Interview with Dr. Mark Hyman, Functional Medicine Physician: The 5 Health Markers Every Woman Should Know

Why should we care about our bloodwork before we feel sick?

Because feeling fine and understanding our health are not necessarily the same thing. We can go through our days, get an annual checkup, hear that everything looks normal, and still have questions that deserve a closer look. Are we becoming insulin resistant? Are we missing important nutrients? Are our cardiovascular risk factors moving in the wrong direction? Dr. Mark Hyman joins Dr. Thais Aliabadi and Mary Alice Haney to discuss these questions and more.

Our goal should not simply be to wait until a number crosses a diagnostic threshold. We want to understand the direction we are headed and what we can do about it.

That is the thread connecting this entire conversation: know our numbers, understand them in context, and turn that knowledge into action. Not panic. Not a shopping cart full of supplements. Not the latest injection we found online. Action that starts with food, movement, sleep, stress management, and an informed relationship with our medical team.

This conversation is educational and is not a substitute for individualized medical advice. Testing, treatment targets, medications, hormone therapy, and supplements should be discussed with our own healthcare professionals. The clinical preferences described here are not universal recommendations.

What does functional medicine actually mean?

We are looking at the same body through a different set of lenses. Rather than treating every diagnosis as a completely separate problem, we ask how the systems involved are connected.

Our gut, immune system, hormones, metabolism, and brain do not operate in sealed compartments. Yet our care often gets organized that way. We might have one specialist for acne, another for mood changes, and another for irregular periods. Each can contribute something important, but we still need someone asking how those symptoms fit together.

Functional medicine emphasizes that larger picture. What is interfering with health? What is missing that would support normal function? What can we change about the conditions in which our bodies are operating?

That does not make a diagnosis irrelevant. It makes the diagnosis a starting point for further questions. We still need appropriate treatment, but we also want to understand contributing factors rather than stopping at the name of the condition.

In practical terms, we are trying to create health while addressing disease. Those goals belong together.

What experiences shaped this approach to medicine?

The background here includes both conventional medicine and an early interest in nutrition, ancient healing traditions, and systems thinking. Before the focus on functional medicine, there was full-spectrum family practice in a small Idaho town: delivering babies, performing C-sections, treating emergencies, and caring for people across an enormous range of needs.

Then came a very personal experience of illness. After time in China, Hyman developed severe fatigue and cognitive difficulties, along with digestive and immune problems. He describes going from long-distance cycling to struggling with stairs, and from remembering complicated patient details to losing his train of thought. He later connected that illness with mercury exposure.

Hearing Jeffrey Bland speak prompted a deeper investigation into functional medicine. The appeal was not simply that the ideas sounded different. It was that they offered another way to investigate complicated symptoms and look for connections.

The lesson we can take from that story is not that one approach explains every illness. It is that medical curiosity matters. When our current explanation is not helping us move forward, we need room to ask better questions.

Why does fragmented care become such a problem for women?

PCOS is a perfect example. We can have acne, irregular cycles, changes in hair growth, mood symptoms, and metabolic concerns, and end up with separate appointments for each. Without coordination, we can collect treatments without ever getting a clear explanation of the overall pattern.

We discuss that need for accurate diagnosis and personalized support in our resource on understanding and managing PCOS. The important point is that symptoms deserve to be connected, not dismissed or treated as unrelated inconveniences.

One useful framework discussed here is P4 medicine:

• Preventive: We address risks before avoidable problems develop.
• Predictive: We use available information to understand where our health may be heading.
• Personalized: We consider our individual history and circumstances.
• Participatory: We take an active role rather than receiving instructions without understanding them.

Participatory care is not about blaming us for being ill. It is about giving us useful information, practical support, and a meaningful place in decisions about our health.

Why is insulin resistance such a major part of this conversation?

Because metabolism connects to much more than blood sugar alone. In this discussion, insulin resistance is a major concern across cardiovascular health, diabetes risk, and hormonal problems, including PCOS.

We can miss part of that picture if we look only for established diabetes. Hyman describes checking fasting insulin for decades and previously using glucose tolerance testing that measured both glucose and insulin. His concern is that we may recognize metabolic dysfunction late if we never investigate it earlier.

He also discusses an insulin resistance score offered through Function Health that uses insulin and C-peptide measurements. That is a specific testing approach, not a requirement for everyone. The broader question we can bring to an appointment is simpler: Are we evaluating our metabolic health adequately for our symptoms and risk factors?

We should also be careful with population statistics. Hyman cites research indicating that only a small proportion of Americans met a stringent definition of optimal cardiometabolic health. That does not mean everyone else has diabetes, or that body size alone tells us who is healthy. It reinforces the need to look at several measures together.

Which five health markers should we understand?

When asked to narrow the list, the priorities discussed were fasting insulin, ApoB, vitamin D, a more detailed lipid profile, and high-sensitivity C-reactive protein. This is not a universal screening panel. It is a useful starting point for a more informed conversation.

1. Fasting insulin: This adds information about insulin levels alongside glucose-related testing. Hyman describes a preference for fasting insulin around 5 or lower, but interpretation requires the laboratory’s units, testing conditions, and our clinical context.
2. Apolipoprotein B, or ApoB: We discuss this as an important cardiovascular risk marker that can add information beyond a basic cholesterol report. The conversation favors lower levels, while individual targets need to reflect our overall risk.
3. Vitamin D: Hyman includes this because nutrient status is part of the picture he evaluates. Testing and supplementation should lead to an individualized plan, not automatic high-dose treatment.
4. A detailed lipid profile: This overlaps with ApoB but broadens the discussion beyond a single cholesterol number. We want to understand what additional lipid information would actually change our care.
5. High-sensitivity C-reactive protein, or hs-CRP: This is discussed as a marker of inflammation. It provides information, but it does not by itself identify the cause.

The value is not in memorizing five abbreviations. It is in knowing what each test is meant to tell us, why it is being ordered, and what we would do differently with the result.

Does a normal laboratory result always mean everything is optimal?

No, but we need to be precise about what that means. A laboratory reference range, a diagnostic cutoff, and an individualized treatment target are different things. A result can fall within a listed range and still deserve discussion because of our history, symptoms, or other findings.

In this conversation, both physicians challenge the reassurance that can come from looking at one number in isolation. They discuss hemoglobin A1C, ApoB, insulin, and other markers as parts of a larger risk picture.

That does not mean a slightly higher result automatically means disease, or that everyone should pursue the lowest possible number. We need interpretation, not a new reason to be frightened of our lab reports.

A practical response is to ask: Why is this result reassuring in our particular case? Has it changed over time? Does family history affect the interpretation? Would another test meaningfully clarify our risk?

We can use the same broader perspective when thinking about body weight. Our discussion of why health assessment needs to go beyond BMI explores why metabolic markers, lifestyle, and personal history matter alongside measurements of body size.

What other tests came up, and how often should we repeat them?

The conversation also includes hemoglobin A1C, lipoprotein(a), ferritin, omega-3 status, homocysteine, and thyroid antibodies. These are not interchangeable, and we should not assume that more testing automatically produces better care.

Hyman discusses homocysteine in relation to methylation and B vitamins. He describes preferring levels below 9 and considering B-vitamin support when appropriate. That is a clinical preference from this conversation, not a reason to treat an isolated result ourselves.

For timing, he describes Function Health’s larger annual panel and smaller midyear panel, with additional testing when needed. Examples include reassessing A1C after dietary changes or checking whether treatment has improved iron or vitamin D status. Some follow-up may happen over three to six months, depending on the situation.

Hyman is associated with Function Health, which he discusses as a way to make broad testing more accessible. We should keep that connection in mind and distinguish the educational principle from the service being promoted. The principle is useful anywhere: get appropriate testing, understand the results, and have a follow-up plan.

What is the food playbook for improving metabolic health?

Before we get lost in the doctor rabbit hole, we need to come back to what goes on the plate. The central advice is straightforward: reduce ultra-processed foods, cut back on added sugar and refined flour, and build meals around foods that provide real nourishment.

The conversation gets playful about candy, but the point is serious. A product can be edible and enjoyable without being a strong foundation for our daily nutrition. We do not need to pretend otherwise.

Instead of organizing our diet around what we are removing, we can focus on what we are building:

• Adequate protein to support muscle.
• A variety of colorful plant foods.
• Plenty of fiber.
• Fats from foods such as olive oil, avocados, nuts, and seeds.
• Less dependence on sugary and refined-starch snacks.

This is not an argument that every carbohydrate is a problem. The discussion distinguishes the heavy intake of refined sugar and starch from the fiber-rich plant foods we want more of.

For those of us managing PCOS, our guidance on PCOS diet and exercise connects sustainable food choices and movement with the larger metabolic picture.

Can we really eat this way on a limited budget?

We need to take that question seriously. Food access, cost, cooking skills, and the equipment in our kitchens all affect what is realistic. Advice is not helpful if it assumes resources we do not have.

Hyman pushes back strongly on the idea that healthier eating must always be expensive. He describes developing meals around a food-assistance-sized budget and using lower-cost vegetables, less expensive cuts of meat, and basic home cooking.

His example from the documentary Fed Up makes the practical barriers especially clear. He worked with a South Carolina family facing serious health problems and limited resources. Rather than giving a lecture, he took them shopping and prepared a meal with them. They needed help with basic skills such as chopping vegetables, peeling garlic, and roasting food.

They also needed knives and a cutting board, which he later sent them. That detail matters. Sometimes the missing intervention is not another explanation of why vegetables are good. It is the equipment and confidence to prepare them.

He reports substantial changes in the family’s health and describes the son eventually becoming a doctor. It is an individual story, not a promised result. Its value is in showing what practical support can make possible.

What actually helps our gut microbiome?

Here is the good news: we do not need an entirely separate set of fundamentals for every organ system. Many of the same habits keep coming up. Eat a nourishing diet, move regularly, limit alcohol, and stop making ultra-processed foods the center of every meal.

For the microbiome specifically, Hyman emphasizes fiber, prebiotic foods, and polyphenol-rich plants. We can think of prebiotics as food that supports beneficial gut microbes, rather than confusing them with the live organisms in probiotic products.

The examples discussed include asparagus, artichokes, and plantains, along with fermented foods such as miso, kimchi, sauerkraut, and pickles. Variety is a major theme.

Polyphenols are another part of that conversation. Many plant foods contain these compounds, and choosing a range of colors is a practical reminder to broaden our diet. The goal is not to reduce nutrition to a color chart. It is to move beyond eating the same few foods repeatedly.

Hyman suggests aiming for at least 30 different plant foods a week and discusses a fiber intake of roughly 30 to 50 grams daily. Those are his proposed goals, not instructions to make an abrupt change regardless of our digestive symptoms or medical needs.

Where do probiotics fit?

We should not expect a probiotic capsule to do the work of an entire diet. Hyman explains that many probiotics do not establish lasting residence in an adult gut, so benefits may depend on continuing to take them.

That does not mean they are always useless. Later in the conversation, he says a broad-spectrum probiotic can be helpful for some people. The distinction is between a potentially useful tool and the foundation of the plan.

We want to ask what we are trying to improve and whether the product makes sense for that purpose. At the same time, we should not ignore persistent bloating, pain, or other symptoms simply because we have been told to eat more fiber. Diet matters, but symptoms may need medical evaluation too.

How should we think about GLP-1 medications?

As tools, not magic. The discussion acknowledges meaningful benefits while emphasizing side effects, muscle preservation, and the possibility of weight regain after stopping treatment.

Hyman’s strongest recommendation is that these medications belong within a broader program that includes nutrition counseling and exercise support. We need to consider what we are eating while appetite is reduced and whether we are doing enough to protect strength.

Weight loss alone does not tell the whole story. We want to understand changes in body composition, physical function, food intake, and metabolic health. Adequate protein and resistance training are central concerns in his approach.

The conversation includes numerical estimates of adverse effects and muscle loss, but those figures should not be treated as universal across medications, doses, and patient groups. The useful takeaway is that benefits and risks deserve an individualized discussion.

Medication and lifestyle are not opposing teams. We can use appropriate treatment while also supporting the habits that make long-term health possible.

What about peptides and the latest biohacking trends?

We need to separate a category of molecules from the way products are being sold. GLP-1 medications are peptides, and some peptide-based drugs have undergone clinical trials and regulatory review. That does not make every peptide offered online equally studied or trustworthy.

The concern here is the unregulated marketplace: uncertain sourcing, unclear contents, self-injection, and little meaningful medical supervision. We should not confuse enthusiasm with evidence.

Before adding an advanced intervention, we need to ask whether it has been properly studied, whether it is approved for the intended use, and who is monitoring our response. Lab testing alone cannot make an inadequately studied product safe.

Hyman’s favorite “biohack” is considerably less exotic: a sauna. His larger point is that we often chase the next breakthrough while neglecting ordinary habits. A new label does not make the fundamentals obsolete.

What does a realistic daily health routine look like?

We do not need a perfect schedule. Hyman describes a routine that changes with travel and work, but keeps a few anchors: several minutes of breathwork, meditation, journaling when time allows, and regular exercise.

He reports exercising at least five or six days a week, generally for at least half an hour. But the encouragement is not that we must copy that immediately. It is that something done consistently has value. If our starting point is a few push-ups, we can start there.

The comparison is compound interest. Small deposits, repeated over time, become meaningful. We do not have to turn every workout into a major production.

He also describes rebuilding muscle after back surgery and significant muscle loss. His own routine includes a protein shake, creatine, and other supplements, but that is a personal regimen rather than a template for everyone.

The transferable idea is simpler: protect muscle, make movement repeatable, and build a routine that survives a busy life.

How do sleep, alcohol, and preparation fit into the plan?

Sleep is not what we get around to after everything else. Hyman describes winding down with lower lighting, time away from devices, reading, and a hot Epsom salt bath. The purpose is a transition out of the day, not another elaborate performance standard.

He aims for about eight hours, while acknowledging that real life varies. That honesty matters. We can prioritize sleep without pretending we control every night perfectly.

Alcohol is another place where he recommends being candid about trade-offs. He discusses concerns involving the gut, hormones, cognition, nutrient status, and liver health, and says he drinks only occasionally. The message is not to build a health routine around alcohol’s supposed benefits.

Preparation also helps. He carries foods such as jerky and nut butters so he is not completely dependent on whatever happens to be available when he gets hungry.

We do not need the same backpack menu. We need our own answer to a familiar problem: what will we eat when the day runs late and we have no plan?

Does every woman need hormone therapy or the same supplements?

No. Asked about an asymptomatic woman around age 50, Hyman emphasizes personalization. We need the full history, the symptom picture, and a discussion of what treatment is intended to accomplish. Hormone therapy is not presented as an automatic prescription based on age alone.

Supplements receive a similar discussion, although Hyman identifies several favorites: vitamin D, omega-3s, B vitamins, magnesium, and sometimes probiotics. He also discusses creatine for muscle and cognitive support.

He describes personally taking 10 grams of creatine daily and distinguishes that from the 5-gram amount he mentions for muscle support. These are details of his approach, not a recommendation for us all to begin the same dose.

The better question is what we actually need. Are we addressing a documented deficiency, a dietary gap, or a specific treatment goal? What dose is appropriate, and when will we reassess?

We should not finish a conversation about personalized medicine with a one-size-fits-all supplement list.

What does endometriosis teach us about looking at the whole picture?

It reminds us that digestive symptoms and pelvic disease can overlap. Dr. Aliabadi describes patients whose bloating and gastrointestinal complaints did not resolve with dietary changes alone, and who responded better after their endometriosis was addressed.

Endometriosis involves tissue similar to the uterine lining outside the uterus. In this discussion, we explore immune dysfunction, inflammation, and gut health as possible parts of a broader picture. Those ideas should not be flattened into a claim that endometriosis is simply an autoimmune condition or that changing our diet cures it.

The practice percentages mentioned are personal clinical observations, not established prevalence estimates for all women. What matters for our care is that persistent symptoms deserve investigation.

We do not have to choose between gynecologic treatment and attention to nutrition, stress, or digestive health. We need coordinated care that takes the underlying condition seriously while addressing the rest of our health.

Are seed oils really the biggest dietary problem?

Hyman is more measured here than the online debate might suggest. His concern is largely that refined oils frequently appear in ultra-processed foods, making it difficult to separate the oil from the overall dietary pattern.

He does not think the evidence supports treating seed oils as the single dietary villain. He favors foods such as olive oil, avocados, nuts, and seeds, but brings the focus back to excess refined starch, sugar, and ultra-processed products.

That is a useful reminder for us. We can spend enormous energy debating one ingredient while overlooking the pattern of our meals. Improving that pattern is more constructive than finding one substance to blame for everything.

What should we take into our next appointment, and what makes the future promising?

We can bring questions rather than demands for every available test. What risks are most relevant to us? What do our current results show? What is still unexplained? Which additional information would change the plan?

The discussion of thyroid antibodies illustrates the need for that nuance. Hyman favors broader testing and closer attention to abnormalities even when TSH is normal. That remains a discussion to have in context, not an instruction that an antibody result automatically requires medication.

Looking ahead, he is excited about growing attention to the microbiome, mitochondria, inflammation, and insulin resistance. He founded Cleveland Clinic’s Center for Functional Medicine in 2014 and sees these connected systems as essential to a more proactive approach.

Data and technology may help us identify patterns, but information still needs careful interpretation. No panel can predict every illness or guarantee prevention.

Our next step does not have to be complicated. We can improve one meal, establish a repeatable exercise habit, protect sleep, reduce alcohol, and get clarity about our numbers. Then we can follow through with the medical care our individual situation requires.

Better health is not one perfect test or one perfect intervention. It is useful information, appropriate treatment, and everyday habits that keep adding up.