Young Forever: The Secrets to Living Your Longest, Healthiest Life (The Dr. Mark Hyman Library Book 11)

by Mark Hyman

CORE SYSTEM 2: IMMUNE AND INFLAMMATORY OPTIMIZATION

1. Eat an anti-inflammatory elimination diet. The most powerful way to dramatically lower inflammation is to eliminate the most common inflammatory foods. I have written extensively about this and designed a clinically effective short-term diet to address inflammation. It is laid out in my book The Blood Sugar Solution 10-Day Detox Diet and eliminates sugar, starch, processed foods, gluten, dairy, grains, beans, coffee, and alcohol. In ten days, you can see remarkable results. We have seen an average 70 percent reduction in symptoms in all diseases in just ten days. Ideally the diet is continued for three months, or indefinitely if you find it works to relieve your symptoms and diseases.

3. Treat infections. Most of us live with a host of viruses, bacteria, and parasites that our immune system manages. The balance can tip when our immune systems are suppressed. Think of a cold sore from a herpesvirus. The virus is latent but manifests under stress. The most common cause of chronic inflammation is either diagnosed or undiagnosed tick-borne infections such as Lyme disease. These may need to be treated with prescription and/or herbal antimicrobials. However, other therapies such as ozone, hyperbaric oxygen, and hyperthermia (see later in this list) are often as or more effective in treating resistant infections than traditional antimicrobial therapy. 4. Treat mold toxicity. Undiagnosed mold exposure and toxicity are extremely common and treatable with the help of a functional medicine doctor experienced in mold toxicity. 5. Use senolytics. Zombie cells produce an inflammatory cascade that hastens disease and aging. Plant compounds such as quercetin, fisetin, curcumin, and newer drugs in development target and kill the zombie cells. 6. Try peptides. Peptides can also support immune function; they help address infections as well as support many aspects of healthy aging (see Chapter 11). 7. Ozone therapy is one of the most powerful germicidal and anti-inflammatory therapies available (see Chapter 16). It can be helpful in treating chronic infections, autoimmune disease, and inflammaging.1 8. Hyperbaric oxygen therapy (HBOT) is another effective strategy for help...

1. Follow the Young Forever Longevity Diet (see Chapter 14), which is low in starch and sugar and high in good fats and phytochemicals. 2. Eliminate or reduce environmental toxins (see “Core System 4: Detoxification Optimization” later in this chapter). 3. Practice hormesis daily (see Chapter 16). Time-restricted eating, intermittent fasting, ketogenic diets, phytohormesis foods and spices, strength and HIIT training, cold and hot therapies, hyperbaric oxygen, hypoxia practices, breath work, and ozone therapy all support mitochondria. Include as many of these practices as you can. 4. Take the Young Forever Supplements (see Chapter 15). 5. Consider additional mitochondria therapy, depending on your health status and testing (with a functional medicine doctor): coenzyme Q10 or PQQ, alpha-lipoic acid, and acetyl-L-carnitine. See Advanced Longevity Support Supplements (here in Chapter 15). 6. Also consider NMN, pterostilbene, and urolithin A (Mitopure) (see Chapter 15). 7. Use red-light therapy (see Chapter 10) to boost energy production in the mitochondria. 8. Consider peptide therapy, such as SS 31, humanin, and MOTs-C. Peptides are little proteins that modulate most aspects of our biology, including our mitochondria. They are now available mostly as subcutaneous injections (see Chapter 11). 9. Consider calorie-restriction-mimicking therapies such as rapamycin and metformin (I do not routinely prescribe these and think we need more data on humans before we recommend their us...

1. Reduce toxic exposures. Do your best to eat organic food or regeneratively raised food. Use the Environmental Working Group’s Dirty Dozen and Clean Fifteen as a guide to which fruits and vegetables are the most or least contaminated (ewg.org). Filter your water, ideally with a reverse osmosis filter, and get an air filter for your home. The ones I recommend can be found at drhyman.com/filter. Eliminate high-mercury fish. Use the Environmental Working Group’s Consumer Guide to Seafood. Eliminate toxic household cleaning products and personal care products. Use the Environmental Working Group’s guides (ewg.org). 2. Enhance your body’s detoxification systems. Drink 8 to 10 glasses of filtered water a day. Have one to two bowel movements a day. If you are constipated, try magnesium citrate, buffered vitamin C, probiotics, and fiber such as flaxseeds and chia seeds. If you are still struggling, see a functional medicine doctor for further evaluation. Sweat daily with exercise, saunas, steam, or hot baths. 3. Upregulate your detoxification pathways. Consume detoxifying foods daily, including 1 to 2 cups of cruciferous vegetables, garlic, onions, artichokes, watercress, beets, avocados, lemons, green tea, ginger, rosemary, and turmeric (see Chapter 7 for more on food and detoxification). Take supplements that support detoxification. The liver has many pathways for detoxification that require vitamins, minerals, and amino acids. The B vitamins, especially folate, B12, and B6; s...

CORE SYSTEM 5: OPTIMIZING COMMUNICATION, HORMONE BALANCE, AND METABOLIC HEALTH

Optimize Glucose and Insulin...

1. Consume a low-refined-carbohydrate, higher-fat, high-fiber, phytonutrient-rich diet. 2. Consider my book The Blood Sugar Solution 10-Day Detox Diet to address sugar addiction and reset your biology (see youngforeverbook.com/resources). 3. Consider a ketogenic diet if you have type 2 diabetes, until your diabetes is reversed. 4. Exercise. Build muscle and optimize your VO2 max. 5. Take the Core Supplement Plan (see Chapter 15), which includes magnesium, chromium, biotin, vitamin D, and omega-3 fats, which all support optimal glucose control. 6. Add the Advanced Longevity Support Supplements (see Chapter 15), which benefit insulin signaling, the sirtuin pathway, and AMPK to improve insulin sensitivity and glucose control. 7. Add alpha-lipoic acid, 600 mg twice a day, and berberine, 1 g a day (such as CM Core by Ortho Molecular Products). 8. Address causes of inflammation, including dysbiosis and environmental toxins. 9. Consider a prescription for metformin, 500 mg before lunch and dinner. If your blood sugar is ideal, though, metformin’s longevity benefits are as yet unproven. 10. Use a continuous glucose monitor to track your response to food. Try Levels Health to track your blood sugar and progress (levelshealth.com/hyman).

Hormone Optimization Therapy

Here are the basic rules for hormone therapy: 1. Use only bioidentical hormones (the same forms made by your body). 2. Use the lowest dose possible. 3. Use for as short a time as possible. 4. Use topically or by injection. 5. Ideally, work with a functional medicine doctor experienced in hormone therapy.

Women’s Hormone Optimization

Common hormone replacement therapies are Premarin (horse estrogen) and Provera (a synthetic progesterone). Premarin has significant side effects, including higher risk of heart attack, inflammation, stroke, and female cancers. Provera causes weight gain, facial hair, and depression. However, bioidentical hormone therapy may not have the same risks. These are human or bioidentical hormones, which are usually much better tolerated with fewer side effects and risks.

It is important to see a gynecologist for breast exams, mammograms, Pap tests, and intravaginal ultrasound before starting any therapy, as well as for a yearly assessment. If treatment is needed, these are the best options: 1. Topical bioidentical estradiol and progesterone (creams, gels, drops, patches). 2. Vaginal estradiol (creams or tablets such as Vagifem) to address vaginal dryness. 3. Low-dose testosterone for low libido, which can be added to compounded creams, gels, or drops. 4. Clitoral testosterone drops, 5mg/mL, 2 drops each night—from a compounding pharmacy. This can be very effective for low libido when taken consistently. 5. Peptide therapy. PT 141, also known as bremelanotide, is effective for enhancing libido and sexual function in both men and women.

Thyroid Hormone Replacement

This can result in increased risk of heart disease, memory loss, depression, fatigue, muscle loss, low libido, hair loss, constipation, and dry skin and hair. Gluten and environmental toxins are common causes of thyroid dysfunction. Many who are diagnosed are not adequately treated because most physicians use the inactive form of thyroid, T4 or levothyroxine, which doesn’t work for everyone. It is important to do the correct tests (see Chapter 13) because most physicians just check TSH, which will miss many cases of thyroid dysfunction. I have written an ebook, The Ultra Thyroid Solution, that explains in detail how to assess thyroid dysfunction, identify the causes, and optimally treat the thyroid. You can learn more at drhyman.com/ty-thyroid. If you need thyroid replacement, here’s what I recommend. 1. Use bioidentical thyroid replacement. 2. Use a combination of levothyroxine (T4), the inactive hormone, and liothyronine (T3), the active hormone. Dosing must be personalized and adjusted with your doctor. 3. Ideally use desiccated porcine thyroid, which contains all the compounds in the appropriate balance to support optimal thyroid function, including T4, T3, and T2. Brands include Armour Thyroid and Nature-Throid.

Adrenal Support

1. Wake and sleep at the same time daily. 2. Get exposure to morning sunlight for 20 minutes a day. 3. Eliminate blue-light exposure at night with blue-blocker glasses, and use red-light bulbs. 4. Exercise, but don’t overexercise (not usually a problem unless you run marathons). 5. Avoid sugar and starch, which cause elevated cortisol and adrenaline. 6. Practice a stress-reduction strategy daily, such as breath work, yoga, meditation, massage, or a hot bath or sauna. 7. Take the Young Forever Core Supplement Plan. Vitamin C, B vitamins, and magnesium all help adrenal function. 8. Consider herbal support, including adaptogenic mushrooms like cordyceps and reishi, and herbs like rhodiola, Siberian ginseng, ginseng, and ashwagandha. 9. Low doses of DHEA (an adrenal hormone) can improve energy and overall well-being. Women can start at 10 mg and go up to 50 mg and men can start at 25 mg and go up to 50 mg. This can have some androgenic effects—for women it can increase facial hair and for men it can cause hair loss.

CORE SYSTEM 6: TRANSPORT OPTIMIZATION

1. Eat the Young Forever Longevity Diet, which includes many foods that help improve blood vessel and lymph health. 2. Move. Any type of exercise supports the health of your circulatory system and lymphatic circulation. 3. Start a regular yoga practice. Combining deep breathing and stretching is one of the most powerful detoxifying practices and supports your lymph flow and stimulation of your intestines, liver, and kidneys. Hot yoga gives the added benefit of sweating. Also, consider a daily Wim Hof breathing practice, outlined in Chapter 16. This moves (or exercises) the diaphragm, the main muscle that brings lymph flow back into your heart. 4. Use sauna therapy or take hot baths regularly. This increases circulation and helps reset your nervous system and boosts your overall health and longevity. 5. Follow heat therapy with a cold plunge. The cold helps to boost lymph circulation.5 6. Get massage regularly if you can, especially lymphatic massage. This helps flush out muscles and supports lymph flow. 7. Try muscle-recovery devices that passively increase lymph flow using pneumatic compression of lower extremities, such as Hyperice (hyperice.com).

CORE SYSTEM 7: STRUCTURAL OPTIMIZATION

1. Engage in regular exercise, including aerobic conditioning, strength training, and flexibility. I am a huge advocate of the TB12 Sports program developed by Tom Brady to keep him active, pain-free, strong, and winning into his midforties. The program uses resistance bands and specially designed workouts and vibrating foam rollers to increase muscle pliability and to reduce injury and pain. They have an app or you can work with one of their body coaches on Zoom (tb12sports.com). The TB12 Sports band-training program is my staple for strength training. 2. Yoga is a powerful way to help the body relieve pain and decrease stress and can be done at any age. 3. Supplements can help build muscle, repair tissues and joints, and reduce inflammation. Try omega fats such as Dutch Harbor Omega with high levels of inflammation-suppressing resolvins; Zyflamend by New Chapter, an anti-inflammatory herbal mixture; collagen peptides; bone broth; and glucosamine. 4. Peptide therapy with BPC-157, thymosin beta-4 fragments, and GHK can help reduce pain and repair injured tissues and joints. See youngforeverbook.com/resources for how to purchase and use peptides. 5. Work with a physical therapist and body coach if you have chronic issues. After my last back surgery I used the TB12 Sports body coaches, who are trained in a special form of physical therapy that helps get to the root of the problems and heal chronic injuries. 6. Try Prolozone therapy if you have chronic joint pain or arthritis...

OPTIMIZING NUTRITIONAL STATUS

1. Take the Core Supplement Plan. 2. Add Homocysteine Supreme by Designs for Health if you have a high homocysteine level on your Young Forever Function Health Panel or a score of more than 50 percent on the methylation quiz.

OPTIMIZING MIND-BODY-SPIRIT HEALING

2. Try dynamic neural retraining, an online program that can help heal the chronic stress and trauma we all experience that keeps us in a state of fight, flight, or freeze. It targets brain function to regulate a maladapted stress response and teaches you how to rewire the limbic system (emotional center of the brain) and change the structure and function of your brain. This allows your body to move from a state of survival to a state of growth and repair, where true healing can take place (see Dynamic Neural Retraining System, retrainingthebrain.com). 3. Try ketamine therapy for anxiety, depression, and post-traumatic stress disorder (PTSD). Ketamine is an anesthetic drug that is now approved for treatment of resistant depression.7 The FDA approved a nasal spray called Spravato. It is a dissociative drug that allows you to see things from a different perspective. It also has direct effects on healing brain function and structure, increasing neuroplasticity. Ketamine clinics are now legal and can be found in nearly every major city. 4. Try a stellate ganglion block for anxiety, trauma, and PTSD.8 Since the 1940s, stellate ganglion blocks have been performed to treat pain conditions driven by the sympathetic or stress response in the nervous system. The procedure involves injecting local anesthetic in and around the stellate ganglion, a bundle of nerves in the sympathetic nervous system (located at the base of the neck) to temporarily block its function. Hospitals and clini...

DR. HYMAN’S LONGEVITY PROGRAM

Diet I follow the Pegan Diet, focused on high levels of phytochemicals, especially those known to support the longevity pathways and work on the hallmarks of aging. I drink my Healthy Aging Shake (here) daily within an hour of exercise to build muscle.

Exercise Four to six days of aerobic exercise with interval training, including road and mountain biking, tennis, hiking, and swimming, for an average of 30 to 60 minutes a session. Strength training using TB12 Sports resistance bands and the TB12 Sports workout app three to four times a week for 30 minutes. Hot yoga or vinyasa yoga twice a week and daily shorter yoga/stretch sessions.

Sleep 7 to 8 hours a night. I am usually asleep by 10 p.m. or 11 p.m. and wake by 6 a.m. or 7 a.m. Magnesium glycinate, 200 to 400 mg a night. Eyeshades and earplugs to create a light- and soundproof environment. Sleep and b...

Stress Management 20 minutes of mantra meditation once or twice a day. Breath work ideally daily. I prioritize spending time in nature and the wilderness; it restores my nervous system and inspires me. I spend time with friends and family in play and adventure whenever I can (and I ...

Hormesis I practice time-restricted eating with a 14- to 16-hour window three to four times a week. I include the most potent phytohormesis plant compounds in my diet on a regular basis. When I have access to saunas and cold plunges, I do them daily. At home I have a steam shower and a big bathtub I fill with ice-cold water and do a few rounds of therapy daily—10 minutes in the steam, then 3 minutes in the cold bath. I spend 30 minutes three to four times a week in my sauna when home or do hot yoga when I am on the road. I use a red-light therapy device as often as I can when I am home, for 10 minutes a day. I use blue-blocker glasses at night. I use ozone therapy weekly as a tune-up when I am home or have access to it. Even monthly is a good hormetic reset. I have used hyperbaric oxygen therapy to reset my syste...

Basic Supplement Plan Vitamin D Supreme by Designs for Health (vitamin D3, 5,000 IU a day with vitamin K2, including MK-7 form) Dutch Harbor Omega from Big Bold Health (EPA/DHA, 1 to 2 g a day) Multi t/d by Pure Encapsulations, 2 a day (multivitamin and mineral) Homocysteine Supreme by Designs for Health, 2 a day (methylation support with B6, B12, and folate because my methylation genes need extra help) Ma...

Longevity Stack NMN, 1,000 mg a day Fisetin, 500 mg a day HTB Rejuvenate by Big Bold Health with quercetin and other flavonols, 2 twice a day Pterostilbene, 100 mg once or twice a day Curcumin with Bioprene, 500 mg a day Epigallocatechin gallate, 500 mg a day from green tea OncoPLEX by Xymogen (sulforaphane from broccoli seed extrac...

Sarcopenia Support Amino Acid Complex from Thorne Research, 1 scoop a day after workout Creatine, 5 grams daily ...

ADVANCED LONGEVITY ...

Remember, I have chosen to try these knowing the potential risks and that more research is needed. Each of us has a different appetite for exploration and budget. You can choose to explore all or none of these: Peptide therapy Exosomes Stem cells Natural killer cell infusions Transfer plasma exchange (TPE), a more palatable approach to cleaning the blood than parabiosis