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Dr. Justin Marchegiani and Evan Brand talk all about gut testing today. Find out about the protocols they’ve done and what additional tests and new recommendations they have in battling gut issues when you listen to this podcast.
Learn how it is quite normal for a new infection to pop up after having been treated with an initial infection. Discover what steps you can take to effectively treat these parasites and other digestive issues. Find out what different parasites can cause infections and how you can get tested for them.
In this episode, topics include:
02:47 Evan’s testing and symptoms
09:19 Next steps and recommendations
14:39 Additional testing and treating new infections
19:30 Dr. Justin’s lab tests
25:40 Conventional vs functional medicine treatment
Dr. Justin Marchegiani: Evan Brand, it’s Dr. J, man! How are things going?
Evan Brand: Hey, things are good! Winters coming, unfortunately it’s rainy and cold here today. What about—how you doing?
Dr. Justin Marchegiani: Yeah, it’s actually about 75 and sunny and really nice today. So it couldn’t be better.
Evan Brand: I—I do miss the weather. I do miss the Austin weather.
Dr. Justin Marchegiani: Yeah, It is, in general, it is quite good especially this time of year. I was actually last weekend waterskiing just before Thanksgiving and it was perfect. I mean, the temperature of the water was great. I didn’t even have to pull out my wet suit yet.
Evan Brand: Wow, that’s—that’s awesome. I miss the weather and the food.
Dr. Justin Marchegiani: Yeah, absolutely. And it’s been a while since we chatted a bit. I’m, you know, I need my Evan Brand daily dose here.
Evan Brand: Hey, man. I agree. It’s a pleasure talking with you as always.
Dr. Justin Marchegiani: Absolutely. I know you been doing the Adrenal Summit with Dr. Christiansen, which is great. How did the Summit go?
Evan Brand: Oh, man. It went good. I think we ended up with like 60 or 70,000 people registered so it was much bigger than Alan and I anticipated. I don’t know why or how it became so much more successful but put it this way, I’ve spent many hours on the phone with HostGator trying to upgrade the hosting. We ended up having to get a dedicated server because they said, “Oh, yeah. With this upgrade should handle your traffic,” and then we upgraded again and still crashed it. So we ended up having to get an insanely expensive server just to handle the traffic. So that’s a good problem to have. I’ve—I’ve not had that much success with something to continually crash and crash and crash websites so that’s cool.
Dr. Justin Marchegiani: Absolutely, that’s a definitely what we call a better quality problem for sure and if anyone’s listening and wants to get access to the Summit, what’s the best way for them to do so.
Evan Brand: They could just check out adrenalresetsummit.com and they can check it out. There’s 34 speakers including yours which I think was definitely top three talks for sure. Your talk on conventional versus functional treatment of adrenal issues. They can get your talk, the transcripts, all that stuff if they get the—the full package.
Dr. Justin Marchegiani: That’s awesome. Very, very cool. Well, today we talked about gut testing. I know we reported on a podcast we did back I think early in the spring where we reviewed some of your lab tests and then we talked about reviewing some of mine. So today we’re going to review some of my older podcast or my older labs that we did on an earlier podcast, as well as some of yours and some of the retest, and basically the moral the story on this—on this podcast will be recurrent gut infections. Great! You’ve gone through a second, a third round, what do you do? What’s the next up? And typically, other things that happen like what if a new infection comes up that wasn’t present the first time, which happened in your case that I’m really excited to go over.
Evan Brand: Yeah, absolutely. So where should we start? Should we start at my first symptoms when you saw me and you like—you said, “Evan, man, that looks like you got an infection.” Where should we start the journey?
Dr. Justin Marchegiani: I think there will be a good place and then also reviewing the labs that we did back in the spring, kinda reviewing the results of those and then sliding up to present day with you and present day with myself.
Evan Brand: Yeah, I wanna hear about yours, too. So with my—with myself, you know, it took me a while maybe 3-4 months before actually got the test run, wife was busy, we were moving, you said, “Evan, get checked out.” That was like right when I was moving, you know, to—back to Kentucky.
Dr. Justin Marchegiani: Yeah.
Evan Brand: So I the test done. I got the 401H run and that’s where we found the abundant growth of E. coli, that’s where we found the Cryptosporidium, the Giardia. Both of those are bad parasites. You do not want those and so–
Dr. Justin Marchegiani: 100%.
Evan Brand: That’s when—that’s when you and I talked and crafted a protocol together about what we should do to get rid of these things and then it took me from March until August to get the retest of the same lab. The Crypto and Giardia gone. Great. Did not show up with parasites.
Dr. Justin Marchegiani: Nice.
Evan Brand: Something that was detected that wasn’t detected before is H. Pylori. So as of August, the H. pylori showed up and then you and I chatted again about, well, what should we do now? What’s next steps for gut—got gut protocols for H. pylori. So I’m finishing up H. pylori protocol. I plan to retest probably January-February. I’ll do a retest and see—see what’s going on. See if the H. pylori’s gone. Symptoms, skin has improved massively. I’ve showed you and you’re like, “Wow.”
Dr. Justin Marchegiani: Yeah, I could see it in your videos. You—you’ve better skin tone, a little clearer and less—less redness or irritation. So I can definitely see a huge improvement on your skin.
Evan Brand: I—I didn’t realize how inflamed my face was and having breakouts.
Dr. Justin Marchegiani: Uh-hmm., Uh-hmm.
Evan Brand: So I didn’t realize how profound it was until it’s gone. It’s almost like these infections have played dingdong ditch on my skin for so long that I didn’t remember what clear good skin should feel and look like. So that—that’s a massive improvement. Energy levels have gotten better. Sleep is way better. I was waking up in the middle of the night all the time.
Dr. Justin Marchegiani: Yeah.
Evan Brand: When I had those parasites especially around full moons. Now I’m getting some of the best sleep. Also adding the fact that I moved away so—from those high electromagnetic fields, now I’m sleeping better than I have since I was probably 8-9 years old.
Dr. Justin Marchegiani: Wow.
Evan Brand: Like I feel like I’m sleeping like a little baby, like a kid again, and it’s remarkable.
Dr. Justin Marchegiani: Love it. So in general just kinda going back and letting the listeners know a little bit more about your history in case they’re coming into a this a little bit late. You did have a history a while back with IBS, right?
Evan Brand: Yeah, that’s what started this whole journey back 2008-2009–
Dr. Justin Marchegiani: Yeah.
Evan Brand: When I was in college. I mean, the first thing I had to do when I went into a building was figure out where the bathroom was because–
Dr. Justin Marchegiani: yeah.
Evan Brand: I may have to run to the bathroom and that was a—a life, in a lifestyle strategy that I assumed, maybe some people dealt with but it just became normal, right? I mean, I didn’t think anything of it. I knew it sucked. I knew it wasn’t fun but I didn’t know there was a way out. And I went to the conventional docs, they prescribed three drugs which I did not fill any of the prescriptions, acid blocker, anti-spasmodic and some other type of drug, did not take any of those. Removing gluten basically cured 80% of the issue.
Dr. Justin Marchegiani: Yup.
Evan Brand: But 20% of the issue remain where I had this cyclical issue with my gut where every month or every couple months, you know, symptoms would pop up. Maybe get some loose stool and then things would go back to normal. And you think, “Oh, maybe it was just something I ate, maybe I got gluten somewhere, but no it was these infections.”
Dr. Justin Marchegiani: Exactly and the big thing, too, some of the symptoms that you experience after you cut the gluten out even though you had these infections, you had a big improvement with some of the IBS symptoms—bloating, diarrhea, constipation, those kind of things. But you still had other symptoms, right? You are very blood sugar sensitive. You had the cold hands and cold feet, and sometimes you’d have some like some panic attacks, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: Anxiety, heightened anxiety.
Evan Brand: Yeah, I remember—I remember calling you when I was still in Austin. We were going to move and I said, “Dude, I cannot slow my heart down. My—my heart is beating out of my chest. This is abnormal.” Now granted there was a huge amount of lifestyle stress. I think we were moving–
Dr. Justin Marchegiani: Right.
Evan Brand: Driving cross-country in two days. I mean, there was huge–
Dr. Justin Marchegiani: Huge.
Evan Brand: Impending stress, but I was still adrenally fatigued where I was not able to handle it. And my adrenals showed low which I’m going to say is due to some of the malnutrition cause from the digestive issues. My fingernails had the vertical lines. The weight loss like I told you and you saw me when I moved to Austin, I was about 160 pounds and I was down to like high 130s or 140. I lost 20 pounds in a year without trying which some peeps, “Oh, Even, I want that problem.” No, you don’t. No, you don’t.
Dr. Justin Marchegiani: Yeah. It’s definitely not a good type of weight loss, right?
Evan Brand: Yeah, exactly. So weight has stabilized. I’m actually approaching 150 pounds. So I’ve gained back—what is that? About 12—mmm, give or take 5, 5 to 12 pounds, just depending on what my official starting point was when the weight loss stopped.
Dr. Justin Marchegiani: And very little diet changes because you were really on point. I think the only thing we tweaked in your diet is pulling out a little bit more dairy.
Evan Brand: Yeah, unfortunately I had to get rid of the—the organic raw, grass-fed cheeses that I love. The—they’re gone. So now I just do a little bit of butter, some ghee.
Dr. Justin Marchegiani: And you did a lot better. I remember seeing your skin really improved when we pulled out the—the dairy, that last piece there.
Evan Brand: Yeah. Yup, absolutely, man.
Dr. Justin Marchegiani: And then tell me about that the—the cold hands and cold feet. How’s that improved since we knocked out the Crypto and the Blasto—or no, Crypto and Giardia?
Evan Brand: Cold hands, cold feet still there like I told you. I—I’m wearing these elk moccasins with sheep skin in them.
Dr. Justin Marchegiani: Any change at all? Any change at all? 5, 10, 15%?
Evan Brand: I—I say nothing.
Dr. Justin Marchegiani: Okay.
Evan Brand: I think—I think no change at all.
Dr. Justin Marchegiani: But the bigger change you’d say would be more of the mood stuff, the anxiety, those kind of things?
Evan Brand: Oh, for sure. Yeah.
Dr. Justin Marchegiani: Okay.
Evan Brand: I mean mood’s much better. Brain fog, you know, if we looked at—
Dr. Justin Marchegiani: Brain fog, yup.
Evan Brand: If we looked at the 02, you know, we had high candida markers on there.
Dr. Justin Marchegiani: The fungus. Uh-hmm.
Evan Brand: Yeah, so the yeast problem was also causing bloating which was unusual for me. I’d never have bloating before. And when you see—we see people joke about, “Oh, I feel pregnant.” No, for real like you can have massive yeast problems that can be—that can be successfully treated. So the—so the yeast gone. I have no bloating issues anymore, but the cold hands, cold feet, we gotta figure that one out. So if you help me figure that one out, I’m gonna be eternally grateful.
Dr. Justin Marchegiani: Yeah, and it could be some type of inflamed—inflammatory type of thing that’s affecting your thyroid or your adrenals. We’d have to look at your adrenals again. That’d probably be the next step and we got some—some potential test coming up soon. Go ahead.
Evan Brand: Thyroid—thyroid looked good. I remember we talked about that. We looked at antibodies, looked at thyroid levels. I’d have to look back again but it checked out okay. There was no—no Hashimoto’s, nothing that looked really out of whack. So maybe we’ll have to see once this new adrenal test that I told you about the other day, once we get that run on ourselves we’ll have to see what’s—what’s changed. Maybe there’s still some lingering adrenal issues. I would say so, because any type of days where I’m really pushing it, you know, 12-16 hour days, I feel it. I’m like, “Oh, that was too much, too hard.” So I think there’s still some adrenal recovery going on.
Dr. Justin Marchegiani: And one thing we miss though during your last lab test. I have your lab test up here now. Do I have permission to—to go over it?
Evan Brand: Sure.
Dr. Justin Marchegiani: Okay, cool. Your TSH came back really good, 1.290. Your T3 actually looked pretty good, 3.5. One thing I noticed though is your T4 Free was very high, 1.82. That’s off the charts. So I would be curious to see what you’re reverse T3 levels are like. I would not be–
Evan Brand: I don’t think it was on the panel.
Dr. Justin Marchegiani: Nope.
Evan Brand: Was it?
Dr. Justin Marchegiani: No, it was not.
Evan Brand: Darn it.
Dr. Justin Marchegiani: I would not be surprised if your reverse T3 levels were very high because I’m seeing a very high amount of T4 and then a good amount T3. So there’s a—a spillage with that T4 to T3 conversion. So I wouldn’t be surprised if we saw an increase in reverse T3, which you know, are the metabolic blanks that fill up the—the space for the bullets and the clip, right?
Evan Brand: So, wouldn’t this be pointing us back to the adrenals again?
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand: As a major factor?
Dr. Justin Marchegiani: Yeah, one thing that I think we’ll have to do next–yeah, one thing I think we’ll do next is we could talk about looking at the new Biohealth Adrenal Test that’ll be coming out soon which I’m really excited about that we talked about last week.
Evan Brand: Yup.
Dr. Justin Marchegiani: As well as comparing it to the Dutch. I love to see looking at both of those side-by-side what kind of Intel we get and I wouldn’t be surprised over time once we get you fully infection-free because that H. pylori, like we said, is still there. So that’s probably affecting stomach acid and enzyme levels and mineral absorption.
Evan Brand: Yup.
Dr. Justin Marchegiani: So we gotta make sure you’re on hydrochloric acid. How’s that going with you?
Evan Brand: Oh, I take enzymes like Skittles, so I love them.
Dr. Justin Marchegiani: How about hydrochloric acid thought?
Evan Brand: Yeah, HCl, I’m getting about 600, 4 to 600 mg–
Dr. Justin Marchegiani: Per meal?
Evan Brand: With each meal. Yup.
Dr. Justin Marchegiani: I would say taper it up to 3000 mg per meal, so about five capsules of HCl combined. In Dr. Jonathan Wright’s book about, you know, why you need stomach acid. He finds people may need, clinically up from 1000 up to 5000 mg of betaine. So I kind of go somewhere in the middle because I don’t want you to get a peptic ulcer.
Evan Brand: Yeah, I know.
Dr. Justin Marchegiani: So I would—I would try inching up to 4 to 5 capsules slowly in the middle of the meal and just make sure you’re not getting any warmness or irritation.
Evan Brand: So you’re thinking about of a—a gram on the low end then?
Dr. Justin Marchegiani: On the low end, you should be starting there and then working your way up. I’ll go up to at least 3 g.
Evan Brand: Mmkay. So-
Dr. Justin Marchegiani: 300 mg, 3 g.
Evan Brand: So what—what I’ve been using, I’ve been experimenting with the pure—I’ll—I’ll send you—I’ll send it to you about the Pure Encapsulations one where they have— I wanna say there’s 250 HCl in each capsule, and then plus—plus all the enzymes.
Dr. Justin Marchegiani: So what I do with patient like yourself–
Evan Brand: So would you say add–
Dr. Justin Marchegiani: Uh-hmm., go ahead.
Evan Brand: I was gonna say, so with these extra enzymes I’m not sure if I really need X amount of protease x 5, so I wonder–
Dr. Justin Marchegiani: Bingo! Yup.
Evan Brand: H—HCl by itself.
Dr. Justin Marchegiani: Bingo! You’re leading me.
Evan Brand: Then would be the solution.
Dr. Justin Marchegiani: Exactly. So when I’m dealing with patients, typically anyone that has a gut-related issue where we see digestive-related issues or digestive-related gut infections, depending on how bad their gut is, we’ll either separate the enzymes from the HCl just so we can get the pill count more reasonable for the HCl because a lot of the combo ones are about 200 mg. So you need about three times more pills to get the same HCl amount and that becomes a little, you know, convoluted when you’re taking 15 or 16 capsules per meal.
Evan Brand: Yup.
Dr. Justin Marchegiani: So would like the HCl like in my line, it’s HCl Supreme at anywhere between 1 to 5 capsules which that’ll—the 5 will get you about 3 g or 3000 mg on the high-end and then play with the enzymes been 1 and 3, 1 and 2 will probably be fine with the enzymes per meal.
Evan Brand: Mmkay. I’m gonna do it. Let’s see what happens.
Dr. Justin Marchegiani: And when I say play with it, what I mean is with the HCl you have a palpable effet, right? You get the irritation or the—the warmness, right? Those—that kind of feeling with the HCl. Take in the middle the meal. With the enzymes, it’s hard to say. So get the HCl dose gonna fine-tuned first and then once you have the HCl dose, just taper up the enzymes and see if you notice an improvement with how you feel. Like it may just be lighter after a meal, better bowel movements. You just feel like there’s less bloating or less digestive issues, better regularity, start with one. See how you do and then go up to 2, and see if you notice an improvement with any of those symptoms I just mentioned. If you notice an improvement, keep it at the higher dose. If you don’t notice an improvement, you can just keep at the one capsule per meal kinda standard dose.
Evan Brand: So how do you feel about upping the pepsin, because I’m—we’re gonna be upping in pepsin closer to a gram there for it, you know, 3 g of betaine, we may be at a gram of pepsin. How do you feel about that?
Dr. Justin Marchegiani: It’s fine. No problem with that.
Evan Brand: That’s good. Okay.
Dr. Justin Marchegiani: Yup, no problem with that. So looking at your test I would just say the thyroid, I’d like to redo it with the reverse T3 and then follow up with those 2 adrenal tests just because it’d be really great to biohack that and present it to the listeners.
Evan Brand: I know. Were—were the antibodies on there? I couldn’t remember.
Dr. Justin Marchegiani: They were and they came back good, 5 on the TPO which is great, you know, anything below the teens is fine, and then below the one on the thyroglobulin antibody which look good as well.
Evan Brand: Cool, excellent.
Dr. Justin Marchegiani: Yeah, very cool. So recapping, right? You came back with Crypto-Giardia to start and some fungal issues, right? And then we retested and then we saw Crypto and Giardia gone–
Evan Brand: H. pylori.
Dr. Justin Marchegiani: But H. pylori popped up. So this is kind of irritating for a lot of people that have an infection. They get it treated. We see some results with those initial infections being knocked down but a new one pops up. And typically what happens is gut infections can kind of burrow in to the gut wall, so they go, you know, more superficial, right? More distal, the proximal in relation to the gut wall. So they—they burrow deeper in. So typically what happens is the gut lining heals from inside—or I should say from the outer layer to the inner, deeper gut—gut wall layer. So outer layer to deeper gut wall and if infections are penetrating deep into the crypts or into the gut lining or gut wall, then it may take time for them to show up on a stool test. So t typically we knock out those infections, they can hide in what’s called the crypts and we can get this crypt hyperplasia phenomenon where they dive deep into the crypts, so if you look at your hand where your fingers meet your palm, that little indentation, that little U spot, that’s like the crypts. So imagine the outer gut lining, right? The outer gut lining is like the fingertips and the inner gut wall is like the palm, and it can hide in where those fingers actually meet the palm and that’s like the analogy of the crypts in relation to your hand, so you can physically see it. So that’s kinda, as we go deeper in, and we go from like the first knuckle to the second knuckle to the actual palm part where the infections burrow deeper in in relation to your gut.
Evan Brand: Yeah and we’ve discussed that on previous podcasts about healing from the inside out or the outside in, however, you—you want to say it but this is the proof right here. I mean, here these infections are they’re gone but then something else is still there. So basically what you’re saying is with this H. pylori, you’re saying that would’ve been a deeper infection, so maybe longer-lasting or you—you’re thinking maybe H. pylori, the Crypto-Giardia, but since we’re working from the outside in and we’re working deeper now that the H. pylori has now revealed itself. Is that right?
Dr. Justin Marchegiani: Yeah, I think it was always there and now because the immune system has been supported by just knocking out some of these infections, and the gut has kind of healed somewhat, so we’re kinda getting down into the deeper parts of the gut where some of these infections may have been buried deep. And H. pylori is known to burrow deeper into the gut lining, too, right? So scen—two scenarios, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: Number one—actually three scenarios. Number one, the infection wasn’t there and it was a new—it was reinfection over the last 2 or 3 months during treatment. Scenario number two is the infection was missed by the lab or scenario number three, the crypt hyperplasia phenomenon and you know, sometimes it can be typically two or three. The lab may have missed it. That’s why a lot of times we run 2 tests with patients that we highly suspect of gut issues and as you talked about, I’m not sure if we mentioned it, but your GI Map that we ran side-by-side the 401 missed the H. pylori. So little bit different, but the 401 also is the H. pylori antigen where the GI Map was a DNA test for the H. pylori. So the antigen’s the gold standard, right? We have a higher level of false negatives than positives. So the fact that we got a positive on the test is a really good sign we know it’s there.
Evan Brand: Yup.
Dr. Justin Marchegiani: So again, infections kind of burrow in to the gut lining deeper into the gut walls, so the gut’s gonna heal from the outside in and being deeper into the gut wall where those fingers meet your hands so to speak, and that’s what tends to happen we get these infections come into the surface. So with you, we have the H. pylori present but the Blasto—or the Crypto and the Giardia is clear. Is that correct?
Evan Brand: That’s right.
Dr. Justin Marchegiani: Excellent because the Giardia and the Crypto are much more virulent infections than H. pylori.
Evan Brand: I know. I’m glad those were gone. I was thrilled. That was a great day.
Dr. Justin Marchegiani: And so we tweaked your protocol a little bit and we’re gonna check in and see where you’re at in the next month or two.
Evan Brand: Yeah, we’ll see January, come round the time of my birthday or so. We’ll see what’s going and hopefully I’ll be sym—you know, infection-free for my birthday. That’d be a good goal.
Dr. Justin Marchegiani: Yeah, I agree. Anything else you wanna add to what we just chatted about?
Evan Brand: I don’t think so. I’m excited to talk about yours.
Dr. Justin Marchegiani: Yeah, absolutely. So I did some lab tests, too. Okay and I’ve been doing lab tests for years on myself, so it’s always fun to see what new stuff comes back, plus some–
Evan Brand: So where should we start—where should we start your journey. I wanna hear what you think is your starting point.
Dr. Justin Marchegiani: Well, I mean right now gut-wise, I’m pretty darn good, like no real symptoms with my gut unless I eat some bad food. So I try to, you know, for the most part be 80% Autoimmune Paleo, and with the exception of, you know, some nuts and here and there and a little bit of butter here and there, but outside of that I’m pretty–
Evan Brand: Chocolate.
Dr. Justin Marchegiani: Pretty sure, yes, a little bit of dark chocolate. That’s kind of debatable but you know, high-quality 90% organic, you know, good dark chocolate. So that’s kinda where I live most of the time.
Evan Brand: Yeah.
Dr. Justin Marchegiani: And typically I never cheat with gluten. If I cheat, I try to always make sure it’s a gluten-free cheat just because, you know, why not? I have options to do that and I know how good I feel being off that. So that’s where I’m at there.
Evan Brand: I agree.
Dr. Justin Marchegiani: I have a previous history of Hashimoto’s, I mean slightly elevated antibodies, so I gotta be careful with gluten. So I’m really diligent to make sure that’s a priority to not get exposed to that kryptonite for me. That’s number one. Number two, I’ve done gut test and I’ve had relatively good success with being clear with infections. I came back I think in 2009 with the equivocal Giardia infection. I cleared that out. I had a lot of fungal stuff in the past. So I’ve really knocked out fungus, little bit of Giardia in the past. And my most recent lab test in the 401, I actually came back clean. I mean nothing. No growth, no bacterial issues, no, nothing. So I was really excited about that and then on the GI Map test, I did come back with a little bit of C. diff, a little bit of salmonella, a little bit enterococcus overgrowth, a little bit Morganella morganii, and then a little of Geotrichum fungus and–and some lower enzyme. So you know, I’ve upped my HCl, upped my enzymes, we’re knocking out some of the bacteria and that bacteria isn’t that bad. That’s kind of benign stuff, so we’re knocking that down right now, and then I also ran the DRG. So I ran the DRG, the GI Map, and the 401H, all at the same time, which is really cool. And on the DRG, I came back with a little bit elevations in fecal fat which we kinda suspect right because my enzymes were lower so we’re upping the enzymes, upping the HCl a bit, that’s—I’m confident it’s helping. E. histo came back slightly elevated. Come back—came back at 688 on the GI Map—I’m sorry, on the DRG. Anything 350 or higher is considered positive and–
Evan Brand: So let—so say that one more time. So anything above 350 is a positive for the histolytica and you were what?
Dr. Justin Marchegiani: I was 688, so I was–
Evan Brand: Ahh.
Dr. Justin Marchegiani: Almost twice the limit.
Evan Brand: Tell people—tell people what that is, just so they don’t like glaze over and glaze over and go like, “Whoa! Histolytica, what is that?” Talk us through it.
Dr. Justin Marchegiani: Yeah, so a Entamoeba histolytica, it’s an amoebic infection. The histo- means cell, -lytic means to cut, so it’s an amoebic infection the cuts through cells, right? Doesn’t sound too nice. We see it quite frequently but it’s, you know, on the nastier side. It’s a pretty bad infection. Dr. Kalish was one of his weak links that really knocked him out for a bit, infection-wise. Other people and clinicians I know have gotten it and been hurt by it, but it’s a nasty infection. It’s an amoeba. So it’s gonna be small. You’re not gonna see it in your stool. I do a lot of waterskiing in Lake Austin so it’s possible it maybe some water. I swallowed some water and I got it that way. I go to Mexico quite frequently, so it’s hard so it’s hard to say what the vector was, but we’re knocking it out. We’re knocking it out right now. I’m on a protocol, just about to be finished, and I’ll be retesting soon and we’ll report our retest results for the listeners.
Evan Brand: Awesome, awesome. Yeah, I think—I think it’s probably—my guess is the waterskiing. Now, what makes me wonder though. Let’s just say that if—maybe you did swallow water, you probably did, but what if it went up your nose, too. So let’s say you fall off the skis, the water goes up the nose. Could you get the same level of—what would you call that? I guess you would just call it an infection. Would—can—can you get that same amount or is the same amount of susceptibility to the infection nasally as opposed to orally?
Dr. Justin Marchegiani: I would say it’s possible for sure. I would say it’s definitely possible. I’m not a—I don’t see many nasal parasitic infections. I mean you’re gonna have a lot of IGA and immune membrane protection there that’s gonna help kind of knock things down. Plus I think–
Evan Brand: Well, I just wonder—sorry, I don’t mean to interrupt you.
Dr. Justin Marchegiani: Yeah, no problem.
Evan Brand: I was just wondering if you get it up your nose and then you feel it drain down into your throat and then go into the GI tract that way.
Dr. Justin Marchegiani: Yeah, that’s what I would imagine what happened because your body’s gonna produce mucus and things to—to slide it down into the gut because the gut’s got a highly acidic environment where it can kinda be like bleach on that dirty picnic table and kinda clean things up. So I would imagine the body’s gonna start the immune response there, and also flush it into the stomach.
Evan Brand: But if HCl was low due to–
Dr. Justin Marchegiani: Stress.
Evan Brand: Stress.
Dr. Justin Marchegiani: Yeah, poor habits, eating gluten.
Evan Brand: Then that could have led to the inability for that infection to become more invasive, right?
Dr. Justin Marchegiani: Yes.
Evan Brand: So now that the enzymes are there. If you’re in the same situation again. Let’s just say maybe it was from skiing, if you’re taking enzymes now as a pre-ski supplement, then it’ll you know, that’s—that’s gonna significantly increase your protection. Wouldn’t you say? Because anything that does–
Dr. Justin Marchegiani: yeah.
Evan Brand: Get down, there—there’s protection there. So maybe you did like an Epic barn and enzymes before you went skiing or something.
Dr. Justin Marchegiani: Yeah, maybe maybe some enzymes, some probiotics, HCl, maybe a little bit of herbs. I tried to do a little bit of herbs with some probiotics just to make sure that doesn’t happen. But there’s, you know, there’s the two types of scenarios where this happens, right? There’s the opportunistic bug where you’re your immuno compromised, you’re stressed, your diet’s not good. A lot of physical, chemical, and emotional stress overload and your immune system is now weakened and then these critters kinda sneak their way to the front door, right? That’s like the first scenario. Scenario number two is you get hit with a whole bunch of infectious debris, and it’s like having a gang of people outside your door knocking it down, where you’re kinda defenseless, right? So scenario is kind of a chronic set up where you’re compromised. Scenario number two is you‘re just overwhelmed with the amount of debris coming in there and it’s harder for your immune system to respond.
Evan Brand: Yup, could you speak on the conventional treatment for this. I think sometimes you and I we love functional medicine so much, we forget that there are conventional practices out there which are typically very inferior for this type of issue?
Dr. Justin Marchegiani: Yeah, for conventional parasite, the most common medication that’s gonna be prescribed is gonna be Flagyl or metronidazole that’s gonna be thrown at people. Typically 1 to 2 weeks at the most, and that may work a third of the time, and quite frequently it won’t work at least two-thirds of the time and then you have more conventional docs that have—are using more let’s say advanced type of antibiotics that may work better where it’s a paromomycin or it’s Nidazole or Alinea or Humatin, so there’s other medications that may be used. Again I like to use the herbs first because of their safety record, tend to be a little bit more selecting towards the bad critters and away from a good, and then to also working its biofilms, too, and they have synergistic effects like berberines and Artemisia work really strong together and if you add in silver, it can also make the herbs work better and then you have other herbs like clove or grapefruit seed extract that may be beneficial for fungus as well. So there’s a lot of synergy that you get with the herbs and you can do it longer term without the side effects that you get from the antibiotics.
Evan Brand: I love it. I love it. Well, thanks for bringing that up because I know you’ve had clients and patients say the same thing they say to me which is, “Oh, Evan. I’ve done all the herbs. They don’t work.” And it’s like maybe you’ve just not done the herbs long enough. Maybe the practitioner didn’t create a protocol that was effective enough, but the herbs do work and you and I see it every single week in the clinic that it’s real and you absolutely can’t get rid of infections with functional medicine and the right type of approach.
Dr. Justin Marchegiani: 100% and again it’s gonna come down to what’s the infection and then the dose, you know, we’re using much higher doses. I mean, typically, if you look on the instructions of some of the supplements we’ll use, the dose is probably 75% less recommended and then we use a lot of herbs and nutrients together synergistically. And the key is in my opinion that really helps is we’re building up the immune system by making the diet, the lifestyle changes, supporting the adrenals and/or other hormonal imbalances before we go after the infection. That’s what really supports the immune system so it makes the whole process of eradication much easier and easier to—to rebound back from both.
Evan Brand: Well, that and the fact that you and I both use professional healthcare companies to manufacture our product. So if we’re comparing–
Dr. Justin Marchegiani: yeah.
Evan Brand: A consumer grade herb say from Now Foods or Gaia Herbs or something like that, which can be great. Compared to a professional healthcare product, I mean the quality is completely different, much, much higher. So when you get, say 250 mg of something, you’re actually getting that or you’re getting close as you can to that, versus with consumer grade products that you may buy at Whole Foods, you can’t say the same about absorption rates and bioavailability, things like that.
Dr. Justin Marchegiani: Yeah, absolutely and then we’re combining it, and then the real key thing is we test afterwards, right? You never wanna guess. You wanna test. So then we’ll follow up with that retest and like in your situation, we know the H. pylori came—the H. pylori was—was there, right? That was a new infection. So now that’s on our bull’s-eye. We tweak your protocol a bit and make sure everything’s dialed in and then we go back to the drawing board. So the next step for you is while we’re doing all these things with the H. pylori is get that adrenal re-tested and see where we’re at with it and then the next step would be support whatever systems are out of balance with the adrenals and the thyroid and make sure you’re infection-free.
Evan Brand: Yeah, and I’m going to continue to—I took a little break from adaptogens but I’m gonna continue to add adaptogens back again. I can feel it. I got out of the sauna the other day and I was—I took a shower. I just had a real, real light breakfast, didn’t—didn’t have much at all and—and I had some shakes going on in my hand, so I knew it was a combination of maybe like a healing reaction, but some adrenal stress, too. I could feel it. I was like, “Oh, man.” It’s like Justin, he’s in my head. “Blood sugar, Evan. Blood sugar.” So you know, I had to eat something and—and felt significantly better. But I know there’s still—there’s still some work to be done on the chemical front, too. You and I—we’ll have to do another show if we haven’t already on the GPL talks and we need to get you checked out, too, because I had those insecticides on that GPL that were off the charts and those are probable carcinogens. So that’s a whole another, a whole another podcast.
Dr. Justin Marchegiani: Yeah, we’re gonna have to get that done and we’ll do a whole podcast on that. So kinda wrapping things up for you, knocked out 2 infections, Crypto-Giardia, awesome, really, really good there. Myself, I just came back with the E. histo and a little bit of bacteria and a very small amount of fungus, cleaning that up, been doing that for the last two months, getting ready to retest soon, and again the key thing is doing 2 tests was helpful. I find this really helpful–
Evan Brand: Yeah.
Dr. Justin Marchegiani: Especially when you really want to rule out gut stuff and then outside of that, following up with the retest and making sure everything else is dialed in.
Evan Brand: Yup. Are you doing any—any oreganos for like that geotrichum or some of the other fungus.
Dr. Justin Marchegiani: Uh-hmm. Yeah. My line—I used the GI Clear 5 and I use that at 6-8, 6-9 capsules that I hit it up pretty hard and then I—
Evan Brand: Wow.
Dr. Justin Marchegiani: I followed up with the GI Clear 4 in my line and then I rotate between the 1 and the 6. I went back and forth and I add a little bit of silver, you know, again, I could do a little bit more intricate things because I know I’m gonna do it, but sometimes with patients the big thing you gotta do is compliance ,right? So if you get too intricate with patients, it may create some compliance issues. So I try to keep it more simple, but for myself I—I played around with mixing some things on and off which can be helpful, but again even just going at it straightforward would probably knock the infection out. No problem.
Evan Brand: Agreed, man, so you’re—you’re hitting it pretty darn hard then, 9 of those a day?
Dr. Justin Marchegiani: Yeah, yeah, just about done though. I think I used my last GI Clear 4 this morning so I’m switching over to probiotics I think tonight and then I gotta get those tests back in and retest by the end of the year.
Evan Brand: Yup, how long—how long was your—was your protocol. Was it—did you do 4, 6, 8 weeks?
Dr. Justin Marchegiani: Yeah, I did about 8-10 weeks.
Evan Brand: Okay.
Dr. Justin Marchegiani: I was off for a little bit because I was traveling. It was tough to—to bring everything but I—
Evan Brand: Yeah.
Dr. Justin Marchegiani: I was able to maintain it pretty well. Typically if I cheat with the herbs, I’ll at least take morning and night so when I wake up–
Evan Brand: Yup.
Dr. Justin Marchegiani: And when I go to bed, so at least can get both those in.
Evan Brand: So if compliance is 90%. Most cases you’re gonna do well. Like you said, if the foundations are already built into place and diet, lifestyle, stress management strategies, all that’s in place, too.
Dr. Justin Marchegiani: Exactly, so the key things is if I miss my afternoon dose, I make sure if I’m supposed to get 6 of 1 pill, I wanna make sure it’s 3 and 3. I don’t do 2 and 2, and then just say, well, I’ll go with a, you know, a 30% less dose. No, I keep the dose the same. We just double up.
Evan Brand: Now, so do you believe—do you put faith in the idea or the term, a healing reaction, or do you think that’s just an overhyped term that’s kind of an excuse for someone that’s not getting supported properly, meaning someone’s hitting something too hard but the practitioner maybe is not giving them the proper liver support or if this person is not pooping enough and they’re really constipated that they’re having some of that autointoxication that way. I mean, is there something to healing reactions or do you think that there’s maybe another part of the wheel that just hasn’t been cranked at the same time that you’re killing this stuff off?
Dr. Justin Marchegiani: I think both. I think if someone’s having a healing reaction to start at the normal dose, it tells me that their infection is quite virulent and their immune system and lymphatic system and detox are having a difficult time. I went right up to the full dose with mine and I’d no problem, like not one symptoms.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Maybe a tiny but of lethargy or fatigue. No issue. So if a patient goes up to that full dose and they have reaction, it tells me something. It tells me there’s probably a lot of debris the body is trying to respond to and—and kinda flush out and it’s having a difficult time, so you know, our list making sure diet and blood sugar is there and making sure sleep’s there, and making sure waters there, right? Once that’s off our list, making sure we have adrenal support, digestive support, and nutrient support. Good, now that’s off our list. Then we go to the infection and if we’re still having that, during the infectious time and we’re pooping regularly and bowel movements are regular, well, the real simple thing is we cut everything down, cut it out 2-3 days, get symptom-free, add everything one at a time half dose to full dose, and if we’re really sensitive we may go quarter to half to three-quarters to full. Then add the next product in and as long as we don’t have a negative reaction, we go up to the full dose. If we have a negative reaction, we back off, go to the next product. Like so if it’s at 4 caps, the reaction happens, well, great. Back down to 3. No problem.
Evan Brand: Move on.
Dr. Justin Marchegiani: Go to the next one. Move on. And then once you get everything back in, then you got back up to the first one again and you try inching it back to the full dose. So that’s my supplement reaction or my detox protocol, and then we’ll typically add in side-by-side that is some ginger tea, some activated charcoal, and/or bentonite clay or diatomaceous earth. I typically pick one. I’ve been going more with the charcoal in the DE these days. We’ll even throw in some fiber. It just depends with patients.
Evan Brand: I love charcoal.
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand: Charcoal is amazing. I mean, I’m visualizing this. It’s so fun because it’s almost like being a sound mixer. You picture—you picture the guy at the concert, you know, he has this little lever over here, this little dial. He spins this dial this way, backs this dial down, pulls up this little switch, flips that level, turns that button—boop! I mean, it’s his—it’s so fun to do this stuff, man. It never gets old.
Dr. Justin Marchegiani: I totally agree. So regarding the healing crisis, I think it means something, but I always tell people, don’t be the tough person. Don’t try to tough it out. It means something.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Back off. Get the ginger tea in. If you want to throw in some charcoal in between meals or some extra fiber, fine, and then we’ll gradually increase at one by one. Now typically anyone that has a long history of autoimmune stuff or gut stuff, I always go slow but sometimes you get people that are doing pretty well and then you’re like, well, let’s just back right in to a full dose and they get hit by a bus.
Evan Brand: Right.
Dr. Justin Marchegiani: So we just go back, quarter, half, three-quarters, full or we just start at a quarter half and then increase and any negative reactions, back off to the last safest dose, or—and then move on to the next supplement.
Evan Brand: You’re not going to win a trophy if you finish your protocol faster than somebody else.
Dr. Justin Marchegiani: Exactly, exactly.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Most times if we had add the detox support and curtail the dose, it’s like throwing the lobster in the water that’s already cold. It doesn’t scream, you know, you can—you can just turn it up slowly. No problem. You throw the lobster in the hot water, man. Those things make a, you know, some nice screamy noises that aren’t too pleasant. Even though I love lobster, I hate that—that part so–
Evan Brand: I’ve—I’ve not cooked lobster to—to experience that myself.
Dr. Justin Marchegiani: Yeah, yeah. I have a lot of empathy for animals but I also know it’s the circle of life, and there’s a lot nutrient density, but that’s the whole analogy is, going back, is if you slower you don’t get the—the nasty effects, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: Instead of lobster screaming at your body and your tummy and your limb screaming.
Evan Brand: So for you hopefully on retest, everything’s gone. We’re hoping nothing extra shows up for you like a deeper H. pylori infection.
Dr. Justin Marchegiani: That’s the goal. Yup. I’m i’m feeling pretty good about it, man.
Evan Brand: Awesome.
Dr. Justin Marchegiani: Cool, very cool. Well, anything you want to address, Evan?
Evan Brand: I don’t think so. I think this was well said and we should wrap it up. I think if we keep going then people will fall asleep.
Dr. Justin Marchegiani: yeah.
Evan Brand: So hopefully this was entertaining and I mean, talk about a level of transparency, I don’t think there’s anything higher than what we’re doing and what we’re talking about, so I hope you all enjoyed that and—and appreciate that fact because it—it’s rare to find this level of transparency and we have nothing to lose. I mean, this is—we’re in the trenches every day. So I mean, this is what it’s all about.
Dr. Justin Marchegiani: I think people will really have a lot to learn seeing that their—their doctor or their healthcare practitioner is in the trenches, too, and doing it and still working on their health. And again, I can’t think of any people on, you know, health people on the iTunes or on the Internet world that are getting this level of transparency and exposure out to their listeners.
Evan Brand: Yeah, I mean, not that we have the time to go and—and research, but I feel like we would’ve known by now if somebody was revealing everything. There’s this weird perception, you know, where if you’re the practitioner, you’re the expert, you know, you’re the—the caretaker that everything is just 100% perfect and that’s not true. There’s many different exposures. I mean, you and I do as much as possible as we can to do everything right, but you still go skiing in water where there could be something.
Dr. Justin Marchegiani: Yup.
Evan Brand: I’m convinced that I got the Crypto and/or the Giardia from swimming in Barton Springs.
Dr. Justin Marchegiani: Yup.
Evan Brand: I took in a huge amount of water. So life still happens and as much as you and I can do the things to try to create these little bubbles of you know, a nutrition bubble and lifestyle, and all these great little parts of our ecosystem, we still operate in an ecosystem that is generally pretty toxic in terms of all the things that are out in the air, food, water, soil and you’re going—you’re going to come across stuff and it is just about what do you do to increase your resilience against these things once you kill them off, like you said was some of the post infection support, you know, people may hear—hear this and think oh kill, kill, kill, but eventually we’re strengthening us, too, as the host and so that’s why you and I, you know, maybe we take an extra day off or we go spend some more time in nature because that’s the stuff that’s going to heal you in the long term. You know, you can—you can continue to go through rounds of a gut killing protocol, but at the end of the day, if you’re not healthy, you’re going to continue to get reinfected because the host is weak and if the host is weak, then I mean, that—that’s something Reed Davis said to me, that I though was pretty profound. He’s like,
“Kill, kill, kill.” He said, “But you gotta fix you, too.” The host has gotta be resilient. So that’s where the adaptogens and all the other fun stuff that we chat about comes in.
Dr. Justin Marchegiani: Absolutely and if you guys listening and really enjoying it, give us a nice review on iTunes. You can click the link below. We appreciate your support. Anything else, Evan?
Evan Brand: I don’t think so.
Dr. Justin Marchegiani: Hey, man. Great chat today. I look forward doing this again real soon.
Evan Brand: You, too. Take care.
Dr. Justin Marchegiani: You, too. Bye.
Evan Brand: Bye.