, and this code will get you to the front of the list. You'll be able to download the app immediately, so listen out for that code. I think you guys are going to really enjoy this episode. Please don't forget to leave a review. If you enjoy it, hit the subscribe button.

And without further ado, let's chat to Mark. Doctor Mark Hyman, welcome to the show. Well, thanks for having me, Marie. I am so excited to sit down with you. I've wanted to chat for so long.

You have become such an important voice in this industry, and I know you were. You have a medical degree, trained a little more traditionally, but now you have such a passion for functional medicine. I'd love to hear about how you became so passionate about health. I think I was always kind of passionate about it. I actually had a gym teacher in the 8th grade named mister GibsoN who showed us this movie of people doing incredible acts of fitness.

Mark Hyman
Like this Guy, LarRy Lewis was 105, and he would run 5 miles to work as a waiter every day. And 5 miles back across the golden Gate bridge, there was some guy who ran the Boston marathon on stump. So I got very inspired to start running. My mother, when I grew up, they lived in Europe, and so they really shopped every day. Ate fresh food.

My mother cooked fresh food every day. We had a garden in the backyard. I'd go pick tomatoes and eat them right off the plant. We'd have fruit trees in our backyard in the suburbs, and I would just eat the fruit. So I was very kind of already kind of prepped for that.

And then in college, I got very interested in yoga and sort of yoga way of life, which was very much focused on health and wellness, which was vegetarian for years, and sort of always focused on the kind of other side of health and traditional medicine. But I was like, I think I'll try to go to medical school, see if I like it, and if I don't, I'll quit. But if I like it, I'll stay. And I liked it. And then I ended up being really well trained in traditional medicine.

But when I was 36, I got very ill with chronic fatigue syndrome from mercury poisoning that I got in China, and my whole system broke down. And I went from being riding my bike 100 miles a day to not be able to walk up the stairs. I could remember 30 patients seeing in a day and not take any notes and dictate all the charts at the end of the day perfectly. And I couldn't even remember where I was at the end of a sentence. From where I started, I was just completely disabled.

Gut issues broke down, immune broke down, brain fog couldn't sleep, muscle pain, just complete breakdown. And I had to dig my way out of it. And I went to doctor after doctor, got no help. Take Prozac, take Ativan, take the sleeping pill. It's depression.

And I'm like, no, it's not. I am a doctor. I know my body's not working, and I have all these weird symptoms. And so I had to really reverse engineer my way back to health through figuring what was going on. And that's when I encountered functional medicine.

It's when I learned about doctor Jeffrey Bland. I got to meet him. I got to understand the paradigm shift that was happening in medicine and really the science of creating health as opposed to treating disease, and basically had to build myself up back cell by cell, you know, tissue by tissue, organ by organ, to health. And it was an incredible process, very painful, very difficult. Took a long time.

You know, I didn't have the full roadmap that we have now, and I started using it on my patients, and I was just seeing kind of miraculous recoveries and things. I was like, you did that, and you got better from this. And, you know, your autoimmune disease went away, and your Alzheimer's got better, and your autism improved, and your, you know, your chronic migraines went away, your depression result. I'm like, how did that work? Because it didn't comport with everything I learned in medical school.

And so I really went deep, both for myself and for my patients. And that's what really led me to sort of get really passionate about understanding the way the body works. And I think where we're at in medicine is this incredible moment where we have kind of developed our current medical system based on the best we could do, which was looking at people's symptoms, where they are in the body and trying to treat them the best we can. But it's an organ based medical system that's disease based, it's symptom based that has nothing to do with the cause or the mechanism. We're seeing this kind of in psychiatry now.

We're like, well, psychiatry is just a description of symptoms. You're depressed because you have no interest in daily life. Your appetite's low. You can't sleep. You have no happiness.

You're not interested in sex. Oh, I know why you have these things. You have depression. Well, depression is just a name of bad condition. It's not the cause.

And now the cause could be many things, like eating gluten or having bad microbiome or having low vitamin D or low omega three s. Or mercury poisoning or a million things. And that's what we navigate to with functional medicine. And so I really began to understand that there was a whole new set of laws of biology, laws of how the body's organized as a system. And now we're seeing systems, medicine, network medicine, textbooks being written about it, journals, medical journals dedicated to it.

And I think that there's a real understanding that we need to really dig deeper under the hood to see what's going on in the body as a system. And that's really what my life's been focused on. How do we create a healthy system? How do we create a healthy ecosystem in the body and not just treat the diseases with medications that suppress symptoms, but actually, how do we create health? I feel like we're hearing the term functional medicine so much more than we ever have before.

Mari Llewellyn
For anyone listening who maybe doesn't understand the difference between, yeah, western medicine and functional, how would you describe it? Well, sort of hinting at it. But I think, you know, functional medicine is really looking at causes and mechanisms and the underlying underlying understanding of the body as a system, as a network where everything is connected. And that rather than focusing on the diseases, if we focus on the root causes and the underlying systems that go wrong, that we can create health. So we treat the basic fundamental systems.

Mark Hyman
The body has these seven physiological systems that are all networked together that give rise to disturbances because of different insults or lack of certain things. And when there's disturbances in this ecosystem, we get sick. So, for example, you take an antibiotic, that's an insult, that destroys your microbiome, right? The microbiome then can create a problem because you've got a leaky gut, and that creates inflammation in the body. And that can cause metabolic health problems like diabetes, or it can cause psychiatric problems like depression, or it can cause an autoimmune disease.

And so we begin to say, oh, well, maybe we need to think about the body in a different way. So we understand these sort of network effect. And we look at the, the systems like the gut, the immune system, the energy system, mitochondria, how we make energy, how we detoxify our circulation, transportation systems, our communication systems, hormones and neurotransmitters and peptides, their structural system, you know, biomechanical structure. And those are all influenced by the environment. So we have a lot of control over these systems.

And I think of these as sort of the laws of biology. You know, if I said to people, what are the laws of physics? They go, yeah, I learned about the laws of physics in school. But if I said, what are the laws of biology? People go, I have no clue what you're talking about.

And in medicine, we're, we're very reactionary, we're very descriptive, but we're not, we're not really focused on the body in the way we should. So my daughter's in medical school, and I asked her, why? Are you learning about the microbiome? No. Are you learning about insulin resistance?

No. Are you learning about nutrition? No. I'm like, well, these are the fundamental things. Are you learning about toxins?

No. These are the fundamental things that are driving our chronic disease epidemic that we're seeing at scale. And so I think we have this incredible moment in history where it's a paradigm shift that's akin to the earth being not flat or the sun not revolving around the earth, or the idea that species evolved through natural selection versus being rising fixed in their state that they are. So we have all these massive scientific paradigm shifts for Einstein saying that time and space are relative. I mean, these are, these still, people have a hard time getting their mind around these ideas, like, this table here is mostly empty space.

Well, how does that, how does that true? But it is true. And so we're seeing that in medicine now because medicine is extremely young science. And I think I'm so excited about this moment in history where we're able to actually take these insights, take the powerful computing power we have, take the deep ability to diagnose what's going on under the hood through deep phenomic testing. The phenomena is essentially your expression of your biology at any given moment.

Your genome is your fixed genetics, but your phenomenon is your current state of biology. So what's going on with your, what, your, with your microbiome, your metabolome, your, all your biomarkers, your nutrition, and all these things can be now measured so we can get literally, you know, terabytes. And I don't know what's bigger than a terabyte. Like, I mean, you've got 100,000 terabytes of data in your gut microbiome alone, right? And theres 37 billion trillion chemical reactions every second in the body.

And we test like, 20 lab tests go to the doctor, right? And so we like getting almost no real data on whats happening in the body. And so im so excited about this moment in history were having this convergence of these different advances in technology, like AI, machine learning, the omesh revolution, biosensors, wearables, and this framework of systems or network or functional medicine, whatever you call it. It's just medicine, right? It's what everybody's going to be practicing.

I recently had a patient who was seeing the top cardiologist at Cedars Sinai in LA, and I'm like, wow, this guy's testing nutrition. He's looking at all these things and biomarkers and stuff that we've been doing in functional medicine for decades, and now it's kind of creeping and leaking into traditional medicine. You've got departments of nutritional psychiatry at Harvard and metabolic psychiatry at Stanford. You've got people thinking about these things that in a very different way. And so the concepts we have around health are really outdated.

Mari Llewellyn
Do you think academic programs are going to shift in that direction? They are. I mean, they are. I'm seeing it happening. I mean, you know, at Cleveland Clinic, where I started the center for Functional Medicine, you know, there's Stan Hazen, who's studied the microbiome and heart disease, and chair Tsang, who studied the microbiome and cancer.

Mark Hyman
And these are, these are like world class scientists who are understanding the body is just not organized the way we think. When you go to the doctor for heart disease, they don't say, let me look at a stool test, but they should. Or if you go to the doctor with an autoimmune disease, they don't go, well, let me look at your stool test or your heavy metals or things that we should be looking at and that we are looking at now with function Health, which is a company I co founded, to help empower people to get access to their own data. And so we're doing deep testing of people at an affordable price. It makes it accessible and allows people to really understand what's going on in the hood.

And what we're seeing is remarkable. We're having so many discoveries about what we found in the 40,000 members that we have to date, with over 5 million biomarkers tested. And that kind of data is just so rare to get. I have a colleague who's founded the Institute for Substitute Biology says, yeah, we're doing a study in 2000 people, and it's going to cost $25 million, and we're going to get the money from the NIH. I'm like, it's great, but we're just getting this data at a massive rate, at a massive scale, and it's going to help us really deeply understand what's going on in the population, how to help people, and correct a lot of the things that finding.

Mari Llewellyn
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I think what you guys are doing with function is absolutely incredible. I was telling you before the interview, I got to sit with your business partner, Jonathan, at a dinner recently, and he told me all about the new business, and I think it sounds incredible. And just from, you know, being the host of this show and getting a lot of feedback, I think the number one thing I see is, how do I get my test done? Who do I talk to? They can't always afford a naturopath to speak to on a weekly basis.

And I think this is such a needed technology. I know you guys have a waitlist right now, right? It's about 200,000 people. Well, we're gonna. We're gonna get.

We're gonna get to put my email on. I was like, but the problem is, you know, we. There's such pent up demand because people really are desperate for this. And medicine has unfortunately been a very paternalistic, top down system with a firewall of the doctor between you and your own biology. So you have to go to the doctor.

Mark Hyman
You don't even know what to ask for. If you do, you have to ask for it. You have to hope your doctor will say yes to do this test. Well, why should I measure insulin? Why should I measure vitamin D?

Why should I measure homocysteine? Why should I measure your mercury level? It's not part of the normal panel of 20 or 30 tests you get. We're doing over 110 biomarkers on the first panel we do for people, and we're looking at everything you could possibly imagine, from hormones to metabolic health to cardiovascular health to nutritional status to toxin levels to inflammation markers. It's an incredible deep analysis of what's going on in your body.

And before now, no one's had the ability to get that. I mean, you could wear an oura ring, you could have an apple Watch, and you could get your biosensor data. Great. People are desperate to know what's going on with their bodies, to track what's happening over time. And there was no way to do that before function health, because you had to go through the healthcare system, which is so onerous, and you had to, you know, get tests which usually weren't covered by insurance or cost an astronomical amount of money or, you know, the, you know, the average, you know, I mean, I had a friend who I just ordered basic panels, and she's.

She things that I like to do similar to what? Function before function. And she. She said, oh, my God, mark this test for like, $8,000. And I'm like, well, that's crazy.

Let me talk to the lab. This is, you know, and we kind of negotiated down, but it was, it was, it was so frustrating for her and for people who want to know what's going on. And now for, like, $4.99 membership a year, you get twice a year testing, deep analysis of your biology. You can do all sorts of add on tests. I mean, we found people with cancer.

It's amazing. We hear amazing stories of people who, we're now doing something called liquid biopsy called gallery. And, you know, you heard about Kate Middleton and you heard about how young she is, and, you know, this is the. And got cancer, and she didn't know. And it was just sort of an accidental finding.

But if people were screened with this new test called gallery, it's a liquid biopsy test. They can find cancers, early stages, often two years before they ever show up on any other screening test and checks over 50 cancers, not every cancer, but most common cancers. And it's highly accurate, and there's very few false positives. And we're saving lives, and people are writing into us saying, you know, we didn't know this, and I have kids, and I just found out I have this, and this saved my life. And if I'd let it go a little longer, I wouldn't have known.

And so we're hearing stories of people really having profound impact from the use of function and helping them to understand what's going on in their bodies and doing things that your traditional doctor wouldn't do. Yeah. I think hearing this through my lens as a woman going into a doctor's office and usually being a man and trying to get advice on hormonal health, fertility, pcos, number one, very intimidating and a little bit shameful. And even in my position being, I consider myself pretty knowledgeable about health and fitness. I have access to experts.

Mari Llewellyn
I have the income to be able to afford a naturopath. But it took me years and so much money to get to the bottom of my personal hormone issues. You know, I was told you have high testosterone. You have high testosterone. Never was.

I told that I had heavy toxins in my system and that my liver was overloaded and that I needed to work on cleansing the liver. And I didn't know that the liver had anything to do with mine. Hormones. Hormones. And working with a naturopath was the only way that I kind of had that full circle moment of, oh, my God.

It's not just about having hormonal imbalance. There's other things happening, too. And now I just got my GI map test results back, and that's a whole other thing. But it's a great example. PCos, I think, is what you're talking about, which is polycystic ovarian syndrome, which is really common condition that affects women's health in really uncomfortable ways.

Mark Hyman
It causes them to have acne and hair growth on their face. It causes heavy or irregular menstrual periods. It can cause infertility, weight gain, diabetes, and some resistance. In large part, it's treated in traditional medicine with the birth control pill or other hormone suppressing drugs, or sometimes diuretics that affect hormone metabolism. But never are we looking at what's causing it, what the root cause is.

And you mentioned a few things like toxins or your liver. But there are many things we look at from our perspective that make a huge difference, like looking at your gut. Microbiome plays a huge role in hormone metabolism. And having an unhealthy gut will drive really significant hormonal dysfunction. Having environmental toxins that we're all exposed to are often hormone disruptors or endocrine disruptors that screw up our sex hormones, estrogen, testosterone, progesterone, our diet of ultra processed food and sugar.

It drives also a lot of hormonal dysfunction and diabetes and prediabetes and insulin resistance. It's not really an ovarian problem most of the time, there's some genetics involved, but a lot of times it's related to the amount of starch and sugar in our diet, the environmental toxins we have that changes to our gut microbiome and our problems with detoxifying these things. And that's the kind of perspective that people deserve, and the science is there. People go, where's the evidence? This is not evidence based medicine.

Like, listen, have you read the 10 million articles on Pubmed or how many published medical articles there are? No. The average doctor has not searched for, looked for, or understood it. It doesn't mean it doesn't exist. And there's plenty of data to support everything I'm saying.

It's just that it's not part of the medical paradigm. So it's like, if you don't, if you don't, you don't, if you don't know what to look for, you're just seeing things through the blinders that you were trained in. And unfortunately, that misses a lot of what's really causing people's discomfort or disturbances. And then, you know, like in our cohort of patients from function health, we're seeing, you know, about 10% of women have some degree of this hormonal dysfunction with elevated testosterone, high levels of DHEA sulfate and other biomarkers like high insulin, and things that are completely treatable and that are often ignored and that lead to unnecessary suffering. And so, for me, my whole career has really been about how do we relieve unnecessary suffering.

I mean, I think there are certain things I can't control. I can't end war, I can't fix the crisis in the Middle East. I can't really do a lot of things, but these are solvable problems. We have the science, we have the understanding, we have the capacity, and we need to empower people with their own data. And that's really why, with my other co founders, we co founded Function Health, to empower people to be the CEO of their own health, to take control of their own biology, to not have to go through this onerous process of trying to find somebody who can possibly help you, who knows enough.

And the beautiful thing about functional health, it doesn't just give you your numbers, and it does, and you get a beautiful dashboard and you can track it over time, but has deep insights from the world's experts and from deep science, all evidence based on what it means, what you can do about it, how you can deal with it through understanding the root causes as well as deal with lifestyle factors. And then if you need to go see a doctor or get medical treatment, here's what probably would be most beneficial. So it's really deep insights and guidance for supporting people to kind of empower themselves around getting healthier and being the CEO of their own health. I want to touch on the PCOS piece a little more. I think it's, to me, the most common issue that I see in women my age, and I think many of us millennials were on birth control for ten years plus.

Mari Llewellyn
I mean, yeah, I know for a fact that I don't have ovarian cysts. I simply have the symptoms of PCOS. Regardless of the fact that I live such a healthy lifestyle, I don't consume sugar or starches. It feels like I'm doing everything right, and yet I still have this problem. What are some of the go to tools you recommend to women who come to you who have hormone dysfunction, or pcos?

Mark Hyman
Yeah. So, in my personal practice at the ultra wellness center in Lenox, when I see patients like this, we do a very deep analysis. So we look at their hormonal stats. So I do a deep analysis of hormonal patterns, the same we do with function, health. You don't have to actually come see me.

We look at toxins, environmental toxins. We test the gut microbiome. We look at hormone metabolism through urinary metabolites of estrogen, which are very helpful. We look at their diet, we look at their lifestyle, we look at stress, we look at sleep. We do deep, deep analysis of what's happening, and then we get a sense of what the root causes are.

So it's different for different people. And that's part of the problem, is that in medicine, we label people with the diagnosis, and then we think all people who have that label are the same PCOs. Okay? Everybody with PCOS falls in that bucket. It's not true.

There are maybe ten causes of PCOs. There may be ten causes of diabetes. Depression is, like I said, it's just a name we give to people who share a set of symptoms, but it doesn't tell anything about the cause. And now psychiatrists like at Harvard, like Chris Palmer, talking about the mitochondrial dysfunction from our poor metabolic health. Uma Naidu at Harvard is talking about the microbiome and mental health and curing patients with schizophrenia by a ketogenic diet.

And it was really crazy stuff. That is something that is happening in academic medical centers. So it doesn't mean it's reached the clinic yet, but there are a few pioneering doctors in many of these centers around the world and around the country that are actually doing this work. So I think it's sad that traditional medicine is so slow to adopt things. It's like between 17 to 20 years before a scientific discovery becomes clinical practice.

There's a great story of Semmelweis, who was a viennese physician in the 18 hundreds who said, gee, I noticed that the midwives, when they deliver babies, their mothers are not getting childbirth fever, but when the doctors are delivering their babies, a lot of their patients are getting childbirth fever. He noticed that the midwives were washing their hands in between deliveries. And he's like, gee, maybe we should wash our hands. Good idea. But it was such an act of heresy against these traditional establishment that would imply that doctors could be causing their patients to be sick by not washing their hands.

So he was expelled from the medical community. He died in disgrace, and it took 50 years for the medical establishment to say, yeah, probably we should wash our hands before surgery. I mean, McKinley, President McKinley died because McBurney, a very famous surgeon at the time, he was shot in the stomach, came and stuck his finger in the wound and kind of contaminated him and got him infected, and he died from infection. So, you know, it takes so long. And that's what we're trying to do with function.

Health is accelerate the timeline from scientific discovery to adoption and for giving people access to the most up to date medical science in a way that's extremely actionable, usable, and up levels their health. And it's really, to me, this company, I've done a lot of things, but it's really one of the most consequential things I've done, because I can sit in my office all day and see 1012, 2030 patients a day till I'm 120 years old, and I'm still only going to see a few thousand patients in one year. We have 40,000 people who've been helped, and we're going to have millions, and I won't, hopefully billions. And I think I'm so passionate about getting this timeline accelerated from the discovery of things that can really help people, like pcos. We know how to approach this problem from a systems point of view, from a functional medicine point of view.

We help so many people. I've had so many women who I've helped get pregnant just by helping them address this. It's not that hard once you understand how things work. But right now, we don't really have the map of how things work in traditional medicine, and that's what we're applying to our work and function. We're bringing the latest scientific insights which are just medicine, and applying them to what we're finding with people's biology.

And it's really been an extraordinary journey, and we're just getting started, but it's pretty exciting.

Mari Llewellyn
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Mark Hyman
Yeah. And you find that someone has a super messed up gut. Like, let's say, hypothetically, they had H. Pylori and Sibo and tons of bacterial overgrowth. Yeah.

Mari Llewellyn
Is there ever a time you'd recommend western medicine approaches? Well, see, this is the thing. I don't make a distinction between western medicine and systems medicine, network medicine, functional medicine. It's all just medicine. And I'm agnostic to the treatment.

Mark Hyman
So, for example, if someone comes in and they have H. Pylori, you know, sometimes we can treat with herbs, but often we'll need antibiotics. Or someone has bacterial overgrowth or fungal overgrowth, we'll need to address that directly by fixing the gut. And so we'll use medication. So it doesn't matter if it's exercise or exorcism.

I'm going to use it if it's the right treatment for that patient. So antibiotics are okay sometimes. Yeah. I mean, if you're treating, like, if you're treating something that's causing a problem. So I'll give an example.

I had a patient come to see us at Cleveland clinic, and she was a 50 year old business coach and very smart, very capable, was seeing the best doctors at Cleveland clinic, and she had a whole list of problems. My joke is, you know, I take, I'm a holistic doctor because I take care of people with, like, whole list of problems. And traditionally, medicine, it's like, don't bother me with things that aren't in my specialty. I'm a dermatologist. I'll take care of your psoriasis, or I'm a neurologist.

I'll take care of your migraines, or I'm a gastroenterologist. I'll take care of your irritable bowel. But don't tell me about these other problems. Go see that specialist. I don't know anything about that, but it's not how the body works.

So this woman had psoriatic arthritis, which is a horrible condition, which is not only skin lesions, but joint disfigurement and arthritis. She was on a drug that cost $50,000 a year. She had terrible bloating and irritable bowel syndrome. She had terrible reflux and heartburn. She had migraines.

She was pre diabetic. She had depression. And she was getting treated by the best, best migraine medicine. Best medicines for irritable bowel, best medicines for reflux, best medicines for psoriasis, best medicine, arthritis, and so on. And she was on metformin for prediabetes.

She was getting all the best treatments and was still miserable. A little bit better, but still miserable. So I said, gee, maybe all these conditions are related to inflammation. And by the way, on function health testing, uh, its striking, 46% have elevated c reactive protein, which is a biomarker of inflammation. 30% have a positive autoimmune biomarker, which is just staggering to me in the population.

So almost half the people have have level of inflammation thats driving some dysfunction in the body. We can talk more about that. But this patient had got a lot of gut issues, and the gut is the source of most of the inflammation in the body because 60% of your immune system is in your gut. So she had bacterial overgrowth. She had fungal overgrowth.

And I gave her an antibiotic, I gave her an antifungal. I gave her some probiotics and things to help rebuild her gut. I gave her a multivitamin, fish oil, vitamin D, just some few simple things. I put on an elimination diet to get rid of all the inflammatory foods, all the sugar and processed foods. And I said, just stay on your medication.

Come back over you. Results in six weeks. But I just did this based on her history, and she came back in six weeks. Well, Mark, I stopped all my medications, like, oh, okay, but everything's better. I have no more psoriasis, no more arthritis, no more migraines, no bowel, no more reflux.

I'm not depressed. And I lost 20 pounds. And I was like, I didn't treat all the diseases separately. I treated the root cause. And the root cause was her gut.

Mari Llewellyn
Yeah. And for so many, so many of our conditions, whether it's mental health issues, whether it's Alzheimer's, whether it's cancer, whether it's heart disease, whether it's pcos, whether it's infertility, whether it's autoimmune diseases, whether it's autism, a lot of these conditions, the gut plays a huge role. I'm not saying the gut is the only cause of all these things. And I think we get so confused by these labels because, okay, everybody with autism is the same. Everybody's depression is the same.

Mark Hyman
Everybody with rheumatoid arthritis is the same. They're not. So I'm one patient with rheumatoid arthritis might be better by eating, getting rid of gluten diet. Another person might have a parasite. Another person might have a bad bacterial overgrowth and a leaky gut.

Another person might have heavy metals, an environmental toxin that's causing autoimmunity. That's what we now call autogens because they cause autoimmunity. So. And the treatment's different. One person may be getting gluten.

My person may be healing the gut. Another person may be, you know, treating the, um, treating the environmental toxins and getting rid of those from their body. So we have to be very personalized, and that's where the future of medicine is going. It's a personalized, individualized, customized approach to our health. And the only way you can know that is knowing what's going on in your body.

So it's great to get on a scale, to check your blood pressure, to do your biosensors, but you need to look under the hood. You have to know about your biomarkers. It is a huge factor in determining what's really going on. And the thing is, Mary, is that the disease doesn't just come on all of a sudden. It's a continuum from wellness to dysfunction to illness to death.

And so anywhere along the continuum, you can identify dysfunction and correct it and get people back to wellness. So if you do what traditional medicine does is like, you wait till there's a disease that you can treat and then you give a drug, rather than saying, I'm going to look at what we call scientific wellness. This was a term developed by Leroy Hood from the Institute for Assistance Biology. And it's a real framework for understanding how to look at this continuum and the subtle disturbances that happen over time that can give you clues about where you're headed. So let's say just take blood sugar, for example.

Your blood sugar should be 70 to 85, 100 is considered prediabetes, 126 is prediabetes is diabetes, type two diabetes. So what if your blood sugar is 98? Are you okay? No, you're not, right. And what about the things they don't measure?

We measure on the functional health panel and give people access to getting testing that nobody's really doing out there in medicine. And for example, lipoprotein fractionation is a way of looking at your lipids or cholesterol. Its the gold standard for how we should be looking at the cholesterol. This has been around for 40 years. Theres abundant evidence about this.

It doesnt cost that much, but its almost never done. And you cant really tell whats going on with someones limited profile unless you do this special kind of test. We asked Quest whos our partner. People can get function health lab tested over 2000 quest locations around the country. Super easy.

You sign up, it takes five minutes. You go the lab, it takes 15 minutes. You're in and out and you get your results. It's super frictionless. And we asked Quest, you know, how many of the lab tests that you're getting for cholesterol are these lipoprotein fractionation tests and they're like probably less than 1%.

And they're, they're asking us, how do we get doctors to do this? How do we get doctors educated about whether you should be looking at, to properly assess cardiac risk, like insulin? I said how, how many people get their insulin tested? How many people out there have ever had their insulin tested? Very few.

And is probably the most important test to know whats going on with your metabolic health and your risk for all chronic age related diseases like heart disease, cancer, diabetes, and dementia. Its the single biggest problem we have in this country. 93.2% of us are metabolic and healthy, which means were on the continuum from prediabetes to type two diabetes. Less than 1% of tests out there, people are getting insulin. According to Quest, we're like, this is a standard test we do as part of our panel.

And if your insulin starts creeping up, the reference range in America's on the quest lab is 15. So we give you optimal ranges and the quest reference ranges. The quest reference ranges are based on a statistical method that we use to create a reference range, which is essentially what is the average in a population, what is, quote, normal. And it's two standard deviations from the mean. So you take, you know, the whole population, and you kind of look at what's mean.

If you were a Martian and you land in America, you go, it's normal to be overweight because 75% of people are overweight. So the reference range for weight should be like. Is skewed in the wrong direction. Same thing for insulin. So your optimal insulin less should be less than five.

Five to ten is. You're creeping up over ten, you're concerned, but the reference range in quest is 15. But that's because everybody's walking around metabolically unhealthy, and that's what they're seeing in the population. So we give people really deep insights about not only what is the, the lab tests say is the normal reference range, but what. What do we think is the optimal range?

Right. Like your blood sugar, it shouldn't be a 98 or 99. It should be like 70, 85, because we see from the data that anything over 87, your risk goes up for high blood pressure, heart attacks, strokes in a linear way with every bump in blood sugar. So it's really important to know your numbers. And knowing your numbers is something that I think is going to be revolution in healthcare, because people, people are, people are hungry for this information.

People don't want to feel sick. People don't want to feel like crap. You know, people want to understand what's happening in their body. And you can see it. I mean, you can see it happening with all the trends of wearables and biosensors and people trying to like Biohack.

I mean, there's a whole movement around understanding that our current healthcare system doesn't have all the answers and that we need to be in charge ourself. I think lab testing is so powerful. I've learned so much about myself and my personal healing journey, and I. It's fantastic that you guys are making it more accessible. I want to jump and affordable, easy.

With deep insights that you're not getting from your traditional doctors. It's difficult to recommend it to people when, you know, it's not as accessible. You know what I mean? So it's really nice to have this tool to reference. You mentioned Metformin.

I did. I want to ask about Metformin because I've heard a lot of, like, rumors. People speak about it from a longevity perspective, from a PCOS perspective. What are your thoughts on Metformin? Well, you know, there's.

This is a drug discovered in 1957, and it's been used very safely for treating diabetes for a long time. And it helps by improving insulin sensitivity. And it works on a particular pathway called AMPK, which is what I call one of the longevity switches in the body. And it's highly influential for so many downstream functions. So it improves insulin sensitivity, it improves rheumatoid hydro function, it reduces inflammation, it helps turn off cancer genes.

It has many, many, many benefits. And so it's a great drug to use. If you're insulin resistant diabetic, it can be very helpful. I mean, obviously, diet works better. One large study called the diabetes Prevention study, where they look, there were, I think it was over a thousand people over a number of years, and they put them on a rigorous program called the Diabetes Prevention program, the DPP, and they gave them lifestyle, aggressive lifestyle changes.

Metformin or nothing. Okay? Right. The lifestyle had a far greater impact than doing nothing, obviously, in preventing the progression to diabetes from prediabetes. Metformin worked, but far less than the lifestyle.

So the metformin, I think, reduced the risk by 31%. The lifestyle was 57%. So it does have a benefit, but actually, lifestyle works way better. So I often use food as medicine, pretty much primarily, and I often don't need to use these drugs, because if you figure out how the body works, but they can be helpful. Now, in respect to certain conditions, like pcos, certain genetic problems, that people have really struggled insulin resistance, or sometimes people with type two diabetes, it can be a helpful drug, but I think there's problems with it.

And I think that in the longevity space, there's been some confusing information, data about it. What happened was it was a study a number of years ago that was a population study. Now, these studies cannot prove cause and effect. They look for associations and try to see signals in the data to do further research and do clinical trials, which means you do a proper experiment which can prove causative effect. So the first study was a large study where they found that gee, people who took metformin seemed to outlive people who didn't take metformin who were non diabetic.

So diabetics and metformin outlets. But there was a lot of problems with the study design. And I won't get into all the technical details, informational bias and informative bias and all this kind of technical scientific stuff, but it showed a positive benefit. Another study was repeated and published only about a year ago that showed the exact opposite. It was a twin study.

It was done a little bit better. And they showed the actually, the people who took metformin had higher risk of death. So right now theres a large trial going on, I think three, 4000 people with near bars alive who have had my podcast at doctors pharmacy talking about metformin and its potential use for longevity. And hes doing a randomized control trial where hes giving one group metformin and one group of placebo. Theyre going to follow them for many years and theyre going to track every biomarker and everything that happens and see whats going on.

I think it may end up being useful, but I'm still in the wait and see camp. I don't recommend it to my patients longevity, because I think it has a couple of downsides. One is it inhibits something called mitochondrial complex one, which is necessary to produce energy in the body. And mitochondria are key to health and longevity. So you might be robbing from Peter to pay Paul.

The second thing is they've done studies, randomized control trials using progressive strength training on metformin or off metformin. And what they found was that there was no muscle gain on metformin. Oh. With the same rope program that caused muscle game off metformin. Oh.

So it may, it may blunt the ability for the body to gain muscle, which is an incredibly important thing as you get older, because muscle loss is what leads to frailty, disability and dysfunction. Okay. I had someone recommend me take it for pregnancy reasons, like for fertility reasons, which is why I wanted to ask you about it. Yeah, no, I can't. Like I said, it can be useful.

So I can't give you a recommendation as I looked at all of your data and was your doctor, and there may be cases where I would recommend it. So I'm not opposed to any drug or any treatment. Like I said, I'm agnostic if it's surgery, if it's exercise, if it's a drug, if it's, you know, whatever. I'm for the right treatment, for the right person, for the right time, for the right reason. And I think, you know, we don't practice medicine like that.

It's not personalized. What are some natural methods you recommend to people who come with, come to you with fertility problems? Well, I did a whole podcast on fertility and preparing for conception. And so I really do a deep dive. And a lot of the tests that we do with function health on the panel are the things that I would look at deeply.

So, you know, do a deep dive into their lifestyle. Right. Because it plays a huge role in fertility. Stress, exercise, alcohol, sugar, processed food, all those things will affect fertility. In fact, there was a book written called the Fertility Diet by Walter Willett from Harvard, and essentially described the problem of our ultra processed food, high sugar and starch diet, driving this epidemic of insulin resistance that's making women infertile.

One in six couples now, I think is infertile, or one in seven. It's a lot of people. The idea was, start there with diet and lifestyle. Then I looked deeper. I look at whats happening with their microbiome, whats happening with their level of toxins, whats happening with their immune system, and do they have things like leaky gut?

Whats driving the hormonal dysfunction? And I get very deep, I look at their nutritional level. Like, for example, a lot of people might have problems with B vitamins, and we measure things like homocysteine on the function health panel that you dont get with your traditional doctor, that look at a deeper insights into folate and methylation, which can affect fertility. Ill just tell you a quick story about. Was in a movie called Fed up.

Mari Llewellyn
You were in the movie? Yeah. What? What were you doing in the movie? I was, you know, one of the experts talking about obesity and.

Oh, like a documentary? The documentary. Oh, I thought you had an acting moment. No, no, no. Okay, okay.

Mark Hyman
It was a document. It was a very successful documentary. What is this a little like. No, no, I've never been. Not that I know of it.

Or maybe I'm walking by a sec. You're like the star of the movie. Got it. No, no, I was just in the, in the documentary as an expert. And the director of the movie was a woman who had multiple problems with fertility.

She had multiple miscarriages. She couldn't get or stay pregnant. She had a baby with anencephaly, which is a baby born without a brain. It's a horrible condition. And it was just heartbroken.

And she knew about me and had kind of googled some things I'd written, and she googled this article about methylation, which is a big medical term. Essentially, it means how your B vitamins are regulating your biochemistry, right. And its a really essential process in the body. Its essential for fertility, its essential for brain health or for detoxification for DNA regulation. Its one of the most central things thats happening in the body.

And in the article I wrote about how it can affect fertility and that theres a gene that 35% of people have called MTHFR that affects your ability to turn the folate from your diet into the active form of the folate in your body. Its common. And so she said, I want to go to my doctor. So she read the article, she went to the doctor and said I want you to test me for this and test me for this lab test homocysteine, which is a measure of how this gene isnt working properly. So its a homocysteine is a measure of indirectly of your B vitamin status, folate, b six, b twelve.

And she found she had this gene and she had a high level of homocysteine. And then she said, her doctors said, okay, this is a problem, let me give you some folate. She goes, no, no, no. Doctor Hyman wrote that I have to take this special form of folate that bypasses this gene called methylfolate. And so he said okay, so he gave her that vitamin, basically.

Mari Llewellyn
What is it? It's called five methylfolate. It's already an active form of the vitamin which your body has to make, but if you have this gene, you're not good at making it. Now she took the folate and she got pregnant. She had this beautiful baby and we were on tour for the movie and we're going on tour.

Mark Hyman
She's bringing the baby with her everywhere and this beautiful ten month old little baby and all the premieres and everything. And she told me, I was just like crying because it was such a moving story. And it's because she was able to access the right health data about her biology. And it's what we test with function health that you're not getting when you go to the doctor. And so many women may have such a simple answer, right?

Why am I having miscarriages? Why am I doing this? It's not that doctors are bad or they don't want to do the right thing, it's just that our educational system is so antiquated that they're not learning about the most important things that are changing the face of medicine. Wow, so much pain for such a small thing. Yeah, I mean like literally she had like years of misery and agony and loss and having a full term baby that had no brain I mean, it was just horrible.

And all she needed to do was take a vitamin. That we were able to find out through the right blood test. Incredible. I'm sure you've been hearing about people getting pregnant on ozempic. Apparently it's happening a lot.

Mari Llewellyn
Number one, why? And number two, is that like a reasonable treatment? Treatment. And then also, like, what's gonna happen when people are pregnant on ozempic? Like what?

It's kind of confusing and weird. And I just wanted to ask you. Yeah. People know ozempic is essentially a weight loss drug, but it's originally a diabetes drug, and it works by acting to create the same peptide that our bodies makes to regulate appetite, that regulates insulin sensitivity. So when you take this compound, which is not really a drug, I mean, it's something our body naturally makes.

Mark Hyman
It's just given in high doses, like insulin, for example. Insulin is something our bodies make. That's a peptide. If you're diabetic, you don't make enough insulin, you give yourself insulin. Same idea.

There's many reasons our glp one is low. Our.org microbiome environmental toxins there's a lot of ways to naturally increase glp one. But that said, some people find enormous benefit from taking these drugs because they help to improve insulin sensitivity, they help to reduce appetite, and they help you to lose weight. And when you lose weight and you fix insulin sensitivity, by losing the weight, you will become more fertile. It's just how it works, you know, if you fix insulin resistance, whether it's by a drug or diet or exercise or the right supplements, you can actually improve your risk of, I mean, you improve your chance of getting pregnant.

So it's not surprising to me that there's an increase in pregnancy on ozempic because it's fixing the very problem that's causing the infertility in the first place, which is insulin resistance, which again, affects 93.2% of the population at some degree or another. So let's say someone's taking ozempic and they get pregnant. Obviously, they should stop taking the ozempic. What's going to happen? Like, what if people stay on it and they're pregnant?

I don't think we know. Yeah, I mean, part of the problem with these drugs is they're new and they've not been in use a long time. And so we don't really understand their total effect across the spectrum of a person's health and lifespan and different conditions like pregnancy. And, you know, I read an article in the New England Journal of Medicine once they said, make sure you use new drugs as soon as they come out, out before the side effects develop. And so we're seeing a lot of side effects as a consequence of ozempic.

So we're seeing this meteoric rise of this drug. And I understand why, because people are struggling with weight, and we live in a toxic nutritional wasteland and food carnival that makes it almost impossible to be healthy. And I understand people want support and help, but the problem is that these drugs are not without side effects. And they're often given in high doses, which have more side effects, and they can cause bowel obstruction, pancreatitis, kidney issues, and they can also cause rapid weight gain if you stop them. And they also cause you to lose muscle, which affects your metabolism.

So unless you really do it properly, and I did a whole podcast in the doctors pharmacy, how do you use these properly? And there are compounding pharmacies that do make it. It's a little bit on the side of medicine. It's not well regulated, but there are ways to do it. It's also obscene how much we're charging in this country.

In countries like Canada and Europe, it's like $100. It's not like $1,000 a month. It's a reasonable price. And price gadgeting for the pharma in the US is just a whole other conversation. But I do think that these drugs are going to, they're having their heyday, but there's going to be a backlash, and eventually we're going to see certain problems with that.

And, you know, just the economics of it is not sustainable. And unless people do it right, and there's a way to do it right, it can be problematic. Last question I have on fertility, because this is like a big part of my life right now. You want to have a baby? Yes.

Mari Llewellyn
So badly. So badly. So the confusion I have is people tell me, you want to gain weight right now and eat more and stop weight training, but then I'm seeing people lose weight on ozempic and get pregnant. Well, it depends where you start, right? If you're like, if you're 200 pounds and you know, you're insulin resistant, you're gonna, you're gonna do better.

Mark Hyman
When you become less insulin resistant, if you over exercise and you're too thin, it will suppress your hormones, because if you, if your body, as a woman thinks you have enough reserves and body fat, you will not. Your body's designed not to get pregnant, right? So think about it. If you're in a period of starvation, um, it's not a time to get pregnant because it's not an abundance of food from an evolutionary perspective. So women who are super athletes, who have 16, 17% body fat, you work out all the time, you know, or extremely thin, can have problems with fertility as well.

So it's on both ends of the spectrum, you know? Okay, noted. So I don't. I don't. I don't know.

I think unless you're like, you know, your body fat's under 20%, you're probably okay. I don't know. I got to do that Dexa scan and figure it out. Well, this was fantastic, and I am so excited about function. I think you guys have a code so that our listeners can skip the waitlist.

I mean, listen. Yeah, it's 200,000 people you're jumping ahead of, so it's pretty good deal. I'm using the code. This code is for only. Only for a thousand people.

Mari Llewellyn
So if you guys hear this code right now, I would run and use it because this waitlist is 200,000 people long. So what's the code? POW 100. POW 100 stands for pursuit of wellness. 100, not prisoner of war.

Mark Hyman
So PoW 100. Mark, you're going to get me in trouble. Thank you so much for offering the code, and thank you for coming on the show today. The final question I have for you is one I ask every single guest. What does wellness mean to you?

Wellness means to me the ability to wake up every morning and do whatever it is you want to do that day. So I'm 64. I wanted to go heli skiing for the first time. I didn't want to think about it. I want to be able to just get up and do it, even though I've never done it before, and not to be limited by any restrictions in my health that I have control over.

Some things I don't have control over, but I have enormous control over how I take care of my body, what I put in my body, how I treat my body, and to keep it healthy. I think this is really what function health is about. It's about how do you live to 100 healthy years? And I think at this moment in time, given what we know scientifically, we all have the ability to get to 100 healthy years if we know what's going on in our bodies and are proactive, not wait until we get sick, but proactive to change those things that are. That are taking us off center.

And so I spent a lot of my time understanding the science and applying apply to myself. And I get younger as I get older, so my goal is to die young as late as possible. Fantastic. I just saw a video of you galloping down the beach on a horse, which is the goal for me as well. So I think you're doing just that.

Mari Llewellyn
Where can everyone find you? Your podcast function? Everything? Well, functionhealth.com is where they can find function. I have a website, dryman.com dot.

Mark Hyman
You can learn more about me and I have on social media. It's Doctor Mark Hyman and my podcast is the doctor's pharmacy and check it out. Fantastic. Thank you so much. Thanks for joining us on the pursuit of Wellness podcast.

Mari Llewellyn
To support this show, please rate and review and share with your loved ones. If you want to be reminded of new episodes, click the subscribe button on your profile, podcast or video player. You can sign up for my newsletter to receive my favourites at mari llewellyn.com. it will be linked in the show notes. This is a wellness out loud production produced by Drake Peterson, Fiona Attics and Kelly Kyle.

This show is edited by Mike Fry and our video is recorded by Luis Vargas. You can also watch the full video of each episode on our YouTube channel at Mario Fitness. Love you power girls and Pow Boys. See you next time. The content of this show is for educational and informational purposes only.

It is not a substitute for individual medical and mental health advice and does not constitute a provider patient relationship. As always, talk to your doctor or health team.

Dr. Mark Hyman on The Truth Behind Metformin, Gut Health, PCOS, Fertility Issues, Hormone Health & Ozempic

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1. Introduction

2. Dr. Hyman's Journey

3. Functional Medicine Explained

4. Metformin and Ozempic

5. Empowering Patients

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