IBS affects millions of people but is often misunderstood and poorly treated. In this episode, Dr. Justin Marchegiani explains the root causes of IBS and how functional medicine approaches digestive health differently.
In this episode of Beyond Wellness Radio, Dr. Justin Marchegiani and Evan Brand break down why IBS (Irritable Bowel Syndrome) is often misdiagnosed and why conventional treatments frequently fail to resolve digestive symptoms. Most traditional approaches focus on managing symptoms like diarrhea, constipation, and abdominal pain rather than identifying the underlying cause.
From a functional medicine perspective, IBS often stems from deeper issues such as gut infections, dysbiosis, poor digestion, food sensitivities, stress, or toxin exposure. By identifying and addressing these root causes, it is possible to restore gut function and improve overall health.
Irritable Bowel Syndrome (IBS) is a digestive condition characterized by symptoms such as bloating, abdominal pain, constipation, and diarrhea. Functional medicine focuses on identifying root causes like gut infections, microbiome imbalance, and digestive dysfunction rather than simply managing symptoms.
• IBS is often a symptom-based diagnosis rather than a clear root cause condition.
• Conventional medicine typically focuses on ruling out serious diseases and managing symptoms.
• Many IBS cases are driven by gut infections, dysbiosis, or digestive dysfunction.
• Antibiotics and medications often mask symptoms without addressing the underlying issue.
• Functional medicine evaluates diet, microbiome health, digestion, and stress.
• Gut health impacts many systems including skin, hormones, mood, and immunity.
Doctors typically diagnose IBS after ruling out major diseases like Crohn’s disease, ulcerative colitis, or colon cancer. Once serious conditions are excluded, patients are often left with a symptom-based diagnosis without deeper investigation.
Common IBS treatments include medications such as laxatives, anti-diarrheal drugs, acid blockers, and antispasmodics. These treatments may temporarily reduce symptoms but rarely address the underlying cause.
Many IBS cases are linked to underlying infections such as:
• Bacterial overgrowth (SIBO)
• Parasites such as Giardia
• H. pylori infections
• Candida or fungal overgrowth
• Gut microbiome imbalances
These infections can disrupt digestion, cause inflammation, and trigger IBS symptoms.
Dr. Justin Marchegiani: [00:00:00] Hey guys, it's Dr. Justin Marjani. Welcome to the Beyond Wellness Radio podcast. Feel free and head over to justin health.com. We have all of our podcast transcriptions there, as well as video series on different health topics ranging from thyroid to hormones, ketogenic diets, and gluten. While you're there, you can also schedule a consult with myself, Dr.
J, and or our colleagues and staff
to help dive into any pressing health issues you really wanna get to the root cause on. Again, if you enjoy the podcast, feel free and share the information with friends or family and enjoy the show.
And we are live with Dr. J here in the house with Evan Brand. Today we're gonna be talking about IBS and what most doctors miss about it.
We'll be talking about kind of the functional medicine principles and the things that we look at clinically, especially with our thousands of patients of experience. We'll dive into those things and when you deal with IB S's, a lot of different things you have to address. It's not just a one kind of home run situation.
There's a lot of things you have to look at. We'll dive into all of those things today, so make sure you guys stay tuned. Evan, welcome to the podcast, man. How you doing? Hey man. Doing
Evan Brand: [00:01:00] well, doing well. You know, years ago I had IBS, that was my diagnosis, and
Dr. Justin Marchegiani: I went
Evan Brand: through the barium swallow and everything came out fine and they just said it's IBS and it was junk.
And fortunately I was able to look deeper and figure out, okay, IBS is a generic idiopathic term that you get slapped with when you have any sort of digestive concerns. It never explains the actual root causes, and I don't even think if you brought up crypto or Giardia or h pylori, I don't even know if the doctors I saw over a decade ago if they would've even.
Listened, or maybe they would've scoffed at it and said something like, well, did you go to Mexico? Did you go to a tropical country? Did you go to a foreign country? They act like parasites can't exist in the United States, but once I've resolved those infections, my IBS went away. And so it's been interesting to see just in the last decade, talking with thousands of people who have IBS.
There's a thousand [00:02:00] different flavors of IBS and we'll unpack that today, but. It could be a bacteria in one person. It could be a parasite in another. It could be mold in another. So this idea that there's gonna be one drug or one mechanism that's gonna fix IBS, it's just, it's shortsighted and it can go much deeper than that
Dr. Justin Marchegiani: a hundred percent.
Now, when we deal with conventional medicine, I always like to compare and contrast. What makes us unique is we have to really be skilled about the other team's approach in addressing. IBS because you have to understand what differentiates you, what's what makes you better? Are you holistic? Are you getting to the root cause?
We have to be able to, to distinguish what the difference is. That way when we talk to the patient, we can draw a clear distinction of how we're gonna be more unique, how we're gonna be more root cause. And so when you look at conventional medicine in general. They are gonna be looking at symptoms, right?
You're gonna have diarrhea, constipation, you're gonna have some kind of inflammation, motility issues, digestive upset, dyspepsia, where you just don't feel like your food's being broken down. Well, and then. [00:03:00] Conventional medicine's goal is, okay, let's just rule out the big stuff. Let's rule out irritable bowel disease.
That's Crohn's, that's ulcerative colitis, right? That's significant ulcerations. That's let's rule out maybe cancer, right? With some kind of a colonoscopy or endoscopy. Maybe we'll run like a CBC or metabolic profile to make sure enzymes aren't crazy or immune cells aren't crazy. We're gonna rule out potentially, um, gut inflammation, sky high calprotectin, and we're gonna look at blood in the stool, oco blood in the stool, if it's some kind of, um.
Weird thing where they'd wanna run a parasite, parasite test, or gut test. Most don't run it. But if they do, it's usually more the conventional old stain technology through a microscope and a stain that are gonna be less sensitive. And then from there, they're gonna rule out IBD, Crohn's, ulcerative colitis, uh, maybe even celiacs, right?
They'll use a crude way of looking at celiacs. They're gonna look at like a MAR score. See if you're a MAR score three or higher, they'll look for that 80% micro V lab. Atrophy. It's gonna be things that are gonna be really big, big issues are ruling out. And then once those are ruled out, they're not [00:04:00] gonna have that much to offer you.
Some will recommend a low FODMAP diet. Again, the conventional low FODMAP diet isn't that great 'cause there's still a lot of grains and other things being consumed. Um, there's no. Emphasis on reducing inflammation and maybe they run a SIBO breath test, maybe where they give you a lactose solution, but for the most part, that's it.
And then now you're left with laxatives, maybe, uh, motility things that decrease motility if you're on the fast side. Right? Decrease it on the fast side, on the diarrhea side, or speed it up if you're on the LA on the. On the constipation side, maybe antispasmodics, right? Maybe things that help with the pain or coat the gut.
Maybe acid blockers. Maybe they recommend an antidepressant to help with motility, and that's it. And then that's, you're you's it and then you're just managing symptom with drugs. And then we as a, on the functional medicine side, or have a much more of a system-based approach where we look at all of the big inputs, food, the multitude of different infections, not just parasites.
It could be parasites, worms, h pylori. Different SIBO bacteria, uh, Clostridium [00:05:00] fungal or yeast or candida overgrowth, maybe even colonized molds. We look at the whole gamut, and that's just the gut bugs, and then we can go into everything else deeper in the podcast.
Evan Brand: Well said, man. It's a great way to unpack it and it's not, it's not a bad idea to rule out the cancers and the polyps and No, the scary things like if you have suffered, especially if it's been a decade or more and you've suffered, sure.
You might want to go through that conventional workup and just see and make sure there's nothing crazy. Can't hurt.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Most of the time people have already done that though, before they come to us and they're like, Hey, I've already been ruled out of X, Y, Z, but I still feel like crap. My gut's still a mess.
Now what? And that's where the GI testing that we do is gonna come in, because this is gonna show things that they miss. So we're gonna see things like gluten antibodies, and you could have a woman who says, oh, I was told that I don't have, uh, Celia. So they're just eating a bunch of gluten, which is irritating their gut causing skin, mood problems, anxiety, depression, things like that.
So there's definitely a gut brain connection that they're not gonna help with, and they're definitely not gonna help with finding [00:06:00] the bugs, and they're definitely not gonna help with using herbs and botanicals, roots and barks and flowers, and all the extracts we use to clear gut bugs. So this idea that an antibiotic course is gonna fix your sibo, it's not gonna work.
In many cases, people have already been treated with rifaximin for sibo. And it's interesting, not much on the functional medicine side, but on the naturopathic doctor side, I see this a lot. People that use rifaximin, it's an antibiotic. They use it for si and most people have already done that and they relapse.
I just, I think it's generic. Maybe it does some good, but we found much better success with the herbs. So we do not need to prescribe pharmaceutical drugs to fix IBS. And I'm living proof. I mean, my gut is calmer than it's ever been, and it's such an amazing feeling. Your gut should be so calm that you don't have to think about it.
You can just do your job. You can go to work, you can take care of your kids. You could do the daily chores, but if your brain is going alert. Something in the gut, it's still not right. So whether that's gastritis [00:07:00] created by an inflammation or a food sensitivity, we're gonna be able to uncover it. We just have to get some data.
And the gi, you do it at home. That's the first place to start.
Dr. Justin Marchegiani: Yeah. And when you look at, you know what the conventional medical treatment for a lot of these things are. So 1 99, 90 5% of patients that go through that workup, they're gonna have nothing. They're not gonna come back. Right. And let's say they're in that 5%.
Okay. So let's say they say you have celiac. Well, they're still not gonna fix the underlying inflammation. A lot of times they make you do a challenge test, they can make you feel worse. Uh, they're looking for a significant amount of micro vli atrophy, 80% what have you, 50% right now. What? So then you do, you, if even if you have celiac, they're probably gonna misdiagnose that because the amount of atrophy they need to see is very high.
Uh, next to medications are gonna have side effects and they're not gonna fix the underlying systems, right? The body systems, hormone, gut immune detox, mitochondria. They're gonna fix the underlying systems that are being impacted. And so then you're left with more medications. You're left with omni prazole, you're left with antispasmodics laxatives, [00:08:00] motility enhancers.
And let's go look at some of the top 10 medications of the last year. Um, when you look at some of the big ones, you're gonna see Humira. Which is gonna be autoimmune conditions. You're gonna see things like skyrizi, again, that's gonna be psoriasis, Crohn's autoimmune conditions. You're gonna see things like Stelara, autoimmune conditions, right?
They're blocking interleukin 12, interleukin 23 TNF alpha. And then before that we had Humira, which lost its patent in the last few years, and Skyrizi is kind of knocked it out, but we have like really top three. And then you can even do Dupixent for skin, which is another autoimmune issue. So when you look at the top 10 medications.
Sold in the last year, like four out of the top 10 have an autoimmune component. And so that connects right back to the gut because we know 80% of the immune systems in the gut. And so see how conventional medicine is just prescribing medications, they aren't really fixing the underlying issue. 'cause more people have autoimmune condition conditions in ever before.
And more people who have cancer than ever before. You're looking at, a lot of the cancer increases [00:09:00] with more drugs and more treatments. We're still having more diagnoses, so we're not fixing the underlying issue. We're coming late stage. We're not fixing the underlying systems better out of balance that are driving these symptoms downstream.
We wanna go upstream to the systems we. Hormone gut detox and look at the underlying stressors, the food, the infections, the mole, the poor digestion, the low enzymes, the low acid, the denomi, right? The adrenal dysfunction, creating that sympathetic response that's shutting down the motility, that's shutting down the acid production, that's shutting down the enzymes, that's shutting down the bile support, and then obviously that shuts down that migrating motor complex, so it's harder to move things through.
Or if I got inflam, we may have very loose stools and now we're. On the diarrhea side, and now we're now we're not absorbing our electrolytes, we're not reabsorbing our protein, our fats. And that can create nutrient efficiencies on the backside as well.
Evan Brand: Yeah. So if you've got brittle nails, if you are losing your hair, your hair's thinning, you feel like your thyroid is not performing well, there's some kind of a weight issue, either weight loss or weight gain that you can't figure out.
We're gonna look in the gut for that as well. And you did a great [00:10:00] job unpacking that whole drug. Thing. It's kind of crazy, you know, there's just billions and billions of dollars being made by just telling the immune system, Hey, shut up. You're being stupid. When reality, our immune system is just being dysfunctional because of these internal infections and toxins and your immune system can self-regulate.
We've seen thousands of cases with autoimmunity completely resolve and go into remission just based on clearing bugs. There's not necessarily a magic. Autoimmune protocol. It's just fixing the different triggers that are in each person's body. You and I have talked about Hashimoto's and Klebsiella, so Klebsiella's a known trigger of autoimmune Hashimoto's.
Mm-hmm. We test for that in the gut. So if you have an autoimmune thyroid condition, you gotta look in the gut. You can't just go on Synthroid and call it a day. You gotta look deeper.
Dr. Justin Marchegiani: 110%. Now, when we go look more at conventional, I like to compare and contrast. So we have food sensitivity evaluation. Most conventional medicine won't look at food issues, and if they do, they look at it from an IGA skin prick standpoint where there's more of an [00:11:00] anaphylactic connection.
They don't look at other chronic food allergy issues where there could be more IGA stuff, more T-cell mediated issues. I'm not a huge fan of testing 'cause a lot of times. The immune system may have other ways of reacting, and so I'm a bigger fan of an elimination provocation diet as well. Um, also we have to look at the nervous system because how conventional medicine looks at the nervous system is they may just throw an SRI at you to kind of help with motility, but we know if someone's in chronic fight or flight stress, right, adrenal dysfunction, chronic stress, that may impact their ability to make enzymes and acids.
And conventional medicine is notorious for shutting down acid production, not increasing it. And that may be necessary if someone has ulcerations and gastritis and Barretts and all these different things. But either way, we still need acid. Acid is part of normal physiology. Some may not be able to handle it.
And there's other strategies that we can do regarding soothing the mucosa using different nutrients that are less [00:12:00] inflammatory to support digestion in the gut while we build things back up. And then we add an acid down the road. Two.
Evan Brand: Yeah. I love taking acid and enzymes. And the other day I just had this weird spell where I was like, uhoh, it feels a little, a little gastritis like, and so I just popped a few capsules of some herbs, aloe, some zinc, carnasine, some marshmallow, and then boom, it quieted the thing down.
So who knows? I mean, you could pick up a random norovirus or enterovirus, something that tears up the tummy and you don't know really how to approach it. So I want you guys to have this stuff. In your cupboard, in your pantry, I want you to have some tools. That could be acid and enzyme, that could be gut soothing remedies like zinc, Carine, DGL.
There's so many options that we have on the natural medicine side that for you to go and reach for Tums or Imodium ad or Pepto Bismol. I mean, there's still commercials of that stuff. It feels so outdated. I'm like, I was watching commercials of that stuff when I was a little kid sick from school. I'm at home watching Price is right, and here comes Pepto-Bismol commercial.
I'm like, this [00:13:00] is still on tv. I can't believe it. And it's not. It's just not, not the, not the place to be in a short pinch stranded on a desert island. All you got is Pepto-Bismol. Yeah. Maybe to take away some of your misery, but man, on a daily basis, to see even young kids being prescribed miral relaxes and saying, I had a case last week of a young child, 6-year-old, with gut issues.
Pediatrician, put 'em on MiraLax. I'm like, really a pediatrician passing out MiraLax. This is unbelievable. When we know extra berries, extra vitamin C, extra magnesium may be enough to get the bowels moving. So it's just insane how quickly we're just gonna throw in. A manmade synthetic chemical into the body.
When there's something like vitamin C, you can buy a pound of pure sodium ascorbate for 20 bucks. If you take a teaspoon or two mm-hmm. Per day, it's gonna be rare for you not to be pooping.
Dr. Justin Marchegiani: Oh my gosh. And then when we look at MiraLax, MiraLax is an osmotic. So it's a polyethylene glycol, it's an [00:14:00] antifreeze derivative, it's an osmotic.
So it's pulling water into the colon to, to help move the bowels. Right. But you know, there's other side effects. So if you have, let's say you have IBS. Well, you're doing MiraLax to help with constipation, but it also can create bloating. It can also create gas and cramping, and then it can create loose stools, it can create nausea.
And then over time, guess what? It can cause it can create electrolyte imbalances. That's a big deal. And when you have electrolyte imbalances, guess what? You can have headaches. You can have dizziness, you can have fatigue. You can have brain fog issues can now your potassium, magnesium and your electrolytes are low and it does not fix.
The bio flow issues, it does not fix the stomach acid. It does not fix the dysbiosis, did not fix the nervous system imbalance that's causing the migrating motor complex. It doesn't fix anything. And so when you, when you understand functional medicine and you see the bandaid approach that conventional medicine takes, it ignores too many of the root causes.
So conventional medicine may work great in a couple of days a week. You're, you're under stress, you got this, [00:15:00] you need a bandaid thing for the holidays, but you understand, hey, I'm gonna get back at it with my functional medicine doc in a week. Okay, that's fine. Right? I have no problem with that. But the problem is the bandaid approach ends up being the forever approach, and that's where we have to kind of draw that line.
Nothing wrong with the bandaid. I'm not a purist, right? If you drank too much alcohol the night before and you have a headache, take an ibuprofen. That's fine. I mean, but make sure you take some electrolytes, maybe go to the natural stuff first, but then get you to the root cause down the road so you're not having to re rely on that thing all the time.
That's
Evan Brand: all. Yeah. Well said, and we want your feedback on the podcast too. We were chatting pre-show. We've recorded between us both and then other shows we've recorded with other people over a thousand episodes. Mm-hmm. Between us, easy, easy, easy. In the last decade and years ago, some of our podcasts were an hour, some were 45 minutes, some were half an hour.
And we're looking at some of the, the stats and the retention and everyone, I mean, probably us included, so no judgment has. A short attention span, like a goldfish. And so it seems like the sweet spot is somewhere [00:16:00] in maybe the 15 to 20 minute mark. Unless it's like a crazy Elon Musk or a presidential interview or something like that, people are gonna tune in for two, for three hours.
But let us know. Put your comments if you're listening, uh, to the, the live video on Dr. Jay's Justin Health YouTube channel. Put some comments there. Don't be shy. Let us know if you've made it this far. Let us know. Is this a good. Uh, I guess duration for you. Do you start to lose your, your, your attention span, so to speak?
After 20, 30 minutes, then you gotta get back to life. Let us know 'cause we'd like your feedback on that and we can certainly summarize things quickly, but we also don't want you to miss valuable information, so it's kind of like a sweet spot of how much can you unpack without you getting too distracted and too busy.
So let us know.
Dr. Justin Marchegiani: Yep. Absolutely. Someone in the comments also asked questions about skin stuff, including psoriasis, and I can connect psoriasis, eczema, maybe even subic dermatitis, which has a fungal connection root. Anytime you have chronic gut issues, whether it's IBS or we can connect issues like [00:17:00] IBD, so if you have Crohn's or ulcerative colitis, that's just a genetic predisposition, you could still have the same root causes, right?
Dys, biotic, bacteria imbalances, infections, dysautonomia, that's impacting acid, enzyme bile support. But then genetically, you're expressing with more of an IBD inflammatory issue where IBS doesn't have the inflammatory component. They may have similar symptoms, they may not have the blood, they may not have the increase in calprotectin or ol blood or eosinophilic protein, but they still gonna have symptoms.
And in the end, well, how do we get to the root? And so the genetic predisposition is a big factor in it. But the skin stuff's a big one. So we may see eczema, psoriasis, and when you get to the gut, um, and you fix that and you start to improve it, there's things that can happen that can, that can improve the skin.
Now, with skin, we may think use, like things like curcumin, we may use things like andrographis. We may use things like, like lark tree. These are very helpful at modulating the immune system. And of course there's some good topical things to kind of build back that skin barrier. Sometimes there's microbes in the skin.
We may have to use different. Compounds, whether it's [00:18:00] sulfur soap or tea tree or salicylic acid or good, uh, moisturizing oils to build back that lipid barrier. That can all be important things to, to work it from the outside as well as the inside. Ideally, you wanna hit it from both sides?
Evan Brand: Yeah. The makeup industry, they don't want us because all the foundations and the concealers, and I've seen these makeup videos online, I'll stumble upon a video where you have a woman that's completely covered with acne, like the most insane cystic acne.
The whole thing. Yellow, red, pink, just all shape, all sorts of discoloration. And by the time her makeup tutorial's over holy smokes, you would think she's a supermodel with the amount of layers. And I'm not saying don't do makeup, but I'm saying there's so much you can do for your skin by healing your gut, correct.
Pictures of me, I don't think I have any on this computer, but pictures of me when I was 16, 17, first, first met my wife. My skin was not good. My skin is much better now. It's very rare. Mm-hmm. That I get something now. I think it's [00:19:00] dairy for me. Like if I get, if I get into dairy mm-hmm. I think it will still trigger something on my skin.
Yeah. But overall, my skin is much healthier than it used to be, so I just encourage you. Yeah. If you feel like you're having to quote, cover yourself up and you can't be seen out of the house without makeup. Like if you're to that level of self-confidence, self-esteem issue with your skin quality, the gut is the first place we're gonna look.
Dr. Justin Marchegiani: Yeah, and I watch women as they age. They can be massive differential in how women can age once they get above, you know, 50 compared to men. I think men have twice as much collagen in their skin as women. So women at 50% less, that's a thing. But I think also if you have decades of wearing makeup every day, that has a toxicity element to it.
That's just not gonna help your skin. Or if you're doing extra fillers or Botox, that's not gonna help the skin quality. So one, nothing wrong with using makeup. Just make sure you're choosing ones that are gonna be healthy and clean, right? Use the cosmetic skin database or environmental working grip. Try to choose ones that are gonna be good, clean, healthy minerals.
Try to use, make sure you cleanse your skin with good, healthy, you know, a sulfur soap or a nice gentle soap, [00:20:00] and use good healthy oils. Healthy oils, whether it's emot oil or a good healthy oil moisturizer, to bring that, that skin barrier back and that good moisture back to the skin. And then obviously get the building blocks in.
Get your vitamin A through co liver oil and egg yos. Get your 20 or so grams of collagen peptides a day. Make sure you're digesting and absorbing your healthy fats. I think all those things are important, but if you're putting a lot of toxins on your skin over years, that's gonna compound and and hurt you.
Evan Brand: Yep. Yep. Well said. We'll also look at the urine. There's some stuff we can find there. Fungal mold issues. We don't have to get ciff into that, but
Dr. Justin Marchegiani: urine's great for c diff. It's great for fungus.
Evan Brand: Yeah, but the stool's, the number one, so if you're listening, we have international distribution, so there's no need to, I'm not saying don't go to your local person.
I mean, if you've already done that though, and you've exhausted it and you're still not getting the answers. Let us help, let us get a GI on you and figure out what the heck's going on. Within three months, we can make a significant difference in your gut and your skin heals as a side effect of fixing your gut.
Your fertility [00:21:00] improves by fixing your gut. Your mood improves by fixing your gut, your sleep. Yeah, your hormones. There's so much going on. We didn't even unpack the geeky stuff, which is why we're like, how long do you make a good podcast? But there's the issue of glucuronidation, so. Elevated beta glucuronidase happens when you have dysbiosis, and that causes a recirculation of toxins and hormones, making things like PMS and estrogen dominance worse.
So ladies, if you're struggling with irritability, anxiety, worry. We're also gonna be looking in the gut and fixing some things there. So it's amazing how much of this stuff goes back to your gut. Hippocrates set it however many thousands years ago. He's pretty dang smart.
Dr. Justin Marchegiani: Yeah. And then I think a hundred years ago you have the, um, gastroenterologist, Metchnikoff said, life and death starts in the colon.
Mm-hmm. And so, yeah, the intestinal tract is a, is a big thing. And so whether it's skin, whether it's mood, whether it's energy, or whether it's just, you know, your typical digestive symptoms, bloating, gas, diarrhea, constipation. We gotta look within. Now, when it comes to dealing with the gut, it's not just about killing bugs.
We have [00:22:00] to work on repopulation, re inoculation, prebiotic fibers. We have to work on reintroducing healthy foods. We have to make sure we're actually breaking down the nutrients, and sometimes we have to retest on the backside, of course, and make sure we gut it all. I think it's a, it's just. It's an assumption that, okay, we did one treatment, that we got it all.
That may or may not be the case. There may be infections that are layered deeper into the gut lining that are coming up. It could be you got reinfected from your wife or kids, and so don't forget to do a retest. You may have to do a couple of rounds to make sure you get to the underlying issue of what's there.
And also, you know, you gotta make sure your diet's good, your lifestyle's good. You're not overly hydrating with food. Water's a pH of seven, your stomach's pH of two that can disrupt that pH and acid and enzyme levels. So these are all important things you gotta look at.
Evan Brand: Yeah, and if you're listening and you've suffered for 10 years and we tell you six months to fix your gut, that's pretty fast.
So just try to keep a realistic timeframe in your head, because this idea of like taking an antibiotic for a week or taking an acne medication for a month or something, it's just, it's not, it's not it. As you mentioned, there are sometimes [00:23:00] layers. When I killed h pylori I, crypto Giardia, then new bugs showed up.
So it can happen. And this is why once a year, I think it's a great idea. It's definitely doing more for you than. Getting blood work done, in my opinion, like blood work rarely shows issues unless you're really, really ill. Correct. But once a year, try to try to take a look and get your kids, you mentioned wife and kids.
We work with a ton of kids too. So kids can definitely have strep that goes around the whole family. So once again, if there's mood issues, family wide, we're gonna be looking at the gut. We're gonna try to get the kids, get the spouse dialed into.
Dr. Justin Marchegiani: I agree. And then also when it comes to retesting, that's very important.
I tell patients outta the gate, to be a good patient, you have to be willing to commit For six months, patients are gonna, ideally, you know, we're gonna see at least five to 10% improvement per month. That's compounding. But in general, that six month commitment is important. Now, some patients are brand new within two to three months, but you just don't know.
And there's a lot of layers you gotta unpack. There's a lot of inputs that we're dealing with, a lot of levers that we're pulling, and so it's very rarely just one thing. [00:24:00] Like if you have someone who's celiac and it's purely just a celiac issue, when you really get their diet cleaned up, they can be brand new in a month or two.
But that's not everyone's at that extreme level. Right? And so you just gotta, you gotta have enough wiggle room so you can come back to the drawing table, make a new play and make adjustments. 'cause healing's not a straight line. And so the more patients can get that, their head around that, that the better they're gonna be.
And we can make adjustments along the way.
Evan Brand: And this is fun. Okay? This is supposed to be fun. Eventually, by the end, if we do, if we've done it right, you're actually geeking out on this. You're looking at the biomarkers with us. You're having fun. I know if you're mentally not in the place to have fun, you just wanna get out of misery, totally understand that.
But by the end, the goal is you're gonna be. We're teaching you how to fish. And by that point you're learning, oh, this feels like some upper GI stuff. Maybe I need to reintegrate this compound, or maybe I need to reintegrate this. So we wanna leave you with some tools like that to be able to, to fix yourself.
'cause if you're stuck in fear all the time, that's not a place to live either.
Dr. Justin Marchegiani: Correct. Well, we'll put some common supplements that we like to [00:25:00] recommend out of the gate. We'll put 'em in the description here. So see that. We'll put some lab tests that we recommend as well. Also, feel free, reach out. Evan and I are available.
We see patients worldwide. Evan brand.com for Evan. Dr. J here just in health.com. We see patients worldwide, so if you want that support, feel free to reach out to our teams. We're happy to dive in and get to the root. Hopefully this was a pretty good compare and contrast. So if some of you have already gone the conventional route, maybe some of those things resonate.
Maybe you've already gone that way. Oh, also, I didn't even mention antibiotic use, right? Antibiotics. The excessive antibiotic use creates this rebound effect that can really throw off the microbes, throw off the good and bad bacteria, and that can set you up. I can't tell you how many patients I've seen that have been set up with a lot of excess antibiotic use or even anesthesia from surgery, which can act like a supercharge antibiotic to the gut microbiome.
So those things can be a big thing in patient's history to look out for. And again, if you have that, you wanna see someone like Evan and I so we can fix that and get to the root.
Evan Brand: Yeah, I hit the Rifaximin piece. I see the relapse with the Rifaximin a lot for sibo, but
Dr. Justin Marchegiani: Yep.
Evan Brand: Yeah, [00:26:00] amoxicillin, doxycycline.
There's a lot of these things that are prescribed, passed out like candy. It's wild. We could do a whole part two on antibiotics versus natural ones. Maybe we'll save that for a future date.
Dr. Justin Marchegiani: Yeah, and rifaximin and neomycin tend to be a little bit better. They're a little bit more localized, but still, um, the herbals tend to do better when you compare them in different studies.
They tend to work on biofilms, they tend to work on some of the EFL pumps better. They tend to create less oxidative stress and mitochondrial damage. I mean, just go on chat GPT and have it pull up studies on antibiotics and mitochondrial damage, and you'll see all kinds of different studies are oxidative.
You'll see all all kinds of stuff there. Yeah. Plus we see every day things like h pylori more and more antibiotic resistant too. That's, oh, yeah. You've seen a lot of that too, right?
Evan Brand: Oh, yeah. Every day.
Dr. Justin Marchegiani: Yeah. Saw a patient that had antibiotic resistance in, in all the three major antibiotics, right? Um, amoxicillin, clarithromycin, the tetracycline.
All resistant. It's like, well, of course, of course. Right? And that, that's what they've gone through the triple or quad therapies and they're just not working.
Evan Brand: Yeah. And CDC wrote about that like a decade ago. They called, they [00:27:00] said that we are in the post-antibiotic era because of the rise of these super resistant bugs.
So once again, you damage mitochondria. Now you're chronically fatigued. Your gut's still screwed up. We could rant on this all day, so we'll save it. But this is, yeah, it's a whole nother can of worms.
Dr. Justin Marchegiani: That's a part two. We'll come back to that maybe next week. I like it.
Evan Brand: Alright.
Dr. Justin Marchegiani: Alright guys, hope you enjoy today's podcast.
If you do, thumbs up, comments below. Love to see it. Share with family and friends. Peace out.
Evan Brand: Yeah. And if you need help, justin health.com, that's dr. J justin health.com. We can get labs done in two to three week turnaround time. So just fyi, it's about how it works. Get the test kit sent to your house. You mail it back, two to three week results come in, boom, jump on a call.
By the end of the first visit, you're gonna have a protocol in place if we've got those labs in hand. So that's how it works. It's easy. And we have worldwide distribution supplements. Yeah, unfortunately. Sorry, Canadians. Yeah. Your exchange rate. It's not too good Europe, sorry your government wants to tax you and the VAT and all that, but hey.
Oh, great. We can still get you better. We can still get you better. Yeah. There's a couple, couple hoops to jump, [00:28:00] but you know it all works.
Dr. Justin Marchegiani: I agree. And also last podcast of the, of this year, 2025, so
Evan Brand: Oh yeah.
Dr. Justin Marchegiani: Cheers. You guys enjoy. Yeah. Here's to a great 2026 with everyone's health and healing and happy New year, Evan.
Evan Brand: Happy New year, man.
Dr. Justin Marchegiani: All right. Take care everyone. Bye.
Evan Brand: Cheers.
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