Apple Cider Vinegar and Functional Medicine Application | Podcast #242

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Apple Cider Vinegar, a popular type of vinegar, is claimed to lead to all sorts of benefits.  Weight loss and reduces belly fat are just one of the things that it's most well known for. Made by fermenting the sugar from apples, this turns them into acetic acid which is the active ingredient in vinegar.

Listen to this as Dr. Justin and Evan Brand discuss the wonders of ACV, their amazing benefits, contraindications, topical applications and more! Most importantly, how this infamous vinegar can help you in a functional medicine world.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:08 All about Apple Cider Vinegar

06:59 ACV in Meal Times

09:52 ACV’s Amazing Benefits

15:41 ACV Topical Application

32:59 Low Potassium


Dr. Justin Marchegiani: And we are live. Hey Evan, how are we doing today? Today's podcast is going to be on Apple cider vinegar and its application with functional medicine and we see patients all over the world and we're always trying to use supplements and natural medicine tools to help improve blood sugar, to help improve energy, to help improve a whole host of various physiological markers. So I'm excited to dive into this topic. How are you doing today, man?

Evan Brand: Me too. I'm doing great. I'm actually surprised at how effective Apple cider vinegar can regulate and change insulin sensitivity, blood sugar levels. We're going to get into some of that because you'll see some of these articles that are geared towards moms or just women in general, like here's all these weight loss miracles and it we'll discuss using Apple cider vinegar as a weight loss remedy, which on the surface seems kind of silly and it seems like there's no way that's possible. But you and I were looking into the research and this is totally true, what Apple Cider Vinegar can help with blood sugar. So let's talk about it.

Dr. Justin Marchegiani: Yeah, absolutely. So one of the biggest things that we look at in functional medicine world is going to be blood sugar stability and or insulin sensitivity slash insulin resistance. So blood sugar, the more we can keep blood sugar relatively stable in between meals, there's going to be less surges of insulin on the high side and less surges of adrenaline and cortisol on the low side. So by just keeping blood sugar relatively stable, we prevent a lot of our adrenal and pancreas from having to come to the rescue to help buffer the highs and lows. So of course we make dietary changes, you know, protein, you know, eating more of a good quality protein and fat, having carbohydrates adjusted to our macronutrient needs, right? If someone's more insulin resistant, we'll adjust carbohydrates, focus more on non starchy vegetables versus a starch and fruit. Now that being said, there may be extra supplements we use to help improve insulin sensitivity. On top of that, we may use things like magnesium, vanadium, chromium, gymnema, various berberine. But Apple cider vinegar is shown in many studies to have a similar effect as Metformin, which is kind of an extract from a French lilac flower. But Metformin has great ability of decreasing glucose hepatic uptake, decreasing gluconeogenesis, a gluco gastric uptake, meaning less glucose absorbed through the intestine, less glucose being produced by the liver. So Apple cider vinegar has some great benefits in that it actually is shown to reduce insulin secretions and blood sugar in that first hour after eating. And that's really where most of the insulin and blood sugar is going to bump up is that first hour. So for instance, one study showed reduced blood sugar by 34% after eating 50 grams of white bread. I have one study here in the journal of the American Diabetic Association, vinegar improves insulin sensitivity to a high carbohydrate meal and subject with insulin resistance. And just looking at the graph here, you see a significant reduction in insulin levels, 55% in subjects with diabetes compared to the other. So fasting glucose concentrations, we're 55% more elevated in the group that did not have Apple cider vinegar. So great benefits. They are a lot of that is happening via acidic acid and its effect on the insulin receptor sites and its effect on the liver producing glucose and on the effect of the intestines absorbing that glucose. Pretty cool.

Evan Brand: It seems too easy. You just do some Apple cider vinegar with your meal times and you're going to be better. It sounds like too, let's say you were more lower carbohydrate even indicated genic diet and you want to go do some carbohydrates. You want to eat a big baked sweet potato but you don't want to have as big of a glucose spike. Sounds like this would be a good time to whip out a tablespoon of Apple cider vinegar, throw with some lemon juice in there with it, a little bit of water and drink it down.

Dr. Justin Marchegiani: 100% and in functional medicine world that we're dealing with lots of people that have adrenal issues and thyroid issues and frankly blood sugar imbalances and high insulin levels tend to be a big thing. We see lots of hormone and fertility patients that have PCLs or polycystic ovarian syndrome and there's a strong etiology and those types of conditions with insulin secretions, I mean high levels of insulin, insulin resistance, which is like the higher your insulin becomes. It's like your kids kinda like fighting in the corner after you told them to be quiet like 10 times. You just kind of tune them out and ignore them, right? You become resistant to their, uh, to their, uh, noise, right? So the same kind of thing ourselves become resistant to that high level of insulin. So we can kind of get that volume turned down a little bit. That resistant volume turned down a little bit by using Apple cider vinegar, but we're never going to just rely on one thing. So we're kind of focusing on one tool in that tool belt today. But I want people to, to know that we are zoomed out and we're trying to look at a big picture, but we're trying to zoom in today and give you one tool and that tool belt and talk about where it really benefits and helps.

Evan Brand: Yep. So that was another piece of literature here. This is all in pub med so people can look it up themselves if they want to. We could put links with your show notes for just two tablespoons a day of Apple cider vinegar over a 12 week period resulted in four pounds of weight loss with no other modifications to diet or lifestyle. So I mean that's pretty easy. I mean it sounds like as long as you don't have any major gut issues that would cause you to, uh, you know, have heartburn or anything like that. And even if it's diluted, it would help heartburn. Why don't we talk about the stomach acid connection a bit and how it can help with basically inspiring the body, is kind of my way of looking at it. It's really the, the catalyst, if you will, almost as if you're taking digestive enzymes by taking ACV.

Dr. Justin Marchegiani: Yeah, absolutely. So off the bat, if we're not absorbing and digesting a lot of our nutrition in our food, that's going to be a problem because all of those nutrients go work out, work their way into the Kreb cycle, the January energy. They're gonna work their way into beta oxidation so we can generate ATP and energy from fats. They're going to be involved in our neurotransmitter function, which allows us to manage stress, to feel good, to focus, to feel energized, to have reward pleasure for certain activities that we engage in. And then also they're going to help provide building blocks for our thyroid and our adrenal hormone. So very important. If we can't digest and break down these things, there's going to be a problem. Also, if we don't digest and break things down, then things raw inside of us. They putrefy, they ran certify, they ferment, and that's an a create stress in our intestinal tract as well. So if we can make sure we're digesting and breaking things down, that gives us a huge one that takes stress off of our body. And number two, we get all the nutrients on the back end that helped run all these important metabolic pathways. Very important.

Evan Brand: Yup. So Apple cider vinegar could be used before meal time. To me, that's the best time to do it. If you're going to go for it, you could start out, maybe just one teaspoon, dilute it. I like to make a little homemade lemonade out of it. So I'll do like Apple cider vinegar, lime or lemon juice, sometimes both. And then a little shot of Stevia or monk fruit and some good clean filtered water. And that's it. And just drink that. Not saying drink a whole huge cup of it, but I'm talking maybe like a three to four ounce large shot glass worth of this combination.

Dr. Justin Marchegiani: Exactly. So Apple cider vinegar is acidic, right? It's a C to gases. So it's got a pH of like three to 3.5 or so. So we'll help lower acid. That acidity helps activate enzyme levels, right? So then that's going to help with getting your enzymes and your proteolytic enzymes. And then the more that your food is acidified, that triggers your pancreas and gallbladder to work better and make more bile and more lipolytic enzymes and proteolytic enzymes. So that's really helpful. Also, the nice low pH. Um, and also some of the antibacterial and antifungal benefits may help with CBO and it may help with fungal overgrowth. There's lots of studies on, um, let's say Apple cider vinegar right here, antibacterial action of Apple cider vinegar for foodborne pathogen bacteria, including the really nasty E.Coli 0157. This is the journal of food protection and they showed that E. Coli was significantly altered and endo or destroyed with Apple cider vinegar. So that's really, really, really awesome benefit because we see lots of patients with SIBO and lots of patients with fungal issues and it could be beneficial. Now that being said, I do see some patients with a significant amount of SIBO that sometimes can feel worse with Apple cider vinegar because there is some fermentation with like a healthy Bragg's Apple cider vinegar and that fermentation may increase the FODMAP content of Apple cider vinegar and people may, some may feel more bloated. So that's the case. There may be more significant SIBO that you need things outside of Apple cider vinegar to address that bacteria or that fungal overgrowth. So most people are going to need something stronger than ACV to address those issues, like an herbal actual program and they'll need specific testing to see what's there. But for someone that's kind of pretty stable, you're going to have pretty good benefits, but it may not be enough if you're trying to go after things very specifically when you have chronic gut issues or deeper infections.

Evan Brand: Yeah. Well said. I'm glad you brought that up, which is that this stuff is great, very helpful, but it's not going to replace your diabetes medication if you're still trying to regulate diabetes. It's not going to eliminate parasites and candida overgrowth. It may be an adjunct if you will, but you can't just get rid of gut bugs. Would just drinking Apple cider vinegar all day everyday won't work.

Dr. Justin Marchegiani: Yup. 100% yeah, also, Apple cider vinegar has amazing benefits at flushing out and Guana Dean from protein metabolism and this is part of how it can increase, um, this how we can increase fat burning is it can flush out this Guanidine which the more that's flushed out, that can upregulate your metabolism. And then the glucose six phosphate pathway is upregulated, which allows you to burn better fat and allows you to burn fuel better, like glucose six phosphate is part of that pathway involved in glycolysis and the Krebs cycle. So glycolysis is basically burning of glucose. And that happens right before the Krebs cycle where we have [inaudible] in all these different metabolic pathways that run round. And those spit out ATP. We create a whole bunch of, um, extra hydrogen molecules there. They can enter into beta oxidation, which allow us to generate more ATP through beta oxidation and the electron transport chain. So really, really good benefits with Apple cider vinegar and energy. And then of course, we already talked about the insulin resistance. The more insulin resistant we are, the more we're gonna burn up things like magnesium and B vitamins because those pathways are, let's say, upregulated when there's more sugar and more insulin. So we actually deplete magnesium and we deplete B vitamins more when we have higher levels of blood sugar.

Evan Brand: Man. So let's go back for a second. That's pretty crazy. So I've seen articles and things mentioned where people say, Oh, Apple cider vinegar increases your mitochondrial function based on what you just said, talking about Krebs cycle. That makes sense. So you could argue that Apple cider vinegar could almost be like a pre-workout if it is going to help fuel that Krebs cycle. You could use it, maybe mix it with some of your pre-workout amino acids or something like that. Is that what you're saying?

Dr. Justin Marchegiani: Yup, exactly. Yep. So here's one study here talked about vinegar as a functional ingredients to improve postprandial glycemia control. And they talk about that. Um, the molecule mechanism by which vinegar can improve, I seem to control the mechanism include activation of the free fatty acid receptors. So it's helping you burn fat better. It upregulates the A M P K pathways, which are, let's just say, um, this is the adenosine monophosphate activated protein kinase. These are going to be pathways that are upregulated. They're anti-aging pathways and they get upregulated with certain antioxidants and I'm pretty sure they also get upregulated with fasting as well, leads to increase fatty oxidation. So oxidizing fat is basically shuttling it into the mitochondria and burning it for fuel. It decreases gluconeogenesis. So gluconeogenesis is when the liver makes glucose out of either stored glycogen or protein, which is great. Um, and then also it lowers the free fatty acid in circulation. I think it's cause it's burning it more, it increases blood flow to peripheral tissue, which is amazing. Better blood flow to peripheral tissue is going to help with inflammation because inflammation tends to cause constriction in regards to blood flow increases satiation. So the more satiated we are, the less chance we are. We overeat, the less we overeat, the less insulin we surge. And then, um, so those are the, are the big mechanisms in this one article. So we want people to understand why most people that talk about these things just say, Hey, check out these cool benefits. But then it's like, Hey man, we're the heck the science about it. So we want to make sure that these articles are present. We'll put them in the reference section down below. So if you guys want to take a look at it either on YouTube or on the iTunes podcast, feel free and check. We'll take a take a look at that.

Evan Brand: So blood pressure. There was some research on this too. I saw one study, it looked like it was an animal study. There's probably a human study I haven't found yet, but that the acetic acid, which is the main component in the outside of vinegar, reduce levels of blood pressure. Now, if you're like in a major hypertensive crisis and you are trying to prevent yourself from having a major issue, no, don't just go drink Apple cider vinegar. Make sure you get help from your doctor and get a blood pressure medication, even if it's temporarily while you work with somebody like us to get to the root cause. But this could be a good regulator if you will. Like maybe you're just slightly hypertensive. Maybe you're at like a one 30 over 90 maybe you can help get that closer to your one 20 over 80 with the help of Apple cider vinegar.

Dr. Justin Marchegiani: Correct. Yep. I think it's excellent. Also, we talked about fungal kind of eradication internally. So we may take anywhere between one to three teaspoons as a great way to kind of start things going, mix it in water because the Asita gas, it can be a little bit hard on the enamel, the outer part of the teeth. So we want to mix it with a little bit of water. That way it's going to be diluted and then we just kind of shoot it down and do it like five or 10 minutes before your meal to kind of get your digestive juices going. And that will kind help the application of it. Also you can, um, if you have a sore throat, you can do that same thing and just kinda gargle with it and let it hit your throat for a minute or two. If there's any mucus hanging out in the back of your throat, the acid will kind of emulsify it. Meaning, if you have a whole bunch of fat on the pan and you put a whole bunch of 'em soap on it, emulsifies it, it breaks it off so it can, it can be flushed down into the drain. Same thing with mucus from a throat infection in the back of your mouth. It really emulsifies it. So from an application standpoint, one to three teaspoons is pretty good. Three teaspoons of the tablespoon and at the highest we may even go to two tablespoons on the high end. And that can be great for just the digestive aspects. And then higher more for like weight loss benefits. So you want more benefits outside of just the digestive, you can go even higher and see how that goes.

Evan Brand: Cool. Good advice. Let's talk about topical application.

Dr. Justin Marchegiani: So yeah, I wanted to address that. Go ahead.

Evan Brand: Yeah, so you know, we talk about poop and all that a lot, so I'm not embarrassed to talk about my story. When I had major gut bugs like four or five years ago, I had hemorrhoids and it was very uncomfortable. You're trying to go walking and you feel the hemorrhoid. It's not comfortable. It's a huge, huge common issue. Many, many people don't even talk about it. Everybody just kind of deals with it. And Apple cider vinegar was what I use topically. Just took a cotton ball, put it right on topically. Uh, you know, dabbled in some Apple cider vinegar, dab it directly onto the hemorrhoid and literally within two days it was gone. I did nothing else. I believe I had some Witch Hazel. You and I were kind of talking off air about that too, about witch hazel being a good sort of a stringent, but I don't think I had it with me. I think I only had Apple cider vinegar. I have used witch hazel with many, many other benefits, but I believe Apple cider vinegar was my only remedy and I used it when I had poison Ivy too. I had poison Ivy real bad when I used to work at the park system and I would just do the same thing. I would just do topical, a cotton ball or cotton swab and just rub it right onto the poison Ivy. And it was a huge.. it sped up the recovery time much, much faster and reduce the itching. That way you're not spreading the poison Ivy oil everywhere.

Dr. Justin Marchegiani: Oh 100% yeah, that's totally smart. Love that.

Evan Brand: I've heard of natural remedies like using Apple cider vinegar along with essential oils for like killing fleas and such like on your cats and dogs. But I don't know. I don't know if I would, I'm not sure if it's powerful enough to really do that. Do you have any, you have any feedback or experience with your pets using Apple cider vinegar and..

Dr. Justin Marchegiani: Yeah, so typically there's a Cedar oil that I use from my pets for fleas and I have a couple of herbal callers that have a lot of Cedar oil as the main ingredient. So that's the big thing that I'm using for them now for feed stuff, Apple cider vinegar, I use a herbal nail foot fungal soap or to soak it to herbs and you mix the herbs with Apple cider vinegar and that works phenomenally. I've seen amazing benefits with just cracking heels and extra skin from fungal overgrowth on the feet and or fungal nails and that can work amazing. And the Apple cider vinegar is great because the acidity on it can help decrease bacteria on the skin. So you can either use it kind of topically on your face, almost like as a toner or cleanser. And that can kill some bacteria on your skin. You'd want a moisturize, have a good moisturizer on the back end because it could dry things out. And then you can also topically use it on the hair. So any type of psoriasis or dandruff, a lot of times the dandruff is going to be fungal based. Psoriasis may be autoimmune based, there may be other things that happen have to happen there. Eczema, it could be autoimmune based as well, but it's worth trying it on some of those things. But definitely for seborrheic dermatitis and or dandruff, Apple cider vinegar can be very helpful with too.

Evan Brand: Cool. Yeah. So acne scars, we found some limited research on that. Helping with scarring, so helping just reduce the skin issue. So, I mean, I may even go as far as to say possibly stretch marks. I mean, if it's the same mechanism of tightening things up with the skin, it's possible. I'm not going to sign in blood, but it's possible it could help with stretch marks, but I know at least acne scars, you know there was some cool stuff on that.

Dr. Justin Marchegiani: 100% yeah, of course. Other nutrients are going to be important for that. Like vitamin C and vitamin A are going to be really important because those actually provide building blocks as well as collagen. But it could be an important stimulator.

Evan Brand: Yeah, it's not, it's not a a miracle, it sounds like one, but it still, you still have to address these root causes. Like you could put Apple cider vinegar on your face five times a day, but if you've got bacterial overgrowth in your gut, you're going to have skin issues. You have to get the proper testing and eradicate your bacterial overgrowth problem.

Dr. Justin Marchegiani: Yup. Absolutely. Yeah, 100% I'm also Apple cider vinegar has been shown to help reduce cholesterol. Now is that necessarily a good thing? Well, here's the deal. The worst way to reduce cholesterol is going to be a statin medication because that's gonna decrease cholesterol formation via the melodic acid pathway and that pathway is very important for producing cocuten. So when you take medications to reduce cholesterol, you're blocking internal cocuten production, which is really important for your mitochondria. So we never want to use things that are going to really block internal nutrients, but there is some good benefits on helping it help lower cholesterol. Part of that could be through metabolism. It's not quite sure how that's happening, but it seems to be through healthy metabolism, which is really good and all you need is a tablespoon or two to help improve that. I think a lot of that could be via insulin because when you lower insulin, the hemo method, literary coli reductase enzyme is the main enzyme that's involved in making cholesterol. 90% of your cholesterol is actually made by your body. So when you decrease insulin, insulin's the major stimulator on that enzyme making more cholesterol. So I think the more plausible benefits and to be more metabolic and or through decreasing insulin when insulin is down, you're going to make less internal cholesterol, which is good because then you're, you're only getting what you need and you're not going through it and a means that are gonna have to block it and create more side effects.

Evan Brand: That makes sense. You may, and we probably did a show on this several years ago, but we should probably do it again on cholesterol. Talk about like plant sterols and some of the things we've seen, because we've had a lot of people bring that up with us with, Oh my doctor's freaking out, my cholesterol is this, and we've been able to help regulate those levels using just natural plant sterols and some other nutrients.

Dr. Justin Marchegiani: Yeah, exactly. And we talked about the endothelial synthase and nitric oxide, which is kind of a vasodilator that kind of opens the blood vessels up. We talked about how mold exposure may have caused less of that compound which would constrict more of the vessels. We talked in the past about fructose, high amounts of fructose and sugar. Actually, well, fructose is going to be fruit sugar, but you're going to see more of it with high fructose refined corn syrup that actually decreases nitric oxide endothelial synthase. That's the enzyme that helps vasodilator, opens up your blood vessels. So if we decrease that enzyme, we're decreasing blood flow and acidic gas that which is the main component in Apple cider vinegar is actually shown to increase that which is going to increase blood flow, which is great to help combat inflammation. The more we can, um, open blood flow up, that's like a firefighter having a hose that's wide open when they're putting out a fire. Right? The better waterflow someone can have, the more we can put out the fire or decrease inflammation in your body, which is really important.

Evan Brand: Well that would make sense why it would lower blood pressure too, right? If you're getting more blood flow, more vassal dilation, you know, people may say, Oh well I don't do fructose. I don't do corn syrup. But even if you're not doing soda, for example, corn syrup is in so much, I mean if you're doing just conventional ketchup, for example, let's say you do some homemade sweet potato fries and you're going to do some ketchup, there's probably some corn syrup in there if that's not like an organic ketchup. So you know, sugar and corn syrup can be very sneaky. So just cause you don't drink soda and you're not literally putting a spoon of sugar on your food, it can be hidden in so many different sauces. So make sure you look over that. Even some organic sauces I've seen like organic barbecue sauces I've found that have been loaded with a guy, the nectar, which is going to be really um, blood sugar spike. And then also corn syrup. I've seen corn syrup, like solids for example, in organic flavoring and organic spice mixes, which is just not good.

Dr. Justin Marchegiani: Totally. Also, some of the questions coming in on the live chat, some are talking about the taste. Brags actually makes a really good Apple cider vinegar drink sweetened with Stevia. There's a couple that have sugar, but some have Stevia in it. The lime ones are really good one ginger and Apple cider one have a little bit of sugar in there at the Lime one and there's one other one that's pretty good, that's pretty low in sugar, so those are great options. If someone doesn't like tasting it, you can get one of those strengths and as a full [inaudible] they're really nice. I really enjoy them. The lime ones.

Evan Brand: Yeah. Had the lime one the other day I tried to get my wife to drink and she's like, Oh, so whatever, you know, just get it over with then fine. Put it with a shot of some lemon and lime juice and water and just get out.

Dr. Justin Marchegiani: Yeah. My wife and I are going to be delivering our second child next week, at the end of next week, so we're really stoked. But early in the pregnancy she was having some nausea, so we did ginger, Apple cider vinegar and she did a really good with it and it helped with her digestion. She avoided any acid reflux. We also did some enzymes and HCL, but it really helped with their digestion and to help with the nausea. So if you can kind of pack it up with ginger, ginger is a mother and natural bitter. So it also helps with digestion of you can combine it. It's even better.

Evan Brand: Beautiful. Well I'm, I'm excited for you. I was going to ask you when the countdown is, I forgot to ask you about that.

Dr. Justin Marchegiani: Yeah, it's coming. It's getting real man. And so we're almost there down the final stretch.

Evan Brand: Oh, awesome.

Dr. Justin Marchegiani: So any other questions here or any other things you want to add regarding important topics on the Apple cider vinegar?

Evan Brand: I didn't have, I didn't have my questions pull up on my end. Is there anything else that we should hit from the people?

Dr. Justin Marchegiani: Um, see here? A couple of questions here. Let me kind of dive in and see which one's most relevant.

Evan Brand: If you're reading those. Let me, let me just mention this one other study that we had here, which was about the circulation benefits and the, this is, this is a legit study, uh, from complimentary medicine. The effect of external Apple cider vinegar on varicose veins and guess what? It seriously works on varicose veins. Now my personal preference, I've helped many, many, many women with varicose veins. I've got some amazing before and after pictures I could show you of using a pine bark extract. The pycnogenol extract on an all helps.

Dr. Justin Marchegiani: Those bioflavonoids are very powerful.

Evan Brand: It's amazing. I had a woman who in six weeks, literally 80 to 90% improvement with her varicose veins, but turns out Apple cider vinegar topically can help reduce varicose veins as well, so that's pretty cool. I'm still going to be using the pine bark, but maybe I could throw in some ACV too.

Dr. Justin Marchegiani: Yeah. Some patients or some people here are asking about Apple cider vinegar helping with blood flow. I'm going to guess it does help with blood flow, partly because anytime you reduce inflammation and earth, any blood, their question was more around sending blood. Anytime you open up the vasculature and you reduce inflammation, blood's gonna flow a lot better and the stickiness and the coagulability of the blood will drop so it won't, it won't create clots or stick as much cause inflammation and insulin are big driving factors of that. That's part of the reason why diabetics have so many side effects, especially when the vessels go into your eyes. They're really, really small capillaries. So any stickiness or blood flow issues can decrease blood flow to the eye, which can create cell death. So of course that's going to be a factor. So I'm going to go out in the limits. Apple cider vinegar will help thin out the blood and of course will help improve blood flow based on all those mechanisms just mentioned.

Evan Brand: Makes sense now is they're going to get you to a point where you're, your blood is dangerously fan and like you shouldn't be drinking Apple cider vinegar before you go into surgery. I mean if you're doing a teaspoon a tablespoon a day, I really don't think it would be that powerful.

Dr. Justin Marchegiani: Right? You're probably okay. But worst case, you just cut it out a couple of days ahead of time. That fish oil, any systemic enzymes like Sarah pep, today's can be helpful. Yup. She wrote in, um, is it okay to add baking soda to an ACV? Drank? Well, if you remember like the old volcano experiments and in science class you had a whole bunch of baking soda, it will cause it to foam up. So that may be an issue for people and that may, uh, decrease the palatability. So I would probably say no. Also baking soda has a more, it will alkalize it will neutralize the pH of the Apple cider vinegar. So I'm going to, I'm going to go out on a limb and say that it will actually decrease the benefits of it. Cause part of the benefits are the acidity. And by you neutralizing the pH, I think by carbon it's like a pH of 10 or 11. You're taking away some of the digestive acids stimulating benefits of it. So example soda with it.

Evan Brand: Yeah. I don't even think you're going on a limb. That's totally valid to me. You're, you're literally counteracting the ACV by doing that.

Dr. Justin Marchegiani: Yeah, and we want to kind of look at Apple cider vinegar as a tool plugged into a functional medicine program. Some patients are talking about like, Hey, what if I have stomach irritation or stomach pain from taking Apple cider vinegar? Well, my sentiments would be that you have probably thinner gut lining, like some atrophic gastritis. Now if that's the case and you're taking it five or 10 minutes before a meal, maybe we want to do it with food. Maybe we want to take it with food. Instead of doing a teaspoon, maybe you do a quarter to an eighth of a teaspoon. See if you can tolerate that. Maybe you do it right before you eat, just a couple ounces of water and that's a problem. Maybe you do it with food already in your tummy that way food's already kind of coating your gut lining. So it's not hating raw mucosa, it's hitting some food. So those would be the ways that I would kind of paradise it or kind of titrate it in if someone was already pretty sensitive.

Evan Brand: Well, and let's add an extra layer on top of that conversation, which is, well, if that's happening, there's probably a root cause that hasn't been addressed yet. So make sure you look at getting organic acids testing done. Get some proper stool testing done. You could have some type of infection. It could be something as simple as H pylori that's messing up your gut. It could be bacteria, parasites, worms, it could be any of, it could be all of it. So you'd want to get some biomarkers looked at and measure your inflammation in your gut. Measure your gut lining. You can look at that secretory IGA number on the stool test. Those are all the data points that Justin and I would refer to if we had that come up in conversation.

Dr. Justin Marchegiani: 100% and someone wrote is ACV Ok if you're on blood pressure medications, magnesium, ACV, any of these nutrients, Hawthorne, that helps improve blood sugar, I'm sorry, blood pressure levels as well as blood sugar too, right? Um, it's fine. Just make sure you're monitoring your blood pressure and as your blood pressure drops, you go talk to the prescribing doctor. And have them decrease the medication. That's right. That's simple. So blood pressure is nice cause it's very objective. You can measure it daily. There's no blood draw. Um, the key blood pressure is tested when you're like getting up, test it when you're like relaxed. Cause most of the time people are in a relaxed state, right? If you're sleeping eight hours a day and if you're, you know, you're not super go, go, go, go, go. You know, hopefully you know, 15 hours a day, 16 hours a day maybe outside of the Workday you're in a more relaxed state. So kind of get a window where your blood sugar is when you're more relaxed, when you're stress, blood pressure because blood pressure and or blood sugar should go up because your body's trying to manage that response and it's trying to get more blood flow to those stressed out areas. Right. The fight or flight mechanism, the hands and feet. So definitely monitor it, use other nutrients. Don't be all in one where it's just one thing and work with a good functional medicine doctor so you can help drop those, that dosage.

Evan Brand: Yeah. My grandfather was able to get off his blood pressure medication he had been on for several years by using Hawthorne and some other blood pressure nutrients. Also. I got them off of fructose completely and his blood pressure was like one 20 over 80 now I still keep them on some kind of a baseline blood pressure support protocol, but he's off the drugs. So it is possible.

Dr. Justin Marchegiani: Absolutely. When you get to the root cause it's amazing how much your body can just heal on its own. It's like it's on autopilot. We just got to remove some of the stressors and there's a lot of natural compounds that can help accelerate that. And if we make the right diet and lifestyle changes, just like we really accelerate that path of healing.

Evan Brand: And are we saying drink Apple cider vinegar and go cold Turkey on your blood pressure drugs? No. Obviously you still gotta get to the root cause of the blood pressure drug may be needed and I'm not a huge fan of drugs, but it may be needed until you do fix those root causes. You know, if my grandfather was at 190 over 120 or something and he tried to go off the drug, that'd be dangerous. So we got it back to a really healthy level using the nutrients at the same time as a medication before we even talk with the doctor about changing the dose or getting them off of it.

Dr. Justin Marchegiani: Yeah, and one major side effect I want to highlight because someone in the chat already mentioned this and it's really important, high amounts of Apple cider vinegar can lower potassium. So one person writes in, I usually to drink about two tablespoons of ACV a day, but one day I drank almost eight tablespoons a day and I led to me feeling anxiety after every drink. Why is that? The mechanism is that it can decrease potassium. So when you do with that much amount of Apple cider vinegar, it can lower potassium levels and more than likely that's affecting the heart heart rates. You can just go online and type in hypo kalemia with a K that's low potassium and that can have a lot of effects on heart and breathing. And metabolic function. We need healthy levels of potassium to run our sodium potassium pump. So more than likely, if you're going to opt the potassium, if you're going to up your Apple cider vinegar, that much one probably don't go that high. But if you do, when you're going to push it, make sure you're getting extra potassium, whether it's do potassium citrate in new or cream a tar tar or you're eating extra avocados to give you that potassium, just make sure you're not, um, you know, letting that potassium drop too low. So just be aware of that.

Evan Brand: Yup. Well said.

Dr. Justin Marchegiani: Any other comments there Evan?

Evan Brand: No. Did you see any other good questions? Those are really helpful. I think those added to the conversation significantly.

Dr. Justin Marchegiani: Yeah. So I just wanted to highlight one thing here. So when we look at low potassium, this is a really, really important thing. Most people's potassium levels are low just because you're not consuming enough. So you're going to get enough potassium through consuming six to eight servings of green vegetables a day. You know, one full avocado, maybe a serving a squash or sweet potato, you'll get enough potassium. But the big signs and symptoms of low potassium or hypokalemia are going to be muscle weakness, muscle cramps, heart palpitations. So if you're having those heart pals, difficulty breathing, feeling moody, muscle aches, stiffness, just poor digestion. That's a big sign of low potassium and we need 4,700 milligrams of potassium a day. And if we're more stress and our cortisol is all jacked up, we could be peeing out potassium as we'll pee it out when we're stressed to how buffer that that acidic load from our body's internal acids from being stressed. And so our body will lose potassium. So you may need to get even more potassium when you're stressed and too much Apple cider vinegar will definitely cause you to dump more potassium and be careful with that.

Evan Brand: Yeah, and we're not pharmacist, but we do have some basic knowledge of drugs and think about the mechanism of things like Lasix and some diabetes medications, some blood pressure medications. These can cause you to go pee more. And if you're going pee more, you could be dumping out potassium there. So I've had some family members that were on Lasix temporarily and they ended up getting low potassium. So then of course the doctor puts them on some really garbage potassium tablets to try to help prevent them from going into a low potassium state while they were on these water pills basically. So you've got to always factor in your drugs. How does that factor into the equation? But it's not, uh, not too common for somebody to be on those.

Dr. Justin Marchegiani: I do find Apple cider vinegar though does help with a lot of cramping. So even though you're not getting extra minerals, I do find there's some mechanism where Apple cider vinegar is mobilizing minerals at some level because I do see cramps, eye twitching, muscle twitching, little fussy collation, things do improve. So that's important. So if you do have a little bit of eye twitching stuff or a little bit of like kind of cramping or twitching a little bit of Apple cider vinegar may help. Of course you want to add in the minerals like Redmond's real salt, potassium, magnesium are going to be the low hanging fruit from a mineral perspective.

Evan Brand: Here's one funny one that I'm not going to do but I'll just mention it because it was in some of the articles we were reading. Uh, Apple cider vinegar acts as a natural deodorant.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I wouldn't want to walk around smelling like Apple cider vinegar. So yeah, I may help the armpits but I'm not putting it on there.

Dr. Justin Marchegiani: Right. Yeah. I have a brand that I like. I'll put the brand below Native COS, they're great and they use Shea butter, they use probiotics in there and they use um, caprylic acid from coconut extract. So it just blends in really well and it smells really nice. Um, but yeah, I agree. Not the most pleasant thing, but also just kind of a side note, Apple cider vinegar bug bites. Really good. You get your, this is the time of year bug bites are happening. Put a little bit on your outside table there and get a little cotton swab and just any bug bites hit it. Also, if you have a wart or any lesions, you can get like a um, cotton swab, soak it up, put it on that area and then put a bandaid or a bandage around it and hold it there for a day or two. That will really help potentially these warts heel and other potential skin growths like skin tags, heels, so that can be helpful too.

Evan Brand: Cool. Well let's wrap it up. No, I think we hit it really good. I just want to point out one more time, the fact that we're just using this as a tool in the toolbox. This is not something we're going to go to. If somebody says, Hey look, Dr J, I've got bloating and gas and burping and you know, I look six months pregnant after I eat a meal and I'm not pregnant. What do I do? We're not going to say just drink a bunch of Apple cider vinegar. No, we're going to say, well we need to run some organic acids testing and measure rabid nose levels, right? Acid. We've got to look at mitochondrial function cause you're tired. We've got to look at all your nutrients, amino acids, we've got to take a stool sample on you and look for infection. So this is just one fun tool to discuss in the toolbox, but it is not a replacement for getting a good functional medicine workup.

Dr. Justin Marchegiani: Yeah, the key to a good plan is we need a cohesive program that makes sense over a period of time and you need to assess the body systems and see which systems are working and aren't working and then, why, what's the root cause, how do we get here and make sure the root cause is fully addressed. While we may implement tools that fix the root cause and then some tools are just palliative, they just allow you to feel better in the process with the least amount of side effects in the interim. And so if you guys enjoy this, feel free to click below. You can head over to Evan's site, or my site, at we are available for consultation worldwide and if you guys are enjoying this, thumbs up comments below. Want to know your ideas and your thoughts and um, you know, comments for future podcast topics and also, um, feel free to leave us a comment below like regarding like on our iTunes, let us know, let people know this helps us go up in the rankings. And then last thing, last but not least, as we improve the audio quality. So on the actual podcast we have upgraded crystal clear audio. So if you want to even get better audio than what you're hearing now, feel free and subscribed to the actual podcast channel on iTunes and you'll get like DVD quality audio. So if you want to hear our voices and even better light, that's your opportunity.

Evan Brand: Yeah, I think it's even better than DVD. It's like in studio broadcast in studio.

Dr. Justin Marchegiani: Yeah. So we're trying to up that, trying to make a better product for you guys to enjoy, make the ride home a little bit more enjoyable. Anything else Evan, you want me to do?

Evan Brand: I would just say take care. And if people are suffering, we're a huge fan of people going to the internet and looking out, looking up and finding like natural remedies, home remedies, that type of stuff. I'm a huge fan of that stuff. But you know, please don't replace our podcast on Apple cider vinegar. As you getting medical help, you know, if you need help, you gotta reach out. Whether it's to us, whether it's, you know, talking with your doctor about modifying your diet to help you with, with blood pressure. I mean you've got a, you've got to work backwards. So I just, I, I got to keep reminding people of that because I've had comments from clients before where they'll say, Oh, you know, I did this home remedy for urinary tract infection and it didn't work. You know, I did this or this suppository and it didn't work. And then I had to go to the ER cause I had such bad –. It's like, okay, well yeah, I mean you read an article on the internet that was a remedy for a urinary tract infection. Not the best idea.

Dr. Justin Marchegiani: May not be enough. Totally. Well, great feedback, Evan. Really enjoyed today's podcast. We'll be back next week and you guys have a phenomenal week. We'll talk to y'all soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.


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