The Mold Gut Connection – How Your Digestive Issue Maybe Caused by Mold Toxins | Podcast #371
If you’ve encountered mold from a water-damaged building or contaminated foods, you’ve likely encountered mycotoxins—toxic byproducts of mold. They’re common environmental toxins, and they have adverse effects on many body systems, including the gastrointestinal tract.
While you’ve probably heard about other symptoms that can follow mold exposure, Dr. J and Evan discuss that mycotoxins can also cause severe problems for your gut. They also talk about how mycotoxins impact gut health and the microbiota and what you can do to help restore your gut health once you are exposed to mold.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:57 – Mycotoxins
10:16 – Functional Medicine Approach
13:54 – Dopamine Mechanis
15:20 – Mold Inhalation Effects
Dr. Justin Marchegiani: And we are live, It’s Dr. J here in the house with Evan Brand. Today’s topic is gonna be wonderful for the podcast. We’re gonna be talking about the mold-gut connection and how your digestive issues may be exacerbated by mold toxins, so great topic here Evan, personally been affected by himself and we see lots of patients all the time with these issues so let’s dive in. Evan, how are we doing today man?
Evan Brand: Yeah man, doing really well, and a lot of people have been to naturopaths, they’ve been the functional medicine people they’ve been a conventional doctor, they’ve been treated for SIBO and SIFO, whether it’s Rifaximin or natural SIBO protocols, maybe they’ve done SIBO diets or some of these rotational food diets and that sort of things, maybe they’ve tried berberine, oregano, garlic, and maybe they’ve made some progress, but then they’re still stick, they’re still suck, I’m gonna mix up my words, they’re stuck and sick so that’s a bad combination of essays and this is likely due to a mold toxin problem because I’ve seen it too many times and I suffered on my own and even the labs now tell us they give us a cookie-cutter report but that cookie-cutter report nonetheless is still valuable because even the lab has painted the connection between mycotoxins which are essentially mold farts that you breathe in, in a water damage building and the connection to certain bacterial overgrowth, specifically Clostridia but also Candida and the mechanism of why this is so damaging especially to young children is because we know that Clostridia bacteria screw up the organic acid levels called HPHPA and this affects levels of neurotransmitters, so when you get these children, they have behavioral issues, they may be diagnosed with something like PANS, which is a Pediatric Acute Neuropsychiatric Syndrome. These kids usually have sensory problems, food sensitivity, skin issues, histamine problems, allergies, maybe they’re biting children, maybe they’re angry or irritable, this can all be traced back due to this toxicity.
Dr. Justine Marchegiani: 100%. So that’s quite interesting, now you talked about mycotoxins essentially being mold fart, so essentially the mold off-gasses, right? And, your different kinds of mold, right? It could be Penicillium, it could be Aspergillus, right? It could be the black mold, Stachybotrys, these types of things and then they produce various mycotoxins and when we do different tests, like plate testing on homes, supposedly each mold or so can produce about 300 different mycotoxins, whether it’s Ochratoxins, or aluminum is that correct?
Evan Brand: Yeah, which is crazy because we can only test for a very, very small amount on the urine so really, we’re trying to just look for some evidence of this bonfire, we’re looking for the ashes, Oh my god, there must have been a fire here, this big mold exposure, we’re only looking at the tip of the iceberg so yeah, you’re right. Our testing is good but it’s still very primitive compared to the amounts of mycotoxins that are being produced.
Dr. Justine Marchegiani: Yeah. And the type of organic acid testing that we’re doing is on the great plains. We’ll look at some of the organic acid compounds that correlate with, like Aspergillus or different mold toxins. Is that correct? What are those big mycotox? What are the big organic acids again?
Evan Brand: So, it’s all on paper.
Dr. Justine Marchegiani: Membranes
Evan Brand: Yeah. So, you’ll see oxoglutaric. You’ll see citric acid can be high in a fungal overgrowth too so it’s all page 1. Oxaglutaric, you got hydroxybenzoic which is related to bacteria. I could pull up an O but in general it’s just page one. It’s typically numbers 1 through 18. If you see any big red flags on that either a combination of a bacterial overgrowth specifically a clustering problem and or Candida or fungal colonization and the lab indicates that so tartaric acid would also be on there, carboxy citric acid is also on there. So, in parenthesis, you’ll see under these organic acids now which is great because this has improved over the years that you and I’ve been running these labs. It now says Aspergillus so on number 6, which is tartaric acid under number six, it’ll now say Aspergillus. And you’ll know if that’s elevated, you’re colonized for Aspergillus which means that you’ve now been exposed to a couple situations could have happened either you had a large enough amount of mold, you were exposed to mold, long enough or your immune system was weak enough where now you become a mold factory. So, you can be a mold reservoir, more specifically a mycotoxin reservoir where you just have this exposure at the moldy hotel in Mexico and then you come back home and you’re sick or if you were weak enough, now you’re growing mold. Even if you move to the desert to avoid mold, you stay sick because you’ve got that colonization so with
Dr. Justine Marchegiani: Ionization, that’s happening.
Evan Brand: Yeah. So, you can prove that which is very important because now that would justify the use of herbal antifungals to try to remedy this situation.
Dr. Justine Marchegiani: That makes sense. Let me go pull up one of my old tests. Let me see if I can find it. Hold on.
Evan Brand: Now, the conventional treatment is typically antifungal medications that are gonna knock this out. But, as you and I with our functional practice, we don’t like to use that. So, number 4 would be classified as the fungal, the ferran-2,5-tricarboxylic, you’ve that Ferran carbonyl glycine. Yeah. So, number six. Yeah. So, this is old enough where they didn’t have the molds but on the new ones in parentheses
Dr. Justine Marchegiani: Let me say Aspergillus. It is primarily Aspergillus for all three of these.
Evan Brand: Yeah, and the number nine tricarboxylic is Fusarium.
Dr. Justine Marchegiani: Fusarium. Yep. And then Arabinose and Tartaric are also correlated with yeast overgrowth. This test here for instance, I did a great plane and a Genova test at the same time and this one actually came back much higher on the Arabino side than the great plains. then the Genova tested. So, it’s interesting you know different samples and such. But yeah, this one Arabinose is strongly correlated with Candida but then
Evan Brand: I just ran my own, I’ve got Candida right now too so I’m on a protocol, right? Now, I just run. Yeah. I showed up with Candida and I want people to know because you were a speaker on the event. It was called the Candida summit which I ran like five years ago and you know we had like 30 people talking about it and I could look back but I tell you I don’t think anybody had made the connection here which was the mold Candida connection back then and now what I’m finding is basically you’re just playing whack-a-mole with Candida until the mold’s gone meaning you may rotate through various rounds of antifungals but out the back door, you’ve got to be using the appropriate binders to pull out the mycotoxins so if you’re just beating Candida down and it keeps coming back. It’s probably the mold, not the Candida that you need to be after.
Dr. Justine Marchegiani: Yeah. And, that’s where it’s good to run a test like this. Also, maybe a urinary mycotoxin test or just make sure your environment’s good because I always tell patients if the environment’s not good and you’re having reoccurring issues then you’re just not getting to the root cause. So, the first thing is to isolate the environment. Make sure the environment, your home, your apartment wherever you’re living run a high-quality mold plate test on there. We’ll put links down below where you guys can access the plate testing. Isolate that, right? Make sure there’s no water damage or if there’s been leaks. Make sure it’s been addressed and dealt with. Make sure that’s dialed then the second thing is you can run a test like an organic acid test with your functional medicine provider. See if there’s any colonization. And, it that’s chronic, yo can get to the root on that and then you can always run urinary mold where you’re looking at mycotoxins coming out in the urine that can also be helpful but typically if this is good and there’s nothing at the home then you’re probably in pretty good shape and it’s probably more of an acute kind of dysbiosis thing probably from poor diet, poor digestion other bugs, other infections, etc.
Evan Brand: Yeah. And the cool thing is that you can kill two birds with one stone or even three birds with one stone and what I mean by that is let’s say you run that oh and you showed the elevated Arabinose, you know, there’s a Candida problem but if we see tartaric above that’s high and then down below, we see some of the bacterial overgrowth markers, the blends that you and I formulate and have, we might be able to kill bacterial overgrowth, fungal overgrowth and a Candida problem. All in one fell swoop and that’s incredible and you know your gastroenterologist or even your mold doctor is likely not gonna be able to do that. They may come in specifically with itraconazole or fluconazole or nystatin. But as you know, we’re facing this big problem of antifungal resistance just like we’re finding with antibiotic resistance and so now, you’ve got these very virulent strains which are difficult to kill with conventional medications. You and I have talked about this before but the long story short of it is all the different alkaloids and terpenes and beneficial nutrients in the plants, those don’t have this resistance problem. And if you’re mixing this herb and that herb, it’s not one plus one equals two, it’s one plus one equals ten. You get the synergistic effect.
Dr. Justine Marchegiani: Yeah. You see the same thing with addressing bacteria and other bigger bugs and berberines and Artemisia Wormwoods have synergistic effects. Also, the fact that you get a lot of antioxidants in a lot of these herbs. And so, especially if they’re high-quality, you get a lot of antioxidant support because when you start killing bugs, it’s a lot of oxidative stress that’s happening. And then, when you provide like an antifungal like Diflucan or an Amphotericin or a nystatin or a ketoconazole, obviously, there’s no antioxidants in those drugs and so you’re gonna have a lot of oxidative stress so it’s nice to have a blend different herb in there. One, to prevent the resistance. And then, also, people have yeast issues and a lot of times they have bacterial bugs as well and efflux pumps are a big thing that a lot of bacteria and bugs use to kind of protect themselves. So, I cannot say, like bacteria is like a sinking canoe, right? and essentially, you poke holes in that canoe with a lot of the herbals and think of the efflux pumps as the person in the canoe, baling water, right? So, they try to keep on bailing water, bailing water, so they don’t sink, right? And so, think of the herbals when you inhibit the efflux pumps whether it’s a ginger or different antimicrobials, it’s like taking the buckets away from the bacteria that’s bailing water and allows then to sink that allows them to effectively be destroyed that along with addressing biofilms too.
Evan Brand: Yeah. That’s awesome and the cool part too is you can minimize the die off if you’re doing this right. You know a lot of people when they hear these conversations, they get afraid. They go oh my God, Candida, mold, bacteria, parasites, worms like oh my God, this is a lot of stuff in me. I want it out of me but now I’m afraid. Am I going to feel worse before I feel better and the answer is if you do it properly that should be minimal to a nonexistent problem? I think you and I have refined our protocol so much over the years now that we have these tools and these other therapies in place that are standalone products but we often add those in or if we see that we hit a roadblock or a big bump in the road like a die off, we can change dosing. We can rotate. We can add in other support. We’re always talking about liver and gallbladder and binders and hydration and biofilms. These other pieces, these other variables, these are the make-or-break things for some people.
Dr. Justine Marchegiani: 100%. And when people kind of want to go after the gut, we live in an antibiotic like kill, kill, kill generation so people tend to, when they find out they have an issue, they want to go kill, kill, kill and that can be very stressful in the body so it’s always very important to calm down the inflammation, get the immune system stronger, get the hormones that help with anabolic metabolism which is healing, recovering, anti-inflammatory support that kind of sets the table because the more stressed and inflamed you are, your lymphatic system, your detoxification system, your immune system won’t work as good and plus people forget your detoxification system, right? The cytochrome p450 oxidized pathways, especially the phase two pathways, they’re gonna run off of a lot of sulfur-based amino acids and so if we don’t have great digestion and we’re not eating you know good healthy animal protein or good healthy plant cruciferous vegetables. If we can’t tolerate them, we can’t break them down. May not have a lot of those sulfur building blocks to run those phase two pathways and so that’s why kind of getting the deck set so to speak so we can really hit phase two better just not with support but just getting digestion working better and a good diet working better sets the table and allows us to effectively kill so much better.
Evan Brand: Yeah and I know we’ve talked about a lot in a short amount of time, we’ve gone fast so listen back as needed but I want people to understand the connection because of the title of this episode, I want people to understand the mold-gut connection. So, the connection is the following: the mycotoxins weaken the immune system and allow the opportunistic bacterial overgrowth to thrive along with the Candida. So, if you’re working upstream at the SIBO-SIFO situation but you’ve got an underlying mycotoxin problem, you’ve got to address that if you fully wanna get better. The other mechanism of the mycotoxins is a couple. Number one is they damage the microbiome so we know specifically that mycotoxins do the same thing as, like food allergens, they disrupt the gut barrier and create intestinal permeability. So, that’s another reason you want to pull those out of the circulation by using specific binders based on your labs. And then the other mechanism too is we know mycotoxins affect the brain chemistry and specifically lower dopamine so when you get into pain signaling, you get into motivation and mood and just your overall vitality. If your brain chemistry is affected, we can also measure that but it could be directly attributed to the toxin for example in like rat studies when they inject them with mycotoxins or expose them to mold toxin, the dopamine levels crash. So now, all of a sudden, you’ve got this brain chemistry piece to address too, now people have heightened pain sensitivity, they’re depressed. They may be just more flat with their life. Once again, they go to their psychiatrist. They’re not gonna bring up mold toxicity, they’re putting them on an antidepressant medication. They’re never gonna say, “hey, oh your basement is flooded, that’s why you’re depressed and anxious and you have diarrhea”. So, the connection of the gut symptoms too, the diarrhea, any type of bloating, burping, digestive pain especially in children. Children don’t use the same language as adults. So, if your child is complaining about stomach pain that could be one clue that there’s something related. That was my issue for my daughter, Summer. She was complaining of tummy aches so we did run stool on her. She did have H. pylori when she was two. We tested real high. Maybe I gave it to her by sharing water bottles or something but either way, we took care of that and then stomach pain was continuing that was when we had got exposed to mold. Luckily, I got her on binders. Now, she’s in a better place. So, I’ve seen it unfortunately with my own kids and it’s stressful to see your kids suffer but it’s a good lesson. It’s a good learning lesson that your children are not crazy and if your kids are complaining of a chronic issue like this with pain, you know, consider this as a possibility especially if you as the mother are toxic because the toxins go through the placenta and they also go through breastmilk. So, if you have your own digestive skin, whatever problems, mood problems in your kid, has similar issues as you, well, it could be the generational passing of toxins.
Dr. Justine Marchegiani: So, let’s go over that mechanism one more time with dopamine. So, obviously dopamine is a neurotransmitter and when we’re chronically stressed, physical, chemical or emotional, dopamine can go downstream and get converted into adrenaline which kind of helps manage the acute stress response. Is it just a fact that the mold is inflammatory and creating a stress response and activating the sympathetic nervous system that the dopamine is being taken and depleted downstream or is there something else? I want to make sure I get that mechanism hammered down.
Evan Brand: I don’t know. Type in rat dopamine, mold or rat dopamine, mycotoxin. See if you can find it. There were several papers on this. I don’t know if they discussed the mechanism in it or not. My assumption would be that it’s multifactorial. I think the big mechanism would be that the mycotoxins affecting the gut barrier then affecting nutrient absorption then there’s likely less amino acid conversion to dopamine. So, I’m thinking, it’s more of a malabsorption problem but also we know that ochratoxin for example damages
Dr. Justine Marchegiani: Like malabsorption, like it’s affecting the absorption of protein in the gut?
Evan Brand: Yeah. I think that’s one mechanism. I think the other mechanism would be direct brain damage. We know that okra toxin for example damages the cerebellum. We know that the Verrucarin and the Stachybotrys mycotoxins affect the brain and the prefrontal cortex which impairs, like your ability to think clearly. So, I think it’s both. I think it’s the gut damage and I think it’s the direct brain damage too. I am going to pull it up here. Can you see it on screen?
Dr. Justine Marchegiani: Yep.
Evan Brand: Let me make it bigger on my side here.
Dr. Justine Marchegiani: Yeah. So many mycotoxins, trichothecenes. We test that in some of the mycotoxin tests. Yeah. Induced neuronal cell apoptosis so some of that could be you’re just causing the cells in the brain and especially in the substantia nigra of the midbrain. That’s where dopamine cells are being produced. Some of it could be apoptosis that means programmed cell death and or inflammation in the olfactory epithelium.
Evan Brand: Interesting.
Dr. Justine Marchegiani: So, it seems to be a neurodegenerative and then look it says it caught ochratoxin A causes acute depletion of dopamine and its metabolites.
Evan Brand: Look at that.
Dr. Justine Marchegiani: So, I wonder if that’s a, it sounds like it’s possibly a stress response, right? Because dopamine can, tends to go downstream to adrenaline. It could be almost like an autoimmune response because you’re having apoptosis. This is neuronal cell death, program cell death. This is part of the reason why apoptosis is important, right? Because if you don’t have good immune function, this is how cancer forms, right? Your immune system helps program cells to die when they need to die. This is apoptosis but if you can’t do that then cells can overgrow hence you have a tumor, right? And so, this is actually happening to unhealthy or the very healthy tissue that you need to be functionally healthy that produces dopamine in the midbrain. So very interesting.
Evan Brand: Yeah. Talking about the hippocampus too, we know that hippocampus, I’ve got two of them. Remember, that’s why a lot of people have brain fog problems and also I would say that short-term to long-term conversion is impaired.
Dr. Justine Marchegiani: Can you see this one here? The mold inhalation one
Evan Brand: I’m just seeing that you’re highlighted on the hippocampus word for now.
Dr. Justine Marchegiani: Let me switch back to the other one here. This is mold inhalation. This is interesting. Let’s go pull this up. All tight. Mold inhalation causes innate immune activation, neural cognitive and emotional dysfunction.
Evan Brand: So, this is pretty new. July 2020 paper here so relative.
Dr. Justine Marchegiani: Yeah. Yeah. So, the ability of mold to cause such symptoms is controversial since no published research has examined the effects of controlled mold exposure on the brain. Patient symptoms following mold exposure are indistinguishable from those caused by innate immune activation by bacterial or viral exposure. Interesting. So, in this study here they added in. See here. Toxic and nontoxic mold stimuli would cause innate immune activation with concomitant neural effects and cognitive and emotional behaviors. We internationally administered intact stachybotrys. This is black mold extracted non-toxic stachybotrys spores and a saline vehicle to mice.
Evan Brand: You don’t want to be that mouse.
Dr. Justine Marchegiani: Wow. No. As predicted, intact spores increase interleukin 1 beta, immune reactivity in the hippocampus both spore types decrease neurogenesis. This is forming new neurons in the brain and causing striking contextual memory deficits in young mice while decreasing pain thresholds. So, this is another word saying, causing more pain in the body. So, if you have mold exposure, joint pain could happen, right? And enhancing auditory acute memory in older mice. Nontoxic anxiety. Yeah. Also increase anxiety like behavior. Levels of hippocampal immune function correlated with decreased neurogenesis that’s creating new neurons in the brain. Contextual memory deficits, right? Obviously, less memory and or enhance auditory cued feared memory. I wonder what that means. Maybe it’s just like, uh, you’re more sensitive to external stimuli.
Evan Brand: I read that. Yeah. I read that as sound sensitivity which is yeah part of the toxin and light sensitivity too so people will often have to wear sunglasses even when it’s not very bright. You and I talked about that in the context of adrenals years ago but that’s also a mold toxin thing.
Dr. Justine Marchegiani: Yep. And an immune activation may explain how both toxic mold and nontoxic mold, skeletal elements cause cognitive and emotional decline. So, it’s really important. We don’t wanna be in an area where there’s a bunch of mold toxins and we can do a whole other podcast on how to mitigate mold toxins as a whole. I mean, of course, get your home tested. That’s the first thing. If you have water damage, make sure it’s mitigated by a professional right away because mold starts to form when sitting water in as little as two days. Got to make sure that’s under control and then if you’re on the fence, get yourself tested, right? We’ll run an organic acid test. Maybe run a urinary mycotoxin test and see what your actual load is but again one of the big telltale cue signs is you know, get your home. If there’s mold there and you start feeling significantly better and you go back, you notice an increase and definitely get your internal mold tested as well via urine.
Evan Brand: Yeah. Well. I know we got to wrap this thing up. We got calls to get to but I hope this is helpful for people. We can always get geekier and dive deeper and go longer but I think you guys get the gesture, the connection of the brain toxicity, the gut damage. There’s a mitochondrial element with the chronic fatigue piece. So, if you are suffering from any chronic issue whether it’s mood like depression, anxiety, energy problems like chronic fatigue, low libido, poor erectile function, cold hands, cold feet, increased light sensitivity, blurry vision could be other things but this is a big smoking gun and all of us are inside way too much. We’re not outside like the Amish are all day. They might have moldy homes but they’re not breathing it in the majority of time. They’re outside in fresh air where the toxins are diluted. So, us with our indoor lifestyle as modern humans, we’re at more risk of this stuff and our buckets are already full due to pesticides and other toxicity in the environment so this is a really, it’s an epidemic problem, maybe the biggest one.
Dr. Justine Marchegiani: And not everyone is as genetically sensitive, right? Some people, they go into a moldy area. They get brain fog, right away. Some people do fine. Either way, it’s definitely a stressor in the stress bucket and if you know it’s there, you definitely wanna pull it out because it’s gonna help give you more resiliency and more adaptability. Great podcast today Evan. Everyone listening on the audio version, we pulled up some studies and some lab tests on the video version. We’ll put the link down below so you can see the video version. We’ll put some links to some of the labs and the products that we talked about today so you guys can take a look at those. Evan, great chatting with you. Head over to evandbrand.com to reach out to Evan via functional medicine nutritional support worldwide as well as justinhealth.com, Dr. J myself at justinhealth.com for me myself. We are here to help and support you guys wherever you are. Have a phenomenal day everyone.
Evan Brand: Take it easy. Bye-bye.
Dr. Justine Marchegiani: Take care. Bye now.
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The Root Causes of Anxiety – A Functional Medicine Approach | Podcast #370
Conventional medicine labels anxiety as a neurotransmitter imbalance and relies on pharmaceutical drugs to dampen the symptoms. Although, prescription medications can be a helpful and even necessary tool in periods of overwhelming anxiety. But we have so many more tools at our disposal than just medications!
Dr. J and Evan explain that they recognize that anxiety is often the proverbial “tip of the iceberg” in functional medicine. It’s the clear and present warning that something is going on below the surface that needs our attention. Our current circumstances may have been the breaking point, but the anxiety manifests in underlying issues. That’s why rectifying these issues is necessary to make anxiety more manageable or even eliminate it!
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:06 – Acute and Chronic Stress
4:06 – Amino Acids and Herbs
11:24 – Gut Issues
16:26 – Functional Medicine Approach
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the root causes of anxiety, a functional medicine approach, and how to get to the root cause. Really excited about this topic. We see many functional medicine patients with these exact issues and we always want to get to the root cause of why that is so. Evan, how are we doing man?
Evan Brand: I’m doing good. You know the anxiety story for you and I talking about anxiety goes back literally eight years. It would have been late 2014 when I was in my luxury apartment in Austin and I was calling you and I was saying, “dude, I can’t stop this”. My heart is pounding. I’m freaking out. What the heck is going on and you said, “man, if you go to the emergency room, all they’re gonna do is they’re gonna give you some sort of anxiety medication. So why don’t you go and take about a gram of magnesium and see what happens.” And so, that’s what I did. I think I might have had some pharma GABA or some other tools on hand, maybe some passion flower and luckily, I calmed it down but little did I know back then that I had some of the big root causes of anxiety that were unresolved which included mold toxicity, Lyme, Bartonella, some of these tick-borne infections that drive up the nervous system, unfortunately. Now, knock on wood, anxiety’s been a minimal to non-existent part of my life and It’s incredibly freeing because anxiety can be so debilitating that people become housebound or they become afraid to travel, they become afraid to go on planes. They become afraid to seek the raise at their job. They just want to live in this little cocoon because they’re so afraid and anxiety is also very debilitating for children too. It affects their confidence and their self-esteem and their motivation for school and how they get bullied and so, I mean, we could do an hour on this but think just to open this thing up with a bang, I would say that infections are a big driver of anxiety so whatever that is a tick-borne infection like a Bartonella, Babesia, Lyme situation or gut infections like we’ve talked about a thousand times in the last 10 years together which is parasites, bacterial overgrowth, worms, Candida, anything that’s gonna release a toxin or aggravate the immune system.
Dr. Justin Marchegiani: Yeah. 100%. So anytime you look at anxiety, you always have to get to the root cause, right? Obviously, if it’s unresolved emotional stress, your body is designed to create anxiety for a certain situation, like if you, I don’t know, if you have lived in a forest across the street and there are bears, there should be a healthy amount of anxiety so you know, don’t leave food out and you’re just a little bit more careful with your habits so you don’t get attacked by a bear, right? There’s a healthy bit of anxiety there which is good to kind of keep you on edge so you are alert and you make good decisions. We’re talking about things that are, you know, unhealthy amounts of anxiety where you don’t have those types of emotional stressors, right? Obviously, if those emotional stressors are there, kind of take inventory of them and figure out what that corrective action is you need to kind of close the anxiety loop. I always say close the anxiety loop. What is that action? You have to take that allows you to feel confident that you are not ignoring the reason why there is anxiety there. If you did that, great, awesome. Check that off your list. The next thing is like you mentioned, obviously, any type of chronic stress or acute stress can create anxiety, right? And so, chronic and acute stressors do different things to your body. They’re going to cause B vitamins to get recycled and used up at a higher rate. They’re gonna cause magnesium to get used up at a higher rate. They’re gonna put you in a fight or flight position, where your body goes into fight or flight and then that’s gonna cause increases of cortisol, increases of adrenaline and it’s gonna cause your brain to get hyperactive and obviously at the same time it’s gonna affect digestion too when you’re in fight or flight. It’s gonna decrease your body’s ability to make stomach acid and enzymes and it makes it harder for you to break down your food. And so, and then of course, the more stressed you are, now you’re gonna start craving more processed foods that increase dopamine and increase a lot of those, uh, feel-good brain chemicals to buffer that but so, I always look at like what’s the constructive vehicle to fix this, what’s the destructive vehicle. Destructive vehicle feels good at the moment but creates problems down the road. Constructive helps at the moment. May not, maybe not quite as fast but then actually gets to the root cause over time. And so, some of our constructive vehicles like you already mentioned, magnesium, right? Theanine, right? B6, B5, right? And I always look at nutrients first, like nutrients are in the hierarchy before herbs so nutrients first and then, in the hierarchy coming down would be herbs, Ashwagandha, passion flower, Valerian. Those things are nice herbs that kind of activate and stimulate GABA. So, GABA is an inhibitory neurotransmitter. So, it’s the brake pedal on the nervous system. So, think of the gas pedal as adrenaline, as cortisol. That’s the fight or flight nervous system response and the gas pedal is gonna be GABA and the things that are gonna help with GABA are gonna be Taurine, Theanine, GABA in and of itself. And then on the herbal side, things like Ashwagandha have multi-adaptogenic effects. They can increase cortisol and increase stimulation when things are too low but they can also tamp it down when it’s too high. I like my wife. She was really stressed the other day. We are getting our kids out for an easter party and she’s like, “you have something to give me? I am so stressed.” And I’m like, “here you go”. And I gave her a bunch of GABA, Taurine, and Theanine and magnesium, some B5 and vitamin C and some Ashwagandha and she looked at me like two hours later, she’s like, “what the heck did you give me. I’m on cloud 9.” I’m like, yeah, you know that, the better living through chemistry right there.
Evan Brand: That’s great. Yeah, and motherwort. I love motherwort too. It’s great for the anxiety when you’re having, like, heart palpitations, blood pressure type issues as well.
Dr. Justin Marchegiani: Hyperthyroid too. They use it on hyperthyroid, as well.
Evan Brand: Yeah. That makes sense.
Dr. Justin Marchegiani: Too high thyroid, it can also be. It can help dampen that down, as well, which is nice.
Evan Brand: It’s great for grief too so like the cool thing about certain herbs is they can be an emotionally calming tool but they can be a nervous system calming tool too. So, like, as you mentioned, there could be an emotional thing like a bad boss, a bad spouse, a bully. You know that type of emotional anxiety driver but it could be a chemical driver too, meaning like a toxin driving the nervous system to be ramped up. Also, we should talk about blood sugar. I know we’ve done podcasts on this before but you know there’s a big impact on issues with blood sugar. Thank the Lord, my blood sugar is so good now, I could eat dinner at five and not eat till 1pm the next day and I’m stable, like, I can fast for extended periods of time as needed and I don’t have any issue but however when my gut was a wreck which I want people to pay special attention to, if your digestive system is compromised, you’re not gonna be tolerating fasting that well because you’re already so likely nutrient deprived because of the malabsorption due to the infection. So, years ago when I tried doing this type of fast, I would have major anxiety and that’s low hanging fruit so do what you got to do but you got to get your gut tested and then fix the infection first.
Dr. Justin Marchegiani: 100%. So, just kind of looking at a bunch of different things. So, on the emotional side, right? If it’s unresolved emotional trauma that’s creating anxiety, you know, someone wrote about DNRS, that’s great. You know, this NLP, where you kind of visualize a stop sign or something to kind of do a pattern interrupt. That’s excellent. EFT, EMDR with eye movement or different tapping on meridian points to kind of dampen down that sympathetic nervous system response. And again, these are gonna be good, you know, uh, more chronic issues. Yeah. If it is an acute issue, you know, a lot of times, just get to the root underlying issue where that issue is acute.
Evan Brand: I was on a plane one time and the turbulence was so bad and I started tapping on the plane. That really helped. I’m like okay. Even though it feels like this plane is about to crash, I love and accept myself and I’m like okay that’s fine.
Dr. Justin Marchegiani: Yeah. Especially things like that. You don’t have control, right? There’s nothing you can do outside of just sitting there and getting through it. And so, it’s better when those things are kind of the case but you know, it’s kind of like, I’m just trying to think of you know an example, it’s kind of like, you go upstairs and don’t turn the alarm on for the house or like maybe did I leave the front door unlocked, right? And so, there’s a natural bit of anxiety. You start going down to bed and that little bit of anxiety kind of creeps in, you’re like, I’m not gonna be able to get to sleep fast if I don’t at least just check on the front door, right? So, let me make, oh good, it’s locked. Oh good, the alarm is on. Good. Now, that anxiety can go down because it’s there for a reason, right? So, if there’s a root cause, act on it, right? If there’s isn’t a root cause, right, but it’s more emotional, you can do some of the tapping and you can work with a practitioner to get to the root cause on that and then of course having better biochemistry will get will make every bit of anxiety better because you’ll be able to adapt to it and deal with it better. And so, of course, like we already talked about with cortisol, chronically high levels of cortisol and adrenaline are gonna be big so you have to get to the reason, the root cause why. And again, foods could be a reason why like gluten, too much processed sugar that can drive up that anxiety. Again, you already mentioned blood sugar fluctuations. If you’re on this reactive hypoglycemia roller coaster ride where blood sugar goes up because you ate too much processed carbohydrate, refined foods, junkie, vegetable oil, omega-6 fats. Blood sugars up and then it can crash right back down. The crashing is where you tend to get a lot of adrenaline cortisol stimulation and on the way up, you get lots of insulin so you get this insulin-cortisol-adrenaline kind of tug of war happening and that can be very stressful on the body. And then, of course, if your blood sugar is chronically high and you’re making tons of insulin that can also be a problem too. High levels of insulin can cause all kinds of problems with hormones, especially in women, it can cause issues with ovarian cysts and testosterone problems. And then, high levels of blood sugar deplete a lot of your B vitamins and magnesium. And so, if we have poor levels of B vitamin and B6 and B5 and B1 and B2 and B3 and folate and B12 and magnesium is depleted, that’s gonna cause more stress and more cortisol issues and it’ll be harder for you to deal with and adapt to that.
Evan Brand: And I would say, if you have anxiety longer than the week, I would almost consider that chronic. I mean, it’s crazy to me, how many people you have and I’ve talked to over the years who’ve had anxiety for a decade or longer and sometimes as one person commented that anxiety and OCD together is terrible. A lot of times OCD does come hand in hand with anxiety. We’ve done podcasts specifically about amino acid therapy and we use amino acid therapy in our clinics but if you have OCD, anxiety, low self-esteem, worry, negativity, depression, disturbed sleep, those are all symptoms of low serotonin. So, what you need to do is to get an organic acid test so we can measure this and look at the brain chemistry because if you’re not testing, you’re guessing. So, when you’re listening to this conversation about anxiety, I swear to you, you’re never gonna find a psychiatrist that’s gonna say, “hey, maybe we need to run an organic acids test, maybe you have low brain chemistry because you have bacterial overgrowth. So, we’re also gonna run a stool test. If they’re out there, send them our way, we’ll do a podcast with them but I doubt your psychiatrist is ever gonna consider running functional medicine testing on you to investigate this. I don’t care if you do lorazepam or the klonopin or whatever. It’s not the root cause and it’s gonna dig you.
Dr. Justin Marchegiani: Any benzo
Evan Brand: Yeah. Any benzo is gonna dig you further in the hole because now you’ve got this dependency issue and now you’ve got his issue of withdrawal and I don’t know if you’ve read some of the stories on this but my God if people try to acutely stop those benzodiazepines, there’s major major major side effects. So, it’s just not around
Dr. Justin Marchegiani: Especially, if you’re on doses, you know, above one milligram or so on a benzo, it can be harder to get off and sometimes the taper can be, you know, six months to a year coming off of it. If you’ve been on it for a while or been on a higher dose. Yeah, you need to kind of do a slower type of taper for sure.
Evan Brand: And there’s so much, I mean, just think of how many millions. I didn’t look at the numbers here but how many millions of people are on prescription anxiety medication and they never ever get to the root cause. It’s so sad to think about someone that’s been on like a Lorazepam or another benzo for 20 years and they’ve never once asked about the gut. The question came in, how does dysbiosis cause anxiety. What are the mechanisms? Well, I think, one, right out of the gates is gut inflammation. Number two would be nutrient malabsorption because as you mentioned, a lot of these B vitamins are necessary for many processes in the body including energy production so sometimes you have anxiety and chronic fatigue and that sucks too because now you’re too tired but you’re anxious so that’s not a fun recipe either. What else would you say about the gut anxiety connection?
Dr. Justin Marchegiani: Well, so anytime you have chronic gut inflammation whether it’s from food, whether it’s antibiotics. Antibiotics are creating rebound yeast or bacterial overgrowth. We could put H. pylori in that category, and other infections, as well. That’s a one you and I already mentioned, creates malabsorption just from indigestion, right? Not enough enzymes, not enough acids, not absorbing things well. Two, you’re gonna have exogenous production of lipopolysaccharides which in and of itself are a toxin, right? They’re produced, they’re part of the gram-negative bacteria in the gut and they’re stressful on the liver and there’s also can go to the blood-brain barrier. And when they’re in the brain, they can create mood and anxiety issues as well. So yeah, lipopolysaccharides, you could have acetaldehyde and mycotoxins from fungus. You could have issues with the parasites producing their own type of internal toxins for sure. Of course, your body also produces through healthy gut bacteria, a fermentation process to make its own B vitamins, vitamin K. Those kinds of things. So, if we have dysbiosis, we typically are gonna have low levels of beneficial bacteria so we don’t have that good endogenous production behind it. And then, of course, that’s gonna over activate our immune system. So now, we have all these toxins kind of slipping through our bloodstream. We have undigested food particles, getting through our bloodstream. Now, our immune system starts becoming hyperactive and that can suck up energy. That can suck up resources. So, there’s studies on for instance H. pylori creating mental health issues, mental, emotional issues, depression and anxiety partly because of the lipopolysaccharides and endotoxins are the same thing by the way. LPS or endotoxins and obviously nutrient absorption problems too.
Evan Brand: Man, when I had H. pylori, I was super anxious. I don’t know if I was depressed as much but I was definitely anxious and you remember how skinny I got, I mean, I lost so much weight too. So, a lot of people, you know, they look at anxiety on the surface right. And everyone looks anxiety is just like this mental thing and you just need to watch some hoorah motivational video and just get over your fears and that I was like no anxiety goes way deeper than that. You just eloquently illustrated this, the aldehydes from the yeast and the fungus toxins and the bacterial toxins and the parasitic toxins and the mycotoxins. You guys, this anxiety is not in your freaking head. It’s not. It may manifest in your head but the root cause is not in your head unless you’re describing like, this toxin getting across the blood-brain-barrier but beyond that, the gut I would say is the biggest driver of anxiety. I’d say, if I had to pick one place to look, it would be the gut.
Dr. Justin Marchegiani: Yeah. So, when we look at this, what’s kind of the hierarchy of addressing this? So, of course, you fix the foods, right? Because the foods are one. You’re gonna decrease inflammation from the foods. And the inflammation in the foods is gonna cause gut permeability so you cut out the gluten, the dairy, the processed refined sugars and flours, the junky omega-6. You focus on good high-quality animal-based fats, good healthy proteins, you know, more carbohydrate from fruit and starch, especially if there’s blood sugar issues and then from there, then you work on digesting it. So, make sure enzymes and acids and good digestion are there. Get your gut looked at especially if there’s any type of chronic bloating or motility issues or indigestion, unadjusted food in your stool, diarrhea, then you get your gut looked at and of course if this issue is more chronic, you want to look at your stress handling system so the interplay sympathetic and parasympathetic nervous system in your body and your nervous system is your adrenals and so you can get your adrenals looked at cortisol rhythm wise, you can do a cortisol panel. Look at your cortisol in the morning and throughout the day. Make sure it’s not too high or it’s reversed. On a good organic acid test, we can look at neurotransmitters like Vanilmandelate which looks at adrenaline. We can get Homovanillate which looks at dopamine, right? We can get the DOPA which looks at dopamine. We could also get 5-hydroxyindoleacytate to look at serotonin and then of course we can look at B6 like a kind of urenate or xanthurenate, right? We can look at brain inflammation markers like picolinate and quinolinate so there’s inflammation in the brain that gives us more indications. We can look at oxidative stress markers like 8-hydroxy-2-deoxyguanosine. There are good markers out there to look at these different things to give us a window of what’s happening so you know, we work on the food, work on the lifestyle, sleep. Make sure we’re digesting and breaking things down. Look at the nutrient deficiencies, look at the gut, look at the infection, look at the digestion and then of course, you know, we can always branch out and look at mold or mycotoxins or heavy metals or more toxic burdens down the road. That’s the foundation first and then I would say on top of that, if there’s any type of chronic pattern where there’s an emotional trauma involved that’s more unresolved definitely bring in a good practitioner, you know with some tools in their tool bag of NLP or EFT or EMDR or hypnosis. Anything that you want techniques to get into the subconscious but again the healthier you are the better the emotional stuff is to resolve so if you’re doing EMDR and EFT and NLP and you’re eating processed food and crap, it can still work, but it’s gonna be better when your brain chemistry is healthier.
Evan Brand: Oh, yeah. Amen. Well, think about all the people that are in talk therapy and then they go and they go eat a subway sandwich for lunch, thinking that they’re doing themselves a good favor by eating turkey on wheat bread with processed cheese and then they get mayonnaise or sweet and sour sauce on it or whatever the heck they’re doing and then they feel like crap, I mean.
Dr. Justin Marchegiani: Yeah. I’m not a big fan of talk therapy in the long term. I think, talk therapy is good did you kind of just consciously process something like how did this happen maybe you’re learning some tools to enter into your life from a habit standpoint to fix whatever that issue was but then most of that trauma sits in the subconscious area of the brain which is where 90% of all your thoughts are subconscious and so that’s where you want some of these techniques like we talked about but I think talk therapy is good to acutely process what you’ve observed whatever your experiences are and then talk about, hey what can you do, you know, as a person today as an adult today, um, you know, from a habit standpoint to address it but then after that then you gotta, you know, if you’re in talk therapy months and months later and you’re still just ruminating over the same thing then it’s a subconscious thing you got to work on next.
Evan Brand: Yeah, and look, don’t let me talk people out of doing it. I’m not trying to do that but what I’m saying is I’ve had people that said, “oh yeah, I’ve been with this therapist for 3 years and I meet with them every week or every other week”. And I’m like, “okay and what do you do with this therapist?” “We talked.”, “Okay and what else do you do?” That’s it. It’s talk therapy and I go, okay, you’ve been doing talk therapy every week or every two weeks for 3 years and you still have anxiety that’s this bad. We got to dig deeper. So, like I said, there’s a role for that but it’s not gonna get you out of the woods. The person who commented about the dysbiosis and anxiety question, they also commented in here said they did have a stool test that showed H. pylori. They have extremely high Morganella which is one of those bacteria we’ve talked about and calprotectin which is gut inflammation over a thousand. Fatigue and anxiety were the main symptoms. We see this everyday all day.
Dr. Justin Marchegiani: Yep. Exactly. I’m familiar with that case for sure. And inflammation in the gut can definitely create those types of issues and get to the root cause of it too. And then, someone writes in, about Accutane too, I mean, this is super common if you get into the dermatology world. I mean, dermatologists, they either cut something. They burn it off with a laser. They freeze it off or they use some type of antibiotic, topical or internal or they use some kind of like, synthetic vitamin A. That’s it. That’s the dermatology world you know in a nutshell and they tend to not get to the root, you know, we’re talking like more chronic acne, chronic skin stuff. They tend to not ever get to the root cause of how or why that’s even there. Diet, sugars, junky, omega-6, poor digestion, poor fats, poor proteins. They don’t really get to the root cause of what that is and so, they recommend synthetic vitamin A, which is Accutane, which again, will decrease the amount of oil produced by your sebaceous glands which can be helpful in the short run if they’re producing too much oil but they can create chronic skin and eye dryness in the long term and they’re not even getting to the reason why your skin’s producing too much oil to begin with. Usually, it’s too much insulin. Insulin is a huge driving factor of excess oil and then of course, you have different food allergens, gluten, dairy, too much sugar. That can also cause a lot of problems with the skin cells.
Evan Brand: And not to mention, the connection between people that have anxiety and acne. Guess what, they’re both linked to the gut. So, if you have acne and anxiety, you gotta investigate your gut. Please. Please. Please.
Dr. Justin Marchegiani: Yep. 100%. And again, you know, outside of that, you know, we look at different toxins down the road. If we look at heavy metals, there’s different tests. We can look at, to do a challenge test on your metals with a DMPS or some kind of a challenge agent. We can definitely look at mold if there’s mold in the environment that’s important to look at. And again, if you’re in an environment where you feel better leaving that environment then there could be some mold in there, especially, if a history of water damage that was unresolved, definitely want to get your mold looked at or just your home looked at too, especially if it’s something that the whole family is dealing with just get the home looked at to start. It’s usually cheaper and more effective out of the gates.
Evan Brand: Yeah. well said. And, heavy metals too. I’m glad you brought that up. You know, mercury and other heavy metals that can stimulate the nervous system and cause issues. So, if you have a bunch of silver fillings in your mouth, you’ve got to consider that. May not be your number one smoking gun, sometimes it is but heavy metals are a big problem and even detox too can make people feel too sick. I mean, you and I have seen this many times. Other practitioners that have handled people before they come to us or they’ve done something too aggressively with chelation or other detox methods and then they’ve ended up worse. So, there’s like a tight rope and that’s where the art of medicine comes in. Everything is not just like cookie cutters. So, too much is a problem. Too little is a problem and that depends on gut and detox and beta glucuronidase and liver and all of it. So, like if your friend got better and you tried what your friend did and you didn’t do well, that might not be your right protocol.
Dr. Justin Marchegiani: Yeah. Exactly. And then, just to kind of highlight the nutrients in, compared to talk therapy, Julia Ross is out there. She’s like a family therapist person but she’s done a lot of books on amino acids and diet and she had different clients that she used to use talk therapy for years and years and years and said, “hey, let me just try adding in some amino acid therapy to their protocol and let’s see how they do with their talk therapy when we add in the amino acids”. She started to do that and then these patients would come the next week and they’d be like, “Yeah, just, I’m just good. I just don’t even feel the need to talk about it. I’m over it”. And it’s like wow so it’s like it gives people the equipment to kind of, like, process these issues and again I think talk therapy acutely may be fine. It’s just when you’re talking about the same thing for years and years and years, you’re probably not getting to the root cause, right? This is probably just covering up something else, you know. Now, I think it’s better than being on a drug, right? So, if it’s helpful and you don’t need a drug that’s great but, in the end, you know, if you can do some of these nutritional things along with it, you may find that you can just deal with the issues better you know I, the analogy I get patients is, try dealing with difficult problems around the home and not having slept for a couple nights. You’re gonna lose your patience with your wife with your kids. You’re not gonna be able to think right, you’ll be foggy, get some good night sleep and then wake up and deal with the problem. It’s like you’re gonna be way more equipped to deal with it. I think that’s kind of how brain chemistry works when you’re dealing with these stressors.
Evan Brand: Yeah. Absolutely. Well, I remember in that book too, talking about how, like, amino acids were administered, right? At the beginning of a session and then the people would just immediately like, smile or loosen up or relax and so it’s amazing no matter how much you talk. Long story short, I know we’ve beat the drum on this for a minute but last thing, no matter how much you talk. It’s never gonna change your levels of serotonin just by talking it out. If you have a gut problem that’s affecting your nutrient absorption which is affecting the tryptophan and the conversion with the B6 over to 5HTP and then over to serotonin and then to melatonin so sleep issues too. So skin, sleep, anxiety, they’re all connected depression. We’ve already talked about that. This person here’s putting a bunch of question marks like they’re mad at us. What is the connection between Accutane and depression?
Dr. Justin Marchegiani: It’s just a side effect. It’s a side effect of the drug.
Evan Brand: It could be a side effect. Yeah.
Dr. Justin Marchegiani: Yeah. Just the side effects of the drug. That’s all it is. Yeah. So certain drugs, you know, are gonna have side effects. Ibuprofen can cause ulcers and liver issues, right? Just a drug side effect.
Evan Brand: Yeah. Well, we got to wrap this thing up. But if you need help clinically, you can feel free to reach out. We work with people around the world. We send these functional medicine labs to your door. We have an incredible logistical team on both sides where it’s incredible. We can help people in literally every part of the globe where people like us don’t exist or maybe they do but we’re better. So, if you need help, you can reach out directly to Dr. J, that’s Dr. Justin Marchegiani at justinhealth.com for consults or me, Evan Brand at evanbrand.com. We’re happy to help. You guys, don’t give up. We’ve been through it. We are warriors ourselves and we’ve worked on our health for years and we love what we do and we love helping people and there’s so much possibility when you can beat an issue like anxiety. So, like I said in the beginning, whether it’s seeking that raise, that new promotion, that new job, that new spouse, you know, that partner, that relationship that you want to grow but you can’t because you’re held back by anxiety. This is a huge huge problem and you can overcome this. So please don’t give up.
Dr. Justin Marchegiani: Yeah. If you guys enjoyed it too, look down below, you’ll see a little link where you can write us a review. We appreciate the review and if, also, it’s benefiting you, feel free to share with family and friends and there’ll be links where you can reach out to us directly to get that extra bit of help. All right guys, have a phenomenal day. Take care. Bye everyone.
Evan Brand: Bye-bye.
Dr. Justin Marchegiani: Bye.
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How to Address Sinus Infections Naturally | Podcast #368
A sinus infection, also called sinusitis, is a common problem that causes your sinuses to swell up. The sinuses become inflamed and cause symptoms similar to the common cold. Many people can contract a sinus infection after having a cold or the flu. A bacterial infection usually causes sinus infections, but viruses or fungi can also cause them. These infections can either be acute or chronic.
Dr. J and Evan discuss nasal flushing, which can help clear the mucus out of your sinuses. It is one of the most effective home treatments for a sinus infection. They also emphasized the importance of rest, filtered air system, and other nutrients to boost the immune system.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:17 – Nasal flushing products
10:03 – Mucus and nebulizer
16:54 – Sinus anatomy
Dr. Justin Marchegiani: For today’s podcast, we’re gonna be talking about how to address sinus infections naturally with Evan today. Really excited. Good topic here. It’s a common topic that people are experiencing especially in the winter season so we’re gonna go through it. What we gotta do to heal fast from sinus infections naturally. Evan, how are we doing today?
Evan Brand: Hey, doing really well. Why don’t we start with the conventional approach? What is that? If you go to your ENT with a sinus infection, what are they doing?
Dr. Justin Marchegiani: Well, it depends, I mean, some are gonna be more antibiotic hesitant and say well you know it could be a viral infection, right? You know, almost a quarter of all antibiotics are actually prescribed for sinus infections. You know that? It’s crazy. So, most of the time, they’ll wait and see how bad it is. See if you have a fever, uh, usually like you have that punch in the face kind of feeling where your teeth are really starting to hurt, chronic headache and then you’re having a fever usually they’re waiting seven to ten days or if it’s gotten better and then gotten worse again and it’s usually seven to ten days out with a fever then they’ll start to, you know, typically prescribe antibiotics. Again, most sinus infections are viral so you know, you have to get to the root cause of that so a lot of times antibiotics won’t work. The problem with antibiotics is you’re swallowing it, it’s going 2 or 3 feet away from the actual issue so you’re basically dropping a systemic bomb to instead of hitting a localized area. Now, there are some more, I would say functional based medical doctors that may do some kind of an antibiotic in a compounded powder like an amoxicillin, something like that in a suspended solution or powder and they put it in a sinus rinse bottle like this and then you can flush your nose with that. Better, right? At least it’s more localized. We’ll talk about some strategies using saline flushes and different things that I recommend to help get that under control, naturally and not have to destroy your microflora in the gut. So, that’s a big thing out of the gates which can be very helpful. I got a sinus infection last week from a viral infection that my kids brought home. I never have been exposed to so many bugs since I have two young kids, 2- and 4-year-old boys that go to an outdoor wilderness school and they bring stuff back home from all their classmates and so I’m getting inoculated every single day and so we’ll talk about some of the strategies that I take so I can recover fast.
Evan Brand: Yeah. I still hear a little bit of you. So, what are you doing? You mentioned you got some kind of tools on your desk there.
Dr. Justin Marchegiani: Yeah. So, couple of things out of the gate, you know, to irrigate or flush that area out can be very very helpful. One, to flushing the viral particulate out. Two, we may add in some components to actually help kill what’s up in the nose as well. So, we have our saline, so you can either do NeilMed saline, which is really good. We’ll put links down below. The Neti Xlear is really great. I’ll kind of go back and forth between those. I have both. And so, we’ll take this and you’ll add eight ounces of water in one of these types of bottles. This is actually the best bottles. It’s made by Xlear. It’s Xlear’s bottle. It’s the best because of the plastic isn’t cheap so when you press it, it recoils really fast so when you’re doing good flushes, sometimes you’re pressing and then you’re having to let it reload so to speak and it’s just a really good plastic. Some of the plastics are weak so then, it kind of just stays sunken in so I also have a NeoMed bottle, definitely a cheaper plastic. And there’s another bottle by Walgreens. It’s even cheaper. So, this one is okay, you know, they give it away with like 60, 70 packets of saline so it’s pretty cheap. It’s a nice bottle. I have like three or four of them lined up in my office sink so when I’m in between patients, I’ll just give it a good flush. And so, we’ll take the saline packet. We’ll mix 8 ounces of water; we’ll add it to it and then I’ll take either food grade hydrogen peroxide. You could do regular hydrogen peroxide from the drug store. It’s not as big of a deal if you’re nebulizing it. Again, it you’re flushing it, if you’re nebulizing it, you probably wanna go more food grade just to make sure any stabilizers are out. And then, I typically just fill it up just enough to cover the bottom part of the cap. That’s it. Just about that.
Evan Brand: That’s like a dash. I mean just a tiny amount.
Dr. Justin Marchegiani: Yeah. And you know, you went too much if you put it into the water and then I would just pour it into the saline, my finger over and just shake it up and then you know you did too much if you feel any kind of irritation or burn. You can so you can always start less and kind of work your way up and then if you do too much you can just add a little bit more water to it and back off so that’s a good option right there. Another option I have is I’ll do like my GI clear 3 silver and I’ll add a cap full of that to it. You can do that. You can add just straight up betadine iodide. I’ve stopped doing that because of the orange color. It just stains. It’s really annoying so I’ll go to, like, a clear simple potassium iodine which is good. Those are a couple good options out of the gates and so we’ll basically irrigate 2 to 3 seconds of flow, clear everything out and blow your nose in between. 2 to 3 seconds of flow below your nose. That’s a good way to do it out of the gate. Now, there’s a couple of other strategies that you can do, so some of my sinus sprays that I’ll use and so I have 3 big sprays so here’s extra rescue which is really a good one because it has six different herbs in there. It has, like pau d’arco, parsley, eucalyptus, oil of oregano, tea tree, right, so it’s really good. Six different herbs and so what I’ll typically do out of the gates if you’re new to using the product. I’ll do it, about 2 sprays in each nose, about ten minutes before a sinus flush. What I find is, it starts to, like, agitate and release all the mucus. That’s kind of stuck to the inside of the sinus cavity and so like five to ten minutes before spray it, wait, and then do a sinus flush. I find that it releases things a lot better. So, that’s really good there. And once you’re better with it and you feel more comfortable, you can do it after as well. Just see how you feel. If you’re really, really inflamed too, there’s another product called Xlear max, which is a good one.
Evan Brand: I’ve never tried that one. I’m scared of that one.
Dr. Justin Marchegiani: Yeah. Well, the rescue one, I think, is like the strongest form, like a killing perspective. The Xlear max is more, like anti-inflammatory. So, the big difference is, this, the last one was grapefruit by the way and the Rescue.
Evan Brand: Okay.
Dr. Justin Marchegiani: And so in the max, the difference is it still has the same saline, still has the same xylitol. So, this has xylitol plus six herbs, okay, saline. This says xylitol saline, the difference is it has aloe so it’s a little bit more soothing, all right, for the sinus. It has the grapefruit as well, which, so it still has some killing effects in it and it has some capsicum which is like a homeopathic anti-inflammatory. So, this is like, if you’re like the tissue is really inflamed, really raw, this is a better one. This one’s really good for killing because of the different herbs that are in there. And then, there’s a regular one out there. I have it upstairs, as well, which is the regular Xlear and that’s more like people that have chronic sinus issues, you can use that more every day and it’s a little bit more gentle where it’s just the xylitol and the grapefruit extract and it has the saline and again the benefit of that, the xylitol, it really kind of knocks down some of the bacteria that could be there. It prevents biofilms from adhesions so biofilms are like the protective shields that a lot of the bacteria used to protect against the bugs. So, that’s very helpful. And so, the nice thing is if you do the saline, right? Oh, by the way, the water reverse osmosis or distilled, make sure it’s high quality filtered water. Do not use your general tap water, very bad, so make sure it’s really good. Don’t even use, like, river water, it’s gotta be really good clean filtered water. Like even now and then, I’ll use the water out of my faucet because I have a whole house activated charcoal system so it’s still good but I also have a RO system where my countertop is, so that’s where we cook in and drink out of that water so I use that 99% of the time. So, I’ll use that, I’ll add the packet, fill it up to 8 ounces, pack it and then I’ll add either hydrogen peroxide or silver. It’s good to have a couple that you rotate through just in case there’s some resistance which is, you know, meaning like there’s some bacteria or viral resistance. It’s going to have a couple of things there and then I also have just a straight grapefruit and saline solution as well. This one is okay. It’s gentle and so those are good ways to do it. I recommend, start to do it before you flush like 5-10 minutes before because a lot of times it just releases a lot of mucus and then it allows the flush to do really well and then depending on how you feel afterwards, you can also try it after a flush and then give it a sprayer. So, once everything’s really clean and see how you do afterwards. So that’s a good start out of the gates. Of course things like N-acetylcysteine are wonderful. NAC is great. That helps with the inflammation. Really helps drying up the sinuses. I’ll do glutathione, as well. I’ll do high-dose vitamin C. We’ll add in some different nutrients, zinc, those kinds of things as well. All the good immune nutrients, vitamin D decrease all the sugar consumption. A lot of that is very very helpful. I also have a red light in the office and so I’ll kind of go up against it and let the red light get in there because that’s very anti-inflammatory as well.
Evan Brand: Man, I should have paid better attention to the label on that Max. I was afraid of that one because I thought that one was more intense than the rescue. I’ve done the Rescue forever. I kind of like the berm. You will get a little burn with that Rescue one but the way you talk that Max is actually more soothing than the Rescue. The Rescue is more hardcore so I need to try the Max, I’ve never experimented with it.
Dr. Justin Marchegiani: Yeah. I think the big thing in the Max is just people are already, like more inflamed because there’s less killers in there, it’s grapefruit. It’s got the same sodium chloride, it’s got the aloe which is soothing and that has the Capsicum. I’ll do that right now actually.
Evan Brand: That’s very cool and the question came in about colloidal silver so in some of the rinses you could do a little bit of silver. We, also, have talked about it.
Dr. Justin Marchegiani: I already talked about that so I said you can do the hydrogen peroxide, add it or like I’ll do my nano silver like my GI Clear 3 or some kind of a silver so you’d add like a dropper or 2 worth of silver in there which is what I have for there. So, you can do silver, you can do hydrogen peroxide and you can also do some iodine. Those are your three good ones that you could do. You could also throw in like someone in the chat wrote about like oil of oregano or tea tree or something of that. Maybe overkill if you’re already using the Rescue afterwards or before because you’re already adding that to it.
Evan Brand: Yeah. And so, we could do that in a nebulizer protocol too, so if we’re doing a hydrogen peroxide or a glutathione or a silver nebulizer that could be another sinus support.
Dr. Justin Marchegiani: Yeah. The problem with the nebulizer, I find it’s just, it’s deeper, it’s better for, like lower respiratory stuff. The problem with, like the mucus that comes out of the nose, it’s very tarry. It’s very sticky, right? And so, what is the mucus? Well, you have one just mucus which is clear which is like your body trying to flush bacteria or virus out and then you have the immune system interacting with the infection and then the dead soldiers, right, of that fight, that battle are essentially all the green and yellow and so the more dead soldiers, right, the more battle we go from like light yellow to yellow to darker yellow to green, right? So, the darker, right, and the, the more chunky the mucus is, the more there’s an immune fight happening up there and so what happens is, you have, you know not that, this is the best analogy I can think of is you have all these dead soldiers from the immune reaction just like sitting up there and sticking all to the sinus cavity preventing breathing oxygen exchange and also some of that can eventually go down the eustachian tubes which connects to the back which can go to your ears then you can start to get an ear infection and all that dead debris can also become like fertilizer for like a bacterial infection down the road. So, you got to get it out. So the problem with nebulizer, it’s in a vapor form so it doesn’t have the ability to push the junk out and so with a nice bottle like this pressurized, you can come in there and you can really pull all that stuff out and push it out where you’re not gonna get that with a nebulizer so your nebulizer is gonna be, you can still do it, I still did it daily but it’s gonna be better for lower respiratory issues and this have all the same stuff in it a nebulizer will, the difference you’ll have the pressurized force behind it to really get it out. Push it out. That’s the difference. And there’s some like I mean there’s sometimes, I mean I won’t get graphic but like I’ll blow my nose I’m good right? I’m good, go flush it out and then there’s twice the amount of junk left behind after the flush that was that what I couldn’t get out through blowing and so you get a much deeper cleanse of the sinus cavity with this because a lot of times you’re getting stuff out literally in this upper forehead area in here and so you’re just getting a lot better release.
Evan Brand: Yeah, you mentioned NAC already, which NAC got banned from amazon so if you need access to it, Justin seems on your store, I believe I’ve got a glutathione NAC combo. I do not have an NAC by itself. What do you do, do you have something to offer there?
Dr. Justin Marchegiani: Yeah. We have different products like in my line have a detox amino product that has more other stuff in it. I just have a straight NAC here. I’ll go, there’s a couple of brands that I’ll go back to before, in between 90% are out so a lot of times I just have to get brands right now. That I typically wouldn’t get if we had a better supply chain with NAC right now but yeah we’ll put a link down below anyone needs NAC, they can reach out to the office but to highlight back on what you’re saying there, NAC is super helpful and then also there’s a Nasaline you can get which is like a pressurized syringe which is great. So, you suck up the saline from the bottle, it’s like a syringe, you put it up against your nose and you press it, that’s helpful. Also, I find too if things are really stuck, sometimes you need to go like pulsations so you need to like squeeze hard, relax, squeeze hard, relax, squeeze hard, relax because I find that the pulsation sometimes will free up some of these mucus that’s really tarry and sticky so that can be very very helpful.
Evan Brand: Knock on wood, I never ever get sinus infections.
Dr. Justin Marchegiani: I don’t either. It’s my first time.
Evan Brand: I don’t know what to, what to attribute them to like you said is it an exposure, is it a weak immune system, is there a gut connection to it?
Dr. Justin Marchegiani: It’s just part of the viral infection so viruses tend to go in two major areas. They go upper respiratory or lower respiratory, right? So, a viral infection that goes too deep can eventually become pneumonia. A viral infection here can become a major sinus infection and so by being on top of this, you have your tools, your sinus flush is your best for your upper respiratory, your nebulizer is best for your lower respiratory and so you can prevent those things once you have viral infection, it’s replicating it creating inflammation. You could prevent these things from going too far with those tools.
Evan Brand: Well, that’s a great point you just made which is the possibility of it turning into pneumonia so people listening are like well why should I care, why should I try to do this and speed the process up, why should I try to intervene? Well, because you don’t want to create more systemic inflammation or lead to something more serious especially in a person who’s 80 years old or above, you know, that could create much more problems if they didn’t treat it while it was just up here and it went further south.
Dr. Justin Marchegiani: Yeah and if someone’s sick and they’re trying to prevent it, I think two to three flushes a day is good for, like, prevention especially while you’re sick. I think it can’t hurt just doing straight saline rinse once a day in general. I wouldn’t add any killers or anything to it. Just a straight saline. I think it is fine, just to kind of keep your nose clean at the end of the day. You wanna do that, I think it’s fine. If you’re sick, I’m going like every hour or two, I’m flushing my nose out just because at one it feels really good. It’s really clean and just as long as you’re not irritating the mucus, you know, its isotonic solution, so you have like the sodium, the chloride, it has the bicarbonate in here. Those are the two major compounds, right? Like sodium chloride is basically your sea salt, right? And then, you have your bicarbonate in there. So those are the two major ingredients and then of course this is like USP grade so it’s just really really clean.
Evan Brand: And what do you mean by that? For people listening, what you’re saying is that pH balance so it’s not gonna irritate your sinus cavity.
Dr. Justin Marchegiani: Yeah. You can’t just take regular, like, clean water and put it in your nose. If you will absolutely burn it and irritate it. It would feel like someone punched you in the face because the mucous membranes need a certain pH and a certain level of sensitivity so it’s kind of like using eye drops, right? Same thing. You need to have, like, saline-based eye drops. This is, you’re using sodium chloride. Pharmaceutical grade plus the bicarbonate which is baking soda. That’s everything nice and balanced for the tissues. So, when you flush it, it shouldn’t irritate the sinuses and it should have allow it too feel nice and smooth and gentle afterwards and then if you have some kind of infection brewing even preventative for a bug just add a little bit of silver or hydrogen peroxide in there or a couple of drops, you know, some iodine that’ll give you enough killing capacity to knock down any bugs that could be multiplying but I’m going every hour or two, for me it just feels really good very soothing. It feels like plus if you blow your nose too much, you just keep your nose all raw around the side so it’s nice to have a nice clean flush. I kind of call it like, it’s like a bidet for your nose. It’s kind of how I look at it.
Evan Brand: That’s hilarious. You know, this would be a good strategy for travel too. So, if you need something portable like the excellent Rescue. If you’re on a plane or after you get off a plane it’d be a good idea to boom boom do a couple of sprays that’ll be great.
Dr. Justin Marchegiani: Oh, also, amazing for kids. Kids cannot honk their nose, blow their nose or the damn right. They just cannot get a good blow in there and you get these things on the market like a nose Frida which you know we have one you get like that deep in the cavity. We’ll do the whole nose Frida for you to think about the nose and then we’ll do this with my kids, flush it out and you’ll see so much junk come out. This is how kids get ear infections right? If you look at sinus anatomy, once you go up this far, there’s this canal, right here that goes straight to the ears and it’s called the eustachian tube and with kids it’s a little bit flatter a delta kind of angles up a little bit so it’s harder to get things uphill with kids because it’s a little bit flatter so it’s easy for the mucus and the junk to go into the ear and then you have an ear infection and of course like if your kids are getting ear issues to the food, sugar and of course high dairy products are gonna create more mucus, more mucus in the sinus cavity can make their way and so if your kids are more mucusy, one make the diet changes but two get their nose cleaned out as well so it doesn’t travel to the ear and this is why you want the mucus cleared up because if you let all the mucus and all this coagulation of all the immune soldiers so to speak, stay up there, it can make its way to the nose and now you have an ear infection.
Evan Brand: Yeah. Good point about the diet. I know we got to run here in a minute or two but that’s a good point about the diet if you are looking for like preventative maintenance strategies, I mean obviously you can’t just live in a bubble and not get exposed to things but you wanna have the good foundation of your diet to reduce inflammation, I mean so many people come in and say they have quote sinus problems, really it appears that they’re food allergies because once they clean up their diet, they get rid of gluten, they get rid of dairy all of a sudden their sinus is clear.
Dr. Justin Marchegiani: Yeah. And people have, like, allergies to the environment. One, have a really good high quality air filter. We recommend the Austin air because it has the activated charcoal, the Zeolite plus the Hepa. Hepa is, like, usually standard in most if you’re on a budget. You know, go with the Hepa to start but definitely get one that has an activated charcoal, Zeolite, the Austin air, the filter lasts five years per replacement so you don’t have to spend as much money replacing it every six months and the activated charcoal and the zeolite filters out more toxins but I’ll tell patients like you know, do a flush you know in the morning when you get up, do one after you’re outside working and then do one before bed. Just the saline’s fine. You could do a little bit of spray, you know, before or after. Try before that’s helpful but just try to get the allergen out especially before bed because if you have all these allergens way up here and they’re creating inflammation that could be a stress response during sleep that’s preventing you from deeper restorative sleep and so the sinus can be flush really helpful along with some of the uh some of the remedies that we have here.
Evan Brand: It’s a good call. Well, if people need help, they can reach out. You can book a consultation with Dr. J at justinhealth.com. So, if you have sinus issues or other health symptoms, you wanna talk, see what’s going on, see if we can help that would be justinhealth.com for Dr. J, or if you need help from me, that’s Evan, evanbrand.com. We’re available worldwide. So, most of these products we can get and we can ship to you. I know a lot of people internationally have trouble getting some of this stuff, silver and NAC. Some countries are just weird and it’s hard to import stuff but usually we have. Our team is great with logistics. So, I think it’s good to just have a stash of this stuff if you don’t already, don’t wait till you get the sinus infection then try to order, get it. Get it now. Get it, get prepped.
Dr. Justin Marchegiani: They have a bottle of it there. Someone said, can you do too much of it. I would say it depends, right. I would say, if you have an active infection, I think you’re gonna be fine just make sure the water is clean, RO high quality water. Make sure you’re using a good quality sodium bicarb, I think if the killers are making you more sensitive, right? You could always do your spray or killers before and then do the just the saline without anything in it after so then everything’s clean and flushed out so then you don’t have anything overly abrasive in your sinus after the fact, that’s a good way to do it and if that’s still a problem you could even, you could even just do a saline flush and not anything else after that. It’s still better than nothing just to get everything out of the sinus cavity but worst case do your spray before and then afterwards just the flush. And they have spray that are just silver too, so you have, I have a silver spray too. You can just do that, I’ll do that for my kids sometimes because they’ll complain about it like just the feeling it’s a tiny tinge of a burn for like 10 seconds and so I’ll do the silver sometimes with them. Oh by the way, my kid had a pink eye issue, used to silver spray, opened his eye up, I just like this, I went, gone in two days. So, silver is excellent for some of the pink eye stuff, I would never do it with this. That would burn but the silver is good. I hope that makes sense. Any other questions about that so far?
Evan Brand: I think we got most of the questions answered here, there was one question about getting mucus after food and these were things like yogurts, ice cream, soy sauce, wheat products, well yeah, I mean it sounds like food allergy so obviously I would clean up your diet. I don’t recommend any of those foods, maybe if it’s like a coconut cream ice cream with low sugar maybe but beyond that all of those foods to me sound like potential irritants.
Dr. Justin Marchegiani: Sugar and inflammatory foods, especially excess sugar and inflammatory foods will cause mucus, that’s part of the inflammatory response, that’s just part of it. Yep. That’s part of the reason why people have sinus infections outside of just getting upper respiratory tract viral issues.
Evan Brand: Yeah. Absolutely. How many people are going to the ENT and getting a paleo diet prescription, probably not many.
Dr. Justin Marchegiani: No, and there just gonna recommend steroids, Flonase, steroids, antihistamine, they’re not really ever get to the root cause that’s the problem and so It’s really good that people are bringing these things to the light, you know, this guy Dr. Mehta, I think it’s Dr. the NeilMed guy, he’s really been on top of it, which is great. I mean this is an MD that’s talking about using really good options to clean out your nose and then you know having more of these sprays together is really good and having things that can add to them, I mean, just amazing and a lot of these viruses live in your nose so preventatively we can be on top of it, you’re out with a bunch of people, you know, instead of being overly worried about washing your hands which you know, that’s fine, wash your hands but flush your nose, easiest thing, flush your nose.
Evan Brand: Totally more valuable in my opinion for sure.
Dr. Justin Marchegiani: Yeah. So guys, to reach out to Evan, evanbrand.com. Evan is available worldwide for health consultation support. I am as well, Dr. J, justinhealth.com, we are here to help you out. We’ll put some links here. Give us a little bit of time. I’ll put the links down below very soon so you can see some of the products that we use. Also, we’ll put some of the products that we recommend from our own store so you guys can get an idea of what we like. All right, any questions feel free to put them in the chat. We appreciate it. Share with family and friends, they could benefit and have a phenomenal day. Take care.
Evan Brand: Take care. See you next week.
References:
Audio Podcast:
https://justinhealth.libsyn.com/how-to-address-sinus-infections-naturally-podcast-368
Recommended Products:
How to Get Your Energy Back Post-Infection | Podcast #365
When people start to feel better after an infection, it is often tempting to return to previous levels of work, leisure, and social activities. However, too soon, trying to do too much can often be counter-productive. It is easy to get caught up in a ‘boom and bust cycle of activity that can prolong your recovery.
Dr. J and Evan discuss that if fatigue and other symptoms persist, it’s important to remember to allow yourself time to recuperate by finding the right balance of rest, relaxation, and activity for your circumstances. It is essential to listen to your body and gradually build a physical and emotional recovery plan that can help you get back to your life and stay on track without experiencing too many setbacks.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
5:11 – The essential vitamins to boost your immune system
10:12 – What is the goal of the Krebs Cycle?
14:06 – Mitochondria and microbiota dysfunction in viral pathogens;
17:12 – The role of mitochondria, oxidative stress, and the response to antioxidants in chronic fatigue
20:08 – The neurotransmitters from amino acids and tryptophan pathways in B6 deficiency
Dr. Justin Marchegiani: With Evan Brand, really excited today. We’re gonna have a nice conversation on how to get your energy back post-infection. This is the topic that we’ve been getting a lot from our patients and again a lot of our inspired podcasts and videos come from real life clinical work with patients. So, we’re excited to bring you the real-life actionable information here to improve your health. Evan, how you doing today man? What’s cooking?
Evan Brand: Hey. Doing pretty well, uh, cooked some bacon this morning and that was about it with some organic blueberries and so I’m feeling good. my brain is clear and I look forward to helping people on this energy conversation, you know, so many people have chronic fatigue post-infection and they’re not fully bouncing back and so, I think that there are some easy low hanging fruit strategies that we can talk about but I’m just gonna jump straight to the big smoking gun which is looking at your mitochondria. We’re seeing a lot of issues with mitochondrial dysfunction or mitochondrial damage. I’m also seeing issues with neurotransmitters. So, I think, if you are to pick one and only one functional medicine test to look at to investigate yourself after this infection and fatigue, it would be the organic acids because you can get a great window into not only your gut health. We know that with infections, it does damage the gut, we know that there are ACE2 receptors in the gut so people that are ending up with irritable bowel or diarrhea or other problems during and post infection, we can look at that. A stool might be smart too but if you had to start with only one thing maybe the window into your gut via urine organic acids would be good enough. But more importantly, I want to see what the heck is going on with mitochondria and what kind of damage do we have because once you have the data then you can put together a protocol to fix it.
Dr. Justin Marchegiani: 100% agree. So, we know with chronic inflammation, especially like, post-viral inflammation. We know one of the biggest drivers is gonna be oxidative stress, right? So, oxidation is nothing more than your body losing electrons, right? And one of the big things that helps oxidation within any type of infection pre, ideally, we’re doing these things pre to mitigate al of the oxidative stress that’s happening at the mitochondrial level but simple low hanging fruit, out of the gates, is gonna be glutathione, vitamin C, these are really powerful antioxidants. Vitamin D even kind of fits in that category, right? Your big antioxidants are ADEK, um, I’m sorry, no, those are your fat-soluble vitamins but E is gonna be an antioxidant A is gonna be an antioxidant, right? I would even say E and K would for sure but your B and C are gonna be your water-soluble kind of more antioxidants for sure but the big are gonna plug in, you know, post-viral oxidative stress and/or pre is glutathione and vitamin C, out of the gates. And we can also look at low-hanging fruit on the mitochondrial side, which plugs into the Krebs cycle and the electron transport chain is gonna be B1, which is thiamine. I would say B vitamins as a whole was great but B1 has a major, major role and I’d even say B5, as well, pantothenic acid. So, you have thiamine, B1, right? You have Riboflavin, B2. You have niacin, B3; Pantothenic acid, B5; Pyridoxine, B6; biotin, B7; folate, B9; B12 is your methylcobalamin or hydroxyl or adenosine. And so, we’re talking B1 and B5 are gonna be big when it comes to post-viral fatigue. Those are really, really important nutrients that we can add in out of the gates and, why it’s all of this oxidative stress that’s happening when this infection is present. And so, the more you can do things like hydrate, keep inflammatory foods down like the excess Omega-6 fatty acids, um, keep the carbohydrate and the sugar in check, right? That’s gonna play a major, major role in not adding fuel to the fire if you will as well.
Evan Brand: Yeah, and you can do oral glutathione. So, we have a combination product, which is an acetylated glutathione along with an acetylcysteine. So, you can give your body the nutrients to make more. You can give the precursors but then you can also take just straight glutathione. There are some liposomal versions. There’s reduced glutathione. There’s a nebulizer version that you can take so you can inhale glutathione if you feel that there was some lung involvement. You may consider doing both. I personally did both. I did oral and I continued to do oral glutathione daily and then, also, during the acute situation, nebulized glutathione with silver. And then, you mentioned B vitamins and you can measure all this, right? So that’s the important thing is, you know, you’re shouting out all these different names but people can look at this, right? We can look at this on organic acids. We can look at the various B6, B12. You can’t look at every single nutrient in the body but you can look at a ton of nutrients from one urine sample. So, it’s pretty awesome. And then, vitamin C, believe it or not, we’re seeing a lot of issues with viral infection and acute scurvy, which is pretty interesting. If you just put it some of this data and scurvy into the research, I guess, it’s due to the oxidative stress. It’s happening quickly and every single person I’m seeing post-infection is showing low vitamin C. So, we’re just keeping people on 2 to 3 grams every day. We’re doing a powdered version with a mixed ascorbate. So, you probably don’t want to do just straight ascorbic acid and you probably wanna do like a sodium ascorbate, magnesium ascorbate, if you can get some citrus bioflavonoids in there too and just take it ongoing. Don’t wait until you’re sick. We, as a family, we just take vitamin C ongoing because we know it’s important for the health of your capillaries and all that. Can you speak on that for a minute? Like vitamin C and skin and collagen, I mean there’s a role in other things. People think vitamin C, immune, but there’s other benefits to see, right?
Dr. Justin Marchegiani: Yeah. Vitamin C plugs into making collagen, which is all of the connective tissue for your skin, uh, hair, you know, cartilage, vitamin C is really important for that. Vitamin C is a very similar molecular structure as glucose, right? Don’t quote me but it’s similar to I think C6H12O6 or O8, it’s right in that molecular area, looks very similar. So, what does that mean? That means, vitamin C has a docking site on the macrophage that actually goes and gobbles up bacteria and potential viruses and it’s gonna use that vitamin C that docks onto that macrophage to deal with the oxidation. So, I kind of think of it as like a firefighter going into a house and the vitamin C is like that fire fighter bringing that hose to squelch that fire, to squelch it, right? That’s kind of what I see vitamin C as, right? And, it’s almost like with the macrophage, it has a docking site and that glucose can actually come in there because it looks very molecularly similar to vitamin C and it can almost dock on that receptor site on that macrophage and take that vitamin C where to be used. It’s almost like giving the fire fighter a water hose, taking the water hose out and giving him a gas hose and he doesn’t even know. It’s almost like that and that’s why glucose and high levels of glucose and when it comes to a lot of these post-viral illnesses, you’re gonna see people that have very high levels of blood sugar, insulin resistance and even the extreme on the diabetes side are gonna have most of the side effects of most of the issues partly because of the oxidative stress, partly because of poor levels, you know, when you have insulin resistance that’s gonna affect oxygenation, right? Because, you’re not gonna have good blood flow and when you have poor blood flow and poor oxygenation, we need oxygen to plug into that mitochondria as well. It’s part of, you know, the key nutrients, right? We talked about B vitamins, B1, B5, very important to plug into the Krebs cycle. Well, guess what, when you have a high level of blood glucose and you’re on that pre-diabetic to diabetic side, right, 110 to 126mg/dl on the blood glucose side, your body has to process that and if you just go pull up, you know mitochondria, Krebs cycle and nutrients, right, you’re gonna see all the nutrients that are involved in that Krebs cycle to process that glucose because how it works in the Krebs cycle, everything gets funneled down to acetyl CoA, right? So, you have glucose comes to acetyl CoA, fatty acids come to acetyl CoA, they can also go this way into ketones and then you have protein coming down to acetyl CoA. Acetyl CoA pumps around the Krebs cycle twice and if you look, there’s gonna be nutrients that have to come in there to help that acetyl CoA to come around and a lot of those nutrients are gonna be B vitamins, magnesium, amino acids and so, if you’re coming in with lots of glucose and you’re not bringing in a lot of nutrients to funnel down to the acetyl CoA side, you’re gonna run that Krebs cycle twice and you’re gonna be using more B vitamins than you’re coming in. So, you can actually create a lot of nutrient deficiencies and oxidative stress when you consume a lot more glucose because it’s a transaction fee for your body to process energetically.
Evan Brand: Nice. Nice. That’s a great way to put it. And, the truth is people are coming into this infection with nutrient deficiencies already due to bacterial overgrowth problems, Candida problems, maybe post-antibiotic therapy, you know, they have issues with the gut now and they’re not making enough of their nutrients in their gut. And so, a lot of people will just depend on diet and they’ll simply, well, can I just get enough on diet, can I just eat liver and grass-fed steak and all that and get enough nutrients from that and I’ll say, look I’ve tested and I know, you have too. Over a thousand people and many of those people were already dialed in with their diet for years before they got to us. Paleo, carnivore, autoimmune, paleo, we’ve had people that have been doing an incredibly job with nutrient density and they still show up with nutrient deficiencies and so I would love if everyone could just eat their way out of this situation but I just think with the modern stress that we’re under we’re dumping a lot of those Bs. You’re mentioning all these that are fueling this cycle. We’re so depleted and burned out emotionally, physically, chemically, we’re exposed to toxins. We’re just not living in Paleo time, so Paleo, you can’t just like paleo your way out of this and you know, that’s why I used to call my podcast years ago ‘Not just Paleo’ and then I got rid of it, just call it Evan Brand now but, um, that was my whole thought at the beginning. It was like, man, if everybody could just eat their way out this and get enough Bs in the diet then you and I wouldn’t be needed.
Dr. Justin Marchegiani: 100%. Let me just kind of break this down for people just so they can get a better understanding of what’s happening here. So, when we have oxidative stress, oxidative stresses, we’re losing electrons. What’s the whole goal of the Krebs Cycle? The whole goal of the Krebs cycle is essentially gathering up electrons. Okay, so, you have fats like I mentioned before, they’re all funneling down to Acetyl-CoA. Proteins all funneling down to acetyl-CoA, right? Then you can see on the carbohydrate side like I mentioned, look at a lot of the nutrients that are involved in funneling the carbohydrates down to acetyl-CoA, different B vitamins, okay?
Evan Brand: Zoom in so,
Dr. Justin Marchegiani: B1, B2, B3, magnesium, all play really important roles and then look at the carbohydrates, look at the amino acids that are involved. Cysteine, that’s a major precursor of glutathione, serine, really important for stress. Glycine, that’s your major amino acid in collagen, right? This is why, when you’re stressed and you’re sick, it’s why your grandma tells you to have chicken soup, right, especially with the whole bone in there because you’re getting a lot of these amino acids in a liquid form. So, if your tummy doesn’t feel good and you’re nauseous, right, because the infections tend to really cause nausea because your energy is going to fight an infection versus digestion. So, it’s trying to shut that down. That’s why your grandma said chicken soup, right? Ideally, we keep the noodles out now. Now, look at the fats, right, look at where the fats can go so the fats go down to acetyl-CoA but it can also go and create these ketones, right. This is beta-hydroxybutyrate. This is a ketone, okay? Now, really important here. So, we have this acetyl-CoA, right, this is kind of our energy currency that everything gets converted from our three major macronutrients, fats, carbs and proteins. And again, if you’re listening at home, there’s a video version of this of me going through it. I know, it’s a little confusing but I’m going to try to make, break it down. Acetyl-CoA comes around this citric acid cycle or Krebs cycle. It’s the same thing. It goes around twice, okay? And you can see GSH that stands for glutathione. Fe stands for Iron. So, if you’re a female and you’re very low iron or you’re anemic or vegetarian vegan, that could be a problem.
Evan Brand: So, let me pause there, really quick, because I want to point out something. You’re showing here on this cycle that you’ve got to have not only glutathione but you’ve got to have iron so you gave a shout out to the anemic women and what I want to point out is that the women that came into this infection, anemic, which is extremely common. Women have hormonal imbalances. It’s an epidemic problem so many women have heavy periods or maybe post childbirth, their period was screwed up and they’re having heavy menstruation. So, they’re coming into this anemic or they’re coming into this with low ferritin and then that’s compounded by maybe a mold exposure where now they have low glutathione levels. The way you’re showing this cycle here, if you come in with low iron and low glutathione, you’re in big trouble.
Dr. Justin Marchegiani: You’re in big trouble. And, women are more predisposed because if they have hormonal imbalances, guess what happens to their period, they get heavier. Heavier period, they’re just gonna lose that iron. Now, men on the other side, men have it, you know, they can have increased iron. They can cause oxidative stress because iron is like, you know can be like gasoline on the fire if it does get too high, right? But you can see glutathione, iron, you can see B vitamins, you can see magnesium, you can even see manganese here and you can see different B vitamins. And, what they do is you’re creating NAD and FADH and they’re grabbing hydrogen, they’re grabbing electrons, okay? So, typically comes around here twice and you get usually two NADHs and one FADH2 per cycle and then essentially all of these things will jump into the electron transport chain next. If I could find that section here, but the electron transport chain is the next big step for that kind of gathers nutrients but for really, for today’s talk, this is the really most important thing and then just kind of highlight, you can see some of these toxins over here that come in, right? You can see fluoride, Hg is Mercury, As is gonna be, uh, arsenic, Al is gonna be aluminum. So, you can see some of these toxins, how they can kind of come in there and sabotage some of these things. And, to kind of highlight one thing, this is an article we saw here. Mitochondria and Microbiota dysfunction with post-viral issues, you can see how the gut microbiome also plays a certain role and why is that? Well, I think, because 80% of the immune is in the gut so if you have a pathogenic or dysbiotic microbiome, it’s gonna affect toxins being produced, right? It’s gonna put you right here in a hyperinflammatory state, right? We already have a lot more cytokines being produced if we have an illness and so we have to be able to calm down our immune system’s inflammation to what’s happening from an immune stress standpoint. And so, the microbiome plays a big role, iron dysregulation, reactive oxygen species, right? Vitamin C plays a major role here. Vitamin, uh, glutathione plays a major role there as well.
Evan Brand: Yeah, right there, look at that one, the mitochondrial, the heightened inflammatory oxidative state may lead to mitochondrial dysfunction and so this is what we’re seeing on paper. We’re seeing this in the stool test. We’re seeing this in the organic acid test, this issue with the gut with the mitochondria.
Dr. Justin Marchegiani: Yeah. It talks about platelet damage too which is important because what do platelets do, those are your clotting factors. And so, if we can have increased coagulation cascades, that means more clotting, right? And, you can see more clotting events, more thrombosis is that’s a blood clot, right? And so, you can see furthermore, mitochondrial oxidative just make, may contribute to microbiota dysbiosis altering coagulation and fueling inflammatory oxidative response leading to vicious cycles of events. So, this is really important and so things that we can do to be on top of the fatigue is gonna be the same things that we can do to help mitigate a lot of the inflammation. That’s gonna be keeping blood sugar in check, adding in some of these additional B vitamins, um, adding in anti-inflammatory anticoagulants. What do those look like? That could be ginger. That could be curcumin, which has anti-inflammatory and anticoagulation effects. That could be adding some extra Cod liver oil that has more vitamin A in it, which is a really powerful antioxidant but it also has natural blood thinning aspects because of the extra omega-3s in there. So, there’s different things we can do to really help reduce a lot of that inflammation. Any comments on that, Evan?
Evan Brand: Yeah. On the more intense side of supporting hypercoagulability, lumbrokinase is gonna be your most powerful. That’s your earthworm-based enzyme, which is just a cool, cool thing. Natto, there’s also serratiopeptidase, so there are other enzymes that you can use and I personally take those. I take lumbrokinase, one per day just ongoing and it’s been very helpful. I also did a podcast with Dr. Thomas Levy, all about vitamin C IV and he’s got some dark field microscopy photos of people that we’re having blood clotting issues and the vitamin C along with ozone and IV was like a game changer and vitamin C can help energy too, so I don’t want to get too deep in the rabbit hole of blood clots but we’ll just say that the vitamin C is helpful for energy also.
Dr. Justin Marchegiani: 100%. I want to show you guys one other journal article here, role of mitochondrial oxidative stress and antioxidants when it comes to chronic fatigue and so one kind of thing here, it talks about the known role of oxidative stress and how it can relate to essentially fatigue, as well as, potential, uh, specific therapeutic treatments for the mitochondria so that’s really powerful. And, you know, here are some of the big things, they’re gonna talk about vitamin C, talk about B vitamins, talk about glutathione and then also some of the more natural anti-inflammatory things but you know, each study is going to find out focus on a couple of their major things but, people in the literature are looking at these things. It is real and, um, we’re seeing it in our patients and we’re trying to apply some of these things to get people’s health back.
Evan Brand: Yeah. So, the way you look at this is what you can do to protect against oxidative stress, we covered that glutathione. What can we do to help support the Krebs cycle? We talked about B vitamins. You’ve also got just things that are gonna help the mitochondria in general, like CoQ10 and then also you can do things like PQQ and there’s other nutrients that actually create what’s called mitochondrial biogenesis where you can literally make new mitochondria. And so, I don’t think it’s in that paper, it does mention CoQ10 there but
Dr. Justin Marchegiani: Right here in the mitochondria, there are enzymes and coenzymes such as vitamin E, CoQ10 to remove ROS, that’s reactive oxygen species to prevent DNA damage. So, these are really powerful things that we can add in. For example, low CoQ10, they’ll see an increase in damage, so Coq10, PQQ, you know pyro quinolone, right? Vitamin E, and then, you know, we try to give Coq10 with vitamin E together for that same reason to prevent a lot of the oxidative stress while fueling the mitochondria. Any comments on that?
Evan Brand: Yeah. Look at the next part there too, talking about exercise. People that come in with chronic fatigue and how they’re having an increased oxidative stress after exercise and that’s a problem that we’re seeing a lot too is people that now are having, uh, post-exertional fatigue, people that are crashing. Even athletes that were really high performing people that now their performance is just in the tank and a lot of that is just this ongoing oxidative stress and mitochondrial damage that’s not, that’s not been supported and you can’t just exercise your way out of this and I get kind of annoyed when I see like those motivational videos of people that are really sweaty like you just nee to suck it up, you know, pain is weakness leaving the body. It’s like, no, you’re wrong, you got to fix the mitochondrial damage. I hate those like raw-raw videos because it’s ignoring all the nutrients. That video really needs to be talking about, hey get your glutathione up, get your ribose up, get your CoQ10 up, come on people, like that’s what he used to say.
Dr. Justin Marchegiani: And this is a similar marker that we use on the organic acid test, the one that we use 8-hydroxy-2-deoxyguanosine, this is very, very similar to that. But this is a marker for oxidative stress so we’ll actually use the same marker on a, um, on a mitochondrial test on the organic acid. So, we’ll look at some of these things to get a window of how stress these pathways are so that’s very powerful.
Evan Brand: Yeah. Ribose is amazing. Carnitine is amazing. Acetyl-L-carnitine is amazing. Also, you know, let’s hit the, let’s go up a little bit like that picture there was a like a neurotransmitter picture there that you had. Maybe, we should talk about that a little bit because it’s not directly gonna be a mitochondrial support, yeah, right there, but I think, that’s cool to point out too, which is that, if we’re coming in with nutrients like phenylalanine or tyrosine, eventually some of that may convert over to your neurotransmitters but then also your adrenal hormones like epinephrine and I think a lot of people and I know you see this too, a lot of people are showing up with just low brain chemistry across the board. And so, I’m thinking out loud with you that like, the real magic remedy is the mitochondrial support plus throwing in some of these neurotransmitter supports as well.
Dr. Justin Marchegiani: Well, that’s why we talked about B vitamins and I kind of went to the gamut, look how important B6 is in regarding the synthesis of tryptophan to serotonin, really important so you can see how B6 deficiency is really important in this process to convert this inflammatory product here, quinolinic acid, uh, back to tryptophan, it needs B6 or to avoid that whole thing it needs B6 so that’s really important. So, B6 is really important in the synthesis of amino acid tryptophan to serotonin, very important.
Evan Brand: And so, vegetarians, vegans, obviously, you’re gonna be at increased risk of issues and your recovery is not gonna be as good as someone who’s getting these good animal proteins because you’re gonna be getting adequate tryptophan and other nutrients from your animal-based products. So, even if we could get these people on eggs, if we could get these people on organ capsules, if we could get these people on even like a protein like, I’ve got one we call carnivore collagen, which is a like a beef peptide, I mean something you gotta supplement at some level if you’re not eating those foods. So, please, if you’re a vegetarian vegan and you’re exhausted then look at some of this and hopefully we can convince you to change and improve your diet a bit.
Dr. Justin Marchegiani: Yeah. No, I totally agree. I think that’s really important. I want to see if there’s anything else here, I want to highlight now because that’s enough, that’s powerful enough. Anything else, you wanted to highlight there?
Evan Brand: Well, we hit the urine, we hit the stool. Looking at the gut, you showed the study about the gut changing, we’ve seen that, I mean, you and I were talking about that march of 2020, I mean that was 2 years ago. We were talking about being affected. And so, obviously, our message is the same that it’s always been is get your stool looked at so we can see what kind of dysbiosis do you have going on because if you’re taking all these supplements, you’re doing all these foods but you’ve got malabsorption or you’ve got gut inflammation. You’re not gonna, you know, people say you are what you eat but you really what you digest from what you eat. So, if you have all these other issues in your gut, the grass-fed steak is not gonna be as valuable to you. Now, I’m not saying stop eating it, I’m saying still eat it but we’ve got to improve the digestion and assimilation of that.
Dr. Justin Marchegiani: 110%. And one thing here, I just want to highlight here, just to kind of this article, it’s talking about mitochondrial function in infections in the gut because we’re trying to talk about mitochondrial and energy post-illness, that could be a viral illness, it could also be a gut illness, right? Because, it’s talking right here, even virus dedicated virulence factors and talks about downstream of an infection. It’s fascinating that a plethora of immune responses but, uh, be it against viruses, bacteria or LPS. LPS is lipopolysaccharides or endotoxin, this can come from H. pylori, this can come from SIBO, or dysbiotic bacteria and they strongly impact tht mitochondria which is really, really important because they’re toxic, they kind of throw a monkey wrench in how the FADH and the NAD is kind of moving around the Krebs cycle, collecting hydrogens and then bringing into electron transport chain. It talks about, um, governed by the mitochondria can be translated into active therapeutics to boost immunity against pathogens to over immune responses under control in the case of inflammatory disorders. So, essentially, the more you have these infections there, the more inflammation your immune system creates that can actually impact your mitochondria. Again, when you have a lot of these illnesses, it’s not just the stress from the illness, it’s the immune response from your own immune system that creates inflammation that can actually disrupt your energy pathway. So, sometimes, you’re just fighting against yourself. And so, using nutrients to help modulate the immune response i.e., glutathione, Vitamin D, vitamin C, right, really important nutrients there. I’d also say, you can do things like curcumin, or resveratrol as well. You can have immune modulating effects. These are powerful. So, it’s good to kind of get your immune system in check. Most people that are having longer term, we call it kind of long haulers type issue. It’s typically their immune system has over responded and it’s just creating so much inflammation. So here, this illness, they’re no longer testing positive for whatever this illness is and they’re prolonged 2 to 3 months out and they’re feeling like crap still, it’s because they really didn’t get their immune system’s inflammatory cascade in check afterwards.
Evan Brand: Yeah. Well said. So, a couple comments. Number one, you can improve your energy by simply fixing your gut and that’s exactly what that data is showing and that’s exactly what you and I have seen and done clinically, hundreds and hundreds of times. People that were exhausted coming in, we give them a gut protocol, sometimes, not even giving them energy supplements because on paper they look good and all of a sudden, their energy level doubles and all we did is fix their gut so that’s the number one comment. And then number two comment is that, people need to stop waiting for some illness like this to take them down before they take this stuff serious. I mean, you and I are all about preventative approaches meaning getting your mitochondria, you gut, your brain chemistry getting all that stuff optimized now so that you’re a warrior on a daily basis so that when you do come across something like this and there probably will be more things like this that you do to get exposed to, you’re ready and you’re able to handle it and you’re not coming in so sick and looking for this emergency therapy at the end stage, it’s, in some cases, it’s too late. I think, a lot of times you can turn it around but you should have been working on your health years ago before you got this stage.
Dr. Justin Marchegiani: Yeah. And a lot of it is, you know, anytime you have some type of illness coming up, the more you can be on top of a lot of these key immune modulating anti-inflammatory nutrients ahead of time and or during versus coming in at the end when the inflammation is super high. It’s like coming in when the fire is a little baby fire and knocking it out versus having a full five alarm and trying to stop it, right? That’s kind of the analogy. So, I always recommend telling people have a couple of nutrients. You may not be taking it everyday but they may in your medicine cabinet is kind of like a, um, you know, last ditch kind of effort to kind of come in there if you start to feel a little bit ill so on my line, we have Immune Supreme, which is nice because you have some green tea in there, you have some echinacea, you have some medicinal mushrooms, you have some antioxidants and some immune modulators, that’s kind of cool. Have that in your medicine cabinet. You start to feel the tiniest thing, start taking that to get that immune system, obviously, you can ratchet up, vitamin D, vitamin C. These are easy first line things, if you have any NAC or glutathione, we can ratchet that up. These are easy things that we can do to kind of take charge of our health and prevent our immune system from throwing us off.
Evan Brand: Yeah. Well said. And, if you need help clinically, we do offer one-on-one consults around the world with people so we’re very blessed to be able to help so many people by getting the proper testing done, making the proper protocol to get you better. So, if you don’t test, you guess, you got to see what you’re up against first, look at your Bs, look at your gut, you know, once we get the data, we can help you more accurately and you’re gonna save a lot more money, a lot more time and a lot more suffering and you’re gonna get out of the dumps out of the trenches, out of the depths of hell, depression, whatever you’re dealing with. You’re gonna get out of that faster if you’re using clinical data and you have a tour guide to your body. So, if you need help clinically, you can reach out to Dr. J at justinhealth.com for consults worldwide or me, Evan Brand at evanbrand.com and we’re here for you guys. So, we look forward to helping you out.
Dr. Justin Marchegiani: 100%. I appreciate it. Yeah. Anyone that wants to reach out, Evan already gave you the links, really appreciate it. Comments down below, I really appreciate your feedback on that and also, we’ll put links down below with some products that we chatted about. We have different ones that we recommend in our line. Just wherever you go, make sure you get them from a professional grade company because raw material does matter in the supplement world. You can buy, you know, the equivalent of the grass-fed steak from the local farmer or you can get it from McDonald’s, right? And so, we want to get the high-quality raw material that’s tested to make sure there’s no impurities and just building blocks are excellent. Evan, excellent chatting with you man, really appreciate it. Guys, um, have an awesome week and we’ll talk soon. Take care you all.
Evan Brand: Take care, now. Bye-Bye.
Dr. Justin Marchegiani: Bye.
References:
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https://justinhealth.libsyn.com/how-to-get-your-energy-back-post-infection-podcast-365
Signs and Solution for Gut Inflammation and Leaky Gut | Podcast #351
In this video, Dr. J and Evan stress the importance of what you eat and how it impacts the rest of your body. However, what you might not realize is how your food is digested in your body, and when it gets inflamed and leaky, how do you fix it?
A lack of digestive enzymes can cause leaky gut syndrome—another unfortunate result of chronic inflammation in the digestive system. Many culprits cause leaky gut, including stress, medications, poor food choices or quality, alcohol, cigarettes, and even hormone changes.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:08 – Poor Gut Health Connection to Virus.
4:31 – What is the role of bile movement and production?
11:16 – The influence of gut michrobiota on Inflammation and Insulin Resistance
19:29 – General recommendations on carbohydrates and for a healthier gut
Dr. Justin Marchegiani: Hi! Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the signs and solutions of gut inflammation and gut permeability or leaky gut for short. Really exciting topic. We see it a lot in our patients every single day. Evan, how are we doing today man?
Evan Brand: Hey. I’m doing really well. I can’t remember if we covered this on the podcast or not, this specific study but there was a paper that came out all about leaky gut and worsen outcomes with the virus and so people could put in the, you know, what virus in PubMed and leaky gut and we’re finding that a lot of people with leaky gut that’s actually one of the precursors and that’s what’s leading to worse outcomes so this is more important, It’s always important but this is more important now because we know that there’s a massive link and I’ll actually pull this up here and I’ll show you this, American Society for Microbiology, they did this. Did we talk about this yet or not?
Dr. Justin Marchegiani: Let’s talk about it. Let’s go ahead.
Evan Brand: This particular paper. Let’s bring it up there.
Dr. Justin Marchegiani: Let me check here. Oh yeah. Let me add it on. Go ahead.
Evan Brand: Yeah. So, there we go. So, poor gut health is connected to severe blank, new research shows and long story short, you can go into this microbiology article but long story short they actually show a picture too. Let me see if I can get to that picture. Here we go. That was the picture. I think, we already showed this picture but forgive me and people listening on audio. Basically, we’re just showing that viral particles with a leaky gut are gonna be able to get into the circulation and that’s gonna increase your inflammatory response so the real goal of today is making sure that your gut is in good shape because therefore you’re not gonna have leakage into your circulation. You’re gonna be far far better if you have that healthy gut barrier. So, that was really kind of the spark notes of that but that’s like a 19 pages paper that you can dive into and many people I think have thought of leaky gut as kind of trendy topic that only people like you and I talk about but this is finally, actually getting into the mainstream. So, I hope gastroenterologists are gonna realize the importance of addressing the gut and I hope they actually start taking it more seriously. Right now, it’s just antibiotics that’s really the only thing that gastroenterologists do for gut, right? I mean steroids maybe and immune modulating drugs in the case of like, ulcerative colitis and Crohn’s but beyond that there’s not really much leaky gut conversation going on.
Dr. Justin Marchegiani: No. There’s not and again, really, a leaky gut has an effect, right? Or we’ll call it gut permeability, right? If you go on PubMed, a leaky gut is like a slung. If you want to really find it, you want to look at, you know, gastrointestinal permeability, right? These are gonna be the big things, it’s the tight junctions, the epithelial cells and the small intestine, they start to come apart like my fingers here interlocked like I’m saying a prayer, they come apart and then you can see lipopolysaccharides undigested food particulate can slip out. So, this is, um, this is part of the major, major mechanism. Now, with gut permeability, it’s an effect not a cause so I always tell patients, we don’t go in and treat leaky gut, we treat the corresponding vectors of inflammation that drive gut permeability so that could be food allergens, that could be immune stressors like virus, parasites, small intestinal bacterial overgrowth, general dysbiosis, poor digestion, antibiotic exposure, creating rebound overgrowth, fungal overgrowth, you know, just poor digestion, lots of stress, increased sympathetic tone and adrenal stress, that’s shutting down the digestive system and making gut permeability more probable. So, these are the big vectors so we always wanna draw a line. What’s the root cause and what’s the effect and gut permeability is in the effect not necessarily a cause.
Evan Brand: Yeah. I’ve seen a lot of, even advertisements now on social media for all these leaky gut healing formulas and that kind of stuff and it always has the word heal involved but you could take as much glutamine and whatever else you want. You could go into an elemental diet and all of that. It’s not gonna get rid of these big root causes and certainly for me, I tried some gut support but ultimately it was resolving my parasite infections. That was the most important thing for me and so, you can test for this. This is not an uncommon situation; you and I personally and clinically see parasites every single week. So, when you hear this idea of like, oh, it’s a third world country problem, you haven’t traveled to Mexico or anything like that. That’s just crap, I see it all the time and I had them and I was not out of the country and I had multiple parasite infections and then that affects your bowel flow, right? Can we talk about the bowel for a minute, what’s the role there, because you and I talked about how you have to have adequate bile to act as sort of a natural antimicrobial but how is this happening. What do you think are the big driving factors for why bile production is just not good?
Dr. Justin Marchegiani: Well, first off, we look at the domino rally of digestion. The first thing that has to happen is good, nice aesthetic pH in the stomach. So, we need adequate HCl in the stomach, hydrochloric acid that lowers the pH and again, lower pH tends to have an antimicrobial effect, right? So, if we have to bring the pH down a little bit, that makes it harder for bugs to grow and that pH is also responsible for activating a lot of proteolytic enzymes in our stomach so if we have a good pH, we activate our enzymes, that starts the digestive cascade, we make it harder for bugs to grow and then once all that kind that mixed up food and enzymes and acids and all the stuff in our stomach is all mixed up. That’s called chyme, C-H-Y-M-E, that gets released into our small intestine, our pancreas then produces a bunch of bicarbonate to bring that pH back up to around neutral but that pH being nice and acidic, it triggers bicarbonate and then it also triggers cholecystokinin production, CCK, which then causes the gallbladder to contract so then you get a whole bunch of bile that comes out, you get a bunch of bicarbonate that comes out of the pancreas but then you’re also gonna get a bunch of lipase and proteolytic enzymes, trypsin, chymotrypsin lipase, lipolytic enzymes is coming out of the pancreas as well. So then, you bring the pH back up, you add the fat digestive enzymes, the proteolytic enzymes and then you also stimulate that bile production which then emulsifies that fat. Think of emulsification as you have a nice greasy pan where you cook some bacon on, right? Throw under water, you feel the fat on the pan, throw some dawn soap on there, it emulsifies it. It breaks that up so then you can get it all out the intestinal tract and be able to absorb it, carry on, mycells and be able to use it for lipid bilayer, hair, skin, nail, energy all that stuff. Prostaglandins.
Evan Brand: Yeah. Well said. And though bile is produced by your liver but it’s stored in your gallbladder so people that have had their gallbladders removed which is a very common surgery, a lot of surgeons are very happy to remove gallbladders, I think in many cases, they may have been saved with fixing these other upstream issues but, well, once it’s gone, it’s gone. So, people listening that have no gallbladder, you have to take that into consideration. There was a study here in 2018, it was in the annals of gastroenterology, it found that poor bile flow can contribute to the development of inflammatory bowel disease. So, you’re really setting yourself up and find all the time with people clinically when they come in, they’ve had gallbladder removal, we see a lot of issues, we see massive bacterial overgrowth problems in these people and I think that’s partly due to not having enough bile being stored anymore like you and I have talked about it before, I think you said it was a 10x concentration in the gallbladder, is that right?
Dr. Justin Marchegiani: 10 to 15x. Yeah.
Evan Brand: So, you’re missing out on that when you have just liver production, you don’t have that storage facility. I mean you have some but just nowhere near what you would have had if you had your gallbladder. So, please. Try to save your gallbladder. You got to fix these upstream infections because that’s gonna be and get off proton pump inhibitors with the help of your doctor if you can because we know that, that suppression of stomach acid is gonna lead to the overgrowth which then fuels these downstream issues to not happen the domino effect, it literally gets stopped or prevented by the PPIs.
Dr. Justin Marchegiani: 100%. And so, we need good, think of bile, it’s an emulsifier, it breaks down fat, it’s also an antimicrobial and so we create antimicrobial environments by having good, nice, low pH by having good enzyme and acid levels that also helps and then also by having good bile output and plus the longer that food sits there and rots and putrefies because we are not breaking it down into its constituent parts, right? Then it’s gonna create future petrification, fermentation, and rancidification. Essentially proteins and fats and carbs are rotting, right? Then you can get gas and bloating and that just creates this incredible breeding ground for bugs to grow. It’s like you can have this beautiful home that you take care of but if you leave the garbage in there like, a week too long it’s gonna get like, stinky and then you’re gonna get a whole bunch of bugs attracted to it, right? Same kind of thing in our microbiome so it’s really important that we stay on top of, you know, those good health practices.
Evan Brand: Let’s hit the symptoms and signs and symptoms because people know most of the gut ones but there are some that you and I find clinically that maybe people wouldn’t think are a gut symptom, right? It might not manifest outside of that so we can cover the stuff like unusual color texture, smell, messy poops, you have floating stool. You have maybe alternating diarrhea, constipation, bloating, gut pain. But, what about like, skin issues and what about anxiety and depression and hormonal imbalances and brain fog. I mean, you and I have seen, we lost count how many times we’ve seen cases where we simply just fix the gut and all the sudden, this depression is lifted. I had one client named Miranda, who she had been depressed for, she said quote 20 plus years, all we did is do a gut protocol. I gave her no antidepressant herbs. We simply just did a gut protocol and when we did a six-week follow-up, she said her depression was 90% better and when she said 90% better, she didn’t even sound too excited and I said, are you realizing what you just said to me. You’ve been depressed for over 20 years and you’re 90% less depressed in six weeks of doing a gut protocol like do you realize how profound that is and she goes oh yeah, I guess that is amazing. Thank you. And, I think people, they get so used to feeling a certain way that when the clouds lift. They’re almost not even ready for it but depression, anxiety, I would put at the top of the list for mental health issues connected to these gut inflammation problems, I will tell you. And, you and I discussed this I remember calling you one-night years ago is probably like coming up on be six, seven years ago was like 2014, 2015 and I was like man, I’m having like a panic episode or something and this was when I was living down in Austin and it was H. pylori. It was driving that because as soon as I cleared the H. pylori, all those weird episodes of panic completely disappeared and I’ve seen that more than just the n equals one, me, I’ve seen it many, many times. So, if you have anxiety problems, you go to the psychiatrist. They’re not going to suggest you have gut infections but that’s something you need to be thinking about.
Dr. Justin Marchegiani: 100%. Yep. 110% for sure. Anything else you want to add in that topic?
Evan Brand: If you’ve got mental health issues, look in the gut maybe even look in the gut before you look in the brain. Now, obviously, we’re gonna be doing organic acid testing and other things to look at neurotransmitters so we’re gonna check out dopamine, serotonin. We’re gonna look at what’s called quinolinic acid so we can look for actual brain inflammation or brain toxicity related to gut infections like sometimes Clostridia, we’ll see will drive up the quinolinic acid markers but we still have to fix the gut. So, if you have a family member, they’re anxious, they’re depressed, they’re fatigued. We’ve seen a massive link between chronic fatigue and gut infection. So, there’s another big one that people may not recognize, the gastro doc may not suggest your chronic fatigue is from a gut infection but it certainly can be skin issues as well. My skin was a wreck years ago. I had major acne even though my diet was clean. It was my gut.
Dr. Justin Marchegiani: Totally. I also wanna highlight one other kind of variable here. I think it’s really important. I’m gonna pull this on screen here. I think this is really interesting. So, an interesting abstract here and it’s looking at the influences on the gut microbiome on inflammation and insulin resistance so this is interesting because we talk about insulin resistance, right? Consuming too much carbohydrate and refined sugar. All carbohydrates get broken down typically into glucose, fructose or a combination of the two, right? And so, the more sugar that gets released into our bloodstream that gets broken down whether from refined sugar, sucrose which is fructose in glucose, high fructose corn syrup is fructose in glucose 55, 45 concentration and then of course we have starches which get primarily broken down into glucose and then we have fruit which is more on the fructose side. These things all have an impact on our blood sugar and the more insulin resistant we become, we, it drives inflammation. It’s hard to utilize these fuel resources and these fuel sources to get deposited in our fat because our muscles don’t have the ability to store it. our liver loses the ability to store it. We don’t have the activity level. We don’t have the mitochondria stimulation to burn it so we store it as fat. Now, this article is interesting. It talks about obesity as the main condition that’s correlated with the appearance of insulin resistance. Think of this as when your cells get numb to insulin. Now, this is on screen here. People that are looking if you’ve got mental health issues on the audio version, we’ll put the link below for the whole video. Whole bacteria, their byproducts and metabolites undergo increased translocation through the gut epithelium. Translocate, let me give you the translation on that. Here’s your gut. Leaky gut happens, right? Where it talks about gut permeability and things start to translocate meaning move from the inside of the gut back into the bloodstream, right? So, it translocates through the gut epithelium into circulation due to the degradation of tight junctions. This is a leaky gut, right? Here. And it increases intestinal permeability that culminates in inflammation and insulin resistance. So, what this says is the inflammation caused by gut permeability caused by gut permeability caused by lack of enzymes, bile, food allergens, all the gut microbiome issues can actually drive inflammation and insulin resistance. Now, it makes it harder for your mitochondria to generate fuel because you’re not able to get that fuel into your cell and you start to become more of a sugar burner. It’s very difficult to burn fat when you have high levels of insulin, Very, very difficult. So, several strategies focusing on modulation of the gut microbiome using antibiotics, again, we would use antimicrobial herbs, probiotics and probiotic fibers are being experimentally used to um, in order to reduce intestinal permeability, increase the production of short chain fatty acids. Guess what, things like butyric acid, medium chain triglycerides. Those are all very helpful. And again, this helps promote insulin sensitivity and counteracts the inflammation. So, really, really important here. This study, influence of gut microbiome on subclinical inflammation here and this is the 2000, see what’s the study, 2013 study so we’ve known this stuff out for a long time here that the gut microbiome plays a major role on your blood sugar, blood sugar handling and if you’re a diabetic or someone with insulin problems, you need to be looking at the gut. Yeah. look at the diet, look at, you know, getting your diet and your macros in order, make sure your food quality is good and then look at really getting the microbiome dialed in to really help. That could be a missing piece of the puzzle for people that have really changed their diet but not quite gotten the metabolic benefits of losing weight yet.
Evan Brand: Wow. That’s a good point. You know, when I think back, when I had gut infections, my blood sugar was definitely not as good. I mean, 2 to 3 hours is as far as I could go without having to eat a meal. Now, I could fast all morning and not eat till 1 pm and I’m perfectly fine. I think there is an adrenal component too. I think I’m in a lot better place with that but I can tell you that certainly after mixing my gut, my blood sugar and blood stability is much better. So, I think you’re onto something with that paper and how people that even have gone paleo or animal based or keto. That still has issues with blood sugar regulation. That could be a sign of gut issues and I think even If diet dialed in in some cases what like you’re showing here, there could still be issues with the blood sugar. So, sometimes, it’s portrayed as like just fix your diet and everything else falls into place but you have to consider these other factors and also, I’ll throw in at the, you know, 11th hour here, mycotoxins, we know that mold toxins significantly affect the gut barrier and create a leaky gut. They damage the mitochondria, and we know that certain mycotoxins promote the overgrowth of bacteria like Clostridia and Candida. In fact, the lab will tell you that on paper, for example mycophenolic acid, it’s a very common mycotoxin that we see that comes from water damaged buildings. You breathe that in, that’ll then affect the gut and allow the overgrowth. So, if you’re just treating the antimicrobial herbs or fungal herbs and you’ve missed this giant mold exposure that can still affect the gut, still affect the brain and people won’t get fully better. So, that’s really the beauty of what we do is we try to work through all these puzzle pieces and help you because you could have this guy who says everything is gut and you go all the way down this gut rabbit hole and not get fully better or you go all the way down this insulin resistance rabbit hole and you still miss the smoking gun. You got the leaking dishwasher and your whole kitchen cabinetry. We had a woman in Texas last week, her dishwasher apparently leaking for years. Her entire kitchen has to be replaced now. She’s looking at 25k, just to replace her whole kitchen and she’s been to 10 doctors, 10 practitioners and nobody’s figured it out and I’m not trying to toot my own but I’ll just say I kept suspecting something because she said that she would always feel weird while she was washing dishes at her sink. She would get a little bit of a headache, feel a little bit sick to her stomach, said, ‘huh, is it possible that something’s leaking?’ and then boom brought in the remediator and they found it. There was a leaking dishwasher black mold everywhere.
Dr. Justin Marchegiani: Yeah. Mold plays a major role in stressing out the immune system. It can create gut permeability within itself and then obviously drives the insulin problems. And also, people that eat this type of diet, I mean, it’s natural when you have microbiome issues to create a bunch of sugar because these foods are from an evolutionary standpoint, things that had a lot of sugar in it ended up having a lot of nutrients in it, right? Oh, a bunch of berries, some honey, right? And they were very rare in society. It was hard to find a lot of these things. Even fruit, you know, back then, tended to be a lot more sour and bitter and we’ve kind of hybridized and you know selectively grown fruits that tend to be sweeter and more, uh, and more plump and luscious now they taste. And so, we have sweeter fruits today and so it’s natural for people to want to crave all the crap that feeds the bad bugs because the bugs are producing chemicals to make you crave these foods. So, you have to be educated and understand that these foods, even though you’re craving them, you need to like not listen to those cravings sometimes and really shift your gut in it. If it shifts your macronutrients in a way to starve out some of these bugs, it can make a big difference.
Evan Brand: Yeah. Well said. I mean, a lot of fruits hybridize now too as you mentioned to be sweeter, so like a strawberry. I’ve seen strawberries as big as my hand sometimes, like, ‘God’, you know wild strawberries, they’re tiny. I mean they’re like the size of a fingernail, if you’ve ever seen wild strawberries out in the yard, very tiny and definitely not anywhere as sweet as the other ones. So, when you hear people talk about fruit, like our modern fruit, like you said it’s not really, it’s more like candy with some, it’s like natural candy as opposed to the more ancient fruits so If I can find like some heirloom apples and that kind of stuff, I’m totally into it.
Dr. Justin Marchegiani: Exactly. And you know, my general recommendation with carbohydrates, just make sure you earn it, make sure you’re not in a place where you’re inactive and try to get some activity because sugar goes three directions: gets stored in the liver and muscle, okay, so, if you’re working out, you’re always draining that muscle every day, you have a storage reservoir for it a little bit in the liver; It goes to fat or it stays in the bloodstream and gets burned up by the mitochondria essentially. It gets burnt up mitochondria-wise by the muscles etc. So, it’s gonna go either stored, burnt, you know, it’ll stay in the bloodstream but burnt up by the muscles of mitochondria or it gets converted to fat. So, if you’re doing things that allow you to utilize the glucose in that bloodstream, not as big of a deal, but that’s what you really have to look at what activity level is and you have to work with your functional medicine doctor about dialing in those macros and some people they need to starve out certain macros especially the fermentable carbohydrates and a lot of the inflammatory foods especially grains, legumes, dairy. Those things are really, can be, drive a lot of inflammation and that can keep your sympathetic nervous system and your immune system on high alert which just drains a lot of energy from you. Food allergens can make you fat and they can drain energy from you. Yeah. Seeds too. You know, I cut out almond seeds, nut seeds. Yep, even some eggs too for sure.
Evan Brand: I cut out eggs for her while greens, I mean, some people are way overdoing it on the leafy greens. I can’t tell you the last time I ate a salad. I don’t really care. I don’t do leafy greens. I used to but, you know, I see way too many people doing these like kale smoothies. I had a lady doing like a pound of kale a day. Oxalates were off the chart. We know those affect the gut barrier too so there are downsides to plants.
Dr. Justin Marchegiani: Yeah. I mean, it’s all about, you know, how you tolerate it, can you eat and feel good afterwards, how does your stool look? Do you see a bunch of undigested particulates? If so, you may want to work on just chewing your food up more. Taking some enzymes. See if that helps or sauteed it a little bit and see if that moves a needle. Again, there’s almost always a way, we can adjust things so it works but everyone’s a little different.
Evan Brand: If you need further help, you can reach out to Dr. Justin at his website, justinhealth.com. Now, we do worldwide consultations, phone, facetime, skype, whatever it can connect to, we do it. Lab tests are sent around the world. It’s awesome we have distributors to work with. We can get these things to your door. We sign off on it and get you rolling so we can investigate and look deeper. So, justinhealth and then for me Evan Brand, it’s evanbrand.com. You can reach out and we’re both happy to help you. We love what we do. We’re very blessed for the opportunity to be in the trenches. We’re always improving our own health. We work on our families, our children. We work on everybody around us. We’re always trying to improve them and to be able to do it clinically too is just great. We learn so much from you all and we like to be the shining light in a world of darkness where people have been to countless practitioners and the stuff that to you and I is just common everyday conversation, functional medicine stuff. This stuff to some people is like wow why has nobody ever mentioned that to me before. And for us, it’s like, oh yeah uh-uh, we do it with everyone. So, we look forward to helping you uncover your root causes if you have gut inflammation, what’s going on. There’s something under it so don’t give up, keep pushing forward and please reach out if you need help. We’d love to help you.
Dr. Justin Marchegiani: Yeah. Evanbrand.com, work at Evan. Dr. J, justinhealth.com, works with me. We are here with you guys. And, put your comments down below. Let us know the different things that you guys are applying, what’s working, what’s not and if you get overwhelmed listening to this. Try to take at least one action item out of it. I would say action items from a supplement standpoint. We’ll put our recommended supplements down below. We have different hydrochloric acid and enzyme support products that we’ll put down below for links. That’s always low hanging fruit. Again, diet wise, you know, a good autoimmune, lower fodmap diet can really be a good starting point and I would say for liver gallbladder, you know, we have our different formulas. I have one called liver supreme and again some of the hallmark nutrients in these products are gonna be bile, phosphatidylcholine, taurine, some products will have things like Tudca, which can be very helpful for biliary flow. Beetroot can be really helpful. if I didn’t mention Ox Biles. These are all maybe some milk thistle, very supportive for liver, gallbladder function, liver-gallbladder flow. So, very beneficial, we’ll put the links down below so if you guys enjoy the information and you wanna take action feel free to take a look at some of those links and support the show by grabbing some of those products and Evan will have his links down below as well. Anything else, Evan, you wanna add?
Evan Brand: I think, I said, we give people the links. Make sure you subscribe to the podcast if you’re listening on apple that’s probably where most people find us if you’re looking up. Justin’s show, make sure you subscribe there or my show, Evan Brand. We don’t care how you’re listening, you know, obviously we cross pollinate. We put these on each other so make sure you’re subscribed to both of them so you don’t miss it and we appreciate it. give us a review too. I think we should probably do a giveaway. I know some people giveaways so we can give away a book or you know free supplement or something but, in the meantime, give us a five star review on apple, we would love it. That’s how we stay up in the rankings so that we can actually share true functional medicine education to the masses because right now there’s still a lot of people that are in the top charts just theory. They’re not clinicians. They’re not in the trenches every day, all day, I mean we look at an exhaustive amount of lab testing that helps us to really dial the stuff we’re saying in. We then sprinkle in some studies and we stay up on the research but you could keep your head in the research all day and totally miss what actually works and it’s all about what actually gets people the results. So, keep that in mind and make sure you subscribe. Give us a review on Apple, we’ll love you forever. Thank you.
Dr. Justin Marchegiani: 110% All the links will be below for you guys. Alright, thanks a lot. Evan, great chat with you man. Have a good one. Bye everyone.
Evan Brand: You too, take it easy. Bye-bye.
References:
Audio Podcast:
https://justinhealth.libsyn.com/signs-and-solution-for-gut-inflammation-and-leaky-gut-podcast-351
Recommended products:
The Nuts and Bolts of Your Mitochondria – How to Enhance Mitochondrial Function | Podcast #349
Have you ever thought about what powers are inside your body? In this video, Dr. J and Evan talk about mitochondria and how to boost them.
When we talk about your body’s powers, the easy answer is nutrients, of course! Our body transforms those nutrients into energy, and it’s that energy that boosts the cells in our body. All types of cells have small generators called mitochondria that, in many ways, are their sources for life. Mitochondria are the only part of the cell where our basic life requirements — food and air — are combined to make energy in a process known as the Krebs cycle.
Dr. Justin Marchegiani
In this episode, we cover:
0:00: Introduction
1:30: The role of creatine in mitochondria
6:34: Energy pathways
14:47: Cell Danger Response
16:07: Citric Acid Cycle
Dr. Justin Marchegiani: Mitochondrial function, your mitochondria, little the powerhouses in your cell and they help generate ATP which is the cellular currency of energy so to speak. And we’re going to talk about natural ways to improve mitochondrial function, Evan, and how we doing today, man.
Evan Brand: Doing really well. I think first, let’s dive into some of the big assaults that we have as a modern society on mitochondria. And that could be anything from viruses, bacteria, parasites, gut infections, pesticides, herbicides, heavy metals, plastics, phthalate’s, the BPA, the BPS, flame retardants, nonstick chemicals, car exhaust, air pollution. That I miss any I mean.
Dr. Justin Marchegiani: Like you hit a lot of I would say being sedentary. There’s a lot of mitochondria in your muscles. And if you don’t do enough, you’ll put enough force to those muscles, they will atrophy. And so just not doing enough about creating enough stimulus on your body. That could definitely we can and decrease your mitochondria in your muscles. So, I would say, sedentary and in active resistance through your muscles.
Evan Brand: OK, OK that’s a good point. That’s a good point. So, you’re saying that, like, just in general, you have to have some level of physical stimulation physical activity to keep the mitochondria working. I guess it’s kind of like an old car that you’ve sat there…
Dr. Justin Marchegiani: All your muscles at least. Yeah, ’cause if you decrease, you know your muscle levels via just atrophy due to lack of use. Yeah, your muscles will shrink absolutely and that’s your mitochondria will shrink for.
Evan Brand: Sure, what about creatine? Do you know anything about the role of creatine in mitochondria? ’cause I know when I’m taking creatine, I just I feel stronger? Obviously, there’s creatine’s used a lot in like bodybuilding world, but there’s gotta be a mitochondrial mechanism there because I’ll tell you I feel like. I can lift, you know, at least a good 1020 pounds heavier on particular exercises with creatine in my system.
Dr. Justin Marchegiani: Yeah, me crazy definitely has an effect on growth hormone and improving growth hormone stuff that will help with muscle. Creatine is like instant energy for the muscle. So, it’s it’s there. It’s ready to be used right away in that first 10 seconds or five, five to 10 seconds of muscle use or like explosion movement through that muscle. So, that definitely plays a role in muscle. I’m not sure how it plugs in 100%. I see ’cause really you know with ATP right in the mitochondrial function? If you look inside the mitochondria you have glycolysis and then you have the electron transport chain. Or I’m sorry, you have the Krebs cycle citric acid cycle and that plugs into the electron transport chain. So, glycolysis that’s going to be utilizing the carbohydrate in the muscle right glycogen in the muscle. Fast immediate source. I think creating plugs into that top part. And then you have the Krebs cycle citric acid cycle, where B vitamins, magnesium. All these different things kind of plug into that and with that. With the citric acid or Kreb cycle, that didn’t mean the same thing. Essentially, they’re grabbing hydrogens, right? So, there it’s it’s a reducing agent, so it’s just grabbing reproduce. Reduction is a gain in electrons and so you have NAD goes around. Then it grabs NADH so you get 3 NADH and I think 1FADH2 so you have FADH. And it grabs another hydrogen and that becomes FADH2, and so it’s grabbing all these hydrogens. And then it’s essentially bringing those hydrogens downstream into the electron transport. Jane and Beta fatty acid oxidation there and so yeah, I think you generate was at 36 to 39 ATP through the Krebs cycle and the electron transport chain.
Evan Brand: Unless you’re in like chronic fatigue stayed, this cell danger response, and I think you’re spitting out something low like 2 maybe 3 ATP. I’ve read about this cell danger response. They just call it HDR in the literature, but it talks about how. The cell danger response, could be initiated by trauma or a car wreck or even mold exposure or tick-borne illnesses, or viruses. There’s a lot of you know, Epstein Barr. You’ll see the link between like mono and chronic fatigue. It said that these people are in this state of just a low power output, or even if you have the nutrients, you’re just not generating the ATP with some I don’t know if it was Caitlyn or somebody that you and I had looked into where there was a talk on this about. How the w the the ATP was literally in the single digits. The low single-digit output in some of these states. So, the message here is that for people that have chronic fatigue, you got to realize there is a mitochondrial component to this. Why don’t we talk about testing a little bit? The main thing that you and I are going to look at is going to be the organic acids. I know there are some other tests out there. I’ll admit I’ve had clients send them to me such as the mito swab. I’ve not run the model swab. Personally, I don’t know enough about it to speak on it much, but I’ll just say that it does exist. I believe it is a a mouth swab and it’s probably looking at just a couple generic markers in the saliva. But we like to use the organic acids test because, as you mentioned, there’s the Krebs cycle metabolites on there. We can look into the supinate or what some people call succinic acid. You’ve got the malic acid. You’ve got fumarate. There are other markers on there, and we we see when people have talks and exposure. Like I said in the beginning, the heavy metals, the mold, the pesticides will see those. Mitochondrial markers go up. And the higher the numbers go, generally, the more tired someone is because that indicates more damage to that Krebs cycle. So, the oh is huge, and then obviously we’ll look at stool too. Now the stool test you don’t measure like the stool tests we’re running. You’re not measuring mitochondrial function, but I look at it in a roundabout way. Meaning if you have all these gut infections producing toxins that could be damaging mitochondria as well, so we know that when we clear the gut out, we see the mitochondrial function improve.
Dr. Justin Marchegiani: 100%. Yep 110%. I want to just put something on screens. People can see it here I guess is really helpful.
Evan Brand: Have you seen or heard about that my to swab before? Have you seen anybody send you those?
Dr. Justin Marchegiani: I have, I’ve ran up. Fulham, it’s kind of a binary test. It gives you a result my the issue I have it’s not a lot of actionable information. It’s like OK, you know there’s some issues there, but then now what’s, what’s the remedy that you’re going to plug in from a diet lifestyle supplement? Toxin reduction execution right? What’s the next step on it? So that’s the problem with some. Of those tests, I always. Look and I always ask well what’s the corrective action based on the test showing uses a concern.
Evan Brand: Yeah, yeah
Dr. Justin Marchegiani: That makes sense.
Evan Brand: That’s the problem with a lot of them like I’ve seen a lot of these stool testing companies. Same thing there’s like so much data. Well, this percent of this bacteria and this percent of that. It’s like, what do I do with that? Is that an infection? Is that not an infection? So you and I’ve seen the same problem in other categories of health tests do.
Dr. Justin Marchegiani: 100%. I want to show a couple things on screen here? Just so it’s crystal. Where the mitochondria is and how all these different energy pathways plug in, I think it’s important I’m going to pull it up here on screen in just a second so people can see it.
Evan Brand: Yeah, people listening on audio, they’re going to be lost. So just look up Doctor Justin YouTube page and you’ll be able to view some of this stuff. Some stuff, like mitochondria, gets a bit geeky. The the main thing here is toxins are a big factor in damaging this cycle and you gotta get toxins out. Reduce exposure where you can and we can run actually chemical test on your current too so we could talk about that in a minute.
Dr. Justin Marchegiani: Absolutely, and so if you look here right. Do you have the mitochondria right here. Some middle part, the mitochondri. The outer part is the cytosol. So, from what I understand, like creatine is going to plug more into the cytosol and glycolysis, OK, but then you’re going to see you get about two ATP which is adenosine triphosphate. And this gets broken down into ADP and you get energy right? And so, you have glycolysis which generates a little bit of ATP 2. And creatine to plug more on the outside then that goes into your mitochondria. Now you have the Krebs cycle and the electron transport chain electron transport chains part of also the beta fatty acid oxidation. That’s how you burn fat for fuel. OK, so Krebs cycle that churns around twice, and essentially what you’re doing is you’re gathering NAD and FADH2. NAD&FADH are grabbing hydrogen so and a design to grab a hydrogen making NAD. HFADH is going to grab a hydrogen, making FADH2, so I think you’re going to grab it’s like two or three. NADH is, and then one FADH2. And all those hydrogens then go into the electron transport chain here and this is where you generate most of your ATP. And again, what comes out, oxygen comes and this is why, if you’re like anemic right? And you’re not carrying oxygen. Well, that’s why you’re going to get tired and this is going to have an effect on your thyroid and your adrenals because the mitochondria is important for energy at all levels. And so if we have anemic issues or were inflamed because inflammation is going to make it harder to carry oxygen all. And also nutrition, because this electron transport chain, when we run the organic acid test, we can look at citrate, malate, fumarate, succinate. These are important metabolic essentially inputs into the Krebs cycle that correlate with certain nutrients like amino acids, alpha-lipoic acid, magnesium B vitamins, and so we can get a window on how this. Krebs Cycle was functioning based on the organic acid testing at some of those compounds and then all sister connotate citrate, right? These are really important, and then electron transport chain we can get a window into things like carnitine and Co Q10 ’cause they also play a major role in the electron transport chain. So we get a good window with how the mitochondrial function functioning by looking at the B vitamins and looking at a lot of these nutrients and so essentially things that can impair this. As you mentioned, pesticides. Heavy metals, mold toxins, antibiotics, and all these things have a negative impact. But that’s kind of how things look, so we have. Glycolysis is the first part that then goes into the mitochondria, and then we have Krebs cycle and electron transport chains. These are the big three. If you can kind of zoom out and see how it looks and how it makes sense. That should hopefully make more sense, so on that front. Any question that, Evan?
Evan Brand: Well people listening to that. They’re going to be like wow, this sounds like a really crazy rare problem, right? This must be just rare. This must be like a one in million case and I would say. Not going to say 99. I would say 90% of the people we work with. I see some level of mitochondrial dysfunction or damage either on the chemical profile test, so that’s something I alluded to earlier. We can run chemicals so we can look at gasoline. We can look at xylene. We can look at phthalates, all sorts of organophosphates. 24D is a major herbicide. I still see people at Lowe’s and Home Depot in the Garden Isle buying grass seed. That’s called weed and feed, weed and feed is a grass seed mixed with three different types of herbicides. It’s 24D, I believe it’s dicamba and glyphosate. Wait, I could have mixed one of those up, but either way, it’s three different chemicals, very toxic substances mixed with grass seed, and that’s like people just buy it and they don’t think anything of the term weed and feed. That means you’re going to be killing all the good stuff in your soil and poisoning yourself at the same time. It’s just not smart. So this mitochondrial thing. My point was, this is not rare, like when you show that image and people see that like. Oh no, that’s not happening to me. It’s like it happens every day, all day. I had mitochondrial damage, my latest test shows our mitochondria are much, much better, but I had significant mitochondrial damage from my mold exposure.
Dr. Justin Marchegiani: Very interesting, I want to highlight one thing here so you can see creatine does primarily exist here in the cytosol, right? So if we zoom out, right cytosol is outside of the mitochondria, right? Right glucose, pyruvate here, so just so you guys can highlight here, creatine does go from the cytosol and it can go into the mitochondria. So, we did talk about creatine. It does primarily happen more in the cytosol outside the mitochondria, and it can go in via this. Mi-CRT kind of transport. Compound, so yeah, so creatine is a compound that we talked about that goes outside but can also go inside the mitochondria. To yeah Doctor Neil Nathan.
Evan Brand: That’s awesome! Doctor Neil Nathan did a huge thing for 155-page slide show that people can look up just called the Cell Danger Response. It’s very complex stuff. There’s going to be maybe a few geeky on that. People want to dive into that, but for your average person there’s not much takeaways built into that. But if you want to look into more of like the biochemistry side of it, then then you could look at it. But I think the big summary is it’s all. It’s all the Chemicals, and this is a relatively new problem I mean we face now over 80,000 chemicals are in the environment. Depending on what number you read, there’s only a small amount of those that are even tested. You’ll see stuff in Europe like oh Europe has banned these chemicals and makeup and personal care products, but the US was very far behind. And if you look at the environmental working group, they have a water testing report. You can look at and you can plug in your zip code. I mean just the amount of trihalomethanes’s pesticide herbicide residue pharmaceutical drugs that are in the municipal tap supply in your city are massive and you’re getting hit with this all the time. If you go to a restaurant and you eat rice, what do you think they make that rice with? They make it with tap water so you’re getting exposed to it that way too, which is why if I go out to eat, I don’t really do rice that often anyway. But if I do it, It’s going to be at home with good, clean filtered water.
Dr. Justin Marchegiani: I like it. Anything else you want to say on that, so obviously get the toxin exposure. Super important hydration obviously really important to anything else you want to say on that?
Evan Brand: Yeah, you hit you hit the the Co Q10. You mentioned some of the markers we’re going to look at on the oak test, so we will use those. We have a formula. I believe you’ve got 1/2 mines called my to boost. It’s essentially like a multi for the mitochondria with all the Co Q10, ribose, carnitine B vitamins. So, when we see mitochondrial dysfunction, we can supplement that and we tell people this is a band-aid for your mitochondria. This is not some of it is the root cause, right? If you just are simply low and depleted in Co Q10, one could argue supplementing Co Q 10 is the root cause, but in reality it was usually. Oh here we go. Let me see if I can share this slide with you. Mainly it was the the toxins that led to this so let. Me share my screen really quick.
Dr. Justin Marchegiani: And there is going to be because we do make Co Q10 on our own via the mevalonic acid pathway. And of course, as you get older, just like stomach acid, you’re gonna make less of it and so there there could just be a depletion based on age as well.
Evan Brand: Does that show up at all on your side? The video is that screen share show.
Dr. Justin Marchegiani: Try again.
There’s like a little bell there. Let me let me pop it up again. How about that, yes? Oh yeah, let me let.
Dr. Justin Marchegiani: Me highlight it, go ahead.
Evan Brand: Yeah, there we go. So, this is this is kind of what I was alluding to, and many many other people may have different ways to look at this, but this is from Neil Nathan. He had a great paper on this cell danger response and it just shows at the top here. Basically, everything I already mentioned like a flame. Heavy metals, pesticides, infection, so that would include viral issues as well. Mass cells, NK killer cells, cytokines, the microbiome. All these issues here are what really breaks this role. You know, the one of these is the final straw that breaks the camel’s back and then you end up in this what’s called the cell danger response phase. And then that’s where you get the issues with the mitochondria down regular. So there’s more in that. Like I said, it’s 155 pages. It’s like you got to be, you got to be, you know, have your bulletproof coffee before you look through that.
Dr. Justin Marchegiani: No, that makes a lot of sense, so your kind of really focusing on the toxicity and how that negatively impacts it. I want to just kind of tie in the dietary component. Why is food so important to enhancing the mitochondria? Let me let me break that down for a second here. This is important. OK, so this is really important. We talked about like Kreb cycle right? And so like this is our zoom out right? What’s happening here? We have glycolysis, Krebs cycle, electron transport chain outside of the mitochondria with the cytosol inside. Now check this out. This is a good one. This is from textbook of functional medicine, so. We have fats, carbs and proteins. These are our primary nutrients where everything comes from right. Fast could be coconut oil, grass fed butter could be fats from. Uhm, grass fed meat right? Our carbs can be vegetables, fruit, starch and our proteins could be protein powder or it could be animal protein, right? All of these essentially shuttled downstream. Fats get carried into the mitochondria via carnitine, so if you go into any biochemistry textbook, it’s called the carnitine. Shuttle right. Every medical doctor, doctorate level person would studied this at a graduate level. I studied as well now in the textbook of I think that guidance Physiology, but there’s another textbook of biochemistry that’s common at the graduate level. You know what the rate limiting amino acids to make carnitine are. It’s methionine and lysine and so really important.
Dr. Justin Marchegiani: Guess what some of the rate limiting amino acids are in a vegetarian diet.
Evan Brand: Oh yeah, well.
Dr. Justin Marchegiani: Medallion Leisinger actually very deficient in vegetarian diets, and so this whole process of a carnitine shuttle here that helps bring carnitine converts it into acetyl Co A. So then the actual it can get inside the mitochondria. And run through the citric acid cycle again. That’s the same thing as Krebs Cycle. They have multiple names. In medicine for the same thing, it’s just meant to confuse people. So citric acid cycle or the Krebs cycle. This is how we get fat inside the mitochondria is via carnitine. So very important, right so if we zoom out. Here, we have energy out here, fat. We get it inside via the carnitine shuttle. Super important there and then you see carbs. Right glucose, other sugars. We go pyruvate to lactate and we need guess what B vitamin? So if we’re putting in lots and lots of refined processed sugar and we’re insulin resistant, we can actually deplete B vitamins. And we can actually deplete a lot of magnesium and other nutrients downstream. So, this is really important. Too much carbs, too much sugar, especially if you’re insulin resistance and you’re putting on weight due to too much carbs. That’s going to be a problem, and you’re going to deplete nutrients now. Then we have proteins, amino acids. These all get converted downstream. We also need B itamin to support that now the difference is if you’re eating high quality protein. Guess what? You’re getting good quality B vitamins in that. Protein if you’re doing a lot of refined processed sugar, guess what? You’re not getting vitamins and nutrients with it. So carbohydrates, it’s possible to eat a lot of empty carbs that are actually going to deplete your nutrient levels. Protein not as much if it’s grass fed and organic right now, really, you’re taking all these nutrients, fats, carbs and proteins. You’re converting them into acetyl Co A. OK, you’re converting it to acetyl Co A and again we spit off beta-hydroxybutyrate what’s that? That’s a ketone now this is important. If we keep our carbs in check we can use ketones for fuel, so this is a really important fuel source or people that are going to be lower carb because we’re going to be more keto adapted. We’re going to be able to use that and then you can see here that acetyl Co A. Runs around the Krebs cycle. Twice we go 2 turns. Guess what, we need cysteine amino acid iron really important. So if you’re a female you have heavy bleeding your estrogen dominant you heavy bleeding that’s in effect energy magnesium manganese B vitamins lipoic acid magnesium B vitamins B vitamins tyrosine phenylalanine aspartate, glycine, histidine, arginine, proline. Glycine, valine methionine, right? These are all amino acids over here. So, we need amino acids to run these systems. We need B vitamins. We need magnesium and then of course, once we pump these things around, here’s our NADH and then our FADH should be there somewhere as well. So here NADH, it may not. They may just be oversimplifying it not showing it. But we have NADH here. We should have an FADH2 coming in. This all goes right into. Guess what? This is the electron transport chain and base. Yeah, fatty acid oxidation right there, right? This is now now hydroxymethyl Glutarate. This is Co Q10. This is where Co Q10 comes in and this is where it runs through the electron transport chain and burning fat for fuel and we generate our 36 to 38 ATP from all these three sources 1-2 and three and so that’s what’s happening in your mitochondria. So just to kind of highlight macro nutrients, fats, protein, carbs, very important two, don’t junk it up with all the toxins that you mentioned. And then of course, making sure we. Can breakdown protein. Make sure we’re getting enough iron making. Sure, we’re not. Anemic right? All of those things kind of flow into allowing all these pathways to to work optimally.
Evan Brand: That’s amazing, I love the breakdown to that. The visual super helpful. So just to clarify a little bit. So for women out there, you’re saying that if having heavy ministration, they have low iron. It’s not just the the low iron that we assume is creating like a low oxygenation, you’re you’re showing here. The low iron is literally creating a mitochondrial deficit.
Dr. Justin Marchegiani: Correct. You’re not getting the oxygen in right? If we go back to here, right? Mitochondria, what do we need to get into the mitochondria? Oxygen, what’s one of the big carrying capacities for oxygen in the body? Hemoglobin and then iron affects hemoglobin in red blood cells, right? Hemoglobin is part of the red blood cell carrying capacity and we need the iron to really keep the hemoglobin levels up so we can carry enough oxygen.
Evan Brand: Wow, so there’s why you’re tired.
Dr. Justin Marchegiani: Could be. Yet, one and then of course all of the other nutrients play a role. Not enough of the amino acids. The only issue with this graph, any biochemists that are looking on? I think the only thing that’s missing is really the FADH2, so it should. So, all these things, they’re just reducing compounds. Really, the whole goal of this Kreb cycle to run is just grabbing hydrogens. And then once we grab these hydrogens, Uhm, these things get cleaved off, and then it generates ATP. What’s happening there? And all these things like hydroxymethyl iterate. These are right. These are all driven through Co, Q10, right? We need Co Q10 to make that happen.
Evan Brand: Now for people like supplementing ketones, if you go back up to the top there, you can basically kind of inject your own spark plug into the cycle, I guess right? If you’re taking exogenous ketones, what is that doing in relationship to this whole cycle?
Dr. Justin Marchegiani: It’s giving you more beta hydroxybutyrate. The problem is your body is going to primarily want to use that when insulin levels are lower, so you have to keep your insulin levels and check. If not, you’re not setting your Physiology up to want to burn that. If you’re probably, gonna pee it out more like more than likely versus burn it. Cause typically, your body has an enzyme called hormone sensitive light pace where it wants to break down fat and convert more of these ketones. Hormone-sensitive light base is inverse with insulin. So hire your hormone-sensitive light pace is you need lower insulin to make that happen.
Evan Brand: So the lady who eats the donut and then goes to the store and buys her exogenous ketones, she’s wasting her.
Dr. Justin Marchegiani: Probably not as good. There may be some mild benefits that you get cognitively just ’cause your brain has some additional fuel to run on. If people brains are insulin resistant, they may have a lot of sugar from that doughnut, but the cells in their brain maybe so numb. To it that they may not be able to access it so some ketones could be helpful, but in the end, you want to fix the insulin resistance if you’re going to do it. Try doing both. Don’t just do the ketones. Try to do both that you can.
Evan Brand: And you can make your own ketones too. For free.
Dr. Justin Marchegiani: Yeah, yeah, that’s how you’re doing that you keep in your insulin in check. And you’re going to start. Making your own. 100%.
Evan Brand: Yeah, cool.
Dr. Justin Marchegiani: Cool, that was awesome. Very cool guys. I hope you guys enjoyed today’s podcast. We’re trying to be a little bit more visual; you know. Go into some hard hard science Y stuff, but you know just kind of zoom out. Like what’s the take home right? The take home is don’t put junkie toxins and that screw up your mitochondria right? Antibiotics, I mean antibiotics? You know if if you have an acute infection that’s not resolving, you know you gotta do what you gotta do, right? You have an acute pneumonia. You gotta do what you gotta do. Talk to your doctor about it. Just don’t go to antibiotics all the time as your first line defense. Try to do some. More natural things to fix it #2 you know, try to be aware of mold in your environment. Make sure you’re not. Getting exposed to pesticides. Chemicals heavy metals. Make sure you’re doing your best to hydrate right. We need water to make this whole thing work too. I would say after that make sure you have your macronutrient style, then good quality protein fats and carbohydrates. Organic sources dial in your carbs so you’re not insulin resistant and make sure your inflammation is good. Inflammation helps with oxygenation and blood flow. Then after that we can look at using supplemental nutrients in my line and Evans line we have mito supports products mine is mito synergy. Evans is my toe. Boots will put links down below. Those products have a lot of these nutrients. It’s going to have the ribose to creatine the carnitine, the B vitamin. Since it’s going to have the Co Q10, it’s going to have actually Kreb cycle intermediary compounds like fumarate malate, succinate. All those different nutrients or run those pathways better. Of course, that all sits on top of a solid diet. Don’t take supplements if you’re going to eat crap, eat really great and then say OK now I’m going to work on enhancing it. And again, we can run testing on organic. Message to look at some of these intermediary nutrients, like citrate to connotate succinate bloomer, a mallet we can actually test them, which is pretty cool.
Evan Brand: Yeah, the testing is the best part because you you know if you actually need it. I can tell you the average person has mitochondrial problem, so in general, could you just take this? I kind of call it a multi for the mitochondria. Could you just take that test? You know like a guess and check you could, but we like to see the data and obviously my biggest thing is looking for mold colonization. Candida overgrowth clostridia. Some of these gut infections and how that affects your brain chemistry too. So when you do the oh, you really are getting the best bang for your buck in terms of testing. Like if you could only do one test out there, I think the oh it would. Probably be the number one most.
Dr. Justin Marchegiani: Important 110%. Anything else you want to say?
Evan Brand: If people need help, they can reach out to you worldwide or me worldwide. Doctor J at justinhealthcom me Evan at evanbrand.com and we would love to chat with you about your symptoms, your goals and we’ll tell you for your good fit for care, so please feel free to reach out. Look forward to helping you.
Dr. Justin Marchegiani: Foot and get adjusted. Help calm here and then you guys have any questions, comments or concerns. Put him down below. Let us know. Kind of what you’re doing. What’s working that really helps us out as well. Very cool. Alright guys, well you guys have a phenomenal day here and we’ll. Be in touch. Take care of y’all.
Evan Brand: Sounds good.
Dr. Justin Marchegiani: Alright Bye bye.
References:
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Genova Organix Comprehensive Profile
Vitamin D Benefits You Should Know
Vitamin D has a couple of different benefits. Let’s go over some of the benefits. We’ve talked about the natural antibiotic that’s being produced by vitamin D, which is called cathelicidin, a kind of antibacterial enzyme. It is super helpful at being able to knock down bacteria. It also has antiviral mechanisms, as well as antimicrobial peptides and antiviral mechanisms.
Part of that is it stimulates and it can modulate the Th1 immune response in the Th1 immune system where you’re making a lot of your natural killer cells and your helper cells. Good helper cells can also help your antigen-presenting cell and it can help make antibodies more efficiently. So, you’re also going to have a better Th2 immune response. You’re going to make antibodies to whatever that infection is. Those tend to come a little bit later in the game, but good signaling to make your antibodies is super helpful as well.
There is a couple of other studies here that are talking about different things. We have a reduction in our MMP-9 concentrations. We have a reduction in bradykinin storms and reduction in our cytokine storm. So, basically we have a lot of inflammatory molecules that get produced such as bradykinin, cytokines, interleukins MMP-9. These are inflammatory types of chemical messengers. Vitamin D can help modulate that and prevent that from being overproduced. The more we overproduce those, the more our immune system responds. So, we can create more cytokine storm issues because our immune system will be on this positive feedback loop, responding and creating more issues with the cytokines. When there are less cytokines, there’s less chance of a cytokine storm, which is basically our immune system responding.
Imagine a fight between two people where one person yells out first and the other person yells back. Then they’re pushing, shoving, and hitting and the violence escalates. That’s what happens with the cytokine storm with your immune system and all the different cytokines and immune chemical signal. So, we can keep that modulated a bit which is very helpful. Vitamin D plays a really important role in that.
Recommendation
Get vitamin D supplementation from Thanksgiving to spring. At least, make that investment. If you want to come off the rest of the year, as long as you’re getting some sunlight, it’s fine. At least do that vitamin D supplementation to give you a good bump and the fat-soluble nutrients you’ll get over those four or five months will hang around months afterward because it takes a while for that vitamin D level to build up.
If you want to learn more about Vitamin D, click this link where you can schedule a chat with me!
Effective Ways to Increase Your Vitamin D Levels
Back in the 1980s, a guy named Edgar Hope-Simpson proposed that a seasonal stimulus was intimately associated with seasonal epidemic influenza. Long story short, winter comes and then all of the sudden viruses become more of a prevalent issue. There was this whole interventional study that showed vitamin D is reducing the incidence of respiratory infections in children. So, this was specifically talking about kids but there are countless of these for adults.
What’s happening when the vitamin D levels are sufficient are a multitude of things but in particular, it’s helping to reduce Interleukin 6 (IL-6), which is one of those inflammatory cytokines that get people in trouble. So, if you can reduce your cytokines, that’s going to be beneficial. Also, another cool benefit is not only a sort of an antiviral but there’s some antimicrobial benefit. It can actually activate your immune cells to produce some antimicrobial like a natural antibiotic if you will by upping vitamin D concentration.
How do you take Vitamin D?
Is it just an ongoing thing? If you think you’re getting into trouble with illness, do you go high dose of it? It depends on what your levels are.
So, get a baseline first. I would say the lighter or more fair your skin is, probably the more efficient you are gonna be in converting vitamin D from the sun. The darker your skin is, the more melanin you have. You’ve got different spectrums and for example, a full-on African-American has the highest amount of melanin.
What is Melanin?
Melanin is like your natural UV block and it helps block your skin from the sun’s rays. So, due to evolution and where we evolved, there are people who live closer to the equator and there’s more UV light based on the angle of the sun hitting it. These people naturally evolve with more melanin in the skin. People that evolve further away from the equator get less direct UV light, so there’s less melanin in the skin because it’s all about making vitamin D.
So, the more efficient you are at making vitamin D, you probably will be able to get away with not supplementing as much or as frequently. The more melanin in your skin, the more you have to be on top of your vitamin D because unless you’re going to be outside 6 to 8 hours a day and you’re at a mid to low 30 latitude, you’re probably just not going to be able to ever make enough vitamin D. Therefore, you really have to be on top of everything in your testing.
Vitamin D Dosage, Testing, and Recommendation
For lighter skin, in general, a good rule of thumb is 1000 IUs per 25 pounds of body weight, especially in the fall and winter months. If you want to take a break in the summer, that’s fine. Just make sure you get a test here there to confirm it. The darker your skin is, you may even want to double that in the winter months. Then you may want to follow-up and retest in the early spring to see and to monitor where you’re at. If you’re someone who works outside, you have to make that adjustment. If you’re an office person and you’re inside all day, you also have to make that adjustment, too. So, in general, 1000 IUs per 25 pounds of body weight.
If you have darker skin, you may want to double that for the winter months, and then it’s always good to confirm some time in the winter and some time coming off the winter or early spring-summer to see where you’re at. We can always adjust accordingly and if there is any risk of autoimmunity or cancer, we probably want to be testing just a little bit more frequently. Once you know where you’re at, you can guess based on how well you’re doing.
How To Enhance and Support Fertility with Functional Medicine | Podcast #332
There are two main methods for getting pregnant and if you’ve struggled with conceiving then you’ve likely looked into and/or pursued traditional medicine. This doesn’t necessarily make you healthier, but your doctors will try to change your hormones to encourage pregnancy. On the functional side, Dr. J would focus on enhancing health, enhancing physiology, regulating hormones, etc. Even then, sometimes measures like IVF are still necessary for the end. But before we get to that, we want to look at all the natural ways we can encourage your body to prepare for baby-making in both men and women.
Dr. Justin Marchegiani
In this episode, we cover:
0:24 Two Approaches in Fertility
7:29 Root Causes
17:20 Right Diet
30:40 Prenatal Supplements
34:54 Adrenals
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house. Evan, how are we doing today man?
Evan Brand: I’m doing better. I had COVID Believe it or not. And that was like a five day journey. I think I’m over the hump. So if I sound a little weird, that’s why, but family’s healthy. And I’m a survivor. Now I’m going to be in the, quote, recovered category.
Dr. Justin Marchegiani: Love it. That’s good. Excellent. Well, today we chatted kind of pregame that we wanted to talk about fertility, talk about natural ways to enhance fertility. We see lots of patients that as a side effect of getting healthier through natural medicine, functional medicine, good nutrition, diet and lifestyle. They get pregnant, even if fertility wasn’t a goal, and we have some patients that come in with a goal of fertility and the nice thing is, fertility is a byproduct of getting healthy. So I mean, there’s kind of two approaches to it. There’s the conventional medicine side where they’re not really making you healthier, they may just be changing some of the hormones in your body. So you can get pregnant, right? IE via IVF therapy, those kind of things, right. And then there’s kind of natural ways that we are utilizing the enhancing of healthy and enhancing physiology to get pregnant. And sometimes IVF may be necessary. If you’ve done everything you can do on the health side, and you’re still not getting pregnant, that may be an option, right? But we want to do everything we can do on the natural medicine side, because if you do that, you know, 80 to 90% of people I think are going to get the results they want, which is getting pregnant. So I’m excited to dive into this topic with you today.
Evan Brand: Yeah, I would say that it’s pretty rare to need IVF based on some of the people that you and I’ve seen clinically, I’ve had several men and women and it’s good as a couple right. So that’s the important thing to mention. It’s important for the couple to get healthy the a lot of the blame is placed on the woman but in many cases, you know, male sperm motility or sperm concentration is a big issue. So the men kind of, you know, I don’t know why, but in general, the men get ignored in this conversation, but it’s really important for them to get optimized as well. And we’ve had couples where they looked at the cost of IVF, you know, typically 10, upwards of $15,000, depending on where 20,000 Really? Yeah, okay, so 15 to 20. And people come to us first and say, Well, you know, we didn’t want to go to IVF yet, because of the cost cost was kind of their main motivator, and maybe they, you know, hopefully had some sort of a natural minded bias. And so they said, well, let’s see what we can do first. And then 100 out of 100 times, so far, we’ve been able to avoid IVF for those people. And we’ve had, you know, between you and I alone, we’ve had four healthy children on our own. And then, you know, countless women that have had healthy pregnancies with our support
Dr. Justin Marchegiani: 100% it’s all about getting to the root cause, right? And yeah, there is that whole idea of the pottenger cats experiment where pottenger was in a medical doctor, I think, in the 50s, and he had different cats and he would feed some raw food, some processed food and and then there was, I think, within three generations of eating processed food. The cat group that ate the processed food lost the ability to reproduce. So there is this idea that we’re on like the third generation or so of this pottenger cat experiment. And there is some people that are just at that and end level where they may have reduced fertility just because they’re living out the pottenger cat experiment in real life. It’s possible some of that is the case. So we want to do our best to really emphasize a whole food nutrient dense anti inflammatory diet. We know that pregnancy involves healthy hormones. And as a starting off point, we don’t want to eat foods or toxins or hormones in our animal products that could throw off our fertility. So the first step in any fertility program, nutrient dense anti inflammatory, low toxin, that’s going to mean an organic whole food diet. that’s going to mean cutting out hormones and antibiotics and pesticides, and GMOs. A lot of these pesticides are xeno estrogens, they mimic hormones as well because they affect the insects from reproducing. That’s how they kill them. Right. And so it can also have an effect a cumulative effect on women and men on the sperm count women on the fertility side. So diet is going to be one of the first things and the second thing is going to be blood sugar stability. I think this low fat low cholesterol era, skipping meals fad dieting has prompted lots of insulin resistance, lots of reactive hypoglycemia, meaning too much sugar, too much carbs, blood sugar goes up and then spikes down, which then creates this insulin surge and high levels of insulin is really what’s behind the leading cause of infertility in women which is pcls. That’s polycystic ovarian syndrome. And that the mechanism there is high levels of insulin, insulin resistance insulin surges, thus increase androgens, and then the androgens also can throw off prolactin and then that can dis regulate a woman’s cycle. So you can see There’s a lot of different hormonal rhythms that can that can go off together and create many issues. So the major mechanism is in the beetus, insulin resistance, followed by increased level of androgens, free testosterone, testosterone, and then also prolactin issues to boost. Those are kind of the big initial sequelae that we see. And of course, usually if they’re eating a lot of crap or hydrating junky foods, people that are missing that level of awareness, tend to also be consuming the pesticides, maybe going to low fat, low cholesterol, maybe not getting high quality animal products and getting all the hormones in there too. So that’s like kind of my first two things out of the gates.
Evan Brand: Yep, well said and just want to quickly go over the conventional treatments for infertility, especially resulting from pcls. That’s what we did on our gut health podcast, kind of the conventional versus functional gut health. People loved it. I got a lot of good feedback on that. So thanks for the feedback. But it’s not pretty you mentioned it’s not root cause and it’s not so you’ve got this clomiphene which is the American College of obstetrician gynecologist recommendation that’s their primary medical medication for pcls patients with infertility, it indirectly causes eggs to mature and be released. Then you’ve got Metformin, which we just talked about the insulin resistance problems. So Metformin would come in and help. They talk about it helping just in terms of population, but that would probably be just due to helping to lower insulin. That’s what it is.
Dr. Justin Marchegiani: Yeah, Metformin, it liquefies. That’s a big one.
Evan Brand: And then you’ve got the letrozole. This is a drug that slows estrogen production causes the body to make more follicle stimulating hormone FSH, which is what you need for ovulation. And what else here they’ve got just other hormones in shot form, which are going to cause ovulation and then the craziest one, let me just read this one here and then we’ll we’ll move on into the functional you’ve got ovarian drilling. And so the surgeon makes a small cut in your abdomen inserts a long thin tool. And they use a needle with an electric current to puncture and destroy a small part of the ovary. This surgery leads to lower androgen levels, which may improve ovulation. So Wow. And if you do all those and you don’t get pregnant, then you could go to the IVF, which is where the sperm in the egg are put in a dish outside the body fertilization, fertilization happens, and then they put the fertilized egg into the uterus, and then boom, there you go.
Dr. Justin Marchegiani: Exactly. Now, I kind of want to tie back to the root cause I want everyone thinking about fertility from a root cause perspective, because when you think about it from a root cause then you can say, hey, are we getting to the root cause doing this procedure or doing this thing? So first off, like I already mentioned, pcls is a big one. Now with infertility, there’s usually going to be some level of insulin resistance or blood sugar dysglycemia meaning your blood sugar is up and down. And your body has to make a lot of hormones to regulate that flow blood sugar So when your blood sugar goes really high, right, because of excess carbohydrates in balanced meals, not enough protein and fat, you’re going to surge a whole bunch of insulin to bring the blood sugar back down. Now, women that tend to be more on the heavier side, usually that blood sugar eventually start staying higher, because that’s that’s what diabetes is right chronically high levels of blood sugar, but usually before that, there’s some level of reactive hypoglycemia where blood sugar goes up and then crashes down because the body over secretes insulin. And when the cells are still sensitive to insulin, that blood sugar will drop down really, really fast. And then your body has to make a lot of adrenaline and cortisol to bring it back up. Okay. So if we tie in prolactin, prolactin is going to go high when there’s high levels of estrogen. So when we start having more estrogen dominance, Okay, first mechanism, how does estrogen dominance happen? Well, it’s going to happen one through exposure of estrogens and the environment to with gonna happen through metabolism of progesterone. So progesterone is a really important progestational Pro fertility hormone very important. When we get stressed we’ll actually convert progesterone downstream into cortisol. So when we get chronically stressed, we’re going to decrease progesterone. And then number three high levels of estrogen, estrogen dominance, that is going to start driving prolactin issues. And when we start burning up dopamine, right, dopamine is a very important neurotransmitter. Dopamine gets used to make adrenaline so when we start making a lot of adrenaline, a lot of stress neurotransmitter, dopamine gets used, and dope means a tonic inhibitor or prolactin. So imagine you have prolactin and you have dopamine level is like the foot on the brake, right. And as you start depleting your dopamine and you start getting more stress, you’re taking your foot off the brake and what happens to prolactin, it goes up and prolactin starts to go up one of the side effects Next is loss of ovulation. Right You can go, [inaudible]. So you have a couple of mechanisms, right? You have this prolactin mechanism from dopamine, you have estrogen dominance, which can affect prolactin as well. You have this infertility through pcls. And insulin resistance and elevation and androgens, right. And then also all of the food components, all of the hormones and the toxins and the pesticides also contribute to that.
Evan Brand: Yeah, those are, I would say the biggest and most important things affecting your average american. There’s a couple other small subgroups, I want to mention what I’ve seen with infertility, one being people that are overtraining with exercise, you mentioned also the period. So I had a woman who she was, she was in the small percentage, but we have to talk about the small percentage because you know, people who are healthy and want to be healthy, listen to our podcast, and so there’s people that may be overachievers will call them and so we had a lady that was doing CrossFit like four or five times a week 45 minute sessions, and just beating the pavement. Now, typically when someone’s doing that we don’t really need to run a hormone profile. But just because I knew that it would increase her compliance. If I told her to stop exercising, she may not listen to me. So we use the testing to prove on paper what we already knew intuitively, which is that she was causing her cycle to be disrupted due to the chronic stress of the overtraining. So when we ran the hormone profile, and we showed her what her cortisol look like, it was basically flatlined, except for the time of the day when she did the exercise, she had a mild spike, which is why she felt better. You know, she said, Oh, my day is not complete until I exercise that’s because her cortisol was so low, and when she whipped the tired horse, all of a sudden she got this temporary boost of cortisol and adrenaline. She felt normal and that was it. But the prescription for her to get pregnant was simply just go down in the exercise. I just told her do three days a week Max, but do yoga, restorative, do biking, do hiking, do gentle things that are fun for you, and fun. For your family, and that’s all she did. I mean, her diet was already dialed in. We did look at her gut. We didn’t see any infections there. You know, we knew that there was no insulin problem, the carbs were not an issue. And she got pregnant just by simply reducing the training. And then another small group of people are people, women, specifically that were just going to low carb. So I had several women that were on a ketogenic diet. And some would argue well, our ancestors they could have been ketogenic, right, they were out in the prairies eating the bison, and they may not have had access to potatoes and whatever else but I do believe that some carbs are beneficial and necessary for fertility and for healthy pregnancy. So I had some women that were on keto for a long time, all we did is just add in some starch, organic white rice, we did some potatoes every once in a while and boom, they got pregnant and we didn’t change anything else. This is of course after we do the whole functional medicine workup, which you and I will talk about in a minute. That was after we did all that then we tweak the diet and then boom, she got pregnant.
Dr. Justin Marchegiani: Yeah, and I would say because information ability is primarily driven through PC OS and PC OS, the major mechanism behind it is going to be insulin resistance. I think a default template should be a lower carb paleo ketogenic template. But just because that’s our default doesn’t mean we’re not clinicians and adjusting things for the patient. So of course, with this girl, she may have done really well with that. And then she may have tapped out her benefits with it. And she may have already been at a really good place with her insulin. Because if you get insulin too low, and you’re already are relatively healthy body comp, that could also be a problem too. So this is why we have to individualize it for patients. So we’re talking about pcls and insulin resistance. And for most people, that kind of a dietary strategy is going to be a really important starting point. But for some people, you may hit the wall, and you have to adjust like you haven’t talked about others, you may have to hang out there a lot longer. So it’s kind of keep that in the back of your mind because we’re kind of having two conflicting recommendations. And that’s because everyone’s at Individual, and we have a starting point for most and then we adjust according to the patient’s needs after.
Evan Brand: Yeah, and that’s just an extreme case, but I at least wanted to mention it right? Because you always have the people that say, well, I’ve already done paleo and I still you know, had issues of course, there could be other underlying causes, you know, infections or whatever else we’ll get into, but in her case, this lady who was literally just doing like meat, and maybe a salad, you know, she literally had almost like virtually no carbs at all. So, so that’s just an extreme manifestation. But if you’re doing your, like you said, just kind of standard paleo template, you’re probably going to do maybe it’s plantains or some berries or you’re probably eventually over the day would accumulate enough starch or carbs to to fuel the fertility, but in her case, no, she was too low.
Dr. Justin Marchegiani: And again, if you’re insulin resistant, the starch or carbs may be keeping you infertile, right? Yeah, we can always do testing. We can always run fasting insulin and we can see where your fasting insulins are at. If there’s pcus. We may also want to look at prolactin, we may also want to look at free and total to stop Throw a see where that’s fitting to make sure it’s not, you know, in the top half top top 25% of the reference range. That’s pretty good to look at. So what’s the underlying mechanism? So if this person’s over exercising, it’s probably one over exercising, it can create estrogen dominance, right? So it can decrease progesterone. It can also decrease your dopamine and adrenaline which can be that driver that increases prolactin, right. And it can also just deplete hormones in general, I see a lot of women that are low estrogen, low progesterone, and they still may be a little bit in estrogen dominance because the ratio is still skewed, but their hormones are just low across the board. I see that a lot as well. So you have to this is why it’s super important to to test right because if you’re not testing you’re guessing. So with fertility cases, we may run a month long test to see where you’re at from day one when you bleed, all the way to oscillation all the way to the end of the month looking through the luteal phase to see how high that progesterone gets. We may just come in there and run a snapshot on the luteal phase two If patients have some infertility issues, but it’s not a primary thing, then we may just come in there with the luteal thing. If they’re really struggling on the fertility side, then we may do that full month. So I’ll typically do one or the other. And of course, looking at the adrenals are so important. Why? Because the adrenals interplay with dopamine and adrenaline and cortisol and estrogen dominance, ie via progesterone going to cortisol, we have to look at the adrenals because they play a major role as a backup generator with the female hormones.
Evan Brand: Yeah, absolutely. I mean, adaptogenic herbs are part of my life. They’re part of your life, you know, on a daily basis for us clinically And personally, and it’s a game changer. I would say it’s one of the biggest, one of my most favorite and biggest tools that I will use with a woman who is struggling with infertility, especially because there’s so much emotional stress. And there’s trauma associated with this, especially if a woman’s had a miscarriage or if a woman you know, has worked on this for months and months and years and been to several doctors in practice. And she feels like she’s at the end of the rope and she’s aging and she’s kind of running out of her her fertile window anyway. I mean, there’s so much stress associated with the emotional component of this as well and maybe family pressure when you’re going to have kids and that whole thing so, to me, that’s where adaptogenic herbs come in and not only help with the hormonal side, but the mental emotional stress as well.
Dr. Justin Marchegiani: Exactly. So in general, like with women and men, similar things with the diet, right men, there’s less of a hormonal fluctuation that’s going to be throwing fertility off. So keeping the pesticides, the hormones, the artificial hormones, these you know, estrogens, the growth hormones, really emphasizing good proteins, good fats, high quality cholesterol from animal products, lots of good antioxidants from leafy greens, keeping insulin in check. That’s a good first step. Of course, we can add in resistance training, we can add in mitochondrial nutrients like carnitine and co q 10, and arginine and zinc and selenium. Again, it was certain male patients will come in. We’ll run a nutrient profile and see what nutrients Their low end as well and of course, we’re going to be fixing the gut fix to the adrenals. And using a lot of those first line things, it’s also herbs we can use as well. ashwagandha is a big one tyrosine and dopa means a big one right? You see macoun as well as a big one. Why? Because dopamine helps with fertility. You mentioned earlier tongkat Ali really helps with that upstream signaling from the banana tropic releasing hormone, which then helps with FSH and LH. Lh is really important for spermatogenesis and making healthy sperm. So these are really good first line steps for enhancing male fertility. Anything else you want to add about that?
Evan Brand: Yeah, we weren’t. We didn’t press the record button yet. When we when you were now we’re talking about that. So let me just give just a quick little story on Tongkat Ali. There’s a Latin name for it as well. It’s something that’s beneficial for for men. We give it a lot to athletes, it does help with testosterone levels. And there are a couple of really, really cool papers on it. Where it’s increasing supermoto Genesis by influencing that HP ga axis the hypothalamus pituitary go Natl access. And long story short, not only did it increase the sperm count, but it increased the sperm motility. So you’ve got better swimmers. So when we talk about men, you know, having an important role in this fertility, you know, piece, that’s also a game changer. And then tribulus is another, you know, tribulus is once again kind of used in the bodybuilding community quite a bit to help with muscle mass and androgen increasing effects and all that, but it does help with the testosterone in the DHT DHT levels, which are all sex hormones that are important. And then also, what about the What about the influence of the gut? Do you want to talk about that now because I’m just thinking out loud with you here. We should probably talk about the mechanism of beta glucuronicdase issues with men and women where they would be re circulating estrogen and having issues with estrogen due to the beta glucuronicdase. enzyme being hired. Due to like a bacterial overgrowth problem, for example.
Dr. Justin Marchegiani: Yeah, so in functional medicine, right, we may look at things a little bit closer when it comes to fertility, but we’re still going to be doing the same things with the gut because if we don’t go to the six R’s of healthy gut function, we don’t go to the six R’s, removing the bad foods, replacing enzymes and acids repairing the gut lining in the in the hormones, removing the infection, repopulating rynok elating, good bacteria retesting. The gut is where everything happens 80% of the immune systems there, that’s where all the nutrients are absorbed and digested and assimilated and utilized. So if we just were to skip that and go to a hormone protocol, or a typical augmentation program with progesterone, we may miss a lot of those nutrients getting assimilated, broken down and absorbed and utilized. So we have to always assume the gut could be a major interplay. And again, most people, they’re not connecting the gut with their hormones. They just never right. But like you mentioned beta glucuronidation plays a role in hormone detox and We could be increasing estrogen dominance to the bad bacteria causing us to reabsorb estrogens. Right. We could also just have bad liver and gallbladder function because we’re not digesting fat, partly because of low stomach acid partly because of an H. pylori infection or grd infection. And that can make us hard to break down and assimilate cholesterol and essential fatty acids, which are important building blocks for fertility, right. So these things always kind of connect whether they’re one two or three degrees away from the root.
Evan Brand: Now if you’re a little brain fog, and you’re listening to Justin talk, you’re like, Oh my God, he’s talking fast. What is he saying? Giardia? What the heck pet parents Oh my god. So yes, literally, gut infections can literally make you infertile. We had several women who were infertile, and we ran their stool panel, they showed up with parasites, whether it was Giardia or krypto. As you mentioned, H. pylori being a big influence on stomach acids. So now, if we think about we always talk about good diet for mom, which is going to be a good diet to feed and grow a baby. But what if she does have these infections, and she is doing a paleo template and she’s doing her Grass Fed Whey or whatever to get her amino acid profile complete. And now all of a sudden she’s got these gut infections. So literally, just by running a gut panel and walking someone through using herbs to eradicate these infections, boom, I’ve had I lost count many women who, during a parasite protocol, they’ll email the office, I’m pregnant. What do I do? I’m like, holy crap. Yeah, by the way, this protocol by eliminating parasites, it actually increases fertility. Boom, there you go. Congratulations. And so it’s, it’s pretty nuts.
Dr. Justin Marchegiani: In general, anything else you want to say about that? So we talked about gut being really important. So HCl, enzymes, those kind of things are really important. We talked about the six hour if you’ve done podcast on that topic, so just make sure if you’re thinking about fertility, make sure we don’t ignore that right. has to be on the women has to know On the men, usually male men are easier to deal with because they don’t have a very unique symphony of a cycle. They kind of have a foghorn of hormones. And usually that’s going to be depleted by stress and poor nutrition and gut stuff. So it’s a little bit easier on the hormone side. But with women, it’s a little bit more complicated because of the cycle. So we talked about IVF. We talked about medication like clomiphene citrate or Clomid, which is a stimulates gnrh, which then stimulates FSH and LH and follicle stimulating hormone luteinizing hormone from the pituitary, which then stimulates egg maturation and oscillation. So there’s that right. But that’s kind of like a stimulator. Like Think of it as you got a tired horse. Do you really want the horse to perform by whipping it harder? Right? Is that the mindset? So for some people, that’s like an easy, you know, quick, simple, okay, I’m pregnant now. And most people who are aren’t as natural minded, that’s usually the first line of therapy that they’re going to do on the fertility side right. Then usually after that, they may go I UI which is the inter uterus insemination and then they may go into IVF or they shut down the whole HPA access using Lupron, they come in there with certain like follistim and different hormones at certain times so they can grow the eggs, harvest them, put them back in, get the whole hormone cascade going with all the injections, and then while you’re pregnant and then maintain the pregnancy with progesterone, that’s kind of what happens on the IVF side. But that may not be necessary for a lot of women. We already talked about the major mechanisms. Now, what are some deal breakers that may hold you back from getting pregnant even with doing all this? So there are certain things you have to look out for fibroids are a big one. If you have some big fibroids that are just hanging out, they could be there could be enough there where it’s disrupting blood flow, because the fibroids are a blood flow hog, and that could be preventing the egg from implanting into the uterus lining. Also, the fibroid can create a little bit of inflammation now everything we’re talking about is designed to To help prevent those fibroids from growing, the question is How long have they been growing they’re they’ve been hanging out for like years and years and years and decades. Some of the natural things just make take may take too long. And so you have to be very, very aware of that. Or it may be so big where it has so much momentum, it may need to be removed surgically. So you have to be mindful of things like fibroids. Also, endometriosis is a big one. That’s endometrial tissue, can it which is basically the endometrial lining tissue starts growing in areas it shouldn’t be, it could grow on the ovaries, it could grow on the bladder. Sometimes endometriosis, endometriosis can cause inflammation in that area. And then a lot of times with a simple procedure where you come and take a laser and kind of laser it off can be very helpful. conventional medicine won’t fix the root cause of why the fibroids there or why the endometriosis is there, but sometimes it’s gotten so bad where that may be necessary. There’s also something called a chocolate cyst, which is basically an Dimitrios in the ovary and that can Definitely be a problem as well. So that may need to be drained. So that you have to look at some of these things, some of these tissues that have grown for a long period of time, they may need a conventional intervention. Now, as long as you’re relatively young, and you have some time, try the natural stuff first and see if your body can handle it. If not, that may be the next thing to look at. And then of course, we already talked about pcls, which is polycystic ovarian syndrome. And that’s where there’s system the ovaries from all the things I mentioned, elevations and insulin and androgens, and I seen those reabsorb time and time again. So I’ve seen the body be able to handle that. I don’t see most patients that will have to go in and get those things drain per se, I find the body can handle that. The other things may need to be addressed at some point over time, but I always say wait and see work with a good functional medicine Doc, have a good ob gyn or a reproductive ob gyn kind of in your back pocket. So you’re monitoring things as you move forward. And if you have to go a surgical route, don’t throw away the functional medicine doctor keep both of them working together.
Evan Brand: Yep. Yeah, good point. And you know, it’s possible that you could find like a holistic or more natural minded ob as well, that would be good to have on hand that way they would help support you with some of the dietary stuff. But yeah, with endometriosis, you know, there’s a hormone component to that as well. So we already talked about diet and things like that, but of course, in the beta glucuronidation, so like calcium D glucose rate, for example, you know, that’s something that we may use to help with getting out these excess xeno estrogens. And that could be a game changer too. And of course, in the diet, you’re getting some like, you know, calcium D glucose, right? You’ll get some of that naturally in the diet. So whether you’re doing like broccoli, or blueberries or whatever, I mean, different. You know, cruciferous veggies, you’re going to get some beneficial stuff like that. Anyway, that will help. Regarding the hormones. It sounds crazy that broccoli could help pregnancy but yeah, but it definitely could. And then also, I mean, there’s no there’s various exercises to that can be helpful. Exercise in general is helpful. So I mean, if you have a sedentary woman, and you get her moving, but not to the CrossFit, five, you know, five times a week level, you know, that could be a game changer.
Dr. Justin Marchegiani: Exactly. So you got to look at everything holistically, like, I’ll tell you my personal story. We have two Healthy Kids, two healthy boys. And my wife and I had a hard time getting pregnant in that first year. And we found she just had a really, really, really, really, really big fibroid, very big-
Evan Brand: Was that ultrasound or how gel, figure that out?
Dr. Justin Marchegiani: Transvaginal ultrasound, and my wife before she met me, she was on birth control pills for over a decade. So I think there was that she wasn’t he she was eating a lot of conventional foods in the beginning before she met me before we tweaked her diet. So I think there was a lot of hormonal growth that was going on for decades that caused some of that growth. And you can’t just pull it away and expect it to just reabsorb all of a sudden, right? You can’t take 10 years and just expect it to go away. And so we actually tried reducing it. Now there are things you can do, they can work there. You can do things like egcg epigallocatechin is in the green Green tea you can do things like resveratrol and lipids or curcumin, and you could do systemic enzymes like Sarah peptidase and lembrar kinase, which are helped to metabolize some of that tissue and can work. The question is, can it work fast enough? And so we went the surgical road that the fibroids removed and literally within two months of it being gone pregnant, no problems. And so sometimes that can be an issue. So you have to look at, okay, what’s the root? Cause? You know, do we have some limitations of matter, right? Were those tissues just been hanging out too long? Just the body needs a little bit of a head start getting that tissue removed. And if you got time, you know, do the natural things and just watch and wait, right watch and wait. So if you’re a female listening, and you’re not in a relationship, or you’re not looking to get pregnant anytime soon, but you want to at some point, I just recommend getting good, good workup with your ob gyn to make sure there are no endometriosis or fibroids, endometriosis. This is hard. Typically the only way to figure that out is laparoscopically, little incision for the scoping. So it’s kind of tough to know that one. But you know, usually a lot of the telltale symptoms like the painful periods, like those kind of things, if you’re having those symptoms work with a good functional medicine doc to help it, but keep an eye out on bigger issues, like fibroids and those things so you can act on it early.
Evan Brand: Yeah. Thanks for sharing the story. And now you got two little boys and they’re keeping you busy. So everything worked out.
Dr. Justin Marchegiani: You got it? Absolutely. So keep that in the back of your mind. Anything else you want to add? On the supplements? I know you were kind of riffing on a couple of adaptogens earlier. Anything else you want to add? You mentioned while you listen tongkat Ali?
Evan Brand: Yeah, so that could be for the men. I would just say during during the you and I’ve talked about this idea before we kind of call pregnancy more like a four trimester thing which women like cringe at like, Oh my God isn’t pregnancy long enough, but not just meaning that there’s a kind of a pre, a preNatal phase that happens before you even get there. Right now kind of a pre, you know, fertility supporting area. So we’ll bring in multis and omegas. And like you said, maybe systemic enzymes will bring in trace minerals, micronutrients, maybe Grass Fed Whey protein, maybe some Oregon supplements. I mean, there’s a lot of things that we can do right away to kind of prep the body before you even get pregnant. It’s not I disagree with this idea of you got, you’ve got a pot of positive pregnancy test start the prenatal, it’s like, No, you could be six weeks in already, like you should have been on the prenatal six months before you got pregnant in my opinion.
Dr. Justin Marchegiani: Yeah, and most prenatals I mean, prenatal is a more of a marketing thing, like in some of the prenatals that we recommend, what makes it a prenatal Well, there may just be a little bit more calcium, there may be some extra full weight in there. And of course, everything’s active, full light, no folic acid, everything’s mthfr. Of course, everything’s methylated. There may be some extra iron in there, right? So there may be a couple little nutrients that are a little bit extra. But if you look at a really good high quality multi versus a prenatal they’re going to be about 90 95% At the same Yeah, if you’re getting a high quality couple little tweaks here and there, of course, you may want to add in some extra essential fatty acids cod liver oil, those kind of things I think are are very, very helpful.
Evan Brand: I get so mad I get so mad when you go like if you go to like Whole Foods or I mean even even places like that where you’ll go and you’ll see these little cute gummies in like a clear container. And it’s like six gummies a day and the first ingredients like fructose or fructose tapioca syrup. And it’s like, okay, here you are taking the woman who, you know may not know exactly what’s going on may not understand the root causes, and he or she has eaten these little gummies every day as a prenatal it’s like no, it’s like candy.
Dr. Justin Marchegiani: Totally 100% agree. One other thing if you have to go a surgical intervention I recommend personally, if you’re a fertility age and you want to get pregnant that you see someone that has a specialty in reproduction as well as being a gynecologist. I find that certain gynecologist have a A perspective on what’s happening surgically with the goal of removing the tissue, while others have a perspective of that while maintaining fertility. So I find someone that’s a ob ob gyn as well as a reproductive specialist, they looking at the procedure with a lens of keeping fertility intact. So I always recommend if you have to go the surgical route, try to find an OB GYN that also has that reproductive specialty as well. Yep. Good advice. Yeah, I think that’s important. I’ve just seen, I’ve heard too many stories from ob gyns, who don’t have the repro specialty, and they’re just and again, some of these are older stories. They’re too easy. They’re too They jump the gun on just doing a complete hysterectomy or doing a partial hysterectomy just removing the uterus or just removing too much tissue and and that scaffolding of that uterus can collapse and other issues can happen. So I always like to make sure you have someone with an eye Keeping fertility intact.
Evan Brand: Yep. No, I mean that if that’s their job to just remove uterus and ovaries all day Yeah, they may not care about the fertility aspect at all.
Dr. Justin Marchegiani: Yeah, it’s really, really important. And then yeah, and that’s, that’s incredibly important and of course, the most non invasive to invasive is is the best way to go. Anything else having you want to add on the topic? I mean, Today’s been really great. I think we really hit a lot of things from the nutrition aspect to some of the herbs and nutrients just to dovetail that progesterone is a big one we may be adding in progesterone we may be adding in things like chase tree and damiana and different herbs that help modulate maka that modulate estrogen receptor sites and or modulate progesterone and even support progesterone and of course, we’re also supporting the adrenal so all of those key tenants there need to be fully looked at and supported that you want to add anything else that Evan?
Evan Brand: I don’t think so. There’s a Yeah, there’s a good handful of like female supporting herbs, things that we would typically use anyway. To help with like PMS, for example, things that are going to help regulate hormone levels, those things alone can contribute to fertility. So yeah, it’s sometimes where a woman comes to us with a different problem with hormones, they may say, Oh, I eventually want to get pregnant. But right now I need to focus on this major PMS. I’m out of work every week, you know, I’m laying in bed in pain, and we just help regulate hormones using some of those herbs you mentioned there and then fix the gut and then boom, hey, we got pregnant sooner than anticipated. Cool. Let’s go ahead and kind of transition now let’s, you know, let’s get you into this, you know, maternal support phase now and it’s really fun I tell you, there’s there’s nothing better than you know, whether it’s getting a picture in my inbox of a new baby or just a mom telling her birth story. It’s It’s fun, and it’s a very, very rewarding thing. And, and, and I always, I don’t know I like to pop my collar a little bit more after I hear a good story like that, especially when a woman was dealing with the conventional medical world and she was so frustrated. And so hopeless, and then she was able to actually do it naturally. It’s like, Yes, I told you so I told you you could do it because the conventional doctors are obese will be like, nope, you can’t do it. You’re not going to get fertile. You’re too old. Your hormones are too messed up. It’s not gonna happen. And then boom, a baby comes. It’s always just like I told you, so.
Dr. Justin Marchegiani: I like it. Well, after you talked about popping the collar, I’m gonna I’m gonna join you on that one. There we go. Excellent. Very good. So yeah, I love those stories. I think that’s excellent. We always want to focus on the root cause so just anyone listening we want to make sure our goal is that you’re looking at your fertility from a root cause perspective. If you have to bring a functional medicine doctor in great if you have to bring a conventional fertility MD and great just always make sure you’re looking at the root cause. If you have to go you know more invasive on the IVF or surgery side, that’s fine. Just make sure you exhaust all of the foundational options first, nutritionally and functional medicine wise. And then also make sure your husband’s a part of what’s going on. So Make sure he’s getting tested, his nutrients are assessed. He’s doing all the right things on the fertility side, we can also get a sperm count on him as well make sure sperm numbers are good, you know, at least 50 million, make sure shape and morphology and all that good stuff is dialed in as well to assess that being okay. And of course if, if it’s not, then we have to work on all the nutrients and work on removing a lot of the toxins that we already talked about.
Evan Brand: Yep. So get off the mountain dew. Oh God, we had a friend that was an old friend who was having issue with fellow body and her and her husband both just pounded the Mountain Dew. I’m like, who even drinks Mountain Dew anymore? I mean, it’s like, it’s like 80 grams of sugar per bottle. I was like, oh, get off the mountain dew. So of course, you know, typically people would think everybody around you and I like we’re just the circle of health, our family, our friends and everybody would just listen to us and reach out to us for help. But that’s typically not how it we’re not how it is. So of course they don’t ask me anything. What do they do? They go do IVF they spent, I think it was 15 or $20,000. They did like a fundraiser raise money. It’s like how about just like, let us give you the workup, it’s going to be a fraction of the cost. And you’re going to have, you know, minimal to no risk. I mean, like with other procedures, you know, you could have risk of twins and triplets. I mean, they’re not, you know, death necessarily risk, but there are risk associated with some of these other things. So, it’s just sad. It’s sad that people just don’t know. And, you know, you always say, oh, let’s talk about the root cause of this. It’s like, why is that so revolutionary? That should be the first way people think but it’s not.
Dr. Justin Marchegiani: 100% you’re never a prophet in your own town. And also, if women have to go the IVF road, the goal remember the end goal is not just to get pregnant, right? What’s the angle? Let’s huddle up and focus on what’s the end goal the end goal was to have a healthy baby, right that’s that’s the angle and pregnancies one step in that journey. So don’t confuse the first step as success number one, and then number two, If you’re going to engage in more conventional approaches that don’t address the root cause, I strongly urge you to make sure you’re addressing the root cause. So the angle should be having a healthy baby at the end. So just keep that in mind, make sure you are really focused on what the root cause and goals are.
Evan Brand: Let me say one last thing, and then I want to get your take on this real quick. And I love the way you said that, you know, the pregnancy is not just the end all Gold’s it’s the healthy baby and all that. So, you know, what about if a woman does get pregnant, and in an unnatural method, like IVF, for example, but she still has an insulin problem. I’ve seen cases where you could argue with something else, but I would argue that the elevated insulin and the sugar and the carbs and all the crap in the diet could potentially make the baby get too big. And then the doctors are saying, Hey, you know, now you’ve got a nine pounder, we’re gonna have to do a mandatory c section, for example. You know, there’s other complications there.
Dr. Justin Marchegiani: Yeah, I mean, just having that high amount of insulin, gestational diabetes. kind of thing going on, which a lot of times the Hopis don’t even acknowledge, really being a diet thing. I mean, I remember going in and my wife was getting testing on the blood sugar, and we were monitoring her blood sugar at home. And the nurse practitioner said, you know, hey, you know, the gestational diabetes is a genetic thing. And I’m like, I literally pulled up a study of like, literally says more grains, and trans fatty acids can actually increase it. And it was like a, it was just, it was like a paradigm thing. It’s like, even though like, if people are conventionally trained, and have to pass all these, you know, mainstream boards for their licensing, they’re not really up to date with the conventional literature in the conventional literature isn’t really injected in the first line therapies for what these doctors and nurses need to know. So it’s kind of sad. So we just want to bring that information everyone on the forefront now so they’re aware of it, and also test the blood sugar and if you’re at high risk for a miscarriage, then you’d want to keep an eye on your progesterone levels. As soon as you get pregnant. One of the easiest first things is using progesterone, an inter-vaginal progesterone probably 200 milligrams or so a day throughout that first trimester can be a godsend for a lot of women. So if you’re at high risk for miscarriage, make sure you keep an eye on testing those progesterone levels, you know, 15 to 20 or so in that first week, couple weeks of getting pregnant and to be important, so keep an eye on that with your ob. So you’re monitoring if you’re high risk.
Evan Brand: Yup. Well said. Well I’m sure I could break off a few of the things but let’s wrap it up and keep on reaching out clinically. We’d love to help you. Justin is available around the world at JustinHealth.com. Me, EvanBrand.com and we’ll be back soon to talk more.
Dr. Justin Marchegiani: Phenomenal chatting with you all. Have a good day.
Evan Brand: Take Care.
Dr. Justin Marchegiani: Bye.
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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
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
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 EvanBrand.com 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 JustInHealth.com. 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-