The Top 5 Common Digestive Supplement Mistake – HCL, Enzymes and Bile Support | Podcast #338

As a functional medicine practitioner, Dr. J and Evan Brand see many clients who take dietary supplements regularly. But, as simple as it sounds, supplementing can confuse—and people often make mistakes. Do you think you’re taking all the proper nutrients and that you’re taking them the appropriate way? Let’s learn some common errors people make:

Dr. J highly recommends that you avoid having the symptoms cured rather than the source. Don’t just accept your signs and symptoms as usual; consult your doctor and express your concerns. Your doctor may advise you to do diet modifications and have yourself tested to find out the root cause and fix it. Also, watch out for over stressing. Stress can affect your decision-making and as well as your gut health. Another reason can be chewing your food too quickly that makes your digestive system suffer, inadequate water intake, or very few fibers in your diet.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:36    Common Mistakes in Using Digestive Support

12:03   Healing Gut Lining

15:39   Sex Drive and Libido Effects

17:59   Bile Support

21:48   Higher Fat Diets

25:09   Cooking our Food

31:04   Food Quality

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: We are live, it’s Dr. J here in the house with Evan Brand. Today, we are going to be talking about the top five common mistakes. When using digestive support. Again, we’re in the trenches with patients every week from all over the world. And this is a common issue that we see is people are not using digestive support correctly. And if we don’t break down our food, if we don’t emulsify it, break it down, utilize it absorb it, we’re not going to get the nutrients from that meal. So it’s not a given that we’re eating good food, we have to go through good digestive processes to get those nutrients and to decrease stress in our gut. So I’m really excited to dive in today’s topic on that.

Evan Brand: Yeah, me too. So I mean, I was doing digestive enzymes when I still had gut infections. So I know we put together a list here, and I’m gonna just go straight to the one that was a little lower down the list, which was, I think, possibly one of the big smoking guns for a lot of people is, and I technically should have written in our notes, not testing. My note was not addressing infections and how not addressing your gut infections leads to digestive problems, because if you’re someone who’s taking supplemental acids and enzymes, but you haven’t tested or treated yourself for parasites or worms, or H pylori, bacterial overgrowth, fungal overgrowth, mold colonization, you’re gonna have very limited results with your enzyme, enzymes and acids. So for me, I did that mistake. I just had high quality enzymes. I was taking those but yet I still had diarrhea and other gi issues years ago, because I had parasites, and I hadn’t tested or treated those. So that’s to me, I think the big one because people will go to Whole Foods or wherever, hopefully, they’ll buy from us because it’s professional quality, but they’ll buy enzymes take it and then they still have gi issues. They’re like, well, what the heck, I thought the enzymes were supposed to fix it.

Dr. Justin Marchegiani: Yeah, and I see that we see that all the time. Now the question is, why is that happening? So let’s go over some of the bugs and some of the reasons why that may happen. So first off, h pylori is a super common one h pylori is a bacteria that resides primarily in the stomach, you can also go a little bit into the small intestine, and H. pylori is going to produce an enzyme called urease. And urease is going to take protein from you know, which is the protein metabolite urea and it’s going to convert it into ammonia and co2. And so on a positive H. pylori breath test, we’re gonna see elevations in co2 after you swallow the urea from the breath test, and you’re also going to see a lot of ammonia. Now ammonia has got a pH of 11. And so that’s more on the alkaline side, so your guts only a two or three on the pH. So that can start to alkalize the gut and maybe throw off the digestive capacity because we need that nice that nice low pH helps activate enzymes and acids. Well, it actually activates more of the enzymes that can be pepsin, various proteolytic enzymes, and it sets the table for the pancreas and the gallbladder to produce more enzymes, lipase bile, when we get into the small intestine, so the acidity in the pH sets the deck it sets the domino rally, so digestion works downstream and so, infections like H. pylori can cause problems infections like cebo can also cause problems. SIBO is notorious for making it harder for that esophageal sphincter to close and so that esophageal sphincter can’t close is prone, you have proneness to having that acid rise up and burn your esophagus, right? Those are all potential problems. Also, any stressor or infection, whether it’s H. pylori SIBO, which is small intestinal bacterial overgrowth, or it could even be something like a parasite, these infections are going to create sympathetic nervous system stress. And so the more your nervous system is over stressed that sympathetic nervous system that fight or flight tone is being stimulated. What’s going to happen is that fight or flight is going to take digestive enzymes and acids, it’s going to reduce them, it’s gonna start shunting. A lot of the digestive secretions and the blood flow away from the blood away from the stomach and the core and to the hands and the feet to run, fight and flee because our body is trying to move blood and move resources to the areas that are most metabolically high and expenditure. And in a fight or flight circumstance, that’s going to be the extremities fighting, fleeing, running, and our bodies prehistorically driven that way, because you don’t want to be hungry. When you’re running. You don’t want to think about digestion, you want to be focused on getting away or fighting. And that blood has to carry oxygen so these muscles can work. And so that blood moves away from the intestines. And that’s part of the reason why these infections can really throw off your body, they can really increase that sympathetic nervous system and take away from that vagal tone vagas nerve, parasympathetic nervous system response.

Evan Brand: Yeah, I can totally relate. I mean, when I had infections, I was anxious, but I had nausea and I had no appetite. So I would sit down. I remember like yesterday when I was down in Austin, I would sit down at the dinner table. I just cooked an amazing bison steak and maybe I had some veggies with it. I remember looking at the plate and going Ah, I just can’t do it. And some of that was the infections But some of it was the stress from the infections. And some people, they’ll kind of demonize meats and say, Well, I don’t feel good. Like I just can’t do the meat. It’s not the meat in general. That’s the problem. It’s the infections, damaging the parietal cells, reducing the stomach acid, it’s turning that digestive fire back on, that’s really going to help you feel good with those meats. So I, it’s sad because people get scared away from the meat. But in reality, it’s some of these root causes that we’re talking about. And then you hit on this kind of primal response. This is totally normal, by the way, but it’s not normal in our chronic stress lifestyle. So occasionally, if we were stressed, it’d be great. Like you said, turn off the digestive system. So we can run. But the problem is, we’re are we’re always stressed. Now. We’ve never as humans, we’ve never experienced this level of chronic, ongoing stress. I mean, I pull my audience all the time, I’ll do a little polls on my Instagram page and ask people like how you’re feeling. Everybody’s stressed. Everybody’s overworked, everybody’s burned out. So this is an epidemic problem. This is not like a one off thing. This is everywhere. And I think we could transition now if you’re ready. And we could talk about how too much or too little HCl when you’re trying to get this digestive fire back on, there is kind of a sweet spot, and it’s going to depend on the people, it’s going to depend on gut inflammation, maybe diet, infections, and then let me just bring up before I forget, these infections are very contagious. So if you do have h pylori, it’s very probable that your spouse is infected as well. So if you’re someone working on your gut, and you’re not working on your significant others gut, you probably need to whether you’re running testing, or maybe you’re guessing and checking, which is not as wise, but we’ll see a husband or a wife come in to work with us clinically, they have good results and then two to three months later they go backwards. That’s often because the the infection came back due to the significant other and this could even be from children as well or even dogs. Like if you got a dog with h pylori, you’re playing with a slobbery toy, you’re throwing the slobbery toy there Nope, you pick your nose, you bite your nails, whatever boom, you could get, you know, exposed to the vectors that way too.

Dr. Justin Marchegiani: 100% So with the too much and too little HCl, some people their gut lining is so inflamed, they have atrophic gastritis, meaning that gut lining has gotten really thin. And they may not be able to handle much HCl, even though they need HCl, they may not be able to handle it and that becomes dicey. So it’s all about helping people where they’re at, even though they need something, if they can’t receive it, then we need a backup plan. And so you got to know what people are at. And so some people, their digestive system, or symptoms actually get better. With more HCl, even though their gut has a lot of problems, they have a lot of inflammation. Some people their gut lining integrity can still deal with the HCl when you start adding HCl. And it’s like they start getting better and you’re like, but your guts so inflamed, how were you able to receive it, but then patient a over here couldn’t receive it. So everyone’s a little bit different. And so if we’re going to try HCl, I mean, ideally, don’t try it. If you know there’s any alterations, coughing up blood in the stool. I had one person though cut people who had alterations, though, did it and they’re like, it helped my issues, I felt so much better, and actually my ulcer stopped. Now, that may be the exception. I’m just kind of highlighting if you are that person, tread lightly work with a practitioner. And of course, all reactions are dose dependent. So if you’re going to test it, try the very smallest dose you possibly can maybe even a little bit of lemon juice, or apple cider vinegar and some water, dilute it down and then test it. And if you overdo it, you can always try a little bit of baking soda in water to kind of calm it down if you irritated it. But ideally, don’t do it unless you’re working with someone that’s helping you on the functional medicine side. And if you do it, make sure it’s dose dependent on that side.

Evan Brand: Yeah, good call. So just we’ll give a couple numbers. I think numbers are helpful. So if you’re working in HCl, I know you and I we have some professional manufacturers we work with we make our own line of digestive products. We go pretty conservative, like 200 milligrams of butane per capsule. So we could dose that as low as one cap 200 milligram, we could go up to 3 4 5 6. So you could go I’d say 200 on the low end up to I personally don’t see a need much beyond maybe a couple of grams, 2000 milligrams, and even that, to me is sometimes too high for certain people. I just don’t like to push it. I know you and I’ve talked about that test where people will take a ton of HCl until they get burning and then back down from that dose but I prefer not to poke the beehives I personally don’t do that with people.

Dr. Justin Marchegiani: So I will do that within five or six capsules. It depends if someone has a lot of digestive distress. You know, we’re typically not going to go that high, but usually within five or six capsules, that tends to be okay. And Dr. Jonathan Wright’s book, why you do stomach acid, he talks about, you know, being able to go up to four to five grams of HCl. And again, I typically wouldn’t do that if someone’s having any alterations or any incredible gastritis issues. Usually we’re going to test at a much smaller level than that and even with them, we’re still starting at maybe one capsule and we’re gently going up and up. For taking the digestive support in the middle of the meal, because if your guts Ron and flame just enough of that acid leaning on that gut lining directly isn’t to be a problem, at least if there’s some food down, then think of the Oreo cookie, right, you get the cream that you get the the frosting in the middle of the HCl is in the middle of all the food, and therefore the body tends to mix it up. And then when it starts moving throughout the intestinal tract with the throat, the stomach, it’s not going to be as intense at the tissue area. And so that tends to be very helpful. And I’ll typically, you know, try it within four or five capsules, see if we have an improvement. Some people do, I hear doctors doing that up to 1020 capsules. And that’s I think you’re just messing with trouble, you mess up a fire there because your body has to use bicarbonate and from the pancreas, to start to neutralize the acid from the stomach. So like that Domino rally of digestion, you have all this kind mixed up in your stomach, that kind is all the food with the acids and the enzymes that has to get released from the stomach down into the small intestine. And so it’s nice low pH once that goes into the small intestine, right the dwad, then we start making a whole bunch of bicarbonate to neutralize that. Now bile acid will also be produced bile acids still an acid it’s still a pH of around five or so. So it’s still on the acidic side. People have written in o bile acids. Well, it’s a it’s a p it’s a pH neutral. Well, you know, we’re talking bile acids. bile is made up of bile acids, cholesterol, a lot of different substances. So the bile acids are in their very nature by their name on the acidic side. So typically, your body’s trying to take that pH and bring it up to a neutral pH and the more you stress it with tons and tons of HCl, there’s a greater chance that your bicarbonate system may not be able to handle it from your pancreas. And you could develop a peptic ulcer. So we got to be careful with that. Try to use HCl within a reasonable range. And if you’re going to test it, you know, just be careful with it. Just be careful. Make sure you’re taking a look at your gut and making sure you’re you’re you’re knowing what your calprotectin levels are and you’re in you’re taking it the right way.

Evan Brand: That is like the pinnacle of edutainment right there that was so entertaining to listen to. I’m picturing all this going on in the system, I’m learning at the same time. This is why I love what we do. This is so fun. All right, let’s go to let’s go to number two here on our list, which is supporting or healing the gut lining and how that’s very important to do possibly even before you get to the digestive support. So you and I are seeing tons of people that usually have been to previous practitioners or doctors or naturopaths or whoever before us. And so maybe they have healed their gut somewhat already. Or maybe they’ve been wrecked because other practitioners did too much. Or they did too hardcore things. I had one lady who she got put on really high biofilm busting support right in the beginning, she got put on the interface plus from Claire labs, which we can and do you sometimes but man it wrecked her gut, her stomach was so wrong. We had to do almost six weeks of gut healing support before we could even bring it any other support. And and that’s kind of a reverse order thing. Because you and I talked about this idea of healing the gut after you treat the infections, but man, in her case, we couldn’t do that. So I’ve seen firsthand what can happen if you do too much biofilm support, you’re aggravating an aggravated system, it’s just not good.

Dr. Justin Marchegiani: Exactly. And that’s why if we’re having someone with an inflamed gut, one of the first things we’re going to be doing is trying to really dial in digestive nutrients to heal the gut lining. So we may be adding in things like dgl, licorice, aloe, slippery elm, sometimes we’re going to do a lot of zinc or zinc carnosine. A lot of studies on zinc, helping to decrease gut permeability, which is really important, decreasing gut inflammation, there’s studies on zinc showing the decreased calprotectin in the intestinal tract. So that’s wonderful, of course, l glutamine. If you’re very histamine sensitive or very inflamed, sometimes I’ll clue to me can go downstream to glutamic acid and glutamate, and you may have negative symptoms there. Again, typically, I don’t see that and so we don’t see that. I say 95% of the time, there’s no problem with that. But we want to be able to use other nutrients to calm down the gut, vitamin u, which is vitamin oltre. You see that in like a lot of okra, things like that. cabbage juice, I would say Allah we already mentioned. And then of course, there’s just good old fashioned bone broth, and collagen peptides which are very, very high in glycine. And glycine is very important building block for the entire sites that make up the gut lining the entire sites or little cells that that make up the tight junctions and the gut lining in the intestinal tract. And so they love, love, love glycine, and of course, that the same cells that are helping to build the intestinal tract, they also help with detoxification. glycine is a very important compound and toxification. So if you have a lot of gut inflammation, your body’s going to be using a lot of that glycine for healing, inflamed tissue and maybe not running the toxification. So that’s part of the reason why you can have detoxification problems, because your guts chronically inflamed, it’s sucking a lot of the resources Is that it may be using for detox.

Evan Brand: Wow. Yeah, that’s amazing. So there’s a lot of talk Stephanie sent off. And I know some others have talked about using glycine to help glyphosate detox. Yep. So that’s pretty interesting mechanism there, you’re saying that the system can’t focus on the detox. If it’s so focused on the gut damage.

Dr. Justin Marchegiani: The body is always tending to deal with what the more acute matters. And if your guts Ron inflamed, it’s probably going to prioritize that over detoxification. And again, we don’t have like a test that to say that, we just kind of have common sense functional medicine, healing philosophy, the body’s always prioritizing stuff. And whatever the top stress is, the more apparent stresses, that’s where your body’s typically allocating resources.

Evan Brand: Yeah, and I don’t want to get too in the weeds on this, but I’ll just bring up an example of that, for example, sex drive and libido. When we see people that are chronically stressed and depleted, usually sex drive is going to go down or become non existent. I asked that question on my intake form is your libido adequate, and all the sick people know their libido is not adequate. And my interpretation of that is libido is really, a it’s a luxury to be able to do that. You’ve got to have some optimal things that happen. Obviously, there’s other mechanisms at play, but just at a simple basic level. You know, sex is a luxury when you’re running from a bear, you’re not going to, you know, be aroused if you’re running from a bear. And that bear could be your boss, or your spouse or your kids if they’re driving you crazy. And libido is like that, whatever. So that makes sense. 

Dr. Justin Marchegiani: Yeah, and if you just look at how the the nervous system allocates sexual energy, so typically foreplay, or just, you know, that intimacy that you’re going to have before ejaculation, or before an orgasm, that’s all parasympathetic. And so you need parasympathetic nervous system stimulation for, you know, the foreplay aspect of intimacy. And if the parasympathetic isn’t there, that’s where you see premature ejaculation, right? Because ejaculation or orgasm is sympathetic. And foreplay is parasympathetic. And so if you don’t have parasympathetic stimulation happening, because you’re so stressed or so inflamed, it, you know, that’s where premature ejaculation or just not even being able to rise to the occasion, if you catch my drift, because that parasympathetic nervous system response is so squashed.

Evan Brand: Yeah, this is a huge problem. I mean, I’ve seen 20 year old guys that are jumping on Coke, the little blue pill, and you’ve got all these websites now that are promoting like off the market Viagra. It’s like, what the heck, like we have like teenagers and 20 year olds now like carrying around that that you know, used to be like, when you know, high school is kind of the cool joke thing to have. But you got a condom in your wallet. Now, it’s like you have a condom and you have Viagra as a teenager?

Dr. Justin Marchegiani: Yeah, I mean, that’s why you typically need a couple hours of stress free conversation and, and connection before before that kind of nervous system stimulation can happen. You can’t just go it’s harder to go into a stressful day, switch the switch. And then there you go. It’s just tough. That’s because of the nervous system. So we just got, we got to know that. 

Evan Brand: Give us your comments. Do you want a functional medicine, optimization of libido podcast? If so, let us know.

Dr. Justin Marchegiani: We’ll chat about that’s great. All right, I would say next thing we can kind of we talked about the gut lining support, let’s talk about bile support. So bile is really important for fat digestion. A lot of women are going to be affected by bile issues, because it’s very common women, when they’re 40s, they tend to get their gallbladder removed. It’s a common procedure, you have any upper right quadrant pain issues, boom, they’re taking out your gallbladder right away. And your gallbladder is part of what concentrates bile, your liver will make it and then it stores it in the gallbladder. And then it gets released. It very specific times via coli cystic keinen cck stimulation, and cck is going to be stimulated when you have a whole bunch of fat and protein going getting released from your stomach into the small intestine so that we get to release it. It happens at a very specific time. And it’s concentrated 15 to 20 times more than just what your liver would drip it in. Because when you don’t have a gallbladder just chatter dripping. And when it drips, you can you can have bile acid diarrhea. And so that’s where you have to use bile acid sequestering agents to kind of calm it down. And we got to put our bile in at the right time. And so we may have to take supplemental bile definitely for life that we don’t have a gallbladder. If we have biliary insufficiency, we’re going to have to be taken bio as well maybe extra lipase, which is a fat enzyme from the pancreas. But if we don’t break down that fat, you know, we’re gonna see our stool start to flow, we’re going to start to see, you know, St Mark’s skin marks on the toilet, see, because the fat is, is streaking, it’s not well absorbed. And then you’re also going to see a lot more excessive wipes when you go to the bathroom when you clean yourself because it’s just the fat is streaky, right, it’s it makes a big mess. And so we got to break down that fat adequately and then we may have to add extra bile into digestive support may have to add extra label lytic enzymes as well. Also, if you’re a female or even a male, high levels of estrogen is going to make your bile flow more stagnant. So if your bile flow is more stagnant, you’re not going to have good biliary output. And I would say last but not least, if if you’re one of those people that got thrown into a low fat diet Well, when you go low fat your gallbladder is not emptying because it’s the trigger for gallbladder emptying is coli cystic keinen from fat consumption. If your gallbladder is an empty, empty, what happens all that bile, it can start to form bile crystals. And those crystals are sharp. And when you finally do eat a little bit of fat, it’s like giving a hug to a porcupine. All right, it’s gonna be quite painful. And so imagine your gallbladder contracting on it’s like giving that porcupine a big hug and you’re going to inflame that gallbladder. And so chronic low fat diets with a punctuated higher fat meal, and also coming in there with estrogen dominance, a lot of detoxification issues, not clear handling estrogen, well, maybe having a lot of estrogen in your meats in your pesticides in your plastics goes for guys, too, that could definitely screw up your gallbladder and cause biliary and fissures not enough bile flow to that gallbladder.

Evan Brand: Wow. Okay, so let me just clarify, because this is interesting stuff here, because people online, including us were really big proponents of good quality, pastured animal products, and high quality fats were a big proponent of that. But you’re saying that when a person comes in, let’s say they came from the brainwashing of the even 2000s, I mean, part of me want to say 1980s 90s, and 2000s. But it’s still, there’s still the low fat dogma still there, that’s still like one of the labels on a product low in fat that’s still marketed today. So this is still a trend. You’re seeing someone coming from that with gallbladder issues with infections with low stomach acid, then they try to go keto, carnivore, meat based paleo, whatever, they end up with problems. If they have like a gallbladder issue or a gallbladder attack, the doctor is going to blame maybe the fats and just cut the gallbladder out. But you’re saying there’s kind of a few steps, if you will, that have to be a prerequisite to handle a higher fat diet properly.

Dr. Justin Marchegiani: Yeah, I mean, why don’t we just have the propaganda of the 80s and 90s. And just the fact that calories in calories out, right, oh, you’re worried about how many calories you consume? Well, we know one gram of fat got nine calories in it, compared to four in the protein and four on the carbs. So of course, fat gets to be looked at more deeply on that side, because of the caloric intake. And then also, if you’re, you know, a lot of the studies on fat causing heart disease, which we know are all nonsense, we know that the meta analyses in the last 10 years show there’s no correlation with that, with fat and animal cholesterol, a lot of the studies in the 60s and 70s, they did not differentiate saturated fat with trans fats. And so they had a whole bunch of trans fats mixed in with a lot of these experiments. And you didn’t really get good data because they had the trans fats, which we know hydrogenated vegetable oils are terrible and bad for our health, we know that. So you got to pull out those confounding variables to really get good data. And so we know that in the last 10 15 years, that is not the case. And that cholesterol and fat is going to be fine. It’s really going to be the sugar of the trans fats, and maybe an argument for a lot of the refined processed vegetable oils, these vegetable oils during the processing of them, they get damaged. Because your polyunsaturated fats, omega six, they get damaged, and they create a lot of oxidative stress, and they get stored in your cell membranes for a long time.

Evan Brand: Yeah, these are these are super bad oils, and they’re everywhere. I mean, even at Whole Foods. If you go and look at organic potato chips, you’re still sometimes gonna see cottonseed oil, you’re gonna see sunflower oil, you’re gonna see canola oil. I mean, I get frustrated because Whole Foods kind of markets themselves as healthy. But if you go to like their I don’t know, if you call the buffet, but their hotbar, if you will, every single food item they have, there’s canola oil and everything.

Dr. Justin Marchegiani: Yeah, it’s just cheap. And then there’s also a lot of stuff on the olive oil being fake, right? So you got to look at that too. But that’s why at least half your fat should be high quality animal saturated fats, because one, those fats are just really stable, they’re going to be really temperature stable. And if you’re getting organic, decent fat, there’s no processing of that that’s going to damage the fat like you may have with a vegetable oil. But ideally, try to get cold pressed, try to get organic, try to get reputable brands that you know, aren’t going to be a blend of other canola oil mixed in which is terrible.

Evan Brand: Yeah, yeah, let’s hit another point, which is important is the fact that the bile has some antimicrobial properties and all these estrogen dominance issues you’re hitting on you’re hitting on the low fat you’re hitting on maybe the the no gallbladder. Yeah, it makes sense why we see so many women, for example, that have had their gallbladders removed, they have massive, massive gut infections.

Dr. Justin Marchegiani: Yep, correct. And so bile is antimicrobial. And so it’s gonna make it harder for bugs to grow in the small intestinal tract. And so just having good biliary output, it’s going to act like anti microbials and make it harder for these bugs and dysbiosis to grow. So having good fats in there, going to stimulate good bile stimulation and flow in that bile flow is going to help you emulsify and break down the fat and it’s also going to make the environment harder for bugs to grow. So it’s definitely a win win on both sides of the front there.

Evan Brand: Yeah, you and I don’t have any published studies to say hey, we had 278 patients and, you know, 275 had their gallbladders removed and all 275 had SIBO we don’t have it like published like that. But I know that you would agree clinically what we’ve seen, you know, combined over the last 10 plus years is that We see tons of SIBO SIFO issues and a lot of those people have gallbladder issues or they don’t have a gall bladder period. So it’s definitely, definitely correlated.

Dr. Justin Marchegiani: Yeah. 100%. And it’s good to look at that. No, I would say next thing we can kind of switch into is cooking our foods. I mean, sometimes fermentable carbohydrates, sometimes just the fiber in those foods, the rawness of the foods, the anti nutrients, lectins salicylates, females, can really be irritating to someone’s got if it’s already wrong. So sometimes just one cooking those foods can be wonderful. Sometimes even switching to a carnivore diet, as long as we can handle the fats and proteins can be great, because you’re decreasing all those anti nutrients, sometimes just really making sure everything’s really cooked and steamed and sauteed. Or maybe using an instapot, or some kind of a method really helped break it down. And then of course, low hanging fruit, like just chewing your food up really well to like almost like an oatmeal like liquid consistency, making sure you’re not overly hydrating with your meal, maybe just a couple ounces of water to get some pills down. But that’s it you’re hydrating, 1015 minutes before two hours after because water’s got a pH of seven, right? And your stomach’s a pH of two, two and a half and you add a whole bunch of seven, there’s a bunch of two and a half, you start raising the pH plus you’re diluting all your enzymes and ask for the potencies drops. So all those things matter.

Evan Brand: Yeah, here’s an interesting thing. I looked at some of the videos. And I interviewed him on my podcast too super cool guy, Paul Saladino, who wrote a carnivore book and he talks a lot about carnivore diets. He visited the Hodza tribe. And something interesting is he thinks that we’re really like over hydrating, like, if you watch these people, these tribal people, obviously they don’t have water bottles, and they don’t have really access to water the way we do. But he would notice they would eat an entire meal with no liquid. And then here we are in America, you go to the restaurant, and they’re like, what do you like to drink, sir. And if you’re like water, they bring you a frickin huge cup. I mean, it’s probably 1620 ounces of ice water. It’s cold, which I don’t know, people may debate me on this. I don’t know if ice water is necessarily good around meals either. I just feel like no, from an energetic-

Dr. Justin Marchegiani: Your stomach longer sits in your stomach longer because your stomach’s not going to release your internal body temperature is around 99 98 degrees, and you drink a whole bunch of 50 degree water, your body’s gonna hold that water in the stomach until it gets up to body temperature and then release it. I mean, very simple. Just drink a whole bunch of cold water and you’ll feel it sloshing around drink room temperature water and you’ll feel it move through your body way faster. When you move around. 510 minutes later, you won’t feel the sloshing.

Evan Brand: Ah, you know, see just intuitively I just keep I just drink room temperature water now they’re on a really hot day. Yeah, like some ice water. But just like normally, during the office hours, you know, I’m just drinking room temperature water and I feel so much better with it. But yeah, so sorry, I got on a little tangent. But I would-

Dr. Justin Marchegiani: It’s not a big deal. It’s not a big deal. If you do that and drink wine, drink cold water, just be careful of drinking really cold water right before a meal. Because it will take longer to move through. So at least if you’re going to do cold water, make sure it’s not 10 minutes before meal.

Evan Brand: Okay, Okay, understood. But anyway, the idea was like he saw these tribal people and how they’re how they’re eating and drinking. And, you know, they didn’t really do meal combining, there’s a lot of like, when you go to a restaurant, there’s this feeling that you got to have your meat and then your vegetable and then your potato. And obviously this is different. I’m not saying we all need to live like tribal people. But what I’m saying is I find it very interesting that their life is more what our DNA expects, meaning if they’re walking along and they stop upon a bush, they might just gorge on these berries. Or if they stop and find this bail Bob tree with a particular type of honey in it, they’ll cut open the tree, find the beehive they’ll eat just a meal of honey and then they get the kill and they eat just the meat so I personally have experimented with that like just meat, just berries just starch and just try to play around with it as opposed to doing the steak with the broccoli with the sweet potato and I personally do feel better on just those single items so I’ve I’ve definitely been leaning more that direction I feel significantly better.

Dr. Justin Marchegiani: Yeah, I think you know a couple of things one I think most of their meals are probably going to have more protein in it because if you kill an animal that that meat last way longer and if you look at a lot of the the fruit they were to have back then I’ve looked at a lot of these studies that they’re a lot more tart a lot more bitter they aren’t like overly sweet like we’ve due to hybridization and genetic selection we’ve kind of chose the sweetest berries the sweetest this so a lot of the fruits way sweeter than what you would have typically found in nature on average and things like honey would have been a rarity it wouldn’t have been something that you’re you’re have access to every single day and so we have access to it every day so you know if it’s something that’s every now and then it’s probably not a big deal but if they were doing honey like that every single day and they weren’t as active right because they have to be really active to hunt and kill and do all their stuff there may be metabolic issues.

Evan Brand: Oh yeah, I think I read he was just trying to keep up with the tribe. I want to say they were doing something like 10 miles a day walking I mean there’s an insane amount of steps.

Dr. Justin Marchegiani: Yeah, anytime one your stress is decent right because you know most of their life was just focused on the next meal right killing having their next meal obviously making sure shelter stable but once shelter is good Then really most of your focus is on food as a food and safety for the tribe. That’s it. You know, you’re not having to go pay a big mortgage down or worried about your kids private school, right? Yeah, that’s a different priorities right?

Evan Brand: Have you seen the organic strawberries lately? My god, they’re freaking huge. They’re like small apples, man.

Dr. Justin Marchegiani: Yeah, I had a couple over the weekend. They were like almost the size of my hand. I was like, Holy smokes!

Evan Brand: Because I kind of thought that organic was and I guess I thought wrong. This is me being dumb, I guess. But I thought that organic had a little bit of separation from the conventional practices meaning the hybridization process, but my god, you look at some of these apples now to their like softballs.

Dr. Justin Marchegiani: Oh, yeah, I mean, just farmers naturally over hundreds of years, they’re going to just start selecting seeds and, and crops that are going to be more tasty, just just natural selection of what sells. And so that tends to shift over time, where if things are just growing in Mother Nature, you know, we don’t quite have that ability to select it as much. 

Evan Brand: Yeah, I don’t know if you’ve seen this, but I go, you know, I’ll be out in the woods and I’ll find some wild strawberries. They’re tiny. They’re like the size of your pinky fingernail.

Dr. Justin Marchegiani: Yeah. Real. Yeah. Yeah, no, totally. So yeah, but most important thing is the food quality. And, of course, if you have insulin resistance in your inflamed, you know, leaning to less sugar is always better. Just because your body doesn’t have you know, if you’re the hunza, right, and you’re walking 10 miles a day hiking and doing all these things, you have the ability to burn all that stuff up. No problem. It’s not a problem, but you have don’t have the ability to burn it up, what’s your body going to do with it, then it gets stored in the liver, and it’s stored in the muscles, and then when that’s tapped, it’s gonna get converted to fat. And you’ll get insulin resistance. We got probably that’s I’ve got to be careful that.

Evan Brand: Yeah, and the main last point, there was just adjusting how your food is cooked based on what’s going on with your gut. So if you’ve got infections, like for me, I’ve rarely ever do leafy green salads. Raw just doesn’t agree with my gut. And so I don’t do it. And I could, I’m sure I could work it in, but to me, I feel I feel good. My gut feels good. I feel good. So I’m okay with cooked veggies. And those work for me. So.

Dr. Justin Marchegiani: Yeah, worst case, just take your veggies laid out in the frying pan and put a really good saturated fat down and some sea salt, you know, and, and boil it, you know, for 20 minutes at 400 nice roasted vegetables are pretty good. As long as you’re using the good healthy fat on It’s wonderful.

Evan Brand: Yeah, would you recommend something like ghee, because if you go too hot with butter, you might get some smoke, right? So would you say ghee or what do you like?

Dr. Justin Marchegiani: You could do ghee or any Talos you could do a little bit of avocado oil. Avocado oil is pretty heat stable use got to make sure you’re looking at what the heat is. You don’t overdo based on the smoke point. Okay, that’d be cool. Anything else you want to hit on? I just think people that are listening here. If you’re struggling and you’re having a hard time, you know, feel free to reach out to someone like Evan and I would be happy to help you out. And you can see Evan at and feel free you can schedule with him worldwide, as well as myself, Dr. J at Happy to help you guys out. also put your comments down below, let us know your thoughts on the topic. Let us know what you’ve done. What’s helped you in the past. You know, we learn a lot through our patients. Because you know, when you only have yourself that’s that’s only one person. But when you have 1000s of people that you can learn from you just see what works. You don’t need a scientific study to tell you because you see it, it’s real. And then we apply it to help our patients. And we really appreciate y’all sharing your stories here as well. And reach out links below for everything guys, and then make sure you share with family and friends that they could benefit. Please put it in their inbox or share it on social media. We really appreciate it.

Evan Brand: Yeah, yeah, well, awesome job. And yeah, once again, Or, please reach out we’d love to help you. And you know, we didn’t talk about it too much today, because it’s more focused on other things. But testing is part of this protocol. So figuring out exactly what we’re doing, how we’re doing it, when we’re doing it, why we’re doing it, it is based on testing, we’re not just using you as a guinea pig, we are truly looking at calprotectin and stouter crit and Alaska as there’s, there’s so many biomarkers that we didn’t even discuss that we’re working into that. So I just want you to know that we’re not coming in blind here. We have data that we’re using, which helps us to guide these protocols. And that’s really where the magic happens is once you get to the get the data. So test, don’t guess, reach out if you need help. And we’ll be in touch next week.

Dr. Justin Marchegiani: Yeah, just to highlight that. On the digestive side, we’re looking at markers likes the adequate, which if that’s high, that’s a lot of mal digested fat. If we have a lot of calprotectin or lactoferrin, or increased immune response like IGA that means there’s stuff going on in the gut. And so it’s good to know that ahead of time so we can really quantify what’s happening, or maybe even gut permeability like Sanyo, and that can all be very helpful. So I’m glad you touched upon that. We’ll put links below guys for everything that you guys need to take next steps and you guys have a phenomenal week.


Audio Podcast:

Recommended products:

Genova Organix®

Dysbiosis Profile

Genova NutrEval® FMV

Genova ION Profile

Genova SIBO Breath Test

DUTCH Adrenal Test

Organic Grass Fed Meat

Betaine HCL Supreme

Multi Nutrient Supreme

Digest Synergy

Liver Supreme

Enzyme Synergy


Collagen Diet: Collagen-Rich Foods for Healthy Joints, and Skin

We know collagen is going to help with the joints because we know half of your bones are protein. We need good building blocks for our cartilaginous tissue and ligamentous tissue. Frankly, most people get most of their protein from muscle meats. That’s a problem because they’re not getting the knuckles, the bones, and the cartilage, as we would from old-fashioned soups. So, if you’re doing a lot of soups and bone broth soups, that’s great. If not, we really want to add extra collagen.

Click here to consult with a functional medicine doctor for more information on a good collagen diet and supplements.

I do 20 g of collagen in my coffee every morning. I think it’s amazing. I do my true collagen with some MCT oil and grass-fed butter. I love it. I think it’s excellent for skin, hair, nails, and just for overall prevention of bone loss and cartilage loss. We know the wear and tear that most people experience in their joints throughout the year, especially if they do a lot of long-distance cardio. You really need more building blocks to help prevent and mitigate the wear and tear, so you don’t have knee and joint replacements later in life. Collagen can really help decrease some of that wear and tear.

How do you take collagen?

I like adding collagen in my coffee in the morning because it has a nice little kind of creamer-like effect. It gives that little bit of frothiness which is wonderful. I also do it before bed. Sometimes I’ll do a little bit of collagen (glycine), magnesium, and vitamin C because vitamin C is a really important building block for making collagen. I find magnesium has some very good calming effects as well where there are plugs in the GABA or it’s just a natural beta-blocker as well. It can calm the heart and bring the heart rate down a little bit. I think magnesium does work on some of those GABA pathways as well and, of course, magnesium helps with blood sugar. You’ll get deeper sleep and better REM sleep when you have good magnesium. So, I love combining collagen and magnesium at night.

Where can you get collagen from?

You can get collagen from food via bone broth. Chicken skin is super rich in glycine, roughly 3.3 g for 3-1/2 oz. If you make chicken soup, throw the whole chicken in there. Get a rotisserie chicken from Whole Foods and or get the fattier cuts of the chicken at least with the bone and the skin, so that way you get the best of both worlds if you’re going to do it from a whole food source. Regarding seafood, wild salmon is going to be the best source of glycine.

If you want to learn more about the collagen diet and other good sources of collagen, click this link to schedule a chat with me!

Natural Herbs and Foods to Help Fight Stress

When you’re stressed, what are the important things? Blood sugar stability is really important because most people get on a roller coaster when they get stressed, meaning they’re overly gravitating towards alcohol and towards refined sugar. Their blood sugar goes up and then it crashes down, and then it creates more nervous system stimulation via adrenaline, epinephrine, and cortisol being stimulated to bring the blood sugar back up.

Click here to consult with a functional medicine doctor for guidance on which foods to eat for stress relief.

So, I find just keeping it really simple and really easy with your meals. You may be more nauseous when you’re overly stressed because stress hormone does cause you to feel nauseous. So, this is where you may want to do a soup or a simple smoothie, something really easy where there’s not a lot of digestion but you’re still getting some proteins and fat in there, whether it’s some collagen and some coconut milk or just sipping on some bone broth. Something like that’s going to have some good fat and good protein, and it won’t be hard to digest. So, if you feel nauseous, just still know you should probably be eating but just try to make it something very easy on your tummy.

Then think what are some of the nutrients your nervous system is going to need when you’re more stressed. So, the low hanging fruit, B vitamins. B complex is going to be very essential. Magnesium is going to be excellent. GABA and L-theanine are good things that are going to help you relax and wind down. Valerian root or passionflower, which are all connected to GABA and that inhibitory neurotransmitter that helps you just relax a little bit. It kind of puts the clutching gear and disengages the gearbox, so you can downshift so to speak.

I always go to nutrients first and then I go to my favorite adaptogenic herbs second. So, Ashwagandha is one of my favorites. Rhodiola is excellent and there’s holy basil, which are my favorite very relaxing and tonifying herbs.

If you want to learn more about herbs for stress relief, click this link to schedule a chat with me!

Top 5 Warning Signs of Hormonal Imbalance

Let’s talk about hormones. I’m going to dive into a couple of clinical pearls that I see in my practice from working with hundreds of female patients and male patients which have a major effect on modulating and supporting hormonal balance.

Click here for a consultation with a functional medicine doctor if you want to learn more about hormonal imbalance.


These are my top 5 hormonal balancing strategies:


  1. One of the first things in regards to hormones that’s very important, and this may be common sense but I try to give a lot of knowledge guided by experience, is nutritional building blocks for your hormones. Healthy cholesterol from animal products are very essential. Fat soluble vitamins like A, D, K are very important. Lots of good protein are also very important. We have steroid-based hormones that are going to be more cholesterol-based and we have peptide-based hormones that will also be protein-based. So, a lot of these protein, fat-soluble vitamins, and cholesterol especially healthy animal cholesterol are very helpful for hormonal building blocks. If you have a vegan-vegetarian diet or if it’s very nutritionally poor or there’s a lot of processed food, that may set you up with a deficit out of the gates for just hormonal issues. Remember: Make sure the food is nutritionally dense, anti-inflammatory, and low in toxins. That’s vital.

  1. Now, if you’re having a lot of good nutrition in there, the next thing is we have to make sure we’re able to digest it and break it down. So, if we have a lot of chronic acid reflux, poor digestion, constipation, or bloating, we know we’re not quite breaking down our food and our nutritional building blocks. That could tell us that we may have hormonal issues because we’re not breaking that down. Therefore, those nutrients can’t get into our body or get in our bloodstream and be taken throughout the body to be used as building blocks. So, if we have a bottleneck in the nutritional side, that could be a big factor.

  1. Stress, whether it’s emotional or chemical stress. If we’re eating foods that are inflammatory or we’re nutritionally deficient and we have a lot of emotional stress, what tends to happen is our hormones kind of go on two sides. We have an anabolic side which are the growth hormones — testosterone, estrogen, and progesterone — that kind of help deal with growing. Then we have anti-inflammatory hormones which would be cortisol and are catabolic. I always put progesterone in that category because progesterone can be used to make more cortisol. So, we have our anti-inflammatory and then our anabolic. In some, they kind of cross over. Insulin, growth hormones, and testosterone are anabolic. The more inflamed we get, we could have high amounts of testosterone because of PCOS and because of inflammation. So, some of these hormones kind of interact and cross over. With men for instance, the more inflamed men get and the more stressed they get, that can actually cause an upregulation of aromatase and could increase their estrogen. So, see how these things kind of cross react. Your hormones are going to be either pro-building or anti-inflammatory to reduce stress. So, for chronically and stressed out state, cortisol is going to rip up your protein and kind of decrease your muscle mass. As a woman, you’ll see your progesterone level start to drop and that will start putting you into an estrogen-dominant state because if we normally got 20 to 25 times estrogen than progesterone, that ratio starts to drop. Even if you still have more progesterone than estrogen, that ratios is going to throw you off and that can create breast tenderness, cramping, mood issues, excessive bleeding/menorrhagia, infertility, a lot of mood issues, back pain, and fluid retention. All those are possible situations.

  1. Xenoestrogens from the environment and foreign estrogens. They can come from plastic components, pesticides, herbicides or rodenticides, mold toxins, and heavy metals. They are going to disrupt our hormones. The easiest thing is eat organic, avoid plastics, and avoid a lot of the chemicals in the water because a lot of times you can get pesticide runoff or hormone runoff in the water. So, clean water and clean food, and then make sure it’s organic avoid the plastics as well. That’s a big, big thing. Plastics are probably okay if they are in a refrigerator or in a cold environment but ideally if you’re heating stuff up or it’s going to get exposed to light, you want some kind of a Pyrex or a glass container. It’s much better and really important.

  1. Last but not the least would be just making sure our detoxification pathways are running well. So, if we have good hormonal balance but we can’t detoxify it, then a lot of times we can reabsorb it. So, if we don’t have good sulfur, good glutathione precursors, good B vitamins, good methylation, N-acetylation and glucuronidation, we may have a hard time eliminating. Hence, we are re-absorbing a lot of our hormones. So, being able to break down your proteins, break down your amino acid and your B vitamins is going to help with your body’s ability to eliminate a lot of these toxins.


Blood sugar, digestion, stress, xenoestrogens, and toxicity are really big. Those are the big 5 across the board. Try to apply at least one of these things.

If you’re struggling with hormonal issues and you want to dive in deeper, feel free to schedule a consult with myself.

How to Address Your Fatigue and Gut Symptoms via Organic Acid Testing | Podcast #328

Hey, guys! In this video, Dr. J and Evan talk about addressing gut symptoms via organic acid testing. To start with, Organic acid testing (OAT) became very popular amongst functional medicine doctors and dietitians. It is a urine-based test that gives essential information about the functioning of various bodily systems and to identify possible nutrient deficiencies, gut dysbiosis, and more. 

Organic acid testing may be beneficial for people whose symptoms have not yet describe through other stool tests, blood work, or urinary hormone tests. It helps give an immense understanding of nutrient deficiencies, mitochondrial function, neurotransmitter metabolism, detoxification abilities, antioxidant status, and gut health, which trained and experienced clinicians can utilize to dive deeper. 

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:07     Organic Acid Testing, Gut Issues

5:17     Candida, Oxolates

10:27   How Lab Results are Interpreted

17:14   Metabolism, Energy Production

24:35   Neurotransmitters

26:06   Detoxes

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: And we are alive. It’s Dr. Justin Marchegiani in the house with Evan Brand. Today we are going to be talking about organic acid testing organic acids are wonderful technology that we use with almost all patients to really look under the metabolic hood to see what is going on whether it’s functional metabolic issues, deficiencies, certain nutrient deficiencies, gut imbalances, detoxification problems, methylation issues, we weren’t able to kind of peel back the onion, so to speak and look deeper under the hood. Evan, how are we doing today man?

Evan Brand: Doing really good excited to dive in! You know, I can say this with confidence, because I’ve actually spoke to the lab about this that you and I, personally, between us clinically, we are in the top five of practitioners worldwide running the most organic acids testing.

Dr. Justin Marchegiani: Wow, isn’t that cool? I didn’t even know that. I knew I knew we were up there. But that’s really cool to hear.

Evan Brand: Yeah. So So what does that mean? Well, that just means that we’ve looked at so many of these that we can really get good at what we’re doing. And most importantly, we can help you the listener figure out exactly how your symptoms are linked in to a particular body system dysfunction. So we’re going to talk today about how the gut, you can find information about the gut via urine. And we talked about stool testing a lot. But in some cases, the urine is actually a little bit better for investigating the gut, which is pretty interesting. So we’ll dive into that we’re going to talk about energy markers and how your energy and fatigue levels can be tied in also. And the mood category, we’re going to get into possibly depression, anxiety, and how that could be tied in or even OCD behavior, depression, winter depression, and then we’re going to get into nutritional markers. And I mean, there’s just so much information from one cup of tea, it’s like magic.

Dr. Justin Marchegiani: Yeah, we can get a lot. And again, when we’re looking at gut issues, I always tell patients, we’re always going to look at a gut test, like a good high quality gut tasks. You know, there’s a couple of tests that we use, but once the genetic test that looks at the gut microbiome infections, h pylori, bacterial overgrowth, inflammation, markers, digestion, markers, immune markers, so we’ll always want to look at a comprehensive gut test to see what’s going on. But it’s nice to look at the organic acids, because sometimes, most of the time, I would say they kind of correlate where we see some kind of bacterial overgrowth, or a fungal overgrowth, it will a lot of times say it on there, I do find the organic acids do pick up fungal overgrowth far more often than stool test to a lot of times, if you’re looking at under the threshold level of fungal stuff, we do see a lot of fungal stuff. It’s not at the positive level. But if we see it there at all, you know, we typically consider it a problem. And then third, you know, we may not see total congruence, like there may say gut issues on an organic acid test, but not on a gut test. And guess what, if we just see it anywhere once, then that’s enough for us to kind of move forward on it. We don’t need total agreement. It’s just an extra check. It’s an extra net to catch anything that could be missing. And of course, we get deeper look in what’s happening nutritionally methylation, B vitamins, sulfur metabolism, detoxification, mitochondrial functions, we really get a good window at what’s happening underneath the hood. 

Evan Brand: Yeah, I want to show you this three year old, if you’ll let me share my screen, I tried to click on it, it says you got to enable it for me. But I’ve got a three year old little girl as a client who has been to conventional doctors, and she can’t get help. And the pediatrician, of course, is just saying, Hey, you know, possibly do some vitamin D. And that’s really it. Okay, now I can share. So let me pull this up here. Can you see that? 

Dr. Justin Marchegiani: Yes, I can. 

Evan Brand: Okay, good. So the people watching too, if you’re listening via audio, I encourage you check out Dr. Justin’s Justin Health YouTube channel. If you’re listening and you want to see the visual here, we’re going to try to make sure that those doing audio only still get the gist of it. But really, what we’re trying to find here are high markers. That’s when you really see problems. And you can see for this little girl, this is keep in mind this a three year old little girl. And the parents said that the girl is literally addicted to sugar, and she refuses to eat anything else. And she has a ton of symptoms, skin, mood, gut behavior, just all kinds of stuff and look at this tartaric acid, which is an indication of Aspergillus, growing in our gut, we want less than 3.9. She’s 147. I think this is the highest I’ve ever seen. And sadly, it’s an a child. And then of course, arabba knows you and I’ve talked about that being the gas that Candida produces, we want less than 56. She’s off the charts at 226. So right there really high, that’s really high. This is the amazing thing in five seconds of us looking at this page, we know this person’s already colonized for mold, and they were in a moldy house in Texas had major mold exposure. And when now we know that she’s got a major Candida problem. So even if we just had that data and just pursued those two points, we would get a hell of a hell of a lot more results than what you would get if you went to the pediatrician and said, Hey, I think she’s got a problem. They’re not going to know anything about these tests or these markers.

Dr. Justin Marchegiani: Plus in the conventional medical world, I mean, frankly, you know, candida that doesn’t really exist to people like that right. Conventional medical doctors at They’re very rarely saying, hey Candida is a problem. Usually it’s one of those things. They just say, Oh, yeah, that’s just kind of what natural medicine thinks everything is. The problem is candida, but not necessarily. But if we have objective markers that show it, it’s good to really know that and conventional medicine isn’t typically doing testing that sensitive enough to really pick it up.

Evan Brand: Yeah, and I know you run a lot of the Genova panels. And the reason that I use the Great Plains is just because I like to run the combo a lot when I, you know, I’ve kind of attracted a lot of moldy people. And so we like to run the mycotoxin combo test. So one cup of tea, and we get two labs. So that’s why I do the the Great Plains, but the rest of page one was okay, she didn’t show any major bacterial overgrowth, he was starting to creep up there on one of these markers. But overall, it was decent. Let’s move on. Let’s look at this is where all the fatigue is coming from. They said that this kid is just exhausted. And then they described it as poor tone, where she literally just lays on the floor all the time. Justin, I don’t know if you’ve ever even seen anything this high. I mean, look at these oxalates 677 off the charts. We know Candida is a piece of it, but man, and then look at the I call it succinic. But I think it’s actually pronounced succinic.

Dr. Justin Marchegiani: So succinic, yeah, and just so you know, oxalates a lot of times, especially in a kid, it’s probably not like, I would never tell a mom like oh my gosh, like most green vegetables have oxalates in it. So I wouldn’t be telling any mom like oh my gosh, you need to avoid green vegetables. Unless there was some kind of oxalate crystal issue in regards to kidney or significant muscle or join issues. I would just think that, hey, those oxalates are probably high because of the candida, candida that can really increase oxalate production and decrease oxalate synthesis. So I would lean more on the Candida being the oxalate problem.

Evan Brand: And I think this is huge, because you have some unnamed people writing books and fearmongering people about oxalates. And now you have people paranoid vegetables, like you just mentioned, you’ve got people that are like cutting vegetables out because they’re worried about the oxalates. But you and I’ve seen personally and clinically hundreds and hundreds of point reductions in the oxalic acid just by treating the Candida so Yeah, I would agree that when we know she’s not eating vegetables, so we know that that’s not where it’s coming from.

Dr. Justin Marchegiani: Yeah. And so we know if they have a Candida issue and they have a whole bunch of sweet cravings, you know, exactly. They’re not eating a whole bunch of vegetables. That’s not the issue. They’re, you know, a whole bunch of crap. And we don’t want to give them any more ammo to let their that their kiddo eat crap, right. So we want to definitely get some good nutrition in there, more than likely most of the oxalate issues are going to be from the Candida. Now again, some of the exceptions may be if we have vulvodynia, excessive joint pain from oxalate crystals, crystals, maybe kidney stones, or really kidney pain issues, that could be something really clinically significant. If not, we’re not going to worry about the oxalates, we’re going to think of that more as an effect than a cause the cause really being Candida and the effect being more of the oxalates as the cause. So I always when I’m looking at these labs of patients, I always have them in their head, draw a line one sides, cause one size effect affects we watch and monitor causes we treat and work on supporting. And so it’s easy for people to look at an effect think that is the cause and treat the effect. And then a lot of times the result won’t be as good or you do things that aren’t necessary, like cut out foods that may be really healthy for your kid.

Evan Brand: Totally Yes, same thing for the citric acid here on 29. For those listening, we’re looking at these little triangles, basically, the higher the number goes down in general, the more of a problem or dysfunction we have. And we want citric acid, maybe somewhere around 200 would be moderate. This poor little girl is off the charts almost at 1300. And we know citric acid will go high with Candida and fungal overgrowth in general. But all this succinic acid and malic acid oxic glutaric, these things are off the chart. So this just indicates an insane amount of mitochondrial dysfunction. And that’s, that’s why this girl is literally so exhausted. She can’t go to school, the parents can hardly get her out of bed. And she’s three years old. I mean, you know, my daughter, she’s four now, but when she was three, I mean, she bounces out of bed and she’s just running, running, running, going and putting her bird feeders up. I mean, this kid wakes up with energy. So you can just see, these symptoms that kids face in the parents is think gold. They’re just, like bored, or they’re just tired, but they don’t think Wow, she could have a ton of mitochondrial damage.

Dr. Justin Marchegiani: 100% Yep. 100%. So looking at a bunch of these things here. I think we hit a lot of good things out of the gates. Let me just keep on rolling here. So actually, do you want to hit a little a couple more things? I’m going to show some of my organic acid testing to the second. 

Evan Brand: Let me do to show this one page here. So some of the nutritional markers are gonna get, we’re gonna see here that she was very deficient in riboflavin. The higher it goes actually the more deficient and then of course vitamin C is in Charlie is just completely toast. And then we’ve got some other markers ammonia excess and some gi bacteria markers, but overall, the main things I wanted to hit were just massive mitochondrial damage, massive colonization of mold and Candida. So don’t think that just because your kid is young That means they can’t, they don’t have permission to be sick. I mean, I started treating my daughter when she was two because she had parasites. And so I just, I feel bad because you know, these kids, when they’re really young like this, they may not be able to express all of their pains and their symptoms. But hopefully there’s enough whether it’s skin or mood or behavior or, or sleeping issues, that there’s enough justification for the parents to reach out, run the labs, and then we can really show them on paper, what their kids just can’t verbalize.

Dr. Justin Marchegiani: 100% I think it’s really good points. Now, just to kind of give people a little understanding how we interpret how we look at some of the labs pretty simple. So we want some of the markers here on the labs to be in the middle distribution. So if you look at my screen here, can you see my screen? 

Evan Brand: Perfect. 

Dr. Justin Marchegiani: Okay, good. Excellent. And I just make sure that you can see me as well along with that. Okay. So in general, we want these markers to be somewhat in the second to fourth quintile distribution, when they go on the extreme high or low, we always get a little bit concerned. And we get more concerned if it’s near a red area. So there are some of these markers are two tailed meaning, let’s say number seven citrate, where there’s a red on the left and the right, and some are one tail there say most are one tailed, like adipate subarray, [inaudible] where there’s only a red to the right, does that make sense to tail means read on both sides, one tail means read on one side. And of course, if markers are low, and we’re closer to a read that matters more, so we want them to be somewhat distribution in the middle extreme highs or lows are more concerning, especially if they’re grouped together now. So in this section here, fatty acid metabolism, we see them on the lower side, not as big of a deal, because this is only one tail. But we do keep that in mind. We look in the carbohydrate metabolism, you see you’re in the middle here without lactate, which is one of the more important markers, beta hydroxy butyrate, being higher isn’t that big of a deal. That’s a ketone. That’s a ketone. It’s not that big of a deal. lactate is a marker for co q 10. Typically, and pyruvate is a marker typically for B vitamins and B complex as well. So this being a little bit low, less than detectable limit isn’t that big of a deal, as long as you don’t have a whole bunch of them there. But we do keep an eye on it. And I always tell patients chronically high organic acids, that’s like a demand issue. So it’s like you’re making a million bucks a year, but spending $2 million a year you have a lot of income coming in, but your demand for that money for those resources is high. So functionally, we’re still in debt, right? And when we’re chronically low, especially in areas where there where it’s two tailed and red, that’s a sign that there’s a depletion issue depletion, it’s like you’re making 10,000 bucks a year. But spending 100, right, you’re making a lot less, right. There’s not a lot coming in, but but you’re still spending more than you’re making, right? So both in the end, you’re in debt. Okay, that’s kind of the analogy I give. And I always tell patients, well, what’s the root cause? Like? No, we always want to be focused on the root cause we may be doing palliative support. People can feel better in the moment, but we always want to get to the root cause support now, with organic acids pretty simple. First is going to be diet, and it could be a macro issue, and or micro issue, meaning if someone’s eating that looks like a healthy diet, but it’s not organic. Well, it may be significantly deficient in certain nutrients, right. If you look at Joel Salatin runs polyface farm, he found he sent his organic eggs to the lab, and they looked at the amount of full weight that was in his organic eggs, it was 20 times more fully in his organic eggs than the typical conventional storebought eggs. So organic matters. It’s not just pesticides, pesticides is important. It’s a big part, but it’s also nutrition. So of course, eating organic makes a bigger difference, food quality makes a big difference. And then number two is going to be absorption absorption can be affected by gut microbiome issues, parasites, fungal overgrowth, bacterial overgrowth, it could be affected by low stomach acid and enzymes and bile salt levels. It can also be affected by food allergies, chronic food allergens, or chronic inflammation in the intestines, can can drive it to number three, just general stress. Stress can be categorized as physical stress, right? you’re exercising too hard. Maybe you’re too sedentary, maybe you’re not getting enough sleep, maybe your emotional stress is off the charts. And that’s throwing off your cortisol and your adrenals and your hormones. Stress plays a big role. Number four is toxicity, toxicity primarily from pesticides, heavy metals, mold, toxins, pesticides, heavy metal mold, toxins are biggies. And then number five is genetic. Genetic can mean hey, you just need more magnesium, you need more amino acids, you need more B vitamins than the average person just for who you are. Could be an mthfr issue. You need good high quality full eight, that cheap folic acid stuff is not cutting it. You need more methylated B vitamins. So genetically, there could be just some imbalances in regards to what your biochemical needs. I think Roger Williams wrote a book called biochemical individuality talking about people’s need for certain nutrients can be exponentially higher than someone else’s. And so those are kind of the big five things out of the gate. Any comments on that, Evan?

Evan Brand: Yeah. So one thing I think it’s important to point out is people get really caught up in the DNA and the genetic testing and I’m cool with So I’m cool with it. But I just want to highlight something you said here, which is that we’re really going to be looking more at the downstream effect of any of those genetic predispositions here correct meaning, let’s say that there is a genetic predisposition to needing some more foliage or some B vitamins upstream, but then that manifests downstream, we’re gonna see it here, we’re going to see the citric acid cycle, we may see some things off of this carbohydrate metabolism section. So what I’m saying is not that the genetic stuff is useless, but that you and I are going to see the result of those genetic issues here. Is that correct? And the you might not need that genetic data, because you’re going to be looking here at what the actual body has. Is that true?

Dr. Justin Marchegiani: 100% Yep. 110%.

Evan Brand: Because you send us the snips, right, well, I’ve got this snip or this genetic This or this genetic that, but I really would prefer to look at the organic acids, maybe in addition to but if I’m without the genetic information, I still feel confident in what we’re going to do and the results we can achieve with just the test alone.

Dr. Justin Marchegiani: Yeah, here’s one image. I’ll put it on screen. These are two twins here called Otto and Iwa, can you see it? Yep. These are exact twins. Okay, so one engaged in you know, lifting weights eating better the other one? Not? I mean, you can see, look at the difference. Fuller hair for muscles, right? It’s same DNA. Remember, twins have the exact same DNA. Right? So this is important. So we know our genetics can change. The reason why I don’t like the genetic tests as much as because you could have you could have someone being an alcoholic eating terribly. Someone totally changing their life and and eating incredibly healthily. And guess what? The DNA looks exactly the same. So it kind of it’s a snapshot in time. It’s not functional does not change based on your your lifestyle decisions. And so you can see here we know, right, this is the same DNA here. This is the these are two German twins, like 1969. Same DNA. Look at the difference. 

Evan Brand: Okay, yeah, people on audio people on audio listening, he’s showing a picture of these guys, they’re twins, you can see same height, same looks everything. But then the guy, one guy is, who knows, maybe 130 pounds, the other guy’s like 170, and just ripped shredded muscles.

Dr. Justin Marchegiani: Yep. And so basically, it’s the epi genetics. It’s it’s the functional progress that we’re looking at. So just kind of put that there. And again, anyone listening, we’re trying to do enough of a good job describing what’s happening. So if you’re in your car drive and just kind of listen to us, if not, we’ll put a link right below to the YouTube video. So if you guys want to engage in the video, feel free. Let me go back to the organic acids, though. So we talked about fatty acid metabolism, carb metabolism, energy production. So we’d like this to be somewhat in the middle seven through 14 is a bunch of these organic acids here. The names don’t necessarily matter. citrate, Sr connotates, ISO citrate alpha ketoglutarate, succinate, Fumarate analyte, hydroxy, [inaudible] doesn’t matter, right, that’s just just focus on what it means these typically correlate with nutrients like B vitamins and CO, q, 10, and chromium, chromium and arginine and cysteine, and B complex and manganese and magnesium and lipoic acid. So when we see deviations high or low, especially a whole section, higher low, that tells us those nutrients are going to be burnt up depleted. And it just gives us a window, what’s happening. And we got to look at it in correlation to someone’s lifestyle, how good their diet is, how crappy their absorption is all that matters. I always try to look at the top the patient’s top two or three symptoms, I try to correlate it to the, to the systems that may not be functioning optimally based on the organic acids. And then I support based on that, because there’s a lot of things you could support at all times. At the back page, they’ll typically give you a whole bunch of things that were to recommend here. I ignore that. Because because there’s a clinical art to this. And we’re doing a lot of different things. At the same time. We’re not just like running this test. I’m just saying here, take the supplements, we’re really trying to look at the whole big picture.

Evan Brand: Okay, I kind of skipped over some of the importance of the neurotransmitters in the beginning. I mentioned we’re gonna hit some brain chemistry stuff, depression, and some mood issues. Cool.

Dr. Justin Marchegiani: Depending on how bad your gut health is. Ideally, if we’re doing some kind of a really good high quality methylated B 12. Or [inaudible] or hydroxyl and or some kind of something sublingual, usually we can not necessarily need it if we’re doing the high enough of a dose and or sublingual. But if someone maybe has really bad Crohn’s or ulcerative colitis and bloods coming out of their stool, and we see markers on their differentials, you know, hi MC, ah, Hi mctv Hi, MC, hc, and or high methylmalonic acid, we may want to just do a one off injection to bias time, but most of the time, it’s not necessary. Because when patients come in to see us, we’re doing all kinds of diet changes and lifestyle changes a month before these tests even come in. So then the time they get these tests in usually we’ve calmed down most of any acute issues to begin with. Does that make sense? 

Evan Brand: It does. Yeah, I just see a lot of these pop up IV clinics going around and people they’re paying a really pretty penny for some of these injectable B vitamins versus some of the pricing that you and I offer on some of the our professional methylated sublingual nutrients, it’s maybe a quarter of the cost, if not half the cost. And you don’t have to get an injection. You don’t have to travel to a clinic and sit in the chair. You can do it at home and you can fix it. So yeah, I would agree with you.

Dr. Justin Marchegiani: Yeah, I would say depending on how acute The issue is, maybe that may dictate. And also if you’re acutely sick, that may help kind of as a palliative thing, but in general, it’s not practical from a day in day out standpoint. And then we have our neurotransmitter. So vanel, Mandalay and Homo vandelay. They’re kind of they’re two, they’re two sides of the same sword so vandal Mandalay, it’s a marker for adrenaline, home of analytes, a marker for dopamine. Now in the in the neurotransmitter synthesis pathway, it goes phenyl alanine tyrosine tyrosine l dopa l dopa epinephrine norepinephrine. So what does that mean? It means home of anolyte will eventually home of anolyte looks at dopamine, right? So dopamine will eventually go downstream to adrenaline. It’s the next step in the cascade if there is stress going on. So when you support adrenaline, you’re also support a dopamine, when you support dopamine, you’re also supporting adrenaline. And you may not have both of these out of balance. So in this case, this person is having more of an adrenaline issue. Now, by supporting the adrenaline we will be supporting dopamine. But if you have a chronic adrenaline issue, you will eventually be depleting dopamine, because it just comes from it. It’s the precursor, your fan, Amanda lates, the post cursor, dopamine or Homo ventilates, the precursor? Does that make sense? 

Evan Brand: So let me say it in another way, you’re going to see a depletion of your endorphins before you see a depletion of dopamine.

Dr. Justin Marchegiani: Oh, no, you could see both, you could see a dopamine issue before endorphin. That’s gonna be all based on genetics. But if you only see one issue going on, it’s just a matter of time before that second issue kicks in.

Evan Brand: I’d say 75 80% of the time, you are seeing both at the same time lower.

Dr. Justin Marchegiani: So think of it as like this, you have two credit cards, right? You’re only in debt on one credit card. Well, if you keep up your spending habits, it’s just a matter of time before you’re in debt on both credit cards. Does that make sense? Okay, just like that, and then five hydroxy. And these are all metabolites. So these organic acids, they’re metabolites of amino acids. And these metabolites give us a window into certain nutrients. And so as long as you have an understanding on what the nutrients are and what the area is, the actual organic acid doesn’t necessarily matter that much, FYI.

Evan Brand: I think I think of it and kind of refer to it as like the fingerprint of what’s going on or maybe the ash in the bonfire, you can see the evidence of what’s happened. You’re just kind of analyzing the ash and looking at the fingerprints.

Dr. Justin Marchegiani: Yeah, patients usually think of it as like gas in the gas tank. Is it higher? Is it low? I’m like, Nope, it’s RPMs and the engine RPMs is overly overly high or really low or really high demand overly low on the on the stimulation.

Evan Brand: Scroll down to that detox marker. I want to see what you can tell us about that one there that-

Dr. Justin Marchegiani: Let me just finished the neurotransmitters real fast. So five hydroxy acid that’s a serotonin marker. So serotonin plays roles in motility, mood, sleep, happiness. Another big one kind of urinate plays a really important role would be six right B six helps with the synthesis of all these nutrients. All these neurotransmitters and of course, kind of urinates brother or sister is anther urinate so this person has high xanthine Made in high kind of urinate. So we know there’s definitely a B six problem. And B six plays a really important role in neurotransmitters. So if you’re just thinking, Oh, I’m going to just take some tyrosine or phenyl. alanine, yeah, probably not the best, okay? Because you need the other nutrients there. And then also picolinate chronically low is a big sign of low amino acids and if we have low amino acids, it could be a catabolic stress issue. You’re just burning up a lot because you’re you’re a lot of Khattab catabolic stress, cortisol imbalances, hyper adrenal stuff, it could also be, you’re not getting enough protein, you’re not eating enough vegetarian V and not eating enough or you’re not digesting enough, it could be all of the above. And then we have our oxidative stress. Oxidation is losing electrons when you lose electrons. And you don’t have enough antioxidants like vitamin C, or a or E or good antioxidants like curcumin or resveratrol. Those help donate electrons. And if we are donating electrons, when we lose them, we can create free radical damage and that can chip away at our DNA and cause our DNA to age rapidly. Any questions on that last part? 

Evan Brand: No, we’re good. Let’s run into the detoxes part.

Dr. Justin Marchegiani: Yeah, so this person right here is very depleted detoxification. So the most important markers here are these two, or these two tailed markers at the bottom, pirate, glutamate and sulfate. Very important, they all correlate with Bluetooth ion. So when I see low sulfate and low pirate glutamate that almost always means a glue to phi on depletion. So the big neurotransmitters here are n acetylcysteine, cysteine, taurine, glutamine refining, right? glycine, they all play a very important role in making our tripeptide most powerful antioxidant glutathione.

Evan Brand: Let me pose a question to you that some people will have at this section is they’re going to say okay, you mentioned gluta found depletion. So are you saying that there was a toxin issue, maybe a mold toxin that depleted the glutathione and or you’re saying that you may not even have the raw materials necessary to synthesize Bluetooth ion, right. So it could be a two pronged issue, it could be a depletion of glutathione due to toxins, plus the inability to make it is that what you’re saying? This could show?

Dr. Justin Marchegiani: Yes, so it could be one more variable so one, it could be a combination of exposure to toxins that are stressing out that pathway to you’re not getting enough good exposure to sulfur amino acids. Three, it could be not, you’re not digesting your protein well, right. And for when you get stressed part of the whole catecholamine adrenaline noradrenaline pathway require sulfur requires sulfur to help with that conversion and metabolism of healthy, healthy neurotransmitters. So you actually need sulfur on the neurotransmitter. So if you’re chronically stressed, you could also deplete sulfur that way,

Evan Brand: So each each your broccoli, folks as long as you can tolerate it.

Dr. Justin Marchegiani: Well, more importantly, yes, there’s a lot of sulfur there. But more importantly, like your animal protein, like you’re gonna get a lot of sulfur in there. But from an amino acid from a bulk amino acid standpoint, you’re going to get way more sulfur in protein from a caloric standpoint, as a percentage as a percentage of the food, you’re going to get a lot of sulfur and broccoli, but this is just low calorie, right. So you get more from a caloric standpoint with high quality animal products, or honestly, whey protein or college and proteins. Excellent, too, for that, too.

Evan Brand: Yeah, that’s what I was gonna say if somebody is listening, and they either maybe were previously vegetarian or couldn’t get back into the meats, maybe they were having issues digesting meats, we’ve got some really good like grass fed ways or some collagen hydrolyzed beef proteins. Those work amazing.

Dr. Justin Marchegiani: Yeah, or even just free form amino acids that are kind of been fermented that still are pretty balanced, they can, they can help get the needle moving on that. And then this to methyl hippuric can also be elevated due to xylene. And xylene can be in drinking water could be smoking, inhalation, vehicle exhaust, now, a different different nail polish those xylenes one of those things that could be an issue up there as well. It’s possible it’d be put on the list. I mean, most people we’re trying to educate them on healthy products, how you know, good water filtration, good, hygienic products. And then if we look down here below, this is gut bacteria. Now this person only has one elevated gut bacterial metabolite. And I tell patients like what we’re looking at here like this is typically bad bugs, usually more on the gram negative side. It’s not telling us what the bugs are. Could it be h pylori, could it be klebsiella? citrobacter? Could it be prepatellar morganella. It can be all those things. Right? Pseudomonas, it could be it’s just looking at the exhaust. So it’s like, okay, a car was was had their engine on they were in the garage, they left you show up to the house, you open the garage, I feel like there’s some exhaust in here. Like you may not be able to know Oh, that’s a four. That’s a Chevy. that’s a that’s a Toyota, you may not be able to know what car it is, but you can know Okay, something was in here. Does that make sense? And so it just tells us Okay, we got some exhaust of some bad bugs here. And we probably got to work on it. And now if we have the stool test, we can no okay. Yeah, well, you also test the positive for Pseudomonas and klebsiella and H. pylori. So that’s probably what that’s correlating with. I had a patient last week had a lot of bugs and he Laurie, and there wasn’t much elevated at all, I think this is the test. This is the person that had a lot of other big bigger bugs. And that can happen. I tell him, you, we don’t need both tests to confirm most of the time they do. And then I’d say most of the time, the organic acids, picks up the de arabba, Anatol, this picks up the the fungal overgrowth before the GI map or the stool test. So it’s good to have both, that’s a really good marker. And then a lot of times the if we see a lot of bacterial overgrowth here, that a lot of times would correlate maybe with a SIBO breath test where we do a lactulose. And we and we blow into it for three hours afterwards. A lot of times, we’ll see a correlation on that as well.

Evan Brand: Yeah, yeah, well said. And I think you made a great point here, which is that sometimes you’re not going to get the smoking gun on this test, the stool may come in and provide better data and vice versa. Rarely, the Candida shows up on the stool, though the the oat test is always going to be better for Candida at least 98% of the time. 

Dr. Justin Marchegiani: Well, 100%. Now also, with induction, this may also give us a window into bio output, as well as poor protein digestion. So induction issues, you know, usually more purified protein work on HCl, of course, I’m always working on HCl Anyway, I’m just giving you a little bit more of an insight. Usually, with the lactate being on the higher side, that almost always means there’s a lot of extra probiotics in the system. So they may be taking a lot of lactobacillus or bifidobacterium. And usually these patients may get more bloated to those kinds of probiotics. And usually that’s common with SIBO. So we see a lot of the lactate, that can mean there’s other already taking a lot of probiotics, and then that may be a problem. And they may want to switch to a spore based probiotic or even just no probiotics, and maybe even a a low fodmap diet out of the gates. You know, those are different things just clinically, I noticed over the years. And again, when we look at this, we’re taking into account the patient’s adrenal tests, what’s happening with their thyroid? What’s happening with their their gut functioning, what’s happening with their lifestyle? Have they had their had they had mercury fillings removed? Has there been any mold exposure? What’s their diet? Like? What’s their digestion? Like? Are they pooping everyday, we’re looking at the whole picture. So some people may look at this test totally in isolation, not good. You really want to connect it to everything else that’s going on? 

Evan Brand: Yep. 

Dr. Justin Marchegiani: Anything else you want to highlight there Evan?

Evan Brand: If you haven’t had your organic acids test, reach out, let’s get it done. Let’s see what’s going on. This is an amazing test. If I only had like desert island situation, I only had one test to run, I’d honestly probably pick this one, wouldn’t you? Or what would you pick?

Dr. Justin Marchegiani: I would because you do get a window, what’s happening with the adrenals a little bit you do get a window, what’s happening with the mitochondria. And then you also get a little bit of a window in regards to what’s happening in the gut and detoxification. So you get a window of a lot of different things. And I love it with kids. Because, you know, kids don’t want to get their needle, get a needle in their arm, right. And so it’s really nice. This is a urine based test if you want to avoid getting a blood draw. It’s a really easy test to do out of the gate. So I do like that.

Evan Brand: Also. And it’s at home too, right? So if you got people that are elderly, or just you know, paranoid to go out, for example, in the public and go into a lab, hey, you do it at home, you get it back. I mean, how convenient does it get?

Dr. Justin Marchegiani: Yeah, and then also with this test, you got to be careful if you’re chronically low protein. This is running it off of creatine. So if creatine is too low, which is a protein metabolite, you could get some, some false readings on the on the lower side. So you got to make sure there’s a protein in the system. And so if you’re dealing with someone who doesn’t eat much protein at all, you know, we’ll typically throw in some freeform amino acids for a couple of weeks ahead of time. That way, those systems at least have the substrate to move metabolically, if you will.

Evan Brand: Yeah. Great pointing out.

Dr. Justin Marchegiani: Anything else you want to say, Evan?

Evan Brand: I don’t think so we’ll give the links to people. If you enjoyed this, please let us know. I know this was kind of fast, and maybe a little overwhelming, because we’re breaking down. But for us, this is something we do all day every day. And of course, for your unique situation. We’re going to talk you through what’s going on what you need to do, how to fix it. But give us some feedback. So like I said, if you’re on Justin’s YouTube channel, right in the comments, do you like these video versions, because a lot of times you and I are just riffing on stuff. But if people like the videos, we’ve got so much stuff that we can uncover. We’ve got literally 1000s of case studies, we can start reviewing, if you want to see before and after, like, Hey, here’s a protocol we implemented. And you know, we’re not going to give exact dosing and say, Tell it tell you to do it, but we could run you through what we do, if you like it. So let us know because we really need the feedback to help guide the show.

Dr. Justin Marchegiani: Yeah, and also, we’re trying to be different than other people that are talking about these topics, because they’re not in the trenches. So we’re in the trenches. So, you know, our kind of unique proposition for y’all is that we do this every day, and we want to provide valuable information that’s actually actionable. And is it’s real, it’s something that we’re in that this is the patient from last week that I’m talking about here, right? And so we’re trying to provide actionable information and if you see this and you kind of get a little bit overwhelmed, it’s okay, it’s normal to feel overwhelmed. We review 1000s of these tests, it takes a couple you know dozen to kind of get your get your, your feet wet, so to speak. So just an FYI, if you get overwhelmed, not a big deal. If you work with us as patients, you know, we typically go over these things a couple of times and then usually patients have questions a month or two later after the test. We always go back. Part of being a great clinician is you have to be a great teacher. So if anyone feels overwhelmed with it, don’t worry, we tend to take these things, boil them down, make sure you have the key action components. As long as you have the action items, that’s the most important thing. And if you want to reach out to someone like myself or you can reach out to Evan. Evan has the same philosophy you got to have a heart of a teacher. And then Justin Health myself, Dr. J at There’s links there for you guys to click. If you enjoyed it, let us know. If you want to dive in deeper. Let us know if you want to support us in any way you can always purchase any of the labs or supplementation from our website. It goes to help fund this show and make it all possible. Evan, anything else you want to say?

Evan Brand: I don’t think so. You covered it. And please subscribe if you’re not already, you know, I looked at our statistics and a lot of people that listen, they’re not subscribed, so make sure you hit subscribe. I think with no ads and all killer, no filler content. This is a much more listenable podcast, I tried to listen to a couple health podcasts the other day. And there was like an ad in the beginning that was like five minutes. And then there’s like right in the middle of the conversation. There’s like another ad and then like an ad at the end. I mean, I think people take us for granted with our adlis shows I might have to start doing ads just to you know, tell us Hey, didn’t you miss the ad free days?

Dr. Justin Marchegiani: I know man to do that with the switch. So if you enjoy it, let us know and support us down below. Alright Devin phenomenal chatting with you today. We’ll be back next week everyone share, thumbs up comment-


Audio Podcast:

Recommended products:

Genova Organix® Comprehensive Profile

Genova Organix® Dysbiosis Profile

The Benefits of Collagen and Glycine on Your Health | Podcast #322

Collagen is rich in numbers in our bodies. It is an essential part of connective tissues that make up our tendons, cartilages, and muscles. Also, it functions to give fair skin structure, smooth hair, healthy nails, and bone strength.

On the other hand, glycine is an amino acid that your body utilizes to create proteins. It is also responsible for maintaining the connective tissues and making other substances, such as hormones and enzymes. 

Dr. J and Evan Brand emphasized that glycine and collagen provide outstanding health benefits. Our body needs glycine to make essential compounds such as glutathione, creatine, and collagen. Also, collagen helps promote muscle mass, relieve joint pain, and reduces wrinkles and skin dryness.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:44     Glycine Benefits

5:16      Collagen

7:20      Fixing Root Causes

10:40   Natural Supplements from Food

17:36    Detoxification

20:05   Vegetarians

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Evan, how are we doing today man? What’s going on? 

Evan Brand: I’m doing good. I’m feeling better. I don’t think I even told you about this off the air. But I had a bat house on the side of my house. 

Dr. Justin Marchegiani: A bat house? 

Evan Brand: Yeah, bat house. Yeah, to try to get to try to get some bats to basically, you know, take take residents there. So they would eat all of our mosquitoes. And they never came. And I was up on the ladder. I don’t know, this may be two months ago now. And I was up on the ladder. And I was unscrewing the bat house from the house. And as soon as I did that, I noticed it was a wasp nest in there. And as soon as the, as soon as I saw that, a wasp landed on my hand. And last time I got stung, it hurts super bad. And so I wasn’t thinking straight, I thought, okay, there’s a wasp on my hand, I’m gonna get stung, it’s gonna hurt, I might shake my hand and fall backwards off the ladder, this is really bad. So I just turned around and just jumped. And it was probably not crazy high, but maybe eight feet up. And I just jumped and just tried to like, you know, cushion my fall as much as I could and kind of roll after I landed on the grass. But ever since then, man, I’ve had a little bit of some cervical, I probably need to see a chiropractor. I haven’t yet but I’ve had like some cervical tightness. And if I sleep the wrong way, it like flares up the cervical tightness. And so I’ve been using some herbal anti inflammatories and nutrients that we can dive into to help me. But I wanted to tell you that and see if you had any other suggestions of things I should be doing. 

Dr. Justin Marchegiani: That’s really great. Yeah, so we’re going to be talking all about inflammation. And we’ll be talking about natural herbal support to kind of help her natural functional medicine support to help kind of reduce that inflammation. Now, structurally, in your situation, there’s probably some level of inflammation directly to that area. So some level of soft tissue, whether it’s active release technique, or myofascial just to kind of help with that tissue. Because when it gets strained or damaged or inflamed like that, it can get a little bit fibrotic, you can get some scar tissue, it can maybe lose some blood supply and oxygenation. So getting some good movement in that tissue to kind of help with oxygenation, make it more pliable, helps making sure those joints are moving well. So really good chiropractic adjustments through there to make sure everything is moving well, alignments, good. So those are the first things out of the gates that I’d be pursuing. Outside of, you know, just some good soft tissue support in your own like a good massage guns helpful just kind of day in day out. And then seeing good massage therapists, maybe some red light to kind of reduce inflammation, too. I think that’s great out of the gates. And of course, you know, we can kind of go into all of the different natural anti inflammatory, inflammatory support that we use typically in practice, and we’ll talk about what what you’re using already as well. 

Evan Brand: Yeah, I appreciate it. I need to get back in touch with my myofascial lady. I just haven’t reached out to her yet. But I think she left town for a while. So she’s still around. I should probably try. I just got fearful I thought, Oh, god, what did I do to my spine? Am I screwed forever? You know, you hear about these people having like car wrecks. And you know, my wife used to work in a chiropractor’s office, and she would see people that were injured from 20 years ago. And I’m like, ah, why, like, surely it doesn’t have to be that way. And I think we have some good strategies that can definitely shorten the recovery timeline. Let me just talk about the topical aspect first. This one thing’s been very beneficial. It is a company called Ned. Hello, Ned is their company. And they actually just send it to me like a year ago, just as like a free Hey, we want you to sell our products. Here’s some free stuff to try out kind of thing. But I loved it so much. I bought more of it, but it’s called a body butter. And it’s just loaded with CBD oil and frankincense and a bunch of other essential oils. It has Arnica in there. So this is just a topical body butter. And I tell you, if I put that stuff on, it’s a significantly reduced pain. And my range of motion is almost 100% if I’m using that topically, so CBD Arnica frankincense, you know, something like that a good blend, or if you like by that body butter, that might be a good option topically.

Dr. Justin Marchegiani: I like that. That makes a lot of sense. So out of the gates, what’s the first thing so more than likely you get some kind of a mini whiplash? I’m guessing you kind of fell more into flexion. Right? 

Evan Brand: Yeah, yeah. 

Dr. Justin Marchegiani: So you probably had a little whiplash because you probably went forward and then your body had to like kind of seize up to kind of stuff that forward flexion and so it probably just strained you probably had a little spray sprain strain in those back ligaments in the neck. And so getting some good soft tissue out back there will help making sure that joints are moving appropriately will help the problem with like ligamentous tissue, it’s more a vascular, right, you don’t get great blood supply. Or like if you strain your muscle like a muscle belly issue, right, it’s going to heal a lot faster because that tissue is just more vascular, it’s got a lot more blood flow. So anytime you have a vascular tissue, you really need good soft tissue support to really help break down and break down fiber optic tissue, scar tissue and then help that will improve oxygenation and that will improve blood flow. And of course, you know, soft tissue and or red light therapy are all going to be amazing things to really work on the on the blood flow and the inflammation reduction aspects. So that’s good out of the gates. And of course like my good thing in my line, we use something called curcumin supreme. Which is a liposomal curcumin, I like that. I think that’s excellent because it has natural anti inflammatory pathway. So like the big inflammatory pathways that you’re going to see a lot of the medication use are going to be the Cox pathways right cyclo oxygenase pathways. And so like cyclooxygenase, two and cyclooxygenase one are going to be some of the big ones right? Now we can do natural herbs to kind of help produce Cox one and Cox two. So Cox one typically will be reduced by things like aspirin or n sets the problem with these things that can be a little bit more irritating to the liver into the gut. So maybe acutely, it’s okay, but chronically not the best, right? And then we have Cox two as well which these were like the old fashioned, like Vioxx drugs, remember, those, like 15 years ago, caused a lot of stroke and heart issues. Those are like our Cox two pathways. So Cox one and Cox two are some pretty good ones, that major pathways. And of course, we have like our prostaglandin e two, which is an inflammatory pathway as well. And prostaglandin e two is what drives constriction. And it’s what causes more platelets and more stickiness to happen. And so we want to work on reducing some of those pathway. So we want to knock down prostaglandin e two, what’s the best way to do that? Well, high dose fish oil or fish oil in general, of course up a really good whole food, pasture fed kind of paleo templates, it’d be great. And you’re going to reduce a lot of inflammation coming from conventional meats. Again, healthy grass fed pasture fed meats better, right? Less arachidonic acid, which feeds that PG net prostaglandin to pathway, of course, keeping the insulin and the grains and the refined sugar, all that crap in check, all of that inflammation feeds these Cox two and Cox one. pathways, right. And so we want to inhibit those pathways, we want to block them. So more Cox one, Cox two, the more inflammation is going down those pathways. So all the dietary crap sets the table, like my analogy is, imagine you walk into a kitchen and the gas is on the burner. Okay, let’s say it’s been on for a couple hours you smell it? Well, let’s say you pull out your lighter, right? Just a little spark, boom, how’s it gonna explode? Okay, but if you did it without the gas there, no explosion? Well, it’s the same thing. If you have the gasoline going, that’s a systemic inflammation from all of these things we chatted about, that allows the little spark of an injury like that, to set off this whole inflammatory cascade, that’s going to be a lot more, let’s just say amplified in the wrong direction, if you will. 

Evan Brand: Yeah, that’s, that’s a great analogy. So let’s kind of spotlight some of the the key ingredients that we use here. Now some of these we can provide to our clients and to me personally in blends, and then some of them we can do in isolation. So I think the the best one or kind of the best combo for me is really some of the enzymes and then plus tumeric and the boswellia I think that’s been kind of my game changer because I noticed that when I added some extra serapeptodase into my system, I have a blend, I’m using the has some in there, but when I added extra serapeptodase, and also some lambro kinase, my issues, definitely, I would say I felt definitely more mobile, like I have more blood flow. And then of course, my hands and feet were warming up too. So I just know from like a circulation standpoint, that that’s also helping and then we know that tumeric has like an anti coagulating ability. So whether it’s like a tumeric tea or like you mentioned a life was almost a product or even just like a standardized curcuminoid product, something like that is going to be awesome.

Dr. Justin Marchegiani: Yeah, I like it. So if we kind of break things down by Cox one, Cox two, there’s also the locks pathway that’s like the the leuco trying pathway or the light bo oxygenase pathway. Alright, so lipo oxygenase versus cyclo oxygenase. These are both going to be inflammatory pathways. So if we start with like the Cox, one pathways, things like ginger are also going to be very helpful in that. So ginger is really good. Excellent. You can also do things like you mentioned lumberg kinase, or serrapeptase, that’s gonna just sit in your bloodstream, you’re taking it away from food, it’s not like a digestive enzyme. And that’s going to help hit all these inflammatory chemicals that are in the bloodstream, it’s going to start breaking them down and digesting them. And we already talked about the fact that we have a lot of platelet aggregation. So what that means is over time, those platelets are going to increase scar tissue and in decreased blood flow. So what are the enzymes are going to do is they’re going to break up those platelets isn’t help improve blood flow, improve oxygenation and improve nutrition. So and it’s also going to decrease scar tissue formation. So part of the enzymes are helping blood flow. They’re reducing. They’re increasing oxygenation, and they’re reducing scar tissue so then it helps a lot of the other nutrients also work better. So we already talked about like, some of the Cox one stuff is going to be ginger. We talked about that already. Some of the Cox two things are going to be things like curcumin, lipids, omo curcumin, and my line I have one called Curcumin Supreme, which is a really good one. And then you already mentioned a couple things earlier like Frankincense or boswellia. That’s also going to be another cyclo oxygenase ACE inhibitor and the thing I like about boswellia or frankincense, it’s the same thing. By the way, guys, frankincense is the essential oil version of that frankincense, you can kind of put topically on it. And then you can also take boswellia internally, so you can kind of hit it from both ends, which is really good. 

Evan Brand: Yeah, also omegas, I am boosting up my omegas, I’m doing about five grams per day of pure omega, that’s my formula. It’s a triglyceride form of omega as it works amazing. And then also, I’m doing extra course attend, just to really help you know, I’ve had some histamine issues after getting exposed to mold. So for me, I do course attend with an enzyme, there’s a special enzyme we use, it’s a course it’s an enzyme blend that I love. And I actually may start manufacturing it soon. But for now, I’m just mixing these. And the course attend for me is a mast cell stabilizer. Now I don’t know about like trauma, necessarily physical trauma, aggravating mast cells and creating a histamine release. But it would make sense if there’s a stress response from the body, you may be pulling out more histamine, I’m thinking of like a, I don’t know, a car crash or some sort of immediate trauma, you’re probably going to have some histamine to really help increase inflammation, but overall, you don’t want that long term. 

Dr. Justin Marchegiani: 100%. Yep, that makes a lot of sense. So there’s other pathways you mentioned, right? So the course attend, like you mentioned earlier, that’s going to help with the TNF alpha pathway. So TNF alpha is another inflammatory cytokine. So think of a lot of these cytokines are like inflammatory chemical messengers, we have cytokines, we have interleukins, we have nuclear factor, Kappa beta, we have TNF alpha, these are all these chemicals, signalers. And so when we have inflammation happen, these type of chemical messengers can amplify inflammation, the effects of inflammation, systemically. And the problem with inflammation is it’s helpful in the short run, because it helps drive blood flow and helps the healing repair process. The problem is, is when it hangs around too long, right? So for like an acute injury, it’s probably good. I think part of the reason why that pain and inflammation is there is to keep you on your butt, so you’re not continuing to damage that area. So I think part of it is, it’s Hey, you hurt yourself, let’s kind of like rest a little bit right part of its that it’s also going to aggregate a lot of immune cells to help heal the injury, preventing infection, it’s also there to help with healing the body up, right, because the body is not about performance when it’s injured, it’s about band aiding the crap out of that area. So the problem with that is the body doesn’t care if it laid down a whole bunch of scar tissue. And that area is now going to be less flex, less flexible, and less mobile. It just wants the body to heal. So now you have to say, Well, I’m also interested in performance too, right? So then you have to look at the fact that like, Okay, I’m going to reduce inflammation, I probably should still be more mobile, I’m sorry, less mobile moving less, because my body wants me to move around less. I’m reducing the inflammation, pain naturally. But I still have to make sure I don’t overdo it. So you have to make sure if you reduce the inflammation, you still don’t overdo it because your body’s creating that pain to keep you from not moving as much. You probably want some movement, but not as much to hurt yourself. And then number two, you really want to remodel that inflammatory scar tissue. And that’s where you know, massage, soft tissue work, adjusting, maybe some some rolling, some foam rolling, gentle things like that to kind of help realign that soft tissue. So it’s more functional and structurally stable. That’s better in the long run.

Evan Brand: Oh, yeah. Good point. I forgot to mention that. It’s not called the Theracane but it’s similar. I’ve got this wooden like cane from like a physical therapy office like it’s a, it’s a wooden cane basically, and it’s got the wheels on it. I’ve been kind of digging that into my upper mid back area kind of work in my traps. I’ve been just doing some light stretches. I’ve been doing some lateral pull downs, I love lat pull downs, I’ve been doing some seated rows. I’ve been doing my roll machine. So just gently trying to work the area. And I do that after I take these enzymes. And I do notice that it definitely warms up the area and I do feel more loose. So I’m trying to think of you like you and I always talk about you have this stacking effect, right you’ve got the anti inflammatory diet as the foundation, you’ve got the omegas coming in to hopefully help lubricate reduce inflammation. We’ve got the anti histamine anti mast cell course attend. We’ve got the ginger working on the Cox pathway, you’ve got the tumeric you’ve got the boswellia. I mean, that’s just really the synergistic thing here. And I’m not I haven’t taken a single aspirin. So I’m not actually in pain anymore. But like I said, if I sleep wrong, it might kind of flare me up. So I don’t think I’m fully out of the woods yet, but I think I’m 95% there. 

Dr. Justin Marchegiani: Correct. That’s good. So in general, we kind of have our Cox pathways right. Now, arachidonic acid can feed those pathways. So a lot of excess omega six junkie, refined omega six excess junkie animal products can definitely feed those pathways that sets the table like I mentioned gas in the kitchen right below spark and can take it off. And then we have our natural herbals like like ginger can help with Cox one. Fish Oil is actually For Cox two at high doses now if you do high doses of fish oil, you can increase what’s called lipid peroxidation. Because fish oil is a polyunsaturated fatty acid, it’s more unstable, right? It’s got a lot of these. It’s got more double bonds in it, right? omega three means three double bonds, the more double bonds that are there, the more unstable the fatty acid is to heat and things like that, the more let’s say it can be oxidized. So having extra vitamin C, or extra vitamin E on board when you’re taking extra fish oil, just to make sure you don’t have oxidation is great. And we already talked about things like systemic enzymes talked about, like, you know, curcumin, liposomal curcumin is better due to the absorption, or something with black pepper in it helps with absorption to already talked about things like Frankincense or boswellia is great, you could always do some white willow bark, which is kind of how aspirin is naturally made, right? aspirin works more on Cox one. So aspirin is going to be your other natural source. And you can do white willow bark, which is the natural form of aspirin, which is great. There are things like Tylenol, but Tylenol works more on the central nervous system perception, right? So it decreases the nervous systems, perception of pain. And then of course, at the extreme example, we have opiates, which block the pain receptors in the brain, the the opiate receptors in the brain, not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive, right. But we can block some of these natural pain perceptions with CBD oil. So CBD is another great way to reduce perception of pain. But we got to be careful of, you know, Tylenol, or things like opiates, you know, opiates due to their addictive qualities. And Tylenol actually chronically can reduce gluta file and you can just type in Tylenol and low glutathione level. So if you’re taking Tylenol longer term, you definitely want to take it with NAC and or some cloudify and just to be on the safe side. But in general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation. 

Evan Brand: Yeah, well said. Yeah, and the acetaminophen glutathione yeah, it’s a big problem. So that’s why I stayed away. So people listening, if you’re didn’t jump off a ladder like me, and you’ve got osteo arthritis or rheumatoid arthritis, or sports injury, or you’re just trying to heal up maybe post operation, these things we talked about today may be something to implement. And then obviously, working on all the other root causes too, because you are not just what you eat, you are what you digest from what you eat. So if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place. So if you need to reach out, please do so. Our websites are That’s for Dr. J. He works worldwide via phone, FaceTime, Skype, zoom, whatever. And then me Evan Brand, So, please reach out if you need help. We love helping you guys. This is just a wonderful situation that we’re in to be able to help people across the globe get solutions to their health issues.

Dr. Justin Marchegiani: Absolutely. And one last thing to comment is people talk about what we know about cortisone and prednisone injections, right for chronic pain, right? This is a common thing. Well, what’s our natural cortisone? What’s our natural anti inflammatory? Well, our adrenals. So if you have weaker adrenal is going into this stuff, you may not be able to make good amounts of our natural kind of anti inflammatory hormones like cortisol or cortisone, right? This is important. Now I had a family friend come up to me recently, they had chronic pain issues. And it was asking me some questions about things. And they were telling me Oh, I just got a cortisone injection. It’s doing really great right now I said, Well, number one, that’s that’s a really big mistake. I said, you can do a cortisone injection only, only one if it’s really debilitating, and you need that to buy you time to fix the underlying issue. The problem with any injections of steroids is they start breaking down the tissue and the cartilage and the ligaments and the bone in the joint. And actually, over time, they’ll stop giving you cortisone injections in an area after two or three injections sometimes, so then now what now you’re kind of stuck. So the only way ever support a cortisone injection, is if that’s buying you time to do all the other stuff and the pain is so debilitating, you’re just doing that to buy you time because if you’re not figuring out and doing all the other stuff, while that quarter zones working, you’re just going to just repeat its pattern over again three to six months later. And that’s not a good situation. So ideally, you maximize the low hanging fruit, hopefully you won’t have to go to that. And then if you have to go to it, you at least use that time to do more of the right things regarding soft tissue chiropractic work anti inflammatory, there’s another device we we use here we’ll put a link below for the newbie device which is a bio electric device that I have and I use that helps reduce inflammation with special bio electric wavelengths. Electricity wise that reduce inflammation, improve blood flow, help improve the muscle integrity in that area. So the muscles take over the stress the joints and the ligaments and that’s cartilage would normally absorb right we want our we want our shocks to absorb The force not the sensitive material in the in the vehicle so to speak, right we have shocks for a reason. Think of shocks in your body as like muscles. Think of the sensitive tissue as ligaments and cartilage, right? Those are going to be more a vascular right poor blood flow the muscles more vascular. So what’s good let the vascular shocks absorb most of that issue most of the inflammation and for so I’ll put the link down below for that too. So you guys have that for references. Anything else, man? 

Evan Brand: Yeah, the sauna. The sauna has been helping me too. I love sitting in there. Yeah, that obviously warms me up to so I have the infrared heaters in the front and then the ceramic around the edges. So I do try to rotate make sure that the infrared does hit my back and it does help me quite a bit. So that’s also another beneficial thing. Epsom salt baths are very helpful potentially using a floatation tank, a float tank with just tons of Epsom salt and their magnesium and that’s that’s also another great strategy. So hope this helps people and take care yourself. Like I said, if you need to reach out please do or look forward to helping you soon. 

Dr. Justin Marchegiani: We’ll be right over recommended products down below so you guys can see that and take advantage of the things that we use clinically for our family, ourselves and our patients worldwide.


Audio Podcast:

Recommended Products:

TruKeto Collagen


Ariella Nail Fungus Treatment for Toenail and Fingernail

Mother of All Creams

The Allergy and Hormone Connection – Natural Allergy Solutions – Part 2 | Podcast #314

Hormones have profound and significant effects on your physical, mental, and emotional health. In this video, Dr. J and Evan continue their discussion on how these chemical messengers have a significant role in regulating your mood, appetite, and weight, among other things. 

Typically, your endocrine glands produce the precise amount of each hormone needed for various processes in your body. However,  hormonal imbalances have become increasingly familiar with today’s fast-paced modern lifestyle. Besides, hormones decline with age, and some people feel a sharper or dramatic decline than others. 

The bottom line is, your hormones are involved in every aspect of your health. You need them in precise amounts for your body to function fully. Hormonal imbalances may increase the risk of obesity, heart disease, diabetes, and other health problems. Although aging and other factors are afar your control, there are many ways you can take to assist your hormones function well. Consuming healthy foods, meditating, exercising regularly, and engaging in other healthy behaviors can go a long way toward improving your hormonal health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:21     Hormone Connections, Menopausal

8:24    Nutritional Deficiencies, Food Diets

15:58   Proper Lab Testings, Reading Hormone Profiles

22:07   Men and Female Hormones in Allergic Disease

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: And we are live. It’s Dr. J in the house with Evan Brand really excited today we’re going to be talking about the allergy hormone connection. We did. We had a nice chat last week on natural solutions, functional medicine solutions for allergies. So I’m actually very excited to go over the hormone connections, we won’t be going into as much on the supplements or, or things that we do on that side of the fence. We’ll put a link down below so you can see that first podcast. This is going to be building off of that podcast. So if you’re coming in late to the game, you want to take a look at that first podcast, we’re going to be really dive diving in and connecting the hormone piece to it. Because there’s a lot of people that have estrogen dominance, menopause, hormonal issues, imbalances in their adrenal function, and part of that could be driving their allergy issue and you really got to look at everything holistically. And we’re going to be connecting the dots for you guys today. It’s always context, context, context. Evan, how are we doing today, man? 

Evan Brand: Doing good, always good to see on a Monday, it’s like the best part of my week is to start off with a bang. So I actually got a lot of good feedback last week on that podcast, too, you know, you and I kind of joke about how it’s a thankless job because we’ll put out an episode get 1000s and 1000s of downloads and not hear much but actually had a lot of people messaged me and said that that allergy when we did was one of the best of the year. So appreciate your feedback. And we’re excited to take it a step further.

Dr. Justin Marchegiani: Love it, absolutely love it. So out of the gates here, I mean, there’s kind of maybe three categories of patients that I see really benefit from a lot of this out of the gates. So first are going to be our menopausal females,  and menopausal is the one study that we’ll talk about here today that showed menopausal and perimenopausal women having two times the likelihood of having allergy issues. Part of that has to do with the drop in progesterone and the imbalance and progesterone estrogen that can skew the immune system. The other one would be a cycling female who has significant estrogen dominance, massive imbalances in progesterone and estrogen, that’s another kind of category. And then the last would be someone it could be male or female that has significant imbalances and cortisol, right? We know, when you’re having allergic reactions, you’re developing and producing all these inflammatory cytokines, right, interleukin cytokines, and these are pro inflammatory. And our adrenal glands make a natural anti inflammatory hormone called cortisol. And cortisol naturally will have combat and balance out some of the pro inflammatory cytokines. So if we have significant imbalances, and cortisol, cortisol is too high, and and we’re too catabolic, or it’s too low, and we’re not able to combat the inflammation that can really be I think, the starting mechanism of this whole allergy cascade.

Evan Brand: Yeah. And you and I were talking before we hit record about, well, why is it such a problem now, because you look at like tribal societies and such, and you don’t really see any discussion or any big issue with menopause. And we were talking about the difference in the lifestyle, of course, you don’t have the stress as much as we do in the, in the tribal societies, as you do in modern society. You’ve got more family support group, you’ve got parents and grandparents and the whole tribe helping to pinch hit in some of the family roles. And so really, the the, we’ve lost our tribe, and that baseline stress is really just so strong on people that when there’s the transition to menopause, the adrenals have already been weak for 40 years of parenting with just you and your spouse, that, you know, it’s the straw that breaks the camel’s back.

Dr. Justin Marchegiani: Oh, I agree. I think you also have a lot more environmental toxins, you have increased nutritional deficiencies, you have a lot more pesticides in the environment, all those different things. Now imagine if you’re like, you know, living out in the forest or something in some kind of a hotter teepee, or some kind of a structure, there’s quite a lot of environmental molds, just things decaying around you. So there’s probably a lot of that by a lot of rain getting in there. So it’s amazing, probably a lot more natural mold exposure, maybe being out there but you know, a lot less stress on the other side of the fence as well. So I think we know stress plays a major role on your adrenals because cortisol is a natural stress hormone. It’s anti inflammatory. It’s a gluco corticosteroid, which means it pertains to stress and inflammation. It’s also a very powerful Energizer hormone. And cortisol can pull from progesterone. So we know progesterone does have anti inflammatory effects. So for chronically producing cortisol, that can really start to skew this estrogen progesterone balance. Because as cortisol is being stimulated due to chronic stress and inflammation, progesterone can be pulled downstream to make it because progesterone is a building block of cortisol. And if progesterone is being pulled downstream, what can happen to that natural ratio of estrogen progesterone, it can skew now. Typically speaking, progesterone is always going to be higher than estrogen in general, usually it’s about a 23 to 25 times ratio of progesterone, estrogen, but at that ratio starts to drop. So we start talking about estrogen going up, and progesterone dropping. We’re talking about that more in relative terms. not absolute, we’re talking about the ratio dropping, not the absolute numbers going in opposite directions just to make sure that’s clear for everyone.

Evan Brand: Yeah, let’s also tie in the gut piece. I mean, a lot of people responded to me and said, Wow, I didn’t have a clue that bacterial overgrowth in my gut could create the allergies. But in the same vein, the gut issues could actually create the hormone issues. So let’s talk about that for a minute. When you are looking at stool test, and we’re going to look at beta glucuronidation, being high due to a bacterial overgrowth. Now we have the recirculation of hormones happening as well. So there may be this point where we come in with some of the herbal anti histamines that we talked about. But now we also may need to come in with some of the glucuronidation pathway support like your calcium D glue, great, maybe the sulfur based amino acids glutathionre broccoli seed extract, like broccoli sprouts, we like to use those. So that’s another mechanism. I think that once again, the allergist, they’re going to miss they’re not going to give you a calcium D glucrate, but they might need 200%.

Dr. Justin Marchegiani: Yep. 100%. I’m going to read a study here. I’ll get the exact article here for you down the road. But here is the quote, study in Northern Europe included over 2300 women and track their respiratory health from 2000 to 2012. They found the odds of getting asthma quote, we’re more than twice as high for women going through menopause or transition, or after menopause compared to non menopausal women. So there’s something that’s happening at around Peri and or menopausal timeframe. So let’s say early to mid 40s, to early to mid 50s. Right. There’s that timeframe that’s happening, I think the big thing that’s probably happening is you’re having a drop in progesterone. And then we’re starting to happen as you’re having FSH and LH starting to increase. And I think you’re also starting to rely more on the adrenal glands to fill in the gap. And if cortisol is out of balance or imbalance, there is not enough DAGA you’re gonna find a real deficit and some of these hormones and you’re not going to have the same inflammatory backup generator support, if you will, from the adrenal gland. And that’s a big mechanism that’s active here. And that’s why you’re going to see more Peri and menopausal women affected and again, a lot of women are chronically stressed and they kind of fall into that perimenopausal category younger and younger. I’m seeing a lot more perimenopausal symptoms and women in their 30s and early 40s. Now, which is really interesting. I mean, perimenopause is that timeframe before menopause. Usually menopause is when you have one year 12 months without a period. But you can start to see perimenopausal symptoms start to happen younger and younger and younger, I think because of chronic stress. And that could be hot flash issues. Of course, that could be just a lot of the PMS issues. Usually you start to see cycle, missing cycles, hot flash issues, you can also see a lot of mood changes, vaginal changes, sleep issues, weight issues, you can see mood, irregularity, loss of libido. And now again, a lot of those also connect with PMS too. So it’s kind of hard to connect the two but usually you start to see missing cycles and starting to see some of those hot temperature issues starting to occur. And then of course, a lot of vaginal dryness or a lot of mucous membrane dryness issues as well.

Evan Brand: Yeah, that was my next question for you is why are you seeing this in younger women? I mean, because this is kind of a new phenomenon, right? I mean, in the last 10 years, you’re seeing this thing is ramping up significantly. So you think it’s just the stress in the 30s to early 40. Women that maybe previously wasn’t as intense. 

Dr. Justin Marchegiani: Yeah, chronic stress, chronic inflammation. I think a lot of women I mean, this is this is in general, this is people in general, just a lot of nutritional deficiencies due to chronic poor diets. A lot of women if they, you know, 20 plus years ago, they were in that low fat era, and they weren’t getting good healthy fat and good healthy cholesterol, I mean, that’s going to put a lot of stress on your hormones, because you need these building blocks. To make these hormones right hormones made from cholesterol, your body makes a lot of cholesterol, but could never make enough. And you need a lot of important fat soluble vitamins in cholesterol from good healthy animal products that to ideally make it optimally right. It’s hard to do that on a vegan vegetarian diet, because you’re just missing a lot of those fat soluble vitamins, and long chain omega three fatty acids that you get from high quality fish and such. So that’s I think a big thing as well. And also fats play a really important anti inflammatory role, right? We know good healthy fats, like fish and coconut, or have good anti inflammatory benefits. And we know a lot of the Omega six in plant based diets can be more inflammatory. And a lot of the good healthy omega threes on the plant based side that come from flax or chia, right, these are going to be like alpha linoleic acid, these are going to be omega threes, they have to get converted downstream and they go through different enzymes like Delta five desaturase, that makes that conversion. And if you have insulin resistance, or inflamed, it’s going to be harder to maximally convert that some people say maybe only 20% converted. So there’s a lot of conversion issues downstream. We see the same problem with vitamin A. So if you’re a plant based and you’re relying on a lot of beta carotene, for instance, and carrots plant based products, you may not get a good conversion cuz that’s the UK converted. So if you’re getting vitamin A from grass fed liver or beef, or let’s say called liver oil, right or egg yolks as a maximum conversion there because you’re getting active vitamin A in there versus having to rely on a conversion, and the more inflamed you are and the more stressed you are, it’s hard to convert an activate a lot of these nutrients.

Evan Brand: Yeah, well, you know, you gotta you made a good point, too, you got a lot more women doing things they shouldn’t be doing like going on strict vegan diets, doing plant based burgers, getting off of real Whole Foods. So I think I’m trying to just answer my own question in my head here. Like, why is this being ramped up in younger women. And I think there’s a combination of factors like always, but man, it, you got Bill Gates and other people pushing so hard, just get off meat, meats, bad meats, bad, there’s still so much on brainwashing that we have to do in the population. So I really hope folks listening into the podcast, we really hope that you all are eating good quality fats, especially women, we really don’t want you to be afraid of those.

Dr. Justin Marchegiani: Yeah, and kind of my pitch on meat versus plant based products. It’s pretty simple. So number one, plants bio accumulate nutrition. So the benefit that you get from animals is they buy or accumulate plants. So for instance, about one meats, one pound of grass fed meat, it takes about eight pounds of plant matter to make that grass fed meat. And so animals face make sure I say correctly, animals bio accumulate plant based matters. So you get a lot more bio accumulated nutrition. So for instance, 16 cups of kale gets you the amount of protein that’s in six ounces of grass fed beef, right, there’s a bio accumulation of amino acids and fat soluble vitamins, and even things like zinc. And then when you go and look at the bioavailability, of course, plants have a lot more anti nutrients than animal products do. So you have a lot more anti nutrients binding up oxalates phytates mineral blockers, protein blockers that make it harder to break down a lot of the nutrients in plants. And then the my sentience kind of emotional argument is, it’s all about taking, it’s all about having the most the largest amount of nutrition per death, okay, it’s really important, you have nutrients per death, if I have one cow kill for my family, that’s gonna feed my family the whole year, right? If you look at a lot of the factory farming involved in, like, let’s say raising high quality plants, and again, this may not be the broccoli or kale in your backyard, right? But if you look at on a wide scale kind of monoculture kind of scale, there’s all kinds of rabbits and snakes, and badgers and all kinds of things that get caught up in the combines when they harvest a lot of these plants. Okay, so there’s a lot of deaths happening. And so then you got to say, well, is that badgers death equal to this cow’s death, right, then you got to look at and kind of weigh well, whose life’s worth more. And then the third argument a little bit deeper is, well, are you taking the life when you’re killing a plant, and I think my personal belief is, it takes life to sustain life. So everything that you kill, whether it’s plant or animal has to have some level of life force to it. And then you’re just playing this game of well, whose life matters more obviously, I can emotionally connect with the cow because it’s got a mommy and a daddy. And it’s cute and cuddly. Maybe not with the kale, right? But all life, it takes life just to stay in life. So there has to be some level of life in that plant, for it to sustain you. Same thing with the animals. And so keep that there. And of course, when we talk about animals, we’re talking about non factory farming, we’re talking about organic, we’re talking about super high quality raising no hormones, no antibiotics, you know, one bad day for that animal. And that’s it. Right. So I just wanted to differentiate that for people that are kind of listening in on the fence with that.

Evan Brand: Yeah, well said, well said I liked the way you you put it. Alright, so this study and paper that you had, it also mentioned vitamin D. Now, just in case, we didn’t mention it last time, I just want to make sure we mentioned it now that there is definitely a link between more severe asthma symptoms and low vitamin D. So that’s a very, very easy low hanging fruit that should be addressed. If you’re working on some sort of a histamine allergy protocol. You’ve already hit upon increasing omega threes, your nuts, your seeds, your Coldwater fish, you’re doing your low histamine diet, if necessary, you’re treating the gut infections, but then boom, if you miss vitamin D, that’s easy.

Dr. Justin Marchegiani: 110%. And again, the other component, I would say is glutathione. We need that through digesting good proteins, right? So if we’re chronically stressed, let’s connect the dots here. So if you’re chronically stressed, you’re pouring out cortisol, your adrenals are in this fight or flight kind of sympathetic dominant state. You’re over secreted cortisol, and again, that can also look in a chronic state like low cortisol, right? Your cortisol doesn’t get low unless at some point it was chronically overstimulated. So some people think or feel like oh, my God, like my cortisol must be so my adrenal must be so overstimulated right now because I feel so off but it’s possible that they could be in this state of total dysregulation, and they’re on The lower side. So either way, chronic cortisol stress is going to affect your nervous system because the sympathetic nervous system is what’s engaged when you have a lot of adrenal stress. And the sympathetic nervous system affects digestion, right? It’s the parasympathetic that has the rest, the digest the energize, repair. So if we don’t have enough parasympathetics going, it’s gonna be harder to digest and break down our foods, absorb our nutrients. And this can really one start to create indigestion that can create more cebo and dysbiosis and bad bacterial imbalances. And those bad bacterial imbalances can negatively impact our immune system. And an immune system that’s not correctly primed. It’s overly sensitive and going after allergens that are not like a threat to us, that’s going to create allergy issues. So you see how this hormone adrenal Nervous System digestion, gut, immune connection kind of evolves, right? You can really connect it to a lot of different things because they really dovetail so importantly.

Evan Brand: Yeah. Now, the good news is, once you get the proper labs, it’s less overwhelming, because when you’re saying that back to me, I’m like, Oh, crap, how would somebody even know where to start with it? But once you get the data, it’s really easy for us to go and look at the piece of paper and go, Okay, look, here’s the gut analysis. Here’s the hormone analysis. And then on the gut analysis, we get a clue into the, into the hormones to right, because we’ll see that beta glucuronidation marker, if that’s high, we know Oh, crap. There’s recirculation going on. So this hormone profile now we have answers even deeper, we have a root cause of the root cause. Why is the hormone profile working like this? Well, because of the gut profile, and then you piece in the oats, your piece in the chemical profiles, the mold profiles, you look at where does somebody live environmentally, how much outdoor exposure Do they have, then we look at the diet piece, it makes it much much more digestible. So I just want people listening, you may be able to pull out little pieces of the puzzle like oh, I’m going to boost vitamin D, I’m going to do quercetin to stabilize it. But really, you got to get the data. So that’s what we always want to lean upon. for a couple reasons. One, it helps us to shorten the treatment duration, because then you’re not guessing and checking by just giving herbal anti histamines and sending people on their way. But number two, it’s a good compliance piece, because we can show people look, we have the reason of why you’re feeling like crap. Stick through this protocol, it works so much better. You know, there were times where clinically, I would talk to someone, and we would say, Well, you know, it sounds like this, it sounds like that maybe budget was a concern. It’s in a couple of cases. But we would just give somebody a guess and check protocol. But then we always had to go back to testing later. So really upfront, if you have this going on, get some data, so you know what you’re up against, you’re going to, you know, definitely shorten your timeline, and you’re going to shorten and decrease your cost. Like, if you were like me, I’d go buy this supplement, I’d buy that I’d buy that you have the supplement graveyard, you’re spending much, much more money doing that, as opposed to getting a dialed in protocol made for you.

Dr. Justin Marchegiani: 110%. Yeah, if you can see what’s going on is going to help you be a lot more compliant, for sure. And then one other connection here is we know that women who are overweight, they have twice the likelihood of having allergies as well. And again, I think this goes with men as well, when you’re overweight, fat is a major reservoir of interleukins, and cytokines and inflammation. So you can make a lot of inflammation via your fat cells. So the more inflamed you are, right? The whole thing with allergies and asthma and all these different things is the immune reaction that you’re having is an increase in cytokines and interleukins that are pro inflammatory, right. And so when you’re, you have exposure to endogenous allergens in the environment. That’s kind of what’s creating an anti inflammatory response. And then your body is then oversee accreting more inflammatory compounds, they kind of add to the mix, right? So your body’s overdoing it. And you have natural anti inflammatory compounds via cortisol and progesterone in your body. And if you don’t have enough reserves there to kind of let’s say, cover that up or neutralize it. It can really create more and more problems. That’s that’s a big one. I mean, here’s the summary. estrogens role in allergic disease remains complex, as allergenic as allergic disease continues to increase in the prevalence and effect women is fortunately gaining a fuller understanding of its effects. Basically, it’s talking about xeno estrogens and hormonal imbalances driving more allergy issue. It does it because it modulates the immune system, T cells, immune cells, B cells, it’s affecting all of the immune system, because we’re throwing a lot more histamine, leukotrienes and other immune compounds that are just putting our body into a more inflammatory state, if you will.

Evan Brand: Make sense i mean that once again, we’re back to external exposure, meaning potentially environmental but when we say environmental, that’s not just nature, it’s not like that anymore. It’s contaminated. You’ve got so estrogen.

Dr. Justin Marchegiani: Exactly estrogens may polarize T cells and cause more th to immune response that’s kind of more of our antibody immune response. So you may get a lot more of that. Estrogen promotes the class switching of B cells. To immunoglobulin e, IGE is going to be a product that those are eosinophils so it’s going to promote more in a more allergenic side of your immune system via eosinophils. And then of course, estrogen promotes the degranulation of mast cell base fill so base fills are in your blood their immune cells just like you eosinophils are when they start to go into your tissues, they can start they become mast cells, essentially a mast cells produce histamine and we know histamine increases all these leukotrienes and, and cytokines, which are part of this whole allergenic immune reaction. So you can see how all these things kind of, um, you know, roll downstream and create more problems. So when people are listening to this, and you’re like, what the heck is he saying, just focus on this just go upstream. Anytime you get overwhelmed, always go upstream. Okay. Everything kind of gets more granular and nuanced as you go downstream. So hormonal imbalances, imbalances and progesterone, estrogen, especially when you start to have more estrogen dominance, that creates more of a pro allergic response. When cortisol starts to go out of balance, typically, either overly high acutely or chronically low. In a more chronic situation, that’s going to create more allergies, the more your sympathetic nervous system is in fight or flight due to chronic hormonal stress that can create more allergies as well. It affects your ability to digest, rest, repair, and absorb nutrients, and it sets up your digestive tract for inadequate enzyme and acid levels. And it also throws off your gut microbiome start to have more dysbiosis and that can throw off your immune system. Why? Because 80% of our immune system is in our intestines are Gault which is our gastric associated lymphoid tissue, that’s our stomach and our mouth, our mucosal associated lymphoid tissue that’s in our small intestine. hope that makes sense.

Evan Brand: It does. So, if you’re still drinking out of single use plastic water bottles, you got to quit doing that, because you were you were reading through it kind of fast. But basically what I pulled out you were saying that these, you know, estrogens, those have been linked to stimulating or irritating the mast cells. Was that right?

Dr. Justin Marchegiani: Yeah, let me just read this summary here. This is a big one. So female hormones appear to play a significant role in allergic diseases, with estrogens effect being the most well studied estrogen influences, immune cells, favoring that th two immune response, and it causes our B cells or B cells are basically our body’s ability to make antibodies, right? We have five antibodies, right? neutrophils, lymphocytes, eosinophils, monocytes, basophils? How do I remember it? Never let monkeys eat bananas. Okay. That’s how we learn about that in doctoral school. And so we start to have a lot of these B cells, which you know, they can be anything of these five, they start to go more towards eosinophils. And again, he for allergy, that’s how we remember that he for allergy now with the exception is parasites can also increase the ascenta fills there for parasite infections can increase your chance of allergies to see all these things connect over. So the potential role for astron and nasm is supported by epidemiological evidence and increase the asthma prevalence and severity in adult women. And by associating estrogen with changes in airway mechanics and inflammation. However, the mechanism by which it may act is quite complex, we know that exogenous compounds of estrogen activity may influence allergic diseases, how well if we’re getting exposure to potentially birth control pills, or plastics, or pesticides, in the water, hormones and the meat all of these things may potentially throw us more into an estrogen dominant state. Now this study is not saying it, I believe it’s it’s really going to be that hormone ratio. So it’s more that estrogen dominance, unnecessarily high amounts of Astrid that definitely is part of it. But I think also that that ratio, or that Oh, right here, and it says with the effects dependent on the concentration of hormones, and the concomitant presence, or absence of factors such as progesterone, so it is kind of alluding to that the absence of progesterone can also throw that immune system into a more allergenic response, which is what I’m highlighting earlier, it’s more estrogen dominance than it is just estrogen by itself

Evan Brand: Makes sense. Okay. And now I’ve got a couple papers here is talking about estrogen is very stimulatory to the mast cells to release histamine. And then the excess estrogen also is going to down regulate the DA o enzyme that clears his domain Oh, bingo, they’re inactive. And at the same time, histamine stimulates the ovaries to make more estrogen. So the net result can be a vicious cycle of estrogen to histamine to estrogen to histamine, whereas progesterone comes in and stabilizes the mast cells and actually up regulates do production, and therefore can reduce histamine. So many symptoms of estrogen dominance are actually symptoms of histamine or mast cell activation. And then we know like mast cells, and histamine play a role in endometriosis and also pmdd. So that’s, that’s pretty cool. And this is an epidemic problem. You and I kind of talk about it. Like it’s this nuanced thing, but no, this is going on in hundreds of millions of women around the world and probably more so in women than men. But this issue can definitely happen in men also.

Dr. Justin Marchegiani: Yeah, so I don’t want men to kind of feel left out here. There’s a lot of men that have a lot of estrogen imbalance issues as well due to the environment, poor detoxification, gynecomastia excess of just being overweight, there’s some of those same mechanisms that are happening here, member fats can produce estrogens as well. So I don’t want our guy friends to be left out in this here. So just know there’s still a lot of the same mechanisms that are at play. Of course, we’re not going to be you know, hitting the hormones the same way. But we’re going to be looking at the adrenals are same way we’re going to be cutting out environmental hormones, we’re going to be looking at the toxification and your body’s ability to clear these excess of hormones. Of course, if we’re seeing women that come in with birth control pills, we’re going to try to hit that via a different mechanism. without throwing off the hormones, there’s a lot of ways we can hit this. I’m really happy that we’re talking about this because this is something that I see endemic in a lot of my female patients and male too. So I’m glad that we’re on top of this. And we’re not going to be going over too much on the supplement side cut for this because we talked about it last time. So please click down below and look for that previous podcast. But the big thing I would say with my female patients and or hormone patients listening is we’re going to look at potentially using endogenous progesterone, depending on the levels, we’re going to use herbs to help modulate estrogen and progesterone. So some of those herbs could be chaste tree, or maka or dawn quai. There’s a lot of other herbs that we use to modulate that we may use things like ashwagandha rhodiola, ginseng things to help modulate cortisol, of course, we’re going to be fixing a lot of the diet and lifestyle strategies, whether it’s blood sugar, inflammatory foods, sleep, of course, all of the healthy diet and lifestyle, things are foundational. So I’m not going to go into all of that, because that’s all with a podcast within itself. But just kind of keep that in mind. Those are all going to be part of the foundational principles that we utilize. And also I use other palliative things like natural anti histamine, the granulators, which looked at that previous podcast. And then also we talked about sinus flush protocols, and high quality air filtration, which are going to be important components. But you know, see that previous podcast for more instruction on that.

Evan Brand: Yeah, well said last thing here, just a note, it was talking about the whole progesterone, estrogen mast cell connection. And why progesterone, of course, is going to stabilize mast cells and upregulate DAO, and it made just a note here. This is why most women feel better early in the luteal phase when progesterone is higher. So if there is like a cyclical pattern to your issues, pay attention to your cycle. That’s probably a good clue there that it is progesterone deficiency.

Dr. Justin Marchegiani: Yeah, part of the reason it wouldn’t feel bad those last couple of days or a week before is because that’s where we have the biggest drop in progesterone. So it’s this big drop that happens. And usually it happens a little too early. And that’s what kind of gets this whole cascade of PMS or pmdd happening, right. And it’s usually just that fall out and progesterone too soon and too hard. Usually around a 21 to 24 it can just fall out harder versus gradually coming down around day 27 or so.

Evan Brand: And you’re saying we can help blunt the drop with some of the strategies, the herbs and nutrients, getting rid of the excess estrogens in relationship all of it.

Dr. Justin Marchegiani: Yep. And don’t get me wrong. utilizing some of these natural anti histamines that we talked about in podcast one is helpful. But we just have to always draw a line is this the root cause and so I always want to make sure patients know this is not the root cause, but it’s buying us time. And it’s helping us deal with the histamine while we work on all the other diet and lifestyle and hormonal things. And then over time, you become less reliant on those things. And it’s better than taking medications that cause you to be drowsy and brain foggy throughout the day, or even things that add more steroids in your body to which could be more destructive. 

Evan Brand: Absolutely. Well, if you need to reach out and get help, please do. If you need to reach Dr. J, you can at his website, And he does console’s worldwide via phone, FaceTime, Skype, whoever you need to reach him. He’s there. If you need to reach out to me my website, we have all the information in regards to scheduling. It’s a piece of cake and you can book a intro call to discuss your symptoms, your goals, see if you’re a good fit for care, we’d love to help you out, get you off the roller coaster get you off the merry go round, unless you like that kind of thing. But these medical merry go rounds are not something fun. So we want to try to get you off of that.

Dr. Justin Marchegiani: Totally. I have three patients this last week. Two women, one man, one man who had a significant 80% reduction in lifelong allergies, doing a lot of these strategies. So I mean, these things aren’t esoteric, like there’s a lot of thought leaders out there that just talk about things, but they aren’t in the clinical trenches with their sleeves rolled up dealing with people working on this and actually getting results. So you know, I have quote, I have, you know, strong experience in this Evan does too, and we’re seeing it so when you guys are hearing the things we’re talking about this isn’t theoretical. This transcends what you’re reading the study. This is real. So I don’t We say that just to give you guys a lot of motivation and hope that if you’re listening, just start applying it. And then if you’re feeling confused or overwhelmed, we’re here for you. There’ll be a link down below where you can click to reach out to us and we’re here to help y’all. And if this information resonates, please find a family member or a friend that you can share it with because we really appreciate that.

Evan Brand: Awesome, we’ll take good care. We’ll be in touch next week. 

Dr. Justin Marchegiani: Have a good chat with you have a good one, y’all. Bye now. 

Evan Brand: See ya. Bye.


Recommended products:
Allerclear Histamine Support
Nasaline Sinus Flush Bottle
Xlear packets
Xlear rescue spray
Navage Nasal Irrigation
NeilMed Sinus Rinse Complete Kit
Xlear Sinus Rinse Kit
Austin Air Healthmate Plus
Air Doctor Air Purifier
Whole House Water Filter
Water Filtration Devices
Clearly Filtered

Audio Podcast:

Essential Blood Tests to Analyze Your Health | Podcast #305

Regular blood testing is one of the most important ways to keep track of your overall physical well-being. Getting tested at routine intervals can allow you to see how your body changes over time and empower you to make informed decisions about your health. Here’s Dr. J and Evan talking about the areas to check aside from the usual blood tests we know. 

A conventional medical doctor will typically recommend that you get routine blood work, but this is the bare minimum. There are several significant reasons you may want to get blood tests more often than that. Either you want to optimize your health or to reduce the risk of disease and health complications. 

What are some routine tests and others that you should ask or know? Aside from CBCs (Complete Blood Count), Dr. J and Dr. Even pointed out enzyme markers, cholesterol tests, blood sugar tests, liver markers, thyroid panel, and so on. It will help your doctors make a differential diagnosis and dive into the root cause of your present health status. To know more, check out this podcast.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

3:12       Conventional Side of Blood Works

12:14     Thyroid Panels

17:56     Blood Glucose

23:50     Adrenal Issues

29:33     Lipid Panels

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan brand. Today, we’re gonna be chatting about blood tests that we use to help assess our health and help us get better. So we’re gonna be chatting a little bit about kind of intro blood tests, what the best tests are kind of what our perspective on that is, Evan, how are we doing today, man? 

Evan Brand: Doing really well excited to dive into this topic, I went, got my blood work. And I got my wife’s blood work done on Friday. And I just want to give a brief little note on how you and I run blood work as clinicians because it’s very easy. And it’s so convenient, because we don’t have to go and beg a GP or an MD and say, Hey, please, please, doctor. I mean, you and I’ve heard countless stories. Yeah, I asked my doctor to run this, they wouldn’t run it, I asked my endocrinologist to run this, they wouldn’t run it. With us, the accounts that we have with our credentials, were able to order and create customized lab panels. So you and I both have created customized blood panels that with a click of a button, we can go boom, order it for anyone, whether it’s ourselves, or our clients or patients, and then we get an instant requisition form. We go straight into labcorp request, you check in, you sit down, they call your name, you hand them the paper, you get the blood draw, you go home, it is so amazing. Every time I get my bloodwork done, I’m like, wow. And I didn’t have to get anyone’s permission to do that. But my own. 

Dr. Justin Marchegiani: Isn’t that nice? Yeah, it totally is nice. Also, there’s the big insurance scam, right. So because we have accounts directly with the lab companies, we can order tests, and typically we get, you know, an 80 to 90%. You know, discount in price compared to what the insurance would bill. So like my typical thyroid panel, full thyroid panel that I charge my patients probably around $120. And the insurance would typically charge a patient for that well over $1,000. So then patients, most patients don’t get 100% coverage, right, especially if you’re not in network, and then the doctors can’t ever retest, but once every six months, so then you’re you’re stuck not being able to ever retest. But they think, Oh, I’m gonna get coverage for this. And then they get 90% coverage, and they end up paying more money. For the for the 90% coverage, even though they paid 100% cash, it had been cheaper. So that’s kind of the insurance scam. And then the problem with that is they can’t retest but once every six months, so they’re kind of stuck. So yeah, it’s really nice to be able to order what the patient needs and to be able to reorder and reassess. Based on a time that is good for us. Not good for the insurance companies. That’s kind of nice, right? 

Yeah. And you’re kind of we’re kind of circumnavigating that conventional system where you’re waiting two, three months, and then you get a bill in the mail and you’re like, oh, medical bill, What’s this about? And then it’s like, oh, you owe 700. with us. It’s all transparent. It’s up front, you pay, boom, boom, boom, you’re done. I’ve already paid for it. I know that I’m not spending another penny. And the turnaround time is insanely quick to like one or two days, typically on some of these panels are running. So let’s go into some of the details. Now, let’s quickly compare and contrast. I think you and I have a lot of fun. Like where we did our conventional functional medicine vers conventional medicine, gut workup. Let’s talk about the same with bloodwork. So if you go to your doctor, and you have them say, hey, Johnny, we’re going to run your blood. What is that going to look like?

So conventional medical doctor, they’re typically going to do a CBC, they’re going to do a metabolic panel, they’ll probably do a lipid panel that’s usually going to be at maybe a year analysis, that’s kind of it. So like on the CMP they’re kind of looking at liver enzymes. They will look at some electrolytes on the liver on the CMP as well. Those liver enzymes electrolytes, maybe some protein markers there, they’ll probably look at glomerular filtration kind of some baseline kidney function with creatine and and bond. The kit the liver markers are going to be a lt and as to the liver enzyme markers, the gallbladder is ggt but probably look at some bilirubin your electrolytes are going to be sodium chloride, potassium magnesium, all serum not not intercellular which is a difference Okay. And then on the red blood cells are going to look at red blood cells RBC some adequate hemoglobin that’s part of the CBC right complete blood count which is going to help be helpful for anemic patterns right low iron right, although also run indices which are MC VMC, HMCHC right me corpuscular volume me corpuscular hemoglobin me corpuscular hemoglobin concentration. When those markers go high, that tends to mean that we’re dealing with B vitamin issues like b 12, full eight issues, and we call that megaloblastic anemia. So we have two kinds of anemia. As we look at big cell anemia is right we tend to be more B vitamins stuff. And then small anemias. We tend to be more on the red blood cell hemoglobin hematocrit, low iron side, and then we have immune markers, whether it’s neutrophils, lymphocytes, eosinophils, monocytes, and basophils, which could be from bacterial issues, parasite issues, gut inflammation issues, viral issues. And then I would say on top of the CBC, that’s pretty much it and then your limits. So total cholesterol, triglycerides and then of course, your LD vldl pattern, and then there’s some add ons that we may talk about whether it’s c reactive protein for inflammation, fibrinogen, for inflammation, homocysteine for inflammation, methylation, vitamin D. and we can kind of go into each one of those in regards to what we think is important on the functional side. But you know, the whole lipid thing is, it’s kind of overplayed, right people think that lipids are a really important issue now once you start going over 200 or so on the total cholesterol, and that may not be. And we’ll talk about the ratios and the perspective that we add to when we look at it.

Evan Brand: Yeah, so the way you talk, it sounds pretty good. It’s like, oh, wow, that’s a lot of stuff. But truthfully, there are rarely issues that show up on just standard bloodwork. Now, if you have more of the functional training that you and I’ve had regarding blood chemistry, you can kind of, I guess you would just say pick through the CBC with a fine tooth comb, and you can really look and maybe find some functional issues, like for me, I know that I you know, for a very long time, my hematic crit, you know, I’ve always had the hematocrit be a little bit high, which, based on some of the training you and I’ve had, it would indicate that there’s probably a dehydration issue. And that’s tough. You know, it’s, it’s, it’s tough to stay hydrated. And so even if I mean, I’m sipping on water all day, but you know, I’ve heard there’s a big influence on anti diuretic hormone, and all of that when you’re exposed to mold toxin, that’s a conversation for another day. But anyway, unless you’re really looking with a with a fine tooth comb, conventional bloodwork doesn’t reveal much. And you may see a little bit of this a little bit of that, but it’s not, I’m not making too many protocol decisions based on a CBC I would say. 

Dr. Justin Marchegiani: So when I look at blood, it can give me a good area of where to where to look next, or where to dive in deeper, which is helpful. And then if we look at it, using the optimal reference range, or a functional reference range, we can definitely glean better information. So the problem with most conventional medical doctors, they’re looking at blood through a pathological range, they’re trying to pick up like major disease patterns or pathological patterns. And so how it works is you have to show you have all people kind of fit in what’s called the bell curve. And the typical range is going to be two standard deviations to the left and right, this is represents about 95% of the population fit into the so called normal. So you have two and a half on the high two and a half on the low that are on the high or low side, pathologically, right. And so the problem with that range is it as people get more unhealthy and sicker. And as those sick people tend to test more, what happens to the lab reference range over time, it gets wider. And so it becomes more encompassing, it’s like having a bad field goal kicker and you make the field goal every year wider and wider and wider and closer and closer to compensate for the lack of, you know, good kickers out there. So it’s kind of like that. And so what we do is we kind of narrow up that range a little bit, and that narrower range helps us pick things out before it becomes a problem. So let’s kind of go over a couple of things. So with women or people that are vegan vegetarians, women, because they bleed more when they’re when they’re at menstrual age, right, typically 50 or below 48 or below, they can be more anemic. So we may look at things like lower red blood cells, right, red blood cells, you know, below 4.2 or so we may look at hemoglobin below 12, we may look at him at a crit, you know, in the mid to low 30s as a sign that there could be some low iron issues brewing, we may also run an iron panel, it’s not typically run, but we may run things like ferritin, or iron binding capacity. Or we may look at things like iron saturation to get a window of low iron, for instance. And that’s commonly missed, because what most conventional Doc’s do is, their threshold for low iron is really low. And there’s a lot of women I see in vegetarians in general that could be on that lower side could be a little bit anemic, and then they’re not going to be able to carry oxygen throughout their body adequately, which makes a huge difference in energy and stress and and mitochondrial function and thyroid function because you need to be able to carry oxygen to have good energy. 

Evan Brand: Yeah, let’s go into some of the more let’s let’s, let’s break some of the stuff down. But before we break it down more, let’s hit on what are the things that that we’re going to run and so I’ve got my panel pulled up that I ran. And so I’ll kind of run through some of these things. But as you mentioned, ferritin that’s typically not going to get run I’ve rarely rarely seen fair to run by anyone. The iron saturation as you mentioned the iron binding capacity. That’s really wrong. That’s right to be ti BC. Often on your bloodwork, the vitamin D. I mean, my God, it’s so important, but yet vitamin D to this day is still not commonly run. Nope. And if they run it, they may run the wrong one. I’ve seen people where they don’t run the 25 o hydroxy. tryptophan, they’re going to run like the even the beat the D two. They’re going to run the What is it? Ergo? 

Dr. Justin Marchegiani: Yeah, the vitamin D too. Yep, Ergocalciferol.

Evan Brand: Yep, yeah. Ergocalciferol? Yeah. So you have a vitamin D, they may run the D two and you’re like crap I needed to d3.

Dr. Justin Marchegiani: Yeah, the [inaudible]. The animal base kind of the d3 is the more active form. The D two is the more plant synthetic form, typically made from lanolin. A lot of times, that’s the D two, that’s the ergocalciferol. Ah, so vitamin D is really important. And then the range on that is pathological as well. They want above 20. Why? Because they’re looking for rickets, right, the bone bending disease, right, because d3 helps absorb calcium and helps a calcium get into the bone. So we want 50 to 70 or maybe 70 to 100 if we’re autoimmune or cancer risk. So vitamin D is a big one, I would say also on the CBC, we may be looking at immune cells, if I see low white blood cells, you know, below four and a half. There could be some you know, deficiency issues if there’s high white blood cells, you know, greater than seven and a half there could be some immune stress. Now we look at the, the immune cells, how do we look at those never let monkeys eat bananas, that’s the mnemonic device and doctor at school we learned so neutrophils we want to see, you know, below 60 lymphocytes, we want to see mid reference range when we see high neutrophils or low neutrophils and elevated lymphocytes. That’s a common h pylori or bacterial infection pattern. If we see elevations in eosinophils, greater than four, we’re thinking potential parasites or chronic environmental allergies by sea monocytes, greater than 10. I’m thinking some kind of intestinal inflammation. So we there’s different, you know, patterns you may look at, when we look at some of these immune cells. That’s very important. But unless it’s very high, they’re typically not going to say much. And if it’s very low, they typically don’t say much either there. 

Evan Brand: Yep, so also more advanced thyroid markers. It’s very, very sad how many people go to even an endocrinologist and they may only end up with a free T for possibly a free t three, but even that’s not guaranteed. Maybe a total T for you may get Of course, TSH is going to be on there. But you and I are definitely going to be running like thyroid globulin, I mean obat antibodies, we’re going to be running t TPO, thyroid paradoxus antibodies, maybe TSI, sometimes if we think there could be something else going on next. And then you’ve got the uptake of T three, what else you got? You got reverse t three that we’re going to be looking at. That’s an awesome marker. And that’s never run. 

Dr. Justin Marchegiani: Yeah. So when it comes to a thyroid panel, you already mentioned it, most conventional endocrinologist and primary care are going to run TSH because that’s the major screening brain hormone, not a thyroid hormone majrooh. It’s not a thyroid hormone, but it’s a major brain hormone that talks to the thyroid and you’d be lucky to get a T for total after that. But we know downstream is a lot of conversion issues and even patients that have normal TSH, guess what, especially if they’re on Synthroid, which is a synthetic thyroid medication that’s just T for many of them can’t make that conversion. And that’s a problem too. And so you can have adequate T for good TSH and low t three. And you may have a lot of thyroid symptoms. So it’s really important that we look at things complete. And don’t even get me started on thyroid antibodies, because that’s almost never run and thyroid antibodies are the major mechanism why most people sideway glands aren’t functioning properly because their immune systems have beaten the crap out of their thyroid for a very long time. 

Evan Brand: And we’re talking what I mean, you’d say probably over half of cases of hypothyroid are probably autoimmune based on what I’ve seen, what would your guess be? 

Dr. Justin Marchegiani: Yeah, I would say that and some may not even come back on the lab test, but it’s very helpful to be able to look at those we run TPO antibodies and thyroid globulin antibodies. And so my full thyroid panel nevitt, some kind of a TSH, T for free and total t three free and total TPO antibody, federal globulin antibody, and we may run a reverse d3 or an uptake. Those are all okay markers to add to. So that’s kind of your complete thyroid panel. Let me just piggyback to the CVC. Is there anything else on the CDC? I think we hit it all there. We can go to the metabolic profile now if you want. 

Evan Brand: Yeah, well, you mentioned like earlier, like CBR active protein c reactive protein, I guess it kinda depends. I mean, sometimes that standard, but a lot of times that’s not an hscrp is, you know, going to be the same same section of the inflammation panel on your blood. So hopefully you get those two run together. 

Dr. Justin Marchegiani: Yeah, usually CRP and cardio CRP is basically the same thing CRP, they’re just, they’re breaking the number down typically below two, I think the cardio CRP, they typically don’t do it less than two or so. So when they you do a highly sensitive CRP, they’re just breaking it down into a smaller number. Let’s go we want to see that below one that’s great as a good marker of systemic inflammation. And fibrinogen is great. We have for highly inflamed, we may see a lot of clotting happen. And fibrinogen looks at clotting factors, which is helpful. So if we don’t have good fatty acids, good omega three omega six ratio or a lot of inflammation, a lot of trans fat, high blood sugar cells tend to agglutinate they get very sticky. And so it’s nice to see where that stickiness that stickiness level is. And homocysteine is also another measure of blood inflammation because it’s homocysteine is an inflammatory metabolite. That typically happens when there’s not enough B vitamins B six and four And B 12. In their active form, that can be a big inflammatory issue there too.

Evan Brand: Yeah, that was a problem for me. Actually, I did have elevated homocysteine couple years ago and started hitting some more Foley and it fixed it. So it was fun to see how the blood correlated to that. 

Dr. Justin Marchegiani: Yeah, you know, we’re going to try to get as much of that which we can do leafy greens and high quality, you know, essential fats and meats, right, but that’s good. And so metabolic profile, we may look at liver enzymes that could be helpful patients that have a lot of insulin resistance and inflammation, you may see an elevation in liver enzymes. What does that mean? That could be a non alcoholic, fatty liver, non alcoholic steatohepatitis, that’s Nash or non alcoholic fatty liver, meaning your liver has stressed not from alcohol, but from typically too much fructose and junky carbs. So the liver is a people think the liver is just a big filter for toxins. No, it also has a major effect at regulating blood sugar, and is also a storage site for sugar, especially fructose. So when you over consume fructose from high fructose corn syrup, or, you know, just too much carbohydrate, in general, the liver really gets stored up. And then when that liver fully gets saturated, overly saturated with fructose, for instance, you start having all these up regulations of inflammatory enzymes called the the junk enzymes, the J, the J and K one enzymes, and you see a lot of inflammation and a fatty liver there, and you see it an ultrasound. And so that’s a common marker seen those elevated liver enzymes, and it’s good to be able to look at that. 

Evan Brand: Yeah, I don’t know if you’ve tested bloodwork much with people like in the middle of a protocol. But I’ve had a couple interesting cases where, while using binders, we’ve seen liver enzymes go up. And it could have been also parasite protocols and things like that, that were kind of interwoven with detox protocols. But I’ve seen liver enzymes temporarily go up during that. So I don’t know if you pay much attention to that. But I’ve seen it and they always go down as soon as it protocols over so.

Dr. Justin Marchegiani: Even with some killing herbs, like worm woods, a common one that we may see a little bit of elevation and liver enzymes, people that are sensitive, some of the killing herbs, it could be a little bit of stress, is it just the herbs? Or is it the dead debris that is now mobilized from the killing of those microbes, it could be both. That’s where adding things like binders can be very helpful just to kind of put handcuffs on those critters and escorted out of the body versus kind of having it go back into general circulation. also adding an extra glutathione support can be helpful too. Just to really support and tone if I deliver those are very important too. 

Evan Brand: Yeah, well. And it’s common for you and I to use some sort of a liver gallbladder support too. So we may be throwing in like some extra taurine or Mathionine or beet powder artichoke. And there’s many, many things that I say milk thistle already NAC. So there’s a lot of stuff we can do. But yeah, I just figured I mentioned it. Because if someone’s listening and you happen to do blood work in the middle of a protocol, it’s possible that the levels may you may look at him and go, Oh, my God, my liver enzymes, but it will go back to normal relatively quick after killing protocols over. 

Dr. Justin Marchegiani: Exactly. Also, we may look at glucose, blood glucose is going to be on a metabolic profile as well. CMP panel, I don’t love it as much, because most people that are going to get a blood test and they’re getting pricked in the arm of the big needle, or they kind of stressed. Yeah, and so that the cortisol from that can really increase their blood glucose. So I like getting a really good blood sugar kit like this. And then you can measure your blood glucose during the day. So here’s my little kit here. And so I have I use the keto Mojo now because it measures ketones, so I’m a little meter, I have my little pricker here from my finger, and then I have the blood glucose and the ketones. So this one right here is the blood sugar. And this one here in the lighter blue, this is my ketones. So it’s kind of nice to have those. So I can test my blood sugar before I eat. And then I can do a one two hour three hour and play around with my blood sugar. The whole goal is the more you keep your blood sugar down after a meal and bring it back to baseline within two or three hours, the less insulin you’re making, the higher it goes up and the longer it takes to come back down, the more insulin you’re making. So it gives you kind of a good window how you’re responding to food. 

Evan Brand: Yeah, what I wanted to point out is that you’re doing more functional analysis of glucose versus if you just go into your doctor once every six months, you get a morning fasted glucose, that’s just not enough information.

Dr. Justin Marchegiani: It’s not because the whole goal while you’re just checking morning glucose is because you’re thinking your food, so out of whack, that your glucose is now elevated as a result. Now the problem is most people haven’t eaten in 12 hours. So for your glucose is still be out of whack. 12 hours later, the problem has to be pretty severe number one, and then number two, a lot of times it can be elevated not because of food, but because of stress hormones in the morning. And so the stress hormones, people say oh, I’m at 105. Yeah, but it just could be a good cortisol response in the morning called the dawn phenomenon that’s raising that glucose. That’s why you want to check it against your foods during the day. If you have a blood glucose issue. You’re going to see one and two hours later, it’s chronically elevated, and it’s taken a bit of time to come down. So that’s a better marker. Make sure you’re handling glucose okay.

Evan Brand: Yep. How about hemoglobin A1C, this is something that for diabetics, obviously, this is hopefully going to be regularly checked. But for your average person that maybe has some issues, A1C is probably not going to be on your standard blood panel. 

Dr. Justin Marchegiani: I don’t love A1C, I used to like it. I don’t love it as much, I find that when people’s blood cells live longer, because they’re more healthier, they have more time to accumulate blood glucose. So the A1C it’s a part of the hemoglobin and they’re looking at the coding, the coding of glucose on the outside of the hemoglobin, right? So imagine, like, you know, when you, you know, you go up into your car during allergy season, you can see like a big fixed swath of like pollen on the car, they’re kind of looking at the swath of glucose on the outer part of the human lobe. And now the problem is, the longer your red blood cells are hanging around, the more time they have to accumulate that blood sugar. So it can be helpful to look at something. But if you’re, if you’re a little bit on the higher side, or like, let’s say 5.5 or so, let’s say under six, but 5.5. And up, it may just because your red blood cells are a little bit more healthier. So like, for instance, with my anemic women who may have a ton of blood sugar, right, a lot of carbs, because maybe they’re vegetarian or vegan. Guess what? When you’re anemic, your red blood cells die faster. So all my anemic women have A1C super low, like in the forest. And so it’s not going to be a great marker when your red blood cells don’t live that long, and we see it with our anemic patients.

Evan Brand: That’s a good point. Good point.

Dr. Justin Marchegiani: If I see someone six or higher, yeah, it’s helpful, you know, but when you’re kind of in that subclinical zone, you’re going to typically have to go back to one, a meter like this, to really look at it. And then also look at your fasting insulin, which is a better marker, because that’s going to give you a better window, how much insulin you’re making frequently. 

Evan Brand: Yep, good point, that analogy is perfect. The pollen on the car. So good job there.

Dr. Justin Marchegiani: Right. And if you leave your car out there a lot longer, you’re gonna get a lot more pollen. It’s kind of like that, right? 

Evan Brand: I’m always under five though, no matter what with a one C, I’m always right. 4.9. Somewhere in there. 

Dr. Justin Marchegiani: Yeah, I’m pretty low, too. I’m always like, right in the low fives. 5’1 5’2. But I’ve seen a lot of patients in my career that have that have really good diets that have tested their blood sugar, have good insulin, and they’ll still have a little bit higher on the a one C and I’m just like, yeah, it’s just it’s missing some people. That’s all. It makes sense. The question is, what’s the mechanism? And that’s what it is. 

Evan Brand: Yep. Makes sense. You hit the you hit the dawn phenomenon. So you know, cortisol that may be run via blood, although we don’t really like blood cortisol too much. We really like more functional analysis of cortisol, like with urine or possibly saliva? 

Dr. Justin Marchegiani: Oh, yeah. And part of the reason why we don’t we don’t like it, is it because when you’re measuring a stress hormone, while creating a stress response, ie putting a needle in my arm, you may influence that a little bit, right? And so that’s kind of the reason why we don’t love that. And even if you’re like, Well, you know, do the adrenals make cortisol fast enough after the needle happens to show in the blood? Well, it’s not just that it’s the fact that you’re anticipating it happening. Therefore, you’re replaying that stress in your mind all the way up to the doctor’s office to go and then the elevator getting into the you’re already making that stress hormone while you’re anticipating what’s going to happen. 

Evan Brand: Yeah, you go in the friggin lab with the scientific fluorescent lights above your head. It’s all awkward the quiet they got some like drug commercials on in the waiting room, Justin, and they call your name come on back. Yeah. So and, you know, also Not to mention, too, that that’s just a snapshot, right? I mean, that doesn’t tell us anything about what’s happening at two or 3pm when you’re complaining of that midday crash. So I really am not too interested about what happened at 8am. I’m really want to know what what’s going on at 2pm when you’re saying you need that third cup of coffee. 

Dr. Justin Marchegiani: Exactly, yep. 100%. So it’s, it’s really important that you’re kind of on top of that. So I think we hit some good blood glucose stuff, we hit some liver enzymes we hit. I’m thinking here, we hit some of the electrolytes. electrolytes are good, too. So sodium and chloride are really good ones. Now when I see patients that have adrenal issues, you could easily have low sodium and high potassium, or you can just kind of have lower minerals all together. Now the serum is not going to be the best marker for testing minerals. So when you see your minerals out of balance, you know, it’s a big issue, but you could still have mineral issues. And the serum be okay, because it really matters what’s in the cell. Not necessarily what’s floating around in the blood. So think of interesting Imagine you’re in a pool, okay? The pool is serum. Okay, you’re in the little floaty. You’re in the little inner tube, right? So it’s you in the inner tube, right? You and the inner tube and the water in the inner tube that’s intercellular. The water outside of the inner tube is extracellular serum. So that’s kind of how you think of it. So when we test some of these nutrients, it’s better to get a sample of the water in the inner tube with you that’s intercellular versus the water outside of the inner tube. That’s serum.

Evan Brand: Yeah, and how do people get that? What is look like?

Dr. Justin Marchegiani: Well, you can like we can add like a red blood cell serum or a potassium serum on some of these panels, we may run like a spectracell, or a Nutri eval or an ion panel that looks at more intercellular nutrients, we may look at different tests that allow us to do that. But there’s not too many add ons for conventional testing like quest or labcorp. Outside of I seen a blood cell magnesium is good. You can do a potassium if you wanted. So there are a couple that you can do to get a window into that. 

Evan Brand: Yeah, I was gonna say I looked through all the options for the conventional labs, RBC magnesium, I think that was about it. I think that’s all I could find. 

Dr. Justin Marchegiani: So yeah, not too much. But it’s something you know, because magnesium is a big one, right? And with magnesium RBC, we want to see a greater than five on that one, red blood cell magnesium greater than five. So that’s helpful. And then, of course, we mentioned magnesium surround, we want that greater than two. And then your minerals, you want them somewhat mid reference range, once we start going under 100 or so I think like sodium, it’s like 104 is kind of mid range. If you’re under 104, it could be a problem, potassium, I forget the exact ranges in it, but I want them all about mid range. In regards to the reference range. 

Evan Brand: What do you feel about using conventional bloodwork to do like omega three omega six fatty acid panels, I know, there’s some Doc’s that are just so obsessed with all these ratios. But, you know, truthfully, if you’re doing the things that we’re discussing with our clients and patients for nutrition, you’re going to pretty much be optimized anyway. I don’t know what that would tell you. Besides, hey, maybe you need to do a little more this or that? 

Dr. Justin Marchegiani: Yeah, it’s a great question, I think, look at the person’s food. Like someone could have really good diet, but let’s say the meat and the eggs aren’t pasture fed. Well, that could easily be the reason why your omega six to three is off a little bit. Or it could be that you know, you’re just doing too much plant fats, and those plants or from coming from, you know, omega six bass plants soy or canola or safflower. So if you’re doing good fats, like coconut oil, and olive oil and avocado stuff, which are monosaccharides are Yeah, so those are, yeah, those are MonEl fatty acids versus like, vs. poly, which is like a fish oil, right. And then so the fish oils, you have omega threes, right, which are going to be like, the ones that are we talking about that are going to be more on the anti inflammatory side, right? These are the Polly’s. And then of course, the Omega sixes are going to be more on the vegetable side. These are going to be also Polly’s but they’re going to have six bonds, these are going to be your safflower canola, these are going to be your soybean oil, all of your plant based fats, most in the most of your plant bait fast, to extract the fats from them with the olive oil or maybe an avocado, you tend to have to damage the fats, they tend to be more damaged, they tend to be more on the Omega six side. And when you get when you eat plants by themselves, you’re not getting that concentration of fats. And so you tend to not have that high omega six to omega three, when you’re doing just vegetables by themselves. Okay. And so we can just look at how much fish you haven’t per week, how much pasture fed eggs you have in a week, how much steak or meat that is grass fed, you haven’t per week, and then you can kind of look at it relative to what’s high on the Omega sixes like the knots and the seas and the refined vegetable oils. And you can kind of get a pretty good assessment of where you’re at, which is like kind of for one or less. So four times omega six to one is pretty, it’s pretty. Okay. And you can always run that omega three to six tests on the blood too. Does that make sense? 

Evan Brand: It does. Yeah, I just find that it’s not a huge needle mover. So I don’t run it too often. I mean, I think it’s cool to check in you could call it kind of a lie detector test as somebody says they’re doing everything that’s dialed in, but then you find out that Oh, they’ve been coconut grass fed steak, but it’s been in this healthy heart oil blend that they found on the shelf and it was a safflower canola combo. You’re like, Oh crap, then we missed it. And you got to get off of that stuff. So yeah, I mean, I was just gonna say so it’s not really a standard thing. For me at least you know, I’m not running into often with people but- 

Dr. Justin Marchegiani: But it’s there it’s an option and then it’s something if someone wants to run we’ll run it and so we have the polyunsaturated which is the fish oil or on the omega three side, right. And then we also have things like flaxseed oil, but it has to get converted to the to the higher up fatty acid so you know, omega three fish, and then you get to get some mega three from cows that are grass fed as well. 

Evan Brand: What about particle size on a lipid panel? So we talked about that briefly. It’s just a good add on that most people don’t do and our friend jack Wolfson, he discusses particle size and I think it’s something that more people are asking questions to their doctor about but it’s still very uncommon to run. 

Dr. Justin Marchegiani: People that have a cardiovascular history. Just want to run it to begin with. I think it’s okay. I can almost always tell you what your particle sizes if you’re eating good health saturated fatty acids like coconut oil and grass fed butter. And you’re getting meats that are like good quality fish, good quality grass fed beef, egg yolks, you’re keeping a lot of your junky fats down a lot of the refined sugar down and a lot of the trans fats down, you’re going to have a large, you’re going to have a particle size A, which means large and buoyant and fluffy, right? Think of a like you want an ad on your test. And then you have the small dense atherosclerotic particle size B, think B for bad, and the B for bad, more trans fats, more inflammatory, processed vegetable oils, more refined sugar. And so with patients, I almost always can look at their diet. And guess what that will be to begin with. So if I do a dietary check and do a diet recall, what’s what’s the average day look like? And I look at that and I get a window, it’s pretty easy to predict that. And so we’ll run it for patients that have a cardiovascular history, and they just want to know, but for the most part, it’s not hard to predict it. 

Evan Brand: Yeah. And when you see it, are you just tweaking dial? Like, if you see a bunch of small dense particles, or are you coming in? Are you using any kind of like plant sterols or anything like that, to help with it are you just tweaking diet, and then it fixes itself? 

Dr. Justin Marchegiani: It depends how acute the patient is. But if it’s if it’s not acute, meaning the patient’s not dealing with a heart issue right away, then we’re going to just tweak the diet, and that’s going to take care of it, we’re going to add an extra omega three fatty acids from fish oil, we’re tweaking the diet, we’re getting the carbs down, we may be adding extra nutrients to manage blood sugar and manage inflammation. And then usually within a month or so you’re gonna see a big change. After we retest. Awesome, yeah, usually once you get about 100 good meals, then you’re going to see a big shift. A good average person is doing about 21 meals a week, right? So three a day times 721. So four to five weeks, once you get 100 meals in, if you can get them close to in a row. Your body has a huge shift in physiology. 

Evan Brand: It’s amazing how quick you can change stuff I knew. I mean, sometimes we get impatient because like what the detox piece like that takes longer. I mean, I’m here I am a couple years in detox and mycotoxins. I’ve still got some going on. So, you know, with that, it’s like, oh, man, you get impatient. But luckily, with the blood, it’s a quicker turnaround time sounds like. 

Dr. Justin Marchegiani: Oh, totally, man. It’s really important. So I think we hit some of the big markers today. I would say one other one for lipids. You know, I don’t really care if cholesterol is a little bit on the higher side, just I try to make sure the cholesterol to HDL ratio is ideally you know, four. So if the if your Triggs are sorry if your total cholesterol is 200, and your HDL is 60, or what’s that ratio to the math, put my calculator 200 divided by 60, that’s 3.3. That’s pretty darn good. Usually, when you’re under three and a half, that’s half the average risk factor. Okay? When you let’s say you’re at 242 40 divided by 60. On the HDL, now you’re at four. And so I like to look at the total cholesterol to HDL because HDL is what recycles cholesterol. Okay? So if you have good recycling lipoproteins, ie HDL, that’s a good sign. And then I’m also going to look at my trigger to HDL ratio, we want that under two. But if we can have a closer to one, that’s wonderful, what does that mean? Take your trig number, let’s say your trig numbers at 60. Let’s say your HDL is at 50. Well, what’s that? What’s that number? Well, we do 60 divided by 50. We’re at like, 1.2. That’s good. So we want to under two but closer to one’s ideal. That’s a really good marker. That’s my insulin resistance inflammation marker for my limits. So I’ll look at trade over HDL. That’s a really good marker. 

Evan Brand: Yeah, you know, I talked to jack one time about the, the blood and I said, When do you start getting freaked out regarding total cholesterol, because if you talk to a conventional cardiologist, they’re they’re brainwashed on that 200 number. And he says that he’s got people up in the 450s, that he’s not worried about 1%, like total cholesterol being 450. And it’s not an issue. So he just talks about, like he said, ratios, inflammation associated with it, you know, then you get into more trouble. But I mean, the total number, I mean, he acts like it’s just minimally important.

Dr. Justin Marchegiani: Yeah, on its own, I would be a little bit concerned once you start getting in the mid 300. Just because that’s that could be more hypercholesterolemia. And that’s not necessarily a diet thing, that’s more of a genetic thing where you’re making a lot more cholesterol. So I personally would get a little bit more concerned with that and I’d be monitoring that. But it’s hard to really jack up your cholesterol when you’re keeping inflammation down. Like I just did a blood test for my lipids last month, and my cholesterol my total cholesterol and you know what I eat man? I good fats, good proteins, good eggs, good fatty acids. And my total cholesterol was at 165.

Evan Brand: Whoa, yeah, I was like a 202.

Dr. Justin Marchegiani: Yeah, 165 my my trades were at 60. And my HDL is we’re at 50. So I had like a 1.1 1.2 ratio for trigger over HDL, which is great. And so most of the cholesterol, you’re gonna Ahead is gonna be made by your body. So when it starts getting too jacked up and your diets good, you know, we want to look at thyroid hormone, maybe that could be a big thing. And there could be a hypercholesterolemia genetic issue, and we can always run a genetic test for that to see what’s going on. And if that’s the case, what are natural things you can do to get your cholesterol down, you can do higher dose berberine to make sure your thyroids check, you can also do some potential plant sterols as well. But get that check. So my philosophy if it goes a little too high, I’m curious, I’m worried about the hypercholesterolemia piece. 

Evan Brand: Yeah, and I don’t mention that 400 number just to get people off the hook. I just thought it was interesting that that’s what he was saying. And he’s probably talking like, you’re in big trouble if you get to that point. But But anyway, so that’s rare, though. 

Dr. Justin Marchegiani: That’s super like these are very, very rare situations, you know, sub 1% of the population are going to be there. My never seen it ever. I have two patients with that. But most people already know about it, because someone in their family already had been picked up previously. Yes. So most people already know what especially today, you know, maybe 3040 years ago, not as much, but people that have had those issues have already been picked up. They already know genetically, if it’s in their family, and then once you know genetically, if it’s in their family attend to get tested for it. 

Evan Brand: Yep. Right? Well, let’s wrap this thing up. So as we mentioned, bloodwork is a piece of the puzzle. If you go to a practitioner, and they’re like I’m going to analyze your blood and tell you everything you need, they’re wrong, because you mentioned some of the clues into the immune section about parasite infections and all that. However, I will speak for you and say that you’re not going to depend on that bloodwork solely to identify parasites, you’re still going to be running comprehensive genetic DNA based school panels, you’re going to be running organic acid panels to look and deeper. So yes, you may look at those things. And I think it’s awesome that you gave us some insight into that, however, I’m not going to go to a guy who’s going to look at the blood and say, Yep, you’ve got parasites, let’s put this protocol together, I’m going to want more data. So blood is just part of that data. And it can be helpful, especially when you’re working with autoimmune people, because you and I like to look at these antibodies, and it’s very fun and satisfying. And it makes you look better when you could have a a woman come in with a TPO of 1000. And all you do is fix her gut and our TPO antibodies go down to sub 200. That’s exciting. 

Dr. Justin Marchegiani: Totally, that’s huge. So I think today is very great, great podcast, because we’re talking about actual things. We want people to kind of like say, Hey, you know, what’s it like to be inside Dr. J, and Evans head, and this is kind of it. And everything that we look at, we’re kind of like a detective, we’re putting like checkmarks in the column over here that support us going in this direction, or going in that direction. So we add up all of our checkmarks, right, and we’re kind of create what that differential diagnosis is, and what tests we’re going to do to dive in deeper in in whatever those avenues where those check marks are adding up. So that’s kind of inside of our head, we’re walking through you through our thinking. And if you want to dive in and reach deeper, you know, into work with a practitioner, like Evan or myself, you can head over to, you can schedule a consult with Evan or myself at And you can schedule we are available worldwide to help y’all with your functional medicine and natural health care needs. And if you want to get to the root cause we’re going to be the best person to to look at anything else you want to highlight here today. 

Evan Brand: Maybe just one frequently asked question, Well, I’m not where you live. Does that matter? Well, in the US, it doesn’t matter at all. We can run like a blood comprehensive blood panel, we can run that anywhere now. We’ll try to help people internationally in regards to providing maybe some codes or things like that to help people. But at least for the us know, you location does not matter. We haven’t had any issue with that. I think New Jersey for a while was getting a little more strict. But beyond that, no. I mean, nationwide, it’s a piece of cake. So as we talked about the beginning, create a panel, send a requisition form to your email, print it go get your labs drawn, you’re done. It’s awesome. percent was in New York, or was in New York or New Jersey was one of them. 

Dr. Justin Marchegiani: Yeah, both. 

Evan Brand: They’re both difficult. But was it for blood? Or was it for some of the functional or was it- 

Dr. Justin Marchegiani: For blood, but there are some still some Malin fingerprick tests that we have accessible to deal with patients like that. So we still have options for them. Maybe not quite as much. And then if they’re near the Connecticut border or the Pennsylvania border, we have also options there too, but we still have some mail and stuff. That’s helpful. 

Evan Brand: Cool, cool. All right. Well check out the sites We’ll be back next week. Take care.

Dr. Justin Marchegiani: Excellent. Have a good one, y’all. Take care. Bye.


Audio Podcast:

Using Nutrition and Functional Medicine To Enhance Energy and Mood | Podcast #302

It’s summertime! Summer is the hottest of the four seasons. With the summer heat, this affects our body, activities and our energy level. For today’s podcast, Dr. J and Evan Brand share tips on how we keep our energy up and running. More of the information below. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:02        Electrolytes

07:05     Staying Hydrated

15:47     Adrenal Fatigue or Dysfunction

21:44    Cortisols

26:12    Minerals

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. I hope everyone’s having a fabulous day. I’m here with Evan brand, we’re going to be chatting about ways to enhance your energy. In the summertime when the heat is here, certain things have to be done to really keep your energy up. And we’ll kind of start out here with electrolytes first before we do, Evan, how are we doing today, man?

Evan Brand: I’m doing really well, actually just got done. I would show you the color. But now it’s just clear. But right before this was water, this was electrolytes. And I’ve been doing that every single morning. And my oldest daughter now she begged me every morning Daddy, Daddy, I want electrolytes. Okay, and she loves it. I put a little beet powder in there for her too. And she sucks it down. If you want her to drink an entire mason jar of water. How do you get her to do it? You put electrolytes in it. It’s amazing. 

Dr. Justin Marchegiani: That’s awesome. Is this week with any stevia at all to give it a little more flavor now? 

Evan Brand: Yeah, yeah, there is stevia in there.

Dr. Justin Marchegiani: Okay, that’s good. Yeah, cuz electrolytes by themselves, especially with high amounts of potassium. Pretty, pretty raw.

Evan Brand: Yeah, these are good ones. These Good, these are my brand that we that we make. So they’re good.

Dr. Justin Marchegiani: That’s good. Yeah, how I start my day every day I go downstairs and I have a nice big mason jar, probably maybe 12 or 16 ounce size mason jar, I fill it up and I use the Redmond Real Salt minerals just kind of coat the bottom and I just do two full swigs of it kind of get 25 or 30 ounces down to start the day. I also when I when I finished my shower, I also do a cold shower and I kind of drink as much as I can out of the overhead shower when it’s cold at the end. So I try to get about 30 or 40 ounces with extra electrolytes to start my day that’s important. Especially in the summer, people are starting their day with a coffee or some kind of a natural diuretic. If you don’t really hydrate intentionally in the morning, you’re going to deplete your minerals. And especially when it’s hot and you’re sweating, you’re going to lose more minerals on top of that, so it’s very important in the summer, especially when you’re engaging in a diuretic like a coffee or tea. You really have to start your day intentionally with at least 30 ounces of water, clean filtered water ideally reverse osmosis process And you really got to intentionally add some additional electrolytes back there to make sure you kind of prime yourself to start the day.

Evan Brand: Yeah. And people are like, okay, that’s such low hanging fruit. It is. But it’s something that 99.9% of people don’t do and it has a massive impact on your energy levels. I will tell you, if I skip a couple of days, and I’m not doing electrolytes, my energy will tank and I will tire more easily. So if I’m outside, cutting up a tree, or, you know, I was cutting down some honeysuckle and getting that crap cleaned up. If I don’t have electrolytes in my system, I tire out more easily. So would you say that this is just due to minerals that are fueling Krebs cycle or what do you think’s happening? When you’re noticing fatigue and someone who’s dehydrated or depleted of minerals?

Dr. Justin Marchegiani: Well, a couple things right? So our cell membranes work through the sodium potassium pump, right? sodium and potassium out, right? What is it I think it’s two sodium at three sodium into potassium out right? This is the sodium potassium pump. This is how our cells work. So If we aren’t getting enough sodium and potassium, our cell membranes are not going to work correctly. Also our nervous system and how nerves work think of electrolytes as the liquid wiring that helps our nerves conduct in our body, right? We know something called hyponatremia happens many times a year around marathon time when people over hydrate, they actually dilute their electrolytes and they can create a heart attack, the heart just stops, they go into cardiac arrest. Why? Because we need adequate levels of electrolytes for our nervous system and for muscles to work, right? You see this at a subclinical level with cramping? Okay, you can see this at a more acute level with a cardiac arrest due to hyponatremia. So we know electrolytes play a really important role for our muscles for our heart, but we know the adrenals play a big role too. So when someone has adrenal dysfunction, right or the slaying is adrenal fatigue, I like dysfunction better because it’s more descriptive because some people can have this functioning adrenal cortisol is high or low or just somewhere in between but imbalanced. So adrenal fatigue just kind of portrays one side of the adrenal, you know, the adrenal being low, but we know it can it can dysfunction, a lot of different ways that your adrenals play a major role in you holding on to your electrolytes. People think, well, I’m getting enough electrolytes, but they’re not counting in the fact that they have adrenal dysfunction, which makes it harder to hold on to your minerals, because you make things called aldosterone, which are mineral corticoids that help you hold on to your minerals. And the weaker your adrenals are, you may be picking up your minerals at a higher levels that way you got to you got to go over the top. So I start my day with really good fluids, really good minerals. I like Redmond Real Salt. You could probably do Celtic or Himalayan as well. And my wife kind of brought it to my attention last week. She’s like, I’m really chronically thirsty. And then we kind of looked at her routine and she started her day with two cups of coffee with no water. I’m like, that’s what it is. She had a little bit of mastitis last week, you know from You know, breastfeeding and I think a lot of the mastitis happened to just not having a fluid in her lymph. Now, we treated the mastitis with ginger and po group and then infrared light that works phenomenal knocked it out and 24 to 48 hours, no issues. But we looked at what was the root cause, right? We felt like the root cause was just not getting enough hydration to start the day and starting the day with the diuretic that depleted her.

Evan Brand: Yeah, my wife had that wants to when, when my little girl summer was little she had it and we ended up doing I think it was a dehydration issue too, because she was doing coffee in the morning, but we ended up doing like a topical coconut oil lavender essential oil mix, and just rubbing, rubbing, rubbing towards the nipple and then boom. It worked. It was miserable. I mean, it was like the flu. I mean, she got hit like a train. I mean, she was sweating. She had a fever. I mean, it was like whoa, what is wrong with you? And then as soon as that cleared up, all her symptoms went away. It’s kind of crazy.

Dr. Justin Marchegiani: Yeah, a couple easy, natural thing that’s been around for a long time is Poker poker works phenomenal. It really helps with the limp and just kind of takes all that coagulation of all those cells kind of stuck together and it kind of loosens it all up. And you can do ginger as well. Ginger is great as well, those are phenomenal. And then if you have access to red light, red light slash infrared light, it’s even better because that just kind of just calms down the inflammation. And then it really helps just kind of dissolve any clots or agglutination that’s happening in there. So I like it. But the last thing you want to do is get your wife on antibiotics that can be passed down to the baby. So there’s a lot of natural solutions out there so we can we can easily just kind of book in this part of the podcast for a separate video on mastitis poke rose how to be a phenomenal thing as well. And gingers going to be a phenomenal thing as well. And then if we kind of go back to the root cause of our episode here is getting me electrolytes and the hydration to start the day is so important because when you don’t have enough fluids to start the day, you’re more prone to inflammatory issues like this. Now this is, you know, mastitis in the breast tissue but you could just have it Extra inflammation anywhere in your body due to not having enough good fluids and good minerals for sure.

Evan Brand: Yeah. So if you’re like, well, I’m a 50 year old woman I breastfed 30 years ago, okay, this still could apply to you because we’ve seen women with various types of edema, where if you kind of grab your ankle and push your thumb in and you’ll see that pit in the, in the front of your shin there that could be related to some type of a lymphatic issue as well. So yeah, hydration is definitely key. And I mean, here’s the deal. I try really, really hard to to stay hydrated and I still probably don’t do a good job. I’ve got the clearly filtered that I keep on my desk just in case I run out and that we’ve already got a glass to pour but man makes you wonder how our ancestors had such you know, I don’t know, we don’t know. But how were they hydrated all the time. I guess they would just stop at a river and drink straight out of the creek and they were probably they were probably not as stressed as we are. So maybe they weren’t depleting as much minerals from the adrenal perspective. Or the the food may have had more nutrition in it? Of course it did and maybe more moisture in it too. I don’t know it just it makes you wonder like we’re our ancestors sitting around drinking mason jars all day. No. How did they stay so hydrated?

Dr. Justin Marchegiani: Yeah, I mean, they had access to wells and rivers and there wasn’t the pesticide runoff for all the chemicals. I mean, you wouldn’t touch that today. But you know, also, for our ancestors got a parasitic infection and had severe diarrhea. I mean, it could have easily died, right, we still know amoebic dysentery is like the third, the top five causes of death in third world countries. So we know parasites are kind of a big deal across the world when there’s when there’s not clean filtered water or access to antibiotics if needed. I mean, a lot of these cultures are smarter, they have kind of their own herbal medicines like like we’ve formulated for our patients to help these things, but some people don’t have access to that. So for sure, so the water the hydration components really good and we want to keep it clean. My natural kind of electrolytes support which people don’t Want to start them that you can do celery juice, celery juice is excellent. It’s a lot of really good minerals in there and it has a lot of potassium. So you can get about 20 to 25% of your potassium in one day in certain celery plus, that slows a whole bunch of other many minerals, sodium and chloride. Other things besides just the potassium, but potassium is huge. and celebrate just primes a lot of these minerals that are needed for digestion, right, a lot of the minerals that are needed for hydrochloric acid. So I love celery juice, if you want to start your day with, you know, a couple glasses of water and some good minerals and then throw in some celery juice later, then that really Prime’s up your potassium because the two biggest minerals people are missing on the electrolyte side is going to be potassium and magnesium. sodium and chloride. Don’t get me wrong, people aren’t getting good forms of it, but it’s in a lot of processed food. So people still get a lot of access to it even if they’re eating a standard American diet. Now, I’d argue it’s not the best form, right? We want one that’s full spectrum like when you do like a Redmond Real Salt or high quality seesaw, you’re getting 60 or 70 different trace minerals along with that sodium and chloride. So you’re not just getting one thing, two things, you’re getting a combination of different things, which I think is important. And then we can always add in the magnesium and potassium because those are just hard to get in FDA I think, or CDC, one of the two says that 50% of the population is deficient in magnesium. And I would say about the same is deficient in potassium, if you have any kind of heart issue or arrhythmia stuff, or is anything on the cardiovascular side don’t look any further than magnesium and potassium. They really move the needle a ton. Go ahead.

Evan Brand: Yeah, Carolyn Dean. She’s a medical doctor. He’s written extensively about a fib and other heart issues, and it’s all about minerals and repeating minerals and talking about the soil being depleted. I mean, so minerals in the heart go hand in hand, which is why we talked about when electrolytes are low, you’re going to have issues with energy. So the reason that this kind of spurred today’s conversation was I had a woman over the We can email in and say, Hey, I’m wanting to get in my garden and be active and be outside, but I’m just I’m too exhausted. And she was sleeping fine and diets dialed in and all that. But what are the other missing pieces and it could be something as simple as electrolytes. Now, obviously, when it comes into fatigue and chronic fatigue, we talk about all the different branches of that all the time. But we’re talking today about some of the more action steps you can do regarding low hanging fruit, like the electrolytes, but then let’s go into some of the herbs because there’s a lot of things I do in the summer differently. That kind of keep me going, specifically rhodiola is something I bring out more in the summertime because I’m a lot more active in the summer. I’m riding my bike, at least a few miles a day, and I’ve got this little kid carrier so I strapped my daughter onto the back of the bike and I’m pulling her in this carrier and that thing’s heavy. So it requires a lot more work. And so I’ll usually do somewhere to two to 500 milligrams of rhodiola and I can tell you 100% of my I guess you would just call it my peak output. Imagine if I’m like a electric motor, my peak output of wattage coming out of my legs is much higher on I’m on rhodiola, as opposed to when I’m not.

Dr. Justin Marchegiani: On this makes sense too, because we, we always talk about the root cause, right? Like, of course, there could be a root cause of just like one, you’re doing too much of a diuretic, and you’re not getting enough of those nutrients and minerals, those micronutrients in the morning, right? That’s always possible, and that’s the low hanging fruit. The second thing is just your need and demand for it’s much higher, right? So you could be having high levels of cortisol or chronic stress, which is going to cause you to dump more potassium, you can go pull open and guidance, physiology. And you can go to the endocrine portion of that or the kidney section of that book, where it talks about cortisol actually increases potassium dumping. Now, this is important. So you may be going on chronometer, right, Justin slash crono meter and because I tell my patients to go there and run their minerals throughout the day, like you can put your breakfast your lunch and your dinner meal in there. And that calorie calculator will look at micronutrients, which is great. And it will obviously look at the macros most look at the macros, this looks at the micro. So it’ll look at your B vitamins and your magnesium and your potassium. And you want about 45 to 4700 milligrams of potassium a day. And then maybe about a gram or so of the magnesium per day. And again, it depends because certain magnesium is like a mallet or a glycinate. They absorb better than like a citrate or an oxide. So it just depends on what kind of magnesium but maybe about 1000 or so total a day, right, everything all factored in. Some people need a little bit more because they’re dumping these things out. Now, you’ll dump potassium out when there’s cortisone stress issues, you’ll dump a lot of magnesium when you’re consuming lots of carbohydrate and alcohol and you’ll dump a lot of B1, especially when you’re doing a lot of alcohol. It’s why a lot of friends people that are Irish descent, there’s a lot of b1 deficiency because there’s a large percent of alcoholics so B1s really important. And B1 can create hard issues to write berry berries. Which is a deficiency for B1, which is B1 is timing right? Find means B one, B two is riboflavin B three is niacin. And berry berry is Swahili it means I can’t, I can’t because the heart can’t pump I can’t, I can’t. So b one’s really important. So what alcohol and sugar and carbohydrate, you’re going to drive B one deficiency. With a lot of that too. You can also drive magnesium deficiency, and that can affect your nerves and your heart and your mood. Magnesium is a natural sedative so it helps you relax. And then of course, our potassium, potassium can help with the heart as well. It’s going to help with blood pressure, it’s going to help with mood. Anytime you affect your cell membranes fluidity and how your cell membrane works, right? that’s going to affect so many different issues, so many different issues. And it’s like, we need to have healthy cells to work for our bodies to be healthy in the first step for healthy cells outside of good hydration and not putting a whole bunch of toxic soup. There is going to be sodium and potassium.

Evan Brand: Yep. So I think a good test, like if you’re somebody who’s getting into this adrenal testing could be valuable. So we do both. We do saliva, we do some urine. I’ve done some blood just to see. But I just wanted to confirm everything that you and I’ve learned, which is kind of that blood testing for cortisol is typically useless. But I wanted to compare and contrast and so I’ve done some blood testing for adrenals. And it was pretty much useless overall. And reason why you and I’ve talked about this before, but unless you have a very big problem, blood doesn’t really change much. It’s not functional. It’s more of like disease state or not disease state, whereas the urine and the saliva we’re running are a lot more functional. So you mentioned this adrenal fatigue or adrenal dysfunction. You know, we’ve seen people who are exhausted, but their adrenal cortisol is showing sky high and vice versa. We’ve seen people who they say they quote feel fine and their adrenal cortisol is flat. So rather than, you know, I’m not going to mention tired people who want to go play in the garden, I’m not going to say go take a bunch of licorice for example, right out of the gate without testing, we’d push you more towards the minerals and all that because if cortisol is already so high, you don’t know that it’s so high, you go on licorice, which is kind of like, I use the analogy like plugging up the iPhone to one of those little portable battery banks. You’re kind of extending the half life of that cortisol. You don’t want to do that if it’s too high. 

Dr. Justin Marchegiani: Oh, that’s a great analogy. I love that one. That’s good. I’m going to add that to my to my Compendium or my my Rolodex of analogies Dr. J’s Rolodex of analogies. I love it. That’s great.

Evan Brand: Yeah cuz that’s you know, cuz cuz part of me wants to go well, let’s talk about this herb, let’s talk about that or but but I kind of have to hold back of doing too many that are going to modulate cortisol in that way because I do find that it’s concerning how many people just go buy something off the shelf or online, because it’s an adrenal booster and they think I’m tired. It’s got to be adrenals and then they’re going to go pop licorice and a bunch of different stimulating genes. And all that, and then they feel more anxious or they feel worse and they don’t know why. So I guess I would encourage people get the testing done first so you know where you’re at, you could still do the electrolytes bump up, magnesium, potassium, everything that we’re talking about behind the scenes, but that might not get you out of an adrenal situation that’s dumping those minerals in the first place. So yes, more minerals, do the chronometer all that but you got to work backwards to Why are you dumping so many minerals in the first place? And another answer for that question is mold. I was up when I first got exposed to mold. I was peeing like three, four or five times a night and obviously I’m too young to have prostate issues. So it wasn’t my prostate. And as soon as I started going higher dose with the binders. I started sleeping through the night and I was not peeing as often through the night and that’s because okra toxin damages and affects the kidneys. And one of the ways of excretion of the mycotoxins is through the kidneys and through the stool, so I was definitely pooping more and definitely paying more which is good. My body should do that. But man, you talk about parched I mean, was like a camel in the desert. I mean, I could not get enough water. It was ridiculous.

Dr. Justin Marchegiani: Yeah. And you had to know if it’s a prostate issue or not, because usually prostate the swollen pneus of it’s going to prevent good flow. So you’re constantly going into the bathroom because you never get a complete evacuation, right? So you’re always trying to finish off that first piece. So with your situation, you probably had a lot of flow and a lot of stream and a lot of, you know, volume, but it’s just you were dumped. You were just chronically dumping out that toxin via your kidneys.

Evan Brand: Yeah, and I’m much better now. Like I said, I’m not up in the middle of the night anymore. So that’s something else to consider. If you’re listening to this and you’re up in the middle of the night. Let’s say you do start out with the coffee, but then you’re doing electrolytes through the day, but you’re up three, four or five times a night peeing. You know, you’re dumping minerals there too. So you kind of have to address that and figure out what’s going on. 

Dr. Justin Marchegiani: Yeah, I also find just the adrenal dysfunction alone can can cause that because when you have a lot of adrenal and aldosterone issues, aldosterone helps you hold on to your minerals and without it, you’re going to dump it so you’ll just pee a lot more in general with adrenal issue so yeah, it’s possible there could be a mold thing. It’s also called possible, the more than likely thing is just adrenal issues in general, just from stress and food and whatever else. So that’s why you have to see someone that can evaluate it. Because Could it be a mold issue? Sure. Could it be just an adrenal issue from poor food and gut stress and just, you know, poor diet and lifestyle? Sure. So we have to really evaluate both of those. Now, I want to go back to one thing you mentioned, I think this is really important to dive into. So blood testing for adrenals. So Evan highlighted this a little bit already. So blood testing is very helpful on the adrenal side to look at pathological level. So if we look at like an am cortisol serum, if we see it very high, that could tell us there could be some definite adrenal excitability. Now high levels of cortisol is Cushing’s right we remember that because Kush, we think push right Cushing’s we’re pushing cortisol really high Cushing, we’re pushing cortisol really high. So if we see high levels of cortisol on a blood test, it’s you know, we’re in the top 20 25% we’re thinking okay, there could be a problem with that, right? Why don’t I like that because People by nature don’t like getting pricked with needles. Okay, so some people just go into the doctor’s office, they could get a lot of cortisone adrenaline going in their body because of that needle prick. And then that’s going to cause a false high reading. So I don’t like it because you can get a lot of false high readings. Number two is, I do a lot of the Dutch test. And I liked the Dutch testing, because I can look at cortisol serum total via the urine. Now I like it for two reasons. One, it’s not a big stressful thing to collect that right, it’s not a needle prick. So you’re not creating a lot of stress during the extraction process. Number two, we can collect that total cortisol throughout the whole day. So we’re not just looking at cortisol as a snapshot in time, we can collect the cortisol throughout the whole day, which gives us a better window of your overall cortisol output for 20 hours. So if we see higher levels of cortisol over 24 hours, we know that this probably isn’t a blip thing. This is probably a more stronger pattern of adrenal dysfunction when we see that and that test can also separate the free cortisol out which is What Evan highlighted earlier, that’s the more bioavailable cortisol. So think of free cortisol, two to 5% of cortisol free, this is the cortisol that’s not bound to a protein. Think of that as if you’re a woman and you have your purse, right? And you have a key in your hand and you’re putting that key in the lock, right? The key in your hand, that’s the free cortisol, right? It can work, it can go into the lock, think of the other 20 keys in your purse, or your back pocket if you’re a guy, right? I remember like back in school, there were these janitors that walk around with these key chains were just like huge, right, like massive t chains. So imagine the key in the hands, the free cortisol, the key in the back pocket or the purse. It’s the total cortisol or the serum based cortisol meaning you have it you’re carrying it around, but you can’t quite use it to open the doors. That make sense.

Evan Brand: Yes, it does.

Dr. Justin Marchegiani: Okay, so that’s another Rolodex analogy on the cortisol side. So we can swap one today, right? We can swap one. So in general, cortisol can be an issue and we have to know the right way to test it. So blood testing really good on the pathological side. If you I have a lot of people that just come in with these data already. And if I see someone in the top 25%, I’m like, ooh, could be a problem, right? Or someone in the bottom 25%, that could be a problem, we’ll still do further testing. But you know, there’s a lot of data that comes in. So we have to know how to interpret it either way. So cortisol, we know about it, high or low, could be could easily affect the adrenals. High levels of cortisol, you can still dump minerals, right? Because you’re buffering it for the stress, low cortisol, you may not have enough aldosterone function, because the same area of the adrenals, right? The the the cortex of the adrenals, right? That is the same area Well, dosterone is made. Right? It’s right there. So if you have weaker cortisol area, there could be weaker aldosterone. So it’s good to know that on the testing.

Evan Brand: Yeah. And there’s a lot of people that poopoo this now and they say, oh, Adrenal Fatigue is fake. Adrenal Fatigue is a myth. That kind of thing. We’re not saying we’re not we don’t even use fatigue anymore.

Dr. Justin Marchegiani: Right makes sense, because the functions are better terminology.

Evan Brand: Because that kind of insinuates that the adrenals are tired. And that’s not true. It’s really more of a brain issue that’s kind of down regulating this process. It’s kind of like, you’ve been running from a bear for so long, and you’re starting to eat away all your muscle tissue. Because cortisol is catabolic, it’s breaking down the gut barrier, which is why we see so many gut issues and like CrossFit athletes and stuff like that. It’s breaking the body down. So eventually, the brain has to come in and say, hey, we’ve really got to kind of down regulate this guy system. He’s really been running from the bear. She’s really been running from the bear for so long. So to those people like, mad at us right now, Adrenal Fatigue is a myth. Oh, my God, how dare you guys, you’re charlatans or whatever? People say, No, it’s not fatigue, it’s dysfunction. And you have to support the brain. And you got to support the gut. I mean, the whole system, rarely do we come in. And this is just a, quote, adrenal protocol. It’s going to be a whole program designed to fix the issues that are stressing the whole system in the first place.

Dr. Justin Marchegiani: Yeah, so I always tell people when you’re working with the practitioner, Right, you always want to talk about certain things are going to be used as a palliative way to kind of get you feeling better, and to jumpstart physiological and biochemical pathways, and other things are going to be root cause and a lot of times they work together, right? So if I work in support your mineral levels, right supplementally if I work on supporting your adrenals while we get your sleep better, while we change your food while we look at infections, while we help with digestion, and good diet and lifestyle strategies, that’s what promotes the healing overall. It’s kind of like if you if you go and you have to jumpstart your car, right? Well, why the heck are you jumpstart in the car? Well, because I didn’t turn the light on in the car, right? Well, okay, so the root cause is we’re going to make sure that lights turned on moving forward. But if we always leave the light on, then you jumpstarting the car’s a palliative issue, right? It’s not a root cause issue. So we’re always doing palliative things in together with root cause things. We always combine the two because a lot of times, that’s what pulls people out of it faster. If you just focus on it. Cost stuff, it takes a lot longer to feel better. And people need to feel better fast to be compliant and get paid. Yes.

Evan Brand: Yeah. I mean, and that’s something that you learn clinically. So when you have people that just write blog articles or do podcasts, but they’re not working clinically, they don’t understand that so they’ll come in and, and I’m not calling anybody specifically out, but just this idea I’ve seen on the internet where or people say, Oh, you know, this whole, it’s a myth. You know, just take adrenal support, you should need it data. Well, here’s the deal. Like if someone has gut infections, and they’re exhausted, and they have poor digestion, and they have no minerals and they can’t sleep. If we give someone calming an adaptogen adrenal support in the evening and maybe some stimulating stuff in the morning based on their, their adrenal profile, if they start feeling better, they’re going to be more motivated to cook because we’ve got to get these people cooking real food. So the adrenal support could be used to help them to stop going to the drive thru because they’re too tired to cook a meal for themselves. Now they have enough fuel in the tank, they can come home they can cook. Now they’re going to feel better because we’re getting More nutrient dense foods, they’re going to have more minerals so they may sleep better, they’re cramping or pain issues may get better. So you kind of have to give people some good functional medicine crutches sometime and there’s no issue with that.

Dr. Justin Marchegiani: Hundred percent. So the minerals are really important kind of getting back to our our clickbait thread of the day, enhancing energy for the summer. Why is it so important for the summer because with higher temperatures, you’re more likely to sweat and get and lose a lot of these minerals. So now if you’re stressed and you have adrenal issues and you’re drinking coffee to start the day, and you’re not adequately hydrating, you’re not getting minerals, and now the heat and the hot of the summer can really compound more of these issues. So you may notice more exhaustion, more fatigue, more heart palpitations or attack cardia or blood pressure issues either low or high. You may have all these different mood or energy issues, and that’s going to be exacerbated by the summer heat because the more you sweat, the more electrolytes you use. So just be very mindful of that. Starting the summer out is really make sure you start the day you get good electrolytes if you go outside, you know bring a nice bottle of extra electrolytes in there whether you put a trace minerals in there from Redmond Real Salt or you get a good Pellegrino or a good sparkling mineral water that has things in it, you know, make sure you’re on top of that. And then if you’re doing a lot of physical work, you can even come back in with a good post workout shake with some coconut water or something that has, you know, a little bit of extra glucose and potassium could be wonderful. And don’t forget about our favorite potassium source, which is going to be avocados, I mean, they got twice the amount of bananas. So people think well, you know, everyone thinks in general, Hey, what’s up but high potassium food, the first thing they jump to is bananas. Potassium is twice the amount in avocados which is great. That’s a good fat too.

Evan Brand: Give you a good reason gives you some good cassava chips and some nice guacamole with some lime or lemon juice squeezed in there we go.

Dr. Justin Marchegiani: Yeah, mango. It’s a great way to do it. Anything else you want to talk about in regards to the heat I would say people that are more photo phobic or sun sensitive could have adrenal issues too. So good adaptogen formula is always going to be our favorite, you know, additional B five and there may be some additional tyrosine and some our favorite adaptogens are going to be asked Wakanda and rhodiola ginseng and Aluthro and and maybe holy basil. And again if you have a lot of high cortisol issues you got to be very careful on doing too much of the stimulators too much of the Ginseng’s and things maybe too much you may have to focus more on Holy Faisal and and magnesium and ashwagandha to kind of really modulate the High Courts or maybe even phosphorylated, serine and Gabba. Those are all things we’re going to be more careful to use when cortisol is higher for sure.

Evan Brand: Yeah, omegas are key too. So I noticed that I don’t get as tan and if I’m not taking enough or eating enough fish or taking enough omegas I noticed that I burned more easily. So omega is are pretty helpful in that aspect. And then always looking for a deeper cause to because with good weather people are hopefully outside more and unless you’re in like New Mexico where our friend JW lives where he says he hasn’t seen a tick in 25 years, which is ridiculous. A lot of places have ticks and if you’re getting tick bites, you know even The CDC who underestimates the numbers they estimate 300,000 new cases of Lyme, per year in Lyme and co infections like bartonella, or babesia can cause a lot of issues with temperature regulation problems. So if you’re somebody who you can’t handle the heat, but your friend next to you feels fine, but you’re burning up and you feel like you’re gonna die or pass out in the heat. You know, it could be minerals could be low hanging fruit, but we’re always looking deeper because for me, before I started treating myself for babesia, I had extreme temperature regulation issues, I would just be chilled to the bone in the winter, and I could not tolerate the heat in the summer, once I addressed the babesia. And I’ve had so many tick bites over the years, probably 2025 tick bites over my lifetime, even probably more as a kid I lost count, but, you know, I’ve been exposed to all these pathogens, unfortunately. But my temperature regulation system works a lot better now. So I would just encourage people that if you feel like the odd man or the odd woman out everybody’s fine when it’s 85, but you’re dying, you know, address the low hanging fruit that we discussed, but you know, feel free to reach out To a practitioner like Dr. J or myself and we would love to help you and make you resilient because it sucks if you’re trapped inside in the air conditioning because you can’t handle the heat that’s not a way to live in the summer. I like air conditioning, but I don’t want to have to use it if I want to be out in the sun I want to be out in the sun having fun. So if you need help, please book a call with Justin at, and if you want to reach out to me my website, We work with people around the world, we send lab test to your door, you send them back to the lab, we do a follow up call to discuss the results we make your protocol to feel amazing. So that’s what we do.

Dr. Justin Marchegiani: 100% really appreciate it. Again, if you guys are enjoying this content, share it with friends or family most important thing is you take one or two things to apply out of this content and make yourself healthier, the healthier you are the better boss or employee or employer or mom or dad You can be to your community and to your family. And that really kind of spreads the wealth right across the board right? healthier people make better decisions, better decisions help the world so I think we’re on the right track there. If you guys enjoy the content, give us a thumbs up. Give us a share. Put your comments down below, let us know your experience with electrolytes and adrenal dysfunction and things that you’ve done that have helped. I really appreciate it. And Evan, fabulous podcast, man, really appreciate the content and the great back and forth, man.

Evan Brand: Yeah, oh, last thing, we could do a whole nother hour on it. But blood sugar. Make sure you address blood sugar. I tell you, I don’t feel as good. I get weak. I get woozy if I’m having a blood sugar crisis. So I’m not saying you got to prick your finger every two to three hours. But I’m saying you got to make sure you’re getting adequate fat, adequate protein. And especially if you’re moving more, you’re going to be kind of burning through those reserves. So you’re not sitting there reading a book, like you’re in the winter, you’re out you’re moving. So you may need to increase calories, increase fat, increase protein, if your blood sugar’s crashing, you’re going to feel weak, you’re going to feel depleted, you’re not going to feel good.

Dr. Justin Marchegiani: If you’re having a lot of chronic electrolyte issue, there’s probably some adrenal issues as well. So it’s good to have breakfast in the morning. Don’t do an intermittent fast if you’re having a lot of chronic electrolyte issues. Once you’re more stable and you’re feeling better in that department feel free and go do that. But until then, really make sure you’re having a good breakfast in the morning and even myself, right? I’m doing coffee, I’m doing 2025 grams of collagen protein, I’m doing some butter fat in there I’m doing I’ll do a glass of celery juice in a minute. So I’m still getting, you know, kind of a more of a liquid breakfast because I just like a liquid breakfast in the morning. I like feeling lighter. But then I’ll also make sure I get the extra potassium and good fats and proteins through a good through my coffee, so I won’t just do coffee by itself. I’ll combine it and again, if you’re caffeine sensitive, feel free and use a decaf or a decaf tea. And you can do the same kind of a model with that as well.

Evan Brand: Yep Awesome. Awesome. Well once again, the links you need to reach out, we’re very grateful for the opportunity to help you guys so take good care and we’ll be in touch.

Dr. Justin Marchegiani: Excellent. Take care. Bye. 

Evan Brand: Bye now.


Audio Podcast:

Conventional GI Workup vs Functional Gut Health Program | Podcast #297

If you’ve ever wondered how functional medicine differs from everyday conventional medicine, this is the podcast for you. Dr. J sets out to explore conventional medicine GI workup vs. functional medicine gut-health workup. It’s a compare and contrast while looking at what chronic conditions may be missed by conventional medicine. Check out for more info.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, they cover:


0:29     Gut Issues, H. Pylori

7:49     How Are These Detected?

18:04   Tests

24:16   Compare and Contrast of Treatments

32:10   Saliva Secretions

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here really excited today we’re going to be having a phenomenal podcast on the topic of conventional medicine, gi workup versus a functional medicine gi workup. We want to just kind of give you guys a little compare and contrast and talk about where others shine and where others may be better, especially for most people who have chronic health challenges that may be missed by your conventional medical workup. Before we dive in, Evan, how are we doing today, man?

Evan Brand: Doing really well, this podcast started with a story. quick story. The best man in my wedding. He called me last night and Hey, how you doing? Everything’s good. Okay, awesome. And then hey, I need some help with my wife. She’s been having a lot of gut issues for the past several months. She went into conventional doctor then went to a I’m assuming she went to some type of a specialist. Gi probably I told them about her issues which were bloating, major abdominal cramping, cramping, and pain, floating stools, possibly some changes with mood, but I don’t know if that was brought up to the doctor. So just conventional gi stuff and some pain that was radiating to the back. So pain in the front that was in radiating to the back. And her protocol was no testing. I don’t even think they did palpation they didn’t do physical exam. I think it they just listened. And then they said, okay, buy this probiotic. This probiotic was something that you and I looked up. It was one strain of bacteria in the bifido family, and it was loaded with fillers. And it was what’s considered a consumer grade product, meaning you don’t have to be a practitioner to get it. And it was just loaded with garbage fillers and sugar and other stuff. It had sucrose like why do you have sucrose so that was it. So that was it. And so then When you and I called this morning, I just said, Look, we’ve got to cover this because she got nowhere. And she spent all this time sitting in a doctor’s office waiting. And now she’s no better off. So I talked with her for a little bit. And we made a protocol for her that I think is going to be far, far better.

Dr. Justin Marchegiani: That’s great. Yeah. So really excellent. And when we see patients on the functional medicine side, most have already gone through a pretty thorough, conventional workup. So, you know, my perspective on a lot of this, not that I’m a trained gastroenterologist, not we’re functional medicine practitioners. But I see lots of patients who have already been through the gamut. And so I really try to understand what’s already been looked at what’s been tested, and you see a pattern, you know, when you see a couple hundred patients kind of go through these intense workups you see a pattern of what’s already been done, and you can kind of see what’s been missed, or kind of what their perspective is. So, most conventional gi doctors, you know that these are ones that are not functional medicine and nutritionally change right 90% are going to be in the conventional Category right there just following the typical internal medicine gastroenterologist, kind of best practices workup. So most are coming in they’re doing a history, they may do a physical exam some kind of a palpation to see where inflammation may be in the intestinal tract right certain areas may lead them to think certain things right, upper left quadrant, right my left that could be stomach kind of things maybe pancreas things, upper right. Could be more on the gallbladder liver area, you know, bottom, like mid left could be more spleen, bottom right mid right could be more intestines, and then lower right lower left could be either appendix on the right could be colon ascending on the right, descending on the left sigmoid colon on the left so that you kind of get a decent area. If you just know the general anatomy of what the inflammation could be Now, the next step is going to be depending upon you know, how invasive that things need to go right. They may recommend a capsule or endoscopy just to get a window. What kind of inflammation is in the intestine and then almost always though, they may need to go deeper into an actual endoscopy which is scoped down the mouth. Alright, colonoscopy is going to be scoped up the rectum to look in the colon area right you have your sigmoidoscopy, which is the last part of the colon before, stool goes into the toilet. And then you have all the way up the different intestinal tracts in the colon, right you have your descending your transverse or ascending and then on the upper side, you have your tummy. You have your tummy on the endoscopy, and then you have the first part of that small intestine. So obviously on the colon they may be looking for if you’re older, maybe polyps, which could be precancerous, they may be looking at inflamed tissue. It could be inflamed tissue from a ulcerative colitis when maybe there’s bleeding. It could be inflamed tissue from Crohn’s disease, which may manifest a little bit differently higher up usually, and usually there’s some level of skip lesions we’re all sort of colitis may not have that on the upper side. There could be ulcers in the stomach, right? Those are all possible things. And then there may be other tests to look at the levels of blood there may be things done like a fecal occult blood, where they’re testing microscopic levels of blood in the stool, maybe looking at calprotectin, which are inflammation markers in the intestines, maybe doing a barium swallow to look for any fistulas or blockages or even bleeding. On a barium swallow those are all like conventional things, they may pull out a ultrasound to look deeper at pancreas or gallbladder or liver, if some of that area comes back and flame or to even monitor monitor some of the krones type of inflammation. Some of the more progressive gastroenterologist are starting to do more of the breath testing, the lactulose breath testing, which may look at hydrogen and methane gases. Some may even do a glucose type of breath testing, it looks at more of the bacterial imbalances in the stomach. These are all other more progressive, forward thinking kinds of functional medicine, functional GIS, maybe doing that. Not a lot do that though. Then after that you have your conventional blood tests which could look for inflammation or immune cells or calprotectin. Or actually no calprotectin has to be in the stool but you could look at C reactive protein, you could look at immune markers, right. You could also look at the blood, you could just look at red blood cells, hemoglobin, hematocrit, iron, because if you’re losing blood, you may see it on a panel like that as well. And then some may also do stool testing. Now they may do more of your conventional stool testing that is less accurate, less specific, maybe not the more cutting edge DNA testing that’s looking for microbes that are more sensitive level parasites, H. pylori virulence factors Candida sibo bacterial overgrowth, right elastase deatta krijgt elastase is an enzyme markers, the adequate amount of digested fat marker. So these are things that they they’re typically not going to look at that we’re going to really dive in deeper because we’re doing a real functional assessment for what’s happening in the gut conventional medicines more looking at a pathological assessment, where we’re looking at PE, here’s optimal digestion what’s functionally not working compared to optimal, because there’s a big spread between, you know, being functionally optimum, and being disease and pathological is a big spread. So the problem is a lot of people are in between, this is where a diagnosis happens. This is where optimal is maybe somewhere in between that area and they’re just not going to get picked up. They’re not going to get assessed or found. And that’s where most 90% are going to be in no man’s land. In regards to their assessment or diagnosis, now we can go into treatment next, but I’m going to just pause there and give you a chance to comment.

Evan Brand: Sure, yeah. Good. Good overview and H. pylori breath testing is sometimes done. 

Dr. Justin Marchegiani: I forgot H. Pylori. I’m sorry. Yes. H. Pylori as well.

Evan Brand: Yeah. So that’s something where, you know, if we, typically what Justin and I are doing when we work with someone is we’re going to have them send us any labs that they’ve done. Maybe the last six months, maybe a year. If We think it’s still relevant. And we’ll take a look at it. So each problem our breath testing will see those. But the truth is that there can in with all these conventional, less accurate tests, there can be an issue with false negatives. So that’s even more frustrating for the client or the patient because they come to us. They’ve got five or six things they’ve done with the GI people, and they still don’t have any answers. And of course, they don’t have any action plan or protocol. So for me, before I figured out that I had h pylori and parasite issues I did the barium swallow, you drink barium, which is terrible. It’s like drinking chalk. And then you go and you get an X ray. I was having a ton of gi burning upper gi burning so that’s where they did the you swallow it and then you basically lay back they then X ray you and try to see what was going on. And, of course, I wish I didn’t have that done because it wasn’t functional. And it gave me no answers. And all they said was Yeah, you may have some inflammation, they just call it idiopathic gastritis and then they send you on your way. No, yeah, meaning Idiot gastritis we don’t have a clue. And then they gave me the recommended acid blocker and the anti spasmodic and sent me on my way. And I said, I’m not taking them, don’t even give me the prescription pad, I’m not going to take it. And then Luckily, I was able to do functional testing, which then confirm the bugs that I had. So, so I’ve been there, I’ve been there, done that, and you made a great point, I just want to kind of restate it in a different way just to make people make sure people are clear with it, which is this this huge, wide, like you call it a spectrum, the spectrum of all the way over on one side is death disease, celiac krones, just like some sort of like you said, a pathological diagnosis. And then on the other end is like optimal gut health. And you could be so far down this hole, very, very close to pathological level of tissue destruction in the gut, but still not enough to technically be celiac or be krones or be this or that. So until you get to that level, to the conventional world, you’re fine. You just got to keep that Go and keep going, keep going until you get to the level of tissue destruction where you could say you are celiac or Crohn’s or pain, colitis or whatever. Now we can prescribe you this drug. And that’s it. And I’ve actually had doctors tell some of my clients during their workups Hey, sorry, you’re not there yet. You’re not bad enough yet. You’re not sick enough yet. We can’t do anything until you get to this point, like with thyroid, you know, your thyroid is not destroyed enough where we’re gonna put you on this drug or we’re going to cut your thyroid out. So just keep living as if you’re living now, once you’re bad enough, then call us back and we’ll cut your thyroid out or we’ll cut out your colon. If it’s diverticulitis. We’re going to wait until you’re in really bad shape. We’ll go ahead and do surgery. Let’s cut a foot of your intestines out. Yay. No, that’s not the answer.

Dr. Justin Marchegiani: Exactly. And then just to kind of echo on it because we see a lot of H. pylori, and conventional medicine may do a endoscopy for that where they’re taking a sample in the upper intestinal tract view the scope, they may do a stool And that may or may not pick it up. And then they’ll typically do the breath testing and like there’s different kinds of breath testing, as I already alluded, right you have your lactulose, which is going to be more your cebo breath tests, it’ll look at hydrogen and methane. You have your glucose, which may look at upper intestinal, upper gut, stomach type of bacterial overgrowth, right lactose takes about two hours to work through the full stomach, the small intestine, so anything after two hours is usually a pretty good window into the colon, because that’s where lactose starts to get absorbed by the bigger, bigger bacteria in the colon. But glucose tends to get absorbed a lot faster in that first, you know, 20 to 40 minutes so it gives you a better window of the stomach. And then you have your h pylori breath test where they’re giving you like it’s a urea breath test, they’re giving you like a urea tablet or a urea solution. And basically, the H pylori in your stomach will take their urea, right because typically how h pylori works, that makes an enzyme called urease. And that method analyzes the urea and the protein into ammonia and co2. So when you give that urea, the H pylori will convert a lot of it into co2 and ammonia. Ammonia has a pH of 11. So it’s very alkaline so that throws off your stomach digestion and lowers your stomach acid, but it also spits off a lot more co2 than in their mess. They’re they’re measuring high amounts of co2 to get a window if you’re positive for H. pylori on that conventional H. pylori breath test. So they’re looking at three things. Typically, they’re looking at breath, maybe a stool antigen, which is the stool under a microscope, they’re looking at maybe an endoscopy, if it’s more serious to rule out gastritis or ulcers, and then maybe a blood test with a look at like an IGG, IGM, or IGA. And it G’s more of a long term marker, so you really want to request an IGM IGA to see if it’s more active and acute. So those are the big things that they’re going to be looking at on the H. pylori side and I just say that because h pylori is a big thing. We find a lot and can be a problem in a large percent of the population after 30 to 50%. And then I would say things like Candida or a fungal overgrowth are very rarely looked at or assessed and will typically look for that in the stool. And we’ll also look for that in the urine via a functional DRAM and a tough test. So we’ll look at things with a good functional stool assessment. We’ll also maybe do that cebo breath test that lactulose SIBO breath test. Now most conventional gi Doc’s don’t do it. There are some like for thinking conventional MDS that are gastro docs, like Dr. Pimentel at a cedar Sinai, he started making more of the breath testing more mainstream on the conventional side, which is good, which is excellent. But still, a lot of conventional Doc’s aren’t even doing it. So we’ll do that. We’ll look at it we’ll run the more progressive sensitive DNA stool tests. And that will also look at the urine test which can look at bacteria in the urine and it can also So look at fungus in the urine, the [inaudible] or I can look at the hippo rate and the indicator which is a marker for bacterial overgrowth, as well as protein putrefaction not breaking down your protein. So benzoates another big one. [inaudible] in a tick is the fungus. And those are HIPAA raised another big one, there’s a couple of 2 phenylacetic acids. Another big one is about 10 markers that we’ll look at for bacterial overgrowth on an organic acid.

Evan Brand: And none of the stuff that we’re going to do is going to be invasive at all we’re going to get into kind of the, you know, compare and contrast some of the treatment options to we have regarding the testing the stool that we’re going to do, it’s an at home stool test, it’s going to be way more accurate. I’d like to put a number on it and say 100 times more accurate and sensitive but I don’t know the exact number. I would just say that. We’ve had hundreds and hundreds of people who’ve done conventional testing through their practitioners, they show up with nothing, even like doctors data has missed in fact For example, but there’s DNA stuff that will run will find or fill in the gaps where the other testing failed or lacked. So that’s going to be the at home stool testing, and then the organic acids testing. That’s amazing. I mean, that even find stuff that the stool test doesn’t find like the yeast overgrowth, and it’s all done at your house. It’s amazing. Nice.

Dr. Justin Marchegiani: Yeah, it’s very, very nice. It’s non invasive. I’ll tell you the problem with a lot of conventional medical assessment, if they’re doing a breath test, fine. If they’re, you know, obviously a good pal patient is really nice, especially when it’s acute, conventional medicines really good at finding Irritable Bowel Disease, like you know, krones ulcerative colitis, or something more like an ulceration. If you’re older that can be helpful at like precancerous polyps, but even that they don’t address why those polyps grow. That’s another conversation. So they’re really good at finding those kinds of things. But the question is, how do we get there is that underlying cause being addressed a lot of times it’s not, and then a lot of times it’s being managed with ppis proton pump inhibitor. Maybe a corticosteroids, some kind of like they have like natural coating products that kind of coat the gut but still don’t fix the underlying issue. May maybe Imodium or some kind of antispasmodic, or anti nausea medication, especially when IBS is a diagnosis because a lot of IBS type of diagnoses or diagnosis of exclusion, meaning they’ve ruled everything out, therefore, they give you this diagnosis, which means, hey, you have some symptoms, but we have no idea why it’s cost or what the causes so they give you this diagnosis, you feel comfortable that you got a label, but that diagnosis is a diagnosis of exclusion. It’s you rule these things out, therefore it has to be this that tells you nothing about the underlying cause. And you’re still recommended just certain medications that control the symptoms, and may create more problems over time. Like if you’re on chronic acid blockers, you’re going to have issues with minerals, and digesting protein and digesting fats and over time, you can have some serious nutrient deficiencies for sure.

Evan Brand: And then you can have mood issues, you’re gonna have sleep issues, because now you’re not making neurotransmitters from the amino acids. So now you’re irritable, you’re anxious, you’re depressed, you can’t sleep at night, and your guts still a wreck. And that was me. And I got the diagnosis of IBS and it was nothing but drugs. And back to my friend’s wife. So they recommended that we talk about that probiotic. It was just one strain, and it had a bunch of garbage fillers in it. They also, of course, told her to eat more fiber. And this is a woman who’s basically pescatarian and she’s eating cooked organic vegetables for almost every meal, I’m like, wow. So they told you eat more fiber? Did they even ask you about your diet? No, of course they didn’t. They didn’t ask you what you’re eating. I mean, vets are better at helping with gut issues. And dogs then gi dogs aren’t helping with gi issues in humans. Why? Well, because the first thing you do when you go into the vet, what’s the vet gonna say? Oh, what kind of food are you feeding him? You go and you take your puppy and oh, my puppies, you know got diarrhea. Oh, what are you feeding your puppy? But that’s not the first question that gi doc asked. Now It’s not the first question we asked either right boy definitely in our it’s definitely in our workup.

Dr. Justin Marchegiani: Oh it’s something that’s going to be going to be asked on day one is one of the most important things for sure. But kind of getting back to the conventional Sykes I really want to give conventional medicine it’s Do you know hat tip where it’s good, it’s really good at a lot of these conventional, you know, irritable bowel diseases or extreme ulceration, they’re just still not good at getting to the underlying issue. So let’s say you have an Irritable Bowel Disease, right? They may give you something like a lialda or mesalamine or a corticosteroid or a biologic or an immunosuppressant or some type of antispasmodic or Imodium just something to manage those symptoms. If it’s bad enough, they may give you chemotherapy like a methotrexate, something like that. They may do deeper testing like a CT scan, if they’re looking at things or a MRI, which doesn’t have the radiation CT has the radiation they made. They made a deeper testing for that. A lot of times they’re still going to want to go inside Do that colonoscopy or endoscopy for sure, which has its own host of issues because you typically have to be under anesthesia for those, okay? And anesthesia has a major negative impact on your gut flora. And sometimes they may even want you to be on antibiotics post treatment sometimes. So it just depends upon the doctor and kind of your situation. But the anesthesia could have some negative impacts on it. And there’s some data it’s more controversial now, but I’ll put it out there. But there’s some data talking about the fact that the equipment that is used to do a colonoscopy, the cameras or endoscopy cannot fully get sanitized due to the sensitivity of the equipment. It can’t fully get sanitized. Therefore, there could be some potential fecal debris on there. from a previous patient. It’s possible right? It’s more controversial.

Evan Brand: No, I don’t think it’s controversial. I’ve seen it for years man, they call them  HAI- hospital acquired infection. It’s huge. It’s one of the leading causes of death in hospital setting is an infection that you pick up by getting a routine procedure done. I actually had a woman who had this happen, and she developed major, major major c diff infection. So she had issues before. You know, she was having a lot of stomach pain, a lot of burning. She went in, went to the gastro, they did the endoscopic, the endoscopy, and let’s go. And after she got home, she had endless, endless, almost to the point where it killed her diarrhea. And I was like, oh, that doesn’t sound good. And guess what she had Clostridium difficile, also known as C diff. So then what happened? She gets the conventional GI Doc’s to prescribe her antibiotics, very, very strong antibiotics. However, C diff is just one of the major bacterial infections that’s become resistant to the antibiotics. The CDC has been warning this about this for years. They now call what we’re in now is the post antibiotic era. Just look up CDC post antibiotic era, you can read about it. And so this woman still had seed if she did the antibiotics, she killed off any remaining good bacteria. And she was still miserable. We ran the testing on her confirmed the C. diff was there via urine and stool. And then we used anti microbial herbs. And guess what, we got the woman better. We got the C. diff gone, and she was fine. So I’m glad that you pointed out they are good at finding stuff. That’s pathological. But yeah, and then they’re not going to tell you why you have Crohn’s and they’re not going to put you on an autoimmune Paleo Diet like we are.

Dr. Justin Marchegiani: Exactly, they’re not going to do that. Now, just to kind of highlight a couple things here. We talked about the hospital acquired infection, there’s also a chance of, you know, rupture, or, you know, poking the hole with with the cameras that are going into your, into your throat or into your rectum as well. It’s always a possibility. So the nice thing about some of these, the assessment and testing that we do, there’s no chance of any side effects, which is excellent and there’s no chance of disrupting your floor either with anesthesia or swallowing radioactive solution, right? So it’s nice to have an assessment that doesn’t really have a chance of causing any more problems. And it gives you that full spectrum because remember, on the conventional medicine side unless there’s this much inflammation on the scale, here’s optimal. Here’s a diagnose visible condition. There’s a large gap here. And if you’re somewhere in this gray area, this is the gray area where the doctor says, Hey, we can’t help you. Hey, it’s all in your head, hey, you’re just getting older. Here’s a prescription for an antidepressant. Like literally, these are things that happen after the fact and there are some doctors that are saying, Oh, well, here’s a probiotic, like you mentioned with your friend that called you and they recommended a crappy antibiotic right now. Hey, that’s better than jumping on the anti depressant, right? That’s at least a good step in the right direction. I appreciate the thought right A for effort, but outcome Not quite. And so the people are starting to wake up a little bit and I think people are under doctors are understanding that patients are going above and beyond and they’re reaching out the doctors like so some not a lot are striking. Trying to get through games stepped up for sure.

Evan Brand: Yeah. And the other story I had in my head, I may have mentioned this for but a male client of mine, he went in and got an endoscopy. And I don’t know exactly what part what material, what piece of the equipment, but anyway, he has a piece of equipment stuck in his body. And he has to go, he has to go in for surgery now to get that piece of equipment removed. And he just went in for a routine scan into scope. And now he’s got something stuck inside of him. And now they got to cut them open and get it out versus we’re having you wake up and pee in a cup at your house and mail it to a lab and we’re getting hundreds of biomarkers from that. And we’re having you poop into a tray and you scoop that into the collection to and you’re also doing that at home. And you’re sending that into the lab. So I mean, just in terms of ease, and you know, I’ve we’ve talked with quite a lot of few people who they’re worried about their immune system, so they don’t want to go around the hospital anyway, where there may be people that they could get exposed to COVID Yeah, so We’re saying, Look, don’t worry, you’ve never had to go anywhere. And with our practice, you still don’t have to go anywhere. And we’ll still mail you everything. You don’t even have to go to a pharmacy yet to pick it up. We’re going to mail you what you need to your door. So that’s fun, more convenient for sure.

Dr. Justin Marchegiani: Love it. But we did a pretty good job. Now we’ll just kind of compare and contrast a lot of the treatments, right? Because I have my six our protocol on how we work on digests or work on supporting someone’s health. So of course, gastroenterologist are typically going to make zero recommendations on food. Now some of the more progressive ones may say, hey, cut out gluten dairy, refined sugar, that that could be common that a lot of times, that’s not going to be enough, or they’ll recommend a conventional low fodmap diet, which could still have other grains and other inflammatory foods in it. So that still may not be great. So we have kind of our own special kinds of diets that we use, whether it’s a specific carbohydrate diet, cutting out females, salicylates, whether it’s not immune diet, which is kind of paleo plus, right, paleo. No grains legumes dairy right on the immunes no nuts seeds nightshades eggs we may do a keto we may do a carnivore we may look at cutting out histamines and a lot of different dietary templates that we have used thousands of times and we kind of know where the best ones to apply are, that’s important because nine times out of 10 your conventional doc won’t even touch that. Okay, next up is we’re going to recommend digestive support. Now your conventional Doc’s more likely to prescribe an acid blocker than anything to help improve digestion. Now, an acid blocker may be reasonable if there’s an ulcer or an acute ulcer. Now, a lot of times also like pain can improve with digestive support. So there’s also like pain we make ask to try a tiny bit of acid, the tiniest amount, maybe a teaspoon, or an eighth of a teaspoon of ACV or lemon juice. If that causes any irritation. We can all assets we just lean on enzymes. We just lean on maybe some bile salts and then we work on adding in extra healing and soothing nutrients to help support the gut lining conventional Medicine are not going to recommend any healing soothing nutrients, they’re not going to recommend glutamine, aloe, dgl, zinc, rising carnosine, they’re not going to recommend any of these high quality nutrients to help support the Go on.

Evan Brand: Let me point out to if you’re putting anything with acid on the shelf, it’s on the shelf temporarily, we’re likely going to bring that in at a future date where, you know, I got into the debate with the GI doc back in the day, and I asked her, Well, why do I feel better when I do extra acid and extra enzyme? She goes, No, that’s not possible. I’m like, I take more stomach acid, the more stomach acid I take, I feel better. I have less bloating. I have less gut pain. Nope, that’s not possible.

Dr. Justin Marchegiani: Okay, that’s someone that does not have an understanding of physiology, right? Because physiology tells us the more stressed and inflamed we get, the more our sympathetic nervous system is activated. Where does that jump blood to? arms, fingers, feet, why run, fight flee. So all that goes away from the intestine so we have a decrease in our digestive juices and we have a decrease in acidity because that’s part of the juices that are produces and then the acidity triggers enzymes to be produced. So if you have any type of acid irritation, unless we’re coughing up blood, or we have an active Oh sir, I always recommend adding a very tiny bit because sometimes, least half the time, it can make it better. Sometimes the mucosa is so raw that it can’t handle it. So if that’s the case, if we can’t handle it, we lean more on enzymes and healing soothing nutrients. If we can’t handle it, then we just gently taper it up. And again, we’re typically recommending a stool test that’s going to look at old cold blood. So we’re going to get a really good window if there’s blood in the stool or run a conventional blood test that will look at red blood cell hemoglobin hematocrit and particular sites, okay, particular sites or young, immature red blood cells over losing a lot of blood. Guess what goes up particular site. So if we see a lot of particular sites that could be a sign of blood loss. Now, women could have that because they bleed a lot men straight Why’s and have a lot of estrogen dominance? So you have to understand the context of what you’re testing. And when.

Evan Brand: Yeah, good point, good point, the calprotectin we are going to be looking at so that is one marker that does have good overlap from conventional to the functional side. We love looking at calprotectin that’ll kind of give us a clue on just how inflamed is the gut? And is it possible that we could throw in a little bit of acid right away, and I’ve had people that they have had high calprotectin. And we were able to still do a low dose, maybe two to 400 milligrams of patane. And that was enough to really calm things down and improve their digestion so much that we then infer that the malabsorption was creating the inflammation in the first place. And all we did is help them break down their foods better and then the inflammation always drops. It’s so fun to see that I’m sure you get the same high from it that I do where you see high calprotectin you’re like well look at this number. It’s scary. We don’t like it. Yeah, protocol, retest boom, look at the levels drop. It’s so satisfying.

Dr. Justin Marchegiani: Yeah, I would also say a lot of the inflammation and the irritation that is in the inside. decimal track can be from poor digestion. So the food purifies it ferments, it runs cinephiles, it basically rots inside your intestines, and that creates his own host of acids that can be irritating. And sometimes taking a little bit of a digestive acid can decrease the rotting acids from the food. So that kind of thought process is a little bit of acid can decrease the production of more acids from the rotting of the food. And big big clinical pro write this down. I always recommend taking acid with food already in the stomach. People can have false positive ulceration symptoms with HCL by not taking their HCL with food and that’s protein and fat. So I always like protein and fat on the bottom of the tummy kind of coating it and then we’ll typically come in if we’re on the fence with a 16th to an eighth of a teaspoon of ACV or lemon juice, tiny bit and some water just a tiny bit and then that’s a good first step because if you can handle that, then usually you can work your way up. If you can get to a teaspoon to a tablespoon, then usually we can start to add in supplemental HCL and go from there. But worst case, if we can’t, or we’re just being more conservative, we just lean more on enzymes. We go to the gut healing nutrients, and the third are repair right repairing the hormones and the gut healing nutrients where we support a lot of the adrenals. and stuff as well. We need testing for that. The fourth RS where we come in and knock out infections. Most people on the conventional side the antibiotic is prescribed first, not fourth. So we set the table so we can go in there and deal with infections better. And then we’re using herbs that have more of a broad spectrum, but I’m more selective for the bad critters versus the good guys, which don’t create as much of a rebound overgrowth, and then we deal with repopulate rynok good bacteria and we’re not doing just to defeat along them with a whole bunch of additives. We’re doing professional strength professional grade, high potency antibiotics that have you know, that the amount of probiotics on our labels is where that would be at expiration. Not at manufacturing. So when you get a product from us, you’re probably getting double the amount that’s actually on the bottle. And then six RS retesting, and we understand that siblings and their spouses may pass infections back and forth. That’s really important to keep that in mind when we have a chronic issue.

Evan Brand: Yeah, and that’s not that’s not going to get brought up ever. I mean, I actually had a actually had a medical doc send me an email, and they were mad at me because I blamed the husband’s H. pylori infection on the wife. And so the wife was working with this doc and was saying, this practitioner, this guy on the internet, is saying that I’m the reason that my husband got reinfected with h pylori. So the medical Doc’s like that’s not possible. That’s not true. I’m like, Look, man, I could send you hundreds of cases I’ve got before and afters here where we tested someone. We then made a protocol we got rid of the infection two to three months later the infection comes back within test the spouse, boom, the spouse is positive, then we put both Have them on a protocol, boom. Now both of them are clear and both of them stay clear. So, I mean, why that would be controversial? I don’t know. But it was it was a funny email.

Dr. Justin Marchegiani: Yeah, I mean, I have one study right here in front of me it’s called saliva secretions in the efficacy of H. pylori. They’re talking about H. pylori was detected in dental plaque and oral lesions and in the saliva.

Evan Brand: When was the year of that study? Just curious.

Dr. Justin Marchegiani: Yeah, I’ll pull it up here right now. So you can see it may put it right up on the screen-

Evan Brand: Because maybe, you know, maybe this was a guy who maybe he hasn’t looked at a journal in 20 years and he doesn’t know that this is possible or true. And while you’re doing that, too, I want to say something about the-

Dr. Justin Marchegiani: 2011 but there’s a lot of studies on this stuff. So there is going to be some h pylori in the saliva for sure.

Evan Brand: Yeah, and I want to talk about the the herbs in such too. So the cool thing is with the anti microbial herbs, those alone can help reduce them. inflammation and we made out of the gate, as opposed to saying, Hey, here’s an acid blocker out of the gate. If we’re waiting on testing, you know, if someone’s really miserable, it may be 2 3 4 weeks turnaround time. We could throw something in right out of the gate that’s going to address and calm things down, which is very, very good. We talked about a guy had that was a teenager with panchal itis we talked about him a few podcasts ago. But anyway, we got him started on a really potent aloe extract right away. And by the time we got his lab results, Two, Three weeks later, he was already significantly better in less pain, less misery. So that’s the cool thing is there are some quote like, I don’t want to call him urgent care, but for lack of a better term, there are some quick fixes that we can implement right away before we get testing.

Dr. Justin Marchegiani: Totally. And then right here, salivary secretions, the Journal of dental think this is out of two round salivary secretions and advocacy of H. pylori eradication. So basically, they see that hey, the oral cavity may be affected, right. And they see that there could be saliva. saliva could contain H pylori secretions and then the conclusion is they find that h pylori eradication from the stomach may reduce the may reduce the salivary secretion of H. pylori. So we see that in some of the studies and this has been around for a while, so, it’s good to know that and that just kind of supports our theory that we’ve seen clinically with spouses passing things back and forth. And, again, you know, it doesn’t have to be a sexual thing, just sharing drinks and maybe silverware and just living in a house where those kind of things happen easier, right? That increases the chance.

Evan Brand: Oh, yeah, we’ve seen it in kids where it’s like, oh, hey, honey tribe, I did this organic dairy free ice cream, and mom’s got h pylori here. She has given her two three year old the spoon and then you and I’ve seen you know, countless children 2 3 4 5 6 year old kids with H. pylori, and my daughter had it my oldest summer she had h polarized so we tested her gut she had parasites first we eradicated those then on the retest H. pylori showed up and then luckily we were able to get rid of that. So you know, we clinically and personally deal with these things all day, every day, so we have a lot of, we have a lot of sympathy and empathy when it comes to the gut work here. And I just feel for all those people like me that they go to the doctor’s, you have so much hope you’re so anxious about the appointment. I remember feeling comforted. I remember I was in so much pain. I remember being in that office waiting for the doctor to come in. And I just felt comforted back then being in that environment. I’m waiting in the office. I’m like, Yes, she’s going to come in here he or she’s going to come in here. They’re going to give me the answer. They’re going to help me they’re going to get me solved. And then my bubble just got burst. I remember walking out of that place just so disappointed. I thought, oh my god, I remember the beginning of my appointment here. I was so thrilled and happy. I’m going to get to the bottom of this thing. And then here I am, you know, X amount of time later so disappointed and had to keep searching. So we feel for you, we’ve been there.

Dr. Justin Marchegiani: 100% and then again, just because someone has h pylori. The healthier you are, the stronger your immune system, the better levels of IGA you used to create which is going to be in the saliva. mucosa mucosal membrane barriers that’s gonna fight these infections. So it’s just because you get exposed to it in the saliva doesn’t mean you’re necessarily going to get an infection. But the more immuno compromised, you are stressed, weaker adrenals gut barrier integrity issues, poor digestion, the greater chance that h pylori that’s in the saliva could gain a foothold in your body. It’s very possible.

Evan Brand: Yeah, good point. I’m glad you pointed that out. Because there’s going to be a couple haters. Eventually, they’re going to hear this and go, Oh, that’s bullcrap. You know, 50% of the population has H. pylori, you’re painting it to be the bad guy dead. Well, in the modern world, people are so toxic, so stressed, so immunocompromised that I don’t think we can coexist the way we used to, because our buckets are so full. So these things do tend to take on a more pathogenic pro inflammatory state than maybe previously where people stress bucket and toxin bucket was less full. So yeah, I’m glad you made that point.

Dr. Justin Marchegiani: Yeah, and again, not everyone will get exposed to it, because their immune system will just knock it out via their IGA and some may get it but they’re going to be able to be Ace symptomatic, and they’re okay. And then they’re just like, hey, this isn’t a problem. And then they project their their good health and their asymptomatic status to Hey, you know this, this can’t be the problem, because I had the same thing, but everyone has a different constitution. And because of that constitution difference, it could affect you differently. For sure.

Evan Brand: Yeah. Well said, Well, I think we did a good job. We covered the testing piece, kind of the conventional colonoscopy and endoscopy, barium X ray scans, MRIs, CAT scans, CT swallowing, radioactive tracers, compared to the at home, organic acids and genetic DNA based stool testing that we’re doing at home with people. We compared the drugs, the antibiotics, the acid blocking medications, the antispasmodics, the immune suppressant or immune modifiers, like you mentioned, possibly an extreme case a chemo drug, versus we’re going to be going for more inflammatory herbs, natural antimicrobial herbs, anti parasitic antifungals, possibly some extra acid and enzymes, maybe some zinc carnosine and other things to heal up the gut later. Maybe some additional mushrooms and adaptogenic herbs to strengthen the immune system, possibly using these things throughout the family with spouses or children to help protect them as well. And then of course, the diet piece possibly, like my dad when he was suffering. When I was a young kid and he was suffering with diverticulitis, he was told to eat more fiber and that was his diet protocol. And it was take you know, GMO Metamucil psyllium husk or whatever it was with natural with it probably wasn’t even natural flavoring back then it was probably artificial flavoring. And that was the protocol versus you mentioned the templates so possibly, low fodmap low histamine, paleo autoimmune carnivore. There’s different things that we’re going to do based on our educated guesses plus, with the labs, the information and then people’s food journals, how are they feeling basically-

Dr. Justin Marchegiani: Even cooking, cooking, a lot of times just cooking those foods up better, avoiding raw foods and that can help a lot right the cooking is pre digestion and if your tummy has a heart digesting the food The more we can pre digest that food within reason you know steamed sauteed even stews or soups instapot crockpot pressure cooker that can really help with helping the tummy access those nutrients better. 

Evan Brand: I brought out the Instant Pot The other day you know it’s summertime it’s hot so it’s not very attractive to bring out the Instant Pot but man, we threw some organic purple sweet potatoes in that instant pot, 10 minutes. It’s awesome. Oh my god, they were so good.

Dr. Justin Marchegiani: Oh, yeah. Like like my carb cheat on the weekend is going to be potatoes because why? Cuz they’re grain free. They’re starchy. I can handle them on the autoimmune side. Some may not be able to but it’s just it’s a really good healthy safe starts and it gives you that mouthfeel that you’d miss from like, you know, breads or grains. That’s my big cheat and I do 10 minutes on the instapot on that it’s wonderful or, you know, at a nice Steakhouse is pretty good too.

Evan Brand: It was hard to believe I could I mean, it was a pretty good sized potato and I thought 10 minutes there’s no way this thing’s going to be done. It was done. We put some butter on that bad boy, some garlic salt. Delicious. 

Dr. Justin Marchegiani: It takes 45 minutes to do Boiling or steaming in real life. I mean, the instapot is pretty amazing how fast they can cook stuff. 

Evan Brand: This episode is brought to you by Instant pot.

Dr. Justin Marchegian: I know right? Awesome well if you guys are enjoying this content and you wanna share with your family and friends, or you wanna dive in and get support from myself, Dr J or Evan,, reach out for Evan. reach out to myself, Dr. J. If you guys enjoy the content we’re available, click down below, whatever you’re source, we have links down below to get access. Make sure you give us a comment. Let us know what you think, what you like, what parts resonate with you, give us a comment, like, share, hit the bell for notifications and we appreciate you guys sharing this with your family and friends, so they can become empowered about their health. You guys have a phenomenal day. Take care ya’ll.

Evan Brand: Bye now.

Dr. Justin Marchegian: Bye.


Audio Podcast:


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.