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Autoimmune Disease and the Gut | Podcast #224

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With conventional medical doctors, most solutions are geared to a pharmaceutical, surgical-based outcome protocol to fix autoimmune issues. With medical practitioners, it’s gonna be gut permeability, addressing the root cause, stress bucket. Watch the video and learn more!

In today’s podcast, Dr. J. and Evan Brand goes in depth with autoimmune gut disease, the root cause of most autoimmune conditions, how it tends to emanate in the gut, and many other conditions that will happen because of it: Hashimoto’s, type-1 diabetes, multiple sclerosis, and other types of autoimmune issues. Continue for more and don’t forget to share. Sharing is caring!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

00:27    Irritable Bile Disease

04:34    Conventional Doctors and Practitioners

13:55    Genetic Predisposition

20:33    Epigenetics and Stress Bucket

24:48    Dirty Dozen and Clean 15

26:58    The 6-R Approach

31:22    Getting Everyone Involved

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Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani. Welcome back to the podcast. Today we’re gonna be doing a chat all about autoimmune gut disease, talking about the root cause of most autoimmune conditions, tends to emanate in the gut, and using other many other conditions that will happen because of it: Hashimoto’s, type-1 diabetes, uh multiple sclerosis, other types of autoimmune issues, even type-1 diabetes, so, let’s dive in. Evan, how we doing today man?

Evan Brand: Hey man, happy Monday to ya! I’ve got some statistics. So, why don’t we start out this podcast with some statistics from the Center for Disease Control. In 2015, that’s the latest research I can find, 3 million people are reported being diagnosed. Now here’s the important part: 3 million people are being reported diagnosed. So how many people are having these issues, and they are not diagnosed. But this was with irritable bile disease which would either be crohn’s or ulcerative colitis. We’re not even talking about all the different flavors of gut, we’re not talking just IBS that doesn’t have an official diagnosis, we’re talking literally crohn’s and ulcerative colitis which are not good, 3 million people. And so, uh, the- of course it says here that compared with adults without IBD, those with IBD are more likely to have chronic health conditions like cardiovascular disease, respiratory disease, cancer, arthritis, kidney disease, liver disease. So we know, ’cause we’ve talked about it all the time, once you get autoimmune disease, you’re- several times- depending on what study you look at, several to 5, to 10 times more like to get another autoimmune disease. So it’s very likely that if someone’s listening to this and they have let’s say Sjogren’s, or Hashimoto’s, or uh rheumatoid arthritis, they’re more prone to get IBD of some sort.

Dr. Justin Marchegiani: Absolutely. So, with irritable bile disease, you have your two main ones which are gonna be like crohn’s and ulcerative colitis. These are like inflammatory conditions where we see potential ulceration, like in crohn’s we see these various skip lesions in ulcerative colitis, it’s primarily in the colon, we see bleeding, right, ulcerations and blood in the stool. We may see high levels of calprotectin, we may see immune markers of the charts like either high IGA ’cause the immune reaction is acute and- or- or very low and depleted immune system because we have uhm, a chronic immune issue, and we also may see low ferritin and low iron levels because we’re not able to absorb and- and digest a lot of our iron, we may even see wasting issue, we’re not able to gain weight. May- may see lower protein markers too, like c- like uhm, creatinine and BUN, and just sort of proteins. So these may be other markers we see. Now there are other types of issues in the gut like microscopic colitis, those type of things that are like inflammation but they’re not irritable. They’re not- they’re not like inflammatory like you would see with ulcerative colitis. There- there’s issues with the gut, but they’re not at that uhm let’s just say full onboard inflammatory presentation.

Evan Brand: You made a good point. So like low ferritin, uh low iron, there’s-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -certain type of anemia, so in these people, they may be presenting with other symptoms like hair loss, fatigue, uh, you mentioned the- the muscle wasting-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -essentially, uh, so loss of muscle mass could be happening, and then uhm- did I say hair loss already ’cause hair loss is gonna be huge too ’cause-

Dr. Justin Marchegiani: Yeah, we’re not breaking down protein and minerals, right? We’re not gonna have the building blocks for hair.

Evan Brand: -Your nails, your skin, your-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -hair, all that could be affected, you may be short of breath because we see a lot of women, and when their ferritin levels are below 40, we start to see that they can’t catch their breath ’cause you don’t have enough oxygen in your body, because now you’re gonna be low on your red blood cells, too. So the whole thing can get nasty pretty quick and the conventional medical route is just not pretty with this whole IBD category. It’s just uh, basically biologic drugs, right, if something trying to modify the immune system.

Dr. Justin Marchegiani: Yeah, I mean, you have your biologic drugs, you have your immunosuppressant medications, right? Uh, your methotrexate or even your- like your essen- essentially your chemotherapy. As usual, a lot of time for a lot of these irritable bile diseases, and then you have your high dose steroids, your prednisone. So kinda only have a couple of options, right? This thing is like lialda or mesalamine, which are kind of in that anti-inflammatory gut category. And then some of these things maybe acceptable for an acute period. The problem is, a lot of patients, they’re on these things for their life. So then, what do you do? ‘Cause there’s other side effects like high blood sugar and adrenal issues, and even uhm, bone loss, and other issues from these medications, obviously suppressing your immune system is in good- that could uh, allow you to be susceptible to other types of issues, maybe even cancers and such, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, with a lot of problems that are happening because of the medications, and then maybe acceptable for an acute time frame but, they’re not addressing the root cause. And we always have to look at the root cause and not to mention, not really even talking about the standard American diet. I can’t tell you how many patients I’ve seen that have crohn’s or ulcerative colitis that I’ve helped get into our mission. And there- you know, their gastroenterologist just didn’t even- they didn’t even really cared to ask like- as like, lesions were here, healing and fistulas were healing, and inflammation is going down. There wasn’t even like sense of like, “Hey, what are you doing?”, “Hey, are you making diet change?”, ’cause there wasn’t really this sense of curiosity of like, “What are you doing?”, even though they were seeing objective improvements in the mucosa in their intestines, and their inflammatory markers, and also their B12 levels. B12 is another type of anemia, you have your macrocytic anemia where low B12 causes big uhm- big blood cells, and then you have your macrocytic anemia where low iron can cause really weak anemic, small, tiny blood cells. So B12, big blood cells, low iron, uh, small blood cells.

Evan Brand: When I had uh, Dr. Nasha Winters on my podcast, and we were talking about natural approaches to cancer, she said that she had worked with people using Mistletoe and several other herbs to address cancer. And the- and sometimes these cases of cancer would just spontaneously disappear and going to remission, tumors would shrink, tumors would disappear, people were off of chemotherapy, they no longer need the medication, and the oncologist had 0% interest in figuring out what these patients did, they just said, “Well, I don’t know what you did but you don’t have cancer anymore, you know, get out of my office”, and that was the end of it, it was just mind blowing.

Dr. Justin Marchegiani: Yeah, it’s tuff, I mean you gotta put yourself in the doctor’s position, right? You spent anywhere between a quarter to a half a million dollars over 10 to 12 years of your life studying something, and how could you not have been taught this? How is this missing from your curricula? So even if it is right, there has to be this intellectual open-mindedness to say, “Hey, I wasn’t taught all the most cutting edge is really important things in medical school or residency train”. There was this kinda come to Jesus moment where you’re like, “Man, did they-“, like, “-why didn’t I learn it?”, like, “I thought my s- my education was the best”, “I thought doctors and medical doctors know it all”, and it’s really hard because some people, they either have that moment, and a lot of times, in my opinion, the doctors really have the moment, are the ones that experience it personally, where they have a personal health challenge, and then they overcome it and they feel it themselves personally, or a very close loved one. It’s really hard for most doctors to wake up through their patients. It’s a little bit harder just ’cause you can- you’re a little more of attached, you can excuse things, you can say spontaneous remission, “yadi-yadi-yada”, but when it’s you or a really closed person that maybe you lived with and then you can see, then I think you’re a little bit more open-minded to it.

Evan Brand: Yeah that’s- I think that’s what makes us good practitioners, is that you and I both had our own journey of suffering, you know, I doubt with so many gut issues myself and mood issues through college and, you know-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I just had prescription drugs written for me like really high strength ibuprofen and anti-spasmatic drugs and acid blocking medications, and I didn’t take any of ’em.

Dr. Justin Marchegiani: And it’s tough because you gotta look at like your conventional medical doctor, right? A lot of conventional medical doctors, they may not be the best communicators from like a sales and marketing standpoint, so, if you’re going outside of the insurance or hospital model, you have to really be able to communicate with the public to be able to help people, to engage people and to get patients. It’s really easy to just sit there, you know, kinda in the handout line in the insurance model and having patients just drop off of your office. That’s really convenient and easy, and it’s hard to do that especially maybe if you don’t have the best skill set to go out there and communicate like we do to hundreds of thousands of people every week, so it’s tough.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If people get into this path or they may- their whole livelihood is invested, so it’s just really difficult situation that they’re in, so, uhm-

Evan Brand: A little bit of a tan [crosstalk]- a little bit of a tangent but a very important tangent.

Dr. Justin Marchegiani: Oh yeah, I think it’s important because number 1, why aren’t these doctors able to confront people that are getting better? That’s number 1. And then number 2, uhm, bet your doctor may not know at all and this is the reason why, it’s because of the education is geared to a pharmaceutical, surgical-based kinda outcome protocol, and everything we’re doing to fix autoimmune issues doesn’t exist in that realm. So, what’s the big mechanism that we’re seeing here with autoimmune issues, it’s gonna be gut permeability, right? Being able to separate the outside from the inside of the gut is- is very, very, very important. Uhm, and it’s- and it’s actually really important to think too, when you swallow something, and it’s in your intestinal tract, it’s actually still outside of your body. That’s kinda hard to wrap your head around, ’cause then it gets absorbed into the- to microvilli, into the bloodstream, now it’s inside of your body. So even though you swallowed it, it’s still technically outside of your gut tract or outside of your- your digestive system, outside of your body, but then it goes into your body through absorption. And that gut permeability is one of the big factors that can create autoimmune issues. So, if we have undigested food proteins, undigested bacteria and endotoxins that can get through the bloodstream and really exacerbate and flare up the immune response.

Evan Brand: So, get this, this is gonna blow your mind here. I’m looking at a study right now, which is about EMF and gut permeability. And it’s a- it’s a- it is a study uh from 2017 titled, “Evaluation of the Effect of Radio Frequency Radiation Emitted from WiFi Router and Mobile Phone Simulator” and it just talks about the 2.4GHz WiFi connection and the 900 uh MHz mobile phone connection, and how this can affect the gut barrier. So when we talk about diet, it’s a piece of the puzzle but then I think about all these women, you know, especially you and I, we work with a lot of teenagers too like I’ve had. You know, women that are 17, 18, 19 years old and they wear their yoga pants and then they’ve got their cell phone right on their hip of their- of their yoga pants, but they have a perfect diet, like they’re already on like a paleo diet or an autoimmune diet, we get the gut- the gut testing done, maybe they don’t have many infections but all the sudden they’ve got this major gut problem. I’m not gonna say all of it, it’s tied into EMF, but you can measure using a little portable EMF meter, I’ve got one called the Safe and Sound that I use, little RF meter, you can measure that. And so, I think RF radiation, if you’ve got your phone on your hip all day, or if you talk with our friend Jack Wolfson, you’ve got guys with the chest pocket on their shirt with the cellphone over their heart, and-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -this thing like atrial flutter and afib and all these other gut issues form EMF. So, I think if you’re trying to heal your gut, and you’ve got your smartphone on your stomach all day, that’s probably not a good thing to do.

Dr. Justin Marchegiani: Yeah, I mean, you definitely don’t wanna near any sensitive neurological tissue in it. If it’s- if you’re at a desk all day, keep it on your desk, alright? I have it on a little tripod 5- you know, 3, 4 feet away from you at least all day.

Evan Brand: Yeah that’s what I’ve got. [Crosstalk]

Dr. Justin Marchegiani: And then from walking around, I keep it on my- I keep it on the whole strobe on my hip, uhm, if I’m walking around. I don’t- I don’t keep it in my pocket. And again, the radiation is- is the highest to the first inch of the phone.

Evan Brand: Yup.

Dr. Justin Marchegiani: So wherever that tissue is, within the first inch that’s gonna be the most important. So some girls, they’ll have it like right in- on clipped right on top of their breast tissue, be careful. A lot of guys will have it in their front pockets, I mean, I think having it in your back pockets probably is pretty safe just because there’s a lot of thick tissue, dense tissue there and is not really sensitive on the neurological side. So, but in general, like a good holster, uhm ideally if- if you can gonna line it with something, I put a EMF neutralizer on my phone. But, I think, you know, don’t put it up against your head, try to keep it away from your body. But in general, I think it’s one minor stressor in the stress bucket, and I think there’s a lot of other things that will come- be a- even be a higher priority above that. But, definitely don’t talk against it, get a headset and keep it out of your pockets for sure.

Evan Brand: I would still say if you have to pick and choose your battles, you know, it you had your diet dialed in and you use your phone, that’s- that’s okay like you still gotta use your phone. So like if you’re still a bunch of dairy, conventional dairy, you’re eating a lot of grains, especially non-organic grains that are sprayed, you know, people talk about the levels of glyphosate in grains, it’s insanely high. And we know that glyphosate kills off beneficial bacteria in the gut. So, when we’re trying to find mechanisms, you know, how did someone end up in this situation, you know, the gastro doctor doesn’t ask you how much percent of your diet, like, you could have a paleo diet that is not organic, and then you can have a paleo-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -diet that’s organic, and then you can have an autoimmune paleo diet that’s organic. And that’s gonna be like your highest tier, because if you eat a bunch of conventional meats, all those meats can have the chemicals from the grains. So if you’re doing like a straight corn-fed- GMO corn, 98% of corn-

Dr. Justin Marchegiani: Right.

Evan Brand: -in America is GMO, maybe 99%. All of it is contaminated with mycotoxins, just google it for yourself, corn, mycotoxins study, all corn in the U.S. has mycotoxins which are mold, uh basically the off-gassing of mold. That damages your gut barrier too. Just type in mycotoxin intestinal permeability. We know that mold exposure creates leaky gut too. So if you’re eating a corn-fed burger, that’s damaging your gut barrier, even if you think, “Hey, this is paleo, this is meat”. Not necessarily, there’s a caveat to that.

Dr. Justin Marchegiani: 100%. So, what’s- how does this work? So, there’s a genetic predisposition, right? When you may have a genetic predisposition, the genes that may predispose it but, a lot of times people are confusing genetic predisposition as genetic uh- [Crosstalk]- what’s that?

Evan Brand: I would call it genetic destiny.

Dr. Justin Marchegiani: Yes. Genetic destiny. I mean when you have these genes, err- you’re destined for this. But it’s like, hey, you know, you may have- uhm let’s say your genes are like a variou- like various light switches. You may have all these various light switches, that if that light switches flipped on, you may develop cancer or some kind of autoimmune gut issue like we’re talking about. But you have the ability to not flip it on. And you do that by keeping inflammation down, by keeping nutrient density up, by keeping toxins down. And we know toxins play huge role in gut permeability. Uhm, that round up case down in L.A., I think Bayer boughts uh Monsanto and Roundup basically again, I think the appeal process went through- there’s another trial that went through saying that Roundup did cause cancer in this patient according to the jury trial, I think we’ve known this for a long time, there’s been a lot of studies over in Italy showing a lot of these tumor growth. But in general, what we know is that, Roundup, if you look at some of the studies where they look at the gut lining, they can really rip up the gut lining. I think S- Dr. Stephanie Seneff talks about this in MIT. So the gut component permeability component is really important. And then of course just the pesticides as well can disrupt the gut bacteria, and that can create more dysbiotic kind of overgrowth. So you can see more of this prevotella, citrobacter, klabsie- uh klebsiella, pseudomonas, a lot of these dysbiotic strains really start to go up. And of course, then- are beneficial probiotics strains are gonna start to go down. So we get this dysbiotic overgrowth that can really predispose a lot of issues as well. And that- there’s a lot of studies looking at these dysbiotic bacterias and correlating with the- with autoimmune conditions. So we know there’s with, you know, all these autoimmune conditions whether it’s RA, whether it’s rheumatoid- uhm- whether there’s ulcerative colitis, whether it’s type-1 diabetes or crohn’s, or celiac, there’s a- a big connection with a lot of these microbiome, dysbiotic overgrowths.

Evan Brand: Yeah, I’m gonna restate- I’m gonna restate that in a different way just to make sure it gets through people’s head-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -’cause what’s your saying is very important for people to understand, and you’re not gonna hear this from your doctor. Pesticides, whether this is something you’re spraying on your yard, whether this is something that’s in your food because you’re eating non-organic food, whether this is- you live in farm country and you have people like, you’re in the valley California and you see this plains, at an Amon Farms, spraying overhead, they’re spraying the pesticides, that stuff kills good bacteria at the parts per billion level, ppb. So if you kill the good bacteria in your gut, these bad bacteria that Justin’s mentioned, your pseudomona, your klebsiella, your proteus, all your autoimmune bacteria, those autoimmune triggering bacteria thrive and flourish because the good guys got killed off-

Dr. Justin Marchegiani: Right.

Evan Brand: -due to pesticide, then you develop the leaky gut, and then the leaky gut leads to the autoimmune condition. So it can all be linked back to your environment. You living in farm country, and your neighbor spraying tons of glyphosate, or you use this crap which I have a picture of on my phone, this is uh, I went to home depot over the weekend which is a local, uh, not local but it’s a corporate store. People probably can’t see the picture on my camera but it’s Scott’s brand, Scotts turf builder, it’s called weed and feed. And oh, Justin, listen to how gentle it sounds, “Weed Grip Technology. It cleans-“, no, I’m sorry, “-it clears out dandelion and clover”. So it doesn’t kill ’em, by using toxic things that destroy your gut barrier and lead to autoimmune disease, no it doesn’t do that, it clears out the dandelion, and then you look at here at the active ingredients, 2,4-D is the active ingredient. And 2,4-D is the agent orange chemical that Justin and I test for on urine.

Dr. Justin Marchegiani: Yup.

Evan Brand: And this 2,4-D is, oh, “let’s just- let me just scoop this up on my hand, and let me put this in my little grass-eater and I’m just gonna have a smile on my face as I spread this crap all over my lawn. And then let my dog come play in the yard, and then I’m gonna let my children play in the grass”, and it’s covered in 2,4-D, and then the kid gets juvenile rheumatoid arthritis which is the new term that didn’t even used to exist, it used to just be rheumatoid arthritis, now they have juvenile rheumatoid arthritis, it could all be linked back to this crap, you’re buying grass seed at home depot, with pesticide in. So pay attention. Just use regular grass seed, don’t be using this crap, dandelions are good for you, stop killing them.

Dr. Justin Marchegiani: A hundred percent man. Yup, we gotta look at the root underlying mechanisms. So I think we hit the toxin mechanism, and then also, just forget the fact that a lot of the pesticides, especially the Roundups, they’re gonna hug away beneficial minerals. Part of the reason why they work is they kind of- they bind and they culate or they hug away all these beneficial minerals. So then, let’s say you’re growing or you’re buying food, growing in that soil, it’s gonna be significantly more nutrient deficient, so you’re gonna have less minerals, less manganese, magnesium, zinc, we know, if we’re low in certain minerals, those plants are also gonna express deficiencies in vitamins, right? We know like low manganese in the soil correlates with lower vitamin-C in that various plant. So, I mean, this, more than likely correlation with every mineral in the soil, correlating to lower vitamins in that plant. So that’s gonna mean lower minerals for you, and lower vitamins, as well in the plants, and then if you’re eating animals as well, and they’re eating that soil, then guess what, low vitamins and minerals and the animal protein too.

Evan Brand: Well, let’s take that a step further, okay. So now you’re saying we’re gonna be low in minerals, so then what’s gonna happen then? Well, we know if you’re gonna be low in magnesium, you may get heart palpitations, you may get anxiety, you may get restless legs syndrome where your lying in bed and you’re just tapping your little foot in your bed, you may have like a trimmer, or twitching, you may have shaking, uhm, you may have headaches because you’re deficient in minerals, you may have more neurological stuff like you could have forgetfulness, you could have brain fog, you could have chronic fatigue because now you don’t have minerals to fuel your energy cycles in the body. So I mean, if people, you know, people don’t just have one symptom like if they have a diagnosis like crohn’s disease, it’s not just gonna be their gut, it’s gonna be everything. They could be depressed, they could have anxiety, they could have bipolar disorders, schizophrenia, and that could all traced back to this deficiency in minerals, you mentioned the whole zinc thing, you know, zinc deficiencies’ huge. You could have zinc-copper imbalance, so now you’ve got neurological problems and then the conventional doctor, what are they gonna do, with your neurological or anxiety complaints or depression complaint, they refer you out to the psychiatrist, and then what do they do? Well, butrin, zotroft, paxil, prozac, that’s their treatment, which is still not root cause.

Dr. Justin Marchegiani: 100%. And again, there’s been twin studies out there that look at various twins who have the exact, same, genetic code, right? Except, 50% of them don’t get the same condition, autoimmune disease as their twin counterparts. So this is not just a genetic issue, it’s the epigenetics that happen, kind of above the genes. Remember the initial, the analogy I gave up, flipping the switch on, so we look at it, what’s the underlying stressors, here’s our stress bucket, physical, chemical, emotional stressors all go in that bucket, emotional stressors being, you know, friends, family, relationships, work, all that stuff, the chem- the uh chemical stressors are gonna be gluten sensitivity, gut bacteria, parasites and infections. Infections are another component, we talked about bacterial overgrowth, this fungal overgrowth, and even parasitic infections which can increase autoimmunity as well, and then obviously heavy metals, pesticides, Roundup fits in that same category, and nutrient deficiencies, poor digestion, low stomach acid, low enzymes, food allergens. And of course-

Evan Brand: Yeah, this is why you need a practitioner.

Dr. Justin Marchegiani: Yeah. And of course all of the other hormonal imbalances like low thyroid, low adrenals, uhm female hormone, estrogen dominance is a big one, that’s part of the reason why women tend to be 4, 5 times more likely to have an autoimmune condition, compared to men is because estrogen tends to upregulate the various CD4 cells, uhm, a little bit more than you see with men, so, estrogen dominance is a big driving factor. And then of course the physical stressors like I mentioned. Uhm, exercising too much, you’re not doing enough movement, and then of course just not getting good sleep. So these kinda fit into our stress bucket, these cause our body systems to break down, hormone, gut, digestion, infections or- or hormones- hormones essentially in system one, digestion, infection, system 2, detox and nutrients in system 3, these systems start to break down, and then we have symptoms downstream over here whether it’s blood in your stool, and p- pain in your gut, bloating, gas, constipation, most doctors here would say, “Okay you have a consolation of symptoms that may be ulcerative colitis, we’re gonna give you mesalamine, we’re gonna give you lialda, we’re gonna give you prednisone, we’re gonna give you immunosuppressants, we’re gonna give you all these things, but they’re not getting to the root cause in the systems, and they’re not looking at the underlying stressors that caused the whole issue and begin with. So we wanna- we really wanna be looking upstream and not myopically focus downstream.

Evan Brand: Yup. Yup. So, I mean, that’s the- that’s the crazy about this is you can’t- I mean you- so- so if you wanna be a good practitioner, you have to focus on symptoms, but you always gotta trace it back. So I’m glad you did that because I was like going on a rant there, and you- you did a great job of like reeling it back in. Okay, so, the symptom, you gotta trace that symptom back to a body system that’s dysfunctioning. Okay, so it’s a detoxification issue. Like, with estrogen dominance, it’s a detoxification problem. So the liver could be overburdened due to all these pesticides, so now the liver can’t do its process to get rid of excess estrogen. So, then the estrogen dominance problem grows because the liver has so much stress because you’re eating a bunch of corn fed meat that’s sprayed, or you’ve eaten a bunch of strawberries, or you’re doing uh sweet potatoes, everybody loves sweet potatoes but the average sweet potato that’s not organic has 20 pesticides on it, the average strawberry, according to the environmental working group, has 22 pesticides on it. So you put all that crap in that toxin bucket. And then you mentioned the emotional piece too, so let’s say, you know, you’ve got a bad boss, a bad spouse, a bad family member, I mean, that stuff is all part of our problem too. So, this stuff gets complicated but we do break it down into the body systems. So, this is why… you know, I get frustrated when people say, “Well I bought this probiotic and it didn’t helped me”, or “I bought this glutamine for my gut ’cause I heard glutamine can heal leaky gut”, or “I bought…” uhm, “…this gut healing mineral online ’cause I saw this guy did a podcast on it…”-

Dr. Justin Marchegiani: Right.

Evan Brand: -“…and he said this- this supplement is gonna c- clear up my gut” well, you can’t just pick one little tiny piece if this puzzle and expect that to fix you. You’ve really gotta get the systems tested, addressed, and then you retest. So if you’ll look at adrenals, maybe you have really high cortisol because you hate your boss, and your high cortisol all day at work is damaging your gut barrier. Maybe you ar organic with your diet but maybe it’s the cortisol, so we have to test it, right? So, this is why you can’t just go buy a random supplement in whole foods and expect to-

Dr. Justin Marchegiani: Exactly.

Evan Brand: -get your gut better.

Dr. Justin Marchegiani: 100%. Now, off the bat, of course we can eat organic and definitely hormone-free. If we’re out of budget, let’s look at the dirty dozen, right, these are the foods that are gonna have the highest pesticides residue. Strawberry, spinach, nectarines, apples, peaches, pears, cherries, grapes, celery, tomatoes, bell- bell peppers, I’ll put links in the progra- in the uh reference sheet, here for the notes on the podcast transcriptions, so look at it there, and [Crosstalk…]. Yup, and then we’ll the put the link and image in the podcast notes. And then the clean 15, these are the ones that have the lowest uh, pesticide residues. So, avocado, sweet corn, pineapples, cabbage, onions, sweet peas, papayas, asparagus, mangos, eggplants, honeydew, and then maybe one more- then there’s uhm, kiwi, cantaloupe, cauliflower and broccoli. [Crosstalk]

Evan Brand: Here’s- here’s what’s crazy to me, that broccoli is on the clean 15, ’cause when I grow broccoli in my garden, you’ve got the leaves that come out of it and then you’ve got the broccoli head just sitting in the middle of it, it seems like how could that be clean 15 it seems like they would just spray it on top of the surface of the broccoli. I’m- I’m- I’m so grateful that it’s on the clean 15 ’cause if I go to restaurant and they have broccoli I’ll order it. But it seems like, how could broccoli be supposedly clean even though it’s so exposed to the open air, it always blows my mind.

Dr. Justin Marchegiani: Yeah, I don’t want to say it, it could just be that it’s- it’s got a little bit more thicker of a fibrous coating, ’cause if you look at a lot of the uhm, dirty dozen, they tend to have a thinner coating, right? Strawberries, you could eat strawberries raw, you could eat spinach raw, nectarines raw, apples raw, pears raw, cherries raw, so it seems like it maybe just a thicker membrane on the- a lot of the other vegetables, right? So, clean 15, avocados, right, skin, uh pineapples skin, peas, there’s a pot over it, right, mangos, where you gotta peel it. So it seems like it’s more of a thicker fibrous kind of peel that maybe associated with the clean 15.

Evan Brand: That’s- that’s true. That’s true. Well, where- where should we go from here, I mean, I can just rant all day about pesticide-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -but you mentioned the stress piece, we talked about adrenals, so testing for adrenals, we talked about grains, pulling out grains, getting people on a- autoimmune diet, likely pulling out the dairy, uhm making sure the meats are grass fed and not GMO corn-fed meats, and- and-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -and then- and then we going to testing the gut because you mentioned the infections. You and I-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -see so many cases of parasites.

Dr. Justin Marchegiani: I think number 1, that when you work with a good functional medicine practitioner, there’s a certain kind of protocol that you wanna work through so you don’t miss anything. And the problem is a lot of patients that come through doing one offs. And you just- just thing right or that thing right, and they haven’t done everything together, and that kind of makes them a little bit jaded to pull the trigger doing certain things in the future. So, when we work with patients, there’s a 6-R approach. We’re removing the bad foods, and again, that maybe a little bit different for everyone, like I mentioned, we may need to do more autoimmune, or specific carbohydrate or gaps or low fodmap templates, depending on how bad or damaged someone’s gut is, maybe even an elemental diet. We may even- number 2, we’re gonna be replacing enzymes and acids. If we have a hard time breaking that food down, we may have a problem. We may even have to do elemental diet if someone has severe crohn’s or ulcerative colitis, ’cause their gut is just bleeding on the inside. And then number 3, we’re gonna be repairing the hormones and we’re gonna be working on nutrients to help the gut lining. And we talked about some of the nutrients but in general, we may do things that have L-glutamine in it, uh, collagen, we may do things that have uhm, various probiotics in there, we may uhm colostrum, we may do other anti-inflammatory compounds, aloe, ginger, slippery elm, zinc carnosine, other really good healing nutrients. Then on the remove side, se- the second remove which are to remove the infections. And sometimes with ulcerative colitis and crohn’s and- and irritable bowel disease we have to wait longer because the gut is so ripped up and so shredded, coming in there and doing a whole bunch of killing could be very inflammatory. So if you’re listening to this, and you’re on that category, you wanna work with someone and you really wanna make sure those first 3 R’s get 100% dialed in before we progress to that 4th R. And then 5th R, we’ll work on repopulating and re-inoculating with a lot of good bacteria, and if you’re really sensitive to probiotics, maybe spore biotic or soil based strains we have to use instead. And then the 6th R, is retest. ‘Cause sometimes there’s a new infections-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -and then you really- if you have a partner or spouse, you really have to make sure that person is addressed as well if there aren’t chronic infections ’cause you guys can hop potato and pass things back and forth, that’s really important.

Evan Brand: Yeah, I love the hop potato analogy-

Dr. Justin Marchegiani: Yeah.

Evan Brand: And we’ve seen that time and time again right, where we’ll fix a woman’s gut and then we retest her stool, and then all of the sudden, she’s got an H-Pylori infection again and I’m like, “Okay…”, like, “…how did you get rid of it…”, like, “…we got rid of this and how did you pick this up again, and then finally we get the stubborn husband onboard, maybe he’s not stubborn, maybe he’s awesome and he was too- too busy or he was out of town or whatever, but a lot of times the hubber- the husband is stubborn and says, “Well, I don’t have symptoms, why do I need to test my gut? My wife is the one complaining, I don’t have complaints, I don’t have skin issues like her, I’m not tired like she is, I don’t have autoimmune disease”, it’s like, well, you could be the vector. You could be the one passing her the infections, so we don’t care that you feel amazing, congratulations, but we still gotta make sure you’re not the problem and you’re not the one re-infecting your wife and making her sick because she’s susceptible.

Dr. Justin Marchegiani: Yeah, and I- I tell patients sometimes, you know, talk to their spouse about it, it’s not an STD but sometimes we gotta treat it like an STD because people, well, treat the STD a little bit more respectfully, no one’s gonna say, “Well, just ’cause I’m the carrier of herpes and I don’t have it, like, whatever, it’s not a big deal, no!”, you gotta address it, same thing with any other STD. It’s not in that category but it can still be transmitted via intimacy, so we wanna make sure we address that, and it doesn’t go back and forth. And then of course, there’s even things like H-Pylori, which could even spread via saliva which may not even be- you know, obvi- obvious- that’s not even gonna be a sexual thing. You could just kissing your kid on the- on the cheek, or on the lips, uhm, or sharing cup. [Crosstalk] silverware, knives, those kinds of things, and ho- honestly, if someone’s not even washing their hands appropriately after to the bathroom, you know, you may be able to spread a parasite via that way too, that’s very common.

Evan Brand: We- I- I would say anything is possible, right? I mean, we’ve tested thousands of people, we see worms that the whole family can have. We’ve seen parasites that the whole family can have. That’s why I really love working with families because if we got mom and dad tested and then we get the kids tested too-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -we got to compare the gut, that is my favorite part of my- my job is- is- is, “Okay, mom has this, daughter has this, husband has this”. So we get to pin the pieces together, “Oh, daughter goes to a school, or daughter goes to a daycare, so she might have picked up that there, and then dad have this, and mom had that”, so they pass it to each other, it- it’s just- it’s fun to make the connections like that with the family.

Dr. Justin Marchegiani: Uh, 100%. Anything else you wanted to address here today? We have any questions you wanna dive into Evan?

Evan Brand: Uh, while- while you’re looking at questions, I’ll just say that, you know, since I brought up the whole family thing, it’s much easier to do this as a family. So if you are someone struggling, and you have a husband who’s not onboard with your diet. So, here you are eating your grass fed steak and broccoli and he wants to eat pizza, or, you know, the- or you are divorced family and you’re taking care of a child that’s sick with an autoimmune disease or a gut disease, and- and the kid eats really good at your house but then you send them over to dad’s house, or you send them over to grandma’s house, and then they get sick because they’re eating foods over there, that- that’s a huge thing. So make sure that you have the whole family onboard, because, err- when you get to this level of gut problems, there is not any room for cheating. So, your kid can’t eat autoimmune paleo 5 days a week, and then the kid goes somewhere else on the weekend and go eats pizza and like cheese sticks and waffles on the weekend, and then they come back to you and then they’re recovering, and they get sent- sent back again, right? So, you can’t be- you can’t just be picking and choosing when you wanna be healthy, this has to become a lifestyle change for the whole family. And if your family members are not onboard, uh, babysitters, nannies, grandmas, grandpas, dads, cousins, whoever, taking care of your children, or you if you’ve got friends or family that are saying, “Hey, Justin, eat this piece of cake, I promise, it’s just a little bit of gluten, it’s not gonna hurt you”, no! You gotta say “No”, if you’re not gonna support me, you gotta get away, you can’t be pushing this crap on to me.

Dr. Justin Marchegiani: Yeah, and of course, we draw a line, right? If you have autoimmune issues, there- there’s a zero tolerance, maybe if you- if you don’t have an autoimmune issue, there’s a little bit more flexibility. I always tell patients, always try to go gluten-grain-free when you have an opportunity, but if there’s something really special occasion, fine, uhm, you know, just do your best on that. So we- we really gotta draw that line though. But for sure, when there’s- when there’s no autoimmune issues, 100%

Evan Brand: Yeah. Oh, somebody said they love my rants. Did you see that one?

Dr. Justin Marchegiani: I saw it, that’s great. That’s excellent, really cool. And then also, someone says, “Opinion on methotrexate for 13-year-old with juvenile rheumatoid arthritis”. So, yeah, I mean, number 1, you gotta work with someone that’s talking about all the things that we’re talking about. So, feel free and check out Evan or my site an- and dive in, but yeah, you do not want that to be the long-term solution to address this issue, okay? I know-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -that’s gonna be the conventional standard of care, uhm, and that may be fine acutely but, not in the long run for sure. It’s just not addressing the root cause. That’s-

Evan Brand: No, it’s not. And- and there was a second part of the question, “How do you feel about red-light therapy to treat juvenile rheumatoid arthritis?”, well, red light therapy would be considered a –

Dr. Justin Marchegiani: Palliative.

Evan Brand: -uh, palliative care-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -maybe it will help, uh far better than a drug, but it’s still not root cause. That kid needs to get a stool test, figure out what kind of infections are going on, make sure the diet is dialed in, start looking at mineral deficiencies and all the stuff Justin hit on earlier.

Dr. Justin Marchegiani: Yup, 100%. And then someone asked a question about… I think a certain about iron here, let me see if I can find that question.

Evan Brand: Yeah I saw- I saw a question, there was a couple questions about iron.

Dr. Justin Marchegiani: Yeah, so they talked about, well, how to test your iron. So, first thing is, we’re looking at iron serum, that’s gonna kinda give you a window of what’s in the engine, ‘kay? Then we’ll look at ferritin, that’s the equivalent of what’s in the gas tank. And then we’ll look at TIBC and UIC, which give us a window into uhm, essentially, the receptor sites, the binding proteins. The- the higher they are, it’s like, you know, for instance, the hungrier I am, the more I’m- I’m grabbing, right, the more I’m grabbing. So think of it, the more I’m grabbing, the more fingers, the more hands reaching, that’s like the binding proteins being higher, it’s gonna grab more of that iron, and then or course we have the iron saturation, think of that as like the- the uhm gasoline in the carburetor – is it fully saturated, is it- is it- all the way up in there? So we look at all those markers to get a window unto what’s going on.

Evan Brand: Yeah, blood testing can be good for these types of problems. Blood testing from a functional perspective, is- is helpful, but, if someone’s not where they already have a full-blown diagnosis, we may not need blood work right away on someone, we may go straight to the stool testing, organic acids testing, look at that first and if we need further information. And at least how that’s a- how- uh- how that’s I approach. I don’t know Justin of you do blood right in the beginning, but sometimes I don’t. I’ll go stool, urine first and then do blood later if we feel like we’re missing the piece.

Dr. Justin Marchegiani: Yeah, it depends. If someone- if I see IBD, irritable bile disease, I’ll definitely do some blood work just to see where they’re at with the iron and the ferritin and all that.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And then we’ll definitely run organic acids to see how the methylmalonic acid looks, so we can see how the B Vitamins and B12 looks. So that’s- we definitely wanna get a window on those if we see those kinds of problems.

Evan Brand: Yeah, but if they’re not in gut disease level, there just some complaints about gut, you may not go straight into blood right away.

Dr. Justin Marchegiani: I’ve had to have some history that- that would screen that for me.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Right? And then a lot of patients, they come in with a lot of blood to begin with. So, true, you know, I can- maybe see like, “Hey, maybe the RBC is in the very low 4’s”, maybe that hematocrit and hemoglobin are- are creeping into the, you know, in the mid-11’s for hemoglobin or hematocrit like the upper 30. So, depending on what comes back, I may- I may wanna run more tests than what I see from their previous labs.

Evan Brand: Yeah. There was someone who said, uhm, a future topics suggestion, interpreting the O-test, your doctor ordered the test for you, but then doesn’t know how to interpret it. That’s so funny, I’m sorry. There’s a lot of doctors out there that run testing because they hear about it from people like us and then they don’t know what to do with the test. So then you have this like 75 marker information which is just a pot of gold for Justin and I, but then other practitioners don’t know what to do about it, I would say hang tight, eventually, Justin and I both will have a training course, all about organic acid testing. That’s like our bread and butter, we love it. Uh, but in terms of a podcast on interpreting the O, that’s- that’s not really a good podcast thing.

Dr. Justin Marchegiani: I’ve done a couple of videos on it. So if you go and just google “Dr. Justin, organic acids”, you’ll find a couple of things where I really got a little bit more in-depth on that.

Evan Brand: I’ve done a few videos too about like looking at candida overgrowth and bacterial overgrowth so some interpretation, but I’m hesitant to say “Hey, if you see these problems and you need this herb, because it’s not ever black and white like that.

Dr. Justin Marchegiani: Exactly, yup. And then tbone writes in, “What’s your take on doing elemental formula the first half of the day?”, I love that. I do that with lot of my gut inflamed patients where- there’s that first 6 hours of the day, maybe even 8 hours, we’ll have ’em on elemental formula with some good like Odo’s oil or good fat in there. And they just sip it throughout the day and it just kind of gives their gut a break while they still get good anti-inflammatory nutrients in their body, too.

Evan Brand: Yeah, Matt White uh left a comment, “There is an interpretation guide by Organix”. Yeah, so like Genova Great Plains, these companies do produce like an- an interpretation guide of some of the markers, and but once again, that doesn’t always lead you in the direction of what you do ’cause they’re- they’re, uh, recommendations are very cookie cutter. You may look at one particular marker, and they- and they’ll say, it may be carnitine deficiency. So you may supplement carnitine, but it could be 20 other causes too. So-

Dr. Justin Marchegiani: Right. And like you’ll see with, I think picolinate will be like, “Oh, you need more omega-3s”, but it- it’s a sign of inflammation. So then you gotta say, where is the inflammation coming from, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: They’re coming from the gut, so you gotta look- you gotta know, “Okay, what does that mean, what’s the next thing I gotta pivot to?”.

Evan Brand: Yeah, exactly.

Dr. Justin Marchegiani: [Clears throat] Exactly. And Lambros came in, “Dr. J., I just got back from my new thyroid labs, TSH, Free T4 , Free T3, should I further adjust the dose?”. Yeah, I mean, I would say your T3 is in the bottom- it’s- it’s in the bottom 5% of the reference range. So, looking where you’re at, I would definitely adjust your dose based on, you know, one equivalent based on your protocol sheet.

Evan Brand: Yeah, there’s person here, they- they uh, so people listening, they’re going back, well, what’s Justin talking about, this person put their free T3 as a 2.1, uh, that’s too low. We want free T3 closer to 3.

Dr. Justin Marchegiani: Yup. Exactly. 100%. Anything else you wanted to address here? Uh, one- one of the person talked about the uhm, carnivore diet. And I find with some patients that really do have ulcerative colitis or crohn’s, a carnivore template can be really helpful just ’cause you’re cutting out all of these anti-nutrients in plants. And Dr. uhm, Gundry has talked about this in the book the plant paradox, where he’s talked about some of the- some of these anti nutrients, and lectins and mineral blockers, and protein blockers, and sometimes they can really be a disrupting factor. And believe me, I get some hate email from vegetarians and vegans, they’re like, “How dare you recommend meats, it’s so bad”, I’m like, “Hey, I don’t have a dog in the fight”. And then says, you know, if- unless you’re a clinician and you’ve seen people do- do- you know, do things and improve and be successful, just be quiet. Because you don’t have any clinical experience to speak from, you’re talking like it’s a religion, this is not, this is science, and I’ve seen many patients with ulcerative colitis issues and they have s- they’ve serious resolution, I mean, feel free and just google Michaela Peterson, and she’d had serious autoimmune issues that destroyed her bones, and a carnivore template was huge for her healing. Check out my podcast with uhm Caitlin Weeks, I’ve had handful of uh patients that really have done amazing with carnivore templates that have severe, more autoimmune issues. But some, don’t, and some an autoimmune paleo templates, fine. So, that’s why you need a customized approach, you need to be non-dogmatic. It’s like if I have a whole two belt full of tools, and I gotta- is a nail on that wall? I’m not gonna use my monkey wrench to whack in that nail, no matter how much I love this monkey wrench, I’m gonna pull out the right tool for it, called the hammer, right? Same thing as a clinician, with recommending diets. I don’t care, I just want the right tool do- do the right job.

Evan Brand: Yup. At the end of the day, if you get better, that’s what we want. It doesn’t matter the path to get you there.

Dr. Justin Marchegiani: Nutrition though has become like politics. People have a really hard time-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -talking about it, it’s a very emotional issue, and it’s not, it’s very scientific for me, and uhm, you know, a course that I think there are common things like you shouldn’t have sugar, you know, organic, hormone-free, that those things I think are foundational no matter what template on the spectrum you- you’re adjusting your diet to, of course, right? All foods don’t cost new disease, and it gets a good starting point and then you can adjust from there. And obviously looking at the inflammatory value of a lot of these foods too. And, if we didn’t highlight enough, gluten-sensitivity, gluten is a big issue with autoimmune guys, even if you’re not- you’re not silly-ack, there’s still a lot of research by Dr. Alessio Fasano at Harvard that gluten- even if you’re not reacting can increase gut permeability, which increases things getting into the bloodstream that can exacerbate the immune system and attack other tissue that may be an innocent bystander.

Evan Brand: Absolutely. We can go on a whole rant about that. Maybe we’ll do a show on non uh silly-ack gluten sensitivity, that’d be cool to give Fasano on here.

Dr. Justin Marchegiani: Yeah, that’d be really good. Uh, the problem with these research guys, they’re- you know, I wanna- I wanna keep it actionable and down to earth-

Evan Brand: That is true.

Dr. Justin Marchegiani: We’ll just take the research and we’ll just summarize it but yeah, I think that’d be great, that’d be really cool.

Evan Brand: That does make it more fun. Yeah, the research it does get- it does get dry.

Dr. Justin Marchegiani: It- it gets boring. You can take a 5 hours study and you could summarize it in 2 minutes.

Evan Brand: That’s right.

Dr. Justin Marchegiani: Uhm, but yeah, I- I appreciate it, I think it’s great feedback. Anything else Evan you wanna address?

Evan Brand: Uh, no, let’s wrap this up for today. Uh, well we could- I mean we can do a part 2, part 3, part 4-

Dr. Justin Marchegiani: Yup.

Evan Brand: -you can never talk enough about stress and how the different mechanisms of stress affect gut barrier function and all that. But for now, let’s wrap it up. If people wanna reach out to Justin or myself, we can work with you around the world. So go to Justin’s website, justinhealth- justinhealth.com, and you can reach out, schedule a call with him or his staff. Me, it’s evanbrand- E.V.A.N.-brand.com. And we’ll be back next week.

Dr. Justin Marchegiani: Thanks guys. Put your comments below, I want your feedback of new topics, thumbs up and share. You guys have a phenomenal day and we’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care Evan. Bye.


References:

Evaluation of the Effect of Radio Frequency Radiation Emitted from WiFi Router and Mobile Phone Simulator Study

The Plant Paradox by Dr. Gundry

https://evanbrand.com/

https://justinhealth.com/

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