[applause] Liv W i, everyone. [applause] Liv W i, everyone. I'm Liv Wu, Executive Chef, and I'm excited and delighted that Mark Hyman accepted our invitation to speak to us as part of our Optimize Your Life, Health Speaker Series. I first met Mark at a health conference and was struck by-by this man's extraordinary level of enthusiasm and energy. He talks fast. And-and how just passionate he is about health and well being. He tells a compelling story about finding and living in ways that optimizes all our systems and-and-and drive us to perform well and feel well and thrive. I don't think I'll ever encounter the word "ultra" again without thinking of-of Mark. He's kind of the ultra guy. [laughter] The gains, the greatest gains in 90% of medicine and longevity have been about cleaning up; cleaning up the inner and outer environment. And in the early 20th century it was about clean water, basic sanitation, getting rid of infections. And so now at the dawn of the 21st century we need to look at cleaning up again. From processed, highly refined, chemicalized foods we consume to the air we breathe, and-and all the other toxicities that are, that are part of our world. Mark combines his training in conventional medicine with cutting edge genetics and nutrition, and tells us why and how we should clean up within and without so that we can really perform as ultra human beings. Mark is a four-time New York Times best-selling author and Chairman of the Institute for Functional Medicine which is a very exciting new field; a real paradigm shift in-in medicine. He has dedicated his career to identifying and addressing the root causes of chronic illness through a groundbreaking whole systems approach that he calls "functional medicine." He is also Founder and Medical Director of the UltraWellness Center. He advises Dr. Oz-Oz's HealthCorps group and he is nominee to President Obama's advisory group on prevention, health promotion, and integrative and public health. Welcome, Mark. [applause] Mark Hyman, M.D hank you. Thank you. So as I was, I do talk fast so they-they told me you were smart enough you could handle it so I think it's, I should be okay. Now as I was getting my talk ready I realized that Googlers know more about the future of medicine than most doctors do. And they know that because Google is very much like the future of medicine. In medicine we have a new model that's emerging we call P4 Medicine which is personalized, it's predictive, it's preventive, and it's participatory. In the same way of Google, it's very personalized. You-you get to find out exactly what you're looking for at the moment you're looking for it. It's also predictive 'cause it predicts, what Google is [inaudbile] exactly what you're looking for and it allows you to identify exactly what you wanna find at any moment. And it's also preventive 'cause it prevents you from going down all sorts of roads looking for data and information that isn't relevant to you. And it's also participatory 'cause you have to take action based on what you find and what you do. So Googlers actually have created a system that models the future of medicine 'cause the future of medicine is going to be personalized. It's gonna look at your genetics, at your environment and how those variations affect your health in this moment. The future of medicine is taking the data in your story which is called narrativomics this, the data in your narrative, in your story and making sense out of that and seeing the patterns in that. The future of medicine is about genomics and all the omic he proteomics, metabolomics, the phenomics, which is really looking for the patterns in the data which is exactly what you do here. And it's also preventive because we're going to be able to understand how to best look at a health map on a predictive model by looking at all the data points in your story and in your file markers, and tracking that forward to see what your health risks are and how to create a personalized plan to help you get healthy and stay healthy. And it's also participatory 'cause it means you need to be engaged. It's not just taking a pill that your doctor gives you because you're gonna treat some symptom of some disease and not-not to do anything else except pop that pill. So it's very participatory and you have to be an engaged user of health care. So this is, so what struck me this morning at about 6 o'clock in the morning and-and made me realize that the talk today you guys are gonna get it because it really reflects what you guys already do and already know, but it-it's the medicine of the 21st century. And the unfortunate fact is that it takes about 20 to 50 years before a medical discovery gets implemented in practice. It took 50 years for the stethoscope to begin to be used. And-and the future of medicine is-is not going to be creating a hypothesis, as we do now, and then doing a study and collecting data and analyzing the data. It's gonna to be looking for patterns in the data that already exists and the patterns in your story and the patterns in the biomarkers and using the computational power we have now to create a model of thinking about disease, disease patterns, and connections and relationships and linkages in ways that we don't now. Because medicine is completely is completely solid as I'll share with you in a minute. Now this is happening all across the world. You may not have heard of it. You may not be familiar with it in the words that I'm speaking to you about it, like functional medicine or P4 Medicine, but you've heard about the concept of systems and of a systems biology. And schools like Johns Hopkins have created an entire new medicine school curriculum to map to this new concept called Genes to Society. And we don't realize this but medical education was established in 1910 and the-the model of education we have now is pretty much the same as it was then. If you wanna know how a doctor practices you just look at the early graduate of medical school and things are very difficult and slow to change. So they're tryin' to shift that and tryin' to understand how the environment interacts with our genes in any moment to create our phenotype. This is really the-the concept of the future of medicine which is the moment of health that you have now, the person you are right now, is created by your lifestyle and your environment, toxins and everything in your environment, washing over your DNA to create the person you are in this moment. And that it's really a continuum of illness not simply on or off, you have this disease or you don't. One day you have, don't have diabetes, the next day you don't. One day you-you're free of cancer and the next day you have cancer. That's not how disease works. It's a continuum of shift from optimal function all the way to full blown disease. It's the medicine of-of why not what. We're trained as doctors to say, "What disease do you have? What drug to I give you?" Instead of, "Why is this happening? Why does this particular person have this particular symptom at this moment. What are the underlying causes? What are the mechanisms and pathways and connections that we can use to link together this information to understand what's really at the root of disease? And this is happening all over the world. Over 40 countries have participated in educational programs at the Institute for Functional Medicine. There's 31 medical ed-educational institutions that have been involved. There's over 13 residency programs that are exploring this. So this is out there. And today I wanna take you through the lens of the brain and show you how this model applies. And it applies not just to the brain, but to all chronic diseases; all the things that are our pain points as a nation, as a, as a world which we'll share globally. I don't know if you know this but by 2020 there will be less than 20 million who will die from infectious disease. But over 50 million will die from preventable, chronic illnesses, and reversible chronic illnesses like heart disease, diabetes, and cancer. So it's not just in America, it's globally. So how do you power up your brain? It's important to focus on prevention because often as I'm gonna show you with this patient it's difficult and it can be too late if you wait too long you can end up with re-irreversible problems with your brain. And-and hopefully you haven't gotten to this stage yet about where we can do a lot. Now this is a, no joking, this is a big epidemic. There's 1.1 billion people in the world who have brains that aren't working; they have depression, they have ADD, they have dementia and there's all sorts of other spectrum of brain disorders along the continuum of brain dysfunction. And the question is how is your brain working? I mean it's probably a good brain to start with or you wouldn't be here, but is it working as well as it can and if not, why not? And how can you make your brain work better? Maybe you have mood issues, maybe you have a little trouble focusing, maybe you have trouble sleeping, maybe you have trouble with energy, maybe you have trouble with even cognitive focusing and-and memory. Now we have a lot of insults to our brain and there's a lot of damage that happens as a result of things that we do. And there's a way we can understand how to change that. When our brain aches we don't really feel pain, but it shows up as mood problems or focus problems or attention problems, right? If you're, if you have a sore throat your throat hurts. If you have a toothache, you're tooth hurts, right? But if you're, if you're brain hurts what happens? You have ADD, you have autism, you have depression, you have dementia, you have cognitive loss. These are things that happens to your brain as your system becomes imbalanced. And so what we're gonna learn about is how if you change your body it'll change your brain. The inputs you put into your system create the outputs. And if you change the inputs you'll get different outputs in terms of cognitive function, mood, attention, memory, behavior, and so forth.1 So I'm gonna talk to you a little bit today about a pretty radical idea. But I think you1 guys are up for it; which is that the way we think about disease really is pass?. In1 fact and recently at a conference a CEO of a major drug company said that in the future1 there'll be no more drugs for block buster diseases only drugs for block buster mechanisms.1 And the reason for that is that diseases don't exist. Not really in the way we think they1 do because just the way the world looks flat and it's not and just the way it-it appears1 that the earth seems to be the center of the universe, it's really not. Diseases also appear1 real but their simply the downstream effects from upstream mechanisms and causes.1 So we're gonna talk about how your brain works and how we do things that harm it and what1 we can do to help it and how we can optimize your brain function, your focus, your mood,1 and your performance.1 So the way we do this, and-and I've written about this in the books. Many of you got lucky1 to sit in a seat with the UltraMind book which this is what this is and the other ones have1 the weight book. I don't know if it's applicable to you, but you can swap the books around1 and this is a personalized prescription for creating a powerful brain.1 It's-it's not a generic program; it's something that can be personalized and-and individualized1 to match your specific issues. And we'll talk about why that's important. And it's based1 on this notion that P4 Medicine, which its clinical model is functional medicine.1 Most of what I'm gonna tell you is in the book. There's over 400 references in the book;1 there-there's really based on seeing thousands of patients over 15 years using this model.1 Here's the practice that I have in Lennox, Massachusetts which is having an ice storm1 now so I'm thankful I'm not there.1 So the basic notion here is that if you change your body, you'll change your brain.1 We all know that the mind influences the body but we don't think so much about how the body1 influences the mind. And someone mentioned to me earlier that they were having depression1 and that they were gonna go see a psychiatrist and they were probably gonna get a drug and1 said, "Gee if I knew that I could change what I'm doing to change my mood, I might do that."1 So people don't really make the connection between what the inputs are and how they feel.1 We sort of don't think about it. Somehow we wait until we get sick to really think about1 our health, but we don't notice that all these subtle problems and symptoms and conditions1 that we suffer from are really fixable by addressing the underlying cause.1 If you guys want a copy of the slides you can go to drhyman.com/google to-to get a download1 so you don't have to write everything down.1 So this is a pretty shocking idea, but diseases don't really matter anymore. As we understand1 the body as a system our notion of disease is-is taking flight and it's, and it's shifting1 from understanding disease as a discreet set of different conditions to understanding the1 underlying pathways and systems underneath it.1 So my hypothesis today is that there really is no such thing as depression. There's no1 such thing as bipolar disorder. There's no such thing as ADD or autism or dementia; that1 these are really systemic illnesses that happen to affect the brain. And that you have to1 treat the system in order to fix the problem.1 So we get stuck in this whole concept of the name it, blame it, and tame it. We name the1 disease and then we blame the name for the problem, and then we try to tame it with a1 drug. And-and we don't think in a complex way in medicine.1 We get really focused on one disease, one drug model which is really 19th century diseases.1 The bacillus that was discovered by Louis Pasteur and was treated with antibiotic that1 seemed to work, so we try to apply that to all the rest of medicine. But that's actually1 not how the body works.1 And-and we really good at labeling things and naming things. There's this category of1 psychiatric diseases called DSM-IV and I was sitting at dinner with the-the head of the1 National Institutes for Mental Health in Washington a few years ago and I said, "Dr. Insel what1 do you think of this book the DSM-IV which is the Bible for psychiatrists? He said, "I1 think it has a 100% accuracy but 0% validity." Meaning it's very good at describing the symptoms1 people have and putting them into groups according to their symptoms, but it tells me nothing1 about the cause for those problems or even really how to think about them in a way that1 works.1 And this is an article from my favorite alternative medical journal, the Journal of the American1 Medical Association, which has all sorts of amazing things that people just don't pay1 attention to. And-and they-they-they talk about dementia in this article and-and our1 shifts in thinking about it and how when we study dementia and we look at ginkgo or fish1 oil or this or that it doesn't seem to work. Or we use this drug or that drug.1 It's because dementia doesn't really exist the way we think it does. It's simply an end1 result of a whole series of insults and many different kinds of insults that can lead to1 the same common symptoms.1 So in this article they talk about how that-that we classify things incorrectly and we're not1 very good at talking about the cause. This is categorical misclassification and etiologic1 imprecision. Meaning we classify by symptoms instead of by cause which is really what we're1 going to be doing in the future.1 So let's just take an example. You go to the doctor and you feel sad and helpless and hopeless1 and you're not interested in life and sex and food anymore; you can't sleep well; and1 you even have thoughts maybe of killing yourself from time to time. And your doctor goes, "I1 know what's wrong with you. You have depression."1 But that's not what's wrong with you, that's just a name of those collection of symptoms.1 It doesn't tell you anything about the cause. It tells you what, it doesn't tell you why.1 So for example, someone who comes in with depression might have many, many causes. You1 might be, for example, eating gluten and you might have a genetic susceptibility to create1 problems from this which creates an autoimmune disease that attacks your thyroid that causes1 you to have low thyroid function that can lead to depression. And the treatment is getting1 off gluten and treating your thyroid.1 Or you might be having reflux for years and taking an acid blocking pill which inhibits1 B-12 absorption which leads to depression.1 Or you may live in Seattle or work inside all the time, although you guys are out playin'1 volleyball so maybe you get outside and get some Vitamin D, but you might have a Vitamin1 D deficiency and have depression and need Vitamin D.1 Or you might be taking antibiotics for acne or have frequent colds or sinus infections1 and take antibiotics that destroy your gut flora. And that changes the microbiome in1 your gut and changes the regulation of the immune system in your body that leads to inflammation.1 And an inflamed brain is also a depressed blane, brain.1 Or you might love sushi 'cause I see you had lunch today and may be full of mercury. And1 mercury can cause depression. Or you may hate fish and have Omega-3 fat deficiency because1 you don't like fish. And Omega-3 fats are critical for brain development and mood.1 Or you might love sugar and eat lots of sugar and soda which actually leads to something1 called pre-diabetes or metabolic syndrome which has been cause of depression.1 So the treatment and the diagnosis of each of these things is very different and you1 have to ask the question why, not what.1 So in-in medicine we come up with a lot of solutions and often we find out they may be1 the wrong thing later on.1 This is an ad from 50 years ago that more doctors smoke Camels than any other cigarettes1 and 113,000 doctors are coast to coast. So you can substitute more doctors recommend1 Prozac or Lipitor or any other drug for this or that and in 50 years how are we gonna be1 looking at this?1 In fact think about it, is depression a Prozac deficiency? Right? Is it, is this a drug deficiency1 or is it some other imbalance in your system that's driving this?1 Now in the future we're gonna be shifting away from just saying, "You have depression.1 Take this antidepressant," to "Oh this is a-a symptom of some other factors. Let's find1 out what those factors are. Let's look at your whole biology as a system." This is called1 systems biology. And redefine disease based on causes and mechanisms and not on labels.1 And we're gonna be shifting from the silos we have which are all the ologies, the specialties,1 that we have in medicine and we go to a doctor for every different part of our body. We take1 a pill for every ill.1 We're gonna shift into thinking more about complex networks and systems. We're gonna1 be moving away from the 12,000 labels of diseases we have in our code book to an understanding1 of biology as a, as a network or a system.1 And it happens at a, at a very fundamental level. We're-we're discovering this in biology1 that your-your physiology is a web; that it's a network and that it happens at a genomic1 level, at a metabolic level, at a disease level, and there's patterns that connects1 all of these different pathways and things together and link them together.1 And there's also a network at a social level. In fact if your friends are overweight you're1 more likely to be overweight than if your relatives are overweight, or your mother or1 father's overweight.1 So there's a huge component of-of-of understanding the networks and connections between things1 that are important.1 So just as, for example, depression can be caused by many different factors. One causative1 agent can trigger many different diseases. For example, gluten can cause depression.1 It can also lead to autism. It can also cause rheumatoid arthritis. It can lead to osteoporosis.1 It can lead to irritable bowel syndrome or even inflammatory bowel syndrome. Sorry some1 of you guys are eating lunch. And even heart attacks, and cancer, and dementia.1 In a recent study of 30,000 people they found that people who had low level reactions to1 gluten, not even a full blown celiac disease, had between a 35 and 72% increase in their1 risk of death from heart disease and cancer.1 So we have to reframe how we're thinking about these things.1 You can go to the doctor and have all these different conditions, you're gonna get a certain1 specific treatment based on suppressing the symptoms. You're not gonna get a treatment1 based on the cause. And so for all these conditions you might have a result of relieving the symptoms1 by treating the-the gluten problem.1 And this is not just applicable to mood issues. It's across the whole spectrum of what we1 call the B-O-I which is the Burden of Illness, including the big cost drivers and-and-and1 things that drive suffering and disease like obesity, heart disease, diabetes, depression,1 and mood disorders which are rampant; I mean the second leading category of pharmaceuticals2 are psychiatric drugs.2 And then of course these arise in allergies and asthma and respiratory illnesses, digestive2 disorders.2 I was shocked to find that one of the biggest cost drivers for a major insurer was reflux2 and heart burn which is a treatable condition not using PPI's or acid blocking drugs but-but2 using the approach that I'm talking about.2 Cancer, back pain, migraines, and all autoimmune disease which affects 24 million people collectively2 like rheumatoid arthritis, lupus, and MS, and so forth.2 These are all things that-that have really very poor treatments in conventional medicine,2 but in this new model of systems thinking that we addresses the underlying causes; a2 very powerful approach.2 So the question i o you suffer from brain damage, and if you do, what can you do about2 it?2 Now this is what our brain should like, look like, and this is what it may look like if2 you've taken too many drugs or maybe drink too much alcohol or don't get enough sleep2 or drink too much sugar or on and on and on.2 And-and the good news is though, that if you've injured your brain you can repair your brain.2 This concept of neurogenesis is very critical in-in the research. And even in people who2 are dying they're making new brain cells. People who have cancer they, they're-they're2 dividing neurons through a special tag, biochemical tag, and they find that in rapidly dying people2 there are actually new dividing cells in their brains.2 And there's also the concept of neurotrophic factor hings that enhance and optimize2 our brain function. We were talking about that at lunch. There's a molecule for example2 in coffee and-and in actually the coffee bean and in-in curcumin and in fish oil that actually2 help regulate pathways that improve your brain development and improve connections. So you2 have both new brain cells, which is neurogenesis, and-and new connections, which is neuroplasticity2 at any age.2 And the cause of our problem with brains is-is really not a chemical imbalance in the way2 we think it is. There's not a Prozac deficiency. But it's a, it's a series of insults that2 happen over time. It's our nutrient depleted diet. It's our toxic environment, heavy metals2 and pesticides; it's our unremitting stress. It's various triggers that upset our immune2 system such as allergens or-or infections.2 And in many of the things we ea igh fructose corn syrup, sugar, trans fats, food additives,2 pesticides, hormones, all influence our brain function.2 Also things we do everyday affect i ur sleep cycles, our circadian rhythms, levels2 of stress, not-not exercising. Exercising is one of the best things you can do to actually2 prevent Alzheimer's. And a brain trauma, I saw somebody fall off a swing today out there.2 I was a little worried, but brain trauma is not good for your brain and I know they're2 your most important assets. You wanna be very careful.2 And in certain drugs we us icotine, caffeine, alcohol, in some ways are all injuring to2 the brain. Caffeine has a, is a double edged sword. It may help regulate certain pathways2 that control inflammation, but it also may damage you by decreasing dopamine and that2 leads to needing more coffee and then having this sort of crash and burn cycle where you2 basically get a little boost and then you-you fatigue and then you need more coffee and2 it eventually doesn't work. So you have to be careful.2 There's certain medications that can have impac he statins, and acid blockers, and2 various things. So, also heavy metals and toxins.2 So we really have to understand that depression, ADD, and autism and dementia are not really2 diseases they're really just symptoms of some underlying imbalances.2 And they can be nutritional imbalances and this is really the crux of-of the story here.2 And this is what I-I talk a lot about in-in my books and which is the foundation of functional2 medicine is reorganizing biology into a series of-of nodes within the network of-of our physiology2 and the webs of our physiology.2 And these nodes are really the places we wanna look for problems in nutritional status.2 We wanna look for problems with B vitamins and Vitamin D and zinc and magnesium and Omega-32 fats.2 We wanna look for triggers of inflammation in the brain like gluten and food sensitivities2 and infections and toxins and sugar and molds.2 We wanna look for hormonal imbalances like thyroid, adrenal, and sex hormones and problems2 with sugar. Even our gut and I'll talk some a little bit about how the gut plays a role2 in-in our brain.2 And then of course toxic injur eavy metals, pesticides, molds, loss of energy in our cells,2 very important. And loss of energy in our cells and our capacity to produce energy creates2 a decreased brain function and performance and then any sort of chronic or acute stress.2 So these are the areas that we pay attention to and we-we navigate to and filter our information2 through a new set of lenses.2 And the problem with medicine is that the treatments we use don't match the cause. So2 if you're eating gluten and you have depression, taking Prozac's not gonna help. Or if you2 have a folic acid deficiency, for example you get a 6% benefit from an antidepressant.2 If you actually correct the folic deficiency the benefit of the drug goes up 44%. But I2 say, "Why not just try the folic acid first or the folate first and then if it doesn't2 get better use a medication?"2 So let me make this a little more granular for you and show how this works in a particular2 story of-of a boy who came to me with Attention Deficit Disorder.2 This is a rampant problem. There's 12 million kids who have problems and this arises in2 all the whole spectrum of disease like autism over the last 20 years in extraordinarily2 high rates. We've gone from 1 in 10,000 to 1 in 100 kids who have autism.2 And the-the-the hypothesis here is that the cure for brain disorders is really outside2 the brain. It's by treating your system and your body. So we have to ask, "What's going2 on? Why are these kids having this problem?"2 And this is Clayton; this is every kid in America. He came to me he had 11 diagnoses,2 he'd seen five specialists, was on eight medications. He had asthma, allergies, anxiety, ADD, and2 anal spasms, and that's just the A's.2 Now he had lots of other issue igestive problems, and he had anxiety and fearfulness,2 and he was very disruptive, he had bad handwriting. And-and these are his list of problems. You2 can see it's a very long list and he was a long, a long list of medications at 12 years2 old.2 And nobody asked how is everything connected in this boy. Nobody wanted to look at how2 things are out of balance. How is he sort of off kilter? And-and nobody wanted to understand2 how we can look at the underlying factors that are driving his symptoms.2 So we began to do things that put his system back together and it required a sort of set2 of complex changes that-that looked at the underlying factors.2 Now we knew he was on antibiotics, he had frequent infections, he had a horrible diet,2 he ate junk food, and we knew that-that he'd seen a bunch of people, but no one asked how2 is everything connected.2 So we were asking the wrong questions.2 Now this is the map I used to help figure out what was wrong with him. Which is rather2 than seeing a specific disease and treating it separately like his ADD and treating that2 with Ritalin, and his asthma-asthma with a certain inhaler, and his allergies with an2 antihistamine, and so on. I said let's take a map and look at how all these things are2 connected.2 So it just looks like probably one of your white boards as you're doing your-your-your2 programming, but this is a model of-of this little boy, Clayton, who had some predisposing2 factors of poor diet which led to, and antibiotics for lots of infections when he was younger,2 which led to disruptive, disruption in his digestive system.2 And that led to various disruptions in his immune system. And that led to also to antibody2 development related to foods and also gluten.2 So that disrupted his whole system and that affected his-his brain. He also had lead in2 his system and he had also nutritional deficiencies.2 And this was obvious just from talking to him 'cause he had, for example, muscle cramps2 and anxiety and insomnia and-and-and headaches which were all signs of magnesium deficiency.2 He never ate fish so I knew he had Omega-3 fat deficiency. He was always inside playing2 video games so I knew he had Vitamin D deficiency. He also had very poor diet, he didn't eat2 vegetables, so I'm assuming he had low levels of antioxidants like beta carotene. And he2 had a high processed diet and it was high in sugar.2 So these were all clues to me and patterns that I see and I-I see this disruption in2 his basic physiology and I wasn't sort of treating each disease separately I was saying,2 "How do we create balance back in his physiology?"2 "I'm afraid that your irritable bowel syndrome has progressed. Your now have furious and2 vindictive bowel syndrome." [laughs]2 And I think what people don't realize is that an irritable bowel often causes an irritable2 brain; that the disturbances in the gut flora, in the levels of inflammation in the gut trigger2 inflammation in the brain. And that leads to mood and cognitive disorders.2 So we really spent our time looking at all these nodes and this network and this system2 that are all dynamically interactive. These really aren't separate things; they're really2 just, we're just using this as a model for thinking about disease, but it's-it's a model2 that-that can explain most chronic illness.2 So instead of thinking about diseases, I think, "Well what's goin' on with his immune system?2 How's his digestion? What is his nutritional status? How-how's he detoxifying? What's going2 on with his-his gut?"2 So these are the things that I really look at. And we found when we looked under the2 hood, and people say that modern medicine is like trying to figure out what's wrong2 with your car while listening to the noises it makes, right? We need to look under the2 hood a little bit.2 So not everybody needs