Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin. Evan, how are you doing today, man? It’s almost Christmas.  December 23^rd here, really excited for the holidays. How you doin’?

Evan Brand:  I’m as excited as you are.

Dr. Justin Marchegiani:  Great! So the question is have you been a good boy this year?

Evan Brand:  I'm on—I'm on the good list.

Dr. Justin Marchegiani:  Good, awesome!

Evan Brand:  What about you? Are you on—are you on the nice or the naughty list?

Dr. Justin Marchegiani:  Of course, I’m on the nice list. Now the question is, are you gonna leave some Paleo cookies out for—for Santa, or are you gonna leave some—some glutinous cookies out for him?

Evan Brand:  We actually did buy some organic Annie’s cookie for a Christmas party. I will probably not be partaking in them even though it's organic which is great there's the wheat, so I will be avoiding the wheat. I'll probably buy Miracle Tart for myself for Christmas since I'm part Santa.

Dr. Justin Marchegiani:  Yes, exactly. That’s the—the Hail Mary tarts, right?

Evan Brand:  Yes, those are so good. There's only one place in the whole city you can get them here and so that's where I go to—to get them.

Dr. Justin Marchegiani:  Do you guys have a Whole Foods down there in Louisville?

Evan Brand:  Yeah, we got Whole Foods. They don’t stock them there though. They stock them at this little local place called Rainbow Blossom. They have random things like Epic. They have Epic products. They have their pork rinds and that’s the only place you can get him.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  And they’re really darn good.

Dr. Justin Marchegiani:  Wow. Very cool.

Evan Brand:  You know what I’m talking about? Epic?

Dr. Justin Marchegiani:  Yeah, the Epic bars you mean?

Evan Brand:  Have you seen them?

Dr. Justin Marchegiani:  The Epic bars?

Evan Brand:  No. Yeah, but they have pork rinds now. Have you seen them?

Dr. Justin Marchegiani:  Oh, I have seen them. I have patients that just got some recently/.

Evan Brand:  Yeah, the pastured pork rinds. They’re really good.

Dr. Justin Marchegiani:  Gonna have to get them for sure. I love pork rinds.

Dr. Justin Marchegiani:  Love it. Well, we talked pre-show that we were gonna chat a little bit about blood pressure. We really haven't gone into that so much.

Evan Brand:  Yeah, I mean this is common. Just some statistics at a glance, you got 70 million Americans and 1 billion people worldwide with high blood pressure, and if it's left untreated you run into many, many, many issues. The biggest one that people probably know of is a stroke, and one time probably 25-30 years ago my grandmother had high blood pressure so high that she felt a shooting pain in her brain. So she went to the emergency room. She had my grandfather take her in and her blood pressure was over 220 by maybe 150, 220/150 something like that, just insanely high that so high that the nurse freaked out and immediately, immediately took action to get the blood pressure down. So this is not always the way that people find out they have high blood pressure issues. This could be going on behind the scenes for decades, but there are some simple strategies that we can talk about that can help to reduce the risk of high blood pressure. It goes up naturally with age, right? But that still should not be over 200. That's just mind blowing.

Dr. Justin Marchegiani:  Oh, absolutely. So when you look at blood pressure medications, you know, for the most part, that’s a chronic type of ailment. It tends to happen over a long time and it's—for the most part, it's something that's chronic and that the blood pressure medications aren’t gonna get to the root underlying cause.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Now if your blood pressure, you know, you’re upwards of 160—that’s the systolic number. That's the—the pressure that your heart creates in the blood vessels when the contracts and the bottom number, that's called the diastolic number, like D for down, it’s the bottom number and that's kind of where the pressure is in your arteries/heart when your heart’s kind of relaxing. So you pump—the lub dub—that’s the heart contracting and where it’s pressing down, that's the top number, systolic, and then where it’s relaxing, that's the bottom number, the diastolic. So when you get about 160 with the systolic, that can kind of be what I call the danger zone. So if you are at that level and let's say, you haven't quite made the diet and lifestyle changes, I do think being on a medication at higher levels until you get to the root cause is better because you wanna avoid a stroke or some type of a heart attack, right? So we want to make sure that if it's high and you're not doing anything about it, getting that blood pressure down is better, but in the long run we don’t want that to be the only answer.  We wanna look at getting to the root cause and we’ll kinda go over some of the root causes here in just a bit.

Evan Brand:  Great point. So just to be clear if someone's listening and they have high blood pressure but they're scared or they do not like conventional medicine you would still advise that person to go get on the drug even if it is short-term because you're safer on a drug with side effects that lowers blood pressure than having high blood pressure and doing nothing.

Dr. Justin Marchegiani:  Exactly, and you were talking–

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Upwards of above 160 and let’s say you already have a lot of a healthy—or sorry, unhealthy habits going on, poor exercise, sugar, inflammation, all that and you don't quite know where to go yet, again I just would hate to see someone, I'm—I’m a little more concerned and I hate to see someone go and have a cardiovascular incident that could've been prevented with some blood pressure medication in the short-term but in the end, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We wanna get on board with the functional medicine coach/doctor that can get to the root issues because the nice thing about blood pressure, it's easy to monitor. You get one of these $30 Omron blood pressure cuffs, the self ones on Amazon you can monitor it multiple times a day, and then you can see the number go down and guess what? You just call up your doctor. “Hey, Doc, I’m doing some natural things to help lower blood pressure. My blood pressure’s dropping naturally. I like to taper off the medication.” And most medical doctors, if you're being responsible and monitoring it and you’re telling them you're doing things they typically have no problem with that if you show them that you’re responsible by keeping track of it.

Evan Brand:  Yup, well said.

Dr. Justin Marchegiani:  Yeah, so off the bat, anything you want to comment on that?

Evan Brand:  Well, so with blood pressure, you know, there's tons of things that can cause it. I would say we should probably dispel the myth of the salt high blood pressure, I mean, kind of—part of it’s true if we’re talking about the garbage salt, right? The iodized salt, the sodium chloride plus iodide, but with like a good pink salt or a good Himalayan sea salt, there’s so many different options with black salts, there’s volcanic salts, the sodium is not gonna be the problem there, it's the inflammation combined with a low-quality salt that could be the problem, right?

Dr. Justin Marchegiani:  Yeah, they’ve done studies I think it’s in the Journal of the American Medical Association where like salt even, they—I don’t think differentiated the quality of salt, probably your regular table salt that’s not so nice. I think it increased like maybe 2 mmHg, right? Two or three, that's like the top number. That's like going from 120 to 122, 123.

Evan Brand:  Why did that—why did that become such a popular widespread myth do you think?

Dr. Justin Marchegiani:  That’s a great questions. There’s a lot of things in conventional medicine that are that way. I mean, you can look at grains, you can look at sugar, you can look at trans fat. I mean, you can look at cigarette smoking. You can look at so many different things–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Of how they kinda got that way but for the most part the only reason, the only, you know, motivation to avoid salt is if you already have severe kidney damage, maybe the only reason why you'd want to decrease salt consumption is because you have active kidney issues right now. But if you didn't have that, getting high quality minerals on board will be helpful and again, if your blood pressure is excessively low, salt will help bring your blood pressure up kind of in a modulatory way, but it won't make it go excessively high. You won't have high blood pressure because you have more sea salt intake. You will have higher blood pressure but higher and high are two different things. Higher meaning a couple millimeters of mercury bump, that’s where we’re looking at.

Evan Brand:  Makes sense.

Dr. Justin Marchegiani:  Except if it’s low—if it's low, it’ll bring it up much higher because you know, let’s say your adrenals are really key at holding on to minerals and if you’re decreasing your mineral retention because the aldosterone that your adrenals make is low because of the adrenal dysfunction that’s happening, you will pee out more minerals and that—that’s important for regulating blood pressure and that's also important for their sodium potassium pumps, so if we don’t have enough high quality sodium, those sodium potassium pumps kinda that creates the gradient and how things go in and out of the cell, now if don’t have adequate sodium on board, that can definitely be a stressor for the body.

Evan Brand:  Yeah, makes sense and you and I hear this all the time with people with adrenal problems, if you stand up quickly you may get lightheaded or woozy, you're not regulating your blood pressure. You may not have high blood pressure, you could actually have low blood pressure in some of those cases, but either way your body's ability to regulate blood pressure does decrease if there is adrenal stress which definitely there’s gonna be adrenal stress of there's infections and inflammation, and all the things that you’ve already mentioned, maybe other things like insulin resistance. How do you know if you’re insulin resistant? Well, if you look into—well, there’s—there’s calculators and all of that to look at, what is it? Waist to hip ratio and all of that. But if you look into the mirror and you see that you’re overweight, it's likely that you have some level of insulin or possibly leptin resistance problems which can then cause blood pressure to go high.

Dr. Justin Marchegiani:  Absolutely so when we look at blood pressure, one of the biggest things that will throw your minerals off and cause a higher than normal blood pressure is increased fructose consumption, i.e. sugar and just increased elevations of insulin. Insulin will cause a retention of sodium. That’s why one of the first things you notice, you cut out sugar for 2 or 3 days, you lose like 3 or 4 pounds weight, maybe even more. Now you’re not losing 3 or 4 pounds of fat. You’re losing 3 or 4 pounds of fluid because as the sugar goes down, right? One molecule of sugar holds on to—to I think 3 or 4 molecules of water, something like that. So as the sugar goes down, so does the sodium and so does the water. So what happens is you flush out a lot of fluid when you cut down the carbohydrates and cut down the sugar, and with fructose—fructose, high amounts of fructose inhibits this enzyme called en—endothelial synthase. Endothelial synthase is a nitric oxide-based enzyme that’s really important for vasodilating, and dilation means opening up those blood vessels. So if we decrease the enzyme that opens up those blood vessels, it’s like clamping down on that hole. It’s like going out in your garden taking the hose that's putting out water and putting your thumb over the edge of it to make that stream go stronger and stronger.

Evan Brand:  That's a trip. Now let me stack on another idea here. If there is adrenal stress, someone's also gonna be dumping a lot of magnesium which you need that to help relax the blood vessels so you're compounding the issue and if you are adding the fructose or the high fructose corn syrup or sodas in there, that’s gonna cause blood sugar issues which is gonna create a bigger crisis and the adrenals are gonna have to be more stressed if they're not already. They’ll be more stressed because they're having to kick in as the backup generators because then the pancreas and the liver not being able to keep up, so the whole cascade really kinda falls apart at sugar it sounds like.

Dr. Justin Marchegiani:  Exactly. So we have a couple of different mechanisms. Let’s break them down. So we have just the—the general sugar kind of mechanism with it’s table, you know, your sucrose, fructose, kinda glucose thing that's increasing insulin and that’s gonna hold on to more fluid and more sodium, and that will increase blood pressure via that way. We have the fructose mechanism that will increase or decrease the endothelial synthase enzyme which will decrease the vasodilation, i.e. cause constriction of the blood vessels, and we also have plasminogen activator inhibitor mechanism. So the higher amounts of insulin we have, our plasminogen activator what that does is it—it decreases or I should say, it decreases clots, i.e. it increases fibrinolysis. So -lysis means to cut. Fiber means like a clot. So it's breaking down blood clots. So imagine little occlusions from cells sticking together, fibron, it's gonna decrease those clots and allow smoother flow in the plumbing in the cardiovascular system. So if we decrease the clots, that means the plumbing flows smoother and that means we’re gonna have less pressure to have to push through those clots. So we have the plasminogen activator inhibitor-2 mechanism that also gets drained with higher levels of insulin.

Evan Brand:  Make sense. Should we talk about nutrition now?

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  So Omega 3 deficiency is huge, I mean, if you look at hunter-gatherers or if you even just look Ennuit studies, you’ll see that the average Ennuit was consuming anywhere depending on what you look at, but on the low end 10 or 15g, sometimes 20g of Omega 3's per day and we’re lucky if we get someone to take a 1g or maybe 2g supplement of Omega 3's. So there's a huge, huge deficiency and when you look at research linking Omega 3’s to blood pressure problems, what you'll find is the people who have the lowest blood pressure readings have the highest blood levels or serum levels of Omega 3's. This is a huge find and this is why I'm very, very passionate about getting people to supplement with some type of Omega 3. We’re gonna assume that most people are not eating enough wild caught fish and also then you run into the issue of the methylmercury in certain bigger fish like tuna. So for me I'm more pushing people towards a supplement because I know a lot of people don't want to cook fish multiple times a week anyway, so you can look at like a fish oil or a krill oil, but at the end of the day, could you still get some fish into your diet? For sure, a cod or a wild caught salmon would be good, but your—what is it called? StarKist tuna that's probably sitting in genetically modified soybean oil. You want to stay away from that.

Dr. Justin Marchegiani:  Absolutely, and fish oil also is a natural blood thinner. It keeps the cells of from sticking together. So it's kind of a natural thinner, kinda like a Coumadin or a warfarin, but without the side effects. So it does thin out the blood a bit for sure.

Evan Brand:  Great point. Yeah, that’s why we gotta tell people if they’re going to get surgery you would think, “Oh, man, supplements are fine.” That is one case where we would say, “Hey, look, why don’t you stop taking your fish oil for now if you’re going to get surgery, because we don't want your blood too thin.” So it is very, very effective for that.

Dr. Justin Marchegiani:  Absolutely. So we talked about vitamin D. There’s also other natural blood thinners like ginkgo which help increase oxygenation by increasing blood flow. Even things like systemic-based enzymes taken on an empty—empty stomach especially serratiopeptidase. So if you have various clotting or you have occlusions in the coronary arteries, taking some of these enzymes on an empty stomach they’re gonna be enterically coated so they’re not gonna be used for digestion. They won't get exposed and degraded by stomach acid. Ideally they’ll make its way into the bloodstream where these guys can hit areas of plaque or occlusion and break up any fibrin or scar tissues that may be hanging out in there.

Evan Brand:  Here's another—you—you brought up vitamin D. Here’s a good—a good hack and obviously it may take money if you're somewhere closer to the polls and it's wintertime, you’re not gonna have as much sunlight but there's definitely some research that shows that if you exposed your skin to sunlight, that it’s gonna increase the level of nitric oxide which is isn’t gonna naturally help you to dilate your blood vessels and then, therefore, reduce your blood pressure. So you could be taking a fish oil supplement, you could be going to the beach and getting some sunshine, and then what about stress? We should probably mention stress, too, because a lot of this is we’ve already talked about stress, right? Nutritional stress, mineral stress, but emotional stress, too, if that goes unaddressed and people are harboring anger and negative emotions, that's not good. That cannot—it’s definitely not helping your blood pressure. Put it that way.

Dr. Justin Marchegiani:  Well, all of that will basically increase cortisol and adrenaline which does have a vasoconstricting. It’ll—it’ll put that thumb over the water hose a little bit tighter, incre—increase that flow because of the stress hormone. So stress emotionally knocks over a domino cascade of adrenaline and cortisol, which does have a big impact on the vascular system.

Evan Brand:  Which would be good if you and I were running from a bear, right?

Dr. Justin Marchegiani:  Yeah, totally make sense, right? Because we gotta get blood flow to those extremities, the toes, the fingers, the arms, the legs, so we can run and fight and flee. But if we’re just sitting on their desk or like, you know, driving to work and we’re just boiling and we don't—necessarily don’t need that type of blood flow. You can see the stress on the vascular system that is caused by that type of hormonal cascade.

Evan Brand:  Yeah, so I mean this is another example where the ancient wiring system really does try to benefit us but when it's chronic acute stress which sounds like an oxymoron but you're dealing with acute stressors like a cell phone notification—ding! And that goes off all day, that’s a chronic acute stressor. Your body doesn't know the difference, so I encourage people if you have it, get rid of your notifications. I promise the world will not fall apart if you have your phone on silent or even airplane mode most of the time, and then you can get back to life on your terms. Because what I find with people dealing with emotional stress, and—and hypertension is that many people feel like there's never enough time in the day. They’re always playing catch up and I found personally, if I get up a bit earlier I feel more in control of my schedule. You and I are very, very, very passionate about calendar software, so we love our calendars and couldn't live without them.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So that—so that’s another helpful thing. But for me, it's also focusing on the most important things in the morning. You gave me some really good advice when you talked about kind of the morning visualization and all of that. I’ve— I try to do some type of morning meditation, visualization exercise, that helps to increase the amount of control and at the end of the day, the goal is just to reduce your perceived stress. Justin and I can't wave a wand and say, “Okay, look your stress is gone.” But if we can fix or improve the way that you respond to what you have on your plate, at the end of the day, you’re gonna be much healthier. You’re not gonna releasing cortisol all day. Hopefully, you’re gonna have less food cravings. You’re gonna be less dependent on glucose because you’re gonna be burning ketones and fat, and you’re gonna be in a much better place, mentally, physically, cognitively, blood sugar-wise, everything.

Dr. Justin Marchegiani:  A hundred percent and just piggybacking on what you said, just a little bit of sunlight makes a big difference. They’ve done some studies and again a lot of this is correlation not causation, but you know there are some potential mechanisms there, like with the nitric oxide and potentially with the kidney and how vitamin D can really help blood pressure, one study talked about a 10 ng/mL increase, so you know, if your vitamin D's 30, that's like taking it from 30 to 40, and someone who’s vitamin D levels are lower can have a 12% lowering of their blood pressure and also people who had the highest vitamin D levels had a 30% lower risk of developing hypertension. Again not causation but correlation but there are some hypothetical mechanisms that we just mentioned that could be at play so a good rule of thumb here especially in the winter months, get your 25-hydroxy vitamin D looked at and if you haven't gotten it tested yet or you don’t have the ability to test it right now, a good rule of thumb is 25 for every 25 pounds of body weight, you have 1000 IUs of vitamin D is fine. So I'm a little over 200 pounds so I would do about 8000 IUs of vitamin D, maybe round up to 10. Someone who’s half that, obviously 4000 is a pretty good starting point if you're just trying to figure out, hey, how can I take this vitamin D to lower my blood pressure?

Evan Brand:  Yeah, some people worry a lot about the vitamin K because we've talked before about the whole traffic cop analogy of vitamin K helping to direct and keep calcium where it belongs and not into your arteries and things like that. Do you worry much about vitamin K1, K2 supplementation or you just focus on getting plenty of good butter?

Dr. Justin Marchegiani:  If we’re going vitamin D on a high, if we’re using vitamin D and we’re going with it for a long period of time, we’ll make sure there's a couple hundred micrograms of the MK2 in there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Right, MK—I think it’s MK4 and MK7.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Let’s see, I’ll have to look at my bottle over here, but the vitamin K 2, the X factor, the activator, that’s what we’ll use and that will significantly help keep the calcium where it needs to be in the bones, and also just getting high quality grass-fed and essential fatty acids, a little bit of liver, all that stuff’s gonna be phenomenal for vitamin K.

Evan Brand:  Excellent. Now I wanted to get back to more lifestyle things. We talked about vitamin D. We talked about Omega 3’s. Exercise is a good one for sure, I mean, the—the basic part of it is just that you're becoming more insulin sensitive. I mean if you think about how hungry your appetite is when you get done with a good high intensity workout. Oh, my gosh, you can just feel amazing, and if I do a protein shake after an intense workout, I feel like it's going straight my bicep. I love the feeling but now—

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  After super high blood pressure, would we want to tell people, “Look, start with just walking.” You probably don't want to put somebody on a high intensity interval training if your blood pressure is already 150-160. You might not be able to handle it. You might get dizzy and—and more stressed out than—than we want you to be.

Dr. Justin Marchegiani:  Exactly so you have, you know, the mechanism you just mentioned by having the insulin receptors be more sensitive. That means your pancreas has to produce less insulin to get the sugar into your cell, so it can be burned up. Number one. You’re obviously you’re burning—you’re putting less sugar into your body so you’re using more ketones for fuel. So we’re being more fat or keto adapted at that time, and then also the heart just gets stronger. As the heart get stronger, it needs less force to pump. It has a higher stroke volume so it can push out more blood per pump and that obviously will have a—an effect of decreasing the blood pressure and then also growth hormone and/or just exercise will increase nitric oxide. And that will have an effect of—

Evan Brand:  That’s—that’s so cool.

Dr. Justin Marchegiani:  Vasodilating and opening things up, too.

Evan Brand:  Yup. That is so cool. How about—what about indoor—indoor air pollution. You know, the EPA talks about 10 or 100 times more toxic exposures inside your home than outside. So air purification could be a good idea because if you're breathing in these different toxins, that's also an invisible stressor that’s gonna be elevating that whole nervous system sympathetic, fight or flight response, which we really don't need to press that button anymore.

Dr. Justin Marchegiani:  Exactly, so anytime you put a stressor on your body, whether it's physical, chemical or emotional, and this kinda fits into the chemical realm, i.e. toxin realm, that can be a stressor on the body and your adrenals and your fight or flight system may respond. It may put you into a sympathetic type of stress response and again we already know what happens with that cortisol increase that’s gonna create constriction. Why? Because the stress response pushes blood flow to the extremities, right?

Evan Brand:  For survival—survival over I don’t know what the—the other side of the coin would be. But your body goes for survival any day.

Dr. Justin Marchegiani:  Yup, exactly. Surviving over thriving. The problem is thriving only happens after the survival mechanism is turned off, but most people are constantly living with that survival mechanism turned on and activated.

Evan Brand:  So now this can get a little bit complicated.  So I know this may be tough for us to cover this, but let's say we have someone that is already on a blood pressure medication like a lisinopril and we’re wanting them to go the natural route or they have intentions to go the natural route. How does that work? Do we bring the doctor on board and we have to say, “Look, you know, I'm working with a functional medicine practitioner. We wanna start using some natural things like Hawthorne or other blood pressure modulating herbs. Can you help me to lower my medication?” You know, how—how should that relationship happen between the prescribing doc and then someone like us trying to help to switch them to something natural or just get them off any type of meds completely?

Dr. Justin Marchegiani:  So what I typically tell patients, I say, “Are you interested in getting off your blood pressure medication? Do you wanna get off them?” And almost anyone that’s seeing someone like us, they definitely wanna get off them.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Again, the biggest problem with a lot of the blood pressure medications is they actually perpetuate the need for more blood pressure medications. So what I mean is they actually create nutrient deficiencies. Things like potassium which are really important for blood pressure, magnesium which is a natural beta blocker—these little receptor sites in the heart that the nervous system activates and it creates, you know, more excitability in the heart and that can cause the—the heart to have to pump harder and that can increase the blood pressure in the arteries. So magnesium’s a natural beta blocker, really important for relaxation. People that take it, one of the first thing they notice is they start to relax and wind down. That’s why Epsom salt baths are so popular with people that are stressed. So magnesium, potassium, calcium, various B vitamins, so all these nutrients become more deficient in these types of medications. These medications are known to create these nutrient deficiencies. So like I mentioned before acutely if you're not in good place, you wanna be on one of these medications until you can get your—your lifestyle and everything in order, and you find a good nutritionist and/or functional medicine doctor to work with, that's when you can start to move forward and the nice thing is it you just monitor it. You can tell your doctor, “Hey, we’re gonna be doing some things to help lower it naturally. A lot of times they think there’s nothing you can do. I mean, they may be keen on the whole diet and lifestyle thing. They may think that you can’t get down to the point where you are off the medications, but a lot of times they’ll entertain the idea. “Hey, let’s monitor it. Let’s see where you’re at out and you can go from there.” The biggest though misconception you gotta be careful of if you're only testing your blood pressure during the day when you're at the doctor's office, we called The White Coat Syndrome. Just being around the doctor in the office and all the, you know, “Hey, am I gonna get a shot today or a needle or give blood, whatever,” so it’s a lot of stress about getting poked and prodded when you go to the doctor’s office. That can increase your blood pressure as well. So I tell my patients, first thing you get up in the morning. You're still horizontal. You’re lying down. Take your blood pressure there. Take it at random intervals throughout the day and just kinda make some notations of how your blood pressure ranges. It may be 20 or 30 mmHg higher when you're more active, but when you're more relaxed, it maybe 20 or 30 lower, and if you’re sleeping—

Evan Brand:  I had my grandfather—

Dr. Justin Marchegiani:  Yeah, go ahead.

Evan Brand:  Sorry, I didn’t—I didn’t mean to interrupt. I had my grandfather do that because he went to his doctor, which he doesn’t like his doctor anyway, and I tell him, “Look, you can—you can get a new doctor.” I don’t—he feels so tuck. I don’t know. It’s just that mindset. Anyhow, 40 difficulty—40-point difference from morning when he first got up, took his blood pressure—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Compared to at the doctor’s office. I mean, we’re talking a difference of 120 to 160. I mean, that’s insane, 40 points. So here you go and it's not like the doctor is going to monitor you and say, “Hey, let me check your blood pressure again next week.” If they see that high once, they’re gonna put you on the drug.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  And write that prescription that quick.

Dr. Justin Marchegiani:  Exactly and the insurance base model for visits with your conventional MD, there’s just not time to talk about diet nor do they even—are they even educated about it? There’s virtually zero nutritional education and if there is any, it's based on a pathological level, right? Vitamin C causes scurvy, B1 deficiency causes beriberi, or it's the food pyramid—eat your 10 to 11 servings of grains a day.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Let’s not talk about the GMOs or the carcinogenic pesticides sprayed on the food daily.

Evan Brand:  Oh, my gosh. I know.

Dr. Justin Marchegiani:  So you don’t like get the best perspective.

Evan Brand:  I was watching a video by Eric Berg, you know, Dr. Berg?

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Watching a video of him talking about glyphosate which I already knew most of it, but it's just mind blowing that now research is starting to look at how small of glyphosate exposure it really takes to disrupt this whole hormonal health cascade. I mean we’re talking points, parts per billion or are parts per trillion in some cases, I mean, here you are thinking, “Oh, the 80-20 rule, 80 organic, 20 not.” I wanna be as close to a hundred as I possibly can.

Dr. Justin Marchegiani:  Exactly, a hundred percent, and again glyphosate a.k.a. Roundup, right? That's the major pesticide sprayed on a lot of these Roundup resistant crops, basically allows them to not have to do any weeding at all, because it kills everything except the plant, i.e. kills the weed and it's the chelator. So it pulls away minerals, so guess what? It’s pulling away a lot of good minerals, some of the ones I mentioned that are really important for healthy vascular health and controlling blood pressure.

Evan Brand:  Yup. Wow. That’s a trip and you combine that with 24/7 technology, that Fight or Flight mode is going.

Dr. Justin Marchegiani:  Exactly. So obviously getting the adrenals under control, getting the diet under control, getting the—your glycemic load under control, meaning keeping the carbohydrates within range for you. If you're overweight, getting them close to 50 and getting more to a ketogenic approach starting out is gonna be a great starting point and then getting some of the extra nutrients back in like magnesium, zinc, potassium, folate, B6. These are common nutrients that are deficient in people taking blood pressure medications, right? We’ve talked about the nutrient deficiencies caused by these medications and then also adding things like Hawthorne or a.k.a. foxglove. I think there’s a medication made after these herbs, too.

Evan Brand:  Yeah, I think—

Dr. Justin Marchegiani:  That are—that’s conventionally used.

Evan Brand:  I think they’re—they’re rooted from that. I think they come from the plant.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And of course, they patented and changed it to where it doesn’t resemble the plant anymore but—

Dr. Justin Marchegiani:  That’s it. So some medications are actually made from those types of extracts. So we kinda reviewed the diet and lifestyle things, and that these drugs work a couple different ways. You mentioned the lisinopril or the hydrochlorothiazide. These are like water pills. They just cause you to pee more and lose more of the fluid then you have ones that affect the angiotensin-converting enzyme that affects—it’s in the lung

area menu of ones that affect the receptor sites in around the heart whether it's the beta blockers or the—these adrenergic receptor blockers that affect heart contractility, so there’s a couple different ones there and again in the end, we want to get to the root cause of why you have these blood pressure issues to begin with.

Evan Brand:  Yup, absolutely! I’m sure we can make this an hour—an hour-long show but it always is going to end. You got—you gotta dig deeper and figure out. We could talk all day about the lifestyle and all that, but in some cases, people are doing everything right or what they think is everything right and they still have high blood pressure so there could be some other type of infection or something deeper that is causing the sympathetic stress and we just have to uncover it and I don’t know if I mentioned it to you. I ran a 401H and a GI MAP side-by-side on a female, let’s see about two weeks ago, and the GI MAP showed up with seven infections including two parasites and the 401H showed up with nothing.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Is that not crazy?

Dr. Justin Marchegiani:  That is pretty crazy. The other one was–

Evan Brand:  So I sent over—

Dr. Justin Marchegiani:  Was the other one the GI Map?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Okay. So we got DNA technology on one versus the antigen-based under the microscope technology on the other.

Evan Brand:  Yeah and I have to go on symptoms because I mean those a lot of symptoms, so get tested but—

Dr. Justin Marchegiani:  Well, you know my—yeah.

Evan Brand:  What were you gonna say?

Dr. Justin Marchegiani:  You know my method on that. If anyone has got symptoms we always wanna cast a bigger net because we have the possibility for holes in one, so 2 tests as a minimum when we’re looking at gut infections for sure.

Evan Brand:  Yeah.  Yup.

Dr. Justin Marchegiani:  And again the nutrients that are so important for heart contractility where we’re always trying to—if we go off on a tangent everyone, we’ll pull it back in and try to relate it, but the nutrient deficiencies caused by some of these infections, these nutrients like the magnesium and the B6 and the folate and all of the other minerals, potassium, magnesium, etc., zinc are really important for heart contractility and blood pressure, so if we have holes in our intestinal tract metaphorically, where we have a decrease in the absorption of these nutrients, that can affect our vasculature and our blood pressure for sure.

Evan Brand:  Yeah, so we’re talking SIBO, other you know, any type of bacterial overgrowth problems, yeast problems, parasites, things that are stealing your nutrients basically you’re referring to where you're not getting fed yourself because you're starving from the inside out because you’re feeding something else and not feeding yourself or hydrochloric acid levels are low. I mean, could we go as far as to say—

Dr. Justin Marchegiani:  A hundred percent.

Evan Brand:  This cascade could start by having heartburn and then getting put on PPIs which then reduces hydrochloric acid, which then reduces absorption, so then the nutrient deficiencies cause the hypertension.

Dr. Justin Marchegiani:  A hundred percent and I've seen so many patients that are adrenally fatigued or have adrenal dysfunction per se, and they can't really regulate their blood sugar. They have to eat every two hours and their blood pressure gets super wonky, right? It goes down below 90 sometimes and we have to flood their body with extra minerals, enzymes, and hydrochloric acid and eat every two hours just to be able to maintain everything because the glandular system is so out of whack, which again correlates back to blood pressure. Now in this side of the fence, we’re dealing with the lower side which can still create just as many issues, not as quite dramatic as the high blood pressure ones with stroke and heart attack, right? Heart attack is occlusions and blockages in the heart. Strokes obviously conclusions and blockages in the brain. So we wanna do our best to avoid the high stuff and make sure we adhere to as many of these natural strategies as possible.

Evan Brand:  Yup, absolutely. Well said. So if it's high, implement the stuff that you can, take the free information, and then if you need to work further, work further. Reach out to Justin. Reach out to myself. Get help. Get this taken care of. This is something that is so common, but that doesn't make it normal. So many people can relate to high blood pressure, maybe you've dealt with it or you have a family member that’s dealt with it. I could think of a dozen people off the top of my head and they just get put on the drugs, nothing ever changes with diet and lifestyle, they continue to suffer and will get more symptomatic as time goes on. So don't be in that statistic. You can—you can get healed and you can reverse this without too much hassle and a relative amount of time.

Dr. Justin Marchegiani:  Exactly, so if someone's tuning in now, maybe they fell asleep the last half hour, well, shame on you. No. But here’s the general gist, okay, here’s the gist. If you fell asleep and you’re waking up now, diet—get it in order, just what Evan said, get the carbohydrates dialed in. If you’re overweight, start with just vegetables and maybe add in a small amount of low fructose types of fruit. From there, optimize fat, become a fat burner, and then on top of that, look at the adrenals, look at your stress, make sure that’s dialed in because of the cortisol response. And then off top of that, look at the nutrients—magnesium, zinc, hydrochloric acid. Look at blood pressure medications, potential being—

Evan Brand:  Omega 3’s.

Dr. Justin Marchegiani:  Omega 3’s. You can look at herbs that can help, the foxglove/Hawthorne types of medications or herbs I should say, which are based off of medications as well.  Omega 3’s, blood thinning, gingko, systemic-based enzymes, Hawthorne. These are all really good things to help kind of support and address blood pressure and then get to the root cause, work with a functional medicine doctor that can help you put—put it all together because it could be a little overwhelming if you’re walking into this and you’re like, “Shoot! Where do I start?” And then also a little bit of exercise and then really look at the fructose, because how that has an effect on the endothelial synthase and the blood pressure via the contractility in the arteries.

Evan Brand:  Yup, well said. And I have heard people say that they like listening to us because it's relaxing. So you did a great job! In case I did fall sleep for the last 35 minutes, you summed it up. So good job!

Dr. Justin Marchegiani:  Perfect! Excellent and again most people that come and see me at least and I think it may be for you, most people are coming because of a whole bunch of other symptoms, and then blood pressure is kinda like a—an artifact there sitting in the background.

Evan Brand:  Agreed, yeah, that's exactly the case. They’ve been through 10, 20 people. They've been going for fatigue or joint pain, but “Oh, I happen to have high blood pressure, too”. And it's something that gets thrown to the back burner and I don't think it should be on the back burner.

Dr. Justin Marchegiani:  Exactly and most people there are just seeing their medical doctor, and medical doctors are more than happy to manage it which we mention is great in acute cases, right? But long-term, that's not gonna be the best option because of the nutrient deficiency. So in the end, you know, don't look at your medical doctor as the long-term person to give you the answers to fix it. They’re just there to help manage it and again, I mean, who wants to manage, I don’t know, diarrhea forever? You want the diarrhea fixed. Who wants to manage a headache forever? You want the headache fixed. So management’s okay in the short run, but in the long run, it gets pretty frustrating and you want to get to the root cause.

Evan Brand:  Amen. You can only put so much duct tape over that—that red light on your dashboard and you just gotta fix what the problem is. Why is that light on in the first place?

Dr. Justin Marchegiani:  Exactly, yeah. Well, this was a great holiday show. I mean, everyone is probably—well, I shouldn’t say everyone but a lot of people are gonna be getting their carbs and the refined sugar and gluten on on this holiday season. I will not be or if I do, it's good to be in a—a way that is ideally grain-free and lower sugar, so I get the mouth feel effects, i.e, the food tastes good but I don't get all the collateral damage later.

Evan Brand:  Agreed. So what if you wanted to do like some mashed potatoes and gravy, would you do something like that and try to get a wheat-free gravy taken care of like a slow-cooked turkey they would have some natural gravy coming off of it or what? How would you do it?

Dr. Justin Marchegiani:  Oh, yeah, some mashed potatoes, I mean, loaded up with some good butter, heavy cream, and then for your gravy, you just throw some of the drippings from the turkey in there with some celery and I use carrots, and I blend it up just like that and it's just super thick. If you want to make a little thicker, you can add a little bit of coconut flour and that’ll give you a nice thick gravy there, and if you want you know, don't go to the potatoes, go to the sweet potatoes that have a little bit of a lower glycemic index, i.e. they don’t—

Evan Brand:  Yup.

Dr. Justin Marchegiani:  They don't go and then will convert to sugar in your blood as fast, so that could be a good move or you can do the white potato. You can do 25% white potato, 75% cauliflower mash, and you mix it in and it gives a—a pretty similar mouth feel mall feel you won't really know that much if you're not using it another glycemic load is decreased by 75%.

Evan Brand:  I know.

Dr. Justin Marchegiani:  That means less insulin.

Evan Brand:  That's excellent. Excellent. Yeah, I got my wife converted over to sweet potatoes now. She's like, “Wow, these are so much better than white potatoes..” I’m like, “I’ve been telling you that for three years.”

Dr. Justin Marchegiani:  Exactly. Anytime I’m dealing with patient's—the key thing with dealing with patients when you're making diet changes, the first thing that they go to in their head is like, “Oh, crap. I gotta remove these foods.”

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That creates a stress response. So I’m like, “No. We gotta be solution-oriented.” What's the substitute? Because there’s tons of substitutes. So if we get them thinking about what’s the substitutes? How can I create the mouth feel? How can I get that taste in my mouth that I want that I’m missing by eating the bad food? How can we get with the good food? So like last night, I wanted a whole bunch of pasta. I’m like, “Oh, I really want pasta.” So I got some miracle noodles which are made from glucomannan, a fiber, basically has zero calories and zero sugar, and I did a whole bunch of butter noodles and I had it with some rotisserie chicken, and it was phenomenal, and I felt like I was eating pasta, but no sugar, no grains, virtually no calories which obviously calories don't matter but it’s nice that you can eat a lot of it and it’s not gonna impact your insulin levels.

Evan Brand:  That is so cool, yeah, and I'll speak for—for myself and possibly you, too—put it this way. I love eating if this way of eating was horrible, I wouldn't do it. I mean, I am not missing out on taste or pleasure from my food at all. I'm more satiated than ever before. I feel so much better. My brain works so much better. The—there is light at the end of the tunnel for sure.

Dr. Justin Marchegiani:  Yeah, my favorite line is nothing tastes as good as good feels.

Evan Brand:  Say that again.

Dr. Justin Marchegiani:  Nothing tastes as good as good feels.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Meaning, it—for me it's more rewarding to feel good later than to get that short taste in the moment of some crappy inflammatory foods. Because in the end it's great but then I just feel crappy. I’m bloated. I’m gassy. I got brain fog. So you gotta weigh in that, you gotta weigh in the deleterious side effects with that short-term thing and a lot of times, there’s a risk for more analysis you can do where you can do where you can pull out some sugar, maybe use some Stevia or Xylitol or cut down the carbs or do a different source there that’s less inflammatory where you feel good and then honestly, if you’re like, “Screw it!” Well, throw in some charcoal. Take a whole bunch of charcoal to help decrease the toxins. That’s another good Plan B.

Evan Brand:  Yeah, I feel like we’re rambling at this point. I feel like this is the talk after the first cider has set in—

Dr. Justin Marchegiani:  Yes.

Evan Brand:  After the main conversation.

Dr. Justin Marchegiani:  Yes. I know. Nice little tidbit for anyone listening though. These are all gems I think though.

Evan Brand:  Yeah, I agree. I agree. Well, let’s wrap this thing up.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Go check out Justin’s site. Justinhealth.com and then check out NotJustPaleo.com. You could reach out to one of us, get help, get to the root cause. Justin's got some free thyroid videos. I've got some videos on my site as well you could check out. So plenty of information. There's no shortage of—of clinical pearls at this point I don't think.

Dr. Justin Marchegiani:  Absolutely. Anyone that’s—well, everyone that’s getting ready to celebrate their holidays, I wish you a Merry Christmas and Happy Holidays, and if you're kinda on the fence here trying to figure out when's a good time to make changes in your health because you’re struggling, now’s always a great time. The New Year is coming up, so feel free and reach out to Evan or myself. Info is below and we wish you a super happy and healthy new year.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Thanks, Evan. You, too.

Evan Brand:  Bye.

Dr. Justin Marchegiani:  Bye.