The Functional Medicine Approach To Treating COVID-19 And Post-COVID Syndrome | Dr. Mark Hyman

by health and nutrition advice journalist

Dr. Patrick Hanaway::
… These people who are having, let’s say the post-COVID syndrome, they have other underlying issues that are going on. They have other underlying triggers, and it may be related to heavy metal toxins or [organotoxins 00:00:12] or mycotoxins or hidden infections or antigens or celiac disease or some other process that’s going on that has to be taken care of and looked at also.

Dr. Mark Hyman:
Welcome to The Doctor’s Farmacy, I’m Dr. Mark Hyman, and that’s Farmacy with an F. F-A-R-M-A-C-Y, and if you’ve ever wondered about, maybe there’s another way to deal with COVID that we’re not hearing about, that isn’t drug based, that isn’t vaccine based, but it’s based on fundamental principles of how to rejuvenate your immune system, and how to become COVID resilient, you should listen up to this conversation. Also, if you’ve ever had cancer and wondered about some new ways that are being used to think differently about cancer, cancer prevention and treatment, you should listen up because this podcast is with a very special human being.

Dr. Mark Hyman:
My good friend, my colleague,
Dr. Patrick Hanaway:, who has been in my life for decades and decades now, as one of the leaders in the movement of functional medicine involved in every aspect of education, research, training. He’s one of the real dudes out there. He’s a Board Certified family doc, he trained in Washington University, one of the best medical schools in the country. He’s had a clinical practice with his wife, called Family tO Family in Asheville, North Carolina for decades. He was the chief medical officer of Genova Diagnostics, and was the Chief Medical Education Officer at the Institute For Functional Medicine and then also with me, started up the program at Cleveland Clinic in functional medicine.

Dr. Mark Hyman:
He was the founding medical director and we did a lot of stuff there in a very short time, which really put functional medicine on the academic map and without his help, we would not have been able to do it. So I’m forever grateful to him. He’s focusing now his working on cancer and COVID, and he himself developed cancer a few years ago, and we’re going to talk about his journey in cancer. Lately, he’s been doing something which is really important, which is trying to understand a different framework for preventing, treating COVID and even dealing with the aftermath of what we call post-COVID syndrome.

Dr. Mark Hyman:
In his role, leading the project at the Institute for Functional Medicine on COVID, in the functional medicine approach to COVID, has been instrumental in providing education to thousands and thousands providers, and also building a course which is now available online. It’s an incredible course called Resistance, Resilience and Recovery: Patient Care in a Pandemic, by the Institute For functional Medicine. You can go to ifm.org and read more about it. This is a course for professionals but I can imagine anybody can take it who’s really interested. It’s an attempt to try to put together the science of what we know about how to prevent, and treat and even deal with recovery from COVID. So Patrick, I can’t tell you how excited I am to have you on the podcast. Been a long time in coming, and we have lots to talk about.

Dr. Patrick Hanaway::
Well, thanks so much, Mark. Yeah, we do have lots to talk about. We’ve had a lot of experiences, shared a lot of earned and learned wisdom that we’ve gone through it together, and I’m looking forward to the conversation.

Dr. Mark Hyman:
So for those of you who don’t know, we lived together … We were roommates in Cleveland Clinic. We shared an apartment, which is something you do in college, but we got to do it as grown men, which was quite fun and really learned a lot about how we build something new in a very new environment, at Functional Medicine Cleveland Clinic and also learn a lot about each other, which is really pretty awesome. So I have a huge respect for this guy. He’s a man of integrity and wisdom, and by the way, he’s also a…

Dr. Patrick Hanaway::
Marakame. Marakame is the word.

Dr. Mark Hyman:
He’s a shaman. He’s initiated as a Marakame, indigenous healer, by the regional people in the Sierra Madre in Mexico and he holds community fires in ceremonies, traditional healing sessions. So he’s a multifaceted human being and we first had a mind meld when he heard me speaking about Tibetan Medicine decades ago at a conference and he was like, wait a minute, you’re kind of like me, I’m like you. Let’s talk. So let’s get right into it. COVID has been devastating for humanity across the globe. 55 million cases, as of this recording, a quarter million in deaths here, over 1,000,003 deaths around the world. This is a real problem, and our tools are crude at best.

Dr. Mark Hyman:
Our therapies are minimally effective, and people are still dying at incredible rates and getting sick at incredible rates. Now, there’s so many cases and 20% of those cases end up hospitalized and those who are sick with a chronic disease or are obese, overweight, who are in poor metabolic health have much worse outcomes. So from your perspective, from a functional medicine perspective, what’s the approach we should be taking? Where are we at in our understanding, and how do we rethink our approach to COVID, that includes a lot of elements around lifestyle, nutraceuticals and other therapies that are just absent from the conversation, that are not on the news, that are not being talked about by the government and they’re not in academic institutions for the most part?

Dr. Patrick Hanaway::
Well, we have to come back and look at medicine in general and the way in which medicine really doesn’t focus on health and well being. It’s focused on once you get a disease, and then we’re going to give you some medicines in order to be able to decrease the symptoms in regard to that. Whereas with a functional medicine approach, just as with Tibetan Medicine, or Ayurveda or Chinese medicine. It’s focused on a big picture view of how all the pieces fit together, and how are we in harmony. So we have with COVID, a fundamental aspect of us being in disharmony with the natural world.

Dr. Patrick Hanaway::
We don’t know exactly, lots of theories of how it arose, but be that as it may, we were ripe. Things were so out of balance within the world, within the natural world and within us as human beings, and particularly in the United States, where we were so metabolically unhealthy and imbalanced, that we’re susceptible to what’s happening here. So we have an acute disease, on top of the complex chronic disease that is so rampant within our country, and that we’ve exported around the world.

Dr. Patrick Hanaway::
So we see that begin to happen and the first thing is, what do we do? Who’s at risk? Well, who’s at risk, as you’ve said, or those people who are diabetic and overweight and pre diabetic and hypertensive, as well as the elderly whose immune systems have aged. They’ve become senescent. Those are the ones who are at risk for having severe disease going on. So from a functional medicine perspective, or just from a good medicine perspective, we say, well, how do we help the people be healthy enough, so that if and when they get it, that they don’t become overwhelmed by it, they don’t have a severe degree of illness.

Dr. Patrick Hanaway::
If they progress from that, that they don’t have a post COVID syndrome, and if they don’t need to get that because there’s a vaccine that’s arising, that we actually optimize their immune system, so that they’re able to respond to it in the most effective manner with the least risk of harm. We can talk about all those aspects, but really, we’re trying to say, how do we have the rising tide lifts all boats? How do we help people become healthier through the whole thing, so that as we’re exposed to what’s happening in the world, in this case the SARS-CoV-2 virus, we don’t have the severe response to it, or we don’t have the long-term sequelae from it, or where you’re not harmed by a vaccine.

Dr. Mark Hyman:
That’s right. I think that’s a really important point. We’re so focused on the killing of the virus or the vaccination idea that we were missing this fundamental conversation in our society and around the world, which is, who gets sick, why are they getting sick, and is there anything we can do to make the host less susceptible to getting sick, the host more likely to recover, and the host less likely to get long-term consequences, which are quite significant for many, many people. I think that’s really the beauty of functional medicine. There are many reasons why America has the highest rates of COVID infection. Some of them are political, some of them are social, but a lot of them are medical.

Dr. Mark Hyman:
I think in China, there’s three cases of death per million population. In America, there are 500 cases of death per million population. What’s the difference? I don’t know, but China has an obesity rate of 2.6%. We have an obesity rate of 42%. Maybe it has to do with our poor metabolic health, which is entirely tied to our lifestyle and nutrition. This is where functional medicine really focuses on because we’re not so much focused on treating disease. We’re focused on the science of creating health. So can you talk about the functional medicine approach to this and what are the kinds of things in your research and putting together the data on how to create immune resilience with functional medicine? What has risen to the top as the strategies, both dietary lifestyle and nutraceutical strategies, to help patients become more immuno resilient, to rejuvenate their immune systems and to become resistant to the effects of COVID?

Dr. Patrick Hanaway::
So there’s a lot of pieces there [crosstalk 00:09:55]-

Dr. Mark Hyman:
We got a while. We got a while.

Dr. Patrick Hanaway::
First the functional medicine, the operating system and the view is trying to look at the whole person, from illness to wellness and where they are. So we’re doing that. So whether we’re working on someone where we’re trying to prevent them from having a severe illness or treating them for post-COVID syndrome or working with them at any point in severity, the approaches are actually similar. The specifics change, but the approach is the same, and that is what we’re working to do is work with the system of what’s happening with the gut microbiome and how it informs the immune system? What’s happening with the activation of the cytokines and the overall inflammatory response process that’s going on?

Dr. Patrick Hanaway::
What’s happening in relationship to the exposure and risk factors that you have? What’s happening with metabolic health, in terms of the ability of the virus to be able to attach to the receptor in the first place? Taking all of these things into consideration, we start looking at risk. So from a nutritional standpoint, we’re saying, what can we do to mitigate risk of, as you said, of obesity, of metabolic syndrome, and work with that? The kinds of approaches, a beautiful paper by Deanna Minich, that I helped her out with, goes into all that.

Dr. Patrick Hanaway::
We talk about what ends up coming down to, what looks like a low carb Mediterranean diet. You might call it a pagan diet. It’s the … It’s that kind of approach that’s going to help our overall metabolic health and well being. People say, “We can’t do that,” but we actually see the changes in metabolism have, and happen within a couple weeks, even a couple of days. Changes in the microbiome change very quickly. It’s interesting, you’re talking about China. I was just reading a piece this morning that elderly Chinese people who are healthy, have the same microbiome as young Chinese people who are healthy. That’s not the case in the United States.

Dr. Patrick Hanaway::
We see that the microbiome has degraded significantly by the time people age. That has an effect on immune senescence. The immune system is getting old, it doesn’t work as well, and yet, it is possible to be able to keep it healthy, to keep it resilient. So what we did when we began this process, and I recall, I was up in upstate New York at a retreat center, the Blue Deer Center, and coming back from that in the beginning of March, and I didn’t really get it. I didn’t really get how … I was reading it in the news, but I didn’t get how big it was.

Dr. Patrick Hanaway::
Then as everything shifted, those first two weeks in March, we said at the Institute for Functional Medicine, we have to do something about this. So we dove into bringing about 20 different physicians and scientists together and said, “Let’s look at the literature around viral infections, and what do we need to do? What are the things that are going to be able to be beneficial for viral infections? In particular, let’s look at the original SARS virus and the MERS virus,” the Middle Eastern Respiratory Syndrome virus that were both corona viruses and what’s effective, and how can we dial that in?

Dr. Patrick Hanaway::
So we put that all together, and in the beginning of April, we laid out for everybody, and we said, “Well, the things that are going to be most helpful are going to be those things that are going to be able to be both antiviral, they’re going to decrease viral growth. They’re going to improve the immune system, and they’re going to decrease symptoms.” We laid out, we talked about vitamin D, we talked about melatonin, things that are now like, oh, wow, this is a brand new thing in November, And it’s like we laid it out and we laid out the doses.

Dr. Patrick Hanaway::
We said, we can … We want to work with question, a bioflavonoid. We want to work with vitamin A and vitamin C. We want to be able to use anti inflammatories, like curcumin. We want to be able to use green tea extract or green tea, another bioflavonoid to be able to help out. We could see like the data is there to be able to bring all of these components into the mix, including things that I think are particularly important in the post-COVID syndrome, like N-acetyl cysteine, that’s a precursor for glutathione. So we had an idea of what that was, and we laid those things out and fortunately thousands of clinicians have looked at that.

Dr. Patrick Hanaway::
It wasn’t just we were grabbing any ideas, we were going through it in a very rigorous way, and setting up here is the evidence that is for this and here is the risk of harm. When we look at what’s been done with hydroxychloroquine or remdesivir, where the evidence is not that great, and the risk of harm is significantly greater for things. So don’t we want to … Why wouldn’t we use things where the risk of harm is very low and-

Dr. Mark Hyman:
Or non existent.

Dr. Patrick Hanaway::
And there’s very clear evidence, not only from a biological plausibility, like it makes sense because the research is there and the science fits, but from a scientific evidence-based perspective around other kinds of viral infections, because none of us had data on SARS-CoV-2 for the first six months. What we found time again is, this is helpful. We’ve seen it from clinicians, I saw a piece yesterday that was comparing primary care practices to integrated practices, and the rates of hospitalization in those two groups. There was an eight fold reduction, 8X, eight times reduction in the hospitalization in people who are getting this kind of functional medicine approach. Now, that’s all reported data. It’s not a randomized trial, but it’s like there’s something here and-

Dr. Mark Hyman:
800% reduction, that’s a lot.

Dr. Patrick Hanaway::
Yes, exactly.

Dr. Mark Hyman:
We get excited if there’s like a 20% reduction in progression to the ICU or, a couple of days less than the hospital [crosstalk 00:15:59]-

Dr. Patrick Hanaway::
We’ve seen with the vitamin D data out of Spain, where they were able to show that when people were getting adequate doses of vitamin D, and they were hospitalized, that those patients didn’t end up getting into the ICU, and didn’t end up dying. The patients who were in the control arm who didn’t get the vitamin D, they had a much higher rate of going into the ICU, and several other patients in that small cohort died. So it’s like we’re seeing this, we’re seeing the data is coming out, but we know the information now and the interventions are not toxic and they’re not expensive and they can be broadly applied.

Dr. Patrick Hanaway::
So we’re looking for how do we do the research? How do we team up with academic centers to say, let’s do the research on this? We … Unfortunately, we haven’t really had takers yet around doing that, although people … And it’s interesting is like, we found when we were doing research at the Cleveland Clinic, they want to isolate a specific variable, or will do research on vitamin D alone. Well, I’m not telling my patients just to take vitamin D. I’m saying, “Hey, take these bioflavonoids to help your gut microbiome, take these inflammatories, take vitamin D, help your overall metabolic health and eat this really good diet,” and they’re doing better.

Dr. Mark Hyman:
The analogy I get is, Michael Jordan could be the best basketball player in the world, but he’s not going to win a championship on a team by himself. All these things work in concert, in synergy, and have different mechanisms and are additive or even synergistic in ways that are more than that. I think we really don’t have the right paradigm. We’re looking at the single drug models, single disease. We’re not … But then of course, then we throw everything together at the end. So when [inaudible 00:17:48] people steroids and heparin, and they’re giving them AIL-6 blockers, and they’re giving them remdesivir, and they’re giving them a hydroxychloroquine.

Dr. Mark Hyman:
They’re just throwing the kitchen sink at it, but they look at each one separately, they do not see the combination of the effects. I think that’s really functional medicine is quite different. It’s like, how do we create a healthy human? Well, you need high quality protein and high quality fats and low glycemic carbs, but you wouldn’t just eat vegetables and that’s … Even though they’re healthy, you need other components of your diet. It’s the same thing with creating health and creating a robust system. The way I think about what we’re doing and what you’re doing, by assembling all this data is like, what does the data show about how do you create a healthy robust immune system and a robust response to insults, whether they’re lifestyle insults, or whether they’re viral or infectious insults?

Dr. Mark Hyman:
The data is increasingly clear that there are immunologically active nutrients and polyphenols and plant compounds or phytochemicals that we can use that, like you said, are non toxic, they’re low cost. They have evidence. They’re widely available, and there’s evidence for benefit. So why wouldn’t we use these? So what’s your perspective on why we’re so much in the dark about this? Because I was reading the New York Times when President Trump got COVID and I was like, oh, they’re mentioning he’s taking this drug and that drug and he’s taking vitamin D and zinc. I was like, wow, the president gets vitamin D and zinc. Why doesn’t everybody get vitamin D and zinc?

Dr. Patrick Hanaway::
Well, Anthony Fauci is taking vitamin D and vitamin C. It’s like, he thinks there’s enough data there to be able to help. It’s always been a curious thing to me, Mark, when I talk to physicians about nutrients, and nutrition, and they say, “Well, that sounds like good for me, or I’m going to give that to my wife and my kids and my mom, but I would never give that to my patients.” I’m like, “Really?” I try to teach my pay, treat my patients like I treat my family. It’s like, I care that much to give you the best knowledge that I have and there’s an element that is Not only about the whole fallacy of the randomized control trial and the misunderstanding of what that is, that’s been, I would say, kind of foisted on us by the drug companies, because that helps them to demonstrate the efficacy of their point source drug, without any other factors that are going on.

Dr. Patrick Hanaway::
I think underlying all this as well, is the amount of fear that we have about doing the wrong thing and the amount of fear that both as clinicians and one of the big things within COVID, to me is like, life is uncertain. We’re getting to see within that uncertainty, how people respond, and are they moving from a place of fear and pushing against or are they moving from a place of saying, well, wow, things are really different. I wonder why I’m curious, and I’m going to be courageous in going forth in the world and trying some new things, because the way in which we were doing it before, isn’t working. That’s the way you and I have been in our practices, in our careers and we’re trying to say, “Hey, what works?”

Dr. Patrick Hanaway::
I’m trying … I’m back in residency training. I’m like these antihypertensives really aren’t working very well. They’re not shifting the disease for this person. I wonder what would work? What if dealt with heart rate variability and got more vagal tone and then have them in fight or flight response? Would that work? Oh, wow, that works. Oh, they don’t even need medicine anymore.

Dr. Mark Hyman:
That’s right. Amazing.
Speaker 3:
Hi, everyone. I ope you’re enjoying the episode. Before we continue, we have a quick message from Dr. Mark Hyman about his new company Farmacy, and their first product, the 10 Day Reset.

Dr. Mark Hyman:
Hey, it’s Dr. Hyman. Do you have FLC? What’s FLC? It’s when you feel like crap, it’s a problem that so many people suffer from, and often have no idea that it’s not normal, or that you can fix it. You know the feeling. It’s when you’re super sluggish, your digestion is off, you can’t think clearly, or you have brain fog, or you just feel rundown. Can you relate? I know most people can, but the real question is, what the heck do we do about it? Well, I hate to break the news, but there’s no magic bullet. FLC isn’t caused by one single thing. So there’s not one single solution. However, there is assistance-based approach, a way to tackle the multiple root factors that contribute FLC.

Dr. Mark Hyman:
I call that system, the 10 Day Reset. The 10 Day Reset combines food, key lifestyle habits and targeted supplements to address FLC straight on. It’s a protocol that I’ve used with thousands of my community members to help them get their health back on track. It’s not a magic bullet, it’s not a quick fix. It’s a system that works. If you want to learn more and get your health back on track, click on the button below or visit getfarmacy.com, that’s getfarmacy, with an F, F-A-R-M-A-C-Y.com.
Speaker 3:
Now back to this week’s episode.

Dr. Mark Hyman:
So Patrick, you get these calls every day. I do, for sure I know. Which is, “Hey, my brother, he’s got COVID, my mother’s got COVID. What do I do?” Yes, we can do diet lifestyle, stress reduction, sleep and take a bunch of vitamins and nutraceuticals as prevention, which is great. We should all be doing that, particularly now given that this is so widespread, but what happens when you get it, and what do you tell people, given this amazing amount of research that you and the Institute for Functional Medicine has done looking at the data on this?

Dr. Patrick Hanaway::
So there’s the prevention piece of, hey, these are some things that I think will help you to not get it so severely, but then once you get it, once you’ve got that PCR or NAA test positive, then I say well, let’s go with what we know works. Let’s go with vitamin D, good data on that, taking five, probably 10,000 units a day to start off with. I’ve seen people use significantly higher doses as loading doses, but at least go there you go. Let’s look at taking melatonin. We know it’s anti-inflammatory effect. Let’s look at vitamin A, its effect on the mucosal immune system, and using a pulse dose of a higher dose for the first five days.

Dr. Patrick Hanaway::
Yes, it’s true that vitamin A can cause liver damage, if it’s used in access of doses for prolonged periods of time. That’s not what we’re talking about. It’s like, let’s give you a little burst of that to be able to help out with that. Then let’s look at other things in terms of vitamin C quercetin. I love quercetin and I love N-acetyl cysteine. Those are the things that are, to me, the big pieces. Now, if you started-

Dr. Mark Hyman:
By the way, I take those every day. I take all those every day.

Dr. Patrick Hanaway::
Me too. Now … For other reasons, I’ve been taking them every day, but I’m taking them every day. So then if there’s other things that start emerging, GI problems or a significant respiratory problem, then we may get into other kinds of herbs like skullcap and some of the Chinese herbs that can be very helpful in that regard. Now, if someone progresses enough that they’re going into being hospitalized, that’s a different story in terms of how aggressive to be at that point in time. We want to be able to do things that are really going to dampen down the inflammatory response.

Dr. Patrick Hanaway::
We’re not going to want to push the whole inflammatory response, because those people usually have some kind of hyper inflammation that’s going on. I’m also in the big mix and things that we’ve talked about, I’m going to be using prebiotics and even a specific probiotic to be able to help modify the gut microbiome, because the gut microbiome is related to the pulmonary microbiome. They’re connected to each other.

Dr. Mark Hyman:
So it’s really a lot of the similar things you use for prevention you use for treatment, and that’s the way it is in functional medicine. How do you prevent diabetes? You eat a healthy diet? How do you reverse diabetes? You eat a healthy diet. I think the whole idea of prevention as treatment is really a very novel idea, but it is the basis of functional medicine, which is we don’t treat the disease, we treat the system, the human and we optimize their health and systems, and as a result, disease isn’t able to land and take hold and dig roots. Now, there’s a bunch of stuff going on out there. Some of it’s researched, some of it’s anecdotal, but there’s some interesting therapies around the world that are being tried, that are a little out of the box. What have you come across in terms of things that are promising out there that we should be thinking about and researching a little bit more?

Dr. Patrick Hanaway::
We’ve talked about this in various domains in the past, and one of the things where I think one of the key impacts of the SARS-CoV-2 to virus is, is actually on mitochondrial health and well being. We see the changes in the mitochondria and the ability to produce energy being significantly impacted. Now, whether that is a direct effect from the SARS-CoV-2 virus, or it’s a side effect, or a sequela from the hyper inflammation that’s going on, we see that being affected.

Dr. Patrick Hanaway::
We see that also in so called post-COVID syndrome or working with long haulers. Now, interesting to me that when we look at places like Mount Sinai, and other that are setting up academic centers for this, they’re thinking about it as we have a vascular problem. You have a pulmonary problem, you have a GI problem, you have a cardiac problem, you have a neurologic problem, you have a psychiatric problem. I look at it, I’m saying like, well, gosh, there’s muscle problems, and there’s cardiac problems, and there’s brain problems. Gosh, those are the three places that used the most energy in the body. Maybe this is related to the mitochondria.

Dr. Patrick Hanaway::
So when you start talking about other kinds of outside the box therapies, ozone and things of that nature that are experimental. They’ve done some interesting studies in Italy early on, looking at that, but to me, they’re working on the antioxidant capacity and improving the efficiency of the mitochondria so that there’s energy production. We know that mitochondrial health and immune health are intimately related to each other. So that’s how I take off my hat and look at what are other ways to be able to think about this. I’ve also learned from you.

Dr. Patrick Hanaway::
You’re great at, hey, here’s a new therapy and this makes sense from a biological plausibility standpoint. Let’s try it and let’s start doing some … First, some case studies, and then some N of one research where I try it, and then I take it off, and then I try it again, or I try a variant. I’m able to dial in on a very personal level, is this working or not working? A case study is an interesting thing, but an N of one study where you’re actually giving a treatment, taking it away, giving another treatment, taking it away, adding it back, adding the first treatment back, that gives really powerful data to be able to understand is there something real going on here, because it moves it beyond any kind of placebo effect.

Dr. Mark Hyman:
It’s true, and there are a lot of things out there that are being tried. There’s some really interesting early, promising data on things like intravenous vitamin C, intravenous glutathione, intravenous NAD, which is a mitochondrial therapy. Inhaled glutathione and inhaled and N-acetyl cysteine, which you talked about taking orally, which we use in actually asthma and even in some countries, they’re even using inhaled steroids, like in Taiwan, where they’re using nebulized steroids and having incredible benefits. So there’s a lot of things out there that aren’t in the traditional Western model that are actually being used and looked at around the world and unfortunately, not so much here.

Dr. Mark Hyman:
Although, again, those therapies are very inexpensive, they’re very safe and they have the potential to be very effective. I think, if I were putting together a whole protocol, it would include a lot of these things and it would be depending on the severity of each patient. Now, they’re not accessible, they’re not covered by insurance, there’s a lot of issues with it, but from a pure scientific point of view, there’s a lot of ways to actually address this that are really being ignored and it just breaks my heart, even just the simple fact of telling Americans that their diet plays a role in their risk of getting COVID and dying.

Dr. Mark Hyman:
That is a huge thing that nobody can really disagree with, and the data is there and yet, it’s not even being recommended. It’s just staggering to me. You’ve got Anthony Fauci taking vitamin D, but why doesn’t the CDC say take vitamin D? It’s such a simple, simple thing, considering 80% of us are insufficient or deficient. So let’s say someone gets COVID, they recover and we’re seeing this phenomena in up to 87% of hospitalized patients. So it’s probably less if you’re not hospitalized, but I’ve seen this in many of my patients who are not hospitalized who get, what we’re calling post-COVID syndrome or long-haul syndrome, and it’s very reminiscent of what happened with Epstein-Barr and chronic fatigue syndrome.

Dr. Mark Hyman:
In fact, SARS, the original SARS, 40% of those who survived at three years, had chronic fatigue syndrome. That’s a staggering number. So what is the functional medicine approach to looking in dealing with this post-COVID syndrome, and what’s their recovery model? Because a lot of this is in the course, that’s from the Institute for Functional Medicine and if you’re a professional, or you’re just curious, or you want to know more, Patrick and others were really instrumental involved in this called Resistance, Resilience and Recovery: Patient Care in a Pandemic. You can go to ifm.org and learn more about it, but tell us what you learned in that process.

Dr. Patrick Hanaway::
Well, first, I want to just give a big shout out to our friends and colleagues, Dr. Robert Luby and Dr. Joel Evans, they were the principles behind putting the course together. We’ve got over 20 different practitioners who are offering their knowledge and perspective as part of that course. So, big shout out to them and to IFM for putting it together, based upon the work of all the people who were involved from early on. So, I remember you saying one time, “Functional medicine is hard to understand on the front end, but it’s easy to do once you understand it,” and I sometimes sound like a broken record, because it feels like I’m saying the same thing over and over again.

Dr. Patrick Hanaway::
Because it’s a value, and obviously there’s nuance. So here we are talking about, for instance, those IV nutrients of vitamin C and NAC and glutathione, that are all going to have an impact mitochondrially. They’re all going to have an impact on oxidative stress. It’s a similar constellation of things that may actually be used for cancer, and for cancer scavenging in terms of IV vitamin C. So it’s fascinating there, but with the post-COVID piece, I’m really focusing on mitochondrial function, and being able to mobilize and feel like that’s really where the essential aspect of it is, which, as you said, is not dissimilar from the Epstein-Barr virus work from the mid 80s with Paul Cheney, and others in terms of what do we do. How do we actually help those people who have some kind of post-viral fatigue syndrome?

Dr. Patrick Hanaway::
One of the interesting things and I’ve heard people say early on, oh, this is nothing. Half of the people who get it have hardly any symptoms at all. I’m just going to get it and let’s bounce up the herd immunity, but when you start looking at the German data that said, 67% of the people who have had symptoms, only half of whom were hospitalized, but 62 thirds of the people who had symptoms ended up having structural changes on cardiac MRI, three months out from what’s going on.

Dr. Mark Hyman:
That’s terrifying to me. That’s terrifying.

Dr. Patrick Hanaway::
There’s significant alterations and why people are saying, “Well, let’s get to the vaccine,” and I think the vaccine can be a good thing but let’s actually insure, let’s know what’s going to happen with it. Let’s do the science to see how long antibodies last and are there any side effects. There’s a difference between a study that looks at efficacy, which is the gold standard, versus effectiveness, how does it really work in the real world. So these 91 and 94% rates of benefit, we don’t really know what’s going to happen in the real world, but those numbers were much better than anyone expected.

Dr. Patrick Hanaway::
That being said, those mRNA vaccines have never ever been used before. In human beings. We don’t know what’s going to happen. We see a good initial effect. That’s great. We saw a good initial effect when we start … If we give someone steroids, but we don’t want to give them that in the long term. The medicines are beneficial. One thing I want to highlight is that what you and I are talking about is not either or. It’s both, and. So when we’re working with someone who’s severely ill with COVID, or who’s got post-COVID syndrome, we want to be able to take the best tools that are available, but we want to be able to highlight those things that are going to really add emphasis.

Dr. Patrick Hanaway::
Where I’m going with the patients that I’m seeing at this point in time with post-COVID syndrome, and I’ve got a number of them now, is really focusing on immune activation using mushrooms, using those kinds of things to help support their immune system to reactivate it, as well as mitochondrial support and whether that’s NAD, various vitamins, N-acetyl cysteine, CoQ10. There’s a whole array of different components that get built into that. Phosphatidylserine and others. So I use products that are really focusing on that. PQQ, as well as CoQ10 and COQ2.

Dr. Patrick Hanaway::
All of these things … We talk about CoQ10 and maybe I’m getting too wonky about it, but I heard about CoQ10 for a long time and all of a sudden I was like, oh, this actually is the thing that carries the electron in the mitochondrial membrane that helps you to be able to create a waterfall, a waterfall, so you can make ATP. It’s like, of course, if it’s deficient, you’re going to have a problem and don’t you want to optimize, make sure you got enough of that. It’s just an example that when you look at it, it makes so much sense. Why aren’t we doing this as standard of care? You asked that as the question early on and I think that there’s just so much that we don’t know, and the aspect of how powerful nutritional interventions are, has been downplayed during the time that we’ve been in our medical training.

Dr. Patrick Hanaway::
In fact, they’re unbelievably powerful. So, we come back to the dietary aspects, really ensure that there’s not high glycemic foods, no processed foods, and focusing on good fats and good pure amino acids, clean amino acids, or proteins that people are taking. Doing that and then focusing on the immune system and the mitochondria. That’s where I go.

Dr. Mark Hyman:
I do believe that it’s going to be a combination of lifestyle, foundational lifestyle therapies, diet, exercise, sleep, relaxation, stress reduction, and then all the same nutraceuticals that you do to prevent and treat it. Then for people that get stuck, I think there are adjunctive therapies like intravenous therapies of IV NAD, IV vitamin C, IV glutathione, phosphatidylcholine and even things like ozone can be extremely effective intravenously. There’s also peptides and exosomes and a whole category of things that are used to help people break the cycle and I’ve seen these therapies work in a number of patients.

Dr. Mark Hyman:
So I’m hopeful. I think there needs to be more research on this, we need to move forward. The challenges that I don’t think that many people are funding any research on this, because it’s not like at the end there’s a product or a drug or a vaccine, that’s going to make billions of dollars. So we’re kind of stuck, but I do believe that these therapies are out there now, that they’re available, that there’s enough evidence to create a rationale for their use, and that they’re safe and potentially very effective.

Dr. Patrick Hanaway::
One other thing I wanted to add, I agree with you 100%. We also find that these people who are having, let’s say the post-COVID syndrome, they have other underlying issues that are going on. They have other underlying triggers, and it may be related to heavy metal toxins, or [organotoxins 00:38:47] or mycotoxins or hidden infections, or antigens, or celiac disease or some other process that’s going on that has to be taken care of and looked at also. It’s not like you’re just going to treat the post COVID separate from everything else that’s going on in their body.

Dr. Patrick Hanaway::
So we’ve got to dig into what is the root source, and the way I think about it is, I talk about those roots of the tree, which are the intrinsic aspects of our lifestyle, but then there’s the soil. It’s the exposome. If you’re exposing the roots of the tree to poor soil, you’re not going to be able to get healthy, and that’s where we want to bring our focus. So let’s not forget the environmental side of it as well.

Dr. Mark Hyman:
Absolutely. What you’re bringing up Patrick is really important, is that the body is a system and there are a lot of things that perturb or disturb the function of that system, and functional medicine is about finding out what those things are that disturb function, what are those things that optimize and enhance function, and getting rid of the things that are making your machinery gummed up and providing the things that help you run optimally, and I think that’s a very unique model. It’s not something that we learned in medical school, but it is really the foundation of functional medicine, and it’s super powerful for all sorts of things and I believe that this is where functional medicine will shine as we start to see millions of people with post-COVID syndrome.

Dr. Mark Hyman:
If you’re talking about 67% of patients who have consequences, and we’ve got, let’s say, 11 million people now in America, you’re talking about seven plus million people with some complication that makes them have a lower quality of life and some disability. It’s terrifying to me as a physician, on the front line, seeing how difficult these patients can be and the need to really come up with a plan. So I’m just really in awe of the work you and IFM has done to put together a strategy for clinicians and hopefully, that’ll lead to more information for patients about how to prevent, treat and recover from COVID-19.

Dr. Mark Hyman:
So thank you for all that work, I really appreciate it and so does millions of others. I now want to shift gears a little bit and take you down a little personal journey of health. Both of us have learned so much by our own health struggles, unfortunately, or fortunately and it has led us to discoveries that we probably wish we didn’t make, but ended up actually being for the better. There’s always a silver lining, or you can’t always understand the evolution of your soul’s journey and why you end up getting the challenges you do. But a couple years ago, you were diagnosed with stage four laryngeal cancer, which is a big deal.

Dr. Mark Hyman:
It’s a serious cancer and the treatments are rough. It forced you to look at how to address this for yourself, not only in terms of medical treatments, but in terms of your lifestyle and many other things. So can you just share a little bit about how you applied your knowledge of functional medicine to your journey and how it’s unfolded for you, and you recently presented an incredible lecture at the annual conference of the Institute for Functional Medicine where you went through the science around what you did, which led to an incredible recovery, and actually looking at you and knowing you for many years, you’re healthier now than I’ve ever seen you in my entire experience of you as a friend. So I’m just blown away by what you’ve learned and what you’ve discovered about this journey about how to deal with cancer and how it can apply to many other people with cancer.

Dr. Patrick Hanaway::
I’m just going to rest in that one for a minute, because it’s the personal journey, and I’ve watched you, and for as long as I’ve known you, I’ve heard the stories of being poisoned, and what you had to do to move through it and I was always kind of like, man, I’m glad I don’t have to learn things the way Mark does.

Dr. Mark Hyman:
Be careful what you say.

Dr. Patrick Hanaway::
Yeah, exactly. So, it’s interesting. I was reflecting on it this morning. Two years ago, tomorrow, I had the biopsy. Two years ago, Friday, I had the results. They give you that. I’ve said, I don’t … I think if they had said I had stage three, I would have said, “I can deal with this. I got this,” and like stage four, you start looking at it and it’s like, I didn’t have the risk factors. I kind of fit outside the box. So while head and neck cancers are not prominent, of the kind that I had with no risk factors, it’s like, oh, you’re in the 2% that’s of the highest risk of this. I’m still working-

Dr. Mark Hyman:
What does stage four mean? What does stage four mean?

Dr. Patrick Hanaway::
[crosstalk 00:43:42] stage four, it means [non-laser 00:43:47] cancer. So there’s a growth and I got to see it on my … The side of my vocal cord right there, but there were also lymph nodes and that’s what I felt Initially. I felt a lymph node a couple days before, and it was hard, and I’m like, oh, that’s not good. It’s not tender and I thought, oh, maybe I’m coming down with a cold, but the next day, it was still there and unchanged. So I went in and was seen right away. So I had lymph nodes that were positive. One of them, the one I felt was pretty bad, greater than three centimeters. There were actually a few small lymph nodes on this side that they picked up on the PET scan.

Dr. Patrick Hanaway::
So it’s spread metastasis. So what that means is, well, there is a tumor, and then there’s spread and generally when there’s spread beyond the original tumor, that’s kind of in a generalized term, that’s going to be a stage four cancer because the horse is-

Dr. Mark Hyman:
Much harder to deal with.

Dr. Patrick Hanaway::
Yeah, the horse is out of the barn. Can’t just cut it out. So I got that. You mentioned that I’ve been working with the Wixàrika people, the Huichol people and the Sierra Madres for the past 20 years and have been initiated. I’m right now preparing to go back down, to go to some sacred sites and be able to make my offerings and say prayers, the power of that, but I was planning to go down. The doctor said, “Well, look, you’re going right away. It’s not going to change our timing of when we would give you chemo and radiation therapy, so go for it.” So that was part of the process, and for me, that was a huge part of the learning, of being able to begin to receive help from other people.

Dr. Patrick Hanaway::
I’m like a bowl. I’ll just … Put it on my back, and I’ll carry it. I can do this, but now this was okay, I’m not helping anybody, I’m receiving help from people and it was a huge lesson for me. Then lessons also about bringing my voice forward, about this part of myself, that is the tender vulnerable aspect that within medical science, it’s like, I’m going to show my armor and how strong I am. I’m never going to show that I’m weak but here, I needed to be able to reveal this aspect to myself and to others and that was a important part of the journey.

Dr. Patrick Hanaway::
So when we talk about the functional medicine model, and we talk about looking at antecedents, triggers, and mediators, I’m like, I don’t really have any major antecedents, any genetics, any of the major risk factors that are going on, but there were triggers. There was a lot of stress in my life, and a lot of trying to carry things all myself and not bringing my voice fourth. Even though I was doing good things, it wasn’t the whole expression of who I am. Few people know all these aspects of me, and like they say, your friends are the people who know you for who you truly are, and like you anyways.

Dr. Patrick Hanaway::
It’s like, oh, I can actually reveal myself. So that’s a huge trigger, for example of imbalance. What is cancer? Cancer is growth out of control, and it’s also the invitation for transformation. It’s like, if you get that and you say, “Wow, I’m doing things that are so unbalanced. How do I actually transform to what’s going on?” So that was the seed of the change, of beginning to like, oh, I can live my life in a different way. In fact, if I want to live, I have to live my life in a different way and I don’t really have a choice.

Dr. Patrick Hanaway::
Now, within that, there’s also … And I have no idea and I can have no expectation that doing any given thing means I’ll be healthy and fine. So dealing with that degree of uncertainty. So I did my thing. I talked to doctors at Stanford and MD Anderson and Cleveland Clinic and Mount Sinai and Hopkins and in Israel, and mayo and one other, I can’t … UCLA, and they were all saying the same thing. So I got to, okay, I need to actually do chemotherapy and radiation therapy. That’s going to be important, but what are other things that I can do?

Dr. Patrick Hanaway::
I began to take my knowledge of nutrition and talk to the top people. Now, I would say that the people I talked to said, ketogenic diet, this is what you need to do and this is a great thing. I have already prescribed that for patients, I’ve done it myself, felt comfortable with it. Well, doing that, while getting tubed feed because I may not be able to swallow because of the radiation therapy, that’s a different thing of trying to get a high fat diet in through a tube, in through a feeding tube.

Dr. Patrick Hanaway::
So we, I say we, because my wife, Lisa was right there beside me, like how do we figure this out? Now, it turns out that a ketogenic diet is not the answer for every kind of cancer, but it’s really good for cancers where you’re doing radiation therapy, because it makes the cancers much more radio sensitive, because you’re pulling all of the sugar out. So you have this differential stress response. So I’m like, that makes perfect sense, and so we did that. I did that with vim and vigor. As it turned out, I only lost like three pounds through the whole thing and didn’t have to use the feeding tube very much at all.

Dr. Patrick Hanaway::
I used it because you just can’t taste any food when you’re getting radiation and food just … There’s no taste and you just like taking food to get the nutrients. I did that but also did another thing which was working with fasting before chemo and the work of Dr. Valter Longo. So we see all of the fasting mimicking diet stuff that’s coming out now, but that’s actually all derived from their original work in the early 2000s, up to 2009, of working with cancer patients and saying, if we stop giving food before chemotherapy and the chemotherapy, then that’s going to slow down the metabolism of the normal cells, but the cancer cells aren’t going to be able to slow down their metabolism.

Dr. Patrick Hanaway::
So the cancer will be more sensitive and the normal tissue will be less sensitive. So we get better tumorigenic effects or tumor lysis effects, and we have decreased side effects from it. So I went through that, and people were saying, “Really? You’re getting chemo every week, and you have a feeding tube, and you’re eating keto, and you’re not eating any food for two of those seven days, and you think that’s going to be okay?” Like, I don’t know, but I’m going to try.

Dr. Mark Hyman:
Turns out it’s very okay.

Dr. Patrick Hanaway::
Well, as I went through the whole thing, through the radiation therapy, people were like, “You’re Irish. You should be having major burns from the radiation. Why is that not happening? Why are you still eating? Why are you not losing weight?” They’d look at me, and I share with them ad they’d say, “Probably not.”

Dr. Mark Hyman:
Don’t confuse me with the facts. My mind’s made up.

Dr. Patrick Hanaway::
So anyways, the essence of functional medicine is being able to say, let’s look at what’s going on here, let’s see what the triggers are, let’s see how I can work to modify lifestyle, to slow down, to take time in nature, which has this great effect that also is going to actually be a anti-cancer effect. We can see that the forest bathing increases the immune system and decreases the risk of cancer. That’s data that’s actually published in Japan in 2009.

Dr. Patrick Hanaway::
So that’s already known there. So spending time listening, working with the lifestyle aspects to be able to do that, and working with the nutrition and working with the medicine that was there, the radiation and chemo. So bringing all those together and focusing on the person, the mental, emotional and spiritual aspects that are inside the middle of it, that’s what functional medicine is. So, you’ve heard me talk, and I’ve heard you talk about Tibetan Medicine and that is an aspect of each of these other systems of healing, takes the whole person into account, and they’re looking at what are the therapeutic approaches, from illness to wellness across the whole continuum.

Dr. Patrick Hanaway::
The mindset, the approach is similar, not the specifics are going to be different but the mindset is going to be similar. So, I took those nutritional pieces, and went through, it was seven weeks of radiation every day and chemotherapy every week, and PET scan was negative at three months and at 12 months, and the next one will be in a couple weeks. I get scoped every couple months. Just two days ago, they looked down, no lymph nodes, nothing going on and I feel great. I have to continue to work with it and also a shout out to our mutual friend who you introduced me to, Nalini Chilkov, who has been helping me along the way as a guide to be able to remember.

Dr. Patrick Hanaway::
Not only remembering the aspect of the nutrients, and how to be able to optimize the terrain, optimize me, but also to help me with my heart in the process, because after cancer, this is a hard one to say, but after cancer, it’s like, okay, what is my life? Where am I going and then what happened in the experience with working with IFM, and being called to jump into helping with COVID is I did what I’ve done before, and I just put everything into it. And it was great and helpful, but all of a sudden, it’s like, oh, I’m on a balance again. I’m not actually caring for myself.

Dr. Patrick Hanaway::
So how do I live the life … My life, in this world in balance, and those are lessons that I’ll be continuing to learn, but I feel like Being able to begin to talk about it out loud, and to be able to share the importance of having balance in life, and being able to connect to myself and to each other and to the natural world in a way that is bringing balance, and that’s part of what COVID is teaching us as well. So I tie these two things together, because they’re really both messengers of uncertainty. You think you have certainty in the world, and you don’t.

Dr. Patrick Hanaway::
You never have, and if you think that you’re supposed to be certain about what’s going on, how anxiety provoking is that? I got to know everything about everything? Ain’t going to happen. So how do I rest into the mystery? There are guides and spirits all on the way who will befriend us. That’s the conversation I’m interested in, and being able to explore that, which also fits within this big picture that we call functional medicine, and feel blessed. Because to me, it’s like the modern day manifestation of Tibetan Medicine, of bringing all these elements together to make sense of it.

Dr. Mark Hyman:
It’s so true. Reminds me of the great spiritual teacher, John Lennon, who said life is what happens when you’re making other plans. I think that happens to all of us, and it’s really rare for someone to stop and take stock and look at their life and go, “Wait a minute, I need to change everything.” I’ve seen people have quadruple bypass, get their chest cut open, be in the ICU for a month with infections, and then go back to eating the worst diet in the planet, and not think anything of it. So it takes a very special kind of human to go, “Wait a minute, my life’s out of balance. I need to focus on how do I recreate balance. How do I take advantage of the science of how to be healthy,” which you did.

Dr. Patrick Hanaway::
And you.

Dr. Mark Hyman:
Yeah, me too. I’ve had to do that and I continue to do that. It’s a constant journey. I think it’s a lesson for all of us with COVID that we need to stop and take stock and see what matters and what we care about and what’s meaningful, and let go of the things that aren’t. We live in such a consumptive-driven, fast-paced culture that just stopping and being is really hard for a lot of us and I’m really looking forward to the next little bit where I’m going to be dropping down into that.

Dr. Mark Hyman:
I’ve been listening to an audiobook called Becoming Nobody and it’s really about just being and some of the things you’re talking about is right sizing your relationship to your life in a way that you can still be engaged and productive but also you don’t lose yourself and you become nobody, which is really meaning you become your higher self, not your lower self, which is what we’re all so often operating from and it really … I think I really saw how it shook you up and transformed you and you were very humble and how you begin to ask questions about what’s out there and what could help and I think the spiritual lessons that were in it for you were profound, and also the biology that you uncovered, that you revealed in the lecture you gave at the Institute for Functional Medicine, around ketogenic diets and cancer, both in terms of improving … Just going through the chemoradiation experience, but also improving outcomes and reducing recurrences and an increasing survival from cancer.

Dr. Mark Hyman:
So I think we’re on the verge of an incredible era in medicine. I think functional medicine has been at this for a while, starting to get recognition and you’ve been such a central piece of that, Patrick, and I’m just really honored to know you, call you my friend, my colleague and to have your wisdom that is really informing this overall movement, and then I just really thank you so much for what you’ve done and what you continue to do and for being on The Doctor’s Farmacy podcast.

Dr. Patrick Hanaway::
Well, Mark, I know that our friendship, and as you know, we’ve had ups and downs. We’ve fought against each other, we have different opinions and we’ve stayed in the conversation to be able to learn from each other, to not assume that I know more, or, and to be able to find our own voice in our own ways of being able to bring this medicine forward. Because ultimately, that’s what I’m interested in, and I know that’s what you’re interested in and to watch the arc of how you’ve done that is beautiful. To be able to see and bringing new ideas forward and championing that in ways that I feel like I could never do that, but it’s like, that’s not my job. That’s Mark’s job. He’s doing that, and I’m doing something different.

Dr. Patrick Hanaway::
Us, each being able to find what are the gifts that we bring forth and continue to deepen in what that is because it’s not like okay, got there. Greg Plotnikoff, a friend of both of ours, said that when you turn 60, that’s when you begin to actually … Everything else has been a dress rehearsal. Now, what are you going to do to bring it in the world to really manifest the essence of who you are, and how you do that. These birthdays for us are our pivot points, that help to demonstrate, wow, I actually have something to give and I want to be able to give an offer that, in a way, that it can be received, and it doesn’t have to do with me.

Dr. Patrick Hanaway::
It’s like, I’m receiving all kinds of support along the way and my job is to be able to find a way to share that in a way that is of benefit to people, and hat’s a great opportunity. Like how blessed am I, and are we to be able to have the opportunity to be able to do that and share that with other people.

Dr. Mark Hyman:
So true. Thank you, Patrick. Such a beautiful closing thought. If you’ve liked this podcast, I encourage you to share with your friends and family, people with COVID are who are at risk, which is pretty much all of us. Please share with them. If you know someone with cancer or who is at risk for cancer, they need to listen to this. If you’ve struggled yourself with COVID or cancer and have insights about how to help, share your ideas and leave a comment. We’d love to hear from you and subscribe wherever you get your podcasts and we’ll see you next time, on The Doctor’s Farmacy.

This content was originally published here.

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