Speaker 1 (00:00):
Welcome to the Dr. Gundry Podcast, where Dr. Stephen Gundry shares his groundbreaking research from over 25 years of treating patients with diet and lifestyle changes alone. Dr. Gundry and other wellness experts offer inspiring stories, the latest scientific advancements, and practical tips to empower you to take control of your health and live a long, happy life.

Speaker 2 (00:24):
Gout, the disease of kings, and the curse of modern diets. Well, let’s get a little history of gout. So gout, believe it or not, has been known about for centuries. In fact, hundreds of centuries. Early reference to gout was actually made by Epocrates. In the fifth century, BC described this swelling of the big toe, and he made note that it seemed to spare eunuchs and women before menopause. References were made to gout by the ancient Egyptians around 20600 BC, when physicians actually described joint pain in the big toe. Now, in the Middle Ages and the Renaissance, gout was known as the disease of kings and the king of diseases. Why? Because it seemed to affect the wealthy who indulged in rich meals, shellfish, and plenty of wine. In other words, the original lifestyle of the rich and famous. Now, famous sufferers included King Henry the III, Isaac Newton, and even Benjamin Franklin.

(01:29):
Franklin wrote in a letter that his gout was like a cruel partner nagging him to get off the sofa. Weird fact, in 1683, Dr. Thomas Cydaham, sometimes called the English Hipocrates, wrote the first detailed clinical description of a gout attack. He himself suffered from it and described the pain in his big toe as so intense that even the weight of a bedsheet was unbeararable. Believe it or not, that’s still considered a hallmark of the gout flare. But before we jump into what gout actually is and what causes it, if you like what you’re hearing here at the Dr. Gundry Podcast, don’t forget to subscribe and most importantly, share this with your friends and loved ones and like us. Okay. So Edis core gout is a form of inflammatory arthritis. It happens when uric acid crystals build up in the joints, most famously at the base of the big toe.

(02:21):
Now, uric acid is a normal breakdown product of purines. These are compounds that make up our DNA, and they’re also present in many foods. Now, normally, our kidneys are pretty good at filtering out uric acid. But when uric acid levels get too high, either because the body manufactures too much of it or the kidneys can’t get rid of it fast enough, these tiny sharp crystals form. Now, these crystals are like tiny microscopic needles stabbing into the joint, triggering pain, swelling, redness, and heat. But before we go into that even more, once you realize why we’re affected with gout, and none of our other animal counterparts do. It turns out about 10 million years ago, great apes suffered a genetic mutation in how uric acid is denatured. Up until then, all animals have a enzyme called uricase that basically dissolves uric acid. Great Apes lost the ability to make uricase.

(03:35):
So what? It turns out that uric acid is made primarily from two sources. One, which turned out to be one of the major benefits is that uric acid is a product of detoxification of fructose in the liver into two seemingly harmless compounds, triglycerides, which you have measured on your lipid profile by your doctor, and uric acid. Now, it turns out that uric acid is very good at raising blood pressure. It’s very good at storing fat by promoting insulin resistance. And luckily, if you’ve been watching this broadcast long enough, you know that insulin resistance is something that most people in America suffer from, even though they’re unaware of it. And it’s the cause of diabetes, pre-diabetes, fatty liver, all because we inherited that mutation from Great Apes. Why was it beneficial to Great Apes? Because they could out- compete monkeys for fruit in a diminished climate change where forests were shrinking, and Great Apes could take the fructose in fruit and convert it into fat and uric acid and store fat for the winter.

(05:00):
We inherited that mutation. And for years, we thought this mutation was the thrifty gene because we had the ability to endure long periods of time with little or no food. And we thought that that ability to store fat was a thrifty gene. It wasn’t until recently that we realized that the thrifty gene was actually the mutation that allowed us to keep making uric acid and not dissolve it and allowed us to store fat for the winter that now never comes. So that’s why we have these high levels of uric acid. Now, if you watch my episode 194 with my friend, Dr. David Perlman, we discussed his bestselling book, Drop Acid, which is all about how most of us make far too much uric acid. And most of us make it, as I tell my patients, from three things. Number one, fruit and fruit juices. Number two, concentrated fruit like wine or beer.

(06:09):
Number three, animal protein purines, particularly fish and shellfish. So those are the three major contributors that I see in my patients to raising uric acid levels. Okay. So what are the classic symptoms of gout? Like I said, incredibly painful conjoint pain, usually in the big toe, but it can appear elsewhere. It can appear in the elbow. It can appear in your big finger. It often strikes in the middle of the night and people suddenly wake up in excruciating pain. It usually rapidly occurs. It kind of comes out of nowhere. Now, the problem is, even though it comes out of nowhere, the pain can last for days or even weeks, and it is one of the worst pains that a human being can experience. So even though the big two is classic, it could hit other joints. And you can actually get these uric acid crystals that build up under the skin.

(07:07):
They’re often on the ears, the elbows, and fingers. And they almost look like little chalk areas underneath the skin. Uric acid can cause kidney stones. About half of kidney stones are uric acid stones. The other are calcium oxalate stones. And so this is a failure of the kidneys to be able to handle the amount of uric acid that’s coming, and it builds up in these stones. Now, sometimes people have high levels of uric acid, hyperuricemia, without even knowing it. That’s why you should always have your uric acid levels measured in a routine panel. And quite frankly, almost no doctors are trained to look at uric acid levels. And you are better off knowing your uric acid level and getting it down than suffering the consequences. And the point of all this is the consequences of high uric acid aren’t limited to gout. That’s kind of the end.

(08:04):
It’s not limited to uric acid stones. That’s kind of the end. Where most of the time it’s trouble is in causing insulin resistance, in causing elevated insulin levels, in causing metabolic dysfunction. And the sooner you know and get a handle on your uric acid levels, the easier it is going to be to avoid all these long-term complications, thanks to that genetic mutation from great apes. So why are we seeing it so much today? Well, as I mentioned, this was in a response to no longer having uricase to break down uric acid, which means that the more fructose in our food, the more likely this process is happening to you right now. So high fructose corn syrup is in almost everything. Our fruit has been bred for sugar content and size. And lastly, we have to take a clue from ancient man and great apes. Fruit was never available year round.

(09:06):
Even in the jungle, fruit only ripens once or twice a year. We’ve now made it possible to eat fruit 365 days a year, and that genetic mutation that was so beneficial to great apes in early man has now become our Achilles heel. And so looking at why that genetic nutrition was beneficial and why it’s so mischievous, really can help you decide what you wanna moderate in your diet, whether it’s high fructose corn syrup, whether it’s amount of fruit in your diet, whether it’s the amount of wine or beer in your diet, whether it’s the amount of animal protein, particularly fish and shellfish in your diet, all of these have an impact, and you get to choose where you wanna moderate it. Now, the other good news is that there are very effective ancient prescription drug treatments to lower uric acid, but there’s also a very good natural substance to lower uric acid levels, and some of those do work.

(10:14):
Tart cherry extract does work. However, as one of my patients found out, please do not drink dart cherry juice thinking that it’s gonna lower your gout. One of my patients created gout by drinking lots of tart cherry juice. He also made himself a diabetic, all thinking he was gonna help himself, not realizing that there’s still huge amounts of fructose in cherries. So the extracts of dart cherry may in fact help you, but not the juice. There’s also another fascinating compound in India, which can lower uric acid levels, and it’s available as a supplement. Vitamin C is useful, Circetin is useful, and a very interesting flavonoid called luteolin also is very useful in lowering uric acid levels. Coffee lowers uric acid levels, and polyphenols, and pomegranates mentioned cherries and green tea show some uric acid lowering effects. So all of those are options in dealing with uric acid.

(11:20):
So if you’re now worried about the disease of kings and don’t want to follow that path, just remember why we make uric acid in the first place and why we probably don’t wanna make much uric acid anymore, and the easy steps you can take every day to lower your risk of gout.

(11:42):
Let’s talk about Hashimoto’s thyroiditis. So what the heck is Hashimoto’s? Hashimoto’s thyroiditis is an autoimmune disease, which means your own immune system attacks your thyroid gland. Now, over time, this leads to damage and inflammation causing your thyroid to function poorly, and eventually, if it continues, giving up the ghost. Now, what are the signs of Hashimoto’s? First of all, Hashimoto’s can present with swelling in the front of the neck. In fact, it may even feel tender. Your neck sometimes looks puffy or redder than usual. And many times, it’s picked up by friends or family who will go, um, “Do you have swollen glands? Are, are you sick? Did you catch a cold?” This can often be misleading, but I have a number of patients that the first time they realized something was wrong is that a friend noticed that their neck looked fuller in their dress.

(12:54):
Swallowing often feels different. Your thyroid is literally kind of attached to your vocal cord voice box, and you, if you’ve ever noticed, when you swallow your voice box, your larynx kind of moves up and down. And some people notice that their swallowing feels different, and that leads them to feel their neck. Hair thinning or falling out. Now, some people notice they don’t need to shave their legs or their en- underarms as much as they used to, or they notice that, in fact, their hair is falling out or their hair is thinning. So these are all signs of Hashimoto’s. Perhaps the most important sign that people neglect because they don’t associate it is abdominal issues, irritable bowel syndrome, abdominal pain, bloating, changing in bowel movements, either diarrhea or constipation. In fact, I’ll tell you a story from just this past week. I have a colleague who’s a dermatologist in Montecito who opened up a new office and I went over to see her new office and she had a receptionist and started talking to the receptionist and she said, “Well, you know, what do you do?

(14:18):
” And I started to tell her what I did, and 80% of what I do is treat people with autoimmune diseases like Hashimoto’s. I mentioned this, she says, “Oh my gosh, you know, I have Hashimoto’s, and it’s so terrible because I can’t get my intestines under control, and my Hashimoto’s is causing my abdominal pain and my irritable bowel.” And I said, “Well, actually, your abdominal pain and your bloating and your abdominal issues are actually the cause of your Hashimoto’s.” And she was, actually started crying, and she said, “But everybody tells me that I have to do this, this, and this to help my Hashimoto’s and no one has ever mentioned about what I should be eating.” And that’s the problem. All right, so what are the symptoms of Hashimoto’s? Well, first of all, lower energy, feeling tired all the time, changes in sleep patterns, for instance, needing naps in the afternoon that you never needed before, even if you’re young, feeling colder or hotter than normal.

(15:36):
Now, early stage Hashimoto’s can actually make you hyperthyroid at first, and then as your thyroid gland gets destroyed, you become hypothyroid. So the same way, if you’re jittery, restless, or having trouble sleeping more than normal, you could have Hashimoto’s in its early stage where you’re actually hyperthyroid. Okay, so how is Hashimoto’s related to hypothyroidism? So when the immune system attacks the thyroid, the thyroid gland can no longer produce thyroid hormones, T3 and T4 effectively. And this leads to hypothyroidism, but not all hypothyroidism is caused by Hashimoto’s. In fact, most hypothyroidism in my practice is not caused by Hashimoto’s. There’s another major cause of low thyroid, and that’s iodine deficiency. In the early 1900s in the United States, millions of people suffered from hypothyroidism because of low iodine levels. During the 1880s, many Americans moved from the coast into the Midwest, which is often called the goiter zone.

(17:09):
And they moved away from eating a lot of ocean seafood-rich diets, whether it was ocean fish, whether it was oysters, whether it was clams, whether it was shrimp, into the Midwest where there were no oceans, obviously, and there was very little iodine in the diet. In fact, it’s estimated that over 10 million people in the early 1900s died from hypothyroidism. So to fix this, the federal government mandated adding iodine to salt. In fact, the Morton Salt Company with a little girl with the umbrella was iodized salt. And once iodine was added to salt, by law, iprothyroidism and goiter plummeted in the United States. Everyone is p- switching to pink salt, sea salt, or other fancy salts that sadly do not have iodine. So please, please, please use iodized sea salt. Recently, believe it or not, a pink salt has been introduced with iodine added. And it’s amazing how many people who we find with hypothyroidism that just adding iodized sea salt into their diet solves the problem.

(18:38):
The other thing I see is that people who have been told to eat a low salt diet because of congestive heart failure or other issues or high blood pressure, avoid salt, and they’re not getting any iodine. The easy way is there are a number of iodine supplements, m- a lot of them come from seaweed or algae. They’re cheap and you can get your iodine that way. Now, let’s talk about the real cause of Hashimoto’s. Hashimoto’s is caused by a leaky gut. In fact, I have not seen an autoimmune disease that isn’t caused by leaky gut. Now, before widespread leaky gut or intestinal permeability became an issue, it was incredibly rare to have Hashimoto’s. In fact, when I was in medical school back in the dark ages, we knew about it, but it was so rare that most of the time we didn’t even test for it.

(19:43):
Now, it’s everywhere. In fact, there’s some estimates that maybe 60 million Americans, particularly women, have Hashimoto’s that they don’t even realize they have. Now, why is that? First of all, every one of my patients with an autoimmune disease tests positive for leaky gut. And more and more, we’re recognizing that autoimmune diseases are caused by molecular mimicry, and that is many of the compounds that leak through the wall of our gut look very similar to proteins in our thyroid or our joints or our skin, and our immune system gets stimulated to find these odd proteins and kill them. So if your immune system is stimulated looking for these proteins, it comes upon your thyroid and it goes, “Oh my gosh, there are proteins in this poor woman’s thyroid that look a lot like what I’m supposed to be looking for. They’re not quite the same, but we’re at war and there’s a problem and I’m gonna shoot to kill and I’ll ask questions later.” So it’s the molecular mimicry theory of autoimmune disease that is rapidly being proven over and over again, and that’s certainly what I see in my patients.

(21:19):
So what do regular doctors do if they check your thyroid? They check for TSH, which stands for thyroid stimulating hormone. They also check for T3 levels and T4 levels. And if those look normal, they stop there, but quite frankly, that isn’t enough. So what do I check? First of all, I do a leaky gut test. A hundred percent of my patients with Ashimoto’s have leaky gut. The other thing I do is I check for free T3 and free T4. These are the actual active hormones that do the work. And then I check for antithyroid antibodies, which show up if the immune system is attacking the thyroid. And the two most common tests are the TPO test, thyroid peroxidase antibodies, and the antithyroglobulin test. These are the key markers of Hashimoto’s. Many people bring me their normal thyroid test results, but they’re convinced that something’s wrong.

(22:32):
I run my test instead, and suddenly there it is. There’s the real problem. So as you know, the root cause of leaky gut is food, which explains why certain foods trigger Hashimoto’s flare-ups. Take one of my patients, a, uh, Hollywood health fanatic. He was in great shape, but suddenly started feeling exhausted, had low energy, and despite being married to a young, sexy wife, his libido dropped. What did I find? Leaky gut. It turns out he was eating a healthy plant-based protein bar and shake every day, but they contained pea protein and the new in thing, Himalayan sprouted buckwheat, both of which are huge lectin-containing foods. We removed them from his diet, and within one month, he felt like himself again. But food isn’t the only trigger. Viruses can also cause leaky gut. Many viruses are notorious for damaging the gut lining, leading to leaky gut and autoimmune flareups.

(23:56):
A patient of mine recently who caught COVID twice, each time her antithyroid antibodies spiked and her leaky gut returned. In fact, 25 to 30% of people with COVID actually reported GI symptoms, not respiratory symptoms, which tells you what, COVID damages the gut. So what can you do about it? Fix your leaky gut. If you’re struggling with thyroid issues, don’t just look at your thyroid. Look at your gut. Make sure your doctor is running the right test. And if you’re using pink salt, you’d better be getting iodine from somewhere else.

(24:45):
This is a must watch for anyone with high blood pressure. All right, number one. The first thing to do is lose weight. Believe it or not, even five to 10 pounds will make a tremendous difference on your blood pressure. I can see it over and over and over again in my clinics. And again, I see patients every three months in my offices, and we see dramatic reductions in high blood pressure, just with a three to 10 pound weight loss. One pound a week is what you’re aiming for. So five pounds is only gonna take you five weeks. 10 pounds is gonna take you a little over two months to accomplish that, and that’s the right speed. And as weight comes off, your blood pressure dramatically comes down. Now, how do you do that? Well, again, I find the easiest way to lose weight, that you don’t have to make any other change is to shorten your eating window.

(25:58):
By that, I mean, reduce … Lengthen the time you start eating in the day your break fast, and shrink the time you stop eating at night. That’s gonna have really two effects. First of all, we know from human studies that collapsing our eating window to about six to eight hours a day has dramatic effects on weight loss regardless of the calories you eat during that time. And that’s the famous Italian cyclist study. There’s also excellent studies that, uh, have been done at the NIH in rats, looking at that exact same factor. And compressing eating windows actually allows you to get away with murder in terms of the foods you’re eating, and you’ll still lose weight. The second thing that’s really important is stop eating at least three hours before you go to bed. Resist all the YouTube videos that the most important thing you need to do to get a good night’s sleep is to have some protein and slow digesting carbohydrates to fuel your brain through the night.

(27:24):
Nothing could be further from the truth. That’s the exact opposite of what research shows. If you want to hurt your brain, please have a snack late at night to power your brain. You will actually hurt your brain because your brain does not go through a wash cycle that’s critical to clean the debris out of your brain, and you need to be fasting at least three hours to have that accomplished. So a lot of times, when you wake up hungry, it’s actually because you didn’t get the proper amount of brainwash during the night. And when you wake up hungry, guess what? You’re gonna eat and you’re gonna overeat. So it’s a great trip. Number two, drop your alcohol consumption. Studies have shown conclusively, ladies more than six ounces of wine, or one and a half ounces of liquor, or one beer, anything above that per day will raise your blood pressure.

(28:39):
I’m sorry, it will. Men, more than two six ounces of glasses of wine, more than two beers or more than two shots of alcohol will raise your blood pressure. So number one, think about having wet months rather than dry months. What do I mean by that? Have a damp month where you don’t drink from Monday through Thursday, enjoy alcohol Friday and Saturday, and then abstain starting again on Sunday. Rather than dry months, which are difficult to achieve, do damp months instead. Don’t go wet. That’s a great trick. And I’ve seen in patient logs, dramatic reductions in their blood pressure when they try this. If you don’t wanna do that, cut your daily alcohol consumption in half and watch what happens. It’s sad but true. Alcohol increases your blood pressure. Number three, this may sound obvious, but it bears repeating. You gotta avoid fried and processed foods due to the fact The fact that most of them contain killer oils that all raise your blood pressure.

(30:06):
These seed oils, for the most part, contain a omega-6 fat that’s called linoleic acid. It’s a short chain omega-6 fat. Now, don’t get me wrong. Linoleic acid is an essential fatty acid. We don’t make it. So we have to consume some. But almost all seed oils like corn oil, like safflower oil, like cotton seed oil, you name the seed for the most part, contains huge amounts of linoleic acid. Linoleic acid, particularly when heated, is converted into compounds that are called aldehydes. And I’ve written and talked about how aldehydes are some of the most damaging compounds for your mitochondrial function. Moreover, many people have heard of one of the aldehydes formaldehyde. And guess what? We preserve bodies in formaldehyde. How do we preserve them? They actually stop everything from functioning in the body. So the next time you think that you’re going to have a even healthy cracker, look at the label and look at the oils.

(31:31):
Now, are there actually safe oils to use that can lower your blood pressure? We’ll use that next. Now, when I say processed foods, just remember, if something that looks like it’s really healthy, let’s use a wild example like wheat thins. Hey, I gotta have a cracker to have my cheese on. Wheat things. Oh, wow. Whole wheat. That looks great. Check out the back of the label. And you’ll see that one of these seed oils is way up on the list of ingredients. So even though it wasn’t deep fat fried, it was processed with oils. It was baked in these oils and it was heated. And there’s a lot of other reasons to avoid wheat thins, but watch the oil. That’s one of your key ingredients to look for. So number four, there are oils that are from seeds that actually lower your blood pressure. And they work by blocking lipopolysaccharides, LPSs, from causing mischief with your blood pressure.

(32:41):
First of all, is sesame oil. Now, most people are used to toasted sesame oil, but plain untested sesame oil studies show the human volunteers taking two tablespoons of sesame oil, people who had high blood pressure dramatically lowered their blood pressure. And when they stopped doing that, their blood pressure went right back up. Perilla oil. As many of you know, perilla oil is probably my favorite oil. Perilla oil is mostly a short chain omega-3 fat called alpha linolenic acid, ALA, and alfalinolinic acid dramatically reduces LPS activation. Same with flaxseed oil. Flaxseed oil is also mostly alpha-linolenic acid, ALA. The problem with flax-seed oil is it tends to go rancid quickly and you have to refrigerate it. Perilla oil, on the other hand, does not require refrigeration because it has two great compounds that keep that oil from going rancid. Sardines. Sardines have tons of long chain omega-3 fats like DHA that also block LPSs.

(34:08):
So all of these, and some of them are seed oils, lower blood pressure. Number five, saunas. Now, how do saunas help? Saunas actually activate heat shock proteins. And heat shock proteins actually make mitochondria uncouple and repair themselves, and they actually help you lose weight. So dry sauna, wet sauna, however you want to sauna, do it. We can now also buy sauna wraps that will make you sweat without buying an expensive sauna or going to a gym where there’s a sauna. And it’s something to really look into. On the other hand, come visit me in Palm Springs in the summer, and we can spend some time in the sauna outside. And believe it or not, there’s a reason why desert rats, as we call ourselves, have significant longevity. And there’s a reason why older folks tend to head to desert communities or hot communities when they retire to get the benefits of heat in promoting their health.

(35:27):
Number six, green coffee extract or coffee. Now, coffee contains several great polyphenols, one of which is chlorogenic acid. Interestingly enough, dark roasting actually gets rid of most of the chlorogenic acid that you’re looking for in coffee. Green coffee beans, on the other hand, have lots of chlorogenic acid. So green coffee extract gives you chlorogenic acid, but you don’t have to go buy that. When you’re buying coffee, look for light roast or medium roast. Don’t buy the dark roast. Don’t buy the French roast. That will negate the benefit of drinking coffee. Secondly, I’ll say this again, please, please, please do not put milk or other protein containing products in your coffee. It will bind with the polyphenols like chlorogenic acid and inactivate them so you won’t get the benefit. So have some coffee, have some tea. It will help reduce your blood pressure, but remember, light or medium roast only.

(36:46):
And good news, instant coffee or decaffeinated coffee still has plenty of fluorogenic acid. So you’ll actually get the benefits that you’re looking for, even if it’s not so tasty.

Speaker 1 (37:01):
I hope you enjoyed this episode of the Dr. Gundry Podcast. If you did, please share this with family and friends. You never know how one of these health tips can completely transform someone’s life when you take the time to share it with them. There’s also the Dr. Gundry Podcast YouTube channel, where we have tens of thousands of free health insights that can help you and your loved ones live a long, vital life. Let’s do this together.