Stop Blaming Salt: Fixing High Blood Pressure by Treating the Root Cause

Coming up on this episode of the Dr. Hyman show, you know, I was sort of a shock to learn, you know When I sort of got into functional medicine that high blood pressure wasn't just like a plumbing problem That it was an inflammation problem and that the inflammation has many many causes Do you ever wonder why you still feel stressed wired or wake up tired even when you're doing everything right? There's one nutrient deficiency I see over and over again in my community and in my patients magnesium magnesium is responsible for over 600 reactions in your Including energy production muscle recovery nervous system regulation and sleep quality, but here's the problem Most magnesium supplements use the wrong form so your body can't absorb them That's why I take magnesium breakthrough by bi-optimizers It's the only supplement I found with all seven essential forms of magnesium your body needs in one capsule since I started using it I've noticed deeper sleep better recovery and a sense of calm that I can feel at the end of a long day And I hear the same thing from my audience You can actually feel the difference if you're struggling with sleep stress or low energy This is one of the simplest upgrades you can make it's black Friday saving season from November 23rd through December 3rd You get 25% off. 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Don't miss it before we jump into today's episode I want to share a few ways you can go deeper on your health journey while I wish I could work with everyone one-on-one There just isn't enough time in the day So I built several tools to help you take control of your health if you're looking for guidance education and community check out my Private membership the hymen hive for live Q&A's exclusive content and direct connection for real-time lab testing and personalized insights into your biology Visit function health You can also explore my curated doctor trusted supplements and health products at dr Hyman calm and if you prefer to listen without any breaks Don't forget you can enjoy every episode of this podcast add free with hymen plus just open apple podcasts and tap try free to start your 7-day free trial that ninety three percent of Americans have either high blood pressure High cholesterol high blood sugar have had a heart attack or stroke or overweight That means that about six point eight percent of Americans are actually healthy and don't have any of these problems That's scary. That's adult Americans over 18 so Why is this going on? It's because our diet is so bad We have a very inflammatory diet creates a lot of oxidative stress and high blood pressure is a problem of inflammation and oxidative stress And what's triggering that often is the insulin resistance which is triggered by the mountains of sugar and flour we have every day The average American has about 152 pounds of sugar and a hundred and thirty three pounds of flour a day a year That's almost a pound a day and that is driving lots of metabolic issues in some resistance organ fat And that creates a whole cascade that drives up blood pressure and causes weight gain and it's really really important To address those causes so there are there other factors You know the heavy metals can be a big factor often undiagnosed heavy metals led mercury can Drive a lot of issues sleep apnea another big factor if you have sleep apnea snoring night It may be driving high blood pressure lots of nutritional deficiencies can be a factor Omega-3 Magnesium deficiency very common magnesium deficiency about half the population omega-3 is over 90% of the population so these are really treatable causes and And Obviously stress lack of exercise certain environmental toxins all can drive these problems of high blood pressure in a court of the population Who are adults world wide have high blood pressure or hypertension and a lot of people have pre hypertension Which is sort of early hypertension. We know the the levels we say of like 140 or 90 Even when you're down 120 over 80 you're still have risk over below 110 over 70 you're doing good So most of us don't have blood pressure like that because of our lifestyles because of our diet because the stresses of our environment because a lack of Exercise because of all the inflammatory things and then high blood pressures are real killer. It's the silent killer You often don't know you have it, but it's a huge driver of kidney failure strokes heart attacks dementia It's a big deal Now normally it's treated with medications And often combinations of medications which can help reduce the risk of these complications But it doesn't address the root cause So we've got to figure out the root cause these medications are not risk-free often. They have side effects I'm functional medicine. We really focus on dealing with the root cause whatever it is. What's the cause of high blood pressure? So what's really wrong with our current approach? We are just using whack-a-mole medicine We treat the symptoms to suppress them with medication without ever really digging into why so what about salt? Because that's a big question right to salt the cause of high blood pressure Well, no, we need salt but the problem is since we were hunter-gatherers our ratio of salt and potassium is completely flipped We used to be 10 times as much sodium potassium is sodium Or you know potassium is salt But now we have 10 times as much sodium as potassium and potassium helps you lower your blood pressure Potassium actually is a very important mineral that we are not getting enough of but it comes primarily from Plant foods so when you're eating a lot of plant foods you're getting a lot of Potassium if you're eating a lot of processed foods you're getting a lot of salt. How do they make? Basically refined oils flour and sugar taste edible They often will add a lot of salt to the product So it's really a problem with added salt in this country and lack of the right amounts of fruits and vegetables that can help to Provide the right amount of potassium. So we need salt It's not bad and there are certain patients that are salt sensitive genetically often African Americans that have to really restrict salt or Watch their salt intake, but most of us don't really have to worry so much about salt if we're not eating processed food It's not the salt that you add to your diet It's a salt that's added by corporations in processed food So if you want that little salt on your food, don't worry about it If you are using salt is actually tricks you can actually put on after you cook and just put it on top of the food And you'll get the same kind of salt Flavor without having even as much sodium But the key is to actually increase dramatically your plant foods to include in a potassium and that's that's really the issue so a lot of unprocessed plant foods that have a lot of Potassium or spinach broccoli squash avocados papayas bananas also you can make a broth if you make a lot of Root vegetable broth greens mushrooms boil them up You know you don't eat the mushy vegetables, but strain it and drink the broth full of potassium I call it the ultra broth and there's an ultra broth a recipe on our website will link it in the show notes now if you have High blood pressure You know you'll be told to cut your salt, but that may not be great idea There's some studies that did kind of say that maybe we shouldn't be so aggressive about lowering salt for everybody if we're Having them eating a whole unprocessed diet So in fact in one study on heart failure patients those who were salt restricted were 85% more likely to die or be hospitalized And those who did not limit their salt intake now Again, there are people who are salt sensitive. So be careful So Where are you gonna where are you gonna get your salt? We'll get it from foods, which is naturally occurring in there Basically, it's it's high in things like meat and carrots and beans and beans But you can add a little bit of salt like Himalayan pink sea salt is great Redmond salt is great from from Utah. I like those you want to make sure though You're you're kind of you know adding a salt towards the end of cooking because it'll it'll actually help bring out the flavor without having to eat as much so You definitely can eat too much salt for sure. So it's not it's not really Unlimited but be careful when you have high blood pressure and watch what happens. So check your blood pressure check your diet Also, I died salts really common They add iodine into the salt because of deficiencies that we're we're had in there in a population And and you you do need iodine and it can cause problems if you don't have it But often you can get it from fish and from seaweed and other sources. So I think You know it depends on your diet, but we might need a little extra iodine Now what can you do to actually fix high blood pressure? Well, the first is to reduce inflammation To get rid of oxidative stress in your diet and how do you do that? Well, you've got to get off of the junk Right. So eat get rid of all the processed foods eat a whole foods plant rich diet this high in potassium rich foods and I've created something called the 10-day detox diet, which is a very simple 10-day approach to cutting all the inflammatory processed foods and we found people's blood pressure drops up to 20 points when they do that in A week or seven days or 10 days. So it's very impressive when you see the results You want to eat a lot of potassium rich foods? Like I said, the broths are great fruits vegetables nuts seeds high fiber good fats Calcium magnesium magnesium is a relaxation mineral. It's really important for regulating blood pressure In fact when women come in with preeclampsia, which is a pregnancy induced high blood pressure condition They can cause seizures and high blood pressure. What's the treatment? We give them intravenous magnesium Now, I don't know why we start with all the drugs with blood pressure. Why don't we start with magnesium? and and you get a lot of I can get a lot of Magnetism for your diet greens beans that seeds a little chocolate to Carbohydrates or a big factor starch and sugar So make sure you're cutting those down or cutting those out and eating good carbohydrates Which are all the fruits and vegetables? I'm sugar is really the big the big problem. It's driving in some resistance that drives the high blood pressure Eat the right fats. So Omega 3 fats really important help reduce inflammation, but also can help lower blood pressure Those can come from wild fatty fish. I like the smash fish, which are small low in toxins sardines mackerel herring anchovies and salmon on those are all really good good quality fats. So You can get also grass-fed meat so often have Omega 3 is like bison with gas for lamb Chickens that's depending what they're eating all great Get real food. Just eat real food get rid of all the process food. Like I said, make sure you try to avoid inflammatory foods That may be triggers for you like gluten dairy those can be driving problems with blood pressure as well That's why the 10-day detox is a great way to start reset also liquid sugar really bad sodas juices all that fix you Hydrogen fat actually we shouldn't be eating me that anymore, but that also can be very inflammatory. I Get protein and fat for breakfast not starch and sugar most of our breakfast in America cereal bagels muffins Croissants blah blah blah all that stuff pancakes french toast. That's all dangerous to eat for breakfast You want fat and protein? I usually have a protein shake You can have eggs avocados. Those are great flax seeds are great. Also lots of fiber can help improve insulin resistance And alcohol alcohol can be a big factor So I would I would really minimize or eliminate alcohol for a little while stay hydrated really important keeping your blood pressure normal and Don't need before bed That worsens insulin resistance weight gain. So you do all these dietary things. You're still maybe need a little help What do you do? Well, there's some supplements that can really be helpful. I Like magnesium and you can take magnesium citrate or glycinate if you're a little constipated use magnesium citrate If you're not you can use magnesium glycinate Cook you 10 has been shown to help a blood pressure. You can take potassium Omega 3 fats be vitamins extra fiber good multi all those are great strategies What about exercise exercise actually can increase your blood pressure when you're exercising But overall it helps your cardiovascular system and lowers your blood pressure. You'll have to lose weight I mean even if you lose five to ten pounds, we've seen that really have a big impact on blood pressure Exercise is not a luxury. I mean When one cartoon I often use my lecture says would you rather exercise an hour a day or be dead 24 hours a day So it's definitely not a luxury. It's an essential part of living just like eating and breathing and brushing your teeth So what about stress? Well stress is a big factor and we know that stress drives blood pressure up We know that it increases adrenaline which increases blood pressure cortisol So practices like yoga Tai Chi meditation guided imagery breath work All engage your parasympathetic nervous system and help lower your blood pressure and inflammation and help your metabolism And just basically healthy overall sleep also super important a lot of us don't get enough sleep and You know in fact sleep can deprivation can be a factor in high blood pressure as well So encourage you to get good sleep and there's a lot of tricks for that I mean try to go to bed and wake up at the same time every day They use your bedroom for sex and sleep only instead of working or you know doing a lot of stuff that we do in bed I'm watching TV Make sure it's dark and quiet and cold in your room Have you been feeling stressed or tired lately you might be low in one powerful mineral that mineral is Magnesium most people are and most supplements don't fix it because they only include one or two forms I use magnesium breakthrough from bioptimizers because it has all seven forms of magnesium Your body needs for sleep stress and recovery it actually works You can feel the difference from November 23rd through December the 3rd you get 25% off This is the once a year sale you do not want to miss go right now to bioptimizers comm slash hymen and use code hymen Part of the problem with diagnosing blood pressure is that it's often Hard to know if you have high blood pressure because one it fluctuates all day long to Just getting one blood pressure reading the doctor's office may not really tell you what's going on You might have white coat hypertension meaning you get nervous and stressed it goes up I mean when you exercise your blood pressure when you're stressed your body, but what's your average blood pressure? So right one of the diagnostics we do is a 24-hour blood pressure test Which I found really effective because you can see what's happening when they're sleeping when they're active when they're inactive And you get a really good sense of what their pattern is day night and average and that'll tell you what what your real risks are right? So doing 24-hour ambulatory monitoring is something that is really important to do particularly if you're you have any Concern that the readings you're getting in your office are Inappropriate and you mentioned what could hypertension and that is not uncommon It actually is fairly common And so we will oftentimes recommend ambulatory blood pressure readings and that gives us the clear clear as picture possible Yes, true as always you can just get a cuff at home and have people monitor the blood pressure out today and that that'll help too You know, I want to just dig into a little bit before we get talking about The difference with functional medicine And traditional medicine right traditional medicines you check your blood pressure. It's high You get medication you moderate we call it essential hypertension Now there are other causes of hypertension that we know of that are kidney diseases and other problems But for the most part people call it essential hypertension, which I joke and I say it means essentially we have no idea what's causing it But we know that's not true. We know that's not true. So everything has a cause nothing is just random Right, right if you have diabetes, it's not a random event. It's not like oh, I I got a virus I'm right something happened and I be now We know some of the major causes of high blood pressure are never addressed Right and the two biggest ones that I see treating patients is insulin resistance and sleep apnea and sleep apnea So one of the biggest factors is insulin resistance, which is an epidemic in this country We have one in two Americans are pre diabetes or type 2 diabetes 75% are overweight 42% are obese and they all have some degree of trouble regulating their blood sugar Which is causes them to get belly fat and that belly fat is such a big factor in driving all sorts of diseases everything from High blood pressure to cancer to heart disease to diabetes to dementia to depression and so on But the insulin resistance drives Inflammation yeah, and it drives inflammation throughout the body because those belly fat cells aren't just sitting there holding up your pants their dynamic hormonal and immune organs belly fat is an immune organ and it drives Inflammation throughout your body that causes oxidative stress, which is really what causes rusting So it's like your arteries and your pipes are rusting and stiffening I call hardening the arteries and that happens as a result of this inflammation and oxidative stress and So in some resistance is probably the biggest cause of that today in America and it's it's really driven by diet So I think people don't understand how powerful that is diet is very powerful And you know I call it a we you mentioned the adiposity we have around our waist I call that I call that the toxic waste dump of the body Yeah, and it did that fat just does have a metabolic effect that is toxic to the body And as you said it creates the hardening of the arteries, which is you know one important cause of High blood pressure. Yeah, and the other big thing is often misdiagnosed. And by the way by the way in some resistance In fact so many people 90% are not diagnosed Absolutely the way you diagnose it is you do a test for insulin and blood sugar and it's a fast And see the quest tolerance test that we do I do an almost every patient Yeah, and this is the other test It's a little more advanced where you take a sugar drink basically drink the equivalent of two coax check your blood sugar Insulin fasting and then every one in two hours after But most doctors just check blood sugar, but that's a very late fight and you want to check insulin I'm doing a fasting insulin isn't going to give you an answer in some you know, it's still help Yeah, but by the time your insulin goes up fasting. It's already down the road pretty far, right? Yeah, so I agree and then and then we have this other issue, which is sleep apnea. Yeah, which is so under diagnosed Yeah, so sleep apnea through about 25 million Americans asleep apnea. It is under diagnosed It's not just a disease of people that are overweight That's good, you know, most people think about obstructive sleep apnea being related just being overweight, but you also can have upper respiratory Anatomy and muscular relaxation that even if you're thin you can have Abstructive sleep apnea. Yeah, you have an aero pallid the small airway, right? You have sinus issues And when right and when you have sleep apnea that means you're just not getting enough oxygen To your body particularly your brain also to your you know to all your blood vessels And your cortisol levels rise and then you get into that whole cycle you talked about before Which is an inflammatory cycle, which is an oxidative stress cycle which can lead the hardening of the arteries And when you're not getting oxygen to those blood vessels then they're there actually can't perform the work They need to do and create the energy they need to have and so they they can't contract and expand the way they should and that can result Yeah, and and then it also drives insulin resistance. So if you have sleep apnea, it also causes you to be pre-diabetic What you're eating weight gain weight gain needs insulin resistance and leads to diabetes which complicates everything I mean I this guy couldn't lose 50 pounds. He was a he was a lawyer and He told me the story is like he said look I need to lose the weight. I don't know what to do I'm trying to eat right not working. I'm trying to exercise. I Said what is push your life like as well? I mean lawyer and I work really hard and you know But every day I have to stand up at my desk. I can't sit down and this is before standing desk Right and and and I'm like wise as well if I sit down I fall asleep Right, and I'm like gee maybe you have a sleep apnea So if you're falling asleep at work if you're fall asleep in front of the TV If you feel tired during the day if your wife says you're snoring and now there's apps You can get that actually record your you're on your phone They record your snoring so you can see because people don't believe it. I don't snore and I love that And then it's what I call sleep cycle that I like it's record your story and and and It's something that is easy to treat. I mean, there's different methods to see pappen You know, but but it is a treatable condition and the weight loss then will happen and you'll feel better So that's really important I just don't talk about a few other causes that I think are really important and worth noting because Those are the two biggest ones, but there's a lot of other ones people who are nutritionally deficient, right? In certain things can cause high blood pressure. Yeah, like magnesium, right? So and magnesium, you know studies show that, you know There's a very large percentage of people in our country have low magnesium 45 percent right up people have low magnesium Which is you know magnesium. It's not magic, but you know when we replace magnesium patients We see amazing things happen. We see blood pressure come down. We see them being able to sleep better We see muscle twitching and cramping go away We see mood improve magnesium has a very important role in the body and Certainly plays a big role in lowering blood pressure Yeah, but I called the relaxation mineral and you know, it's funny how in medicine We have these blind spots, but when I was training in obstetrics and gynecology. I was a family doctor I deliver lots of babies There's this common condition that women get called preeclampsia, which is high blood pressure and pregnancy and when they come in and They're their blood pressure is high which can cause seizures The treatment isn't high blood pressure pills because they don't tend to work. We give them intravenous Magnesium yeah to relax their blood vessels and save their life I mean absolutely. So we reserve and it's just a strange thing to me We don't think about that way the other thing that is important is omega-3 fats and fish oil because it helps relax your blood Fashals make them more pliable But there's other causes that we also see and for example Environmental toxins heavy metals in particular lead and mercury are really common They're under diagnosed and when you're going your high blood pressure visit your doctor's not checking your mercury and lead levels Not even your blood and probably not on the most important test Which we do with the ultra wellness center Which is a challenge test where we give people a drug to pull out the metals the key later And then we check their urine and see how much dumps in there and if they have high levels That's often a big factor as well And I think you're you know, you're you're really hitting on all the things that I think about and I Tell people when they come to me and hype hypertension is part of what they want me to work with I said we're gonna get your hypertension better by not treating your hypertension. We're not gonna treat your hypertension We're gonna treat everything else. It's causing your hypertension. We're gonna find the sleep apnea We're gonna find the nutritional deficiencies. We're gonna work on your stress levels. We're gonna help you lose weight You know, if when you lose weight, I mean you actually are going to drop your blood pressure I mean, we do know that to that explainer role So somebody who has strong family history of high blood pressure We might want to be paying more attention But as you've said so many times our genes aren't our destiny those genes that we come into the world with are gonna be Influenced by so many other factors many of which can unmask that potential and Manifest this high blood pressure. So some of the root causes of high blood pressure We know that weight gain and insulin resistance is a huge one We know that diet plays a big role because of its effects on oxidative stress and endothelial dysfunction Insufficient sleep whether that sleep quality quantity or timing can play a role with high blood pressure loss of artery elasticity so our our endothelium is a Target for a lot of the negative effects of lifestyle. We know that artery elasticity can be Adversely affected by stress by certain foods and there's even emerging evidence that food sensitivities Disruptions in the vet microbiome and toxic exposures can all have negative impacts on our arteries leading to or contributing to high blood pressure So basically you're talking about modifiable factors that are treatable and fixable They cause the stiffening of our arteries and it leads to high blood pressure when you say endothelium You mean the lining of the blood vessels and that becomes dysfunctional because of inflammation and oxidative stress Which has many causes, right? So, you know, I was sort of a really shocked to learn You know when I sort of got into functional medicine that high blood pressure wasn't just like a plumbing problem That it was an inflammation problem and that the inflammation has many many causes and you outlined some of them genetic predispositions environmental toxins change of the microbiome or crappy high sugar processed diet Nutritional deficiencies all these things impact the the function of our blood vessels and and they're all treatable So you kind of treating patients And you know, I want you to sort of present this case here of Of your patient who had who had high blood pressure and what you kind of thought of what you did diagnostically and to kind of unpack Some of the things we do at the ultra wellness center, which is doing a deeper dive on your biology not just taking it face value Oh, your blood pressure is high here's a pill, but we go into why like what's going on underneath the hood How do we find things in our son search for things and hunt for things that may be treatable and modifiable factors that are driving you touch On a bunch of them, you know, whether it's pre diabetes and in some resistance whether it's Sleep apnea whether it's nutritional deficiencies like magnesium or omega-3s or whether it's Environmental toxins that some of which we can measure some which we can't but heavy metals have been linked to high blood pressure So we kind of have to look for all these things and and that's what you did with your with your patient I'd love you to sort of share her story actually mark I think I love this idea of personalizing the story and the recommendations because you could have 20 different people with high blood pressure and there may be Different combinations of those variables that are playing a role for any individual patient So we have to go back and understand who the person is sitting across across table from us If you see one person with hypertension You've seen one person with hypertension or any condition with its autism or depression And that's the sort of one of the fundamental principles of functional medicine You know one disease can have many causes and one cause can create many diseases We call and of one medicine. What what is that person in front of me doing? What are the risk factors? What is her lifestyle? What are the other factors that may not even know about and how do we dig into those and that's that's what we've been doing for decades at the Ultra Wellness Center by the way if anybody wants to learn more about what we're doing go to ultra wellness center comm you can learn More about how to become a patient but now let's sort of dive into that and that's case and how did you think about this case? Sure, so this was a 56 year old woman and she had a long history of so-called white coat hypertension We'll unpack that in a few minutes She also had a strong family history of high blood pressure and laid-onset memory concerns her mother had recently been diagnosed with Cognitive impairment at the age of 80 who also had a long history of white coat hypertension and then sustained hypertension and She was starting to get concerned about you know What is this white coat variable telling her about her vascular system? How can she do everything she can to try to optimize vascular health and prevent disease down the road? For years she'd been told with her blood pressure. Don't worry about it. She'd go into the doctor What would run 120s 130s maybe as high as 140 and she was told not to worry about it So what do we do in conventional medicine either tell them not to worry about it or you know You think about it you think about the case of oh your blood sugars borderline come back and we'll check it in a year Well, no, we wanted to better than that Or decide okay now we need to put you on a blood pressure medication So what's different in functional medicine as you already talked about mark? We really want to go upstream you want to see what the variables are that played a role with this particular patient Why she's showing up with this reactive blood pressure? One of the things we can do to modify those risk factors and hopefully delay or prevent her from ever needing medication And at the same time keeping her heart and brain healthy and it starts by gathering a story It's important to get into the story because you know like I think of my my parents my mom and dad just Obviously didn't listen to me They ate crappy and they both run high blood pressure pills and I'm 65 and my blood pressure is like one ten over 70 Which is really highly unusual for someone my age But it's not an anomaly It's just because I understand what to do to regulate my biology and stay healthy as they get older and most people don't do that and our Default in our society is basically leading us all to have these problems That's why I wanted to Americans have high blood pressure and pre diabetes and by the way I don't think it's an accident that one of two people in America have diabetes or pre diabetes and also one in two people have high blood Pressure because they're very related going back to her story. I mean she had a pretty uneventful early life She had she was born vaginally. She was breastfed back at a time when it wasn't the common thing to do She didn't have a lot of infections Not a lot of situational stress all of those early life exposures that we know can prime the vascular system to be more potentially more reactive She did have a history of allergies, but I'm unremarkable other than that Started birth control pills at 19 and interestingly enough developed hypertension on the birth control pills. Why is that? Well, the blood pressure that can be that can be genetically determined It may be that it unmasks a potential for oxidative stress I don't actually have the answer to that one, but I think there's some clues later Yeah, I mean the birth control pill is interesting because it you know estrogen does make you retain a little more fluid and That may be part of it and the progesterone can also make you know gain gain weight sometimes that may be part of it So there there are things that you know medications that may also like the birth control may actually drive increased risk of hypertension That's true Especially through the reninaldosterone system that we know plays a big role and they're much higher doses in the birth control pills And what a woman would have made with her own Natural cycling hormones other than that pretty healthy until she had her first pregnancy at 35 It was a twin pregnancy and it was complicated by Low amniotic fluid preterm labor and pregnancy induced hypertension She went on to carry her babies to term. She had a vaginal delivery. She nursed them for a year and a half And that was when she started having the white coat periodic elevations in her blood pressure Again, she was told don't worry about it It was attributed to the stress of being a young mom with two kids and maybe some sleep deprivation and working as an emergency room nurse Fast-forward she in her Early 40s because she was storing probably related to her allergies and she had some daytime fatigue She was set for a sleep study that did not show sleep apnea It showed a pattern that's called upper airway resistance syndrome more common in women That is a pattern we'll talk about in a few minutes But it's where the airway becomes a little bit more collapsible or there's a restriction in the ability to get air into your body Maybe because you've got nasal allergies or you've got a small jaw But you're not actually stopping breathing and you're not really dropping your oxygen level So back then there was no treatment recommended other than to work on her allergy symptoms Just to double down on that a lot of people who have high blood pressure have undiagnosed sleep apnea Yes, even if you're snoring or your partner says you're snoring or you gasp a breath or your other symptoms of sleep apnea Meaning fall asleep easily watching TV or when you're driving You feel tired. I mean these are these are clues and it's important that people get this diagnosed because it's treatable I'm often with weight loss and other things But sometimes you need to take a breathing machine at night and that can often resolve high blood pressure So when I sleep someone that the first two things I think of are Pre-diabetes and insulin resistance and sleep apnea as both causes of absolutely mark and I'm so glad you said that because I think what's Immersed is upper airway resistance syndrome. Is it just benign? I mean, that's another area where it's like don't worry about it. It's not sleep apnea There's really nothing to do except treat your allergies But what do we know about even that pattern if you're having these subtle disruptions in the continuity this of your sleep Even if you're not stopping breathing you wake up tired You have trouble with daytime fatigue and it's associated with high blood pressure This is also a more common pattern for women and it gets overlooked all the time because we have a stereotype about Who's the more likely person to present with sleep apnea? And it's usually an overweight man with a big neck circumference Whose snores really loudly it gets missed and lean women in particular and then what else did you find on her? So well the next piece was she had gone she went through a pretty significant menopause Lots of heavy periods last period was finally around 49 tons of hot flashes and night sweats Why is that important? Well, guess what there's now been a recognized association between women who have more of those vasomotor symptoms also being associated with more vascular reactivity and higher risk of cardiovascular disease But at the time again, we weren't think nobody was thinking along those lines She had a conversation with her OBGYN and decided to go on an estradiol patch and progesterone She had good relief and her symptoms another really important thing though about the menopause transition is The changes in estrogen that happen can also unmask more effects of stress on the vascular system We also know that insulin resistance tends to get worse in the menopause transition So it's a potential window of opportunity to think beyond just should you take hormones or not is again fitting into her story Looking way upstream and trying to put things into place that are going to keep her Heart and her brain healthy. She's always been physically active another piece of her story that I think is going to be relevant down the road She's always been physically active In fact, one of the main things that she sort of hung her hat on in terms of trying to keep her heart and brain healthy was to Stay physically active and she periodically would be plagued by multiple soft tissue injuries She'd had plantar fasciitis. She'd had posterior tibialis tendonitis. She'd had epicondylinus. So she'd had a lot of these soft tissue Injuries which would periodically take her out of commission from her exercise So that's sort of her backdrop and it leads us to some interesting clues of some other things We might want to think about related to her blood pressure beyond just medications or not and think back to her original goal She's really concerned about future risks for cognitive decline What's the connection between blood pressure and cognitive decline? We know that the blood-brain barrier that critical interface between the body and the brain It is really vulnerable to the effects of any kind of as a risk factor whether that's prediabetes insulin resistance high blood pressure oxidative stress inflammation that blood brain barrier can become more permeable or leaky and it plays such an important role at Selectively letting in the new chance to the brain that we want getting in keeping out toxins and microbes that we don't want getting in and then also Supporting the brain's waste removal system the lymphatic system that removes waste from the brain any vascular insults are potentially going to contribute to that leaky blood brain barrier so Optimizing her blood pressure looking at those upstream factors is going to be really really important for her to meet her goals One of the things you should do with your diagnostics is that you look at genetics related to high blood pressure Which we can now do so these are tests that we do at ultra on the center. It's a cheek swab You can look at your full sort of panel of Risk genes and we don't look at your entire genome because it's like too many things 20,000 genes We look at the ones that are common that we can do something about that are probably affecting your your health in an immediate way And we can actually modify and so you found a number of things there And I think there are a lot of variations and we can use the science of genomics and our understanding of the biology of what happens when you have Certain variations to modify your risk factors So the genes like you said, you know load the gun the environment pulls a trigger and there are certain people have salt sensitivity Which we can pick up through genetic testing But not everybody with high blood pressure has a salt issue You know, I think there's a real issue there with like who how many people are salt sensitive and it's probably maybe you know 40% of people who have high blood pressure are Salt sensitive, but a lot of people aren't and there's you know real controversy about salt whether it's the issue or not the issue and and there's been large population studies that Kind of show that there's maybe a slight risk of the inter salt study for example 1988 It was just a tiny tiny little risk and the question is you know, is it the salt or is it and this is just a question I have is it the salt or is it the salt in connection with certain genetics or the salt in connection with Pre-diabetes or in some resistance, which makes you retain more water. Hence, you'll get high blood pressure because you have bigger Fluid fluid in your system. So what are your thoughts about that? I know it's a great question work and I think it's not simple, right? So we know that that that subset genetically of people who are sensitive to salt It's not it's less than 50% But there was an older mouse study that found that high sodium intake actually increased oxidative stress So there may be another mechanism that it's not just about the sodium's effects on the renin, aldosterone, angiotensin system and fluid retention But it also creates more opportunity to produce these free radicals that directly impact vascular health It's also like nobody talks about the fact that Historically we had 10 times as much so to potassium as sodium in our diet as hunter-gatherers now we have 10 times as much sodium So as it's not just the excess sodium It's a lack of potassium and where's potassium come from it comes from all our vegetables and fruits and stuff So we're not eating enough plant foods and those those have Really high high levels of potassium and magnesium and magnesium. Yeah, magnesium is the other nutrient We're probably 45% of us are deficient So is it the salt or is it the balance of all these other Electrolytes like magnesium and potassium and calcium that we can't ignore But that we do look at in functional medicine The traditional doctors won't look for that right and they won't modify that but it can be really a huge factor and you can Give people potassium supplements. You can increase or potassium in their diet You can do the same with magnesium in terms of dietary magnesium as well as Supplements and same thing with calcium. So we had to be really aware. It's not just such a simple Reduction is viewed that oh salt cause high blood pressure and so you should eat less salt I find that most people have never connected to us between how they feel and what they eat They walk around with what I call F L's de syndrome that's when you feel like crap And that is a big problem for people. What do I mean by that? Well, you might be tired sluggish. You might have brain fog Maybe I have digestive issues reflux heartburn Irroll bowel, maybe have nasal congestion sinus issues muscle aches joint pains headaches insomnia Should I go on rash is acne? I mean it goes on and on and on And and many of these things are caused by food And the only way to know is to do a tolling body reset by hitting The reset button on your commuter when all the systems are jammed. It's a complete reboot So how do you do a reboot? It's very powerful and most people have near experience It's and this is why I love to do with people and I actually Then pilgrims all around the world are eager people can come and actually Experiences we we do programs where we have people do this just in five days not even 10 days people have a 70% reduction in all symptoms Of all diseases now I'm going to put in the show notes the medical symptom questionnaire that I use in my practice Which essentially gives you a score based on the degree and frequency severity of symptoms So if you have a headache is a zero being never four you get all the time Or some version in between and then you get a score at the end and you know people have a score of 60 70 100 It should be less than 10 Maybe even zero ideally. I should have symptoms. That's not normal Raymond B. He's to suffer this much And that's really why I created this this book and the program the 1080 talk side because I was doing this with my patients And seeing such incredible results So I do this personally regularly I do it at least two or three times a year four times a year to really reset my system To kind of get my body back on track to get rid of all the bad stuff put in all the good stuff I want to walk you through how to do this I'm going to teach you how to hit the reset button Rebeat your system and to optimize your biology to help your gut to help your detox system to help your immune system to help reset your nervous system And it's powerful So if you want to really see how your body can feel And get rid of what we call flc syndrome. I would do this most people are like a frog that's in Cool water where you turn the heat up slowly and it starts to boil to death We just kind of get used to it and think it's normal these symptoms are not normal My fan I wrote I want to do this with a junior high school once and uh The teachers are like well, I we might have to get permission from the paris to see if it's safe You know, maybe they don't want the children doing this I'm like what is it safe to eat fruits and vegetables and nuts and seeds and protein and cut out sugar and starch and processed food I mean, they should get a note that it's permission to eat the junk food that they It'd be opposite. So anyway, yes, very saying anybody can do this Um, and uh, some people by the way, you know need more certain things or other things But but basically it's a very universal approach to resetting your system a second pillar Aside from what you need the the food is really important And then by the needy approaching the morning You need to make sure you get rid of sugar starch in the morning super important When making will start their diet their day with carbs, which is the worst thing you can do with sugar sweetened coffees teas cereals muffins bagels breads done Um second pillar by your daily habits This is a mom's a pattern eating and living that puts your body back in rhythm It helps you reset your nervous system And and there's two really important habits as part of the 10 needy talk one is when you eat and also when you sleep So let's talk about when you eat now when you eat might be as important as what you eat. So any of us don't In the right pattern we tend to um, you know eat all day long we can snack we tend to eat before bed um We stack late at night. It's kind of bad So basically when you eat is very important research shows that doing that can really be bad for your health Uh, I could eat at night. So the first is make sure you give yourself at least 12 to 14 hours between Dinner and so dinner the sixth breakfast at eight. That's a 14 hour fat. Okay If you eat at six And then you keep snacking all night Not doesn't count right and it's most uh simple form of what we're called time restricted eating And it's basically giving your body a rest and giving the body to reset and I wrote a lot about this in my book the um Young forever, but but basically there's all process at night that happens called autophagy and clean up or repair You want to get your body? The ability to do that the next is food now you can do a breakfast if you're eating You know, for example there at six and breakfast at eight or so that's important or fast Really important to have protein in the morning or not carbs and sugar um, also Not eating three hours before bed is really important. So most people eating snack after dinner. Don't do that Have at least three hours of time you eat and you go to sleep that way you will lose weight Your body can repair and heal instead of trying to digest and store the food What about sleep sleep is one of the most underrated pillars of health? It's probably Even before exercise meditation, maybe even for nutrition because when you go to sleep Well, you're going to eat those sugar and carbs or a quay more Um, so you want to focus on sleep and restore to rest We know that um Getting in a routine of waking and sleeping can help with them deeper and restlessly So try to take the same bedtime every night Try to get off your screens for an hour two before bed Keep your room or use blue block of glasses keep your room dark and cold and probably 65 to 68 Really important because your body does much better with sleep at night Try to relax at night with meditation do a god imagery do Um breathe breath for stretching journaling gratitude practice, whatever you like, but do something very important Uh, so your evening or teen should be like set a bedtime of six over the 10 days Turn your phone off and get out of your bedroom Show the tv off for at least an hour two before you go to bed And then use the time at night to read to journal to meditate to connect with people you love and just kind of wind out Oh, the third pillar is extra support. We need on the journey, right now. We all need nutrients They they're called vitamins because they were vital amines vital to life, right? And and so we've seen a dramatic reduction in The nutrient density of our food Our organic matter's gone out of our soil Nutrients can't be extracted foods travel long differences We have commodity crops that you're bred to actually breed out the nutrients and in the starch and and and and you know yield and so foods aren't as nutritious as they once were and probably 90 percent of americans according to the government Old surveys are decision in one or more nutrients at the minimum level to prevent deficiencies So how much vitamin e or you need you not get rickets? Not very much like 30 It's how much need for optimal health probably three to five thousand So we need to really probably focus on nutrients and even with a perfect diet You know because none of us are hunter-gatherers anymore or you know tons of food that we never ate and I mean nutrient-completed What do we need the basics help me so we need basic sets. It's a multivitamin mineral foundational magnesium a lot of us are deficient probably 45 percent are low or deficient magnesium It's involved in the retreat of different enzymatic reactions. People important helps your lactic nerve system at night They'll be calmed down also people get constipated sometimes when they change their diet So taking magnesium citric and help and lastly vitamin e and it's also a fish well But vitamin e is really important vitamin b over 80 percent lower deficient vitamin b That's it's involved in so many different things in the body. So really important and helps your mood helps your muscle function helps your brain your energy Information out immunity. It's just super important and most of us show out fish shows also important And I often recommend fish all the people or omega 3 fats So one of the Program steps in the 1080 what should be the tips and then we're gonna go to the first step is to eat From the 10 day detox approved list for 10 days. So eat one of the value eats for whole foods uh, you know whole food Based shake in the morning you can add, you know protein powder Protein if you want I have a breast approach called super simple protein But you really need to make sure you have good breakfast second is Committed daily habits, right? Pick your destiny or eating window, right? You want a 12 to 40 hour overnight fast means eating within a 10 or 12 hour window um Don't snack before bed Try to have the same bedtime get off your technology an hour or two before Talk to some active relaxation huge impact on your health step three is add in the supplements Now you don't have to do this, but I really encourage you to have a multivitamin magnesium vitamin D and potentially fish oil every list which the products you should take and the show notes You have it all listed there Also, what you should eat and what you should avoid during your 1080 count. Let's go through that So here's the full food list. Um, you can you know, we're gonna have it in the show notes You can take it with you in store. It's in the book the 1080 talk. It's in the 1080 cookbook But essentially uh, here's what you should eat and what you should actually get rid of What you should eat is um Poaching you need to write poaching right so grass fed or originally raised Uh meats is great. You can have a pastries lamb beef bison venison al um grassy beef pastry is chicken turkey duck all that's fine What you should avoid is conventionally raised chicken poultry and and eggs and so forth and by the way, you can also Ains their pastries eggs Meat get rid of all processed meats deli meats all conventionally raised feedlot meats. Give it all But by fish and season Lots of small fish are good big fish are bad right big fish like swordfish tuna So they see bass halibut most farmish fish are pretty bad for you What you should be consuming are things like the I call this match fish as small wild salmon Uh start beans anchovies herring mackerel Um, you know black cod shrimp scallops trout Eggs as I said, uh pastries eggs are fine. Not organic regular eggs are not fine. What about nuts and seeds? Very important Almonds brazil nuts cashew nuts. Hey, the less macadamia pecan pine nuts pistachios walnuts. All that's great. Um, You can have cacao nins chocolate not chocolate with more shot than comes from Seeds are great chia seeds flax seeds m seeds pumpkin seeds sesame seeds Sunflower seeds pumpkin seeds all great. Uh nut butters also great. So, um Unsweetened nut butters so almond cashew pecan macadamia. I love macadamia a walnut. Oh, that's great. Um, You also eat beans if they're if you're a vegan and you want to do this you can use GMO free or non-gimmo tofu or tempeh as you're approaching Um What you should avoid are nuts there with sugar. They are cooked in oils Uh that are Basically candy and stuff. Uh a lot of nut butters have sugar. I draw junior stats peanut butter peanuts Can be okay, but I wouldn't say mostly avoid peanuts because Uh, they have afro toxin um, they often are rancid Uh, and so you want to be careful with that. Um, what about oils and fats? Well, the ones you want to use are organic avocado oil You can use organic coconut oil for cooking grass fennel ghee If you want to use tallow lard, uh duck fat chicken fat, that's okay as long as they're they're um Pathya raised or we're generally raised for salads and you can use some of that's oils like um and oil flax oil hand-boiled macadamia oil and can work with olive oil Um And you can cook with olive oil, but only like tomato sauces and things like that things are not high heat sesame oil Tahini is great as well great fat Uh, sesame seeds kind of paste while in oil other flavorful oils are not main oils But you want to avoid the traditional oils all the seed oils like canola oil partially hydrogenated oils margarine peanut oils, soybean oils sunflower oil safflower all trans fats vegetable oil vegetable shortening all that that's bad What about veggies? What should you eat? Well, you want to stick with lots of other sardine veggies or orange chokes organic if you can I use the dirty dozen guide some environmental working group bwg.org Tell you which are the clean 15 meaning you can eat them when they're not organic where the dirty doesn't Which usually you definitely not eat if they're not organic But I love asparagus artichokes avocado bean sprouts broccoli brussel sprouts cabbage cauliflower celery cucumber eggplant garland ginger hearts of palm Kohlrabi leeky greens mushrooms of all kinds onion peppers Radicchio radish root of baga's all the kind of stuff seaweed is great lots of minerals shallots summer squash tomatoes turnips Tsukini list goes on we have all in there you can have some Uh, things like sweet potatoes. I like the Japanese purple sweet potatoes with your squash carrots pumpkin. All that's fine No, we cares are fine because unless you're doing carrot juice that that's a problem But basically try to live into uh, like one uh, uh, serving which is like half a cup a day Uh, what you should be avoiding is corn and one potatoes mostly Uh, a little you know some of the little uh, fingerling potatoes or the premium potatoes purple potatoes can be fine. What about dairy? Um, you can eat pasture raised butter or ghee, but I encourage you to get up all dairy including sheep and goat Which are mostly fine for people, but I encourage you to get up all other dairy and if you're having um He encouraged you to have make sure it's grass grass fed or originally raised And what about bees? Well, uh, you can have green beans. You can have green peas Uh, you can have a non-jimo organic soy That's just tofu or tempeh Uh, you can have Snap beans you can have snow peas Um, but otherwise definitely no no beans. Uh, what about grains? No grains at all. So Uh, even healthy grains quinoa buckwheat things like that. I encourage you to get up off all of that Why could it just shuts down the insulin response? I'll see we'll lose weight reduce inflammation Not that these are gonna start all bad, but eventually you're gonna have them back But basically get rid of all all the other all the grains read barley rye, right emerald millet Oh, it's everything. Uh, get rid of it. Uh fruit fruit can be okay, but uh small amounts of non high-gocemic fruits So organic blackberries blueberries cranberries kiwi lemons limes raspberries all that's fine Uh, not too much, right? You know what I mean? Like, you know, two pounds of blueberries But you know top half accompanied it one again all the other fruit all the high-gocemic fruit like bananas pineapple melons Back cherries rages is the worst even foods that food. So you think, you know, maybe good for you are actually good for you, right? Whether it's, you know peaches, pears, nectarines And cherries for example, but you don't want to eat them while you're on the tending to eat You want to really shut down the blood sugar and insulin? What about sugar sweeteners? Sorry the You can sometimes have a little bunk food or stevia you have in the shake We have but generally tend to avoid all that stuff Also, just get rid of all the other artificial sweeteners sugar all that stuff if you have to ask me, basically Hey, uh, then what should you be drinking? Well, lots of water Herbal tea green tea Uh, let's look at the end. That's okay. Love green tea is fine. You know, you gotta be sparkling water, mineral water all the way to void alcohol coffee bottled water It's a pot thick soda obviously sugary beverages Um, basically that's the program. So if you eat that way for 10 days If you use those simple elements your body's gonna totally transform and you're gonna see just how food is impacting your health Which is something most people Don't have a clue about And that's why I love this so much now after the program. It's really important if you do it for 10 days or 21 days or 10 weeks or 10 months you have to be Smart about getting off it where you can get a big trouble Because when you go off of the foods that are inflammatory foods that are learning to and then you reintroduce them you can get a lot worse symptoms Let's say you had migraines before and then they're gone. Wow, you're gonna get a dizzy of a migraine You had gut issues before you had a real problem Or else you had sinus congestion from eating dairy and then eat it again You might get a sinus infection. So you really have to be smart So if you're feeling great, you want to continue and you let's say you have a lot of weight collusion Let's say you're having an immune disease. Let's say you're slightly feeling great. You want to continue No problem. You continue it continue to do it. You can do it for another 10 days. You can do it for another 10 months Totally safe to eat. It's pretty much how I eat most of the time on the occasion grains and meat Um Also part I sleep and obviously your fasting window not eating me for bed And then eventually people can transition slowly to the pecan diet Which incorporates a lot of the principle of the tendy detox diet, but it gets you more flexibility in your diet If you love this podcast, please share it with someone else you think would also enjoy it You can find me on all social media channels at dr. Mark Hyman. Please reach out I'd love to hear your comments and questions Don't forget to rate review and subscribe to the dr. Hyman show wherever you get your podcasts And don't forget to check out my youtube channel at dr. Mark Hyman for video versions of this podcast and more Thank you so much again for tuning in. We'll see you next time on the dr. Hyman show This podcast is separate from my clinical practice at the ultra wellness center My work at cleveland clinic and function health where I am chief medical officer This podcast represents my opinions and my guest's opinions neither myself nor the podcast endorses the views or statements of my guests This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional This podcast is provided with the understanding that it does not constitute medical or other professional advice or services If you're looking for help in your journey Please seek out a qualified medical practitioner and if you're looking for a functional medicine practitioner Visit my clinic the ultra wellness center at ultra wellness center dot com and request to become a patient It's important to have someone in your corner who is a trained Licensed healthcare practitioner and can help you make changes especially when it comes to your health This podcast is free as part of my mission to bring practical ways of improving health to the public So I'd like to express gratitude to sponsors that made today's podcast possible. 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