Dr. Justin Marchegiani:  Evan, it’s doing great, man! How you doin’?

Evan Brand:  Pretty—pretty well. I’m glad we got this internet thing straightened out. Let’s hit this estrogen dominance topic. People have been asking via email, social media. Clients of ours have been asking about hormones and trying to understand them. There’s so many things in the environment that impact them. Your lifestyle, your diet can impact those and so you and I wanted to outline all this together and talk about what’s affecting your hormones, why is it so complicated in the modern world, what are the new variables that didn’t exist and then what do we do to fix it. So do you wanna start—start us off?

Dr. Justin Marchegiani:  Yeah, so hormones are interesting, right? Hormones are these messengers, right? They help with inflammation. They help with growth mediation, i.e., healing and recovering, putting on muscle. They help with reproduction. Not only reproduction like in reproducing ourselves so we heal but also having children and healthy hormone balance is essential to us feeling good, to us having energy, to us being resilient and vital as we—as we age and deal with stressful situation. So hormone balance is really, really important. Now as women—women have 2 different kinds of hormones that are constantly in fluctuation generally speaking, right? Men are kind of this foghorn of hormones throughout the month. Again there’s some fluctuations on a daily basis with cortisol, as are women, but on a monthly basis, you know, men kinda have this flat rhythm regarding testosterone. Women have this kind of symphony of hormonal fluctuations regarding estrogen and progesterone. And I tell my patients estrogen is the hormone that makes you grow. Progesterone is the hormone that makes you grow up. Meaning estrogen just causes cells to just grow bigger, while progesterone helps cells to differentiate and mature, okay? This is important so throughout your cycle, kinda breaking down a woman’s monthly cycle I think is really important for the first place of connecting the dots of where abnormalities happen. So first off, women’s cycle begins with bleeding, with menstruation. Typically about 3-4 days, maybe 5 days long in some extenuating circumstances. That happens because of a drop in progesterone and estrogen. So progesterone and estrogen drop, that signals bleeding. So the uterine lining is now shed over that 3 to 5-day period. The next thing is the follicle starts to grow and that follicle, FSH from the brain is starting to be produced and that causes the follicle to grow. So FSH talks to the follicle, the follicle starts to grow. As the follicle grows, estrogen is produced by the follicle. That’s step 3. As estrogen is being produced, it eventually hits a—a toppling, you know, where it hits its highest level around day 6-9 or 6-10. Then progesterone starts to increase as estrogen tops out, alright? Progesterone is increasing due to LH. LH is luteinizing hormone. That’s a brain hormone. The two brain hormones are FSH and LH. As progesterone topples out around day 20-23 or so, that’s where hormones are at its highest regarding progesterone and then day 27-28, progesterone and estrogen fall. So if we kinda recap it real quick, briefly what’s happening is we have brain hormones causing the follicle to grow. The follicle stimulating estrogen. Estrogen stimulating LH, LH stimulating progesterone. Progesterone and estrogen dropping. And that’s kinda the general dr—gist of the average female cycle, right around 28 days or so, and about day 13-15 is where ovulation happens. That’s right where estrogen tops out and progesterone starts to rise. That’s where that 2-3 window of pregnancy happens. I’ll just take a breath and give you a chance to break it down, Evan.

Evan Brand:  Sure, sure, makes perfect sense. And a lot of women that you and I are working with may be perimenopause or menopausal so we can talk about the ebb and flow and things that change there. So basically as you’ve kinda alluded throughout most of the reproductive years, the estrogen and progesterone are in a pretty good balance, but then if you look at all the information with progesterone and estrogen levels changing, then it looks like the gap becomes bigger where there’s a relatively high estrogen compared to progesterone and that’s what we would call menopause, and then that’s when these symptoms can start to occur. So I guess what I should do now is just go through some of these what consider estrogen dominant symptoms. So this could be allergies. This could be breast tenderness. You have copper–

Dr. Justin Marchegiani:  yeah.

Evan Brand:  Excess.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Which I did a video on copper toxicity and everybody’s like blown away by the idea of too much copper. How about cold hands and cold feet? Decreased sex drive, depression with possibly some anxiety or agitation added to it. Could be dry eyes, fat gains especially around the abdomen, the hips, the thighs, fatigue. Could be brain fog, which sometimes that could be yeast-related as well. Hair loss, headaches, blood sugar issues and fertility, irregular periods. You and I have talked about amenorrhea, just missing your period completely before. Irritability, insomnia, mood swings. I could go on and on. I think that’s a pretty good handful of symptoms though.

Dr. Justin Marchegiani:  Yeah, absolutely. So when estrogen’s out of whack, a whole bunch of symptoms happen. The real common ones like you mentioned—most females—these are the ones that I deal with on a daily basis with all my patients, you know, the big complaints. It’s gonna be moodiness. It’s gonna be breast tenderness. It’s gonna be cramping. It’s gonna be back pain. It’s gonna be migraines, moody, sweet cravings or sugar cravings, and I would say like water retention and even weight gain.

Evan Brand:  Yeah, I would say the sex drive one has been something big. I ask that question on my intake, you know. Do you think your libido adequate? And it’s very, very rare to find a women over age 40 who says that her libido is adequate. You know, some women said they haven’t had a libido in 20 years. So I mean, these things can change with hormones and they’re not just gonna magically fall into place by diet and exercise. So eventually you and I are gonna outline what exactly is going on in the external environment that is throwing off this whole hormonal cascade here.

Dr. Justin Marchegiani:  Exactly and typically, as a women ages, menopause is nothing more than the ovaries not functioning like they were when you were cycling and you have a drop in hormones from that. Typically over time, one the big things we see with hormonal—hormonal fluctuations over time is that estrogen drops at about 35% the rate from age 35 to 50, while progesterone can drop at 75% the rate. So this whole podcast is really surrounding the topic of estrogen dominance and part of estrogen dominance is just being exposed to a high amount estrogens in the environment—that we’ll go into in a second. The other half is is progesterone being essentially dropping so fast that estrogen—the ratio of estrogen goes above and beyond what would be normal essentially.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So if progesterone starts to drop faster than estrogen, even though you may have more progesterone as a basic flat line number, that’s still gonna be estrogen dominance. I mean, some people say over the course of a whole cycle you’ll have 300 times more progesterone than estrogen. At certain times of the cycle, like depending on where you’re at like let’s say, in the follicular phase you may have as many—as much as 25 times more progesterone to estrogen. So it’s different from the perspective of where you are in your cycle, but in general estrogen and progesterone—progesterone will be about 25 to 300 times more in relationship to estrogen, alright? So if that skew starts to get disrupted and we start to have less progesterone, let’s say below 20, you know, below 15 on average, that may be a big driving factor of estrogen dominance and a lot of the whole PMS symptoms and the symptoms that you just mentioned as well—the brain fog, the libido, dry hair, dry skin, dry nails, cold hand, cold feet, cramping, breast tenderness, all the things we already mentioned.

Evan Brand:  And let’s talk about some of the causes here. Birth control being a big one that can contribute because with birth control, you’re basically just keeping your estrogen levels sky high and so this is just a common prescription for many teenage girls, I’ve heard of even girls as young as 12 years old now getting put on birth control pills for their periods, you know, if they’re having really bad periods. So talk us through that. What’s going on with birth control pills? Why are these such an issue?

Dr. Justin Marchegiani:  Well, birth control pills are nothing more than like synthetic estrogens. You have like Yasmin and these synthetic estradiol compounds and they basically jack up your estrogen level as a female about 4 to 500%, 4 to 5 times. And that’s a problem because hormones, right? If you look at—go to any opera or any symphony, there’s a specific timing and a volume in which everything needs to operate in. If something goes too—too loud or too quiet or something, the timing’s off, you can easily have a beautiful symphony turn into noise pretty darn fast. Now taking that analogy to a hormone cycle, if those things start to go too high because of synthetic hormone overload or too low because of hormone stress driven by inflammation, that can start to create hormonal symptoms. So that’s the big thing right there off the bat. So estrogens are gonna be jacked up way high. Sometimes with the Merena IUD, that’s inter—interuterine compound that’s put up there to prevent the egg from implanting in the uterus lining, that is—that’s actually using synthetic progesterone. So that’s a little bit different. But most of the birth control pills are gonna be synthetic estrogen-based and basically what it’s doing is keeping the estrogen so high all the time so you don’t have that rise in progesterone happening. You don’t have that cycling of hormones. So basically it shuts the HPA axis and because your hormones are so high, the LH and FSH kinda go to sleep because–

Evan Brand:  So the body eats—the body thinks it’s pregnant.

Dr. Justin Marchegiani:  Well, not necessarily. The body—well, I guess you could say at a certain level. Typically progesterone’s gonna be really high with pregnancy and you’re gonna have HCG off the chart. So you’re not gonna see that because if you ran a pregnancy test while you were on a birth control pill, you wouldn’t come back with a pregnancy test being positive because you’re not making–

Evan Brand:  Right.

Dr. Justin Marchegiani:  The beta HCG. But what it’s doing, it’s shutting down the brain because the brain has this domino rally of FSH raising and then LH raising, so kinda shuts that down, because when the hormones are really high, FSH and LH don’t really have to work as much because the high amount of hormones is just shutting down the whole entire symphony. It’s like going into a symphony and with the foghorn. You just overpower all the instruments, you just can’t hear anything.

Evan Brand:  Makes perfect sense. Let’s talk about the metabolism of these two. That’s something that people do not talk about. There are side-effects that we could go into. We won’t bore you with those today, but there are nutrients—your vitamin C, your magnesium, zinc, and other minerals that are required for metabolizing these pills through your liver. So if you look at someone who has been on birth control for many, many years, mo—more than likely you and I are gonna look at their adrenals. We’ll probably see low function and if we look at like an organic acids test and if we’re looking for vitamin C or other nutritional markers, they’re probably gonna be deficient. Maybe not a—maybe not the only cause would be birth control but it’s definitely a factor. And then now I know we have to mention the environmental part of estrogen still. You know, we’ve talked about adding excess estrogen in via birth control but we have all the xenoestrogens in the environment, and now we’re seeing teenage boys with man boobs and you know, this is not—this is not good. This is not something that would have happened let’s say even 100, maybe 150 years ago with this breast enlargement. Can—can we go through some of those like the, you know, the—the meats, the plastics, the canned goods, all of that stuff?

Dr. Justin Marchegiani:  Yeah, exactly. So again, we already kinda mentioned some of the mild to moderate symptoms regarding estrogen dominance and again people that are listening that are familiar with some of the pathological situations like uterine fibroids, endometriosis, fibrocystic breast, polycystic ovarian syndrome, even breast tumors. Those are ultimate, you know, severe more pathological forms of estrogen dominance in action.

Evan Brand:  Right. It makes sense.

Dr. Justin Marchegiani:  And then—yeah, and regarding some of the underlying environmental causes, too much sugar is gonna drive a lot of this because too much sugar is gonna increase insulin. Insulin resistance drives more fat growth. Because if our cells are saturated and we can’t burn sugar in our muscles, well, guess what happens to that sugar? It goes right into fat and fat actually is its own exocrine gland. It produces a hormone that’s gonna cause fats—it’s gonna basically produce leptin which is another hormone that’s gonna decrease our body’s ability to signal satiation and signal that we’re full, which is another thing, and it’s also gonna produce more sex hormones like estrogen. So if we have more fat cells, fat cells will actually produce more hormones and throw us off even more. So driving insulin resistance, driving fat, fat will then drive more estrogen and then also it’s gonna screw up the whole combination here with leptin which is gonna make us feel hungrier and eat more of that same junk that got us there and to begin with. So a lot of these mechanisms that we overlay, you can see there’s almost like this vicious cycle to them where they kinda repeat itself on a loop over and over and over again.

Evan Brand:  Yeah, and then like you mentioned, they could all start with diet or sugar. So I mean, that’s a—that’s a huge one. It’s not something that we wanna skip over but you and I, we hit the diet piece so much that we’re assuming if you’re listening to this show, then you’re generally closer to like an AIP style diet where you’re not eating gluten. Maybe you’re doing a little bit of dairy in the form of like some ghee or some grass-fed butter.

Dr. Justin Marchegiani:  Right.

Evan Brand:  But beyond that, you—you gotta have that foundation in place, and then we could go on with the personal care products. You got your pesticides and herbicides.

Dr. Justin Marchegiani:  yes.

Evan Brand:  But you’re eating organic, you’re avoiding that. You got your makeup for women. So that—that is in the personal care category.

Dr. Justin Marchegiani:  Huge.

Evan Brand:  But think about women that are lathering themselves a lot of times with heavy metals and phthalates and all that, too, in their makeups.

Dr. Justin Marchegiani:  You also have your pesticides, I mean, a lot of those are estrogenic in origin. Pesticides, fungicides, herbicides. You have a lot of chemicals in the water as well. Remember when you get your water filtered back, the conventional water filtration in your community won’t filter out a lot of the hormones in the water. So you’re getting–

Evan Brand:  Yeah, we—oh yeah.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  The—the trace amounts of pharmaceuticals you’re talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That people flush down the toilet.

Dr. Justin Marchegiani:  Uh-hmm. Absolutely.

Evan Brand:  Fluoride would be another one that we could talk about.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  That’s another endocrine disruptor there.

Dr. Justin Marchegiani:  Yeah, fluoride. Also a lot of these polybrominated diphenyl ethers that are in flame-retardant products and various solvents, definitely not good. Milk if we’re drinking or consuming conventional dairy, a lot of the milks are treated with a Posilac, which is—or similar—no, Similac’s the formula. Yeah.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It’s Posilac. Posilac is the growth hormone given to cows to produce more milk essentially and then we have conventional dairy or conventional meat which could come from cows because cows are gonna be given hormones as well on the meat side, right? You have your Jersey cows which produce the milk. They’re given the Posilac to make more breast milk or make more you know, cow milk, and then we have the cows that are eaten for steaks and meat and those cows are gonna be given more growth hormone and estrogens to make more meat as well. They’re also given mycotoxins, too, to produce more fat to make their meat more marble then they’re given a lot of grains which are loaded with mycotoxins as well to make the meat more marbled. So a lot of different chemical toxins that are coming in on both sides of the fence.

Evan Brand:  Yeah, not even to mention the grain they’re getting fed is likely sprayed with glyphosate or it’s genetically modified grain that these conventional meat products have consumed.

Dr. Justin Marchegiani:  Bingo. Exactly.

Evan Brand:  Yeah. Last thing on—on the, I guess on the xenoestrogen route would be fragrances. So any woman or man wearing you know, perfumes, colognes, air fresheners, using those little trees that people put on their rearview mirror. It’s the worst smell on the world.

Dr. Justin Marchegiani:  Oh, absolute toxins.

Evan Brand:  Don’t use those.

Dr. Justin Marchegiani:  Absolute toxins. I remember in high school, I used to love having those in my car like the—the vanilla scent one. I thought it was so cool but then the more I studied it, it was just absolute toxins.

Evan Brand:  So were you the guy who when one of the trees ran out of scent, did you go to the car wash and buy another tree and stack it on or did you remove the first one?

Dr. Justin Marchegiani:  Well, I—I would remove the first one, but I always keep a tree in there to keep it going.

Evan Brand:  Oh, I—I’ve seen people who have 20 trees stacked on one another on their rearview mirror.

Dr. Justin Marchegiani:  I know.

Evan Brand:  They can’t even see out the windshield.

Dr. Justin Marchegiani:  Isn’t that nasty?

Evan Brand:  It’s horrible. Well, actually, Luke who and I were talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Before the show–

Dr. Justin Marchegiani:  Luke Storey.

Evan Brand:  Luke—he posted something online about he got in an Uber and he posted a picture of a guy who had like 20 of the black trees.

Dr. Justin Marchegiani:  Oh, God.

Evan Brand:  On his g—on his a—and so he had like a little portable ozone generator that he was breathing in in—in the backseat of the car.

Dr. Justin Marchegiani:  Oh, my God. Unreal.

Evan Brand:  Poor Luke.

Dr. Justin Marchegiani:  I know. What you gonna do?

Evan Brand:  Yeah. Let’s talk about phytoestrogens, too, in the food if—I guess we’ll hit the diet piece again. So these are your sources of soy. So mainly we’re talking about soy bean, your tofu, all of that. Something that’s frustrating for me is when you’re looking for a good protein bar, you may—you might find an organic protein bar at your health food store, but typically one of the first ingredients is gonna be soy protein crisp. It’s like come on, that’s not good.

Dr. Justin Marchegiani:  I know. Whatchamacallit, yeah, Clif Bars has got them. Even I think–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  A lot of the Zone bars, too. There’s only a few bars that actually have decent, clean protein in their bars, but that’s a big one. Soy’s a big phytoestrogen. Outside of miso, natto, or tempeh, soy is—for the most part is not gonna be good. Some menopausal females can get away with a small amount of it, if fermented-wise because it can help modulate their hormones when they’re lower in estrogens, right? Menopausal, but for the most part, people should not be doing soy. It’s not a good thing. It’s—and outside of that, too, we talked about the chemicals. We talked the industrial solvents, the hygiene products. You can always go to the website, skindeep.com or org to look up your products that you use on your face, on your hair, on your skin, your makeup, and see how much chemicals or toxins are in them. Oh, stress! Stress is huge because stress will cause your progesterone which is a major building block of your hormones to go downstream. Meaning it will progesterone and shunt it in the cortisol or stress hormones so you can deal with whatever that stressor is, because your body is hardwired to prioritize stress and inflammation first over recovery and healing and fertility second. And it kinda makes sense because if you’re stressed now, the body wants to deal with that stress, get over it and then because able to repair later, because if it doesn’t deal with the stressor, it may not get to that next point of being–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Able to heal and recover. So it’s just allocation.

Evan Brand:  Yeah, maybe you’re—maybe you’re dead and because you got eaten by the bear because your body was trying to repair and run at the same time. It can’t do both, so people who are listening, you know, always have the ancestral lens added as filter on to our conversations because this is very new. All this stuff that we’re dealing with, the environment is so new and we still have this ancient wiring systems that’s thinking–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Okay, there’s a bear coming down my driveway right now, I need to be in Fight or Flight, so recovery is—is not prioritized. And people listening, even just you having a notification sound—Justin and I have talked about this before, but even just having notifications on your smartphone or your computer “Ding!” every time you get an email, that’s triggering a biological response in the brain, that’s a hormonal response. Your body’s thinking, “Oh, what the hell is in that email? Is that a bill? Is that letter from somebody I don’t wanna hear from? What’s in that inbox?” That could be a huge source of stress so you really need to—you could either track your heart rate variability or just track how you feel. If you feel your heart racing or gut hurting after you’re expose to social media, something like that, these are the invisible stressors that can really trigger stuff for people and if you put—well, what does that actually do? You’re just saying this. But what does it do? Well, it inhibits the conversion of—of hormone, your T4 to your active T3, and so then you’re gonna have those hypothyroid symptoms and it could all be due to the stress.

Dr. Justin Marchegiani:  Yeah, and just think about it like this, right? If you’re barely getting—barely making enough ends to meet, you know, you’re barely getting enough money to make ends meet, so to speak, right? Do you have enough money to go and start investing in things in the stock market or real estate? Probably not because you’re just so focused on getting the bills paid. That’s all you can focus on. Once the bills are paid, i.e., once you’re able to manage stress and inflammation in your life, then you can think about investments after that, right? Same thing hormonally with how your body is prioritized to allocate bandwidth to essentially.

Evan Brand:  Right, that—yeah, that’s well said.

Dr. Justin Marchegiani:  You can–

Evan Brand:  Do you want talk about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Do you wanna talk about solutions for this? I think avoidance is kind of the—the big one that we could say in one sentence and be done with that, you know? Getting these things out of your life, making sure that you’re eating organic, making sure that you are staying away from the chemicals as much as possible. You’re looking at your skin care products. You’re looking at the makeup, the mascaras, the foundation, all of that crazy stuff that women put on to, you know, they feel like they have to put that on to be beautiful. I promise most women I see, they’re more beautiful without makeup. You look so much better. I tell my wife, “You don’t need it.” Country singers they say—they sing that in their songs like, “Oh, don’t put on makeup.” But it’s a real thing, especially if you have, you know, freckles and—and whatever natural skin pigmentation, that’s pretty. You don’t have to cover that up. So maybe turning off the TV is the first step to get through that process.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Because women are brainwashed into thinking they have to—to have caked on xenoestrogens to look pretty and they don’t.

Dr. Justin Marchegiani:  Exactly and that’s part of the whole, you know, brainwashing that Hollywood does, is they try to make most people feel incredibly inadequate about themselves so they can go buy some product and you know, frankly, it works. As much as a lot of women don’t like it and they complain about it, but it works and that’s why they do it.

Evan Brand:  Well, because if—yeah, you’re saying because if one lady is gonna wear makeup, then you don’t wanna be the only one without it?

Dr. Justin Marchegiani:  Right. I mean, I—my wife asked me, “Should I wear makeup tonight?” You know, she’s telling—she’s asking me this. I’m like, “No, you shouldn’t.” I like you better without makeup. It’s just—it’s better. It’s healthier.  But–

Evan Brand:  It really is.

Dr. Justin Marchegiani:  But there are some natural things out there. I know there’s a-

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  There’s some—some mineral-based makeups that you can just kinda touch things up and it’s more mineral and more natural-based and it’s easy and you’re not adding a big toxic load. Those will be if you’re gonna use makeup because some people may not be ready to make that switch, but that’s the better next step to look at.

Evan Brand:  I’ve seen a couple organic mascaras. I don’t know how it could be organic. But Hannah’s purchased a few organic mascaras and then also a few foundations. I don’t know if they were considered organic or they were labeled without phthalates. I can’t think of the brand right now. I wanna say it had the name Doctor in it.

Dr. Justin Marchegiani:  Huh.

Evan Brand:  Doctor’s Best or something and it was a brand of makeup. If you look on Amazon, I know there’s a bunch of different companies out there.

Dr. Justin Marchegiani:  Yeah, absolutely. So diving in here, we talked about the stress allocation and how your bodies and your adrenals can be affected by this whole thing, right? Because of the prioritization of progesterone to cortisol. You also touched in on how that cortisol can affect your thyroid because if your hormones start going off, if progesterone starts going off, that can affect thyroid conversion because if cortisol’s out of balance, that can affect T4 to T3 conversion which is your inactive thyroid hormones, so you’re active thyroid hormone. And also progesterone’s a powerful stimulator of TPO, which is the enzyme that helps bind tyrosine and iodine together to make thyroid hormone. So progesterone is really important to building thyroid hormone. So you can see this is why you don’t just get one symptom when hormones go out of balance because it just has this constellation ripple that can happen and many symptoms can occur because of it.

Evan Brand:  Yup, well said. So avoidance. We talked about lifestyle changes, you know, doing what you can whether it’s a floating tank, whether it’s yoga, tai chi, qigong. There’s meditation. There’s gratitude exercises, journaling. You and I have done entire podcasts dedicated to that. I don’t wanna skim over it but I think there’s so much that said about stress that you—you just have to—you have to do it. And if you say that you don’t have 5 minutes to meditate, well, you probably need quadruple that amount of time.

Dr. Justin Marchegiani:  Exactly. Yup, setting a timer like that can be really helpful. Even just sitting and just breathing. Just—just staring literally out—out your window. Just staring and just thinking about the sky or whatever, just clouding your head or just whatever is going on and just think about whatever you’re looking at. That’s why you talk about forest bathing or walking in nature and just being 100% present where you’re at. Oh, look a tree! Oh, look a rock! And all you’re focused on is what your eyes are gazing at.

Evan Brand:  I love it. Yeah, I mean I’m looking outside right now. It’s a beautiful day here. It’s in the mid-60s so it’s getting chilly but the sky is so blue. I mean, I’m so grateful for that.

Dr. Justin Marchegiani:  Love it.

Evan Brand:  To not have a cloudy day.

Dr. Justin Marchegiani:  Love it. That’s awesome.

Evan Brand:  Should we talk about nutrients? You wanna go there in terms of like estrogen metabolism support–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Stuff like that?

Dr. Justin Marchegiani:  Yeah, so let’s just kinda dive in the gut because the gut’s really important to the nutrients getting to where they have to go. Would you agree?

Evan Brand:  I, oh—yeah, 100%!

Dr. Justin Marchegiani:  Yeah, so we’ve kinda talked about it when we did our dry run round 1 on this podcast on Friday that got—didn’t quite go through on our side, so we’re even more polished for this podcast round 2. We talked about estrogen hormone conjugation, and conjugation is nothing more than putting a straightjacket on the hormone. Okay, so, you know, because we’re talking about estrogen here, estrogen begins with E so we’ll use Evan as our form of estrogen in this analogy.

Evan Brand:  Here we go.

Dr. Justin Marchegiani:  Alright? So E for Evan, E for estrogen. I’m putting a straightjacket on Evan so I can escort him out of let’s say the—the rowdy club, right? He’s—he’s going crazy. He’s fist-pumping. We’re gonna put a straightjacket on him, escort him out of the club. That’s kinda like what our body does to estrogen. It’s done its thing. It’s going. It’s getting shot back out the gallbladder into the gut to get metabolized. We bind these proteins to it. It’s called conjugation or in this analogy, straightjackets on Evan so we can escort it out. The problem is back gut bacteria imbalances meaning more bad bacteria in relationship to good bacteria in your gut—this is called dysbiosis—this upregulates specific enzymes known as β-glucuronidase. You know it’s an enzyme because it ends on the word –ase. This enzyme basically comes over and takes the straightjacket off. So imagine Evan being escorted out of the bar, right? The club. He’s being rowdy. Someone clips open the straightjacket and now he’s loose and he’s—he’s running away from the bouncer or the police. That’s what happens. Estrogen gets unconjugated or deconjugated. Boom! It can go right back into circulation and cause tissue to grow, whether its endometriosis or cause fibroids to occur, or create hormonal imbalances and symptoms and mood swings, and affects your mood and—and cause you to gain weight. All these different things can happen when we have gut bacteria imbalances. So that’s kind of the—the estrogen-gut detox mechanism. And then we also have the fact that if we have malabsorption because we have too much gut bacteria imbalance, more bad than good. We have low stomach acid and low enzyme levels, well, we’re not gonna be able to break down a lot of the nutrients we need to be able to metabolize hormones, whether it’s B6 or zinc and magnesium or various B vitamins that, you know, help with phase 1 and phase 2 detoxification, sulfur-based amino acids. All these things have to be broken down into their constituents so they can be absorbed and get into circulation and also we need to ionize various minerals, like magnesium and zinc. These are really important minerals. We have ionize them. That basically allows these minerals to get soluble. It’s solubilized into the bloodstream so it can do its thing and be utilized.

Evan Brand:  Yeah, so I mean we could add another layer on top of that. Parasites, yeast, we know–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  With Doctor–

Dr. Justin Marchegiani:  All these things affect that.

Evan Brand:  Dr. Jonathan Wright’s book, Why Stomach Acid is Good For You. We know that any woman listening over age 30, you have lower levels of hydrochloric acid and enzymes than you did when you were 20. So it’s not to—you don’t have to guess and—and check and think, “Oh, do I low enzymes?” I guarantee it. I would suggest and you tell me if—if you suggest different, but I generally suggest anyone over age 30 especially people that busy or eating in a rush or scrolling–

Dr. Justin Marchegiani:  Big time.

Evan Brand:  Scrolling on their phone while they’re eating which is a big no-no, you gotta have enzymes.

Dr. Justin Marchegiani:  100%.

Evan Brand:  Supplemental enzymes that is.

Dr. Justin Marchegiani:  Yeah, I mean enzymes and/or hydrochloric acid because hydrochloric acid actually activates enzymes.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Hydrochloric acid activates pepsinogen to pepsin in the stomach and also provides the PA stimulation for the pancreas to produce trypsin, chymotrypsin, lipase, a whole bunch of other proteolytic enzymes that are really important. So without HCl and/or enzymes, you’re gonna be in a world of hurt when it comes to digestion. And most women don’t get this, men as well, but they don’t understand the fact that you can have digestive problems and may not actually have digestive symptoms. People think, “Well, hey I don’t have diarrhea or constipation or bloating, I’m not too gassy, I don’t burp too much, I don’t have any acid reflux, and I got to the bathroom every day. Hey, I don’t have a problem.” Right? But a lot of times, their moodiness, their PMS, they migraines, their other issues in their body–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Can be driven by the inflammation going in their gut because they’re not—they don’t or they’re not expressing with atypical—I’m sorry, they’re not expressing with typical gas symptoms, bloating, gas, constipation, diarrhea. They’re expressing with atypical, outside of the norm symptoms that just are really hard to be connected and their medical doctor they go to won’t ever recognize it because they are great, they’re depressed—could be a hormonal issue, could be a gut issue, but guess what? They’re gonna be put on Wellbutrin–

Evan Brand:  Lexapro.

Dr. Justin Marchegiani:  Lexapro, Paxil. Hey, you know they’re feeling, you know, a little bit anxious. Great, they’re gonna get thrown on Xanax.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Hey, you know, they’re feeling like their cycle’s a little unstable, they’re getting thrown on a birth control pill. It could totally be from–

Evan Brand:  That’s horrible.

Dr. Justin Marchegiani:  All the other dysbiosis and the poor detox happening in their gut.

Evan Brand:  It’s horrible, man. It’s horrible. I had a female last week, she asked me—we found Giardia and Blasto—the double, double trouble there.

Dr. Justin Marchegiani:  Double trouble.

Evan Brand:  And she said, “Well, I don’t have any gut symptoms. Do we still have to treat it?” I said, “100%, you can—just because you’re, you know, not running to the bathroom with diarrhea, the typical manifestation of Giardia, it doesn’t mean we can just let it stay there.” Could you—maybe you would have a—a more, a better answer than me. I just said, “Absolutely.” But I know there could be more to that. You can be as long-winded as possible with this.

Dr. Justin Marchegiani:  Well, I tell people that everyone has the right to be infection-free, right? That’s my goal. To make sure everyone’s infection-free. Now the problem is everyone also has the right to have more than one issue going on at once. So a lot of patients, they have hormonal imbalances, but they also have other issues that are driving the hormonal imbalances that don’t necessarily from bird’s eye view connect, i.e., the Blasto and Giardia and this girl’s female hormone or mood symptoms. So–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah, so anytime there’s a stressor, that’s an issue. It’s like you walk into your house. Okay, let’s say you have a couple of guest bedrooms. Let’s say you don’t go in those guest bedrooms for a while. The guest that was in there last left the water running just a bit. You don’t know it. You don’t hear it. But you get this water bill every month and it’s just a little bit higher than you’re used to and you’re like, “Why the heck is my water bill 30% higher? I’m barely even using it. I’m gone half the month. What’s going on?” And then you look over and you’re like, “Oh, the water in my guest bedroom’s on. That’s what it is. I’m gonna turn it off.” Now what’s this equal? Having water in your guest bedroom on is like having a parasite or a bug stealing your nutrition, pooping inside of you, i.e., creating biotoxins, creating inflammation and maybe even creating leaky gut which is stressing your immune system which takes up energy. All of those stressors like that parasite or infections involved in, toxins, malabsorption, leaky gut, immune activation, that’s nothing more than draining your energy. So instead of your energy being allocated to performance and recovery and healing, right? It’s going towards something else. Just like your water bill’s being sucked towards these guest bedrooms that you don’t even—you’re not even aware of them because you’re not there on a day-to-day basis.

Evan Brand:  Now so from the nervous system perspective, couldn’t we say that you’re gonna be sympathetic dominant, more fight or flight?

Dr. Justin Marchegiani:  More, 100%. Yeah.

Evan Brand:  Because you’re fighting an internal battle.

Dr. Justin Marchegiani:  Bingo! And the problem, the sympathetic nervous system, the allocation because we’re hardwired this way and it totally makes sense is when the fight or flight, the sympathetic, that’s like the gas, go, go, go, go, go. That’s the gas, the sympathetic fight or flight nervous system shuns blood flow towards the muscles, towards the outer extremities because we have to fight and flee and we need oxygen and nutrition and glucose to get to those outer extremities so we can perform. If the blood glucose is inside the intestines and inside all the organs where they should be and they’re digesting, you will not be able to run as fast. That’s the main reason why activity after your meal is destructive for your digestion, you get an upset stomach. Remember the old analogy of like, “Hey, you shouldn’t go swim. You should wait, what, 2 hours or an hour after you eat to go swimming.” Why is that? It’s because at some point, someone did that and they got a cramp because there wasn’t enough blood flow or they got an upset stomach and got sick.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So–

Evan Brand:  Because you’re trying to rest and digest and be active at the same time. You can’t do it.

Dr. Justin Marchegiani:  Yeah, and the analogy is this, right? If the sympathetic fight or flight nervous system is your foot in the gas, and if the digestive system and relaxation and repair is the brake pedal, what happens when you hit the gas pedal and brake pedal at the same time?

Evan Brand:  Yeah, it’s not a good—not a good—not a good picture.

Dr. Justin Marchegiani:  No, no, exactly.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  You’re—you’re spending a lot of time going nowhere fast.

Evan Brand:  Yup, so to wrap this whole segment up of—of this part of the—the conversation. If you’re someone listening, especially female, or you and I are working together, you’re working with Justin already, and you tell us, “Yeah, but my life’s not that stressful. I’m not that stressed.” It doesn’t matter because all of this hormonal imbalance and these symptoms that you have could all be going on due to something in your gut. And Justin, you and I both are—we’ve seen false negatives on stool test results. So sometimes it may take one or two or three times to really find what’s going on. So if you’ve gone to your conventional doctor or even the gastroenterologist, the specialist you’re gonna get referred to that’s gonna throw you on prescription acid blockers, if they run tests on you and how up negative, don’t necessarily take their word for it. I hate to say this that these prestigious hospitals and et cetera are missing infections but you and I see it every single day in the clinic and we’re finding these infections. So if you actually get something on a piece of paper, you’re gonna have a lot more room to work with. So don’t just go buy hormone balancing or hormone this or hormone that supplement. You really need to get to the root of the root which in some cases could be the infection route.

Dr. Justin Marchegiani:  Oh, 100%. And again, really looking at everything holistically is really exactly how you have to do it because of the interplay with body systems that may not typically connect to the average person because you know, they’re not a trained functional medicine clinician and definitely will not connect with the average conventional medical doctor because they’re training is drug symptom, drug symptom, drug symptom, and they don’t look at upstream stressors and body systems that may be out of balance.

Evan Brand:  Sure, so I’ll put it even more—even more direct. If you’re going to your OB-GYN or your endocrinologist, they’re not gonna have a clue about you having a cryptosporidium infection in your gut and giving you an herbal protocol to remove that infection so that your hormones come back into balance.

Dr. Justin Marchegiani:  100%.

Evan Brand:  It’s never gonna happen. I mean, I will—I will bet you know every silver bar that exists on the planet that—that you’re not gonna get it. If you do, then that doctor, they—they’ve stepped up their game and they’ve done some functional, you know, they’ve taken some functional courses.

Dr. Justin Marchegiani:  And sometimes it’s good like get that workup done. You know, just you know, go with the low-hanging fruit. I find most of the time patients come to see me and that’s already been done–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And it’s already been missed but hey, always start with what’s the easiest and you know, what I consider to be the low-hanging fruits, that way you know you’ve crossed your T’s and dotted your I’s so to speak and then you can go up the chain regarding the—the functional medicine, you know, ladder so to speak.

Evan Brand:  Sure, and I guess we could briefly talk about, you know, the financial aspect of it, too. If someone does have health insurance or they’re able to go see a doctor through their work and it’s at no charge to them, then you might as well try to milk that for as much as you possibly can, but unfortunately in most cases the lab results that get sent over to you and I that we review, there’s not much evidence there. We can’t really work with that. We really have to do the more functional tests which are an investment but sometimes that’s what it takes.

Dr. Justin Marchegiani:  100%. So looking at this point here. If everyone listening or anyone listening is dealing with a—a hormonal imbalance, whether it’s men and just having low libido and—and poor muscle tone or women having PMS or menopausal symptoms or everything in between that we already mentioned, the whole litany of—of different items there, the next step is gonna be one, digging into the female hormones, right? Testing hormones at the right time of your cycle. We test female hormones typically around Day 20 or so if we’re looking at progesterone to estrogen. Some we even run a month-long cycle to see how the hormones fluctuate every other day. And some will even dig deeper into looking at thyroid as well as a full gut panel. So depending on where you’re at, if you’re having issues and you’ve already kind of ruled out the things we’ve already talked about on the diet and lifestyle, the next step would be to step it up regarding the functional medicine’s options that are available and kind of our—our palette if you will.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So the next step would be to reach out to either myself, to Evan, notjustpaleo, Dr. J myself, justinhealth.com or some other competent trained functional medicine doctor or practitioner to get everything kinda lined up in order based on what we talked about in the podcast today.

Evan Brand:  You hit on the—the last word that I wanted to say is the order.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  You know, something that is very important for anything, you know. If this is just adrenal problems or just hormone problems or just gut problems, whatever it is, it has to be done in the right order. Please, please, please don’t add to your supplement graveyard because you read about some product on Amazon or you saw it at the health food store and it was in the hormone section. Save your money because if you’re doing things in the wrong order, you’re really just wasting your money. Now I’m not gonna say that taking a zinc supplement is necessarily gonna make you worse because we know that–

Dr. Justin Marchegiani:  No.

Evan Brand:  70% of women or more are not getting enough zinc, so yeah it’s not going to hurt you. It might help you but why go and spend all this money if it’s not done in the right order because you’re gonna save so much more money in the long run if you do things in the right order by working with a practitioner.

Dr. Justin Marchegiani:  Well, it’s like baking a cake, right? Let’s just pretend it’s a gluten-free flourless cake for our—for our healthy analogy, right? You have the eggs. You have the—the coconut flour or you have maybe some Stevia in there, whatever else, maybe some grass-fed butter or coconut oil. Well, how we mix things in baking a cake is really important to the outcome of the product, of the outcome of the cake.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So let’s say you—you do start doing a heavy metal cleanse first, gut-killing second. You work on the diet 3 months into it and then you don’t touch the hormones and the thyroid til month 4. Well, you did a lot of things that were supposed to be done but they were just all done in the wrong order. Just like making a cake, you cook it before you mix the eggs and then you add the—the Stevia at the end or whatever. It doesn’t come out to be a nice-looking cake.

Evan Brand:  Yup, yup, Well-said.

Dr. Justin Marchegiani:  Anything else you wanna add, Evan?

Evan Brand:  I don’t think so. I think this is—this has been good coverage. Share this, if you have somebody who’s going through all this stuff. I mean, I could think of 20 people right off the top of my head who I know have problems with estrogen metabolism or estrogen dominance. So sharing is caring. This is the information that has to get out there. We’re gonna continue doing our work, we’ve got, you know, between Justin and I both, we’re over—likely over 6 million. I haven’t counted. I know for sure, 100% guaranteed over 5 million downloads of conversations that we’re having, probably up to 6 million by the 4-year anniversary of my show which is coming up really darn quick. I think it’s November 11^th of 2012–

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Would be the 4-year anniversary. So that’s—that’s a lot of people but that’s still not enough. That—I mean look at the suffering out there. Look at the people that are going and they’re spinning their wheels and they’re buying these diet programs and they’re buying these fitness books and they’re not getting the answers and they’re beating their heads against the walls, and they’re buying you know, diet root beers and look at Pepsi. I mean they had to bring back their aspartame version of their Diet Pepsi because so many people complained about the taste, you know? So don’t prioritize the taste. You know, prioritize the—the quality of your—of your liquids, the quality of your nutrition. Prioritize that better over taste and if you ask me, I think aspartame tastes horrible and it’s a neurotoxin, not to mention. So always look at something through the lens of the quality, not necessarily the taste or the cost or—or all of that, because you’re really gonna save yourself a lot of trouble if you start turning around the boat now as opposed to waiting til when you hit rock bottom and then you’re coming to Justin or myself and then you’re saying, “Look, I’ve had this stuff going on for 20 years.” Well, how long have you known something was wrong? “Well, I knew I should have gotten help you know, back in 2003, but I didn’t.”

Dr. Justin Marchegiani:  Right.

Evan Brand:  You know, don’t be—don’t be one of those people. Thousands of people have come to our clinics. It’s your turn. If you’re suffering, stop suffering. You don’t need to.

Dr. Justin Marchegiani:  Bingo. Love it, Evan. Well, feel free and reach out to Evan at notjustpaleo.com, Dr. J myself, justinhealth.com or beyondwellnessradio.com. Subscribe to the podcast and the YouTube channel and we look forward to providing more information very soon.

Evan Brand:  Check out Justin’s videos. He’s over 20,000 subscribers on YouTube. He’s gonna be—I’m telling him, he’s gonna be the King of Functional Medicine on YouTube.

Dr. Justin Marchegiani:  Just able to help more people. I love it.

Evan Brand:  Yes, sir. Take care!

Dr. Justin Marchegiani:  Have a good day, Evan.

Evan Brand:  Bye!

Dr. Justin Marchegiani:  Bye!