Looking Deeper at Your Blood Tests – Dr. J Live Podcast # 168

Dr. Justin Marchegiani welcomes Dave Korsunsky, founder and Chief Executive Officer of headsuphealth.com, which is a website about tracking health data. Join them as they discuss about blood sugar levels, ketone levels, blood test and other health-related data that can be integrated with smart devices and the website as a means of analyzing your health.

Know about preprandial and postprandial blood sugar readings and glucose functional ranges. Also, find out more about the Carb Tolerance Test and learn how it can provide value and insight to how your body responds to sugar from different food sources.

In this episode, we talk about: 

05:08   Functional Glucose Tolerance

13:45   Body Composition and Postprandial response

18:16   Quick walk through on Headsuphealth

31:51   Heart Rate Variability

35:54   Stress and its associated markers





Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio! My good friend Dave Korsunsky is in the house. Dave Korsunsky, how we doing today?

Dave Korsunsky: Fantastic, Doc. It’s been far too long since we’ve connected, so happy to be back.

Dr. Justin Marchegiani: Excellent. Love it. So happy we’re connected here, too. Let’s talk about I mean you run the website headsuphealth.com— Heads Up House, phenomenal site where you can track your data. Again, you’re putting lots of new features in there where people can—can plug-in or integrate some of their smart devices, Fitbit, some other ketone or blood sugar reader scales, blood pressure cuffs integrate with lab companies. Lab Corps, coming out soon, you mention Qwest. So great way if you’re kind of like a bio hacker or a health hacker and you want to put everything in one place. Awesome place to look at there. So we have uhm—we have a new feature, where we talked about the new features that are coming up. So we’ll have an affiliate link here below, so if you’re listening to this information and it resonates with you or you want to try plugging it in, we’ll have an affiliate link down below that you can click to get access to some of this information to get your account moving. And again, start integrating some of the features that we’re gonna chat about today.

Dave Korsunsky: Great.

Dr. Justin Marchegiani: Okay. So off the bat, let’s dig in. So, one of the more important things that it’s coming here is we have some newer ketone readers in the market. Uh—one of those readers is called the “Keto Mojo” Cool thing about it is Keto strips are cheaper, which is great. It’s gonna measure ketones along with blood sugar and and it’s also gonna measure hemoglobin and hematocrit. Love it. I’m waiting for just that extra feature of insulin then we got like just freaking lab in the little reader right front of us. Wouldn’t that be amazing?

Dave Korsunsky: Every time I see Dorian the founder, I beat him up to say, “Hey, Dorian, can we get an insulin strip?” Because as you know, that’s— that would be a game changing piece of information that currently there’s no way to do that in a consumer test. But if you can start testing things like postprandial insulin just at home after different meals, it’d be awesome but nonetheless, they’ve put a great product out there and it’s really made ketone testing affordable and accessible to people who perhaps couldn’t have access to this before. So that’s a great one. We’re gonna to talk more about it as we go here.

Dr. Justin Marchegiani: And the reason why insulin is so important is because you have a lot of people that are insulin resistant with their blood sugar looks decent, let’s say 90 or 95 right? But it’s only decent because insulin is compensating and going so, so high. So insulin is shoveling out that blood sugar into the cell, so then the blood sugar looks lower because the insulin is basically the shovel. You got a lot more shovels shoveling that out. So it’s different coz if your blood sugar is here with high insulin, then you’re developing insulin resistance, right? Coz you have more shovels—cons—you know, compensating for that. If we decrease—and your blood sugar’s good, that means you are insulin sensitive.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And we need low insulin to increase ketones, right? Ketones and insular on the scale. So people are like, “Hey, I’m like trying to lower carb or my blood sugar’s low but my ketones are low.” Well, that’s the missing variable is the insulin could be high. So to keep that in mind, we have this little seesaw fat with insulin and ketones. Anything you wanna say about that?

Dave Korsunsky: Yeah. We wrote a blog post exactly on that topic. And we talked about why fasting insulin is one of the most important test your doctor probably isn’t running because you’ll—you’ll get a typical fasting glucose test with no indication of whether or not insulin is artificially inflated, keeping that number down. That’s why it’s important to test both at the same time. So, yeah, I would agree. I think it’s incredibly important. I’d love to see the day we can start testing that at home. But right now, the only way to get an insulin test, whether it’s fasting or postprandial or whatever, is at the lab. And we’re gonna talk about that a little later in this metabolic panel that you have cooked up here.

Dr. Justin Marchegiani: Yeah. Absolutely! And we’re gonna do a screen sharing just a few minutes. The key—we’re gonna kinda just dial a couple of key components here. So let’s say you kinda already transitioned from a Paleo template approach or maybe you’re doing a Keto Paleo where you’re focusing on nutrient dense, anti-inflammatory, anti-toxin foods, right? But you’re keeping the grains, the dairy, the legumes out and such and you’re doing higher-quality fat, but you’re trying a very lower carb version 20 or 30 net grams. Big thing that we can work on integrating today is some of the heads up features looking at that fasting one hour, two hour and three hour glucose tolerance where we called it a functional glucose tolerance. Meaning, we’re not going to drink that 75 gram of glucose artificial sugar crap at the doctor’s office. We’re choosing a real meal not a fake exaggerated meal, but a real meal that we can see how our blood sugar fluctuates over that three-hour period. And you’ve integrated that in there. And why don’t we go to the screen shot on your side and you can kinda just walk us through how that looks. And just for everyone below here, if you listen to this on podcast, the YouTube channel click the affiliate code below we’re gonna have so you can get access to this information.

Dave Korsunsky: Yeah. I remember when you and I first started working together, doc. And I was your patient and you educated me on what the functional glucose tolerance test actually was versus the oral glucose tolerance. And the functional glucose tolerance being something you could do at home after any meal. And for those who were unclear, the oral glucose tolerance is the formal test we go to the doctor, drink the sugar and you hang around and get the— the postprandial blood glucose test done. Not really that practical in reality. But the functional glucose reference you can test with anything. So I’ve got my screen shared, can you see it here, Doc?

Dr. Justin Marchegiani: I can see it. You’re up.

Dave Korsunsky: Yes. So, this is something we ended up calling initially we called it the functional glucose tolerance test, but it was just a little too wordy to fit in. So it’s really just a carb tolerance test and actually Rob Wolf talks about this in his book as well, where based on some research out of Israel, there was a study done following 800 different people and they found that you could give two people the exact same carbohydrate source whether it’s sweet potato or bread or lentils and they would have very different postprandial glucose responses. So the key take away was that it’s different for everybody. And back to the functional glucose tolerance, where you’re actually having people test their favorite breakfast, test their favorite restaurant meals or meals they’re eating at home. So here’s how this works and you can see on my screen here I’ve got the future called the Carb Tolerance test and you can just click the plus button here. You can test anything you want. So let’s say you test your—your favorite breakfast of Denny’s bacon and eggs. And all you do is just put a name in here, but this could be anything. It could be a muffin, it could be 50 g of Sweet potato, it could be anything that you’re curious about. You say I eat this food regularly, I want to understand how my body— my body’s postprandial glucose responses are going to be. So I’ve called this anything I want. And what I do is I test my blood sugar before I eat that food. So let’s say that my—my pre-prandial for example was 85, and if this was a fasting reading, I could also take it as such. And then what you do is you just test one hour, two hour and three hours after the meal and update this intro info accordingly. You can also record any subjective symptoms and this could help you identify—even though you may have a nice, healthy postprandial glucose response, there’s also the ability to record subjective symptoms. “Did I have an energy crash?” “Did I get brain fog?” Did I feel hungry 30 minutes later?” or “Did I have digestive issues?” And you can save that and then share it with a practitioner like yourself. So I’m gonna answer my pre-prandial glucose reading here and then hit save. And you’ll see this will create a new entry here. And then all I have to do is just update the one hour and a two hour and a three hour after I go. And just to give you an example of what that looks like when it’s completed is here’s what I did at In-N-Out Burger because when I’m traveling, often you don’t have access to all of the healthy, low-carb food to do a home. So I go to In-N-Out, I’ll get two lettuce wrap burgers with—they call it the protein style. And I wanted to see, does—does just a protein burger with no bun have an effect on my glucose?

Dr. Justin Marchegiani: Uhm.

Dave Korsunsky: And here with the results: 90- 106 at one hour; 89 at two hour; and then back to about 95 at the three hour mark. So, maybe I’ll kick it back—back to you, Doc. And you can share more about what you’re looking for in the postprandial glucose curve as you have your patients test different meals and different foods.

Dr. Justin Marchegiani: Absolutely. So, in general, you know, we have this kind of fasting ideally below hundred and 95. Again, we got to be careful in the morning because in the morning and that from when you wake up to 30 minutes later, your cortisol is increasing nearly 50 to 60% in that 30-minute period. And because of that healthy cortisol response, you can actually increase blood sugar and that big spike that’s like, you know, you’re making them over three quarters of your cortisol just in that zero- 30 minutes. So that spike can increase blood sugar and you may think, “Hey, you know, this is partly because of my diet.” And it may or may not be. So just kinda keep it like a little, you know, asterisk next to that and really look at your lunch and dinner ones, especially if you’re seeing an anomaly in the morning. So we like that zero below hundred and 95. We like hour number one, below 140 for extra credit. For extra credit, we like it below 120.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Below 120 and then at two hours, below 120 or close to a hundred and below— at three, definitely, below 100. So, kinda keep that as your— as your kind of your baseline. Remember we went out to eat out like a few months back. We went to a steak restaurant. I think I tested mine one hour after a meal and my blood sugar was 70 or 75, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So you can eat really well and you can choose foods that keep your blood sugar from spiking. And the whole benefit that is when your blood sugar’s not spiking like that, you’re not over secreting insulin; when you’re not over secreting insulin, you’re not gonna develop insulin resistance and all of the effects of that may have with ovarian cyst or cancer cells or inflammation and our blood pressure. So all those things kinda benefit. So, just kinda highlighting on your side, we can plug those in and we can map them and we can put the notes in there regarding what meals. Then you can say, “Hey, protein style In-n-Out.” “The steakhouse where I did” or “The cheat day where I ate this dessert or this crappy food.” Right? And then you can kinda map it out. And that can provide a lot of value and insight of how your body responds and also there’s the immunological qualities that Rob Wolf has talked about where it may not be a carbohydrate thing. It may be a cortisol response to a food allergen that’s getting your immune system wound up that could— that cortisol can increase the blood sugar as a—as a side side effect.

Dave Korsunsky: Yeah. And we—we’ve had several users on Heads Up Health test different foods that they thought were metabolically safe for their body and the results were absolutely shocking for someone will test certain foods that they’ve been eating. And I’ll share some results with me anecdotally and I’ll say, “Wow, I thought this food was safe.” And then they tested and it’s—the blood sugar still skyrocketing at the three-hour mark. It hasn’t started to come down at all. It’s a runaway train. And—and people actually had no idea. So this can be incredibly helpful just to make sure that there’s nothing really sabotaging your efforts. And unfortunately, you do need to test these foods yourself. You can’t just rely on things like the uhm— the guidance from the Diabetes Association or from the uh—glycemic load tables. There’s so much individual variance that this is why postprandial blood sugar testing— even if you’re not diagnosed as having a metabolic disease, even just for your own personal health, it is helpful to test different foods and—and just make sure that you are having a healthy postprandial response. So, that’s the new feature we’ve built into Heads Up Health. You can test anything you want and just make sure it’s metabolically safe. All of these readings will be stored. And actually, you can probably add more here, Doc. But after you’ve been on a clean Paleo eating template for several months, you may actually be able to tolerate foods that you couldn’t tolerate before as your body composition improves, your gut microbiome improved. So, maybe, you can comment on how something that might not be metabolically safe now could potentially be reintroduced at some future point after you’ve made some progress on your health journey.

Dr. Justin Marchegiani: Absolutely. So, of course, if you’re not breaking that food down, not digesting it well, that can create a stressor. It could just be a food allergen kinda like gluten. That could be a stress or dairy or casein, right? People on the Keto community, Keto Paleo community, they are notorious for maybe doing excess casein because you know, “Hey, you can do dairy or cheese or all these things.”
Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you got to be careful with the case in uh—from a Ketogenic perspective because that could be__. And uhm—of course, if you have an infection or SIBO or parasite or H. pylori something that’s driving gastrointestinal permeability or the word “leaky gut” That can get your immune system wound up, too. And of course, if you have you know, low levels of probiotics in your gut that can create issues. Coz probiotics help with the immune function to help reduce B vitamins and vitamin K. And of course, you know, good bacteria eats poop and poops nutrition, right? Bad bacteria eats nutrition and poops poop. Essentially, good bacteria provides more nourishment; bad bacteria provides more toxins and stress in your gut.

Dave Korsunsky: Yup. Exactly. So and—and what about body composition as well? Have you seen for example as you increase your lean muscle mass, for example, that may— does that also have an impact on postprandial response? Because we—we talked to a lot of guys who are bodybuilders and they can go out and need a huge quantity of food and—and postprandial responses are very low. So, I know you mentioned gut microbiome, but what about body composition muscle mass in response to uhm— postprandial glucose?

Dr. Justin Marchegiani: So, number one, if you have more muscle mass, you’re gonna have more glut 4 receptors to soak in that glucose. So, think about it as your kid makes a mess on the table, you go with a tiny little sponge to clean it up. That’s like tiny bit of muscle is a tiny of sponge.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Whereas like a huge—like one of those big sponges you used to kinda wash your car you have more muscles equivalent to a big sponge like that. Lots of glut 4 receptors. You can soak about that glucose just like you can go to your table with your kids mess and you can soak it all up and you didn’t even— didn’t even bat an eye, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So muscle does that. Also, muscle, if you have more muscle, that means you automatically have less fat, right? So fats and exocrine gland within itself so it will produce estrogen as well.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And what pretty much drives the fat is gonna be insulin. So excess insulin drives more fat; more fat drives more estrogen. So it’s kinda like this vicious cycle. More estrogen can make you more insulin resistant, especially if you’re a guy and then more insulin increases aromatase, which will take your testosterone and bring it downstream to estrogen. So you become more of a female hormonally and with women, it’s actually the opposite. They get more insulin – more insulin will drive the 17,20 lyase enzyme, which then increases androgens and then they get ovarian cyst and then they get more, you know, hair growth, acne. So it’s this vicious cycle our mother nature kinda swaps the roles there.

Dave Korsunsky: Yeah. I talked to a lot of people who are doing everything right in terms of the macronutrient profiles. They are eating low-carb, they’ve got things dialed in there, but— but little to no exercise. And yes, you will— you will lose that to a certain extent body composition will improve, but there’s—it’s also critically important to be building muscle mass, lifting heavy things and sweating. Those are two of the most important ingredients in my own regimen. Making sure I’m building up lots of muscle mass in in the quads, in the back, in the large muscle groups. And I think that’s something that at least in my experience, people I don’t think appreciate as much as they start down this path. They think that diet alone is going to handle it, but lifting heavy even if you’re just starting out starting to learn some of the functional movements that are— that build a lot of core body strength and really hit the big muscle groups. I think that’s perhaps the next level to get to once you have a solid foundation with the diet. Would you agree?

Dr. Justin Marchegiani: Hundred percent. And also, say make sure you get your 10+ thousand steps. Yesterday I got a 14,000 steps. That’s helpful because that— the steps really allow you to start basically cleaning out some of that extra—there’s little bit of extra carbohydrate in there. You can clean some of it out coz you’re constantly moving and the extra steps really help. And of course if your— you know, “ I don’t have a ton of time, so I’ll just jump in and do a couple cattle bells swings to failure, some push-ups to failure.” And that could help because the—the push-ups, right? You know, I have a push a bar so I can go really deeply, so I get a full range of motion push-up all the way down all the way up. I can get the upper body going. I’ll do my TRX Rose to get the posterior side nice and some kettle bell swings as well. And if you have a lot of time, throw a Tabata in there coz that high-intensity gets the growth hormone. And growth hormone is really gonna be stimulating a lot of that—that muscle tissue.

Dave Korsunsky: Yeah. I definitely have a home gym envy, Doc. I’ve been over to your place and I’ve seen your set up. It’s pretty nice, so I definitely would love to have something similar someday in the home.

Dr. Justin Marchegiani: And if you’re on a budget, really simple, TRX that hangs over door.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: You have the adjustable kettle bells on Amazon and get a push-up bar. Push-up bar is optional but I just like it coz you can get really deep coz I would go so deep I bang my head against you know, the floor. So I can go really deep full range of motion and not have to you know make out the floor, so to speak. So that’s a great option for you.

Dave Korsunsky: Those are great. I’d love to maybe see if we can find some of the recommended products on Amazon— the adjustable kettle bells, the TRX stuff and just actually may be included that here in the notes so people know which ones you’ve tested and they can just go out and get that and try it. So I think that would be uhm—yeah, that’d be cool.

Dr. Justin Marchegiani: We’ll get that in the show notes, for sure. Also, let’s just give—we kinda show some of the functional glucose tolerance stuff but you know—you just give us a cursory. Just just give us a quick walk through through Heads Up so someone that they’re gonna click on the link below, they’re gonna get to the site, but then what do they do? How does it work? Give us that like little round up there.

Dave Korsunsky: Yeah this is—this is my—my personal data. So let me just refresh the screen here because uh— some of the information didn’t actually come in on the last load. And as you share screen that’s what I wanted. So the first thing we’ll ask you as a new user is, “Which devices and apps you’re using to measure your health?” And so at least everyone who signs up has at least one of these devices. A withing scale an eye health wireless blood pressure monitor or glucometer, a fit bit, uh— my fitness pal for tracking the macros, Apple Health. These are gonna be able to pull in things like heart rate and blood sugars, sleep, macronutrient profiles. So all of that will flow in so you can connect as many of these sources as you want and then you’ll see were also starting to build some of the more specialized sources as well. The ones I showed first were more of the commercial grade stuff, but you can also see we’re starting to integrate devices like the Oura ring and the level breath acetone analyzer and things like Elite HRV and the other HRV monitors are coming in. So uh—we’re also working on the decks com, CGM device so we want to make it easy for people to build their own custom dashboard because everyone’s tracking different metrics. So this is all completely customizable. So that’s step one. And then you’re allowed to build your own custom dashboard. So I’ve got the carb tolerance test data here, but if that’s not something I’m working on, I can just actually hide it. And you can see my top three metrics are glucose, ketones and the glucose ketone index, which is just a ratio of these two numbers. A lot of our cancer patients and people with serious metabolic dysfunction are tracking the—the index of the two numbers. And then you can see I’ve got my weight and body fat readings those can come from a withing scale. They can be entered manually. This year is my heart rate variability, which actually comes in from the Oura ring and so that’s on here as well. Same as sleep. So that ring gives me a good sleep and HRV reports. So this is all completely customizable, breath ketones, resting heart rate. And then really what people try and figure out is how is this affecting my clinical markers? Are my lifestyle changes lowering my inflammation or not? And the only way to see that is to put the clinical markers in the same system as the light markers. And typically, the doctor has this clinical data. So it’s very difficult to compare lifestyle changes to clinical markers and that’s what we wanted to solve here and make it available for everybody. So I could just jump down and look at things like my inflammation markers and say, “Okay, is CRP coming down as I go on a clean Paleo template?” And we can actually link directly to your medical facility and pull this data out. So all you do is click the connect data button and let’s say that you’re sending patients to Quest Diagnostics. They would be able to just link their quest account to Heads Up and all of that information would flow in or if they’re using a more traditional health system and billing their insurance, you can connect Stanford, you can connect UCLA, you can connect the Cleveland clinic. There’s over 10,000 medical facilities in here and what we’ll do is we’ll take all of that data, clean it up and organize it from oldest to newest so people can actually have the full picture of their health and what we’re seeing is patients can look back into their history five 10-15 years into the past. Maybe even decades before they’ve even started working with their current doctor and see these patterns emerging years before the disease was diagnosed. And the reason you—you can’t do that today is because every time you change doctors, your health record get fragmented but when we put it all together for people, then you can start to see, “Wow, actually that trend was visible 10 years before I even got the diagnosis.”

Dr. Justin Marchegiani: Right.

Dave Korsunsky: But nobody noticed because I moved and my records got fragmented and my doctor can only see back three years, but I can see back 15 years. And that’s where this has the potential to I think really help people uhm— have actually more power and more information on their health. So, there’s a whole bunch of other stuff that goes into the system, Doc, but it’s really meant for patients and then most importantly all I have to do here is go to care team access.

Dr. Justin Marchegiani: Uh-hmm.

Dave Korsunsky: Give you access and you can come in and review all this data whenever you want. And then if I don’t want you have access anymore, I would just disable that access.

Dr. Justin Marchegiani: And if you’re listening to this on iTunes or a kind of an audio version, we’ll put a link down below for the YouTube video version as well. So if you’re trying to figure out like kinda find us, we’ll put the link but Justin health.com/YouTube Y-O-U-T-U-B-E and subscribe there. That way, you can see the videos well and then you can also listen to the audio.

Dave Korsunsky: Yeah. So I just killed the screen share, but that’s a quick walk-through. I wanted to show people the functional glucose tolerance test because it just allows everybody to test their favorite foods, make sure that they are metabolically safe even things you thought might be safe, may not be. So it’s easy to just test and be hundred percent sure and obviously, you can integrate all the other information. So, that’s a little bit about one of the most recent features we just finished up.

Dr. Justin Marchegiani: Love it.

Dave Korsunsky: And actually we uh— we have a debt of gratitude to Dr. J on that one because he was the one who told me about the functional glucose tolerance test. So we took your vision, Doc, and implemented it into our software program.

Dr. Justin Marchegiani: Love it. That’s phenomenal, man. Very cool. I’m also gonna be doing a live right now—a blood sugar test to myself kinda see where I’m at and put it out live on air.

Dave Korsunsky: Well, I can’t get you go solo there, Doc. I’m gonna have my Keto mojo here.

Dr. Justin Marchegiani: 87.

Dave Korsunsky: 87—that’s respectable.

Dr. Justin Marchegiani: And just so you know, that’s an hour and a half to two hours after having three eggs cooked in ghee with sea salt and then some butter coffee with MCT.

Dave Korsunsky: Alright. Let’s see what I got here. So uh—you mention the mojo here it is—uh 99 ketone strip. I’m not gonna do the ketone test right now. I’m just gonna do a is to glucose strip. This is about I don’t know, half an hour after I had breakfast which is really just a chicken breast today. I’m traveling so I don’t have access to all my food and uh—clocked in at 82. Respectable 82. That’s where I wanna be, so, yeah, I’m dialed in.

Dr. Justin Marchegiani: That’s good. Yup. I mean, my ketones are probably around .6 mmol typically is where they are out of, what, like an 80, 80+ percent fat breakfast. I typically get my protein in the morning from collagen. I did some good quality pasteur-fed eggs, but that’s important. And let’s just kinda hit a couple of the other blood sugar markers that we can do. So, I like the functional glucose tolerance. One: because it’s specific to the meals.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Where if you do kind of a blood test, so you go to Labcorp, it may be helpful, but it’s kinda like a fixed thing—

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: And it’s not something that someone can do all the time. So we can do fasting insulin, which is really nice. And if you’re more insulin resistant, that’s great because your blood sugar may look okay, but it’s nice to see the insulin coming down. And that’s even better coz that tells us that we’re reversing insulin resistance. We can do fructosamine. So, fasting insulin, ideally, below five—the sweet spot.

Dave Korsunsky: So let me—let me jump in on fasting insulin.

Dr. Justin Marchegiani: Yeah, sure.

Dave Korsunsky: A lot of people, probably their doctor might not run it for them because there’s not a diagnostic code. My doctor wouldn’t run it for me and it’s extremely important. As you said, to see glucose and insulin to make sure that one is not overcompensating for the other. And so that’s— sometimes to test that, a patient will have to order on their own and whether they get it from you or whether they go or it themselves online, maybe you can just comment on that. My doctor won’t run that specific test for me and—and how could somebody do that themselves if their doctor won’t run it?

Dave Korsunsky: Yes. So, of course, you want to reach out to a functional medicine Doc like myself. There are others out there because in the realm of functional medicine, we’re not actually treat disease, we’re supporting underlying systems that may not be working optimally. We’re fixing diet and lifestyle and we’re trying to bio hack and kinda maximize optimal performance. So it’s a different mindset and if you’re in the insurance model, things tend to be all disease-based, CD 10 code, CPT attached to it and uhm—it’s just you know, if you’re trying to utilize your insurance for this type of healthcare, it’s typically not gonna work.

Dave Korsunsky: Yup. And so what I did just for myself and my family is we just— we just went on to one of the websites where you can order your own tests. There’s a bunch out there and just ordered our own fasting glucose, our own fasting insulin 70 bucks and just got it done and make sure all numbers were in range. So, at least in the United States, this is not available internationally. But within the United States, we do have direct to consumer lab testing. If you’re concerned and you want to know the numbers and your doc won’t run it, do it yourself and track it in Heads up Health.

Dr. Justin Marchegiani: One hundred percent. And again, a lot of people, they maybe listening concerned about you know, cholesterol, eating this much fat and this much good quality protein, again, I just got approved for the highest life insurance policy you can get from uh—you know, grade wise health and my lipids came back 180-185 for total cholesterol HDL is in the mid-60s Trigs were in the 50-60 range. So again, you know, nearly perfect on everything is wide at the highest rating that you can get for life insurance. But just to show you, you know, you’re concerned about thinking about eating these foods and it jacking up your cholesterol, typically not. The biggest thing that will jack it up will be insulin. Insulin will up regulate the enzyme that makes more cholesterol the uh—Hemo Methyl Glutarate COA Reductase enzyme.

Dave Korsunsky: Yup. So, yeah, we–-and that’s great. And you were just actually also, we were talking about a panel we’re gonna put together which is going to be a fasting glucose fasting insulin A1C and fructosamine. So uh— some people may not be familiar with fructosamine and A1C so maybe comment on those and then we’ll will put the panel together on the website people can just go do it themselves, Quest or Lab Corp and we’ll put the functional ranges in the show notes because the conventional ranges are misleading sometimes. So what do you think about those numbers in general?

Dr. Justin Marchegiani: Yes. So fructosamine, typically is a 10-14 day window. So in the lower, 200 is gonna be great.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: A1C in the lower fives—

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Lower 5’s is gonna be great. Of course, glucose, it depends upon the timing. But fasting you know, below hundred, below 95 is great, you know, we got shot it in the 80’s which is excellent. Insulin below five below six is really good from a fasting insulin closer to two or three is—is—is great, too, as well. And again, if we go really low in the insulin, we have a lot of fatigue issues. We do need insulin to help convert thyroid hormones. So we could be driving insulin too low, which could be creating some other metabolic issues. So keep that in the back of your head if you’re Keto, Paleo and you’re still having some symptoms you may need to actually raise the insulin a bit especially if your body comps are already pretty good. So keep that in the back of head. That could be a little something we have to tweak down the road.

Dave Korsunsky: And that is actually something you help me with last time I was in Austin where I had extremely low carb for a really long time. Potentially, it was even keeping insulin too low and I was seeing some elevated cortisol responses and just having some uh— post exercise uhm— insomnia type issues. And I was able to just dial it back a little bit and over time, quickly correct those. So that was one of the things I learned just from my own personal experience was to cycle out every once in a while and—and dial back up the—the carbs maybe from below 25 to 50 or something around there. I know you’d target 100, you’ve mentioned before. So, I think variance is good, basically. And uhm—I I know I personally may have stayed low carb too long I didn’t need to be I was actually— my body composition was good, but that’s a good point. It’s actually being too low can also have some downstream effects on the insulin side as well. Correct?

Dr. Justin Marchegiani: Hundred percent. And again, for me, I always default to go in low coz it’s easier to start low.

Dave Korsunsky: Absolutely.

Dr. Justin Marchegiani: Kind of stabilized and then move up.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: Coz if you’re kinda in the middle, then which way that you gotta go. There’s more variables that you have to move through; but if you start lower, then you start to move one direction.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you know, then you’re okay. Then if you hit a point, you know, you got, you got—so to speak, some uh—you have a direction that you just got to go the opposite to get back to where in case you just start having a negative reaction.

Dave Korsunsky: Yup, cool. Okay, perfect.

Dr. Justin Marchegiani: So we talked about those couple of markers there. That’s perfect. We hit those things. Also, let’s chat about the HRV a bit. So I see HRV, your heart rate variability, which is the unevenness between the hearts uh—you know, the heartbeat in each second. It’s not a consistent beat, there’s some level of unevenness, which basically is a parasympathetic response. So the more the parasympathetic nervous system is activated, that’s a great sign of being able to heal anabolic hormones, being able to recover, build, back up, recycle neurotransmitters, build muscle. That’s really good. So we have some devices that we can utilize I mean you can do the Amway device by HeartMath. Uhm—I like the just the Fit bit, making sure sleep looks pretty good. Uhm you can check in with the Oura ring. So let’s dial in with some of the things that you use to help improve heart rate variability.

Dave Korsunsky: Yeah. That sounds good, Doc. Give me one second here. Can you hear me, okay?

Dr. Justin Marchegiani: Yeah. You sound great.

Dave Korsunsky: Alright. So, starting to see a lot of individuals who are starting to look at heart rate variability. I think there’s still a lot of people who aren’t quite sure what is. They’re starting to hear that term, HRV. You might not know exactly what it is. I’ve only recently started introducing it into my regimen. Initially I started by very simple—just purchasing a heart rate monitor— a polar heart rate monitor that you can get on Amazon for 30 bucks and it’s a chest strap. So in the morning you would—you’d put it on and you would fire up an HRV app. And in my case, I was starting with the lead HRV. There’s a number of them out there you can pick one that you like and it will just ask you to sit—sit still for two or three minutes in the morning and it will start doing what’s called a readiness score and it will start measuring that variability. The—the time between each heartbeat and looking at the variance and then it will be able to give you a—a measurement of your level of recovery. How well recovered your body is on a given day and it just can help you inform how hard you should push yourself on your training. So some of the popular apps out there that I’ve come across are lead HRV, bio force and the one I’m using now is actually the Oura ring, which is here and this one actually will measure a number of different metrics. It will measure HRV, body temperature, sleep cycle analysis and give you a readiness score based on all that information. But for those who are not familiar with it, HRV is an excellent measurement to start assessing your level of personal stress, sympathetic versus parasympathetic, your level of recovery from physical training on a given day. And it can be a very helpful metric to understand just—just the level of stress in the body that can have implications for inflammation, can have implications for your blood sugar levels. So for those who aren’t familiar with it, starting to look into doing some basic HRV measurement I think is increasingly becoming a very popular metric that we’re seeing requests for from our users.

Dr. Justin Marchegiani: Love it. Excellent.

Dave Korsunsky: Are you testing? Have you tested HRV? Have you use any products there? do you have your patients measured at all?

Dr. Justin Marchegiani: I don’t do a lot of testing with it. I just—I haven’t found something that I’ve been streamlined with because there’s many things out there. So like the bigger things for me are like functional glucose testing. I like the Fit bit. If people aren’t gonna be going to the gym, making sure they’re getting enough steps.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: There’s a cool one that’s out there I’m liking. Coz I see a lot of people poor posture. It goes on your spine.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And then there is an app and that it tells you how straight your spine is.

Dave Korsunsky: Yeah.
Dr. Justin Marchegiani: So you put it on for optimal posture and then if you start moving, there’s a screen alert and it shows you where your posture is. So it’s instantaneous biofeedback for your posture.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: That’s—

Dave Korsunsky: Yeah. It’s called—I forgot the name of it. It’s Lumo Back or something like that.

Dr. Justin Marchegiani: Yes. I’m liking that to a certain degree coz if people sit all day, I think it provides a lot of awareness that, “Hey, your posture is pretty bad maybe get a stand desk.” I stand 5-6 hours a day and have a walking treadmill that I slide into my desk and I walk about you know 5 to 10 miles a day while I’m seeing patients. That’s I think helpful. So I don’t go crazy on that, but I think it’s something that I will look more into. I— I wish that Fitbit would integrate and have a heart rate variability aspect, too. I think some of the more expensive ones do, but I like the Flex for the Fitbit. It’s just a little more durable.

Dave Korsunsky: So this is something that I think would be uh— helpful—helpful to a lot of users on our system who are managing autoimmune disorders. They are managing metabolic diseases. They are managing cancer, for example. And if HRV is a proxy measurement for stress and perhaps underlying cortisol and elevated sympathetic nervous system response, maybe it’s not specifically to HRV, but can you share how things like stress can affect autoimmune, specifically, gut disorders and other autoimmune diseases and how measuring and lowering stress can improve symptoms and associated markers.

Dr. Justin Marchegiani: So, of course, we have stresses –is in a couple different areas, right? We have like when people think of stress, it’s typically emotional stress, right? It’s work, families, relationship, finance. Like that’s one element to you know, emotional stress.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Also things are like blood sugar. Having your blood sugar swing up and down because you’re eating too much carbohydrate or you’re skipping meals and you’re not getting enough nutrition and B vitamins and minerals at the meals coz you’re burning that stuff up, the more stressed you are, right?
Dave Korsunsky: Got it.

Dr. Justin Marchegiani: Think of you driving a car. You gas it on the highway. You’re going faster, you’re making fast turns. Well, you go through gasoline at higher rate.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Well, the same thing happens with people when they are skipping meals, right? And they’re under a lot of stress. They don’t have the gasoline and the take. The difference is our body just starts shifting in the catabolic physiology where it starts breaking down other tissue. The difference in a car is once you’re on empty, right? That Seinfeld episode, how low can you go? Well, eventually, you just—the car just stops. The difference is if the car was equal to our physiology, we’ll start metabolizing the bumper or we’ll start metabolizing the internal uh—gas, you know, the internal oil and fluids and such, right? The car is not quite like us. Once it’s on, once it’s out of fuel, it stops.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: We don’t stop. We break down other tissues and hormones and neurotransmitters and that creates disease because we’re breaking down, we’re getting chronically inflamed. So cortisol is gonna break down of course more neurotransmitters. It’s gonna create— it’s gonna a breakdown gut tissue, which is gonna create more leaky gut and create more immune stress. The more immune stress there is, the immune system sucks up a lot of resources, a lot of energy and of course, when the gut is impaired, when the gut is inflamed, we’re not gonna be able to absorb a lot of those nutrients. So, let’s say you start shifting your diet back to up to a Paleo template or an autoimmune template and you’re not getting better, that’s probably why. Is your sympathetic nervous system is so turned on we have to work on that. We need to support the gut integrity. And there’s probably some infections that have come because your immune system has been shut off. So basically, you left your door in uh— unlocked and now you get five homeless people sleeping your house when you get home, right? That’s the equivalent of you know these parasites. You got to come clean them up, right. You gotta go do all the stuff you need to do in the functional medicine program to get them all dial back in.

Dave Korsunsky: Yes. So my take away from that is heart rate variability is actually a way that people construct to quantify stress because—

Dr. Justin Marchegiani: Another way to monitor it, right? Like heart rate variability is not “tell me what to do” but it tells me that what I’m doing is actually working.

Dave Korsunsky: That’s exactly right. So if someone is suspecting that they’re doing everything right and they’ve got an autoimmune condition, they’ve got some other condition going on, they know that they have some stress in their life that’s probably exacerbating things. Starting to get some HRV measurement can actually give you some hard data because otherwise stress is just as nebulous thing. “Yeah I’m stressed out. It may be affecting my markers, my symptoms. I don’t really know how to quantify it.” And I think that’s where learning HRV can become extremely helpful especially getting that morning HRV readiness score, where it just says, “you got a great sleep” “your HRV numbers look good” “you can push yourself today” or you can say “Your HRV numbers are terrible. Take today focus on rest and recovery.” And it actually gives you a number of quantifiable, accurate number that can be used to start to calibrate lifestyle, actually understand how stressed your—your system is. And then make adjustments and have some data to work with instead of this nebulous “I’m stressed” term. The HRV can give you real numbers to work with. And there’s some great tools out there. The Oura ring is one. The elite HRV readiness score is another. Not difficult to measure and that can help you start to move the needle in terms of stress response. So, I guess that’s my take away from why I recommend HRV, why I test it personally.

Dr. Justin Marchegiani: And what’s your favorite device again?

Dave Korsunsky: Well, right now I’m using the Oura ring. It’s a pricey device that’s the thing, but it incorporates a lot of different things into the uhm— stress response score. It includes a lot of data from your previous night’s sleep. Deep, light, REM, uh— bedtime, wake time, resting heart rate. Things of that nature. So that’s the device I’m using. I also have a Polar heart rate chest strap which I bought on Amazon. I think it was $29 and the elite HRV app is free. So that’s another one. And I know that there’s other HRV apps out there. Pick one you like. Maybe test a couple. Start getting some basic HRV measurements and then it can be just another helpful data point to help you try to assess and measure and improve metrics associated with stress, elevated sympathetic nervous system, poor sleep quality could also contribute to poor HRV numbers. So those are the products I currently am familiar with.

Dr. Justin Marchegiani: Love it. Excellent. Well, I have to get them to sponsor the show here, Oura Ring, phenomenal. Alright, Dave, hey, phenomenal show. We’re gonna put links here kinda link to get access all this material here for you guys.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Get people over there. We’ll put some of the material and things we talked about in the show notes section underneath. So if you’re listening to iTunes or YouTube, we’ll be able to give you access some of those information there and some of those tools. Anything else you want to share that you think is really important before we wrap it up.

Dave Korsunsky: No. I think it’s always good to—to be on here and just –my whole thing is data-driven health and using having access to your numbers and learning how to figure out what works for you and it’s also great to speak with you and get the clinical perspective on how to interpret these numbers as well. So it was just great to be back. We’ve always got a lot of stuff we can talk about. We could probably go on forever but I think we recovered some good information here so uh— it was it was fun as always, Doc. I’ll be seeing you at Paleo f(x) Not to— not too far from now. Always a fun time so I’m sure we’ll have an opportunity to have some fun and uh yeah, otherwise, it’s just great to be on the show.

Dr. Justin Marchegiani: Love it. Great to be here, too. And also you’re listening to this, sharing is caring. Give us a share. Give us the thumbs up. We appreciate it. Spread the word. Uh again, it really fires me up when I see more people getting healthier so make sure you give that a share. Dave, thanks a lot. Great having you here today.

Dave Korsunsky: Okay, great.



Adjustable Kettlebells

TRX suspension trainer

Push up bar

Keto Mojo

Lumo Back App


Oura Ring

Elite HRV readiness

How Sugar Feeds Illness

 How Sugar Feeds Illness

How Sugar Feeds Illness

By Dr. Justin Marchegiani

America takes first place… as the top consumer of dietary sugar in the world. Our sugar consumption is a major player behind the skyrocketing rates of chronic diseases like diabetes, obesity, and cancer. The average American now consumes an average of 130 grams of sugar per dayfor reference, the daily recommendation for women is a maximum of 20 grams a day! This is more than just sad: it’s dangerous. Today we are going to outline some of the effects of sugar on our immediate and long-term health.

What is Sugar?

What is Sugar

This might seem obvious, but food producers are getting craftier with their labeling as they realize more and more people are making the choice to eat healthier. Sugar goes by many names, with new ones popping up all the time. Some sugars are natural, most are processed, and more and more are being created in labs. Here are just a few names to look out for on product labels:

  • Agave
  • Brown sugar
  • Corn sweetener
  • Corn syrup
  • Fruit juice concentrates
  • High fructose corn syrup
  • Honey (raw, pasteurized)
  • Invert sugar
  • Malt sugar
  • Molasses
  • Raw sugar
  • Sugar
  • Sugar molecules ending in “-ose” (dextrose, fructose, glucose, lactose, maltose, sucrose)
  • Syrup

Click here to consult with a functional medicine doctor and discuss underlying health issues preventing you from living your best life!

What About Fruit?

Yes, fruit technically contains sugar, in the form of fructose. However, there is a big difference between enjoying a piece of fruit as an after-dinner treat, versus having orange juice with breakfast and fruit juices as your beverage of choice throughout the day. Studies have shown that eating fruit whole can lower risk of developing type 2 diabetes, drinking fruit actually increases your risk! The fiber you get from eating fruit whole slows the absorption of the sugar and keeps the glycemic index low. Plus, it takes a lot more squeezed fruit to fill a glass than you could possibly eat in a serving, meaning you’re consuming way more sugar than you realize!

The Effects of Sugar

The Effects Of Sugar

Consuming large quantities of sugar has been linked to an increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers!

There are also many health issues caused by sugar that aren’t as talked about:

Sugar depletes the body of critical electrolytes, antioxidants, and minerals, which leads to cell death, muscle spasms, insulin resistance, and other health defects. Its effects on the immune system leave you prone to getting sick more often and more severely.

Sugar feeds bacteria and parasites, like yeast and Candida. It also depletes the body of good gut bacteria, promoting Leaky Gut and other gut infections. Chronic pain, vision problems, and even wrinkles can be worsened by sugar!

Sugar causes chronic inflammation in the body, and inflammation is said to be the root cause of almost all disease.

How Sugar Feeds Cancer

Sugar consumption has been proved to feed cancer cells and speed up the growth of tumors. Too much sugar consumption causes insulin resistance, as well as a specific protein to be released from your pancreas. This protein causes your cells to replicate and become immortal, which is how pre-cancerous cells can begin to take over.

Cancer cells prefer glucose over oxygen, but our mitochondria can’t use the glucose as energy. White blood cells are our immune system’s soldiers, and need vitamin C to function properly. A cancer patient needs lots of healthy white blood cells to fight the disease, however, sugar blocks the absorption of vitamin C in our bloodstream, weakening our immune system.

In summary, sugar causes cancer cells to reproduce and thrive, and blocks the mechanisms that would slow down or kill cancer cells and tumors.


Sugar addiction runs deep, and can be hard to kick. Stay tuned for Dr. J’s thoughts on artificial sweeteners, approaches to beating sugar addiction, and healthy alternatives for sugar.

Click here to talk to a functional medicine doctor about staying healthy this holiday season!

Natural Solutions For Dandruff Fungal Overgrowth – Dr. J Live Podcast #162

Dr. Justin Marchegiani and Evan Brand talk about dandruff in today’s podcast. Learn what causes it and explore other possible underlying health conditions like gut infections involving bacteria, yeast, fungus or parasites.

Gain an understanding on how functional medicine practitioners approach this kind of problem including their clinical strategies and the testing involved.  Get very helpful information regarding the products that they have found effective to address dandruff and the supplements they recommend to improve health conditions related to dandruff issues.

In this episode, we cover:

06:32   Antibiotics and Dandruff

07:27   Fungus and Refined Sugar

14:25   Birth Control Pills Effect and Dandruff

23:03   Hair Loss and Thrush Issues

32:16   Glutamine and Leaky Gut

Just In Health iTunes

Just In Health YouTube

Evan Brand: Weekend was great. Life is good except for the weather—rainy, cloudy cool. Fall is here officially, but what can you do?

Dr. Justin Marchegiani: Very cool. My wife and I brought our new baby to his first wedding. That was pretty exciting. First wedding with the new one was fun and he did a great job.

Evan Brand: Oh, good. Ain’t it great when you go out on public and the baby is good, isn’t that great?

Dr. Justin Marchegiani: Yeah. Totally. How’s your baby doing?

Evan Brand: Oh, she’s great. She’s actually— she’s got her molars coming in.

Dr. Justin Marchegiani: Oh, wow!

Evan Brand: So she’s very incessantly crying this morning. Uh— but wife texted me and said the baby knocked out. So naptime is a good time. That’s great, man. Very cool. Well, we chatted kinda in our early part of the show talking about what we’re gonna talk about today, really. And we kinda discuss that dandruff is a big issue that’s been coming up in our clinical practice. We want to talk about kinda what is and just some of the clinical strategies that we utilize to approach it and to help address it from a root cause functional medicine perspective.

Evan Brand: Yeah. Something I think we should hit on first is what’s the conventional approach is? Is it dermatologist that people are getting refer to? Like what’s the rabbit hole would you say that people end up on with the dandruff problem?

Dr. Justin Marchegiani: So dandruff typically uses excessive shedding of kinda the skin on the scalp. And it tends to be fungal driven. Of course, there are natural diet things that help, right? Good fats, good proteins, like the digestive, the hydration component. All those things are important, but the infection component is really important because you can have the diet stuff all dialed in and that may not be enough to get rid of that infection component. And sometimes the— the fungal overgrowth that—that’s there could be there from a deeper infection. It could be there from H. pylori or blasto or deeper parasite infection. So, it’s important we keep our eye on what could be there in the scalp area, but also what other bigger infections could be promoting that overgrowth.

Evan Brand: Yup. So, if you go to conventional doc and you just happened to bring up dandruff, what are they going to do? You think they’ll just refer you out to a dermatologist in then they’ll give you some steroids for it?  What would the conventional approach be? That way we have something to contrast it to our functional medicine approach.

Dr. Justin Marchegiani: Yeah. So your conventional approach is gonna be head and shoulders or sell some blow. That’s gonna be the general conventional approach. They may give you uh—a uh—you know, systemic antifungal medication that they see other kinds of things happening there. That’s gonna be the general consensus.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So the first thing that we’re gonna look at is we would probably lean more towards a anti-fungal kind of shampoo that’s herbally-based like tea tree or lavender or uhm—neem. These are some of the really good antifungal shampoos that are out. We’ll put some of the links below couple of the ones that I like are Art Naturals and Purely Northwest. We’ll put some links below here, so people can access them. We—I use those in my clinic a lot. You can also just get some pure you know, apple cider vinegar. You can mix a little bit of coconut oil. You can even do a little bit a tea tree and put it straight and kind just gonna do a little scalp massage and get right there in the scalp. That can be helpful, too. Uhm—but  some other shampoos that are out there that already to go. So that’s another good option for you. Just, if you don’t want to have to deal that.

Evan Brand: Cool. So let’s talk about testing. I mean this is always our philosophy. “You’ve got to test, don’t guess.” If you’ve got a fungal issue, we talked about parasites. So we want to look into the gut and in the organic acids testing. Wouldn’t you say that be an important one for this, too?

Dr. Justin Marchegiani: Yeah. I like the organic acids because because you can kinda look at fungus that may be more systemic. So when we look at a gut test, we may see various species of fungus in the gut. We may see Candida. We may see geotrichum yeast. We may see other types of Candida species. These are different species of yeast. And again, yeast is like the big umbrella. Fungus is the big umbrella and then we have some species of yeast there kinda under that big umbrella of fungus. So fungus is the big umbrella, yeast is the— the smaller kind of umbrella. And again,s mold like different molds that you may see like aflatoxin mold or ochre toxin. These different compounds are also kinda under that fungus mold umbrella as well, right?
Evan Brand: Yup.

Dr. Justin Marchegiani: So getting to your question—Those are some of the big ones that you may see. Now, the benefit of the organic acid test is we have some markers that are more systemic base. So we have the D-rabanose. It’s an interesting marker that looks at fungal overgrowth from a systemic perspective. So, sometimes we see people to get the stool test back and they’re maybe okay from a fungal perspective, but when we look at the organic acid urine, we may see that the D-rabanose is on the higher side which tells us there maybe some kinda fungal thing going on at a systemic level and sometimes we may see it systemically but not on the gut. So that’s a good marker, too, for treatment.

Evan Brand: Yep, cool. Yes, so, Justin and I, between us both, we run thousands and thousands and thousands of stool and organic acids testing. I would say, Justin, tell me if your assumption is different. Nine out of every 10 people have a yeast and/or a fungal problem. Whether it’s to the level which can cause extreme issues or not. Maybe it’s not nine out of 10 that have an extreme problem, but someone somewhere, nine out of 10 is gonna pop up with something that needs to be addressed in that category

Dr. Justin Marchegiani: Yeah. 100%. I think there’s some –there’s always some gut component. I would say the majority is a gut component. And most people with a gut component, uh—yeast is gonna be present. I find that yeast as the primary issue isn’t more common—it’s—actually less common, I should say. Where it’s more common is there’s a deeper, infection like a parasite or bacterial infection that’s of a higher level.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And yeast is kinda there, kinda like you see these sharks and you see these underlings that kinda suck to the shark’s belly.

Evan Brand: Yup, right.

Dr. Justin Marchegiani: They’re kinda like that. They’re just there as the underling and you get these bigger, stronger kind of critter that is the primary focus.

Evan Brand: Oh, by the way, I don’t know if this is true, I heard from a client of mine last week, supposedly, diagnostic solutions is coming out with a new panel that can be added to the GI-MAP where we can actually test for worms including pin worms.

Dr. Justin Marchegiani: That’s awesome! I’m really excited. Worms are definitely a concern. I know we’ve talked about, you know, we use –we add in worm wood. We added mimosa pudica, various herbs like that to help with a lot of these worms as well.

Evan Brand: Yeah. So, that’s true. We’re gonna have some really good extra clinical nuggets in our hand.

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: So—I wanted—I wanted to mention antibiotics. So, somebody does have dandruff and we could also convey that message to other issues with the hair, the skin, the nails.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: There’s probably a history of like a urinary tract infection, right? So like these yeast and fungus that you’re talking about. If that’s affecting the vaginal area for a female and they get put on some type of natural antifungal or probably a conventional anti fungal. That stuff’s gonna come back with a vengeance. They may end up doing antibiotics therapy, too. And that’s not good. That’s gonna create a lot of room for the yeast and fungus to overgrow and  all of a sudden, you’ve got the clean up crew that has to come post-antibiotics.

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: We’re not big fans. Like if you can avoid antibiotics, if your life is not in danger, then you could probably go ahead and say skip them and go to the natural remedies instead.

Dr. Justin Marchegiani: A hundred percent. So of course, the big thing when we deal with any type of fungus is really cutting out refined sugar. So, if we could look at our carbohydrates, we kinda draw a line down the middle. We have like real food carbohydrates on one side of the fence, and then we have refined sugar carbohydrate with extra added sugar to the carbs on the other side. So, basically, draw that line, anything that’s refined sugar, we throw out, and then the left side, I kinda break it down into starchy, non –starchy, okay? So, starchy being like sweet potatoes, squash, white potatoes. Non-starchy could be our veggies, uh—broccolis, brussel sprouts cauliflower, kale. Those are our non-starchy. And then basically, we have our high sugar fruit and our low sugar fruit.  High sugar fruit are gonna be more tropical things—bananas, pineapples, mangoes, right? Those kind of things. Then we have our lower sugar fruits— berries green apple, grape fruit passion fruit. Those kind of things. So we try, number one, stay on the non-starchy carbs primarily. And the low sugar fruits. So typically, 1 to 2  servings a day even on an anti-fungal approach is gonna be okay. Some people they go to the excessive and cut everything out but there’s some clinical evidence that these fungal critters may go into the spore-like state where they’re now kinda in  hibernation mode. It may make it harder to kill them. So, we’ll actually have 1 to 2 servings of fruit in there. We may even actually up the carbs even more during the killing to bate them out. We want to wake up that bear so it’s not hiding in its cave  all winter, uh—so we can hunt them down, so to speak.

Evan Brand: That’s a great point.  So if a ketogenic— if a ketogenic diet has been the norm for someone, we may need to bump up carbs a bit, maybe add a little bit of fruit back. And there’s been a lot of demonizing of fruit lately, which I’m just not really a fan of that. I think there’s a  lot of value there.

Dr. Justin Marchegiani: Again, it’s all individual. If you’re super over weight, you have  a lot of markers for insulin resistance, your  waist size is greater than 40inches for male, you know, up 20 pounds too much weight on there, then, yeah, that may make more sense to limit it or at least focus on the lower glycemic, low sugar variety, right? Low fructose variety. Maybe  keep  that fructose below 15g a day. That makes sense. But if you’re pretty active and pretty healthy weight, I’m fine with it. Hand—couple of handfuls about a day, that’s not a problem.

Evan Brand: Yup, good. So you mention the diet peace, now, some talk about diet as if he could cure you of these problems. I mean, I don’t  really agree there where if you just follow this Candida diet, all of a sudden your problems are going to go away.

Dr. Justin Marchegiani: I think if someone is like, you know, they’re kinda like dipping their toe in the functional medicine field like, “Is this worth it?” Well, just start with the diet stuff and see how much you get accomplished with that. If someone is having a lot of refined sugar and a lot of refined carbohydrate, right? Remember that line I drew? Refined carbs and then whole food carbs? If they’re having a lot on this side and they cut that out, they may see a significant improvement, which is great. And they may cut the grains out as well, which is great. But uhm—that maybe that last 20 or 30%. Or if there’s a deeper infection, uhm—that will have to be removed as well. So if it’s purely a fungal overgrowth that you may see a good improvement, but there may be some stuff still lingering. If that’s the case, then we got to dig deeper. Put on our clinical hats and you wanna definitely reach out to someone like myself or you, Evan.

 Evan Brand: Yeah. Well said. I guess my point—I wasn’t trying to pass the diet piece. I guess my point is that a lot of people sell these books, promoting certain diets as if you can magically eradicate all of your gut problems. For me I got maybe 80% better so I dealt with IBS for probably 10 years, maybe even 15years. I mean, I had always had irritable bowel problems. Once my diet was better, my gut problems were there, but then when you first took a look at me, you said, “Evan, you’ve got parasites. And that’s something that no matter how much kale and broccoli I ate, I wasn’t going to get rid of parasites.

Dr. Justin Marchegiani: Or grass-fed meats. Yeah. Exactly. I get that. So, we’re kinda biased because we see a lot of people that already come to us, they got their diet on track and we got to dig  deeper on top of that. So, I get where you’re coming from, for sure.

Evan Brand: Yeah. But the low hanging fruit that is the diet. And then we—we’ve, you know, Justin and I often have people that come to us that have been doing like a Paleo template or even like uh—autoimmune Paleo and they’re still sick and that’s where you say, “Okay, good. You’ve got the diet in place. It has to be in place, perfect.” Now, let’s dig deeper and that’s where we gonna find this other stuff.

Dr. Justin Marchegiani: Hundred percent. So we hit the uh—we hit the fungal component of dandruff. We talked about the excessive shedding of the skin on the scalp. You know, a lot of babies have it. It’s called cradle cap or seborrhea dermatitis, tends to be fungal-based. Again, with my kiddo, or just really giving just real, good-quality breastmilk, but also what the mom eats has a huge effect on the breast milk.

So my wife has kinda have a good Paleo template, really on point. We give our kid probiotics as well. He gets the infant strain probiotic. I know your daughter did the same thing as well, which helps a lot, too. And surprisingly, our baby’s had you know, zero acid reflux, zero spit up. So I think that that’s really made a big difference as well.

Evan Brand: Cool. That’s awesome. Yeah. So mom’s listening, this could apply to babies, too. Now, do you have any evidence on this? Like a mom passing a yeast or a fungus overgrowth to the baby via breastmilk? I’ve heard that was Lyme’s disease and co-infections, you know, the spirochetes can pass through the breast milk but I just wonder about you know, the yeast. Could you pass a yeast through the breastmilk?

Dr. Justin Marchegiani: Well, that may or may not be the case. I’m not really sure. There may be some data on that. Uh—my biggest concern is a lot of the infants that are gonna be fed formula, if you look at a lot of the ingredients, it’s about 50% high fructose corn syrup.

Evan Brand: Oh, God.

Dr. Justin Marchegiani: If you look at the amount of sugar that’s in a lot of these uhm—formulas, it’s the same amount that’s in a Coke.

Evan Brand: Yup.

Dr. Justin Marchegiani: You just gotta be careful because that’s not really the best thing for your child. And then a lot of it is gonna be GMO, too. And there’s evidence of uh— Mercury on getting into a lot of these high fructose compounds due to the extraction process. That’s not good either.

Evan Brand: Wow. So I’ve talked with a couple practitioners who do like a microscope—

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: When you look at the blood and they’ve seen little—little balls of yeast basically in the serum of the blood. So I just wonder, “Huh, wonder if any of that actually gets into the system where— where mom pass it to the baby or not.” Well, I have to keep asking, keep digging. That is just my curiosity, but—

Dr. Justin Marchegiani: I think it’s a really great question here. And I’ve I think clinically, it makes sense. I see a lot of women that have poor gut issues and their child can get it.  You know, they’ll get thrush with that white coating, so to speak. And they’ll get kind of a yeast issue where they get a lot of kind of a diaper rash stuff and that can happen as well. Like with our child, we’ve had no real yeast issues not even any diaper rash. We just kinda—like a couple of times, my wife will put a little bit of coconut oil there. We have some natural stuff. Yeah, we put there. But outside of that, he’s—you know, my son Aidan has been doing great on that side of the fence.

Evan Brand: That’s great. All right, so we hit the diet piece, we talked about antibiotics as a potential problem leading up to this. I would say birth control pills could be a factor, too. I’ve have had a lot of women— I don’t know the exact correlation or causation. I don’t know if that’s doing something with progesterone and estrogen that—that’s causing the dandruff for what it is. Do you have a take on that of why  birth control pills could be a factor?

Dr. Justin Marchegiani: Yeah. Birth control pills have an effect of alkalizing. So we can alkalize the urinary track. It has effect in alkalizing the guts and fungus likes to be more in an alkaline environment. And now everyone’s like “alkalize your diet” right? Well, a lot of these bacteria and we’ll just say fungus’s and bacteria, they like more alkaline environments. If you look at what probiotics do, probiotics actually add acidic load to the intestines. Like if you look at acidophilus, it literally translates to acid loving or acid producing. If you look at a lot of the really good fermentable drinks, a lot of them are very high in various acids, whether it’s glucuronic acid or uhm—

Evan Brand: Acetic acid.

Dr. Justin Marchegiani: Acetic acid, which is the main acid in apple cider vinegar and it’s not a surprise that acids like apple cider vinegar are used to treat fungal issues in the hair or they’re used to treat UTI issues as well. People will then utilize the Apple cider vinegar before meal to help with digestion and also acidify the urinary tract, too. So, a lot of these things are very helpful to decrease the critters and it changes the environment in the gut. So, good probiotics actually spit out more CO2, right? They spit out more of these really good acids to help get the gut into an environment PH wise with these critters can’t thrive, so to speak.

Evan Brand: Ahh. Okay, got it. Yes. So birth control pills, the antibiotics, maybe the prescription Diflucan’s or other prescription antifungals that you could’ve been on before making these strains more resistant. We talked about the sugar in the diet we talked about the gun infections, looking into those for bacteria and yeast fungus, parasites, getting your gut check with functional testing, not conventional testing. We talked about getting the urine organic acids for looking into the yeast and measuring it that way because stool test often gives us a false negative.

Dr. Justin Marchegiani: We may even look at blood, too. We may look at candida antibodies like IgA, IgG, IgM. We may see those on the higher side, which could just mean there’s more of a systemic issue. And it’s nice to know because if we don’t have any gut stuff going on or we don’t even see any organic acids stuff, you know, typically, you’ll see some organic acid. You’ll see the D-arabinose there.

Evan Brand: Yeah. So what do you say to a person when they say, “Oh, Justin, can I just go buy a bunch of herbs and just start randomly throwing stuff from the kitchen sink at this problem and see if it works?”

Dr. Justin Marchegiani: Well, the bigger issue is most people that have these symptoms, they have a whole bunch of other things, too. It’s very rare that you’re like, “Oh, my only chief issue is dandruff.” Or some kind of fungal issue, right? It’s mood, energy, sleep. If you’re female, there’s probably some cycle imbalances, whether it’s menstruation issues or mood issues or breast tenderness, back pain. Whatever’s happening there and then you have this. So there’s a constellation of the different things happening. And body systems, they function and dysfunction together. So, imagine a beautiful orchestra going, right? And one instrument starts going off. Let’s call that one instrument our fungal overgrowth or uhm— our scalp kind of a dandruff issue, right? That’s our one symptom. That’s our one imbalance. Well, it doesn’t take long before the rest of the orchestra starts singing out of tune as well.

Evan Brand: Yup.

Dr. Justin Marchegiani: And that’s what I’m referring to when we talk about the other hormonal issues that go out of balance. And then when we start having gut issues, then we can start having more leaky gut, which then can create more immune stress, then we can have more malabsorption and low stomach acid and enzymes and nutrient deficiencies, which then affect neurotransmitters and other hormone pathways. So you can see how this thing can really spiral out of control pretty fast. So, that’s why it’s good always digging deeper to really get a good body system audit of all the other things that are happening.

Evan Brand: Yup. Well said. I’m so glad you—you said it so eloquently. I did a rant at the end of my podcast that I put up last week and I just told people like, “Look, please, don’t wait until you hit rock bottom. Don’t wait until every body system is falling apart and then you reach out.” Like you and I work with those complex cases all the time. But if you’ve got one thing like it’s anxiety or little bit of depression or little bitt of gut issues or little bit of skin issues, it’s so much better to start getting tested and start digging deep then, as opposed to waiting until you’re symptoms list is 20 pages long. You’ve been suffering for 20 years, then you hit rock bottom, then you decide you want to get better. I’ll tell you, it will save people a lot of money and a lot of suffering if once you see these problems a little tip the iceberg poking out, address it, then don’t wait until like you said you’ve got anxiety, depression, PMS, irritability, mood swings, rage, poor sleep and dandruff to top it all off.

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: Please. And that’s not even to benefit us. It’s to benefit you. You know, we’ve been so booked up that we aren’t necessarily begging you, “Hey, please come see us.” It’s not like that. It’s the fact that, “Hey, look, I just want to save you some suffering and save you some time.” Justin and I came from our own health journeys as well and if we could just give you one piece of advice and maybe I’m not speaking for him, so I’ll let Justin give his— his feedback, too. But If I could  say one thing, it would be if you’ve got a weird symptom, there’s probably some other stuff going on that you just have to find and fix.

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: Like me, I had to wait until I’d lost about 25 pounds. I had terrible sleep. I woke up, I wasn’t feeling rested. I had a lot of stress. I had some anxiety problems even to the point of a panic attack. I called Justin up one day, “man, my heart’s beating out of my chest. I can’t stop my heart.” You’re like, “Well, how much stress do you got going on? I was like, “ a lot” And he’s like, “how are you sleeping?” I’m like, “haven’t been sleeping very well” and then he’s like, “what’s going on with your gut?” and I was like, “Oh my Lord, every body system is affected” My gut has been affected, my brain, my stress response is broken. I was like, “this ain’t even me, I’m even an anxious person. What’s going on?” And you go, “Oh, it’s parasites, Evan.” So, for me, I had to learn the hard way. I had to wait until my symptoms piled up so much that I was falling apart to then fix it.

Dr. Justin Marchegiani: Hundred percent agreed. I think we’re at that the point in our careers where we realize that there’s probably uh— more people out there that we see online with the you know, the millions of downloads we get every few months, that were not gonna be able to help anyone— everyone, so to speak. And there’s just too many people out there to help that— you know, we really want to put as much free content out there and if we can just get most of the people to just apply the free stuff, that is going to be huge. And we’re gonna make a huge difference in the world just by itself.

Evan Brand: Yup.

Dr. Justin Marchegiani: I think we’re really just getting really good actionable information and I think the key thing I want to push to everyone listening, if you can walk away with just one action item, “Hey, I’m gonna do this.” or “I’m gonna add this component.” or “I’m gonna add this diet shift or this lifestyle change, or this supplement change” I think that you’re gonna make yourself better and healthier after every podcast.

Evan Brand: Agreed. Cool. Do you want to hit some questions for a few minutes?

Dr. Justin Marchegiani: Yeah. We’ve got some questions.

Evan Brand: Okay, cool.

Dr. Justin Marchegiani: Everyone writing questions, if you can kinda keep the questions framed towards the conversation, I mean, you know, you can kinda do a little politician pivot where you’re like, “Hey, dandruff” and then you’re on adrenals, right? We could kinda do that, so to speak. But I’m just trying to keep it connected to what we’re talking about as possible. If it’s so disconnected, we’re just gonna have to skip over the question.

Evan Brand: Yup, yup. Well said. Okay. Yes. So a lot of those were like off-subject questions. Let’s see.

Dr. Justin Marchegiani: I got one here about—let me see, I’ve got Gerald’s question here. Gerald was on my G.I. Clear 2, positive for H. pylori. I feel like it’s returned. If add Masika to the G.I. Clear 2 what dose should I take per day? Typically, two caps TID, two caps, three times a day and we need to retest, Gerald. Make sure the infection is gone. Make sure there’s no residual infections. We want to look a little bit deeper to at your partner or any dogs or pets in the house. Uhm— partner for sure is the easy one because that can, you know, you can go get that reinfected back and forth. So we need you to retest and then do GI Clear2 and the pure Masika, 2 caps TID and get that retested.

Evan Brand: Well said. Yeah. I had that a few weeks ago. A lady, she said, “I feel like my—my gut’s backtracked. I got off your herb. So, what’s going on?” and I said, “Well, now it’s time to test your partner. And sure enough, there is the H. pylori.

Dr. Justin Marchegiani: Yup.

Evan Brand: That’s why she’s been getting re-infected. It took three rounds to get rid of it.

Dr. Justin Marchegiani: Totally.

Evan Brand: Alright, let’s go over to the next one here. There was one from Ovi. We’ll call it uh—I don’t know how to pronounce that full name. “Any tips on reducing hair loss and thrush when coming off of HRT as a female?”

Dr. Justin Marchegiani: So— that would be helpful to know. I mean, imagine, I’m just coming guessing this is menopausal female, okay? So, you know 53-54 and up. So depending on kinda where the hormonal imbalance is, it’d be good to know if there is an estrogen dominance present or if we’re just having low estrogen and low progesterone and everything’s kinda in the tank. So, typically, when I think hair loss, though, I’m leaning more on the thyroid side. So, I’d want to know where the female hormones are at or if you’re cycling or not. So, if you want to comment on that, that’d be helpful. Uh— number two, really looking at the thyroid component because the thyroid has a huge effect on the hair follicles, stimulating the hair follicle to grow.  And then number three is the gut component because that’s where we digest and break down a lot of the nutrients and amino acids and fatty acids that become the building blocks for our hair. So I want to look at those three places first.

Evan Brand: Well said. So I’d also add on looking at ferritin levels, too.

Dr. Justin Marchegiani: Yeah.

Evan Brand: See if there’s some type of anemia problem. You hit the thyroid so in—

Dr. Justin Marchegiani: And when I say thyroid, though, that includes all that consolation because iron is very important for making thyroid hormone, so if you have a history, if it’s menopausal female and she’s not vegetarian or vegan, doesn’t have a history of endometriosis or fibroids or excessive menses, it’s probably not an iron issue.

Evan Brand: Good. Good. And then when you talk about the thyroids, too, so this is also including the antibody. So make it sure that there’s no Hashimoto’s at play coz we see that a lot. Justin and I find that many people with autoimmune thyroid, the hair, like nine times out of 10 it’s a problem.

Dr. Justin Marchegiani: Yup. Exactly. We’ll add in collagen peptides, too. Just this collagen is uh—it’s just great. It’s a great building block and then if it’s in peptide form, it’s already super easy to digest. So, give a little plug for my Tru Collagen on that one.

Evan Brand: Yeah. Check it out. Alright. Gerald had a follow-up question for second round of H. pylori eradication, should it be a 30 day protocol or 60 days?

Dr. Justin Marchegiani: Yeah. Typically, a minimum 30. You can’t go wrong with just a 30. It just depends on what other infections were present along with that, but if it’s just the H. pylori, let’s say 30—30 to 45 is typically good.

Evan Brand: Yup. Nice. Alright. Mossimo had a question here, “Are sustained-release essential oils and herbs necessary as opposed to the liquid oil taken internally? It’s kind of a confusing question. I didn’t know there was such thing as a sustained-release essential oil, but what were talking about for this conversation would’ve been like a topical. So like Justin mentioned about those brands of the tea tree oil shampoos and such—

Dr. Justin Marchegiani: Yeah.

Evan Brand:  That would just be a couple of drops on the scalp. Use some type of Jojoba or avocado or coconut oil.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And try to dilute that so it doesn’t burn your scalp.

Dr. Justin Marchegiani: Totally. In my line, we have GI Clear5, which is an emulsified form of oregano. That is more enterically coated. So it does open up more in the small intestine than the stomach. A lot of the fungal issues tend to be more on the stomach. I’m sorry—

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: It tends to be more in the small intestine. H. pylori more in the stomach. Evan Brand: Yeah. I forgot about the—the oregano oils.

Dr. Justin Marchegiani: Yes.

Evan Brand: I guess when I read essential oils, I was thinking just like your standard oils that you diffuse.

Dr. Justin Marchegiani: That’s why I’d like to have some of my, you know, oils or some of my herbs taken on an empty stomach just so it can get fully out of the stomach into the small intestine where it can really help. It and really help can be little more effective.

Evan Brand: Yeah. Alright. So, Samuel had a question. “What’s your take on taking CBD with no THC for inflammation? I take it for the first time and noticed a huge difference in relaxation.” I’ll hit this one.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m a huge fan. I just posted a YouTube video. If you haven’t checked it out, look it up, Samuel. I went to uh—a hemp form here in Kentucky one of the very few hemp programs that has been approved by the state government. And the guys making super high quality CBD and the guy is— so he used it on his son who is having hundreds of seizures per month and now the kid is like 12 years old and hasn’t had seizures in years just from CBD no THC. I think the THC does have benefit. I hope that there’s a couple of bills that are trying to get through for 2018. I hope we can federally just decriminalize cannabis across the board because I have talked with people, especially in the pain department, where when they add a little bit it of THC in, all the sudden their fibromyalgia or chronic pain does get better, which isn’t achieved just by the CBD by itself. So I think both would be awesome.

Dr. Justin Marchegiani: Yeah. I’m not a huge fan of the THC side uhm— I think it can have some really good benefits if you’re going through cancer treatment and have extreme nausea and/or extreme pain and the CBD is not helping enough. I think it can be helpful like if we’re choosing you know, THC over chronic dose of the pain medication or opiate or like a lot ibuprofen, I will definitely reach for the THC component you know, over—over the rest. My biggest thing is just uhm— number one, there’s some potential memory side effects, cognitive side effects. Number two, I would say making sure that you’re not having to incinerate every time, right? Trying to do of a vaporizer or some kind of other medium that’s not involving the incineration, which exposes the poly aromatic hydrocarbons, the heterocyclic ABGs, the carcinogens that are produced. And uh—the CBD obviously is better just because it’s a less psychoactive, but if you can you know— epileptic stuff, autoimmune stuff, anxiety, mood stuff, the CBD for sure. THC more on the—if the CBD is not working and you need the pain or you have a lot of the nausea stuff that may be better.

Evan Brand: Yup. I mean with the THC, I don’t—I mean I’m sure there’s tons of people that still combust, but you really don’t even have to anymore. There are so many different drops and tinctures and potions and such that you don’t have to burn. You don’t have to burn the herbs anymore. And people don’t want to get high, too. So you could do like a 20% CBD like a 1% THC and you’d probably feel really good.

Dr. Justin Marchegiani:  Yeah. I hate the feeling of being high. I’ve only done it a few times in my life, but I’m tired and I just get the munchies. I’m fatigued and I just get really hungry. It’s like I don’t need that. I want to be energized and alert. And I think a lot of the negative studies on marijuana, too, is number one, you really have to make sure you’re not getting pesticide exposure.

Evan Brand: Exactly.

Dr. Justin Marchegiani: And you have to kind of faired out the burning and the incineration of the leaf.

Evan Brand: Yeah.

Dr. Justin Marchegiani: I think if you pick, take those two components out, I think you’ll see a lot of those confounding variables showing negative results in those studies in proof.

Evan Brand: For me, a vaporizer change my life. When I had IBS, the only thing before I knew about by diet changes that help me was a vaporizer. It would slow down my bowels since I was having so much loose stool. It would regulate the bowels better stomach cramps, stomach pains would go away so I had a lot of hands-on experience— super helpful.

Dr. Justin Marchegiani: Go ahead, I’m sorry.

Evan Brand: I just have to say, I don’t vape anymore currently. One is it’s impossible to find a good source in Kentucky. Now, if I go to Colorado and I could find some good organic, high-quality, I’m gonna take a sample, that’s for sure. But for me, I just— I can’t find a good source here. So I do stick with the—the CBD drops, which is legal, too. You know, it’s another thing. It’s— it’s legal in all 50 states, the CBD is.

Dr. Justin Marchegiani: Totally. And uhm—just kinda –I think a lot of marijuana, maybe not the CBD, because that’s more the— the non-psychoactive. I think a lot of marijuana is used you know, to cover-up emotional stress uhmm—you know to the kind of numb yourself out from whatever’s happening in your life. So we just gotta make sure that you’re not using it to avoid reality, so to speak. But there is a lot of drugs out there that are very dangerous and have a lot of side effects and kill a lot of people. So if we’re choosing marijuana over these drugs that kill a lot, I will always choose the drug that doesn’t have the profile of killing people, right?

Evan Brand: I’ll pick it over alcohol, too.

Dr. Justin Marchegiani: Yeah.

Evan Brand: If I had somebody say, “I wanted to drink a bottle wine every night” or “hit the vaporizer, do a couple of drops of a tincture” The alcohol for me is gonna be a bigger problem coz it’s gonna create the leaky gut situation.

Dr. Justin Marchegiani: Yeah. I mean if you’re drinking excessively, if you’re having a glass or two and it’s organic, you know, you’re probably fine with that on the alcohol side. But if you’re going you know, four glasses a night and then it’s consistent, yeah, they’ve done studies. I think it was a Giuliani report they looked at like the highest ranked college students in the country and they say you know, what do you prefer, alcohol or marijuana as a drug of choice? And the kids that have the highest grades were choosing the marijuana and their main reason was the hangover. They could wake up the next day and studying, get their work done.

Evan Brand: Makes sense. Let’s see if we have any other on-topic questions here. Do you see any others?

Dr. Justin Marchegiani: See here—see, we can find some things that we can connect to our little politician side stepped here.

Evan Brand: Gerald had one, about how do you know if you’re eating too many starchy carbs per week? I— I cycle like it depends on the week and depends on activity level how much I’m gonna do.

Dr. Justin Marchegiani: Yeah. I mean it—I think 50 to 150 is a pretty good place for most people to be. And if you’re doing a lot of lifting or a lot of CrossFit, then you may need to go up to 250. So I think, look at your height and weight. If you’re at a really good height and weight, you’re gonna have more latitude. If you’re lifting a lot of weights, I think you can go up to 150 to 200. If you’re doing Ironmans or like you know, those, then you may have to go way higher than that. So I think you really  just figure out where your activity level is at. Figure out where your height and weight is right now. 50 to 150’s pretty good. And you earn your carbs. So you exercise more, you—and you’re lifting more weights, you can up your carbs a little more and just try to keep it whole food, you’re gonna be fine.

Evan Brand:  Here’s another question about glutamine. Should you take glutamine by itself to repair leaky gut or is it okay to combine with protein?

Dr. Justin Marchegiani: I mean glutamine is an amino acid, but if you mean like glutamine and then have real whole food protein, yeah, that’s fine. I mean in my line, we use GI Restore, which has glutamine and a bunch of their healing things and glucosamine and we’ll mix that and add in a drink, take it on an empty stomach and then patients will still have you know, a really good whole foods meal. Or we’ll add in the collagen as well which is very high in glycine. And glycine’s really good for the enterosite healing as well. So you can do either glutamine. I’ll typically only do L-glutamine by itself for patients that are very, very sensitive. We’ll typically add the healing compound in there, you know, the GI Restore, the all the other, licorice, aloe, slippery elm, glucosamine, right? Modify—We’ll all those in together and if that’s causing too much sensitivity, then we will do L-glutamine by itself. But they gotta really be sensitive if that’s the case.

Evan Brand: Yeah. And that’s— I find that pretty rare. The glutamine by itself to me, it just doesn’t move the needle as quick as the combo products like you talk about.

Dr. Justin Marchegiani: Yeah. Only if there’s an allergy issue. And then, the collagen is great. Glycine’s a really big building block for healthy gut function, too.

Evan Brand: Nice. Bone broth, too. I think that’s another—

Dr. Justin Marchegiani: That is very high in glycine, too. Yup.

Evan Brand: Cool. I think that was it. There were bunch of other questions, but a lot of these were super off subjects, so I don’t want to distract from the convo too much.

Dr. Justin Marchegiani:  Yeah. So—

Evan Brand: The others—

Dr. Justin Marchegiani: I think we kinda hit everything. I want to go off to— you know, off to uhm the kind of the __ James here talks about this just kind of the cost regarding the organic acid test and keeping it low. Typically, if— if you’re trying to keep the cost down with the organics, let’s do the test once a year. You know, do it once a year. Ideally, if you can do it uhm— twice a year, that’s ideal, but if not, you can just do it  once a year. That’s kinda your—your best bet kinda just fine-tune your program once a year with the organics. That’s probably the best way to make it more cost-effective.

Evan Brand: Yup. Well said. Gerald said that we guys are the best. Change his life. Hey, Gerald, thanks. We appreciate it.

Dr. Justin Marchegiani: Uhm—Gerald is actually a patient. Glad we could help, Gerald. That’s very good. And one last question, too. Diana talks about doing a podcast on estrogen dominance and progesterone therapy. Hey, you’re kinda—you’re too late. Check out the podcast’s show notes. We did a podcast on estrogence dominance and we talked about progesterone and __ augmentation programs that we do with progesterone therapy, too. So check out that podcast, Diana.

Evan Brand: Yeah. Go on either uh—Go on Justin’s YouTube. That’s probably the best if it’s posted there or to check out his site Justinhealth and just type in estrogen. You should find it either way.

Dr. Justin Marchegiani: And if you guys enjoy this right now, the best way you can thank us is give us a thumbs up, post, share on your twitter and/or uhm— Facebook. We love it. We just want to help more people and you notice, it’s a lot of people that are out there podcast people, they either hold information back or all they do is spend oh, you know, 90% of the time promoting their products and affiliates. I think 95% of our time is just free intel. Of course, we got a little plug here and there, but we’re 95% free information because we know there’s too many people out there that need all this info and we’re just gonna be an open book to everyone.

Evan Brand: Yup. Totally. So, we hope it helps. And if you need to reach out, schedule a consult with either of us. For Justin, check out his site. Justinhealth.com You can look up and click the book an appointment button. Myself, same thing. Evanbrand.com Check us out. Stalk us. Study us. Look under every crevice and corner. Read our reviews. We’re here for you. We’re happy to help if you got this issue going on.

Dr. Justin Marchegiani: Leave us comments below. Tell us what you like about the podcast and tell us about future podcast that you want to hear. We’re reading them and we get inspired by those comments below. So say, “Hey, I like this about this podcast and I want to hear something about” And tell us that topic we’ll add it to the queue.

Evan Brand: Yes, sir. Good chatting with you.

Dr. Justin Marchegiani: Everyone, have a great day. Take care.

Evan Brand: Take Care.

Dr. Justin Marchegiani: Bye.





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Hacking the Holidays – Dr. J Live Podcast #160

Dr. Justin Marchegiani discusses different options, substitutions and modifications that can be made during the holiday season. Learn about what ingredients to use in some of the traditional Thanksgiving dishes including the turkey, stuffing and gravy that can help to still improve your health. 

Gain insight on the different modifications and options that you can use for some of your desserts so you can still indulge without having to feel guilty afterwards. Also, learn about some other cool options including meal timing, fasting, exercise and alcohol intake for a healthier you during this holiday season.Healthy Holiday Recipes

In this episode, we cover:

01:49   Grain-free holiday meal

03:01   Enzyme Support

05:55   Desserts Options

10:36   Timing Recommendations and Alcohol

15:00   Exercise



Dr. Justin Marchegiani:  Hey, everyone! It’s Dr. J here.  Evan, Happy Holidays, man! We got a short Thanksgiving Day week. I love turkey day, man. Some time with the family, really good eating. Are you excited too?

Evan Brand: I am and I’ve got blue skies here which is very unusual for this time of year. We’ve got sunny every single day this week. So I’m super grateful for that.

Dr. Justin Marchegiani: Love it. Yeah, it’s a great time of the year. It’s uh— important year, time of the year to be really grateful and to be extra uh— particular in all the things that we have to be thankful for. Coz there’s a lot of things but it’s easy to be so focused on everything it’s not there. So we got to really focus on all the things that are there. So couple that is just how about, just some really good Intel that we can use to hack our holidays. Meaning we can still indulge in feel good and connect with our family members but not go into a food coma and feel like absolute crap. What do you think about that?

Evan Brand: Agreed. Yeah. A lot of our clients recommend we do this subject because they feel deprived if they’re doing AIP or some type of dietary approach. They feel like that we’re the bad guys and we’re making their holidays not as fun. But that doesn’t have to be the case.

Dr. Justin Marchegiani: Absolutely. So, couple of things if you look at Thanksgiving, it can totally be Paleo, right? We have like basically the centerpiece in the Thanksgiving Day meal is the turkey, right? Awesome. Especially if we can go after the darker meat. That’s gonna be excellent. Good fats, right? Try to buy an organic or at least a Pasteur-fed turkey. It costs a little bit more but the nutrients are to be much higher, right? So you get good fats and proteins there. That’s the kind of a starting point. And then after that, you control your sides. So most people want mashed potatoes and maybe squash which you know, I’m okay doing a little bit more starch in the holidays. I’m okay with that.  It’s better than doing, let’s say a grain-based stuffing, that’s number one. Number two, we try to substitute for the things that we typically have grains. What’s gonna have grains? Well, typically, your gravy is gonna be thickened with flour so we do a gravy that’s gonna be a carrot and celery based and we thicken it with coconut flour if we do it. And we use the actual uhm— turkey stock from the actual turkeys. That’s a huge way to get to the stuffing, I mean the gravy going. And then the stuffing there’s typically some good stuffing recipes out there where we do a celery and carrot-based stuffing and it’s totally grain-free and it taste phenomenal. So, off the bat, you can have your starches. I’m okay with that. Number two, you have the gravy. Because the gravy kinda goes on everything. So if your gravy isn’t too good, you can really mess everything up coz you just basically coating everything with thickened uh—turkey giblets and flour. And then uhm—then after that, you have I mentioned your starches and then after that you can do cranberry sauce, really, you know, super Paleo. You can do like, I’ll do green beans and I’ll cut up some bacon, I’ll layer that on there, too. Uhm—those are kinda my big things off the bat and of course, a really good turkey. We’re gonna smoke our turkey this year. We typically use our smoker this time of the year. Any other thoughts, Evan, off the bat for your? Just with the Thanksgiving Day meal?

Evan Brand: Well, my thoughts are you got me hungry but besides that—<laughs>

Dr. Justin Marchegiani: <laughs>

Evan Brand: But besides that, the enzyme piece.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: You and want to talk about enzyme.

Dr. Justin Marchegiani: Yes.

Evan Brand: So let’s go into that. So one’s that you and I were talking about off-air was one from designs for health. It’s called allerGzyme. And this is more specific to people that if they’re just going to go off the rails, they are going to do or get it possibly get exposed maybe a cross-reactive issue with dairy or egg or soy or gluten or casein peanuts, things like that. You can take the specific enzymes. They’ve got like a patented version they call it what, Glutalytic in there.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: It is supposed to be pretty helpful. And they’ve got bromelain. Way but it’s a very, very super high dose bromelain which is a pineapple enzyme. It’s a really good enzyme. So there’s that. And then you and I both have our own custom digestive enzyme formulas that I say those are the best nutritional insurance policies that you can bring with you like a little glass jar or something.

Dr. Justin Marchegiani: Especially the fact that people forget that I uhm— having a meal like that is gonna be stressful not necessarily because it’s bad because obviously we’re gonna try to make the substitutes. We’re not gonna focus on eliminating. We’re gonna focus on substituting.  So we have the most healthiest options possible but because we’re probably gonna eat such a ton of food, it’s going to be a lot for our digestive system to handle. So we’re gonna really utilize more enzymes and more HCl and maybe even some bile salts to really optimize our ability to actually break it down.

Evan Brand: Yeah. I love it. I’ve got a small little old honey jar that my wife just keeps in her personnel and so if we go out to restaurant or if we got to family member, I’m just gonna pull out those enzymes and popp them down. So that’s can be my strategy and I think everybody who is dealing with bloating, gas, indigestion, a lot of these common symptoms heartburn, you’ve got that excessive heaviness feeling.

Dr. Justin Marchegiani: If you already got those symptoms and it’s not even Thanksgiving yet, then you’re a person who needs extra care when it comes to using enzymes.

Dr. Justin Marchegiani: Absolutely. So we talked about the meal. We talked about maybe the potatoes and/or the sweet potatoes or the squash. I’ll typically put some extra cinnamon on my squash, too, which is great for blood sugar. And the blood sugar and the insulin kina receptor sites that which is good. I talked about the green beans. I talked about how to maximize the gravy because the gravy is one of those things that’s gonna be layered on everything. So if you can fix the gravy component— and we’ll have in the show notes some Paleo uhm— gravy recipes so we’ll make sure we get some Paleo recipes in the notes.  Uh—we’ll make sure we get some stuffing recipes. Coz those are gonna be the the big— the big things—the gravy and the stuffing. Almost everything else, you can dial it in. The turkey’s pretty good. You can do really good cranberry sauce, you can do uhm— squash, you can do sweet potatoes, you can do regular potatoes or any other sides that we’re missing.

Evan Brand: Yeah. You hit the green beans.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Sometimes peas, sometimes carrots you.

Dr. Justin Marchegiani: Yup.

Evan Brand: I think honestly, if you’re eating real food and you just always think, “Am I eating real food?” you’re gonna be just fine.

Dr. Justin Marchegiani: Yeah. Then a couple of things—let’s go to desserts pretty fast. So we’re just kinda laying out the meal options or the meal substitutes, I should say, and then we’ll talk about little hacks that you can incorporate, too. So, off the, my Paleo Apple Crisp is something that I utilize a lot. I actually have it made once a week and it’s basically just a combination of the crust, which is gonna be coconut shreds, pecans and walnuts, kinda crushed up. And it’s gonna be kinda layered over some Granny Smith apples that are cut up. And the Granny Smith apples are basically mixed with butter. And they’re also gonna have a little bit of cinnamon on them and then we also have a little bit—

Evan Brand: I need this.

Dr. Justin Marchegiani: .. a little bit of organic palm cane sugar. And we like the organic palm cane coconut sugar because it’s got a glycemic index of 15. So it goes into your bloodstream a little bit slower and we try to use the least amount possible. So what I recommend is put the smallest amount whether it’s like uhm an eight of a cup or something in there. And just kinda glaze it and then mix it up. And then try a couple before you know, layer all the nuts and cook it. And then just see if it’s at the sweetness you want. So I don’t need a lot. I just put a very, very small amount. Once I have it, you know, typically, an eighth of the cup or sixteenth of a cup, a very—typically, I just glaze it. I don’t even h measure it. I just gently glaze it over so very small amount. And then once I have it to taste, then I pretty much put uhm—then it’s mixed with butter, of course, right? And then I put that topping right on top and there and then 350 for 30 to 45 minutes till the apples are nice and soft. And then you’re pretty much good to go.

Evan Brand: That sounds delicious. Did you invent that recipe or is that something you found?

Dr. Justin Marchegiani: No, I invented that one. That’s a good one. And then if you want mix it up, too, you want to make it more like a cake, you can do uhm—a tapioca and arrowroot flower and then typically you just add the arrowroot flour in with the apples, typically, half a cup to cup each. And then that kind of gives that more of a thickened flavor. And then you can just bake it not use the nuts. And then it comes more like a cake. And that’s a really good option. We have that Apple cake option on there, too. So, apple cake and/or uhm— the Paleo Apple Crisp. Apple crisp I think is a little bit more healthy coz you don’t’ have any flours in there. They’re all just a good healthy nuts and fats.

Evan Brand: Right. Yeah. I have a female client last week. She said she’s going to make a like a pumpkin pie but she’s going to do coconut flour and I think she said coconut flour and Coke and cashews maybe. So I know that there’s options out there. I just don’t eat too much dessert anyway, you know, besides a good piece of chocolate. But if you’re somebody who you’re going to go to one of these events and you think, “You know what I don’t want to miss out” Well then you just make it. You know, let  everybody else bring the meat and veggies. You just bring a healthy dessert. That way, you know that you’re gonna be safe and you’re not gonna cause yourself a flare-up or new problems.

Dr. Justin Marchegiani: Totally. For the most part, your turkey’s gonna be good, right? If you’re gonna do your mashed potatoes, fine. If you do cranberry sauce, if you’re gonna do squash, if you’re gonna do green beans or will do like uhm— Brussels sprouts with bacon, that’s typically gonna be good. You’re gonna mess it up with the excess uhm—gravy. So do the gravy right way and you do a healthy stuffing options. So I recommend is if you’re going somewhere, maybe you bring some gravy, or if you don’t bring the gravy, maybe you just uhm— bring the stuffing. And people won’t even know. We bring some of these healthy Paleo options we go places to get invited. People wouldn’t even know the difference a lot of times.

Evan Brand: Exactly.

Dr. Justin Marchegiani: The big thing is for me it’s about, it’s not about, “Oh, Dr. J, you’re being, you know, such uh—so tight about this. You know, why can’t you roll?” Well, the reason why  is I wanna feel freaking good afterwards.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. I wanna eat a lot and I want to feel good. And there are great options and I don’t notice a difference in flavor. I can make my option and it will taste just as good. So those are some good options. Anything else you want—Oh, also dessert. Just, you know, if you’re doing a pumpkin pie, you can just leave out the crust are there some really good gluten-free, crust options or you can do coconut uhm— crust option. That’s fine. And you can just do your pumpkin pie without you know, just the lower amount of sugar. That’s totally good right there. Uhm— is or anything else you want to mention for desserts outside of the Apple Crisp?

Evan Brand: I think you covered it. I mean you could bring along a piece of dark chocolate if you’re just super scared and you don’t want to go for any of the more processed things. Bring a cup— bring a bar of dark chocolate with there on the fridge when you get to your family’s house.

Dr. Justin Marchegiani: Yeah. And again, you could do Pecan Pie a little bit higher in sugar. You just have to make sure the crust is gluten-free. That’s totally fine, too. And obviously, just some really good maybe some coconut ice cream, coconut vanilla ice cream’s totally cool. And then what about supplement options? So we talked about, number one, the enzymes, HCL and digestive support. Number two, you could always add in some activated charcoal.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Activated charcoal. Number three, you could always throw in some probiotics later just to kinda help soothe and relax the tummy. Number four, well how about the approach like when do we eat the meals? So, number one, I recommend intermittent fasting and adding in some exercise in the morning. Even if it’s just a quick Tabata, or just a quick little weightlifting circuit where you kinda do upper-lower, upper-lower and just kind of a simple circuit for 15-20 minutes. Just something in the morning to really get the metabolism revved up. You may fast a little bit more. You may hold that fast a little bit longer than normal because you know that your gonna feast at the end of the day and all those calories will be coming in there to make up for that deficiency. Most aren’t gonna be working out on Thanksgiving. They’re gonna be relaxing and so it’s not as big of a deal.

Evan Brand: How about alcohol? You mentioned that off-air. You said we need to make sure we talk about that. So you’re recommending after meals instead of before meals saving?

Dr. Justin Marchegiani: Well, yeah, I recommend just have a little bit. Well, number one, there’s a couple of strategy. So I may do one glass just to kinda get that buzz in my system fast. It’s like, “Ooh, I could feel it.”  And then I’ll throw maybe a couple of things, a charcoal in, and then maybe there will be like a shrimp cocktail out and have a couple of little shrimps just to kinda get the protein, fat in there which kinda stabilizes my blood sugar level a little bit more so I’m not gonna go wonky. And then I typically just go with like a dry champagne or a dry Prosseco. So it’s very dry kind of a demi-sack, not a lot of sugar white and I like the sparkling. The sparkling has been shown to increase alcohol absorption. There was a—one study out of a bunch of college students. Can you imagine that? I would love to have been in the study in college where they gave them shots of vodka and then the other group got shots of vodka with carbonated water or like soda water. And they measured their blood-alcohol content and they found that the group that had the bubbles with their vodka had a much higher blood alcohol content for the same amount of alcohol. So, go figure. So what’s the moral of the story? You get— your alcohol goes for little bit longer of array when there’s little bit of carbonation or, bubbles in there. And James is saying, “What about Cheetos?” Yeah. So I would do Cheetos with my ginger Kombucha and a little bit of lime. The lime provides extra vitamin C, which is great for glutathione. The Kombucha has extra B vitamins and antioxidants and EGCG in there and uhm—probiotics. So it actually helps detoxify and help your gut microbes while you get a little tipsy.

Evan Brand: See that almost makes me wanna drink alcohol but every time I drink alcohol, I feel like I can’t comprehend simple things, like I like to I like to always have my brain going going going.

Dr. Justin Marchegiani: Totally.

Evan Brand:  And for me to shut off with the alcohol, it’s almost stressful. It’s almost like, “Nope, my brain is slowing down.” I don’t like this.

Dr. Justin Marchegiani: Well, we should make sure the demand on our brain is less.

Evan Brand: Right.

Dr. Justin Marchegiani: When the time—we’re not gonna be like opening up the champagne bottles when we’re seeing patients, right?

Evan Brand: Right.

Dr. Justin Marchegiani: We wanna make sure our patients get a 100% of our brain capacity. But when it’s the holidays and we’re just watching some football, and our brain is like 80% off, maybe it’s not that big of a deal.

Evan Brand: <laughs> For sure.

Dr. Justin Marchegiani: Yeah. But, yeah, we have the activated charcoal. We just have really good quality alcohol. Uhm— again, why does it matter? Coz I don’t want a headache. I don’t wanna feel crappy. I don’t want a ton of breakouts the next day. So we’ll choose uh—and typically, I’ll just get $15 bottle of really good dry Prosseco from Whole Foods. And I try to, you know, if I can go organic or you know, typically, the dryer ones are not gonna have as much sugar. It’s the sugar that’s gonna really throw you off. Uhm—you can also do the dry Creek wines. They have some decent stuff. Again, they don’t have a lot of bubbles like a lot of spike, Prosecco, I do that because number one, it helps with alcohol absorption. Number two, I just like the bubbles.  They don’t have a lot of options with that. So I will check out some of the whole foods or local stores, they have a very low sugar like as for a brewed or a Demi-Sec uhm—Prosecco option.

Evan Brand: The holidays are fun.

Dr. Justin Marchegiani: They are. Absolutely!

Evan Brand: I think our next month of episodes is probably be silly. It’s coz that’s the that the holiday vibe. It’s relaxing. It’s like, you know what, the summer time things have cooled off. It’s time to relax, time to rekindle, time to cuddle up, snuggle under your wool blanket next to a fireplace. This is a good time of the year.

Dr. Justin Marchegiani: I got a fireplace in my office so it’s actually nice coz I actually get to use it this time  of the year, so—

Evan Brand: That’s awesome.

Dr. Justin Marchegiani: So my dog just like—it’s basically a magnet for my dog. She just kinda—next to it all day. But, yeah, totally. And then uhm—you mentioned a couple things there. We talked about the alco—so yeah, really getting the exercise component going. Coz that really is gonna wring out a lot of the glycogen in your muscles. So think of glycogen as stored carbohydrate in your muscles and imagine you wringing that muscle out. You’re wringing that sponge out so all of that water in the sponge, all that glucose stored in the muscle now gets used up doing the exercise. Now what does that do? It’s like, well, it’s the equivalent of going and having a nice dry sponge to sop up a whole bunch of liquid drink that your kid knocked over, right? So you can just— that sponge is gonna work a lot better and be more absorbent. Think of your muscles as being more absorbent. So when you get extra carbohydrates into your uhm— body from your meal in your celebration that you’ll have a bigger sponge to soak it up.

Evan Brand: That’s a good idea. I don’t know if many people act on it but if they do, they’re gonna see a really good result. Here’s a question for Mike. He says, “It’s crazy. My Oura ring consistently shows my sleeping heart rate 5 to 15 bpm higher even after having just two drinks like red wine. I feel it the next morning. Any suggestions?” Justin, I know what you’re gonna say. Go ahead.

Dr. Justin Marchegiani: Well, alcohol can drop blood pressure. So it could be your blood pressure is lower than your heart has to be a little bit faster the compensate for that drop in blood pressure. That’s probably what it is.

Evan Brand: So you’re thinking maybe you don’t need suggestions. So I thought you might say, “Oh, just are you doing charcoal? Make sure you do charcoal.”

Dr. Justin Marchegiani: Of course, right? Like of course, extra charcoal. We can always throw some vitamin C in there, add in L cysteine. And we could even throw in, yeah like in our lines, we can throw in some detox aminos which is kind like your sulfur base, kinda NAC with a whole bunch of other sulfur amino acid in there. That— that’d be fine. I mean, I would do that. You can also throw a little bit of magnesium in there to uhm— to help with the with that component. But uhm—yeah, I would just look at potentially that just being the alcohol and just do all the things that help detoxify.

Evan Brand: Okay. Cool. Awesome. I think that’s everything we’ve hit. I don’t know if there’s any other piece to the holidays you wanted to go over.

Dr. Justin Marchegiani:  Yeah. I would try to time off like for me, I notice if I have felt any alcohol in my system when I go to sleep, I do not sleep nearly as good so I tried to give myself like a good three-hour washout period before bed. So I don’t have you know a lot of alcohol in my system. I just don’t sleep as good. I literally have more nightmares, I’m more active, I move around the bed a lot more. I had a glass of champagne before bed like a week or two ago and I like literally woke up at a right angle. So I was like laying across the whole head. I’m just way more active. Normally, I don’t move much at all. So again, if I I had that like at seven and I went to bed at like 10, it wouldn’t be a problem. But if I’m having it right up against bedtime, sometimes it could be the__ plus you know, I’m— I don’t know what the alcohol is when I go out if I order it. I try to order, you know, a nice low sugar kind but you have the bottle in front you look at it, so you just try to go off the waiter’s suggestions.

Evan Brand: Exactly. Yeah. I think it’s all good advice the liver-gallbladder support. I mean, that’s always helpful, too. So if it’s milk thistle or if it’s your Cordyceps mushroom. I mean there’s a lot of different products we use for for liver gallbladder support. One of the thing I was gonna mention, too, make sure that you check in with your practitioner if it’s Justin or myself. If you’re taking anti-parasitic herbs, some of these herbs can get intensified with alcohol. So one glass of wine may feel like four. You may not be able to make it home. See—take a  look and see what you’re actually using. I know some of these can create that sensitivity up.

Dr. Justin Marchegiani: Totally. Any other suggestions just like meal wise or anything that you guys are doing with your family for the holidays?

Evan Brand: I’m gonna bring some snacks just in case. I mean we don’t know the full spread coz we’re gonna go to like three or four different events.

Dr. Justin Marchegiani: That’s tough.

Evan Brand: ..this week and we don’t know exactly what people are cooking, what people are bringing. So just in case, I’m just gonna go ahead and bring uh—I’ve got a couple of some jerky like some jerky strips like some grass-fed steak strips that I’ve got and then I’ve also got a handful of macadamia’s of customer cons would also have coconut chips so I’m just gonna bring some snacks just have that in my wife’s purse just in case just in case we get somewhere and it’s just— I have been to a couple events where it was literally like a casserole, it was covered in cheese and that was the only—that was like the main entrée. There’s no way I could do this.

Dr. Justin Marchegiani: Totally.

Evan Brand:  Like you know, with enzymes, I’d be destroyed so uh—that’s— that’s about it. Just be prepared boy scout. Act like I was going to place that had no food.

Dr. Justin Marchegiani: Exactly. And again, there are some people out there where they may be really happy with her health right now. They’re just like, “Hey, this is a once a year thing and I’m just gonna cheat and really enjoy it. And that’s fine, too. But you know, still you can utilize some of the supplements and strategies we recommended so you at least doesn’t hit you as hard. And if you want to wreck if you want to apply some of the substitutes that Evan and I apply, and I’ve done it for years that in my opinion allow me to continue to feel good. I just— for me, it’s not just feeling good that day. I got four days off  work. I don’t take a lot of time off. I wanna feel good for those four days and I also don’t want to get sick either.

Evan Brand: Yup. Exactly.

Dr. Justin Marchegiani: Well, any other thoughts, Evan?

Evan Brand: I think that’s it.

Dr. Justin Marchegiani: So any other plans for you this week? Are you taking some time off from patients or—?

Evan Brand: Yeah. So Thursday, Thursday- Friday I’ll be taking some time off. My wife she’s can go out and participate in the consumer holiday on Friday. And I think that’s about it. I’m gonna try to spend some time out in the woods. I may— I may go out and and go for a deer hunt again. I want to get my own dear this year. 99% of it is just sitting out in nature listening to the birds but may be .01% of the time an animal walks by.

Dr. Justin Marchegiani: Totally.

Evan Brand: Really, it’s just my excuse to go do some forest bathing. I may try to do that.

Dr. Justin Marchegiani: What’s the Japanese term for that?

Evan Brand: Shinrin Yoku.

Dr. Justin Marchegiani: Shinrin Yoku. I love that, man. That is crazy. Cool. And we also add another herb to our parasite killing line, too. The mimosa Pudica. So I know will be adding that to our stores in the next week or two. It’s one of those things that we are kind of experimenting with. We’re helping to kill bugs and some of the wormies. So it’s something out there that if your patient and you want to inquire about that, we can chat about that very soon.

Evan Brand: Yeah. Stay tuned. I’ve gotten many, many pictures in my inbox of worms that people are pooping out from using this Mimosa Pudica. I was just a guest on the parasite summit, which is how I learned about this formula. And tons of people are taking it now and everybody’s saying, “Oh my God! My stool test showed up negative but I took this stuff anyway. And here’s what I pooped out. Surprise!” And it’s pretty nasty stuff. So Justin and I are talking off like, “Are you going to try some of the stuff?”  I’m guessing we’re gonna have to because we’ve been guinea pigs for everything else. So, who knows if we’ve got some hidden—

Dr. Justin Marchegiani: Absolutely. Well, what a great call today here, Evan. Happy holidays and Happy Thanksgiving for you and your family. And we’ll talk next week.

Evan Brand: Take care.

Dr. Justin Marchegiani: You, too.

Evan Brand: Likewise. Bye.



Justin Health Paleo Apple Crisp




Analyzing Your Blood Test Part 2 – Comprehensive Metabolic Profile – Live Podcast #151

Dr. Justin Marchegiani and Evan Brand dive into the topic of blood test analysis—specifically the Complete Metabolic Profile (CMP). Learn about the different markers that they look into like the glucose, calcium, BUN, creatinine, Alanine Aminotransferase (ALT), Aspartame Aminotransferase (AST), potassium and sodium. Know about the different symptoms and health conditions associated with the different blood markers.

Gain some valuable information about functional ranges in blood work and understand how it can provide more information regarding health issues and nutritional deficiencies compared to the general reference range. And lastly, discover some healthy recommendations to address nutritional deficiencies.

In this episode, we cover:Analyzing blood cell

2:56   Glucose Marker

6:10   Calcium Marker

8:20   Protein Marker

10:30   BUN:Creatinine

14:12   Liver Markers






Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani.  I’m with Evan. We’re live on Facebook and YouTube. We’re ready for an awesome podcast. My baby’s doing one week exactly from now we’re really, really stoked. Uh—maybe do a live podcast uh— from the operating room, probably not but maybe something that week, give people some live updates. Evan, how we doin’, brother?

Evan Brand: Life is good. It’s back to school season, so all the school buses are around the city and when people go back to school all of our female clients especially the teachers they start having flare ups of their symptoms. So we got to keep you under control ladies and teachers and men teachers as well. Make sure you’re taking your adaptogens, if you’re going back to school and you’re starting up your teaching again. This is a good time to whip out your—your adaptogen formulas and double the dose of those.

Dr. Justin Marchegiani: Love it. Totally makes sense. Also, congratulations on the new car. You got a great deal on a— on a pre-owned Tesla which is really exciting.

Evan Brand: Yeah. It’s like dropping a spaceship. I’m gonna be putting up a YouTube video. Jack Cruise, who is a mutual friend of ours, he said, “Oh my God Teslas are the worst cars for EMF but that’s actually not true. I’ve actually measured using several devices the EMF from a Tesla. It’s actually not bad. It’s actually less, believe it or not, than Honda Accord that I was driving beforehand. I didn’t take a video so people just have to take my word for it, but the Honda Accord in the backseat where the baby was, I was actually measuring 4 mill gauss, which is a pretty high magnetic field. The Tesla’s actually less than that. So videos and content to come.

Dr. Justin Marchegiani: Unreal. Very cool, man. Well, everything is going here in this front. I’m excited chat with you about today’s topic. Uh—let’s dive in. So, we talked about blood tests in the past.

Evan Brand: Yeah.

Dr. Justin Marchegiani: We talked about the comprehensive—I’m sorry, the uh— complete blood count, the CBC, alright, which is some really cool marker. We chatted about some of the anemia and the B vitamin markers and such. Really cool stuff. Today we want to chat about the comprehensive metabolic profile, the CMP, for short. So really excited to chat about that. Now, let’s go over what the CMP is. So, off the bat, I’ll just kinda give you the list here and we’ll hit the most important ones. Number one: glucose, calcium, we have protein markers, albumin, and total protein. We have electrolytes, including sodium, potassium CO2, and chloride. We have some kidney markers/protein markers including BUN and creatinine. And we have some liver markers including a ALP or alkaline phosphatase, ALT which is alanine aminotransferase or SG PTZ 01. And we have AST or aspartame aminotransferase AST or SGOT, for short. We have bilirubin as well. So let’s start off first with some of the simple ones. So, we have glucose. That’s a really good set kinda general marker. That marker’s gonna be used to look at diabetes, right? 126 or higher is gonna be your diabetes marker. And again, 110 or higher for pre-diabetes and typically, our functional range is gonna be greater than the hundred in the morning is gonna be uh— good a general indicator. Again, glucose fasting is kind of a late stage indicator. It’s not something we want to use as our way to pick up blood sugar abnormalities, in general. I like looking at a functional glucose tolerance. Kind of you can look at fasting in the morning sometimes that can be higher from a cortisol or stress response, otherwise known as the Dawn phenomenon or the somogyi effect. Typically, I like to look at fasting glucose during the day from a functional perspective. So we do a functional glucose tolerance. We tested fasting, let’s say, breakfast, lunch, or dinner and then we look at a 1, 2, 3 hour post meal and just see how that blood sugar is responding. We like below 140 within an hour. Below 120 in two hours and below a hundred in 3. That’s a good general rule of thumb. Ideally, below 120 in one hour and then back around 110 to 100 within two hours and definitely, below 103. That’s—that’s kinda my range. The goal is less blood sugar means less insulin spiking, which is a good thing.

Evan Brand: Yeah, which means less fat storage, too. So when we’re talking about people with uh— a fat loss goal. You’ve gotta have relatively low insulin to be able to do that. If you’ve got high insulin all the time coz you’re eating refined carbs and sugars, blood sugar goes up, insulin goes up, you can’t burn fat. So that’s a really good foundational mark to hit on.

Dr. Justin Marchegiani: Absolutely. I think we need to get a Topo Chico as a—as a sponsor for the show. I love the Topo Chico. It’s like uh—kinda like the sparkling Pellegrino we use here in Texas kinda like a Mexican sparkling water. Uh— absolutely love it.

Evan Brand: Why don’t you email them?

Dr. Justin Marchegiani:  I will. I’ll email them. I’ll make them our show sponsor. I mean, this stuff is awesome, man. It’s like, you know, I used to be a soda addict when I was younger. And I kinda have those, you know, nostalgic memories of drinking out of the glass coke bottle, so it kinda brings it back here.

Evan Brand: [laughs] We need to email them. Just tell them. I mean it doesn’t hurt to ask. So put that on your to do list for today.

Dr. Justin Marchegiani: We’ll get Lululemon as a show sponsor and then we’ll get Topo Chico as the show sponsor.

Evan Brand: That sounds great.

Dr. Justin Marchegiani: Hey, you know, while you’re at it, we might as well reach out to Elon Musk and see if we can get Tesla on board, man. That’d be nice for some complimentary free cars.

Evan Brand: That would be great. I don’t know if that will happen with the—the demand right now.

Dr. Justin Marchegiani: I know. I don’t think that will happen. We’re not the Joe Rogan podcast yet. Alright, so any comments on the blood sugar piece we just uh— brought up?

Evan Brand: Yeah. The blood sugar—you’re always gonna get that run. So this podcast people may say why are you doing this on blood? Your— you guys focus on functional medicine. Well because a lot of people anybody— anybody down the street, your neighbor, your friend, or family likely has some of the metabolic panel stuff that we’re outlining today, plus the CBC from our other blood test podcast, and so, this is designed where if you don’t have functional labs, how can we help you to identify these basic labs at everyone under the sun has access to, regardless of what country you’re in. So yeah, glucose, I think you—I think you killed it with that one in terms of the range. Let’s move on what—what else is on your plate here?

Dr. Justin Marchegiani: Well, we can chat about calcium, too. So calcium is a pretty good marker just for overall blood calcium. Again, blood calcium has to drop down pretty low for them to be a nutritional deficiency.

Evan Brand: Yeah.

Dr. Justin Marchegiani:  And calcium, one of the things I look at when I see calcium go too low, is potential hypochlohydria. Well number one, are we consuming enough leafy greens, right? That’s gonna be a major source of calcium, uh— salmon with the bones major source of calcium. Of course, some dairy products are gonna be great but it just depends, right? Well just use grass-fed butter and ghee over any of the milk and cheese stuff. And if you’re gonna do milk and cheese, you want to make sure that we can—we’re not reacting to. We’re not autoimmune and we’re also, you know, trying to choose raw, organic sources to prevent hormones, the antibodies and also have the enzymes intact to be able to process it. But when I see calcium go too high or too low, I think, potentially nutrient deficiency is number one, right? Not getting the right foods. And I also think low stomach acid and enzymes, number two. And if see calcium go high, a lot of times calcium can be utilized as an inflammatory mediator. So I also look at inflammatory markers when I see high calcium on a flipside.

Evan Brand: Yup. Interesting. Yes. So uh—hypochlorydia, these are the people been popping tums because they’ve got heartburn but in reality they could have something like H. pylori infection or they’ve been on prescription acid blockers which are very, very, very, very common. So if you’re looking at your calcium even if it’s out, sometimes it may be out of the general reference range, let alone our functional range then that’s an issue. Do you have a functional range for us since a lot of people are in the US we may be able to give the measure of units for calcium. Do you have that in front of you?

Dr. Justin Marchegiani: Typically, the calcium range, if I remember correctly will be in the mid 9’s. I think it’s like low 8’s to upper 10. Low 8, upper 8 to low 10’s. So I like in the mid 9’s, it’s a pretty good place. Typically, in the middle of the range, tend to be okay.

Evan Brand: Okay.

Dr. Justin Marchegiani: Any comments on the calcium component?

Evan Brand: No. I think you’re doing good. I’m just kinda uh—walk your hand through this. What’s— what’s next on our list?

Dr. Justin Marchegiani: Yes. So again, I like kinda the middle of the reference range. But next would be uh—protein markers, alright. So we have a couple of protein markers. We have albumin and total protein. And then we also have bun and creatinine, alright. Those are some pretty good markers that we utilize off the bat when it comes to proteins. So number one, I like creatinine above .79. It’s a pretty good place to go right above .79. So for below .79 or maybe some low-protein. And creatinine is a breakdown product of protein as well, alright. It’s a breakdown product, so above .79 if creatinine’s too high, it could potentially be some inflammation going on. It’s very possible there could be some inflammation happening. Uhm— there could be a high workout happening where you know we had a lot of exercise the day before and then we’re breaking down a lot of amino acids from the muscle, right? That’s one component. And then next is inflammation, too, right? There could be some breakdown from inflammation like your kinda—your body’s more in a catabolic state and you’re breaking down. But it can be a good window into protein levels uh—high or low. And then if we look at total protein, I like in the 7. 7 or above is a pretty good place for pro— total protein. If I see it lower, of course, I’m gonna make sure are we eating enough protein? Are we getting about, you know, half a gram per pound of bodyweight? That’s a pretty good rule of thumb, right? They say that 1.2 g per kilogram, right? What does that mean? People don’t think in kilograms in the US, so, I think about a half a gram of protein per pound of body weight. So if I weigh 200 pounds that’s 100 pounds approaching. If I weigh a 150 pounds,

Evan Brand: 100 pounds [laughs]

Dr. Justin Marchegiani: I’m sorry—If I weigh uh— 200 pounds, that’s a 100 grams of protein. If I weigh a 150 pounds, that’s 75 g of protein. And then a good rule of thumb—

Evan Brand: I like your diet, man. A 100 pounds—

Dr. Justin Marchegiani: Yeah. I know, man. That’s it. Exactly.

Evan Brand: Let’s do the BUN: creatinine ratio. So this is something that we see often where this is off. So optimal range, I’ve got a couple pieces of literature here optimal range of BUN: creatinine ratio is gonna be 10:16. A lot of times, we’ll see this altered, where the BUN: creatinine ratio is high. Whether above 16, a couple notes could be antibiotics, could be dehydration, and then in bad cases, some type of G.I. bleeding. So that’s not good. And then you’ve got low issues, where your BUN: creatinine ratio is below 10. This would be issues like we see pretty often. So this would be liver dysfunction, once again, antibiotics, also a diet that’s low in protein. So a lot of older people, I mean, you and I work with a lot of people above age 50, so 50, 60,70-year-olds, they eat less and less protein. It seems they just forget that it’s important they start eating snack foods or their appetite just goes down because they’ve got low stomach acid so they do start to get a distaste for meat. So you’ve really got to use enzymes and HCl with them, ox bile, get their gallbladder working better because if they don’t have a taste for protein, it’s gonna be tough for us to say, you know, “Hey Jack, Hey Jill, we’ve got to get you to eat more protein.” So if you are having a BUN level that is low, or the BUN: creatinine ratio, the BUN: creatinine ratio is low, you might have just a simple issue like not enough protein in the diet.

Dr. Justin Marchegiani: Oh, exactly. Yup. A hundred percent. Now, we talked about creatinine. Now, I’m just gonna crystallize BUN a little bit more. So we talked about creatinine going high, right? Uhm—the potential dehydration as well, potential kind of catabolic physiology rights. That can be a big one. It could be a lot of uhm— creatine supplementation, right? That can be one aspect of—of going high. I just gotta keep that in mind. And on the lower side, of course, will be the protein, right? The low-protein not getting enough of that in there, is really, really important. And then on the BUN side. BUN’s a Blood Urea Nitrogen. That’s another breakdown product. On the high side, we look at hypochlorydia, we can also look at adrenal and dysbiosis, right? And then on the low side, it can be malabsorption, low-protein and low enzymes and liver issues. So there’s a handful of different things that can be implicated either way. I love those as a good rule of thumb of what’s happening. And then we could also look at albumin and globulin. And if we see imbalances in the albumin and globulin, that can also mean issues with protein as well. So if we see like albumin to globulin, I think is on the higher side for globulin and the lower side for albumin, we’re also gonna think of potentially more protein issues.

Evan Brand: Yes. So let’s talk about the biomarkers here. You know, Justin and I are talking about functional ranges. You can make it your blood work if you have it in front of you. You may look at that. It may look okay and actually be in range. According to all the sick people that have been in that clinic. So we’re trying functional ranges. So even if something’s not flagged low or high, or using specific markers, Justin and I have taken some extra training in terms of functional blood chemistry analysis. So we’ve got a tighter reference range. So if you don’t see anything out of range on your paper, it might not be, but the functional range is much, much, much tighter and that’s where we find the issues.

Dr. Justin Marchegiani: Exactly. Typically, it’s gonna be the bottom fifth or the bottom and top 15 to 20% we look at more frequently, like with some of the protein things, some of the albumin high or low. If it’s on the high side, we may think dehydration; if it’s on the low side, we may think low stomach acid or enzymes. And some of these markers kinda contradict themselves, so you wanna kinda look at the complete picture so you can get a window of what’s happening. So I mentioned some of the albumin uhm—there. If you wanna comment on that at all, Evan?

Evan Brand: I was gonna move onto the AST. I had AST notes in front of me. Did you want to hit ALT and AST, the liver markers?

Dr. Justin Marchegiani: Uhm—yeah. Let’s hit that next. It’s one of the common— one more thing on the globulin—So globulin is also one of those things for oxidative stress. So we see globulin go on the high side, that can also mean oxidative stress. Oxidative stress are like, you know, free radical things, right? Oxidation is a loss of electrons. The more you’re losing electrons, the more you want extra antioxidants to help support you out, whether it’s antioxidant, herbs like curcumin, or resveratrol, or green tea, or things like vitamin C, vitamin A, vitamin E. Those kind of things are really helpful. So we have albumin and globulin; We have creatinine; We have total protein; We have uh—those are big protein markers there.

Evan Brand: Good.

Dr. Justin Marchegiani: Next, let’s hit the liver enzymes.

Evan Brand: Yeah. The AST to ALT. I wanted to hit on these because, you know, for my— whether it’s my grandparents, or some of the in-laws, always see markers off with AST and ALT even outside of the conventional range these are some of the markers and I’m gonna see off. So let me give people a bit of background on the— what they call the SGOT, also known as the AST. So this is an enzyme that’s very, very, very prevalent in skeletal muscle, liver, heart, kidneys and lungs. The enzyme can be liberated into the bloodstream following cell damage or destruction. So optimal range here is gonna be 10 to 30 units of A— of AST. If you’re out of the rain, so if you’re too high, this could just be liver dysfunction. So some of the reasons Justin and I may look at your AST and its high, it could be anything that’s affecting the liver. So this could be parasites, this could be bacterial overgrowth, this could be yeast, this could be chemical toxins, like glyphosate. If your diet is not very rich in organic foods, this could be gasoline additives, which is why I got rid of a gas-powered car because my gasoline additives were off the charts on my GPL toxic chemical profile test. Uhm— you’ve got a potential for developing congestive heart failure. So if AST is above 30, so AST—if it’s above 30, and then you’ve got these other symptoms like you have a hunger, your yawning frequently, you’ve got some edema, some of that swelling in the ankles at the end of the day, you’ve got a little bit of shortness of breath with moderate exertion, that may point a picture to some congestive heart failure. That’s possible. Now, the good thing is a lot of that stuff is reversible, but these are just signs that things could go bad. Uhm—and then on AST, you’ve got liver cell damage. That’s possible. So alcohol, that’s huge. We see that a lot with previous alcoholics. People who are trying to get off alcoholics. If it’s tied into the liver, you’re thinking, “If my AST’s high, what’s going on with my— with my liver? Is that the problem?” It could be. Symptoms would be pain between shoulder blades, you’ve got a headache sometimes over the eye, you’ve got those phase 2 liver detox problems, like you’re sensitive to perfumes, or you’re sensitive to fragrances, or you’re sensitive to car exhaust fumes, that’s a big one. Hemorrhoids, varicose veins—that’s also tied into the liver, and excessive muscle breakdown. So if you’re doing a bunch of CrossFit exercise and then you got your bloodwork done, it’s possible the AST could show up high there and that’s not a bad thing. Uhm—

Dr. Justin Marchegiani: Absolutely.

Evan Brand: We got the low side of AST which I won’t take too long to go over but B6 deficiencies, alcoholism. So B6 as we know, Justin and I have talked about it a million times, alcohol burns through some of your vitamin and mineral reserves, so B6 is one of them. And then once again, protein deficiency or malabsorption. So AST, either way, if it’s high or low, your out of that 10 to 30 functional range, we can find a lot of good information out about you.

Dr. Justin Marchegiani:  Absolutely. So let’s go see what once—what we have reviewed so far. so we hit the uhm—the liver enzymes. And again, liver ALT, the alanine, the “L”part, that tends to be more liver, where the AS can be—tend to be more in the heart side, tend to be more on the heart and the skeletal muscle side. So kinda keep that in the back of your head there. We’re looking at these things. So a heart attack, we may see more of the AST elevated and uhm— liver stress more of the uh—  more the AST for the heart and skeletal muscle, more liver for the ALT. But again, things like gluten can easily raise ALT. I’ve seen that. Also, just excessive exercise before, within 48 hours of the blood test could easily raise them of some of those enzymes as well. So kinda keep that in the back your mind.

Evan Brand: Okay. Yeah. I mean, same thing, I want—it sounds like I’d be repeating myself before going over ALT, but functional range for ALT, 10 to 30.

Dr. Justin Marchegiani: Yup.

Evan Brand: Once again is the units. And if people had been doing a lot of uhm— aspirin that could also cause the ALT to go up. So if you’re just somebody who popped—uh chronically pops aspirin, your ALT may go up there. Once again,

alcohols gonna throw off your— your ALT. So pretty common sense really.

Dr. Justin Marchegiani: Yeah. Exactly. And we may also see—if we look at bilirubin, which is a breakdown of a lot of the red blood cells, and if we have excessive breakdown, we may look at potential gallbladder issues or liver, gallbladder stuff going on. So we like, you know, typically, you know, below 1.2 or so, is pretty good for the bilirubin in the gallbladder. If not, we may think there’s some kind of gallbladder issue. We may look at food allergen. We mat really up the bile salts and HCl’s and and lipolitic enzymes— enzymes that really help the fat digestion.

Evan Brand: Yep. Yep. We’ve got— we’ve got a little bit of time left. Should we answer some of these questions here?

Dr. Justin Marchegiani: Yeah. I think so. And the only thing would say is uhm—some of the sodium and potassium and chloride, if we see some of the sodium low, we may think adrenal dysfunctions. If we see some of the potassium excessively high, right, we might think that’s an adrenal pattern of low sodium, high potassium. If we see lower potassium in general, we may think you’re not getting enough potassium, right? We need 4700 mg of potassium a day, so we have to make sure that is kinda dialed in. Same thing with the chloride, I mean, the real easy thing is with the minerals, is number one, we’re getting sea salt in our water, right? High-quality sea salt in our water, half a teaspoon twice a day, we’re eating lots of green vegetables, either cooked, or juiced, or made in away so you can process and digest it down. And then fix the adrenals. These are all things that are gonna commonly be thrown off by adrenal and mineral imbalances. And sugar and insulin can also throw that off, too. Well, adrenal dysfunction.

Evan Brand: Well said. Uh—we got question from—I believe it’s Nalema. Do you have to worry about potassium intake if your bloodwork does not show a deficiency? If you’re eating a pretty good paleo template, I mean, for example you and I have chatted about our love for avocados, you’re gonna get much more potassium in avocados and bananas. So I think if you’re eating an avocado a day or every couple of days, potassium is probably not an issue. What’s your take?

Dr. Justin Marchegiani: Yeah. We’re gonna get one avocado, you get about 1 g a day. You need 4700 mg or 4.7 g. So I would say, if you’re doing six servings of green vegetables a day and you’re doing one avocado, you’re probably  gonna be okay. But I will just throw it into chronometer. Put your height and weight and just ensure that you are getting that 4700 mg, which again is really easy to not get. I think that’s the DRI. That’s the Daily Recommended Intake, not the RDA which is the Recommended Daily Allowance. So 4700 mg, probably good with two servings, probably six servings of veggies and an avocado a day, you’ll probably be okay, but just run it through chronometer to double check.

Evan Brand: Okay. Cool Samuel—uhm a bit off topic. We’ll do a whole show on this. “How do you feel about making your home a smart home?” “Does it create negative effects from EMF like adding nest products and Phillips hue lights?” Not a fan of uh— LED lighting. I’ve chatted with Mercola about that on my podcast and yes, the nest and all the wireless technology, I do avoid that. I’m hardwired everything. No Wi-Fi, hardwired Ethernet. And uh—funny enough I’d been wanting to turn off the breaker to our bedroom so we could sleep better. And all the sudden the power to the bedroom has been off, but all the breakers look fine. So I don’t know if someone from the universe magically cut off the power to our bedroom, but even though the breakers look normal, there is no power in the bedroom and I’ve been surprisingly sleeping way deeper. Uhm— but we could do a whole show on that, but ideally you stay away from the wireless stuff or you just turn down the intensity of your— your products if you can.

Dr. Justin Marchegiani:  Yeah. I’m on the opposite side of that. You have the nest. I do have the nest. I do love it. I think it’s absolutely awesome. Uhm— and again, for me, I have my Wi-Fi on a wireless timer so once 11-11:30 hits, all my Wi-Fi goes off for the night. And that includes nest and everything. So I set it up so during those hours of sleeping, they are not on, number one. And number two, I have— I used a very, very high-end EMF meter and I’ve tested the nest and such and really, the EMF comes out in those first 10 feet or so, away from it.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So I’ve been across the room or sitting in my couch and I aim it at that or it get caught and it’s few—and it take—you got to be pretty close to get that EMF out.

Evan Brand: Yeah.

Dr. Justin Marchegiani: You really do.

Evan Brand: Yeah. Distance. I think your distance should probably much safer. I started doing the Wi-Fi on a timer, then I thought, “What the hell, if I’m sleeping better without it, what am I sacrificing during the day being at home with it. So that’s why I’ve just went hardwired. Maybe I’ll go back, but for now, I’m hardwired and I feel pretty good.

Dr. Justin Marchegiani:  Yeah. I mean—its just, like for me, like I’m at the airport, I’m coming in and it’s like my house is like a hundred degrees. I’m like, “Oh, let’s get it cool, or like, you know, we go away and if like uhm—we’re out of the house, right? It’ll take the temperature up a little bit.

Evan Brand: Right.

Dr. Justin Marchegiani:  You save a little bit of money on—on that side of the fence. So there’s pros and cons. I think uhm—if you can like—I’m hardwired right now. But I think if you can put your thing on a Christmas tree timer at night, I think you really, you know, you can at least have it off when you’re sleeping, which I think is really important. I also sleep on a ground and I have EMF blockers in my room as well.

Evan Brand: Yep. For sure. Let’s keep going. Uh—let’s see what else we’ve got here.“What are some blood test markers for thyroid issues?” I believe we did a whole podcast on this.

Dr. Justin Marchegiani:  Yeah. I would see the whole podcast on that. TSH, T4, T3. Real quick, TSH, you know, below 2.5; 1’s ideal; T4 free: 1 to 1.5; T4 total: 6 to 10; T3 total: 100 to like 150-160. Again, go see the podcast on that. We’ve riffed on it for over an hour at a time, so check that out.

Evan Brand: Yeah. Another question is “Redmond’s real salt worth it if you’re having pink Himalayan salt?” I think so. I switch out. I have a lot of salt Celtic sea salt, I’ve got all sorts of different types and flavors and sources. I think they’re all helpful and they’re not gonna hurt you. It’s in that category of my help— not hurt you.

Dr. Justin Marchegiani: Yeah. And I think, Redmond’s in my opinion just taste better. It dissolves really well in the water. So you throw it in there, dissolves really nice. I mean I’ve used Himalayan and Celtic— doesn’t quite dissolve as good. Maybe there’s a more, uhm—you know, a version that’s ground-up better so it absorb as more soluble in water. But I like the Redmond’s. I love the taste. Love it.

Evan Brand: Yeah. It does taste good.

Dr. Justin Marchegiani: Yeah. It’s very good. And it’s lower in —

Evan Brand:—We do the same. Turn off the Wi-Fi after 10 so that’s cool like I said, I used to, but then I’m like, “Yeah, I’m gonna just get rid of Wi Fi completely especially after I was in a Dr. Klinghardt talk about “How you can detox heavy metals if you’re exposed to Wi-Fi” which is pretty interesting on his latest talk. I was like, “Whoa! That’s pretty nuts, so—“

Dr. Justin Marchegiani:  Yeah. I mean, I think what happens is you get some people who are the exception to the rule.

Evan Brand: Yeah.

Dr. Justin Marchegiani:  Regarding their high level of sensitivity and then you get a lot of practitioners that had had success with that one person.

Evan Brand: Right.

Dr. Justin Marchegiani:  And they they start— this is the rule for everyone. I think that’s really excessive, but if you are chronically ill, should you try it? Heck, yeah. You should try it.

Evan Brand: Yeah.

Dr. Justin Marchegiani:  But it may not be the end-all or be-all. I mean, I love the convenience of having Wi-Fi. I don’t know this as much, Evan, but I do know that, you know, I’m sleeping at night. Maybe I’ll get into a little bit deeper REM sleep. So I’m not using it at night. I get no benefit by keeping it on at night. So why not just turn it off, right?

Evan Brand: Right. For sure. Uh—we got a question from Vevec. He said uh—“How to differentiate between type I and type II diabetes? Any diagnostic test?”

Dr. Justin Marchegiani:  Yeah. I mean, type I is gonna be an autoimmune condition. So what’s gonna happen is uhm—typically it’s gonna happen in the first 12 to 13 years of life. That’s when it mostly happens for kiddos. And their reality tend to be behind it, but one of the big things that you’re gonna see, is you’re gonna see just blood sugar just going up super, super high, right? The reason why it’s going up super, super high is because the insulin isn’t there by the beta cell so it cant’ let the—the sugar get into the cell. So you see blood sugar come up super, super high. These people tend not to be big and be more small. You know, more uh—I should say smaller because they don’t have the insulin bringing the sugar into their cell to get the fat up.

Evan Brand: Yup.

Dr. Justin Marchegiani: But you can also run what’s called the C-peptide test, which will look at the uhm— the beta cell function of the pancreas. And if you see C-peptide on the lower side, uhm— then you’ll know. And you can also run uhm—type I diabetes. I think the beta cell antibodies. You can run to also confirm that too, or pancreatic isolate cell antibodies to confirm that. So there are different things you can do to assess. But you’re gonna know because you just— you’re getting emaciated uhm—and your blood sugar’s off the charts high, for sure.

Evan Brand: Yup. Uh—last question we can take care. Shayna, “What is over a 115 vitamin D level? I mean I don’t take a vitamin D supplement.” First, we gotta make sure that’s actually the vitamin D not the 1,25. That’s a kidney marker but the 25OHhydroxy vitamin D marker. You gotta make sure it’s that one. If it’s that one and you don’t supplement, I’m not too sure. I’ll see if I can find something. Justin, what’s your take?

Dr. Justin Marchegiani:  Yes. Same thing. I would just—I would look at what your—what the marker is. And then number two, maybe you’re getting out in the sun a lot or maybe your—one of your supplement has some vitamin D in there, you’re not aware of it coz that’s pretty high to get to naturally. So  maybe you’re sunbathing a lot, maybe that’s totally natural. I would just double check that and make sure that’s the case. But double check if it’s 25 versus the 125. That’s the big thing I’d say.

Evan Brand: Yeah. I mean my wife’s prenatal, for example, there’s a lot of vitamin D in there. Those other formulas that we’ve taken that have vitamin D, so you could really add up to six or eight or 10,000 IU pretty pretty quick. So, yeah, I second that. Look at your protocol. Make sure there’s nothing in there.

Dr. Justin Marchegiani:  Absolutely. Let me just knock up just one more question here. So regarding alkaline phosphatase—Yeah, less than 50 is low zinc. Again alkaline phosphatase is an enzyme that correlates with zinc. So it’s— it’s a metalloenzyme so when the enzyme’s lower, we tend to have lower zinc. You can also test it Zinc Tally test get some zinc—I think it’s zinc chloride or zinc sulfate.

Evan Brand: Yup.

Dr. Justin Marchegiani: It’s the liquid zinc. And then basically the better it tastes, the cleaner and the more like water it tastes, the less you need it. I’m sorry—the more you need it—the more you need it. The more metallically it tastes, and you know, the more metal it tastes, the less you need it. So that’s a good kinda rule over time to kinda look at. And then A1C—again is a marker for blood sugar. If A1Cis really low, right? We want to look at other markers to correlate anemia. So if we see MCV, MCH, MCHC on the higher side, that could be in some kind of B vitamin anemia or if we see RBC hematocrit hemoglobin below, that could be another indicator for an anemia.

Evan Brand: Oh, we got one more question and then we’ll have to wrap it up. It just gets addicting answering questions.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Abner—he has buddies telling him it’s ideal to spike insulin before weight training. Is there any benefits to it? I mean, I’ve always thought the exact opposite that you want to have a little bit of a spike after—

Dr. Justin Marchegiani: Post work out training.

Evan Brand: –weight training.

Dr. Justin Marchegiani:  Post work out. The reason why is people are incredibly anabolic. Most people that have high levels of insulin, it’s anabolic in the terms of uh—generating fat cells, right? Coz anabolic means to grow in fat cells. But if you can use insulin post work out, you can basically have the key to drive protein into the cell. You’re also driving which is gonna help with, you know, protein synthesis, ideally building more muscle. It’s gonna help spike mTOR and then you’re also gonna have effects of driving sugar into the muscle, which it’s just wrung out all that glycogen during the workout. So you’re repleting the glycogen which will have some anabolic effects and it will uhm—it will help lower cortisol, too. It will drive down some of the cortisol because the cortisol has made all the blood sugar so it’s gonna pull all that sugar from the cortisol into the muscle so it can be used to help generate hypertrophy.

Evan Brand: Yup. I just did a little bit of research on vitamin D. If it’s super high, it could be a buildup of calcium in the blood. So other symptoms that could go along with this could be poor appetite, nausea, vomiting, weakness, frequent urination, kidney problem. So maybe look at your other markers on your blood test. See if you got anything off with your calcium, you got anything off with some of the kidney markers and then if you’ve got those other symptoms— frequent urination, things like that, definitely take a look.

Dr. Justin Marchegiani:  Yeah. It’s almost always from a supplement so just stop—stop taking the supplement if __ vitamin your body will eventually clear it out in a few days to a few weeks.

Evan Brand: Yup. It should be pretty quick. Well, cool. Any last things you wanted to say before we wrap it up. I think we did a great job on this one.

Dr. Justin Marchegiani: Yeah. This is probably my first—my last podcast uh— without a kiddo. So I’ll be officially a dad uh— next time that we are on the air. So pretty excited about that.

Evan Brand: Me too. I’m pumped for you.

Dr. Justin Marchegiani: Can you give me like one fatherly tip or advice here before we go.

Evan Brand: My fatherly advice is just you—you take it day by day and when something happens where you could see yourself stressing out, just remember you have the ability to control how you respond to something. So I like— when the baby is super fussy, and you’re trying to figure out is he tired, is he uh— hungry what is it? I just like take an extra second it’s like, “Okay, let’s run through the day. Okay, the last feeding was this. Okay, maybe it’s too warm in here. Maybe a little too cold.” Before I let my sympathetic nervous system kick in to overdrive, I try to walk through the situation step-by-step and then, “okay” and then that way, I don’t make myself sick by the extra stress.

Dr. Justin Marchegiani:  Right. So instead of getting mad at the situation, you kinda like take a step back like kinda problem solve or think what could be the issue before you have an emotional response.

Evan Brand: Exactly, dude. Try—try to not have the emotional response.

Dr. Justin Marchegiani:  Right. Try to be more—more logical than emotional about it.

Evan Brand: Which can be hard when you’re tired, and your sleep is interrupted and stuff like that, but you just get better and better every day at it.

Dr. Justin Marchegiani:  Appreciate it, man. Excellent.

Evan Brand: Yup.

Dr. Justin Marchegiani: Hey, today was a great chat. Let’s do more, probably in the next two weeks here, but maybe I’ll jump on here while my little paternity leave here for the week.

Evan Brand: No rush, man. You deserve it. You earned it. Take that paternity leave. Will be here waiting for you when you get back and uh—if people want to schedule, in the meantime with Justin, may be a little bit till he gets back. Til his back in the trench but uh—justinhealth.com He will be ready and willing and for me, evanbrand.com you can schedule with either of us. In the meantime, make sure you subscribe if you’re watching on YouTube and we’ll chat with you again soon.

Dr. Justin Marchegiani: It will be a lot of sleep in down time so maybe I can sink one up in there, so we can have a chat in between.

Evan Brand: Sounds good.

Dr. Justin Marchegiani:  Alright, Evan. Great chat. You have a great day.

Evan Brand: Take care.

Dr. Justin Marchegiani:  Take care. Bye.




Redmond Real Salt


Topo Chico




Analyzing Your Blood Test – CBC Blood Test Evaluation – Podcast #142

Complete Blood Count (CBC) Markers

Dr. Justin Marchegiani and Evan Brand talk about blood testing. Listen to them as they discuss about the assessment of significant imbalances in B vitamins or Iron in one’s blood. Know the importance of Vitamin B12 to having healthy red blood cells and determine why it is needed by people on a plant-based diet.

Learn about the tests and white blood cell markers which are significant in determining infections. Discover more about an H.pylori infection and understand how it can be addressed by using a functional medicine approach.


In this episode, we will cover:

02:36   Big Components of CBC

09:00   B12 and the Intrinsic Factor Binding It

11:31   Infection Components of CBC

17:22   White Blood Cell Markers

26:55   Stool Test and CBC Testing







Dr. Justin Marchegiani: And we are live on YouTube and Facebook. Evan, how are you doing, man? Happy Father’s Day Weekend!

Evan Brand: Yes, sir. Same to you.

Dr. Justin Marchegiani: I know. Steaming off; the countdown’s ten weeks and uh– and counting. [croostalk] Your excited?

Evan Brand: That’s it? Ten weeks?

Dr. Justin Marchegiani: That’s it.

Evan Brand: Holy smokes. It goes quick, don’t it?

Dr. Justin Marchegiani: I know. I’m trying to think about all the things I want to cram in before I’m uh – adapt. But I’m just hitting, kind of keeping a pretty simple low key life, so, nothing that’s on my to-do-list that hasn’t already been checked off.

Evan Brand: Great, man.

Dr. Justin Marchegiani: Awesome, and how’s your weekend though. Ain’t it fun?

Evan Brand: What did we do? Honestly, my days flow together so much. I mean, my work– my work and my life, in a great– so much, that I honestly can’t discern the difference between weekends, typically. But I know I went for a hike, and– Oh, actually, so yesterday, I took my brother out for a mountain biking adventure.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I thought I – you know, I thought I – oh, man I’m really not that in shape but then I got my little brother out there, who– he’s not in shape, at all. And I wasn’t out of breath and he was dying. I felt kind of bad. I thought he was gonna pass out at one point. So, we were like two (2) miles into the woods and you know, he’s hyperventilating. I’m like, “Okay, buddy.” Luckily, I brought some uh– professional grade electrolytes along, and so I gave him some of those and he was able to rebound and feel good enough to get back out to the car. So, that was yesterday. That was a blast.

Dr. Justin Marchegiani: Yeah, I mean, it’s amazing. The more, uhm – the more you have inflammation under control in your body, just your resiliency for everything, because the more inflamed you are, the more your body is kind of allocating all of its resources to putting out that fire, right? You don’t have carpenters go into a house while it’s on fire. The firefighters go into the house first. Same kind of thing with your body in– when it comes to performance. Getting the inflammation down helps on everything.

Evan Brand: I was just in better shape than I thought I was. I mean it was a pretty intense trail, and assuming that the adaptogens were probably still in my blood at the time when she was helping with performance, too.

Dr. Justin Marchegiani: Absolutely, we also got a new audio setup today so you can see we’re microphone free. Got a little tip from my friend Abel James on how to set some things up, and I think it may be working out pretty good. And hopefully, people on Facebook Live can hear you as well. So, hopefully. If not, coach up in the YouTube link, as well, to that Facebook live post so they can access it.

Evan Brand: Yeah. Thank you, Abel.

Dr. Justin Marchegiani: Yeah, very cool. And we’ll take questions here on YouTube chat as we go. But, today, we want to talk about Blood Testing. Starting out, looking at your CBC and your CMP. CBC is your Complete Blood Count, and your CMP is your Comprehensive Metabolic Profile. So, your CBC is gonna look of things, such as your Red Blood Cells sizes, like uhm– red blood cells, Hemoglobin, Hematocrit. It will look at thing– and then you also have something called NDC, which is like, MCV, MCA, MCHC. That’s just how big the red blood cell and the Hemoglobin is, right. MCH is Mean Corpuscular uh– Hemoglobin Mean Corpuscular Hemoglobin Concentration, and uhm– MCV is like uh – the width of the blood cells. So, it’s looking at, basically, how big the blood cells are and how many of them there are, and then, it’s looking at also the Hemoglobin content and Hematocrit content. And this is helpful because if you’re Iron or B12 goes low, you’re gonna see your Red Blood Cells, your Hemoglobin and your Hematocrit actually dropped, and actually same thing with your B12; you’ll start to see those drop. You’ll start to RBC, Hematocrit and Hemoglobin start to drop, so that can give you some indications if there’s a potential Iron or B12, and B12 in a Folate and B6 tend to come together. So, it can give you a pretty good indication of what’s going on under the surface. And again, we’re looking at these things from a functional perspective, so the ranges that we look at them at are gonna be a lot more sensitive than, let’s say, a pathological range for let’s say, Iron-based Anemia, right. Your Red Blood Cell marker may have to be below 3.8 for your MD to say anything, we may say below 4.1 on the RBC. Yeah. Same thing with the Hemoglobin, maybe under 11– 11 or so. They may look at it. We may say, “Ooh! Upper 11’s low 12’s for Hemoglobin.” Hematocrit, same thing, like 36, 38-ish, we may start to look at it. They may say 35 or below. So, we kind of have a little more of a narrower range, so for heading in that direction of being more Anemic. So, we know if there’s a B12 or Iron issue from just those markers. And then, we can dig in to look a little bit deeper by looking at the NDC’s, the MCH, MCHC, MCV– These markers get higher, bigger, or larger numbers if it’s a B12 or B Vitamin issue. And they may just stay low if it’s an Iron issue. But again, it may not have to go low but, typically, we differentiate the Iron in the B12, because the MCH, MCV, MCHC will start to go up when their B Vitamins start to get lower. And why is that? It’s because the maturation of Red Blood Cells. They start off really big and they actually get smaller as they get mature. Where, humans, right; we start off smaller and we get bigger, so, the exact opposite of human beings. So, if we don’t have enough B Vitamins, they get stuck in this bigger phase, and they can’t get nice and small like they should. Where, if there’s too much Iron, they actually get too small, right? If you look up– you know, that we’re Anemic, right? It’s kind of mean smaller, weaker, right? So, if we don’t have enough Iron, we can actually get too small if we don’t have enough B Vitamins. We can actually stay too big. So, that kind of just differentiates that. That’s kind of one of the big when I call deal-breakers. What we look at someone’s blood is being able to assess significant imbalances, either in B Vitamins, B12, Folate B6, and then the Iron.

Evan Brand: So, let’s get a bit of context about reference ranges, when you go to your conventional Doc, you’ve got Lab Corp or Quest, or some other Lab running your blood, and the doctor or the nurse calls you and says, “Doctor Justin, everything’s fine. You checked out okay. Go home.” Uh– really– you want to make sure you get a copy of all of your blood tests for many practitioner, because someone’s analysis, may not be the correct analysis. And like we’ll discuss a little bit today, we’re not gonna go too much into the numbers but we will give some about functional numbers. Anyone who’s almost dead, and anyone who’s alive, their getting factored in to the average. So, when you see that the reference range issue’s so huge if you’re anywhere within dead and alive, you’re okay. And for us, that’s just not the case because, if you’re listening to us, we want you to be the top one percent of health, top one percent human performance on the planet, and so the reference range is gonna be much tighter. So, I hear this time and time again, and Justin does too. Every single week, we hear our clients tell us, “Hey, my nurse said my thyroid was fine. Go home.” And then we looked at the thyroid and their TSH is just absolutely in the tank. You know we’re in, like, the single decimal point, through in like a point two (0.2) or point three (0.3), or the TSH is so high – they’re like a six or a seven, and they get told that they’re fine. So, don’t take fine as a correct analysis of your blood work. Get the piece of paper, and you can work with someone like us, and we can help to identify, “Are you actually in the functional range or are there adjustments that need to be made?”

Dr. Justin Marchegiani: Absolutely, and just the people that are seeing on Facebook, give me a thumbs-up or a comment. Let me know if you guys can hear me, or hear Evan’s side of the combo here. We got a new speaker setup, so we’d appreciate that feedback. So, I think we hit some good things, and again, typically, how laboratories are assessed is you got two standard deviations to the left and to the right, right? This is kind of what makes up our Bell Curve. And– so, you have your middle and then you have two – two standard deviations to the left and two to the right. And that those two standard deviations made what’s called the Bell Curve, and 95 percent of the population fits in that Bell Curve. Two and a half on the pathological low; two and a half on the pathological high, so what happens is, there’s always two standard deviations no matter what. So, what Evan said is true. So, as the population gets sicker, those standard deviations get wider and wider and wider. So, that range gets wider and wider and wider. So that’s – it’s really important, because optimal never changes. If here’s optimal, just because you get more sick, people stuck in that reference range, it’s gonna be polluted. Optimal will look more like it’s – it’ll look narrower and narrower as the range gets wider and wider. So keep that in mind. So, we hit the B Vitamins off. We hit some of the Iron stuff. That’s important. Iron’s gonna be more important with female’s that are menstruating, because hormone imbalances like Estrogen Dominance and low Progesterone and Cortisol issues can throw off their menstruation in their cycle. And that can cause excessive blood loss. So, if I see patients, you know, bleeding more than three days and greater than four tampons a day, we’re really going to the super supers[8:39], that can mean excessive blood loss. So, that’s one component. The next is Vegan Vegetarians. Again, really hard, you need to get – plant-based B12 sources aren’t gonna be the best. Even Vegans that are really healthy, they need to be supplementing B12.If you’re not, that can create a lot of problems. And then also, gut issues, right? If we have severe gut inflammation, if we have intrinsic factor antibodies in our stomach, if we have a lot of gastric inflammation in the stomach, it may be really hard to bind up that B12, ‘cause B12 is really interesting. We bind this compound to what called intrinsic factor, and then we– so here’s the B12 that comes into the body via the food, maybe some liver, some really good grass-fed. The intrinsic factor binds it. So, intrinsic factor is made by the Parietal cells using the same cells that produce Hydrochloric acid. So, if we have more gastric stress going on, it’s possible we may not– we’ll have less of these intrinsic factors. So when these factors hits the B12, it goes to the stomach, it goes into the small intestine, the Duodendum, the Jejunum, the Ileum. So, at the very end of the small intestine before it goes into the Cecum, the first part of the large intestine, that’s where it gets reabsorbed into the bloodstream. So, if we have any of those issues in the gut, that’s really gonna affect how we absorb B12. And if we have pathological low levels of B12, we can just have maybe immature, big, goofy Red Blood Cells, like we mentioned, or we can even go more pathological. We start to have nerve issues, Posterolateral sclerosis, Subacute Combined System disease. These are issues, where your Nervous Systems actually gets destroyed because you don’t have enough of that B12 in there to make enough healthy Red Blood Cells.

Evan Brand: Let’s go down that Avenue. Let’s talk about this that will impair stomach acid production. There’s a lot of things out there that people are doing. Things they’re putting into their body. Infections that are going on that could sacrifice this. And so, if we see Blood Tests that are gonna show low Iron, it could be just a Malabsorption issue, right? I mean, you– we see people all the time. They say their eating grass-fed meats but, they could still show up with low Iron because, they’re just not digesting it well or they had a prescription, uh – acid blocker that they’ve been using. Oh, by the way, just feedback for you. Stay close to the mic when you do your visuals, just because, when you go away, you sound so distant. And I know, probably 95 percent of our listeners are audio so, stay close.

Dr. Justin Marchegiani: Evan, I don’t ever want to be away from you man.

Evan Brand: [laughs]

Dr. Justin Marchegiani: No distance now. I’ll get extra close.

Evan Brand: Good.

Dr. Justin Marchegiani: Good feedback. So, we hit the uh– the B Vitamin stuff, right? So, also, platelets, too. Platelets, if they go low, that could be– also an Iron issue, too. Like the big components of CBC. Let’s shift gears if you’re ready to the infection components.

Evan Brand: Yeah, let’s do it. So, H. pylori is the first thing that comes to mind when you’re talking about Parietal cells. I mean, we see that – what would you say the average is? About one in three that you’re saying is infected in H. pylori? Maybe one in four?

Dr. Justin Marchegiani: Absolutely. I mean, here’s the deal. There are a lot of people out there that probably have H. pylori, and they’re symptom-free. So, h. pylori is a helical-shaped, kind of like a little screw kind of shape, uhm– bacterial creature that can burrow itself into the gastric lining. That’s the stomach lining. And it’s gonna be opportunistic. So, the more stressed you are, the more meal-compromised you are, the more your diet sucks, the more your lifestyle sucks, the more that thing will create problems. So most patients that are coming to see us, they’re either– most of them are coming ‘cause they have some kind of symptom that’s driving them in, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: You have some that come in because they want to be at their highest level, and they’re already good but they want to be better. So, if you have an infection, it’s– think it’s everyone’s goal to be infection-free. So, if there are infections there, we want to get rid of the infection. That’s like having a guest come in your house, leave the water on in the guest bathroom you never go in, and then you see the water bill’s like three times higher the next month. It’s the same thing. It’s just sucking resources, may not be financial resources, just maybe energy resources. Uh– mental, emotional resources, that are getting pulled out. Number two, they’re gonna affect, potentially, digestion. And, number three, it’s a ticking time bomb, ‘cause when you do get more stressed, and your immune system got weakened, that can really come in there and create problems.

Evan Brand: Yeah. So, what do you say to the practitioners who tell on their clients, “Hey, look. You’ve got H.pylori. You’re not symptomatic. Let’s just leave it alone – what’s not treated.” What do you say to that?

Dr. Justin Marchegiani: Well, I think we should always get rid of it, because it could potentially be a bottleneck on the digestive system. And then, number two, it will be sucking up some kind of resource on the body, so we wanna do our best to to knock it out. I think, the more resources you can have going towards performing to your optimal level, the brain function, to rebuilding muscle and healing tissue, and going to your healthy anabolic hormones. That’s better. We want to allocate our resources to things that are gonna help us grow versus frivolous things, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, it’s kind of like, investing, right? You want more money going to assets and things that really make your life uhm– you know, better: food, shelter – those kind of things, versus all the things that may not be as much of your priority.

Evan Brand: yeah. I think I told you this already but, I’ll say it again just to make sure it’s on the air. Is– I had a client who came to me a few weeks ago, uh– who went through   medical doctor. He did test, positive for H. pylori, and I said, “Did you get treated for it with the MD?” He said, “Yeah.” And I said, “Oh. Was it triple therapy?” And he goes, “No. They’re doing quadruple therapy now.” That’s for antibiotics instead of three because, H.pylori’s getting so resistant. We probably have to do a whole podcast on antibiotic resistant bugs and how big of an issue it is. But, long story short, the guy did four antibiotics at the same time, and tons of digestive complaints. Still showed up positive for H. pylori.

Dr. Justin Marchegiani: Wow.

Evan Brand: So, it didn’t work.

Dr. Justin Marchegiani: Right. It didn’t work, yeah. Triple therapy is typically Erythromycin, Amoxicillin, and, typically, Prilosec or Bismuth, uh– they used in there. I wonder what the fourth antibiotic they’re adding. Or the third, really ‘cause Prilosec isn’t antibiotic.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Erythromycin and Amoxicillin are– so that…

Evan Brand: I– I think, I’m pretty sure he said it was uh – it was Prilosec so, the acid-blocker and I think three antibiotics. I’m not sure what they were though, in terms of the strains or anything.

Dr. Justin Marchegiani: Yeah. I see so many patients that have uh– zero acid reflex or heartburn and they still put them on Prilosec. Which is just retarded because, it’s like if they’re not having issues with stomach acid and irritation on the gut, why are you putting them on a blocker that may decrease their stomach acid and more nutritional issues down the road. It’s so silly. I get it if they have a lot of the Acid Reflux but, if not, why are you adding another drug in there?

Evan Brand: Yes, there’s a couple markers I wanted to– I wanted to see if I could find them he, in our clinical handbooks on Blood Testing. There’s so many markers that show up as Hypochlorhydria. Do you know any writeup on the top of your head. I guess, you talked about Iron already, so if you have Iron issues, we know that, yeah, that could be yeah, excess of bleeding. But if you’re male, you could still show up low just due to Hypochlorhydria, right? Just low stomach acid?

Dr. Justin Marchegiani: Yeah, you can. Absolutely. That may not be pathological, right? Maybe more of a subtle kind of thing. And here’s the thing. When it comes to functional medicine, we’re moving so many needles, you don’t really know what needle per se is really making the difference ‘cause we may give you Hydrochloric acid, right, and some enzymes, but we may also try to get you to have more time chewing your food, and then drinking water away from food and eating in a more stress-free environment. So, you’re moving six or seven needles right there. I may say, go out get a little more sunlight and Vitamin D, right. So, there’s eight needles we just moved. So, in a double-blind Placebo-controlled trial, typically, they’re moving one needle at a time. Well, man, have you the slow boat to China if you’re moving one needle at a time as a functional medicine practitioner. It’d be so hard to figure out what is the absolute variable, and it will take forever to get patients to get better. That’s why I always say if you can glean from clinical research, do it. Like, you know, the research is the PODMED per se. But a lot of times, the clinical research that were doing, removing so many needles, it’s hard to know what one, but it’s okay because every needle we’re doing on the lifestyle side, we know is helpful. Like, it’s not ever gonna hurt anyone to be in a more relaxed environment to eat, or to drink water away from food, or to chew your food more, right? Those things are gonna help anyone for the most part. So, we combine all of those things with the other stuff and we may see improvements in the B12, or the Iron, or other Digestive things. So, sliding back to the H. pylori, we may look at it indirectly if we’re looking at a CBC, right? We may look at what’s called our white blood cell markers, right. And this is a general kind of indication of our Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils, right? Nutri School we learned it: never let monkeys eat bananas, right? That’s kind of the general jest. And then Neutrophil’s have the highest content, about 60 percent of your White Blood Cells. And Neutrophils all the way down to the uhm– the Basophils, which is like one or two percent. So, kind of keep that in mind. Neutrophils can go up or down for bacteria, Lymphocytes for bacteria and viruses, Monocytes for gut inflammation, bacteria and, potentially, parasites. Eosinophils can go up for, uh– typically, parasites and allergies, and Basophils for Histamine and allergies too.

Evan Brand: Now, is your typical blood test gonna have this broken down like that though…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …or you’re just gonna get a generic White Blood Cell Count?

Dr. Justin Marchegiani: Yeah, typically, you’re gonna have on your CBC your White Blood Cell Number, which will be all of those: Neutrophils, Lymphocytes, Eosinophils, Basophils, Monophils combined– Monocytes combined.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s your White Blood Cell Number. And then you can get uh– a breakdown of all of them. [inaudible]

Evan Brand: So [inaudible] get [crosstalk] a percentage.

Dr. Justin Marchegiani: You get a percentage breakdown, as well as the absolutes. So, the absolutes, the how much Eosinophil’s are in there, and then you get the number as a percentage too.

Evan Brand: All right, so let’s say, I just got my blood work done. I didn’t get the breakdown though. I’ve just got White Blood Cell Count, can we get general inferences about whether White Blood Cell Count– let’s say, their currently up. You can say, possibly active infection, as compared to if White Blood Cells were down, could you have said that that’s a Chronic Infection…

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: …but the body’s not been able to fight it any longer?

Dr. Justin Marchegiani: A hundred percent. So, when you look at White Blood Cells, high or low, but high’s gonna be an active infection. That’s non-specific though. And if White Blood Cells are low, that’s definitely gonna be more of a Chronic Immune depleted kind of situation. And then, from there, we can run the actual individual White Blood Cells. We can infer uh– what may be happening there. So the typical pattern is like Neutrophil’s high, Lymphocyte’s low – that’s a common H. pylori pattern. High Neutrophils, low Lymphocytes, typically, one should get into the mid-60’s– middle-o-60’s. That’s maybe a problem.

Evan Brand: Now, let me clarify here. Is this high Neutrophil’s got a functional range or even like your conventional Lab Corp would flag you, “Hey, look. Your Neutrophils are high.”

Dr. Justin Marchegiani: Yeah. You probably would not– I mean, the functional range is gonna be in the low 60’s. The lab pathological range, typically, is above 70’s, some goes high as 75.

Evan Brand: So, maybe. Maybe your conventional lab will pick it up but,  maybe you got to use a functional reference range instead?

Dr. Justin Marchegiani: Exactly, a hundred percent.

Evan Brand: Okay. So, basically what we’re kind of getting at is we can detect stuff like this H. pylori. We can guess parasites possible based on some of these other components of a White Blood Cell Count but, if any of these stuff is off, whether you’re a White Blood Cell Count, just as a whole, regardless of the breakdown, if the whole WBC is up or down, we could say that warrants further investigation with something like stool, or urine organic acid testing tech sheet, look and prove on a piece of paper, H. pylori’s there.

Dr. Justin Marchegiani: A hundred percent.

Evan Brand: Okay.

Dr. Justin Marchegiani: You got it?

Evan Brand: All right.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: We got a couple questions. Let’s see Samuel asked about lots of Ketosis lately. He said, “Can you give us examples of a day of eating Ketosis?” It’s pretty much meat and fats. I mean, like, I’m probably on Ketosis right now. ‘Did some pastured sausage for breakfast, half of an Avocado, I would say I’m producing ketones right now. Samuel, same thing probably meat, meat and some veggies later for lunch, and meat and veggies for dinner. Like probably do a grass-fed steak tonight. Actually, you know what, I made Fajitas last night. I made some grass-fed beef Fajitas. So I’ll fry the– those again. That’s just bell peppers onions, and maybe a piece of dark chocolate. So, I’ll probably be Ketotic during that meal. Uh – Kendra loves blood tests analysis. Ocasious said, “how do you work” – how does she work with us? Uh – you can just Google Dr. Justin Marchegiani or go to his website Just in Health and then you can check out my website evanbrand.com. Samuel: How do you know if herbal treatment for H. pylori’s working? To eradicate it, are there any symptom during the two-month protocol? What would you say Justin? I mean, sometimes it’s not symptoms during the two-month protocol. It’s just the matter of the removal of bad symptoms. So, it’s like, stomach pain, like you told me. I said, “Man, I had this weird, sharp pain in my stomach.”

Dr. Justin Marchegiani: Right.

Evan Brand: You said, “All right, and you better look for H. pylori.” It might not be that symptoms, like more energy, but it might be the removal of things. Like instead of more energy, I phrased it as “the removal of fatigue,” or “the removal of gut pain,” or “the removal of diarrhea or constipation.” So, I’m kind of worried. It’s like the removal of the bad thing, like pulling off the layer as opposed to saying, “Here’s your positive symptom” if that makes sense.

Dr. Justin Marchegiani: Yeah, yeah. So you make your list of the conventional H.pylori symptoms, which will be, you know, gut irritation, acid reflux, gastritis, indigestion, constipation, diarrhea, like a lot of your big GI symptoms, right? But then, you kind of have your eight typical symptoms, which could be joint pain, mood issues, fatigue, depression, anxiety, uhm– brain fog, so, energy, right, so, a lot of those things, depression. A lot of those things are gonna be a typical meaning they’re not– they’re outside of the digestive sequela of symptom. So, we got to keep that in the back of your minds. So, typically, you’re either gonna see an improvement in some of those symptoms, right? So, if you have mood stuff, you may see improvements in the eight typical stuff, like fatigue, energy, joint pain, start to go down, you may have some typical gastric symptoms, like the bloating, the constipation, the diarrhea. So, you kind of make a list, and see what improves on the typical and see what improves on the eight typical. And again, most people are gonna see some level of improvement there but in general, the goal is to reduce, kind of pull those stressors out of our stress bucket. The more stressors out of that bucket, you may get better. Some people, if you could kill it too fast, they may feel worse during that killing phase. I can’t tell you how many patients I have, where we create, you know, a die-off reaction handout, if you have this issues, make sure you curtail the dose or adjust the tape right up. So many patients ignore that. They just go into the mindset,

“the faster, the better,” “the more I kill, the better,” so they feel like crap, and then, they don’t even do anything or follow the instructions to modify the dose. So, I always say if you’re really feeling like crap, that means you’re just stressing your immune system, your lymphatics, your detox. You’re killing things off too fast and your body’s having to deal with that dead debris. Slow it down. Add in some things to help with uhm– with the lymphatic flow. Change your tea. Maybe add in some binders, some bentonite clay, some charcoal, some citrus packed in. And then maybe, even add in some extra things for your detox phase 1 or phase 2 nutrients, to help push those pathways. But that’s a good start right there.

Evan Brand: I got a couple more questions here. Avie: are there any books you guys have read about functional medicine that you recommend? I don’t know if I would consider a functional medicine book. But Dr. Jonathan Wrights book, “Why Stomach Acid’s Good for You” I think is pertinent to today’s discussion. And it’s like nine bucks on Amazon. What about you?

Dr. Justin Marchegiani: Tsss. I got a book coming out, man, “The Thyroid Reset.” That’s gonna be a great book; all the practical things. I don’t give myself a plug but, it’s gonna be great because it’s gonna be all real practical things. So, look for that soon. And we’ll gonna get that out. I’m just – I’m too busy with patients, so I need to get someone on board to help uh– get it done, because I don’t want to take away from my helping patients.

Evan Brand: Totally, alright. Outside of your books– Your books gonna be a good one, I know. I’m excited. What about other recommendations?

Dr. Justin Marchegiani: Uh– from a functional medicine standpoint, I mean, I have– we have some books here that are more clinician-oriented, right here, on Blood Testing and such, that I use [crosstalk] for myself.

Evan Brand: Uh– Dr– Dr. Weatherby; he’s got – he’s got a good one. It’s titled, “Blood Chemistry and CBC Analysis.” That one’s a cool one. There’s a couple other once out there. What’s [crosstalk] it– what’s it…

Dr. Justin Marchegiani: I– I wouldn’t give – Izabella once had plugged the Hashimoto’s Protocol. It’s a really good book.

Evan Brand: Yeah. Izabella’s book was really good. What else did I read, so far, this year?

Dr. Justin Marchegiani: I got another book over here. Dr. Horowitz’ book, “Why Can’t I Get Better.”

Evan Brand: That’s a great book. He’s got a new one now, too, Horowitz. I can’t remember what it’s called. I think it’s… [inaudible]

Dr. Justin Marchegiani: Play off some word.

Evan Brand: Yeah, it’s like, “I Can Get Better.”

Dr. Justin Marchegiani: I Can Get – something like that. It’s like a play of that same theme. So yeah. Those are some really good things there too, for sure.

Evan Brand: You want to answer Kendra’s question? I’m gonna go back to the blood here.

Dr. Justin Marchegiani: Uhuhmn – so let me hit one thing. So, I talked about kind of the way blood cells stuff, and then, the breakdown of the blood cells. Now, there’s specific tests that you can do for us, specific H. pylori antibodies, right? IGA, IGG, IGN, and then also, you can do Breath Testing, and then also, Stool Antigen Testing so there’s more specific testing. But you can look at the CBC and you can infer and draw things from that, which is nice.

Evan Brand: Okay.

Dr. Justin Marchegiani: And then, what’s Kendra’s question?

Evan Brand: Yes, she says, “Do you consider elevated Eosinophils a good sign – a good enough indicator of infections or do you think Stool Test are always necessary?” I’ll give my two cents first. We run the Stool Test on every single new client, I mean, if we just depend it on blood test, I feel like our– us having all the puzzle pieces on the table would not be complete.

Dr. Justin Marchegiani: Exactly, and sometimes they can take a lot long time for those markers to drop. So, if you’re treating an infection, it may take like months like after the infections treated for those numbers to kind of slowly go down so, it’s nice to have more immediate infection markers that tell the story. But it’s good, because we– number one, it tells me, the clinician, that something’s wrong. And that we got to look deeper in that stool testing area. And then it gives me more ammo to get the patients to run the test that I think are best. So, that way, the patient’s more motivated because, they know, here’s the clinical direction that we’re going down. Here’s the clinical path that we’re going down. Here’s why we’re going down it.

Evan Brand: Yes. She had a follow-up question. She said, “Or rather should you not do a Stool Test if the CBC doesn’t indicate parasites?” No way, always do Stool Testing. I’d say, once or two times a year. Just a preventative, everybody should be doing Stool Testing because, here’s the deal. We can try to make the guesses and checks based on the CBC like all we think it could be this, we think it could be that, but let’s say, you’ve got, like, Klebsiella or Citrobac, or some type of bacterial overgrowth that can trigger autoimmunity. Well, let’s say you’ve also got H. pylori on top of that, or let’s say, you’ve got Candida, or let’s say, you’ve got Blasto with it. you know, the protocol’s gonna be different. If it’s just…

Dr. Justin Marchegiani: Yes.

Evan Brand: …yeast. We’re gonna do one thing, if it’s just bacteria, we gonna do one thing. If it’s bacteria plus parasites plus yeast, that’s gonna  be a totally different protocol so, if you just say, “Oh I think, this number’s off of my blood, therefore, I’m gonna take this gut supplement.” Waste of time.

Dr. Justin Marchegiani: A hundred percent. So, I think that’s essential because you’re gonna treat different infections differently. And then also, you want to know if the infection’s knocked out because, if you don’t see the CBC go down, you’re like, “Well, it’s just in the latency period. It’s gonna drop over the next few months. Where if you get the infection, you retest and the infection’s still there, you’ve a lot more clinical confidence to keep on moving and trying in different things versus the hate that you get. You’re not, kind of in, an uncertain state.

Evan Brand: Now, the question here, uhm– do you agree that low Melatonin on a BioHealth HPA Axis Spit Test– low Melatonin, do you believe that indicates gut dysfunction?

Dr. Justin Marchegiani: It definitely can. It can increase, or can be uhm– you know, something that I would add to the list of potential, differential diagnosis is, or what the root cause could be. ‘Cause if we don’t have the ability to break down, let’s say, Tryptophan, which then gets converted in the 5-HTP, which then gets converted into Serotonin, which then gets inverted into Melatonin, right? That that could be a potential issue. I also look at B6. I also look at the stress because, your body will burn through Serotonin. The more stressed you are, you’ll see that an organic acid test, you’ll see 5-hydroxyl to last, take a high or low. So that can be indication you’re burning up a lot of those uh– precursors there. Uhm– so, I look at the stress components, you know, adrenals and such. And I, also, would look at the gut component, for sure. And then make sure all the diet and lifestyle things are uhm– you know, the T’s are crossed and the I’s are dotted, right? HCL, enzymes, no infections, making sure sleep is getting all those things, but definitely that’s one thing I would add to the list to rule out.

Evan Brand: Yeah, it could be something simple as you look at your phone too close to bedtime. Low Melatonin showed up before [stuttering] your last Saliva Test.

Dr. Justin Marchegiani: Yeah, I mean, I would say, if you’re like running the test right before that, for sure. But if you’re kind of getting more of an average, so to speak, of the night and in snow, that’s probably not enough to not knock it down from an average standpoint. But, punctuated yes, I think that makes sense.

Evan Brand: Yeah. Let’s see what else we have. Questions here. Diana said, “Do you recommend Nystatin for Yeast Overgrowth to keep it in check while taking herbals? I can’t prescribe, and I would not prescribe it even if I have the ability to prescribe it, ‘cause I typically use like Saccharomyces boulardii, and I’ve just never had issues with– with Yeast Overgrowth, as long as people are doing the diet. And, a lot of the herbs that we use and, Justin, you want to add some stuff too. A lot of the herbs we use, like if we’re working on yeast Overgrowth, the parasites, or bacteria– they’re gonna be multifactorial. So, we may be using an herb that’s gonna also– let’s say we use Olive leaf for Oregano. That could kill bacteria but it could also kill Yeast as well.

Dr. Justin Marchegiani: Yeah, absolutely. So, I think uhm – nice that some of the antifungals uhm – may be needed for more severe issues but for the most part, you should always try the herbals first. And, you should always look at other infections because there could be other infections like Blasto or H. pylori, that could predispose that fungal overgrowth. And if that’s – that’s what’s predisposing it, a Nystatin, a Fluconazole, or an Amphotericin B. That’s not gonna fix the H. pylori, or the Blasto, right? So then, the root underlying issue is still there. While you uhm– you know, basically, you went outside, you pulled the weeds, at the ground level, versus pulling the roots up. So that’s the equivalent. Just – just puling the weed out of the surface and not pulling the root out.

Evan Brand: Yep, well said. Samuel said, “How accurate is the Breath Test for H. pylori?” I’ve personally, never actually recommend this one for a client, because the Stool Testing is just so awesome that I prefer to use that. But, Justin, what’s your – what’s your take on that?

Dr. Justin Marchegiani: Yeah, I mean, if someone has insurance, and they’ve met their deductible, you know, I’ll throw it on there an order from Lab Corp, but uhm – I find that patients may still have an H. pylori infection in their stool, and not have a comeback for a breath. The Breath is good for like acute stuff, but uhm – it’s not something I would just run b5y itself, and say, “Yeah, you’re good.” I’ll always wanna go to the Gold standard which is the H. pylori Testing. And again, we’ve been doing a lot of the DNA Testing for the H. pylori about BioHealth. You know, their #418 or their – the #401H. The H part of the #401 does the H. pylori. And they do great parasitology on their H. pylori. They beat a lot of Labs on that, which is awesome.

Evan Brand: Yeah, it is. Avie have a question, “ Should I wear a Blublockers all day on the computer or only  when it gets dark out?” I’m so glad you answered this. It drives me nuts when I see people promoting these BluBlocking glasses in them, like, out of it, hence, like a health conference and they’re just walking around the daytime, wearing your BluBlocker, it’s absolutely retarded, because you’re destroying – I’ve seen people on the Lab results, who said they’ve been wearing BluBlockers all day. They’ve destroyed their Cortisol rhythm because, their body never knows when it’s daytime. So – and this is not against you asking the question but, I see so many photos of people promoting them because they’re like trending and cool now. But it’s absolutely stupid to wear them during the day because, you can just use a screen software, like Justin and I talked about, called Iris, you can keep your screen at a 23 or 1,900 Kelvin. So, it’s pretty much Amber-colored, which is what I do all day. Because you still need those beneficial spectrums, you know. Those like 1,500 different spectrums you’re getting from sunlight. So, if you’re exposed to, like, an LED light, or a screen light from your computer, you can modify those lights to make it a better situation. But you absolutely still has to have those natural spectrums that come from the Sun. Otherwise, you’re really screwing yourself up.

Dr. Justin Marchegiani: Yeah, I mean, during the day, for me, I’m okay being a little bit overstimulated by light during the day, ‘cause that’s just gonna increase my Cortisol. So, if– as long as everything else is going well, I don’t have a significant Cortisol imbalance, I think it’s fine. I just use it at night; just when the Sun sets. That’s where I pull them out. And I have this one, like, brand now, that I put over my glasses. I’ll put them on, typically, between 8:00 to 9:00 – the last two hours before I go to bed, I put them on.

Evan Brand: Yeah. And I put it too early with the baby so, I mean, at that time during the summer, we’re going to bed before it’s even completely dark outside so, I just kindled down. You know, we’ve got like a little salt lamp to use as a night light, and turned that off. And, we’re good. So–

Dr. Justin Marchegiani: Love it.

Evan Brand: I got a little–

Dr. Justin Marchegiani: Love it.

Evan Brand: I got a little ranty there. I see these pictures of these BluBlockers. These people wearing them, promoting them on Health Conferences. There’s people doing like Facebook ads wearing the glasses during the day. It’s just makes me want to sock them.

Dr. Justin Marchegiani: Yeah, I think I had uhm – I had a Neurosurgeon on the jet cruise recently, and he had them on during the day. But his situation was different. He was up all night doing a Neurosurgery. So he had it on during the next day, because he was tryig to, I think, probably get to bed when he got home. So, I think he was trying to dampen it, and kind of tell his brain that it was night time, so he could get some rest. I think that was a different situation people watch that show. You’re probably thinking about him. I know, I could think of a couple of people that do it at conferences like a freak. I  won’t say their name but, I don’t– I just don’t understand during the day why that’s gonna be the best. I get it at night, right, because you don’t want to lower the Melatonin by upping the Cortisol from the light. So, that makes a lot of sense.

Evan Brand: Well, the Sun, I mean, right now, there’s blue light from the Sun. You’re getting blue spectrum’s during the day.

Dr. Justin Marchegiani: Right.

Evan Brand: And so…

Dr. Justin Marchegiani: Naturally.

Evan Brand: Yeah, naturally. So, it’s not – it’s not like you’re, you’re hacking sunlight. Sunlight is good. You’re never gonna be able to beat that in terms of the spectrum – the color– the color ranges.

Dr. Justin Marchegiani: Totally. Well, we just hit the CBC today, I think saved uhm– the comprehensive metabolic profile for next time. Because I– we’ve already done a good amount. We hit the key CBC markers, RBC, Hemoglobin, Hematocrit, right? We talked about the differentiating, the Iron versus the uhmm– the B12. We talked about the White Blood Cell panel, right? The White Blood Cell, we talked about the uhm – Neutrophils, Lymphocytes, Eosinophils, Basophils. And then one of their marker here, I’ll hit is– we’ll hit in the CBC and the CMP part next time. But you can do markers for Red Blood Cell and Magnesium, which is great but, Magesium kind of comes under the Comprehensive Metabolic Profile. So, we’ll talk about that. Intracellular versus extra cellular so, we always like to do if we can do, a specialty test for, like, the Magnesium Serum versus– I’m sorry. Red Blood Cell Magnesium – that’s better, ‘cause that gives us the window intercellular, inside the blood cell versus outside of that. Kind of what the blood cell swims in if you will.

Evan Brand: Yep. That would be fun.

Dr. Justin Marchegiani: Home. Awesome. Home. Any other questions, comments, concerns?

Evan Brand: We had one from Gupta here. Okay. Gupta: “ What’s the best hormone test?” Kind of a general question but, since we talked about Cortisol and Melatonin today, a lot of times, we’re looking at a salivary uh- Cortisol test, which is gonna tell us a lot about Gut Health. If you got high Cortisol, we know that’s gonna damage somebody’s gut. Uh– so that– that’s what I typically write in. Justin, what are you doing hormone-wise.

Dr. Justin Marchegiani: Yeah. Hormones I’ve been doing and going combination between the Dutch and then also doing more of the BioHealth, the Cortisol Awakening Response. So, we’ll run the #201 and the #205, nd then we’ll add the Cortisol Awakening Response, so we can look at zero, 30, and 60 minutes waking and see if we have that ice bump of Cortisol here, a bump at 30 and then a halfway drop down here. A lot of patients, they’re not even getting that, that Cortisol up. In your awakening response, we get a bump, 50 percent bump, a drop of about a third here, like that. And most people they aren’t getting enough, high enough, and they’re dropping down actually lower. So that give us a pretty much good window of what’s happening with our HPA Axis.

Evan Brand: And yeah, it’s so much more fun to have the Awakening response versus impervious times that’s just having that one morning reading?

Dr. Justin Marchegiani: It’s nice. It gives you a pretty good window what’s happening with the brain, and the hypothalamus-pituitary-adrenal axis, for sure. I love it.

Evan Brand: Stacey, thank you for the feedback. We appreciate it. Uh– Kendra said, She gives a podcast idea. “A Recommended Test: Serum, Urine, etc., For Each Essential Micronutrient: Magnesium, Zinc, B6, Fatty Acids, etc.” I’m gonna guess. You’re gonna tell her just to do a SpectruCell but maybe we’ll save that for future reference.

Dr. Justin Marchegiani: Yeah. I mean, SpectruCell will be great, ‘cause you get more intracellular nutrients there, but yeah, we’ll talk about that next time. There’s other markers that we can look at for Zinc, like Alcohol and Phosphatase, and Magnesium, like the Red Blood Cell Magnesium. So, we’ll say that for next time. We’ll dig in more.

Evan Brand: Cool. People can go check out justinhealth.com. They can check out Justin Store, custom formulations there, lab tests, scheduling consults with him– justinhealth.com. Then myself, just Evan Brand. E-V-A-N Brand dot com (evanbrand.com), and check us out. We’ve got, what? Probably a combined total of five or 600 pieces of contents. So if there’s something there that we didn’t cover today I’m sure he have – in some form or fashion.

Dr. Justin Marchegiani: Yeah, just use the search bar on our site. A lot of people, they come in on some of the questions and they asked questions. Uhm– like about stress and things like that. Uh – we may not be able to answer more very generic questions but that’s why we go back to the site and just put that into our Search browser, and you’ll get uh– lots of Podcasts and other articles on that. So, we don’t mean to ignore you but, go back and use that Search Bar first.

Evan Brand: Yep, totally.

Dr. Justin Marchegiani: Cool. And you no longer the Not Just Paleo guy. You’re uh– you changed your brand. I mean…

Evan Brand: It’s on.

Dr. Justin Marchegiani: Evan Brand changes his brand. Is that a coincidence or what?

Evan Brand: It’s gone. The website, like, went down, and I said, you know what, this is it. I finally got it. I was able to purchase my– my name dot com. So, that’s what I did. Stacey: “Is it okay to take D3 on a regular?” Yeah, probably is. If you’re taking Vitamin K, or you’re doing grass-fed butter. Then, you’ve got the K that’s gonna help act as a traffic cop for the Calcium, so that you’re not upping D3 and then Calcium on your arteries but, just get your levels retested. I had a lady who has taken a bunch of Vitamin D. She got her levels tested. She was above a hundred and twenty (120) and that’s toxic, so you can’t have too much of the good things. So just get your blood checked. If you can get it through your doctor, cool. If you need to get it through somebody like Justin or myself, we can do it on uh– an out of pocket basis, as well, for blood. And, it’s always good to check. Make sure you’re about 60 units.

Dr. Justin Marchegiani: Love it, man. Love it. Well, anything else you want to mention here before we go?

Evan Brand: I don’t think so. People listen on YouTube. They can’t give us a review obviously. But, if you’re listening to the audio portion on iTunes. Give us a five-star review, ‘cause it helps sustain the top of the hills chart, and that way, this functional medicine approach can get to more people and then we beat out people like a Jillian Michaels, who are promoting, like, Calorie Counting and Weighing Yourself, and Weighing and Measuring Your Food, and all that other crap that we just don’t agree with. Is not necessary for you to be optimally healthy. If you give us a five-star review on iTunes, we beat out her, and then this info gets to people like you instead.

Dr. Justin Marchegiani: Hundred percent, man. Awesome. Well, great chat today, Evan.

Evan Brand: Likewise.

Dr. Justin Marchegiani: We gotta do it again, real soon.

Evan Brand: Yes, Sir.

Dr. Justin Marchegiani: Alright, take care.

Evan Brand: Bye.

Dr. Justin Marchegiani: Bye.



“Why Stomach Acid’s Good for You” by Dr. Jonathan Wrights

“Blood Chemistry and CBC Analysis” by Dr. Weatherby

“Hashimoto’s Protocol” by Izabella Wentz

“Why Can’t I Get Better” and “I Can Get Better” by Dr. Richard Horowitz

“The Thyroid Reset” by Justin Marchegiani




Magnesium Deficiency Causes and Solutions

Magnesium Deficiency Causes and Solutions

By: Dr. Justin Marchegiani

Magnesium is essential for proper function of over 300 enzymatic reactions and for the performance of many vital physiological functions: from heartbeat regulation to muscle contraction and relaxation. Magnesium is crucial to the body and plays a part in almost every facet of your well-being and that is why a magnesium deficiency can be responsible for almost every symptom dragging you down.



  • Boosts memory function
  • Muscle relaxation and sleep
  • Regulates mood and stress
  • Manages the excitability of the nervous system (calming)
  • Blood sugar control
  • Healthy bone density
  • Cardiovascular support
  • Detoxification pathways in the liver
  • Normal gut function
  • Inhibits calcium-induced cell death
  • Helps prevent osteoporosis, needed for bone formation
  • Vital for proper transcription of DNA and RNA

 A study on magnesium for insomnia in the elderly found that supplementation of magnesium improves insomnia through several measures, including sleep efficiency, sleep time, and concentration of melatonin.



Due to soil depletion and the omnipresence of processed foods, magnesium is becoming hard to find in the average American’s diet. Even within the health-conscious, high rates of prescription medications and antibiotic use lead to digestive disorders and impaired gut function, causing malabsorption of not only magnesium, but of minerals and nutrients in general, despite an otherwise clean diet.

Watching sugar and caffeine intake is important to ensure proper absorption of magnesium. Fluoride in our water supply can also negatively affect magnesium absorption.

A magnesium deficiency can cause:

  • Muscles aches and spasms
  • Poor digestion
  • Anxiety
  • Trouble sleeping and insomnia
  • Kidney and liver damage
  • Hypertension
  • Cardiovascular disease
  • Multiple Sclerosis
  • Alzheimer’s
  • Worsened PMS
  • Behavioral disorders
  • Mood swings
  • Osteoporosis
  • Depressed immune system
  • Cavities
  • Muscle weakness and cramps
  • Heart arrhythmias
  • Headaches
  • Nausea
  • Depression

…and pretty much everything else you don’t want. Neurosurgeon Dr. Norman Shealy says ,“Every known illness is associated with a magnesium deficiency […] A magnesium deficiency may be responsible for more diseases than any other nutrient.”

A study by the British Journal of Cancer in December 2015 looked at the incidents of pancreatic cancer by magnesium intake categories of 66,000 men and women, aged 50-76. It found that for every 100mg per day of magnesium less that was consumed, your risk for pancreatic cancer went up by 24%.

If you are concerned about a magnesium deficiency or have other health queries, book your intro consult today with Dr. Justin: https://justinhealth.com/free-consultation/



  • Leafy greens
  • Nuts and seeds
  • Fish, such as mackerel and salmon, especially eating some of the very small bones
  • Green beans
  • Avocado
  • Banana
  • High quality dark chocolate (It’s postulated that women crave dark chocolate around the start of their period because the magnesium helps with cramps and PMS symptoms)
  • Epsom salt baths are excellent as you have a large surface area (your skin) taking in the magnesium. Try 1-2 cups of Epsom salt (which is basically magnesium sulfate) in your bath for some incredibly relaxing effects.
  • An alternate mode of relaxation through magnesium would be to hop into a float tank. Taking in about a thousand pounds of Epsom salt in about 10 inches of water leaves you feeling incredible.
  • An alternate mode of relaxation through magnesium would be to hop into a float tank. Taking in about a thousand pounds of Epsom salt in about 10 inches of water leaves you feeling incredible.


  • Magnesium oxide only has about a 4% absorption rate and is comparable to table chalk. It’s cheap, easy to find, and works well as a laxative.
  • Magnesium citrate, as you find in such products as Natural Calm, is a step above magnesium oxide. It’s also rather inexpensive, works as a laxative, with a higher absorption rate.
  • Magnesium malate is very well-absorbed and acts as a calming agent rather than a laxative.
  • Magnesium glycinate is also calming without the laxative effect. It is well-absorbed as it binds to the amino acid glycine. The glycinate form tends to provide the highest levels of absorption and bioavailability, and therefore is ideal for those trying to correct a deficiency.
  • Magnesium threonate is a newer form which seems promising due to its ability to cross the blood-brain barrier and mitochondrial membrane.


If you are looking to get some extra magnesium into your diet, try Magnesium Supreme (https://justinhealth.com/products/magnesium-supreme/): a relaxing 50/50 blend of Magnesium malate and Magnesium glycinate.

To listen to Dr. Justin’s podcast with Evan Brand on magnesium, check out podcast #93: https://www.youtube.com/watch?v=9LWIGamxE2k










Dr. Robert Rakowski – Acid alkaline balance, cancer prevention and the magnificent 7 – Podcast # 129

Dr. Justin Marchegiani and Dr. Robert Rakowski talk about what is new in the Functional Medicine Nutrition as they focus on addressing the root cause of a health problem. Listen to them as Dr. Bob Rakowski shares his experience and expertise in addressing conditions he encounters in his practice including diabetes and cancer.

Learn some knowledge bombs about conventional drugs and vaccines, including its implication to one’s health. Gain tons of information regarding his recommendation when it comes to nutritional needs of his patients depending on different situations and conditions. Also, know the importance of acid-alkaline balance and enzymes in our bodies and how it affects our health.

In this episode, we cover:

3:49   Diabetes

9:40   Improving performance through diet

18:01   Recent studies on vaccinations

25:08   Acid – Alkaline balance

29:26   Nutrition Recommendation for athletes

37:43   Nutrition Recommendation for cancer patients







Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. I got Dr. Bob Rakowski here all the way from Houston Texas. We’re just in his neck of the wood yesterday. Dr. Bob welcome to the show.

Dr. Robert Rakowski: Happy Beautiful day. Honored to be here as always.

Dr. Justin Marchegiani: Thank you. I’m looking forward to some knowledge bombs drop here today like you always do. Well, we got this podcast on video today. So if you’re listening via mp3, check out the YouTube channel link below so you can see Dr. Bob in the flesh. So Dr. Bob, what’s new in your world of uh – Functional Medicine Nutrition?

Dr. Robert Rakowski: You know, that’s a really broad question.

Dr. Justin Marchegiani: I know.

Dr. Robert Rakowski: But let’s just say we get better – we get better, stronger, faster, smarter all the time. The research keeps unveiling that our strategies are simply the absolute best in the history of the game. You know I just had a patient come in take 8 different drugs and uh – you know, for diabetes, right? And some of those medicines just – that’s what they do. But yeah. We have people on good nutrition program where their diabetes resolves the typical case in 60 days or less. So she’s pretty excited to get her health back and uh – you know, stop taking some of those poisons.

Dr. Justin Marchegiani: Its really crazy coz in the world of Conventional Medicine, you have diabetes basically a sugar intolerance, right? Too much carbohydrate too much sugar, receptor issues, metabolic derangement. But nowhere else in medicine that if you have a peanut intolerance or a lactose intolerance, the typical treatment is you avoid the lactose, you avoid the peanuts. But only in Conventional Medicine is it – No, No, No. Keep taking what you’re intolerant to, and let’s give you drugs that shut down absorption of glucose. Let’s shut it – Let’s give you drugs like Glucophage that shut down uhmm gluconeogenesis. Or let’s just give you insulin short-acting, long acting so we can just jam that blood into the cell.

Dr. Robert Rakowski: And all of the above for this patient. So, I wish I met her 20 years ago when she was diagnosed with diabetes. But I’d say, “What happened?” “How did you get diabetes?” She says, “I was fat and I ate a lot of sugar.” It’s like, “Okay, you think that’s what caused it.” Yeah. Well, I think we have a pretty easy solution, right? Like you said, I never have to put it that way. That’s brilliant. It’s essentially sugar intolerance. It’s a carbohydrate intolerance. Uh, but now, she’s post stroke in 8 meds and a lot of them are not doing her any good. And she’s like, “I want my life back.” Well, let’s get it back. You gotta be healthy to get your life back. So-

Dr. Justin Marchegiani: And most doctors that are you know – most people that think the doctors know exactly what’s going on with this. They’re really in the dark. I worked in surgery for four years and I was the one literally holding the limbs on the diabetic as the surgeon will come in and literally tie off the arteries and amputate the limb. Hundreds of limbs passed my possession into the morgue. And I talked to these doctors as they were scrubbing out, I’d say well, “How come we’re in front of this? What’s the prevention? What’s the fore thinking so we can avoid this?” and like, it was just like over their head. They were just there doing what  they were designed to do. And that mindset wasn’t quite in play.

Dr. Robert Rakowski: You know, if you go to a surgeon, you’re gonna get surgery. If you go to a drug doctor, you’re gonna get drugs. If you go to a natural doctor, you’re gonna get uh –

Dr. Justin Marchegiani: Natural Solutions.


Dr. Robert Rakowski: Absolutely. So I got patients in here, they’d be pouring after this podcast. But uh – It’s fun to have a little – a little shift of pace. But even really, our number one focus is education. So – As long as it’s the same line, it’s what we do with every patient at a time.

Dr. Justin Marchegiani. Love it. So you’re uh – we’re kinda talking about diabetes right now. So what are the low hanging free- fruit for anyone that has a metabolic diabetes issue. You can be like PCOS coz a lot of people may not be at that diabetic level. They may have the insulin resistance and kinda be in between.

Dr. Robert Rakowski: Well, you said it first and best. You know, it’s gonna be what we called the Ketogenic Diet. But I like a healthy Ketogenic diet.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: A lot of people – lasted Atkins.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: I know some things to blast him about. Like you don’t wanna have the bacon whip cream diet.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: But you know what, I always tell people my favourite ketogenic diet is leans, greens, nuts and seeds. So lean meats, green vegetables, organic raw nuts, organic raw seeds. That’s a great choice. Now there are some so low glycemic fruits and berries and blueberries are awesome. But as a general rule, we’re gonna do leans, greens, nuts and seeds. We’re gonna exercise. Those are the things that can get us there. Uhm you know, I always tell people, I call them the magnets inside of your gut.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Eat like, drink like, think like, move like, sleep like, talk like everyday if you do that.

Dr. Justin Marchegiani: Love it.

Dr. Robert Rakowski: If you do that, guess what? You can keep diabetes away.

Dr. Justin Marchegiani: I love it. That makes so much sense. And you know, you also mention about lean meats. Now, we know that conventionally, a lot of toxins will get stored in the fat. It’s typically where it goes. So it makes sense with conventional meat for sure. If we’re eating like really good pastured meat, high-quality meat, is it okay to have more full fat meats?

Dr. Robert Rakowski: Yeah. Absolutely so. Uh the president of the Swedish Grass Grows Beef Association – uh I’ve stayed with him at his farm house and a dozen trips to US, Sweden.

Dr. Justin Marchegiani: Wow!

Dr. Robert Rakowski: And they test every single lot of grass-fed beef. And the ratio of Omega 6 to Omega 3 and grass-fed animals is 1:81.

Dr. Justin Marchegiani: Beautiful.

Dr. Robert Rakowski: Which is a very healthy ratio. So you’d eat all that fat that you want.

Dr. Justin Marchegiani: Yeah. And we know if you eat the – the grain, it goes up to 30-40 to 1, right?

Dr. Robert Rakowski: Uh – you know it’s stored in so many ways. The animals get sick. They put them on antibiotics and the meat becomes more anti-inflammatory by multiple mechanisms beside the omega 3, omega 6 ratio. So, not a good strategy there. We want healthy animals. Do you know what you’re animals – Do you know what you’re food is eating? That’s important to know.

Dr. Justin Marchegiani: Yeah. Absolutely. That makes a lot of sense. Now in my clinic, when we look at blood sugar issue, some of the things I look at, obviously, A1C, uh- fasting glucose can be helpful. Uh – triglyceride:HDL ratio, fasting insulin. And even just the good blood sugar mirror to see how they do right after a meal. Kind of like a functional glucose tolerance. Just curious to get your take on that. And uh – what test are you doing in your office to look at these issues?

Dr. Robert Rakowski: You know all of the above. Everything you’ve just said. And those are pretty much gold standard solid and we also have a sugar refractometer that can measure urinary sugar which is pretty sensitive.

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: So it’s gonna be all sugars uh – not just uh – glucose. So that’s –that’s interesting. Coz if we do have some more sugars in the __ than glucose. It’s something called Fructosamine.

Dr. Justin Marchegiani: Fructosamine. 10-day window. Yup.

Dr. Robert Rakowski: And uh – uh – uh yeah. That’s a nice test. So quicker response for sure than A1C.

Dr. Justin Marchegiani: Great. Now I see a lot of patients that have higher A1C’s and all the other markers look good. Do you ever get false positives or just false high readings on the A1C but everything else looks on the better side?

Dr. Robert Rakowski: Not typically. But it can happen and – and so, you got to remember they don’t need value and Physiology behaves on bell shaped curves.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: So for instance, when cholesterol’s gonna elevate, that’s a functional__. Actually the uh – the glucose or the insulin is driving HMG-CoA reductase.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: Which by the way is what__

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: So that elevates cholesterol.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: It also impacts cholesteryl ester transfer protein converts HDL to triglycerides. But if those mechanism fail, those numbers can work normally. Even pretty decent or close to ideal – but being on a failure aspect. So, bell shape curves, values rise then fall like insulin, right? We can have a perfect insulin with a perfect blood sugar. Or our insulin rises, rises, rises until our pancreas fail so if we can’t keep up then it falls, falls, falls, falls. So two spots that insulin can be perfect.

Dr. Justin Marchegiani: Yeah. Very good. And that’s the issue, I think – That’s the issue really bankrupting healthcare today. I mean I Think I’ve read that the average diabetic with blood sugar issues, they’re spending $2-3 million managing the disease and it’s – it’s really interesting because in conventional healthcare, there’s like disease management, right? And then with us there’s root cause management. We’re actually getting to the root cause. As we chip away the root cause, we’re actually fixing the underlying issue. Can you talk more about that?

Dr. Robert Rakowski: Well, let’s talk about the cause issue first.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Diabetes is the most expensive problem.

Dr. Justin Marchegiani: Huge.

Dr. Robert Rakowski: And the sick care system. That healthcare – system is sick – their expense on diabetes. And so we do live in a universe of cause and effect. So what did you do that created this challenge? People are sitting on the couch, people are eating chips, drinking Coca-Cola, not making good dietary choices. They don’t eat right, think right, move right, sleep right, poop right or talk right. And they wonder, “Gee, I wonder how I got sick?” Yeah. And doctors will monitor them and then, Well – you know, I think a good doctor would say, “We’re not starting to get out of hand here.” You know, do something a little healthier. Like if they ask them, “Can you be more specific about that?” “Well, sorry I wasn’t trained for that, you know. Maybe go see the dietician. And I haven’t ___In hospitals my diabetic patients peak up high for dessert, you know. So uhm – you really need to go to someone trained natural if you want natural advice. If you want drug advice, go to someone trained in drugs.

Dr. Justin Marchegiani: Yeah. Absolutely. I mean I always tell my patients, “When was the last time you had a good meal in the hospital?” I mean, my god, like never.

Dr. Robert Rakowski: Uh-hmm. Good point, right?

Dr. Justin Marchegiani: Yeah. Absolutely. Now you build your reputation over the last 20-30 years really working with high-end individuals, professional athletes, and then you can name the gamut of the whole field, Yao Ming, and I could think of many off the bat. But working with these guys, what’s – I mean there’s probably some commonalities that you are using, or your addressing with these high-level athletes that you’re also addressing maybe with your – you know, average day person that’s looking to improve their performance? What are those – Let’s say the top three that you can take from the professionals and extract that information for the average Joe’s?

Dr. Robert Rakowski: The big three. From the sickest to the sick and the best of the best. And that’s stress, toxins, and malnutrition. So I think any of these – how are these high level athletes stress? Well there is a performance stress, there’s a recovery stress, there’s a lack of sleep stress. My favourite stress protocol that I use over the last 5 years with a lot  of success even with lab markers is using melatonin, 1-3 milligrams.

Dr. Justin Marchegiani: Wow!

Dr. Robert Rakowski: Every waking hour. We now know that melatonin actually binds to the adrenal cortex and blocks the pituitary gland or at least buffers the pituitary cortisol. And uh – by the way, the gut makes 400x melatanonin as the brain. That’s a proven fact. So it’s not –

Dr. Justin Marchegiani: Right.

Dr. Robert Rakowski: It’s not like the melatonin crosses the blood-brain barrier. Detox – number one thing is you know, keep yourself away from toxins. So create a clean environment. Put clean clothes in your body, clean water in your body. Then you do some medical food based detox –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Which is really, really solid. Now we start looking at malnutrition. You know, I’ve created my own food pyramid. Now they have the plate out there which is no good at all based on how they have it.

Dr. Justin Marchegiani: Terrible.

Dr. Robert Rakowski: But based only the food pyramid, guess what? There can be food and whole natural clean healthy foods. And we’re gonna have super foods and there’s a number of those with super nature in density. And then I actually have medical foods, functional foods. And then to top that off, we have multivitamin Omega 3’s, probiotics, and vitamin D. And by the way, sicker people, they need a lot more of each of those things but you’re gonna have the best of the best in people that are fighting for their life.

Dr. Justin Marchegiani: It’s really interesting that some of the foundational information that we review everyday with average patients, these are some of the things that professional athletes aren’t even doing themselves. I remember a talk that Paul Chek gave maybe a decade ago. And he talked about being in the New York Giants uh wait room. And there was like Doritos and all this crap everywhere. And for some reason they had to do it because of the sponsorship. I just couldn’t believe it. Uhm, I remem – I recall I’m a big fan – I’m from Boston area, so a big fan of Tom Brady. I know they beat the Texans last month. So maybe a little hard feeling there. Uhm, But –

Dr. Robert Rakowski: They beat everybody last month.

Dr. Justin Marchegiani. They beat everyone. Yes, so- But Brady is the functional medicine guru, right? I mean, he told – his records say in 2008 when he had his ACL injury, that he actually got better from that. That he avoided the standard of care rehab life. He saw uh – people like yourself, get the nutrition dialled in. I mean basically eats uh – alkaline, Paleo diet. 20% meat, lots of veggies, avoids nitrates,10 hours of sleep at night, all of the high-quality supplements. And this guy is getting better 40 Years into it. At age 40 – What’s your take? Coz I think most athletes aren’t even doing these things and some are. And you’ve seen the ones that are thriving.

Dr. Robert Rakowski: Now you – you – This thing is if you master the basics yourself, you don’t need anything else.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And I literally got that sick when promoting my real champion Kung Fu guys. But uhm – and then we’re going, “Okay, well how are you doing on the basics?” “Tell me about your diet.” “Well, it sucks, you know.” “How are you doing on your sleep?” “Well, that sucks.” “What do you drink?” “Well, that sucks.” Right. And so we’re just talking with this very very basics and you realise that the best of the best, if they sleep better, they’re gonna perform better. Quick study with the US Military, they found out that when a military gets less than 6 hours of sleep for 6 straight nights, they functioned on a level as if they’re legally drunk. So – so just imagine that, right?

Dr. Justin Marchegiani: Six hours of sleep for six months?

Dr. Robert Rakowski: Six hours for six straight nights. No, not six months, just for a week, right? And then so – do we want drunks walking with high-powered weapons? You know, that’s not a good idea. Uh – and so your cognition drops, your coordination drops, reaction time drops. All these things drop, so – When we started swinging that to the athletes – In Stanford, they had an interesting study. They just had their tennis team stay in bed an extra two hours a day. 10 hours a day within 2 weeks time, they have 17% improved performance on first serve. So sleep has been –

Dr. Justin Marchegiani: Wow!

Dr. Robert Rakowski: Our – our athletes, they’re blessed in so many ways, but yeah, they’re still misinformed like the general population.

Dr. Justin Marchegiani: Oh, absolutely. Especially the fact they’re putting wear and tear on their body so they’re breaking down their ligaments, their tendons, their joints, their tissues. And an old expression – I can’t remember who said it first, but – “You can’t make chicken salad on a chicken shit.” So –

Dr. Robert Rakowski: There you go.

Dr. Justin Marchegiani: If you have the poor quality nutrition coming in, the tendons – all those raw material and building blocks get downgraded each time. And eventually that means more time on the DL and you lose a step, then you’re out of the league, right?

Dr. Robert Rakowski: That’s exactly right. I look at Emman Smith, you know. And – and he was one of my favourite running backs and some people my age will remember him as well. But, you know – one step he went from the best of the game to barely in the game. He lost two games – two steps and he’s out of the game. Uh, but how long can you keep that well? Like you said, Tom Brady is a great example, but others pitcher and way back Satchel Paige.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And I don’t even know how old he was when he was pitching. But he seem to be absolutely timeless. You know, Gordie Howe, the hockey player played – I believe professional hockey in six different decades.

Dr. Justin Marchegiani: Wow!

Dr. Robert Rakowski: I mean how in the world do you do that? Well, one, back then, there’s certainly a lot that are food quality.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: So, uh – pretty remarkable stuff that in today’s environment, goodluck getting good quality food. It’s just harder and harder coz our animals are malnourished and toxic. So when you do supplement – across the border, we need a supplement.

Dr. Justin Marchegiani: Love it. Totally makes sense. I remember Julio Franco the old uh – I think he was uh – outfielder I think from the Cleveland Indians. But he played into his mid-40s. And even – even Nolan Ryan from the uh – Texas Rangers. I mean he played into his mid-40s. Julio Franco – I remember reading articles of him. He had pre-made organic food uh – brought to the ballpark and everyone would look at him eating his own they’re like looking at him like he’s crazy. But the guy played 26 years in major leagues.

Dr. Robert Rakowski: Yeah. Well you look at my athletes that have had longevity, they all got early on that nutrition is important.

Dr. Justin Marchegiani: Yeah. I love it. And what are the most – I mean maybe this is gonna be individual, I know it is. But are there typical muscle imbalances where certain muscles aren’t turned on appropriately that you’re seeing across the board in some of these athletes?

Dr. Robert Rakowski: Well, let’s just go into general population.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: ____ In Geology, there’s something Specific Adaptation__ So we sit longer, we get better at sitting. So –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: You know it starts pulling our lumbar spine into lordosis. Our spine compensates, we get forward leaning posture. Uh – you know, most of us have our shoulders drawn up, rather than down and back like they should be.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And there’s a number of imbalances. But literally the imbalances seem universal in our society. And its’ gonna be the – the – the – like what I just described__with shortened hip flexors. So when you do –

Dr. Justin Marchegiani: And that creates reciprocal inhibition with the glutes. So then your hip extension, you’re gonna be utilizing the lower back versus hip extension for the glutes. So then you get lower back pain, right?

Dr. Robert Rakowski: Yeah. I mean, by the way, you’re gonna lose a step or two or three if your glutes aren’t firing, right? That’s the most __ on a solid splint is that glute causing that hip extension, so – Yeah.

Dr. Justin Marchegiani: Absolutely.

Dr. Robert Rakowski: That’s uh– across the board, super important.

Dr. Justin Marchegiani: One of my biggest 2 investments that I made in the last two years is I got a stand desk that can go up and down. And I also got a walking treadmill that could slide under the desk. So when I see patients virtually, like we’re talking on Skype now, I literally  walk 12 miles a day, 60 miles a week while seeing patients.

Dr. Robert Rakowski: Man, that’s awesome.

Dr. Justin Marchegiani: And isn’t that great? It’s amazing.

Dr. Robert Rakowski: And why these companies don’t introduce what treadmill does? You know, I read a book called, Drop Dead Healthy, years ago.

Dr. Justin Marchegiani: Oh, yup.

Dr. Robert Rakowski: It was a writer from New York magazine. And one of his tips was, “Hey, if I’m gonna sit around and write all day, why don’t I just get a standing desk with a treadmill?” And he’d walk 1.5 miles per hour with a 3% incline.

Dr. Justin Marchegiani: That’s what I do.

Dr. Robert Rakowski: And just type away and had his work and sure enough, burn calories to get healthy. Fire the muscles, stay young and get – and be productive at the same time.

Dr. Justin Marchegiani: Love it. Makes sense. You did a YouTube video, I think it was a Facebook video, uhmm maybe a year or two ago. And you touched upon the MMR Vaccine. I was just kinda curious kinda what your thoughts in – in general? I mean we can touch upon it here, but you brought up – you know, when you speak from it, you’re talking about actual peer-reviewed research. That’s why I love it. It’s not a lot of emotion behind it. What’s your take on that? And what are some of the most recent studies you’re seeing about the MMR? Just vaccinations in general?

Dr. Robert Rakowski: Well, luckily the conversation is coming into the light.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And when you walk at the data right out of CDC you’ll find out that death rate from infectious disease drop 91% –

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: From basically you know, 1900 to 1964 when they started this – started the mass vaccinations. And it hasn’t gone down even a bit. And so – is there justification for some vaccines? Maybe for some kids but certainly not 76 before the age of 6. Uhm – when you look at the child’s immune system, it’s not really fully functional until the age 2. And so they generally are not gonna respond to vaccines. So if you’re injecting a new born with toxins that their immune system isn’t gonna respond to, how can you have anything but a downside to it? So I’m just very much for people making an educated choice. So let’s just look at education for a moment. Guess who does not vaccinate their children? They found out it was people in the highest income quartet, right? The highest IQ, right? And – and therefore, whether we think rich, smart people don’t love their kids –

Dr. Justin Marchegiani: Exactly.

Dr. Robert Rakowski: And the answer is no, they love them enough to look into what’s going their bodies and say, “Hey, something’s not right in this picture.”

Dr. Justin Marchegiani: Yeah. And I totally agree. And if you You look at the World Health Organization info mortality rate, we’re at number 40 just behind Cuba. And if you look at some of the Scandinavian countries that are in top 10, they’ve done some epidemiological studies looking at the trend vaccinations versus the mortality rate. And in- in like Finland, Norway those type of countries only have about 10 Vaccinations in for kids for the first I think 4-5 years, where we have 40 to 50. So these countries are top 10 and they have 75% less vaccinations. So they obviously know something different than we know, right?

Dr. Robert Rakowski: I think they’re not as swayed by money.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: As our government. So by the way, the top lobby of our US government. Number one is gonna be the NRA, number two, pharmaceuticals.

Dr. Justin Marchegiani: Yeah. Interesting.

Dr. Robert Rakowski: So – pretty basic. Yeah.

Dr. Justin Marchegiani: And people also forget, too. The uh – the CDC, I think, make $68 billion dollars a year of off vaccine patent. So there’s a little bit of a conflict of interest there. Also, uhm – you talked about this, too. It’s interesting. In one of your lectures a few years back, you talked about the uh – the Hannah Poling issue. Hannah Poling was vaccine injured. Interesting enough, her father was a neurologist, her mom was a lawyer. So she had pretty good representation in the vaccine courts. One of things that came out of there, I think she had autism and they said that she had autism because she had a potential mitochondrial defect. And very interesting because if the government is admitting that there is potential autism from mitochondrial defects, are we screening mitochondrial defects? How do we even know it? So it’s interesting that that’s out there but we’re not even screening for that. Any take the mitochondrial defect aspect?

Dr. Robert Rakowski: I believe that the stats are just about the exact same challenge that she has. It’s about 1 in 50. But you have to remember that she was developing perfectly normally uh- and now, all of a sudden there’s boom extreme dose of toxins causing extreme brain inflammation uh in – by the way, the brain is the most energy dependent system in the body. So part of that spiralled her into a downward spiral. But to the point that the mitochondria alone is – is blatantly broad.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: Uh – uh and so, you know–

Dr. Justin Marchegiani: Right.

Dr. Robert Rakowski: Plenty of these kids that are gonna have mitochondrial problems are more likely to be injured by the vaccine but it’s not a prerequisite to have a vaccine injury.

Dr. Justin Marchegiani: Now, exactly. Yeah.Totally agree. Any other thoughts on that? Any other comments or research articles that you’re coming up?

Dr. Robert Rakowski: Oh, boy. You know, so – So Hannah got a $20 million settlement.

Dr. Justin Marchegiani: Phew!

Dr. Robert Rakowski: And what’s pretty fascinating is – is Sanjay Gupta –

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: Interviewed Julie Gerberding who was the head of the CDC at the time. And she never answered any question directly. And she just basically said, “You know what, very rare case. Parents, whatever you do, please make sure you go out and make sure your kids get their vaccines.” And after that, after she retired from CDC, she got some –

Dr. Justin Marchegiani: Merck.

Dr. Robert Rakowski: mega contract to be a spokesman for a bright and major drug company –

Dr. Justin Marchegiani: Merck. She’s the head of vaccine research of Merck.

Dr. Robert Rakowski: Absolutely insane, right? So uhm – you know I’d like to hope that somehow, someway in their grey matter they’ve really think that this is a good service for humankind. But oh my gosh, there’s plenty of educated people who’d argue with that. So what’s the stance? I think everybody should get educated.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Everybody should get the right decision and have the freedom to make the right decision for their child.

Dr. Justin Marchegiani: And I don’t personally think vaccines cause autism. It can’t be causal because  it would be a one-to-one relationship. Everyone that got a vaccine, would have autism. But we know there’s definitely stressors out there. GMO’s, heavy metals, whether it’s- forget mercury. It could be aluminium, it could be phthalates, it could be squalenes. It could be other compounds. It could just be antigenic load from too many at once. Uh – leaky gut, uh – babies not being breastfed, right? All these different stressors could add up and make someone more susceptible. What are your thoughts on that?

Dr. Robert Rakowski: I agree with you. You know, but let’s take it a step further. Let’s look at risk-benefit always. I mean, look at the risks of these diseases, it’s relatively minor in the population right now. You know, my kids all got the chickenpox. And –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: You know, none of that – it never lasted more than more than – more than five days. My son got the whooping cough. He beat it and got a lifetime immunity. I had a kid come into my clinic that actually have Rubella. And so found out, I took him home to play with my kids. My kids never got sick. You know, but uh – you know, whether you’re exposed or not, at least there’s a possibility that you can’t beat a natural immunity and a healthy body. And the data is really questionable. What is the risk-benefit? I think for healthy kids, especially the way it’s going right now, it’s more on the side of the risk then benefit.

Dr. Justin Marchegiani: Yeah. That totally makes sense. Uh looking at all the things that are happening to your clinic, is there any new things that you’re delving into clinically right now?

Dr. Robert Rakowski: Uh – Well, there’s the statement there. There is nothing new under the sun, right?

Dr. Justin Marchegiani: Yeah. Fundamentals.

Dr. Robert Rakowski: We always get better, stronger, faster, smarter at what we do, but like you said, the fundamentals. How many people have really mastered the fundamentals? And not many, right? And even if they have, they’re coming in saying, “I’m totally awesome. I feel lots of the charts are amazing. Do you think you can – game up a little bit more?” Uh, so it’s hard to beat the fundamentals, you know. Everybody always wants to come up with a shiny new penny. But reality is you can’t beat good, clean, healthy living. And – and you highlight it. There’s a lot in the basin –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And just focus and discipline and then the magnificent seven.

Dr. Justin Marchegiani: Totally makes sense. And what are the foundational lab testing – I mean, obviously we know you’re drinking clean water, eating organic food, you’re doing all that good stuff, your sleep is probably dialled in, you’re exercise is dialled in. What are the more nuanced things you’re doing right now to assess your health? Lab tests or uh – treatments? What’s happening in your neck of the woods?

Dr. Robert Rakowski: You know, in terms of real subtle things, we’ve been doing this for decades at this point. The pH Balance –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Probably doesn’t get enough press for being so critical. So I always tell patients every single enzyme in our bodies is pH dependent. You know our hormone’s pH dependent. And as we look across the board, we see the sickest people have the worst acid- alkaline balance. Their buffering is actually terrible. Uh – and so how do we buffer it? We buffer it with good elimination, good detoxification.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: High Levels of – of nutrients, quality food choices – But I think pH is one of those markers that we need to spend more time pursuing.

Dr. Justin Marchegiani: Interesting. And how much this diet and food uhm – affect pH? I know we’ve talked about this before. A lot of people say, “Well, we cut out meat.” but then we know that grains are actually 10x more acidic than meat as well. And we know that inflammation plays a huge role on that. What’s your take?

Dr. Robert Rakowski: Well, we have to understand that every process that we have that makes energy, makes acid.

Dr. Justin Marchegiani: Yes.

Dr. Robert Rakowski: So as I explained to doctors and the patients as well, oxygen goes into the cell, product comes out, converts oxide and the one in the blood can form carbonic acid.

Dr. Justin Marchegiani: Carbonic acid. Yeah.

Dr. Robert Rakowski: A hundred trillion cells doing – a trillion times a day. So as we start looking at this process, the Pharmacology Journal say this – They say, “Look, how much acid you eat a day? Maybe a 100 units.” “How many do you produce by living? Probably 15,000 units.” So we have at least a dozen different buffers against acid inside the cell and outside the cell. So we got proteins, we got phosphates, we got minerals, we got bicarbonate buffer. And all our elimination routes get rid of acid. So uh – as I tell patients who contributes very little to acid burden, but it’s basically what makes up our acid buffers. So we wanna make good choices.

Dr. Justin Marchegiani: So what you’re saying is adding the inflammatory foods in there will increase the acid but making sure nutrient rich, lots of greens, lots of rich minerals, magnesium potassium. Those things are gonna help buffer a lot of the – out. A lot of the acidity.

Dr. Robert Rakowski: Well said. Yeah. That’s exactly right.

Dr. Justin Marchegiani: What other lifestyle things are creating more of an acid environment?

Dr. Robert Rakowski: Stress.

Dr. Justin Marchegiani: Yeah. So just emotional stress, physical stress. Yeah.

Dr. Robert Rakowski: All of the above. When you’re- you’re running on a fight or flight mode, understand that the first organ that’s affected is the liver. The second organ that’s affected is the kidney. The third affected organ that’s affected is the brain. Higher-level cognition drops. And so we might not necessarily be a fight or flight circumstance but if we’re sitting under a light of a blue spectrum, where I got a nice screen in front of my computer house –

Dr. Justin Marchegiani: Nice.

Dr. Robert Rakowski: We have a blue blocker app.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: That it’s – it’s actually blocking the blue light. But I’m being bombarded with blue light. My melatonin’s suppressed, my cortisol’s high. I – I basically am not controlling my stress hormones. I’m inflamed and I’m in trouble, so. Several strategies like that. Modern life creates modern challenges and we’re just beginning to see. Wow, okay they made it so this stuff has a real downside to it. We need to deal with it.

Dr. Justin Marchegiani: So a lot of people may justify a vegetarian-vegan diet because of this acid-alkaline theory. So, you know, looking at a pH chat of food and only choosing foods that are seven or above. You- you’re okay choosing some foods on the acidic side, like high quality, clean lean full fat meats that are good quality, etc.?

Dr. Robert Rakowski: We are omnivores.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: I mean, we have canines.

Dr. Justin Marchegiani: Yeah. Incisors –

Dr. Robert Rakowski: For the purpose of tearing meats, right? So –

Dr. Justin Marchegiani: When you look at the fact there’s certain things we absolutely can’t get from plant based diet. We can’t get B12.

Dr. Justin Marchegiani: Right.

Dr. Robert Rakowski: And as a general rule, we don’t get high enough quality protein and we don’t get  bioavailable iron. So there’s a number of factors that come in. We just wanna make  smart food choices. Predominantly plant is good, you know. You know that’s a real good rule. Michael Pollan who work on the book, “In defense of Food” –

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: His top rule is eat food not too much, mostly plants.

Dr. Justin Marchegiani: Mostly plants –

Dr. Robert Rakowski: That’s really solid advice.

Dr. Justin Marchegiani: I mean look at Tom Brady. He’s a big acid-alkaline guy. 80% vegetables, 20% meat. I think that’s a pretty good way to go for a lot of people.

Dr. Robert Rakowski: Yeah. And you look at his body mass, right? And his – his exercise burden. If that’s good enough to keep him in shape, why wouldn’t it be good for the rest of us?

Dr. Justin Marchegiani: And what’s your take on vegan or vegetarian people that are excelling in professional sports? You work a lot with these people. I know there are people out there that say it. My theory is they have to be doing a whole bunch of pea protein or hemp or rice protein. Something to get the extra aminos in there. What’s your take?

Dr. Robert Rakowski: Well, they are. Certainly if they’re seeing meats. We can manage mind to the lean tissue breakdown but there are also supplement branch in amino acids, they’re doing B12 injections. So, uhm – you know, there’s a way but it takes a lot of effort. And a lot of supplementation on a vegetarian based diet.

Dr. Justin Marchegiani: Yeah. Plus you don’t get the rich sulfur amino acid the 12 that run those glutathione detox pathways, too.

Dr. Robert Rakowski: Absolutely. They can get some in cruciferous vegetables but it’s certainly a higher concentration in meats.

Dr. Justin Marchegiani: Plus I noticed too, you have to really combine your, you know, rice and beans for instance. You really have to combine your proteins well because there are some deficiency in methionine and lysine which are really important for let’s say producing carnitine. Run the carnitine to burn fat for fuel. So you really got to combine things well. But if you look at, let’s say, rice and beans, you know,15 g of protein to 75 g of carbohydrate. People that are maybe insulin resistant, that may be a little bit too high in the carb side.

Dr. Robert Rakowski: I’m with you on that. You know, I mean people – we only need to find a diet that works and we need to find a diet that makes sense. And for the most part to me, the  vegetarian diet doesn’t make sense for too many people.

Dr. Justin Marchegiani: Got it. That makes sense. So just looking at kinda like your pre and post workout, you know, set ups with your professional athletes. What does that look like? So you get them ready for the workout. Are they doing a shake before? Are they doing something during? What are they doing afterwards to recover? And what do you recommend supplement-wise pre and post?

Dr. Robert Rakowski: Well I did train them more than—and there’s a before training and after that’s required. So there’s plenty of data just depends on what kind of training. But branch and amino acids help maintain the lean mass.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: The electrolytes, the fluids, and all that.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: He’s not gonna eat a meal. You know, meal is gonna take a lot more time to digest than uh – shake. And so I usually want them to eat a minimum of 2 and a half hours    in front of an intense Workout. So it’s at least well digested. And that should be not a super heavy meal, right?

Dr. Justin Marchegiani: Yes. Coz if it’s – once in the stomach, it’s not gonna get to the extremities or if you’re still eating, your digestion is gonna be compromised. So I really like a prework out shake, a post work out shake and something simple during training. Nothing’s gonna tax the digestive system. Pre form amino acids, branch and amino acids, electrolytes and fluids during the training.

Dr. Justin Marchegiani: Typically, with the electrolytes, will there be a little bit of a glucose or fructose with that?

Dr. Robert Rakowski: I do. I do some fructose. Now we’re looking at these athletes that need fluid replacement and electrolyte replacement. They’re training plenty hard. Fructose has ¼ the glycemic index of glucose. With that said, post workout, for certain athletes, there’s a benefit. Actually spiking insulin, lower cortisol.

Dr. Justin Marchegiani: Lower cortisol, yeah. Bingo. Makes sense. Are you using a product like with the Endura, with the electrolytes and with the extra fructose?

Dr. Robert Rakowski: Yeah. So I – I use a couple of different products. One is Endura and we’ve got a product called, Dynamic Fruits and Greens, which is a powder based of 20 different organic super foods, so. Taste good, goes down good, and certainly works good.

Dr. Justin Marchegiani: Excellent. It’s very, very cool. So are there any challenging cases that have come into your office at all recently?

Dr. Robert Rakowski: Yeah. Everybody has their own unique challenge. Uh – you know, probably the most recent real earth-shattering cases, I have one that it was probably somewhere you like to describe when you go to the foot to be amputated.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Uh, she was – she was scheduled for an amputation. The first thing I saw was a picture. I never cover the foot of just a few days. So I added a dose every single waking hour to kill infection to re-enhance uh – circulation to control the control the blood sugar. I would say two weeks she had a tremendous shift in the color of her blood-

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: A lot of gangrene started to recede. Uhm – we got pictures of the entire process.

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: But literally, she did auto like a tips –

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Uh for the toes a lot. But she kept the rest of the foot fully functional. But what’s better about that case is, at first she was taking a mega dose of insulin and half a dozen drugs, and they were all failing. By the time we were done with her, she was taking just the lowest dose of insulin since her diagnosis is you know, since childhood age, she was diabetic. And the no other drugs and really the tissue help up the entire body improve dramatically.

Dr. Justin Marchegiani: Wow. Amazing. I know you mentioned earlier but taking mega doses are you know, higher amounts of melatonin to help increase uh – antioxidants and such. Uh, tell me about the feedback loop. Do you feel like taking that much in for how long – will that affect the feedback loop of the, you know, gland talking and making melatonin?

Dr. Robert Rakowski: It’s highly improbable.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: That the melatonin cross the blood brain barrier. So the Gas – World Journal of Gastroenterology shows that the gut makes 400x times melatonin as the brain. The gut also makes the majority of the serotonin so that’s – that’s nothing new to people who have been studying that. So it’s unlikely that it will cross the blood-brain barrier. And what – the reason I believe is number one, sleep nutrient, is because it puts the break on cortisol. But I only do that for 7 to 10 days.

Dr. Justin Marchegiani: Because I have ___ and maybe a person’s own production could become altered. So we do it to have a quick shift in the metabolism memory__So I haven’t seen any that’s had challenged it. And on the flipside of that, I’ve seen plenty of people that have been feeling better than they have in decades doing that for a short period of time.

Dr. Justin Marchegiani: And when you recommend hydrochloric acid to your patients, do you feel like giving hydrochloric acid affects the feedback loop at all with gastrin and HCL production in general?

Dr. Robert Rakowski: Certainly can.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: So what we’re gonna do is, we do a hydrochloric acid challenge.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: Which is actually defined by Jonathan Wright –

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: Over 25 years ago. But basically, when people eat their meal, they’re gonna try supplementing with hydrochloric acid coz if they have a burning in their gut, they probably don’t need it. That’s too much HCl.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: Uh they should really have a nice warming sensation, uh –but most people wouldn’t get that. And so what we do is we have to do it after the meal so the body is gonna release whatever they’re gonna release. Then as we start enhancing the digestion to the proteins, the minerals, and to the essential nutrients, the body can be more effective at producing the HCl. Uhm but– you know, we don’t want people to__

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: The guideline is the lowest dose for the shortest duration. So as soon as they can start titrating down their own dose, uh- and by the way, let’s say, you start taking uh- let’s say, 4 hydrochloric acid tabs.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And you have to do that for a few weeks. Also, and 4 creates a little uncomfortable sensation. Guess what? For now, 3 ½ for 3 and then ultimately, we’d like people to be able to wean off it a little bit.

Dr. Justin Marchegiani: Yeah. That’s really good general idea. And regarding enzymes, do you like taking enzymes before, during or after a meal?

Dr. Robert Rakowski: It’s gonna do different things.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Robert Rakowski: And so enzymes away from food, there’s actually a specialized supplement in the gut called an M cell. And the M is for macromolecules. And in a pediatric gut, new born infant section has a ton of those cells. And by the way, when you look at mother’s milk, it has immunoglobulins in it.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: That’s passive immunity.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And the only way that it can get to the infant system is by being absorbed intact so they have a higher concentration in each cell. So we all have the ability to absorb certain macromolecules intact. If you take enzymes away from food, it have a number of systemic benefits. Take it with food, I always tell people it digest food. But away from food, it digests into the system like scar tissue, like infection. And there’s even date suggesting that it’s anti- cancer.

Dr. Justin Marchegiani: Yeah. The serrapeptidase enteric coated enzymes work phenomenal. I used a company about called World Nutrition. They do really good pepsin. Great research on dissolving cancer and such as well, tumors, too.

Dr. Robert Rakowski: It’s fascinating. You know the book, “Wellness against all Odds” Started 30 cancer patients off of being cancer with nothing but actual remedies. One of the things they did was natural enzymes and pancreatic enzymes.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Nicholas Gonzalez.

Dr. Justin Marchegiani: Gonzalez – has passed.

Dr. Robert Rakowski: I had a few years ago, last year.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Last year.

Dr. Justin Marchegiani: Last July.

Dr. Robert Rakowski: He published the longest survivability of non-operable pancreatic cancer patients.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And the only intervention was pancreatic enzymes. So it’s something we need to dive into and look at.

Dr. Justin Marchegiani: I think it’s excellent. Yeah. And you have quite a bit of experience dealing with cancer patient. I know we can do a whole podcast on this. But what are the low hanging fruits dealing with cancer patients? I think you already mentioned the ketogenic diet. So you may – you may add that in there. But what are the top three things that your – we should be listening to or focusing on with cancer?

Dr. Robert Rakowski: Well, you started out right with ketogenic diets.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: We actually did a rat study within a ketogenic diet and I think the exact statistic was it was something like 50, 58, or 59% longer than people who did not eat ketogenic.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: The second thing is gonna be tons – by the way, the entire diet should be organic. But –

Dr. Justin Marchegiani: Of course.

Dr. Robert Rakowski: fruits and vegetables. So-

Dr. Justin Marchegiani: Tons –

Dr. Robert Rakowski: Study goes way back but people that eat the least fruits and vegetables get most cancers than those eating the least. I mean, here’s one that people may not think about, but again, in the book, “Wellness Against All Odds”, daily coffee –

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: Everyone of this patients did that.  And that’s a great way to get the liver dump bile and toxins.

Dr. Justin Marchegiani: Yup. I know you have a little slogan here –

Dr. Robert Rakowski: And if we go –

Dr. Justin Marchegiani: Go ahead.

Dr. Robert Rakowski: Uh – I was gonna say if I tell them one more-

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: But since we’re on the topic of melatonin, National Cancer Institute, talked about mega doses of melatonin at bedtime, 40-50 mg.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: And these patients that have inoperable cancer, live longer with less tissue breakdown. So I think what you’re going with is not by jingle but savaging that live jingle.

Dr. Justin Marchegiani: Yes.

Dr. Robert Rakowski: Way back when 20 years ago, there was a jingle that was the best part of waking up was Folgers in your cup.

Dr. Justin Marchegiani: Yes. Let’s hear it.

Dr. Robert Rakowski: Now the best part of waking up is Folgers in your butt.

Dr. Justin Marchegiani: Yes, I love it.

Dr. Robert Rakowski: But we certainly have better coffee choices, right? We like organic coffee and –

Dr. Justin Marchegiani: Of course.

Dr. Robert Rakowski: But the top super food that is real nice for drinking and detoxing, if that’s how you wanna use it.

Dr. Justin Marchegiani: Yeah. Everytime I see a Folgers commercial now I flashback in to you in seminar, singing that jingle there. So –

Dr. Robert Rakowski: Yeah.

Dr. Justin Marchegiani: Love it. Very cool. So we have ketogenic diet, we have uhm –coffee enemas, obviously the organic greens, organic diet. Anything else? Any other low hanging fruit?

Dr. Robert Rakowski: Well, you have to look at stress management.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: So –

Dr. Justin Marchegiani: Sleep, too.

Dr. Robert Rakowski: The top two enemies of the immune system are gonna be stress and sugar. And  then you threw in sleep in there. You wanna get good sleep. But the first immune cell that drops in a high stress response is a natural killer cell. So daily meditation, visualization. These are things that are proven to have anti-ageing, anti-cancer, certainly long__

Dr. Justin Marchegiani: Yeah. I think the World Health Organisation put shift work. You know, essentially not sleeping when it’s dark out in the same category, in the same cancer category as asbestos and cigarettes smoking. So we know, you know, it’s a non-substance carcinogen.

Dr. Robert Rakowski: I don’t really know why it’s even legal to still do that, you know.

Dr. Justin Marchegiani: I understand that some people need to work the night shift, work the night shift. The idea of shifting your clock so frequently is just so harsh and you’re right. The data is overwhelming. Nobody should do it. It’s toxic on every level to the body.

Dr. Justin Marchegiani: And it’s funny, too, because the people you think of with shift work, you think of doctors and residency, right? The ones that are standing up all night, ER docs, people that are on-call. The people that are supposed to be promoting health will actually making them the sickest. And I think there’s statistics that the average MD lives 10 years less than their average patient.

Dr. Robert Rakowski: Years ago, there was a special on TV – on Youtube uh –and Impaired-

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: And they found out that among all the professions that the medical doctors have some of the highest risk of drug and alcohol dependents, uh – clinical depression.

Dr. Justin Marchegiani: Yup.

Dr. Robert Rakowski: So we gotta take care. These are good people. They’re not in the good system but I hope they got involve to help people. Hey, emergency medicine is great. If you need medicine, medicine is great. But listen, we don’t need to be drugging every man, woman and child for every made up malady on planet earth.

Dr. Justin Marchegiani: Absolutely.

Dr. Bog: It’s just crazy.

Dr. Justin Marchegiani: Absolutely. Absolutely. I had a conversation with Paediatric Oncologist over the weekend. And we’re talking about ketogenic diets and we’re talking about sugar. And one of the most interesting things is oncology – there’s very little nutrition given about cancer. I mean I’ve had many patients seen on-call and they’re like, “No, diet has no implication in it.” And they’ll even don’t take your antioxidants, don’t take your vitamin C, don’t take your curcumin for tumor while we’re doing treatment. So that – that’s always very irritating. But the test that they use to look at cancer, the PET scan, right? Uh Positive Emission Tomography. What the test is, it’s basically giving someone some radioactive glucose. And seeing where that glucose goes because the cancer cells are soaking it up. So we know that we’re using these testing to test in conventional medicine to see where the tumor is going. So essentially we’re feeding it during the test so we can get a radiograph picture. But we’re not even telling people to not eat the foods that’s feeding the cancer in the PET scan got begin with.

Dr. Robert Rakowski: Complete and total disconnect, you know.

Dr. Justin Marchegiani: Total.

Dr. Robert Rakowski: It is uh – cancer cell takes up glucose at about 10x the rate of every other tissue in the body. So, yeah. You nail it right on the head. You know, when you explain it to patients as we just have, they get it. And you know, I got a friend right now who’s finishing  Osteopathic- college. Just an absolutely amazing guy. And he always tells me, he says, “Bob, a big part of education is education against natural medicine.” You know, and a lot of people buy it. But lie in sinker. And that’s why we’re such a sick nation and we started a trillion dollars on sick care.

Dr. Justin Marchegiani: Wow, love it. I mean you said it just so succinctly. Well, is there anything else Dr. Bob, on your mind that you wanted to bring to the listeners?

Dr. Robert Rakowski: You know, it’s always such a joy connecting with you. But I think we hit it pretty well. We don’t need the real extravagant about how we proceed with health. You know the basis of health is love, do what you love, love what you do.

Dr. Justin Marchegiani: Yeah.

Dr. Robert Rakowski: Love yourself, zealously inspect what you put everything in your body. Have a purpose. And in our environment, we need to have discipline. So I was just uh – I’ve read 6 books by Navy Seal in the last year.

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: And listened to a podcast by Navy Seal. But yes, it says “Discipline Is Freedom” you know, and – and so, one of our mentors said we all must suffer one-two pain. The pain of discipline or the pain of regret and disappointment. If we start living an undisciplined lifestyle, eating the garbage that’s stale, watching the garbage that’s on TV, drinking the garbage that they promote to us, guess what? Garbage in, garbage you will be. So uh- master the basics, be very, very careful about everything that you allow in your environment, especially bad TV. I think that’s been my one of my most recent personal discipline is no more TV for about four years and I don’t know that I’ve missed anything. I mean, no news, nothing like that. I haven’t missed anything that happened in the world. I heard we had a presidential elections.

Dr. Justin Marchegiani: Hahaha

Dr. Robert Rakowski: But I mean, seriously, right? How many of us really need to be immersed in the bad news every single day? It’s just crazy.

Dr. Justin Marchegiani: Totally makes sense. And it’s great that you are a physician that totally embodies health. Your practicing and promoting all of it. You’re telling to your patients yourself so you can be a shining example of that.

Dr. Robert Rakowski: Well, back at you. Uhm – when we talk about shining, it’s funny, I’ve been training mixed martial arts and some of my patients look to me, they said, “you get punched in the eye this weekend.” “No, I was playing basketball. We played six hours of basketball.

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: Went up for the board and flicked an elbow to the eye. I wish I had a better story than that. You know, but it’s fun playing basketball with my son who’s 23 and fit.

Dr. Justin Marchegiani: Wow.

Dr. Robert Rakowski: Playing with him for six hours, and everybody else, you know. It’s just – you know, healthy living has so many awards and rewards. I personally don’t understand how can somebody make a choice other than to maximise their wellness. Coz it’s a beautiful way to live longer around this planet and contribute.

Dr. Justin Marchegiani: Absolutely. And last question for you. If you’re stuck on a dessert island, and you only can bring one supplement, one herb, one whatever, what is it?

Dr. Robert Rakowski: Well you know, number one super food I’m planning to get is Ghanaian donuts. It’s got the full complement of vitamins, amino acids, proteins, carbohydrates, fats, fiber and water. I uh – and so-

Dr. Robert Rakowski: It’s considered to cause a sync in nutrition perfection. So that’s what I’m going with. But  let me go with my navy seal buddy. They said, Hey, if they drop you out in any of the world, and you can only have two things with you, whatever weapon, whatever you would take is I’m gonna need two things.  I need oxygen and I need water. And he says the Seals without oxygen, they realize they need it. They go without water, they realize they need it. You know what, guys like us, we can fend for ourselves just give us some air so our brain can work and give us some water so that we can function for about 5 days. Five days anywhere, we’re gonna be okay. We have enough savvy to find what we need to survive and make the world better.

Dr. Justin Marchegiani: Again, anyone that’s listening, thedrbob.com (T-H-E-D-R-B-O-B.com) Dr. Bob lectures to help professionals, physicians, nutritionists, nurses and he also has some excellent coffee in your website, too. I know you’re really big in the coffee that you mentioned as well. So feel free to check out Dr. Bob.  I think you’re also available for appointments worldwide as well?

Dr. Robert Rakowski: Yeah. You gotta love this technology, right? So I do Skype on occasion halfway around the world. We have to get our timing just right. Uh – I always prefer treating patients face-to-face just kinda face-to-face is okay. But I’d rather see them in person. But guess what? We got some pretty good successes across the planet. Just with a different eye looking at the data that they have.

Dr. Justin Marchegiani: Awesome, Dr. Bob. Thank you so much for what you do.

Dr. Robert Rakowski: I appreciate it. You always enjoy making the world better.

Dr. Justin Marchegiani: Thank You.



Nutrient density, eating local and grains – Podcast #120

Dr. Justin Marchegiani and Evan Brand discuss about nutrient density and the different benefits of going organic and local when it comes to produce. They explore the nutrients of juicing, how our body processes such nutrients and its effects on our health. 

Find out how sugar and insulin affects our body when it comes to burning fat. Discover other nutrient dense sources that are available in the market. Learn about grains, anti-nutrients found in plants and how they are related to gut issues facing some of us. Gain valuable information about organic food sources, how our body reacts to it and  how it affects our health.

In this episode, we cover:

4:00   Juicing and how it affects our bodies

11:18   Other nutrient dense sources

14:26   Anti-nutrients in plants

17:00   Grains and how it affects our bodies

25:18   Eating wheat







Evan Brand: Justin, how you doing?

Dr. Justin Marchegiani: Evan, doing great brother. How you doing today?

Evan Brand: I’m pretty. Well- hey, our audio quality assuming everything goes well should be increased by 200% on the listener side of things. So looking forward to that.

Dr. Justin Marchegiani: Absolutely. So if you guys are like in the better on audio quality let us know so we can keep doing it. If not, feedback’s always great.

Evan Brand: Yes sir. So you brought up nutrient density which I think is a good topic to discuss. Something that’s helpful, that a lot of people are promoting online purchasing of meats. There’s a lot of these different companies out there where people are buying subscriptions of this and that with their food, which is great. But to me when it comes to your produce and especially your meat, I’m a huge fan of going organic and local, not just organic or not just grass-fed. If you’re getting some subscription box of meat from California and you live in New York, yes it’s frozen, yes it’s probably still gonna retain a lot of its benefit but think of the carbon footprint you’re adding to transport that stuff via two-day air to get it to your house so that the ice doesn’t freeze. For example, so I mean just from a total overall ecological perspective, you’re probably could be much more, much more cost-effective and double more eco-friendly to go with a local organic source.

Dr. Justin Marchegiani: Well, absolutely. I mean it’s always better to shop local if you can. We also have to understand that there’s a convenience factor too, right.

So if it’s easier for me to get my fridge all stocked up with meat and have it cryovac and sealed that I can put in there actually access what I want, that’s great. If you have a good farm nearby that you can reach out to. You know what, I do it both ways, personally. I have five farms locally where I can acquire stuff, put in my fridge. Ideally I like it cryovak, cryo-sealed. It last longer I can put in the fridge and not worry about it going bad, it getting freezer burned. But is also the aspect of, you know, wanting to support people locally. So I think it’s a fully double edge sword and you have to figure out. Number one, the most important thing is that your compliant, right. Coz you have to eat the food to get the benefit. So number one is making sure you’re actually consuming that higher-quality food coz you get the nutrient density you get all the quality nutrient, that’s number one. And then number two, I consider- well, how do you get it right, you know, if you can buy from sources locally that’s better support your local economy. Number two, you’re not buying meat that has been shipped around which is gonna get a more gasoline, more fumes and all that kind of stuff. So definitely local is better but I always want to make sure that those nutrients in my body first, what do you think?

Evan Brand: Sure, true. That makes a good point if you get a freezer full of bison meat like me, but I got to McDonald’s then what’s the- what’s the whole point? So yeah.

Dr. Justin Marchegiani: Exactly. Yup, that’s totally- we’re on that. Now regarding nutrient density, I think a lot of people when they think nutrient density, they always get into their head juicing or vegetarian nutrients regarding vegetables, kind of stuff which I think is good that you got a lot of stuff nutrients via vegetables. But people forget meat is incredibly nutrient dense. Cholesterol, fat-soluble vitamins, these foods are really really important to up nutrient density and a lot of people I think that are vegetarian or vegan think that plants are kind of the uhm- the monopoly on nutrient density that they juice. They’d be good to go which I think that can be good but juicing is a double-edged sword because you can also get a whole bunch of sugar after throwing carrots and fruit in there and people forget about the fat-soluble nutrients which necessarily snuck in a calm in your juicing. You’re not gonna get the vitamin A, D, E and K. You get beta-carotene but a lot of people may have a hard time converting that over. So nutrient density is also a really important piece of the puzzle.

Evan Brand: Yeah. Well, let’s talk about that a little bit further with the juicing aspect is you’re also gonna to be removing a lot of the fiber which is gonna act like a sort of a slow digesting product that’s going to help you not spike your blood sugar in your insulin levels up as much. And so you and I both had people we work with that are juicing. Maybe they eat some grass fed beef too. But if they are juicing and they’re unable to lose body fat, for example, well if you don’t have any fiber because you’re just juicing it, you’re not making a smoothie. For example, instead where you’d preserve the fiber content and that blood sugar goes up which causes the surge of insulin you’re gonna be in fat storage mode. And no matter how much you exercise, no matter how much grass fed beef you get, if you’re dumping 80-90 g of sugar into your gut and bursting the morning with your morning juice. Then to me I don’t think you’re gonna get out of fat storage mode through the entire day. What’s your thought?

Dr. Justin Marchegiani: Absolutely. I mean the big thing the burning fat is keeping your insulin levels relatively low. Now insulin is a storage hormone that’s also a good thing because we need storage hormones to put on muscle, right. People think insulin is just terrible. People in the in the low-carb world think it’s terrible. But go talk to a bodybuilder, a lot of them are actually injecting insulin to help increase uh- protein synthesis. So there’s good and bad. We can use insulin to our benefit the build muscle but from an every day perspective, we want to keep insulin lower during the day on average because that will help us tap into fat. The better and the more –uh – the greater ability we have the tap into fat, the better our mood’s gonna be, the less hunger pangs, the less cravings for bad junk and the more you’re gonna be stable. My analogy to my patient always is this – when you’re burning fat, it’s equivalent to putting logs in the fire right. Everyone has the baby memories of childhood camping and they throw logs in the fire. So you throw logs into the fire maybe throw little bit of kindling and lighter fluid to get it going and you’re good to go. Best logs in the fire that’s being a fat burner know a lot of people they are sugar burners and what that means is that’s like relying on kindling paper and or gasoline. Gasoline being refined sugar right kindling a paper being carbohydrates. The more your rely on paper, think about it, you gotta sit there and you gotta feed the fire every couple of minutes. It’s kinda like people to graze all day because you’re not getting enough protein and fat and so we want to be fat burners. Logs in the fire versus the sugar burner which is the kindling the paper and even the gasoline for refined sugar. So we wanna on to the logs and away from the kindling as a mainstay the staple were doing.

Evan Brand: Yeah. And there’s a lot of research about insulin and food and all of that I think it gets personally pretty boring and so I go to the first-hand experience and when I chatted with Dr. Mercola on the podcast about a month ago he’s actually using that – I can’t remember what it’s called. It’s that device were you injected into your skin and it keeps your blood sugar you can track your blood sugar like hundreds of times per day. I’m not sure if it does insulin levels too or just blood sugar but either way he found out that the only way the he was able to consume fruit without causing a significant blood sugar, which therefore to me would signal insulin spike, was if he ate fruit while walking. And so when we were doing the podcast, he is like, “Oh Evan, you know I usually don’t do Skype like this”. He’s like “I’m- I’m you know shortcutting my daily walk on the beach for you”. And I’m like, “don’t do that. Let me call you on your phone.” So he gave me his phone number and I called him on his phone and then he was walking and he’s like “Yeah, I’m actually eating on these berries I grew in my backyard right now. It’s like this is the only way I can do it. As I tracked it every other way”. He said, “I’ve done berries before walking I’ve done berries after walking and all causes too much of a blood sugar spike.” So while walking blood sugar spike does not happen which is interesting but at the same time it makes sense. Because if you and I were hanging on the woods together 50,000 years ago we were hunting and gathering together today. Maybe we would camp came across a wild blueberry bush and would’ve ate those berries and kept walking. So kinda makes perfect sense really you wouldn’t be just sitting there eating them, you would’ve been moving at the same time.

Dr. Justin Marchegiani: Absolutely and again I think it’s unrealistic to think, though eating food at all to create no blood sugar spike.

Evan Brand: The question is how do we keep it within a normal variation so our body can adapt to it right. And that’s kind of the key thing that Dr. Mercola probably was was getting at there. He’s- he’s fanatical right. He’s doing everything to the umpteenth degree, which is great, I love it. It’s great to be at that high level but the question is how do we extract that information and make it applicable to my patients. With devices, you will go eat your fruit while walking they would look at me like I have 10 heads. Seriously they wouldn’t- it would not be something that we can apply but what could we apply is- Well, let’s eat that fruit after our meal so it’s the- the absorption is slower or let’s try not to eat fruit on an empty stomach or let’s try to do a post workout or let’s just use lower glycemic versions. And just the glycemic index unto itself isn’t that important. Because it’s looking at sugar and its effect going into the bloodstream and how fast it goes into the bloodstream which again by itself isn’t a big deal because we eat fruit with other types of food, right. But we know higher glycemic index goes into your body faster. Lower glycemic index food goes into it slower. So if I eat lower glycemic index types of foods or in this analogy fruit like berries or grapefruit or green apples or those kind of things. It’s gonna go in slower and if I eat it with some high quality fats and proteins and veggies, it’s gonna go on even slower because the absorption in the stomach slow down because of the protein, right. Things slow down, your stomach take about an hour to pass through once proteins there. So we do these natural things we can slow it down. And also if for exercising and putting on muscle, the more muscle we have, muscle is a reservoir site for carbohydrate in the form of glycogen so that’s great. Because that means it’s a bigger sponge so imagine you’re going to sop up the mess that your kid made on your table and imagine you have just like one small paper towel. You’re gonna wipe through it in that paper towel’s gonna be saturated and you’ll be stuck just pushing around water, right. Whatever they’re still, right? So you go back, so now you get a handful paper towels and now you’re absorption ability is so much higher that’s what muscle does. So simple movements like walking and those things that are good for burning sugar but they’re not good for making the cloth that you’re using bigger. So resistance training, high intensity interval training put on the muscle and burn the sugar. The walking will just burn the sugar and ideally burn the fat as well. So we want to make that that rag bigger so we can clean up that mess and sugar.

Dr. Justin Marchegiani: Good point. So you kinda transition into talking about building muscle then, which is – which is a great point. And I believe all people should have muscle for sure. I’m still building myself back. I’m actually, I bought a mountain bike this weekend and I’ve been riding that. And I feel really good. I already feel like my legs are stronger and more engorge with blood that feels more heart-pumping mountain bike workouts than before. So, for me that’s kind of goal 2017. Pick up all the muscle I loss when I had those infections in my gut. And maybe we should talk about other nutrient dense things too. Something that I’ve been into is broccoli sprouts and I actually have some other sprouts that I haven’t grown yet. I have some sunflower seed sprouts, as in others. But apparently, broccoli is kind of the brand that yield them all because of this sulfurophane. I believe you’re getting something about 35 times the amount of sulfurophane as you get with actual broccoli. And So I’ve been doing a lot of those cool anti cancer benefits of those. But for me it’s just a great easy thing. And it’s fun, too. So basically, me and my wife will grab the – it’s like uh – they call it sprouting jar or basically it’s just a giant, oversized mason jar with uh – meshed lid. You put a little bit of season in it, put a little bit of filtered water. And you put in the darkness for about a day. You take it out the next day, you rinse it, you put it back in the darkness, you lay the jar on the side and then within 2-4 days, you have sprouts that are couple to few inches tall. And we just basically take in the – I need the little shells too. It’s like a nice little crunch, only the shell of the seed. And I just throw those on salad or even I took a seed the other day, I did a bison stew with sweet potatoes. And I threw sprouts on there. And it was incredible. To me, I think if people are looking for what’s one little, cheap, easy, fun hack that you can do at home to get anti-cancer too. And if it’s – you wanna feel awesome and cooler than your friends who are not eating sprouts. Then that’s it, you can go on amazon and you get organic broccoli sprouts. Broccoli – that’s what they call, broccoli sprouting seeds. It’s like 10 box. So – that’s my seeds. Have you done sprouts like that? Have you tried them?

Evan Brand: I have not done it too much just because of the extra bit of time that it’s involved putting, putting into it. I mean, Doctor Mercola has talked about the nutrient density of it. And they’re also very cost-effective so definitely if you’re on a budget when it comes to food, but you don’t want to compromise the nutrient density, I think it’s phenomenal way to do it. If I was back in school again I would definitely look at making that staple again. But for me right now, I’m just trying to keep it simple so I get a lot of my stuff at whole foods locally. And the whole foods that I use usually do procure a lot of their producer meets locally from different farms in the Texas Austin area, which is great. So I can get a bit of the convenience of going to one place and also still supporting some of the local farmers. And there are still places locally that I do get the meat. I get a lot of my stuff the grass-fed meat or US wellness meats. But again their farms are located in Texas too which is really cool so I do feel like that I’m still supporting a lot of my uh – farms locally and getting stuff pretty close by.

Dr. Justin Marchegiani: Cool. And you’re in whole food head quarters so that’s gonna make a difference compared to some of the brands that we have here.

Evan Brand: Oh, yeah. Absolutely. And for me, nutrient density is super important. I think a lot of people who were vegetarian and vegan think that they may have the monopoly on that. But I think it’s really important that plants don’t quite have the same level of privacy protection as an animal does. They don’t have the claws and the ability to run and fight and flee. But plants have antinutrients most antinutrients are, are there for a reason. And they’re so seeds pass out through the stool so then it can sprout and create more of that plant. That’s important but those antinutrients also can disrupt digestion. They can also affect the gut lining whether it’s various lectins or various compounds. Whether it’s mineral blockers or mineral binders, whether it’s phytates or oxalates or various lectins. There are lots of them and there are different ones for each compound. Each kind of plant and cooking can help decrease some of that as well which is great. So a lot of people have digestive issues – digestive issues to get better absorption by cooking and also a lot of fiber in plants that can bind up a lot of nutrition. That’s why one of the things we talked about with juicing is that you can cook some of your vegetables down, you can steam, it sauté it. That’ll break down some of the phytates and oxalates but also liberate some of the fibers that are trapping up nutrients and then from there you can throw that food into like a Vita mix or magic bullet blended up. That way you at least get some of the fiber so some of the fiber that will blunt that sugar from getting into your bloodstream as fast. Remember, the faster your sugar gets in your bloodstream, the more insulin your body has to make the buffer it. So the more you can slow that sugar into your bloodstream, the less insulin the body makes. It’s like push-pull. If we’re doing tug-of-war and I pull back really hard you’re gonna pull back the other way probably just as hard. If I pull back a little, you’re in a pull back a little. Imagine me as the pancreas and you are – well, here. The pancreas is the insulin and then your blood sugar is you. So I’m the pancreas, you’re the blood sugar, right. The faster I pull, the more sugar that you put out, the faster – the more I have to pull back. So think of the first pull is the blood sugar. The higher the blood sugar goes, the more you pull, Uhm – the pancreas, I, make the insulin. The harder you pull, meaning the higher the blood sugar is, the more I gotta pull by producing insulin. Does that analogy make sense?

Dr. Justin Marchegiani: Yeah, it works.

Evan Brand: Yup.

Dr. Justin Marchegiani: I just sent you an article that Mercola wrote. And so it sounds like we may have to interview the author of this book that we got here. The author, this guy John. But basically in terms of grains and and antinutrients and all that, Mercola is kind of – he wrote his No grain book like a decade ago.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Actually more that that and now, after talking with this guy, he’s kinda changing how he’s feeling about grains. And so this guy is saying basically in terms of seasonal eating and looking at genetics and history, blah, blah blah. That we were eating grains potentially a million years as oppose to meat, we’re only eating for like 500,000 years. So now this, this long story here is that he’s basically saying that you should be able to get fat, adapt it first. After you regained your fat burning ability, then add back in grains in the right manner and you should be okay to tolerate them. So that’s pretty interesting coz it’s kind of an antigrain diet community out there. And typically you and I see much better results when we tell people to go away from grains. I think there maybe some validity to this. But to me it sounds like – if you’re up against leaky gut issues, if you’re up against infections, if you’re up against the general stress – to me, you’re not healthy enough to handle that. So I would like to look at this information like, “Oh, yeah maybe your ancestors did this, but at the same time they didn’t have the type of – and 24-7 stress test that we use.” So maybe our ancestors were able to tolerate what would’ve been “Organic Grains” a million years ago. Our modern life is different. And typically there’s GMO or the hydrodize or the spray with chemicals. So I don’t know. This is an interesting uh – wrench to throw into the no grain – no grain, what do you call it, bandwagon.

Evan Brand: Yeah, yeah. Absolutely. Well, here’s my take on it, okay. Playing sports when I was younger, you remember like watching like there was a quarterback or a baseball player they would do things differently. They would show off in a way technique-wise, that maybe wasn’t something that you consider to be a fundamental thing. Like you guys going to the plate and doing all these crazy movements or you get people in the field doing all these different flips and such. And I always tell my patients that’s like you being healthy so when you’re healthy, that’s like being a professional athlete. To be a professional athlete, have to get to that high level with the fundamentals at the highest level intact. But you have to have the best fundamentals. Once your fundamentals are 100% dialed in, you can show off and do different things that someone starting out would never be able to do, right. So that’s akin to someone being healthy. When someone’s healthy, they can go and add little bits of cheat here and there and honestly have no problem with it. Now the question is, how do we lessen, how do we decrease the amount of damage that a cheat does. And that’s where I think some of these things can be added and whether it’s sprouting grains or whether it’s choosing sourdough bread or whether it’s choosing breads that are higher in nutria – nutrient density and less got your tuning compounds. That’s a great starting point. But again, most of the people that I’m seeing and you’re seeing, they’re sick or they have some kind health challenge.

Dr. Justin Marchegiani: Yup. So my goal as uh – a physician is I don’t want to add variables that’s gonna make my job harder when I’m working with my patients.

Evan Brand: Yup, I agree.

Dr. Justin Marchegiani: I wanna cut all the variables out so I know I’m working with a tabula rasa. It’s a blank slate and then from there we can build them up. And once they write a letter to like, “Doctor J, I feel great. My mood’s great. My period’s better. My brain fog’s gone. My libido’s better. I’m sleeping good. My energy is great. Then we could say, alright – let’s you know, if you wanna have a cheat this weekend, it’s your kids birthday party, fine. But if we have an option to choose a grain or starch or tuber, that’s gonna have less issues. I’m all about doing the thing that could have the least amount of damage. Does that make sense?

Evan Brand: I agree, yeah. Like you and I talk about last weekend. You were telling me about those taro – what was it, taro pancakes or taro fruit waffles.

Dr. Justin Marchegiani: Yes.

Evan Brand: – that you had they were freaking amazing. And that’s grain free.

Dr. Justin Marchegiani: Yeah. I was at a picnic last weekend and I had for dessert I had the blueberry pancakes with the – with yucca root. It was yucca root.

Evan Brand: Okay.

Dr. Justin Marchegiani: Which is great. It’s a starchy tuber. It’s like in the same family as sweet potato. That’s much better for my gut. And how I feel afterwards is so much better. My skin thanks me. I don’t get the breakout. I don’t get the inflammation but there’s we can also ignore the research that gluten even if you’re not necessarily having a gluten-sensitive reaction can still increase gastrointestinal permeability. And that’s really important.

Evan Brand: I know. I agree. Go ahead.

Dr. Justin Marchegiani I agree. It’s how do you – it’s like okay, you can take research on this point and say okay, ancient people would’ve eaten more than just meat vegetables. Ancient people would’ve had grain but then we look at what you say. We look at research between uh- gluten and zonulin and tos- permeability and all that stuff we already talked about. And you got all this leaky gut thing leaning over. We got this big leaky gut elephant in the room. And so I think it’s interesting that you and Mercola kinda talk out. Because I wanna address the perceived conflict between this guy saying in his book Eat Wheat and then Doctor Perlmutter in his book Grain Brain and other books. And so basically, long story short, these guys kinda talk it out between each other and then say exactly what we discuss which is yeah, once your digestion is properly restored, maybe you can reintroduce the grains. So really this is the basic of what we already said in 200 episodes but I like how its- the head honchos of, you know, the biggest anti grain guy our there versus the biggest pro guy grain out there. And they’re kinda going head to head. And sounds like they will come to the same conclusion, which is what you said. So eloquently with the analogy of the athlete which is once detoxification is in the hands, once gut health is taken care of, once leaky gut is addressed, maybe you can add the stuff back in. Me personally, I’m not really gonna go that way because I’ve noticed the difference in my skin health. And for sure, even if it’s an organic grain, to me if I know this can contribute to leaky gut, do I really wanna do that? In our ancient world, where we would’ve had less chemicals, maybe intestinal permeability wouldn’t have been a big of a deal. But to me, in the modern world, I don’t really wanna a leaky – a leaky gut world, leaky brain due to all these other chemicals out there. So for me, I’d rather be more protected and just be grain free. And I think that’s gonna help me sleep at night better, both emotional and dietary perspective. What do you think?

Evan Brand: Oh, a 100%. And then. uhm, Dr. Mercola and Dr. – the other doctor that he interviewed here talked about the one of the Italian studies were the gluten-free sourdough bread, uhm – tend to cause no intestinal inflammation. So I think if we can look at good, better, best, right. In my opinion, my biased on my autoimmune condition and dealing with thousand of patients who have autoimmune conditions and also just facing the fact that a lot of a large percent of the population has silent autoimmune conditions. I would say the majority and again the question is, it’s the tincture time, it’s the tincture of stress chemical physical and emotional that causes these things to express so looking at that I always say, try to keep it grain free but if were going to space good sourdough bread to be a great option if you want to introduce them bread in there and not have some of the deleterious effects or just let myself find places that will have the yucca flour. Like I’ll go to uh – Estancia or Fogo de Chao and get some of the yucca rolls or I’ll do the yucca pancakes, right. Or the sweet potato or pumpkin pancakes. So I try to use starchy tubers to get the same kinda molly feel as I would get from the grains without having the same kinda inflammatory response.

Dr. Justin Marchegiani: Agreed. Yeah. And I guess at then end of the day it goes back to the clinical application, too. Because we don’t this guy who’s – who’s proposing this now. We don’t’ know what his clinical experience is. I mean, has he worked with – with people with uh – autoimmune disease, very complex disease like you could have thousand of times or I like what I have a thousand of times now. I don’t – I don’t think he probably has that clinical takeaway where he’s actually worked with people where they got Hashimoto or other disease and they got parasites we’re looking at and adrenal problems. I mean, for us, I don’t know – Obviously we’re biased. But to me, the functional medicine background that we both abide to this whole conversation, it supersedes the conversation of wheat or no wheat because there’s all these other factors that are tied in. And when those factors are tied in, they change the conversation to me.

Evan Brand: Absolutely. I mean frankly when someone sees the title book that says, “Eat wheat”, what’s your response? I mean, for me, I think what that does for most individuals, it justifies them continuing to eat a lot of the crap they eat.

Dr. Justin Marchegiani: Agreed. And if you see wheat, that’s gonna say, okay that means I could go back – back to my burger. I can go back to the sandwich at lunch. I can go back to the pasta at dinner. And I think that is a slippery slope and I think if we were to get this author on the show and I think he clarifies, he’s definitely talking about whole food sources. I think he would even clarify the GMO organic sources coz we know 90% of wheat in this country is not organic and it’s prayed with tons and tons of pesticides. And they’re typically genetically modified which is an experiment unto itself when the human studies on GMO really don’t go past three or four weeks. I have a strong suspect of always going to all foods over new foods when the research is not in-depth and very long and extensive.

Evan Brand: Agree. Yeah people will probably think we’re ganging up on him if we do a 3-way interview. But I think it would be a fun conversation. And the clarification is there were says refined grains and blah, blah, blah – those are bad and you want whole grains, etc. But to me, if we’re talking and kinda wrapping up the nutrient density dot. For me the top of the food chain in terms of what do you best think for your buckets can be good quality, organic, pasteur-raised animals. You’re gonna have a good organic – Even if you could do like organic wild blueberries apparently wild blueberries get sprayed. And if they’re not organic, wild blueberries are sprayed, not good. Uhm – so you know, organic berries, your organic veggies, your good organic butters, if you could tolerate it, your coconuts, your avocadoes. One thing I’d like to say now is do avocadoes or avocado, do macadamia or macadamia oil, you know, you have to go through all these processed products. Avocado oil is more processed than the avocado by itself. So if you get actual food of avocado, do that. Your macadamias, your leafy greens and that’s your nutrient density. And maybe, maybe – 5% that you can have some of these organic sourdough bread like you mentioned. And maybe you’re okay with it. If your gut’s clean, you don’t have infections, your adrenals are healthy. Maybe if you worked on chemicals, you worked on heavy metals, maybe you could get away with that. At the end of the day, what is the whole purpose of our show? It’s to help people be healthy. It’s to help people be happy not to hear our conversation like this and leave feeling more confused than before. So this is not us changing our stance on anything. The same things still apply. Get yourself tested, look for infections, make sure you’re clear, make sure you have healthy adrenals. Your detox pathways are working. You have a primarily organic meat and veggie and a little bit berry –focused organic diet. With maybe a little bit of starches like sweet potatoes and some organic white rice in there.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: Does that summarize it all?

Dr. Justin Marchegiani: Yeah. I think it’s really important. And the last piece I wanna kinda harp on, if someone is not a clinician, I mean, they haven’t dealt with the thousands of patients that have these issues or they don’t have an issue like that themselves, it’s really easy to lose the empathy for the cheat. A lot of times people talking about a little bit of this is okay. Well, it depends. You know, what’s the consequence of that? How many days are you setback? How exacerbated is your autoimmune condition? How much, how bad are the breakouts? How bad are the symptoms that arise from it for days or maybe weeks later? So I think you really have to look at that in the equation and you really have to make your decision based on that. I think it’s really important that if you’re a patient or your someone listening to this and want to use that info to justify eating more of these foods always have someone on board whether it’s a functional nutritionist or functional box or functional medicine doctor that can kinda walk you through it and go to the pros and the cons just to make sure you warrant maybe making a decision that’s a little bit hasty. Uhm – because you get those cravings going on there and make sure you’re doing – your health should be the ultimate goal in there. Not to have a quick short-term satisfaction of some bread but to make sure your health number one And again if you need to reach out to someone, Evan and myself are available notjustpaleo.com and justinhealth.com If you want more information, get in your diet dialed. And then obviously, the last piece is if you gut inflammation and leaky gut and you already have G.I. symptoms, the last thing you want to be doing is showing any bread or grains into your diet right now.

Evan Brand: Awesome. Well said. And people may guess and check the inflammation, words that are around a lot. You don’t have to guess and check whether you have inflammation. If Justin and I are looking at organic acid testing with you, we can look at that. We could clinic 5 HIAA ratio on – planes. That’s a great marker for your inflammation. And also on the GI mock that we use, you can also see how protected levels there for testing inflammation. So even just for that perspective, if you’re curious, “Do I have this inflammation?” “Should I be taking this –cumin supplement – wasting all my money on it?” Well, why don’t you just get tested? Figure out what’s your inflammation levels are. You know, number on a piece of paper. Go to a more clinical route and then you’ll know. We’re huge fans of testing, not guessing because in the long term it will save you money. And you’re not buying 20 supplements that may help you but may not be the really needed as much as you previously thought.

Dr. Justin Marchegiani: Love it. Excellent, Evan. Very good. Any other thoughts?

Evan Brand: I don’t think so. We’ll talk next week.

Dr. Justin Marchegiani: Anyone listening that’s really enjoying this show. Feedback is great. We’re getting a lot more emails and were getting show ideas up in the queue. And also show us your love. Give us a five-star rating on iTunes. Click below the link and give us some love. We appreciate it.

Evan Brand: Take care.







Dr. Andrew Hill – Improving brain function, baldness and head trauma – Podcast #118

Dr. Justin Marchegiani has a special guest back again today, Dr. Andrew Hill. For this podcast episode, they talk about brain function, baldness and head trauma.

Discover the different medications or drugs that are used for ADHD, anxiety and sleep issues and how they will affect people in the short or long term. Find out how mindfulness and meditation can help with brain function and training. Get some information on insulin and the history of gluten as well as a brief history of genetics and evolution. Learn what should be done in cases of head trauma or brain injury when you listen to this episode.

In this episode, topics include:

01:40   Biofeedback/Neurofeedback

14:38   Medications and Smart drugs

40:16   Insulin

48:22   Gluten

56:48   Baldness

62:35   Brain injury/trauma







Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin Marchegiani. We got Dr. Andrew Hill on the show today. Dr. Andrew is a grad over the UMass Amherst School. I went to school as well so we’re fellow alums, also a PhD grad over at UCLA. Dr. Hill, it’s been a while, but glad to have you back on the show.

Dr. Andrew Hill: Yeah, thanks for having me, Justin. I’m guessing a lot has happened for Beyond Wellness, as well as on my end of things, the past couple of—few months.

Dr. Justin Marchegiani:  Very cool! I’m excited. What’s new on your neck of the woods?

Dr. Andrew Hill:  We are—and we, I mean, a new company I’ve been working on called Peak Brain, we’ve been opening up brain training centers, neurofeedback centers. We’re also doing a lot of free mindfulness instruction, you know, I’m sure we talked about this last time.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Just to review a lot of different aspects on you know, call it biohacking, call it therapy, call it exercise. There’s lots of different avenues into this space and for many people, different choices might make more sense towards you know, free things–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Like mindfulness and meditation where you’re always carry around the equipment. Once you know how to do it, you can always practice. So I have this focus, at this point of bringing tools to accessible, or bringing the accessibility to people. So the idea is to provide a lot of you know, open mindfulness instruction and these training centers as well as the higher tech tool that people can sort of you know, buy services and getting a lot of hands on training and qEEG and neurofeedback. So I’m taking it more to the—to the fitness and out of the clinical level as much as possible these days.

Dr. Justin Marchegiani:  And you’re doing more qEEG or neurofeedback work?

Dr. Andrew Hill:  Yeah, the—most of the neurofeedback we do is EEG-based–

Dr. Justin Marchegiani:  Okay, got it.

Dr. Andrew Hill:  Neurofeedback or biofeedback. We also do HEG, which is another form of neurofeedback. We do a little bit of HRV, which is biofeedback referral. Let me—let me break–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This down for one second. There—there’s some overlap in terms. All neurofeedback is a form of biofeedback but not all biofeedback is neurofeedback. The difference really—the central nervous system as—as you know is a pretty savvy guy, but the body is—some of the systems is everything encased in bone essentially. So—all the nerves are inside the spinal column, the brain and so–

Dr. Justin Marchegiani:  Exactly.

Dr. Andrew Hill:  And everything outside is—is peripheral nervous system, and so broadly you can define neurofeedback as central neurofeedback or sorry, central neurofeedback or peripheral biofeedback.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And that’s for the line that—that is getting drawn, but it’s a little blurry because you can do things centrally, like HEG where your training blood flow voluntarily and EEG is a form of central biofeedback where it’s involuntary thing—so the lines blue quickly because the body is not divided into, you know, discrete compartments that are purely isolated from each other in—in a system, so it’s a little bit of complicated but that’s probably more information than you need—on—on the differences. So–

Dr. Justin Marchegiani:  Very cool. So if someone is out here, maybe they have excessive sympathetic nervous system overdrive or an adrenal dysfunction–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Right? Neurofeedback and/or EEG tend to be a really good way to dampen that’s—over sympathetic, over fight or flight response that’s happening. So if someone’s having that, they’re making the diet and the lifestyle changes, maybe they’re on an adrenal program using some adaptogens and nutrients and they’re stabilizing their blood sugar, making themselves be a more—a fat burner, would the next step be, if they’re doing all these things correct, how would they incorporate–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  The EEG neurofeedback into their life?

Dr. Andrew Hill:  The next few steps in terms of you know, adding tools and technology to support, you know, health as well as transformation would be probably to add in either peripheral biofeedback tools like HRV, like all that skin response, like mindfulness, like meditation practice and then I would say the next level is adding in the sort of higher tech tools like the EEG neurofeedback. And—and to enter that stage, you sim—and if there’s a problem, I mean, for the average person who’s working on stress management or just trying to optimize the performance, you know, you will wanna build things to have a good foundation. If you’re trying to remediate a specific issue, you have seizures, you have ADHD, you got some, you know, problems that’s really getting in your way then you can go right to neurofeedback, I think as a, you know, first line intervention. And for something like that, you start with what is called a brain map, a quantitative EEG ideally and those are usually baseline assessments of brain activity that or then compared to a normative database, and out that you get maps that tell, you know, practitioner like myself how unusual you are compared to a population. And then we examine the most unusual aspects of your brain, how it’s functioning and some of those tend to cohere with certain functional limits or patterns or bottlenecks. You may notice I’m using a lot of very tentative language and that’s because the qEEG is not neuroimaging. It’s statistical analysis. You know, it’s you compared to some distribute—there’s some distribution of—of continuum of function, you know? So it’s really you compared to a bunch of different average people and—and your brain can be special and unique and wonderful, and—and really unusual and still be fine.

Dr. Justin Marchegiani:  Uh-hmm. Uh-hmm.

Dr. Andrew Hill:  So qEEG is—is much of an art as is a science. There are a few things in the EEG and the quantitative EEG that are well validated, some diagnostic markers, or other you know, some discriminants, pretty reliably if you have clean EEG, you can spot traumatic brain injuries in people if they are at all significant. You can often or almost always actually spot ADHD. The FDA has a pretty good at this point support of a few discriminants in the EEG that suggests ADHD, including you know, going so far as to support a hardware diagnostic headset a couple years ago as actually diagnosing ADHD passively without any clinical involvement and essentially it’s doing I—I believe it’s—it’s doing a ratios of frequencies in the brain. So you start with these assessment tools to get a peek under the covers, and so the quantified self implication as well as a, you know, remediation benefit and you get a sense of how your brain works and then the next step is to start exercising and training it using you know, biofeedback feedback essentially and we shape brain activity and figure out how that affects function and over time you make changes to the brain. I know we talked about this before, but it’s essentially offering conditioning, not if you could think Skinner not Pavlov–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  So we aren’t—we aren’t making you know, a voluntary response happen by providing a—a random thing like—like the bell and pairing it with the stimulants.

Dr. Justin Marchegiani:  Yes, exactly.

Dr. Andrew Hill:  What we’re doing is instead only rewarding certain stimuli you do. So Skinner, you know, Skinner’s left alone noted Pavlov but it—I think it bears expanding. Skinner trained essentially pigeons to peck along bars or do certain behaviors to get rewards, you know, to turn a light on or you know, hit a switch or something. And a Skinner box is a behavior-shaping device. You don’t just examine how pigeons behave. You examine how they learn so you’re shaping or changing their and the way you do that and operate conditioning is you reward behavior that is near what you want to accomplish, so–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  You find what the brain is doing moment to moment, and then you—you know, when—when a certain brain wave moves a little bit or trends in the right direction or stays in the direction that’s when you provide—provide the reward. So over time your—you’re shaping.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  You’re just rewarding—

Dr. Justin Marchegiani:  Shaping, right.

Dr. Andrew Hill:  A different trend, yeah.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And then you move the goalpost and you reward further, you know, development of the trend, the physiological trend and not direction. The—the weird thing about—about the analogy of Skinner vs Pavlov is this is operate conditioning. However, the pigeon knew what it was doing. It was—you know, it was trying different things. Pigeons actually can get very superstitious.

Dr. Justin Marchegiani:  Hmm.

Dr. Andrew Hill:  If you—you know, if they spin around once, and then get rewarded, they will then spin around once and they approach that food bowl and switch again because they’ve learned. Pigeons are like baseball players. They’re so superstitious–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  A little ridiculous.

Dr. Justin Marchegiani:  That is funny.

Dr. Andrew Hill:  But in the case of EEG—the—the analogy breaks down because what you’re rewarding, the—the behavior if you will of the brain, a fluctuating EEG that’s happening in a time course that is faster than you can perceive or control. So it’s really measuring sort of the real-time, you know, under 100 milliseconds or time window of what fluctuating in your brain. And you don’t really control things in that time course. You are only perceiving in the like 92 to a couple hundred milliseconds timeframe for most of us. We don’t proceed rapidly and we perceive most of what’s going on, you know, neurologically. And so as it’s fluctuating, reward it and shape it, and over time it changes which was kind of magical and lovely. But it—it’s not the magic of neurofeedback that’s doing that, it’s the magic of the brain.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  It’s the brain’s ability to interpret a signal, a shaping signal. It’s the brain’s ability to enhance its plasticity in response to a signal. There’s really good evidence now that neurofeedback rams up plasticity fairly profoundly, something called a—an evoked motor potential can be used to measure plasticity of cortex. Essentially, you—you trans—carry all magnetic stimulations and zap a little bit of the brain and see—like over the hand area of the motor cortex and see how much bulk it takes to make the hand jump.

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It—it sounds brutal but it’s actually a fairly innocuous little thing they do with TMS, just to see if they’re over the right area. The—there was an experiment a couple years ago that showed that before-and-after neurofeedback. After neurofeedback, the motor cortex respond to a much lower voltage, a much lower, you know, signal before it perturbs or it jumps in responds and changes. And—and so this is a sign of motor plasticity or learning–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You know, broadly, that seems to be upre—upregulated regulated fairly rapidly with neurofeedback.

Dr. Justin Marchegiani:  And when you’re saying–

Dr. Andrew Hill:  With the other evidence of this. Yeah.

Dr. Justin Marchegiani:  And when you’re saying neuroplasticity, basically your brain is almost starting to rewire itself essentially.

Dr. Andrew Hill:  Yeah, it’s rewiring itself. You know, I—I think of it sort of like it’s getting younger because–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  For many of us we—we’ve have the experience of being, you know, over plastic. I mean, that’s being a teenager is to some extent. Things just change a little, you know, too rapidly, swing. But there’s this—there’s this proliferation of synapses, of connections between neurons in early seniors,  10 through 14 or 9 through 14, or around 9 or 10 or 11, the brain sort of finishes all this lateralization. It’s often that’s where a lot of final development happens. Post that age is when language acquisition without an accent becomes very difficult, but right after there’s this—there’s this proliferation for a few years or synapses. Massive like overbuilding in some ways. Think of like a forest that is becoming so thick and so overgrown that it just doesn’t have a lot of light getting through it. You know, it’s almost like too much in terms of synaptic density, and then there’s a big period of learning where those synapses change widlly in mid-teen years and many get pruned away, you know, this—this neuropile as it’s called.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It’s pruned away into more discrete circuits. And that’s the time of profound learning and skill development and self-regulation, and other things in those mid-teen years. And so I really do think about you know, the plasticity enhancement features of neurofeedback as sort of rolling back some of the—some of the kid, not the—the decline of synaptic flexibility that was so prevalent when most of us were in our mid-teen years when things were just changing and responding and changing and responding and—and learning was like trivial because it’s just learn, learn, learn, and change and grow and develop. And it all seems effortless, you know? Relative how things feel, you know, 20 years later or 30 or 40 or 50 years later. So—so that’s my goal from all this stuff. Be it nootropics or mediation or neurofeedback. And—and be it for whatever goal, peak performance, substance abuse, you know, remediation if you will, changing your relationships and your—and you’re in control over substance behavior which is hard when you think about it. Getting control of executive function, getting control of aging, getting control of mental illness. These are equivalent in my mind. They’re all about getting some control over this 3-lb blob that uses most of our, you know, glucose and oxygen resources on our body.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  And—and learning to take you know, a little more active role if you will in how it develops, how it changes, how—how it has a trajectory of improvement and aging, and learning and growth. So a lot of my focus is—has really swung far towards encouraging and supporting people’s access to these tools.

Dr. Justin Marchegiani:  Interesting and you mentioned a couple of things especially with ADHD, and it’s interesting when you–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Because when you compare and contrast, you know, the—the functional, more natural alternatives, EEG, nutrition, functional medicine for like, let’s say ADHD, you also have the conventional options which are pretty mainstream, but they typically involve stimulants–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Methamphetamines, Adderall, Prozac, you know, those type of medications where you’re trying to–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Overstimulate the brain into focus, into the ability to pay attention, how is that different? I mean, obviously, one I see is whipping a horse, whipping a tired horse. The other one is—is much more different and is trying to align the brain in a more functional, more sustainable way.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Can you compare that?

Dr. Andrew Hill:  Interesting analogy. An interesting analogy. Let me—let me just talk about medications for a second.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Now I’m not a psychiatrist. I’m a neuroscientist, but I—you know, I know a thing or two about pharmacokinetics–

Dr. Justin Marchegiani:  Of course, yeah.

Dr. Andrew Hill:  And dynamics and how—how they work. The—in theory, they should not be working. Psychostimulants should not be working by whipping the tired horse. In theory, the CEO of the company is asleep under the desk, and the psychostimulant is like a cup of coffee to get something productive again so they control all the random nonsense going on in all the different departments of the company.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  So it—it’s waking up some—an executive that is not controlling thing versus driving an already tired system. I just want—you know, I wanna shift the metaphor a little bit.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Because there’s a couple of other classes of drugs that are now used. You mentioned SSRI’s I think.

Dr. Justin Marchegiani:  Yeah, Prozac.

Dr. Andrew Hill:  Yeah, Prozac. Not as used sometimes—on no longer very much in kids and teens because the—the suicide fatality–

Dr. Justin Marchegiani:  Side effects, yeah.

Dr. Andrew Hill:  Increased risk is pretty high.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  They’ve discovered.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  That’s often not a great course, but the other two classes that are used, some of them promising with—with some promise are mood stabilizers and beta blockers, blood pressure meds that are being used really seem to work for some of the most acute behavioral symptoms.

Dr. Justin Marchegiani:  Are they beta-blockers? That they’re helping to decrease that action potential in the heart and the sympathetics. Is that how it’s working?

Dr. Andrew Hill:  Not sure how they’re working. Things like—like Intuniv which is a—what’s that? Atenolol or something. I forget–

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  What the—what the generic is.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Yeah, it’s basically beta blockers which work great for other things, too. And as well as comorbidity. So I wonder how much is it does ADHD cause anxiety being dealt with better, and you know, but all day long I look at brains that have been labeled ADHD or anxious or other things, and I often find there’s some agreement with labels on the physiology and how it functions, but not complete, you know. And they’re often very coarse and very poor agreement. So I—I will say that—that functional patterns that support the interpretation of ADHD, anxiety, and sleep issues tend to show up together more than they show up separately. So you almost always, if you see two of those three things, you almost always see all three—ADHD, sleep issues, and anxiety.

Dr. Justin Marchegiani:  And I know there are potential adverse–

Dr. Andrew Hill:  In terms of—Uh-hmm?

Dr. Justin Marchegiani:  I know there are potential adverse effects of the methamphetamines long-term on the brain, so I get in the short-term, hey, you got an exam–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  You’re gonna do it to kinda get really get those centers revved but long-term, what’s your take on that?

Dr. Andrew Hill:  Yeah, well, it depends on the class of psychostimulant. I mean, some things like Adderall–

Dr. Justin Marchegiani:  Adderall.

Dr. Andrew Hill:  Since you have a structure similar to—to methamphetamines–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Those things we—we don’t know too much about and—and it’s probably not great long-term. The drugs like methylphenidate, Ritalin–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  That seems to actually be a little neuroprotective but don’t necessarily work for everyone or you know, have—have all the benefits. You know, when I was just post college or in college, I—I need to add Ritalin and it made me really sedated. I was profoundly ADHD, classic ADHD, in you know, even in my 20s, not so much anymore but—but back then I was, and methylphenidate just made me feel numb, you know, Ritalin. And—and it just did not work to control my attention and at that time as a “young” man, I did take Adderall. It worked relatively well and I tried it again about a decade or two later and it my—I have my liver gotten too old. I couldn’t tolerate the side effects. And I—and I think I’m not so concerned about the—the short-term side effect.

Dr. Justin Marchegiani:  Right. It’s definitely the long-term.

Dr. Andrew Hill:  As you say–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  But—but even the short-term side effects can be fairly profound to a developing person. If you’re appetite suppressed, if your sleep’s disrupted, if you have underlying cardiac issues, I—I think that stimulants in general can really provoke a pretty, you know, negative set of consequences in the short-term. I don’t know that we know a huge amount about long-term, but I think that the sort of atypical stimulants like Ritalin, we know are fairly safe long-ish term because of how long people have been on them. And we know that the biggest risk for a lot of the other drugs is more about either sensitivities, like I said, cardiac or other issues or there’s—there’s risk of abuse in—in stimulants, right? There’s often very significant risk of abuse, and I think the problem—that the scope of the problem is actually, even I’m—I’m downplaying it a little bit is actually much more dramatic that I might—that we might suggest because I think ADHD and, therefore, stimulant prescription is so phenomenally rampant and fat outstretched the actual clinical sort of narrow scope focus of pathology that must be addressed. I mean, ADHD is a bucket that has become you know, huge, to swell and catch all kinds of things especially in school systems.

Dr. Justin Marchegiani:  Oh yeah.

Dr. Andrew Hill:  There are like something like half or three quarters of you know, in some school systems have kids that are on psychostimulants, and have these diagnoses. And I don’t think the diagnoses match. First of all, I think ADHD is only diagnostically relevant when it’s getting in the way and—and it’s so profoundly overdiagnosed that you know, it’s a fraction people who have some attention problems under some circumstances that I would call ADHD—you know, capital A, capital H, whatever.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  The—and prescribed for. Because the consequences are high and this is the medical doctor’s you know, job of course to know this that there are—are side effects you must balance against the desired effects–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And the side effects and stimulants are not significant, they’re better than other things. I’m not sure why the beta blockers work. I have a hunch we’re gonna discovered it’s more about reticular activating system issues.

Dr. Justin Marchegiani:  Uh-hmm. Yeah.

Dr. Andrew Hill:  And thalamic—and thalamic activation of downstate–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than it’s really gonna be about you know, cortical activation and—and relaxation if you will. But all those things regardless of how they’re working are doing short-term intervention. They’re not teaching their brain how to not be ADHD, but how to sustain your executive function, and sustaining sort of you know, sustain a—a perspective on attention that is resilient and not reactive. That takes some work and you can get there, but it’s not—you know, it’s not rocket surgery. You can get there through mindfulness or meditation, and you can absolutely work on ADHD and other another cluster type phenomena with a short simple mindfulness practice. In weeks, it will start changing your brain. The research is mounting. You can do a lot of mindfulness to—to reign back in executive function challenges that aren’t necessarily, you know, there.

Dr. Justin Marchegiani:  And I think you can learn a lot by the mechanism of how these drugs work. I mean, if you—if you know about the methamphetamines–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just the average listener here, they really are gonna stimulate serotonin and dopamine and a lot of your catecholamines, norepinephrine, epinephrine. So if that’s helping, while the question becomes how can we utilize construct of vehicles to increase those neurotransmitters? Also they block the reuptake to so they allow more of these nutrients or more of these brain chemicals to sit in between the pre-and postsynaptic neuron. The problem is long-term, we start to have more degrading or recycling enzymes that break them down faster. So if short-term, it works okay. But in the long-term, you start gearing up more enzymes to break them down.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  So the question I guess comes down to what can we do, I mean, on the neurofeedback side to improve these neurochemicals and maybe you want to take it to the diet side and maybe even supplements side, too.

Dr. Andrew Hill:  Yeah, you can do a fair amount. I mean another benefit of neurofeedback is it really makes your brain more sensitive and sort of reset some this—this acquired tolerance. And we see that in psychostimulants dramatically. You know, a couple weeks into neurofeedback you have to reduce your dose usually because you’re suddenly getting hit with a sledgehammer by—by your psychostimulants if you’re taking the.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  We also see it from things like cannabis oddly enough. You suddenly have to ramp your—your consumption down if you’re a cannabis user because your brain is super flexible.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  But some of the—some of the best of research is still coming in. I mean, we don’t really understand nutrition fully in terms of ADHD. And it’s also not a homogenous issue when it’s actually truly present. I mean, there are several variants, some more types of you know, dopamine receptor coding repeats that show up that gets classified as ADHD, and some of them make you more hyperactive but also more resistant to distraction and some of them make you, you know, more distractible but less able to focus—but also able to, you know, almost more able to focus rather when you get checked in. So it—it’s a little bit of confusing space and, therefore, what works for one person is not necessarily what works for other people. But those blog classes like mindfulness and neurofeedback works for pretty much every so that’s why I start there. There’s other things that may work for you. Things like L-tyrosine, which of course is the precursor to dopamine, does work for–

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  A certain percentage of people as a—as a support to attention pretty profoundly and I—I have a hunch that it’s working best for those people who’ve either been on stimulants, on who’ve got you know, one very sort of narrow subtype of ADHD where it’s really about a dopa—a dopamine receptor you know, proliferation. And for those people I think L-tyrosine is actually helping in need. There’s no real evidence that supplementing L-tyrosine increases levels of dopamine, but I have a sort of perspective on it where I’m gonna let the dopamine system regulate itself, because you know, anything goes directly to synapse or increases release of dopamine, things like stimulants. Those are always gonna be adapted to by the system because there are supraphysiological. They’re dangerous. They’re—they’re alarming to the brain and the brain has to adapt and, therefore, meaning tolerance, addiction especially in dopamine. So my perspective on this stuff is always to back up a level in the regulatory space if you will and feed the neurons, feed the dopamine neurons what they need to use their enzymatic chain to make dopamine. And there you’ll only get more dopamine if you actually need more dopamine in the moment. I mean I’m really somebody who—who believes that there’s no such thing as a chemical imbalance in the brain. It can’t really exist and there’s you know, massive sweeps of regulatory tuning in terms of receptor density and receptor sensitivity and all kinds of other things like that but my—my perspective on monkeying with the systems is they know how to regulate themselves and any ideas we have about what we’re are gonna be really imperfect at best, and you know, therefore, we’re gonna be trying things that don’t make sense. I think we got lucky with you know, SSRIs as mentioned earlier, Prozac. We now know that Prozac, yeah, if does work on serotonin, but not necessarily to increase it, you know, all sorts of neurons have autoreceptors that measure the amount of serotonin in the synapse that they are releasing into the synapse.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And if SSRIs decrease breakdown and, therefore, increase synaptic levels of serotonin, the autoreceptor shuts down release. So actually you have to adapt to it, you get sort of lower tonic release of serotonin in your—in your brain than you—than you did before you started taking whatever it was. You know, the SSRI. That’s—that sounds like that can’t possibly be true because serotonin’s the happy chemical and it—it’s antidepressive. It’s just not. I mean, if you—there’s something about the anxiety, it’s a little more closely linked to serotonin. But the antidepressive—antidepression effects of the SSRIs as well as anything else that lists depression, be it learning new things, be it exercise, be it whatever you’re dealing. The final common pathway if you will of depression release seems to be increase of BDNF. Brain derived–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Neurotropic factor.

Dr. Justin Marchegiani:  Neurotropic factor, right.

Dr. Andrew Hill:  In the hippocampus, which is all about learning and integrating information. That—that’s kinda what that job is and that’s really the key, yeah, I think. The key plasticity if you will, neuroregulatory factors. So it’s all about, I think the name of the game is BDNF. And depression is elicited by raising it through indirectly, you know, many steps back by—by tweaking serotonin and the brain responds to that loud signal by—wait, what’s going on? And getting a little more plastic if not integrate the slightly bizarre signal it’s getting from the SSRI is my—is my take on it. It cannot be, you know, perfect.

Dr. Justin Marchegiani:  How about B vitamins? How about B vi—I find B6 or P5P–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Pyridoxal-5-phosphate–

Dr. Andrew Hill:  Sure. Yeah.

Dr. Justin Marchegiani:  Is deemed really important to help convert some of these amino acids in the brain.

Dr. Andrew Hill:  Oh, yeah, all—all kinds of reasons. I mean, just look at the Krebs cycle,

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Just think back to our physical biology, there’s all kinds of amazing things that B vitamins do to the Krebs cycle, specifically some of the, you know, nicotinamide riboside, NA—NADH in terms of electronic streams. There was some related research—sorry—there’s related compounds in the Krebs cycle called alpha-ketoglutarate.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Which recently some research came out of UCLA, about a year ago, that showed that the anti-aging benefits in model organisms, C. elegans in this case. The anti-aging benefits of alpha-ketoglutarate are like 10 times higher than resveratrol in the same organisms and through a differnet mechanism—we know the resveratrol activates sort of the stress response gene, CERT, and that seems to be how they cause, you know, the sort of French paradox and other you know, animal model documented life-extension things. But the—the alpha-ketoglutarate is operating in a different place. It seems to be tweaking the Krebs somehow and, therefore, optimizing energy production. So all the other thing that tweak CERT, like caloric restriction, like cold stress–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  They do extend lifespan in model organisms but they do it at the cost of either mobility or reproduction, right? The animal become less metabolically active and that’s what happens if you restrict calories in humans, too, you know? Eventually we downregulate metabolism, not—not immediately.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  But eventually and—and so caloric restriction is the only biohacking modality that’s been proven to actually affect aging, but in model organisms, it does do it at the cost of metabolic output and it probably–

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Does the same thing in humans. So I’m excited about not only B vitamins, but things like alpha-ketoglutarate and this is the idea of going after the energy, you know, production machinery a little bit more directly. You know, lubricating ATP production. So B5, B12, and of course, we need versions that can cross-convert a methyl state, so ideally hydroxos and things. So yeah, I—I think a really good compliment B vitamin is kinda necessary. I think that you can also get really specific in a way that we don’t really understand yet, in terms of what you might need for B vitamins. I mean, there’s a lot of that genetic research done looking at methylation analyses–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And that’s essentially a study of how B vitamins are used in metabolism of energy and neurotransmitters. You know, that’s sort of how—how that—those analyses are used least. And–

Dr. Justin Marchegiani:  And when you’re talking about B vitamins and B12 though, you have like methyl B12–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  And you mentioned the hydroxyl and the adenosyl, when would you recommend one over the other?

Dr. Andrew Hill:  I don’t know is the short answer.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And I—I don’t—I don’t think enough is known. I mean, the—the methylation stuff, you know, it’s not well-established. There’s—from my perspective and—and I come from sort of the optimism space being clinically many years ago, there’s a lot of focus on methylation in childhood diseases or development including these you know, things like autism and Fragile X and a lot—there was a lot of focus for many years on energy production and methylation. And some of it seems to do something in some of these people and some of it is just bad science, and we don’t know the line between it unfortunately because it’s grown out of a population of people who’ve been trying every—I mean, when you have an autistic kid, you try everything until you find something that works, and almost nothing works. This is how—this is why autistic spectrum population is a pretty good segment of the neurofeedback market because they discovered that it actually affect the brain, very little effects, you know, profoundly affects the brain people of autistic people. Neurofeedback can, doesn’t always, but it can. And that got a lot of attention in that community, so therefore, you know, word of mouth is very high, and—and that’s why there’s a big push there. And the same thing is true with methylation. Sometimes the right B vitamin cocktail, you know, dial it in in an authoritative manner.

Dr. Justin Marchegiani:  Are you familiar with—with pyroluria condition where you need excessive B6 and zinc levels?

Dr. Andrew Hill:  Yeah, I’ve heard of that. It seems to be related to phenylketonuria as well where there’s some aspartame sensitivities, right? It’s a similar genetic, but it’s more about elimination of—of some core vitamins.

Dr. Justin Marchegiani:  Yeah, so they—they need just accelerated levels of B6 and zinc and—and will see some of it–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  On the organic acids test, but we give them higher levels of B6 or zinc and helps their mood or helps their sleep or helps whatever else in their energy systems to function better.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Do you have any clinical experience with that?

Dr. Andrew Hill:  I—I don’t, but really this is outside my area of expertise. I—I sort of do a little bit of personal biohacking in this space but my understanding of supplements is not as broad probably as my understanding of nootropics, so you know, B vitamins when I think about them are all about, “Mmm, how can I t weak the brain?” So I think, you know, B vitamins, I think like saw beauty in the, you know, which is a thiamine, a B1 dimer essentially gets into the brain and then cleaves. Then you have a massive hit of thiamine to the brain and if somebody came in as an alcoholic, I would—I would think, “Ooh, thiamine.” Because they have impaired B1 metabolism from drinking alcohol for many years and they probably have memory issues and—and failing the basal brain like mammal antibodies because of thiamine deficiencies. So I have a very specific you know brain focus on this stuff and not a good understanding of either the—you know, the phlebotomy driven if you will understanding of—of the biochemistry. It’s just not—I work at a very high-level of brain waves, so for me it’s all about tweaking that—that dance versus reading out the—the low-level output if that makes any sense.

Dr. Justin Marchegiani:  Yeah, so let’s shift gears with some of the smart drugs that you’ve–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  You’ve done. I know we kinda have our pallet here, whether it’s modafinil or piracetam or aniracetam or oxiracetam. What’s—what are your favorites? I know in the past you’d mentioned you’re not–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  A big fan of the modafinil, so I’ll let you have it.

Dr. Andrew Hill:  Yeah, you know, of course, I have designed TruBrain.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  And so I’m a big fan of mix of classic you know, a—a racetam plus a good choline, plus a few other things to support it and that’s sort of what went into the TruBrain formulations. Personally I—I’m still, you know, I still—piracetam and either CDP-choline or Alpha-GPC, still the best one to you know, combination I’ve ever found. And—and there hasn’t seem to be any downside or tolerance in these things when used for years and years and years, so that’s the, you know, the more serious biohacker’s you know, stack or the beginning biohacker stack potentially, but a little bit less racy, less risky, less you know, fully understood would be things like L-theanine. I—I mean I’m a big fan. I—I keep a couple things around my house, my office, and my campsite when I’m hanging out with my hippie buddies.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And those include L-theanine and ibuprofen.

Dr. Justin Marchegiani:  Ahh.

Dr. Andrew Hill:  Because L-theanine can pull back over caffeination pretty quicky.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And over arousal, anxiety, and a few other things.

Dr. Justin Marchegiani:  It’s doing that with GABA, right?

Dr. Andrew Hill:  For some people. Yeah, it’s very GABAergically–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  It appears to be very GABAergic in alpha wave productions. If you really, you know, can break some—break some stage that aren’t comfortable, and then ibuprofen for—for those folks that have like, you know, smoked one too many joints or eaten one too many pot cookies and their, you know–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Freaking out because of that. Ibuprofen can knock back THC intoxication a little bit and—and help people who are in crisis. So from my perspective, there’s a 2-mile like emergency kit if you will, nootropics. Even though ibuprofen is not really nootropics. In fact, pain killers in general probably should not be considered nootropics because evidences is—is—and I’m sorry, analgesic pain killers, ibuprofen, acetaminophen, those are just things—the research is mounting that they actually turn off either learning or empathy a little bit in some cases. Now ibuprofen seems to be the better case these days because the cannabis research anyways, there’s evidence that it eliminates the memory formation problems that happen when you’re high as well as–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Reducing some of intoxic—the high level of intoxication that people gotten in trouble with it. So there’s a little bit of benefit there but a lot of things do actually tweak brain function fairly profoundly, and we don’t yet know, you know, what that necessarily is for many of these things. Even things like Tylenol and you know, ibuprofen, these—the brand names—I guess Advil is a brand name of that one, but whatever. Even those are not necessarily you know, that are without side effects and there are organ system issues with all those drugs as well–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, kidney for ibuprofen–

Dr. Justin Marchegiani:  Elevated liver enzymes. Yeah.

Dr. Andrew Hill:  And liver for Tylenol.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And every year–

Dr. Justin Marchegiani:  Gut lining. Uh-hmm.

Dr. Andrew Hill:  You know, people make sui–yeah, gut lining for apirin—or ibuprofen. Every year people make—make suicide attempts with Tylenol and end up in liver transplant wards waiting for a liver because Tylenol’s so profoundly toxic to the liver. So yeah, not those but I—I also think, and get back to the ADHD question, there needs to be a big emphasis on not only systemic inflammation but supporting lipid metabolism through things like fatty supplementation, you know, Omega 3s, medium-chain triglyceride, even get good ketone production. For me, the—the focus on nutrition is shifting more towards getting crap out, you know, bad sugar, bad starch, actually all sugar bad starch and leaving in or enhancing the quality fats which include Omega 3s, Omega 9s–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Medium-chain triglyceride–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Usually food sources of those but I’ll toss them. I’m not a fan of refined oils. I—I don’t love them and most forms of refining I find either strip things out or leave things rancid, and so I try to get as much as possible from food, of course not always possible, and so I do supplement with DHA. That’s the only Omega that I—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Supplement and I get it form of—

Dr. Justin Marchegiani:  Algae or fish?

Dr. Andrew Hill:  In, yeah, exactly. Algae.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  TruBrain—the—the capsule form of TruBrain, still has a DHA capsule in the afternoon packet, and so we—that’s my sort of baseline—gotta get some Omega 3’s in because I know my body can cross convert as necessary. It’s not efficient but if necessary to make EPA from DHA and DHA seems to have more brain affinity so it’s a better, you know, Omega to go after if you’re gonna supplement and then I of course, keep my diet super low and grain-fed in anything including, you know, I don’t eat grains. I try not to eat anything that’s eaten grains.

Dr. Justin Marchegiani:  yes.

Dr. Andrew Hill:  And that keeps my Omega 6’s pretty low, too, which is, you know, something Westerners, specifically Americans are quite bad at.

Dr. Justin Marchegiani:  Yeah, and it sounds like you like really established to—to really have good fats, kind of a Paleo template-esque as well.

Dr. Andrew Hill:  I did, I guess. I mean—I didn’t know it was called that, you know, I was—I was sort of looking at initially of course, I don’t know, 20-25 years ago I—I read this book, and it was all about cycling ultra-low and ultra-high carbs and you know, there’s some flaws in the theories in the book but it had really good explanation how insulin works and it really stuck with me and there’s all kinds of you know, before that I thought insulin was just the thing that your body secretes in response to blood sugar spikes so then your cell can suck the blood sugar up and store it, either as fuel or lipids, whatever. But you know, I sort of realize at that time that it actually is tied to all these other hormones and other regulatory, modulatory things that cause you know, catabolic or some anabolic changes and releases of growth hormone and—and cortisol and it started it started to get me thinking a lot about how probably somewhat a time bomb the—the typical way of eating, which was like repetitively spiking our blood sugar. I mean, let me—let me—the—the blood sugar question is fairly well understood but it’s also not, not magical. We dropped back to a sub—a less well understood but also very similar feature of regulatory systems in the body or brain which is cortisol in the brain, high levels of cortisol, a person responds to stress and it goes up so you can focus and be alert and a bunch of other things happen in the brain and the body, but in the brain, it watches the range of cortisol and as it goes up, it responds and when it goes down, it responds differently. If the cortisol level goes up and stays up, response fails. The brain stops responding and eventually those high levels of cortisol start killing brain tissue and you know what, that’s exactly what happened in things like diabetes. If insulin goes up and stays up with repetitively spiking your blood sugar until eventually your cells stop responding to the insulinogenic signal and that causes a cascade of failures at every level.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  In body metabolism and aging and repair and growth and learning and, I mean, the list goes on.  And so I figured that out about 20 years ago and, yes, I have a slight, you know, problem with ice cream occasionally I will admit it. But on the days that I’m being good, I’m perfect.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And I’m good about 80% or 85% or 90% of the time, and on those days I’m absolutely damn ironclad on keeping my total carbohydrates below 65g.

Dr. Justin Marchegiani:  Yup,

Dr. Andrew Hill:  Unless I worked out you know, hugely—

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Like a 90-minute ______ class when I can barely let myself off the ground, then I might have you know, like an extra 20g of carbohydrates right after that and coconut water or something to replenish my glycogen from my you know, quivering muscles.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  But that’s when I have profound physiologic signal of you know, glycogen depletion and good note for, you know, levels of carb intake, the human body is fully depleted can store about 50g of carbohydrates per hour.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Of glycogen.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So you know, you—it would never make sense to—to take more than you can store and spiking for me anyways, I sort of figured it out it used to be around 20g of raw carbohydrate seems to spike my blood sugar and I—so, so my—my general rule is never more than 20g at anyone sitting, never drink my carbohydrate—it seems to spike things faster if it’s you know, sugar in a drink or you know, even milk or something versus—

Dr. Justin Marchegiani:  How about the Glycemic Index though?

Dr. Andrew Hill:  Ah, Glycemic Index is a load of hooey. It’s—it’s about—it’s about as accurate as—as calories, you know? Which are also a load of hooey.

Dr. Justin Marchegiani:  How about—how about the—how about the glycemic load?

Dr. Andrew Hill:  Ahh, see that’s—that’s a valid concept.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  We just don’t know necessarily how foods produce it.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  The—the rating of food is, you know, arbitrary little bit but the—the effects of load on insulin and—and the carrying capacity if you will is occupying sensory—a sensing molecule is—is a real thing. I don’t know what that is but I do know if you keep your in—if you keep your signal of sugar low, very low in the body, the way regulatory systems work is s they listen harder. What that means for insulin is increased insulin sensitivity.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So I don’t think it matters if you’re in ketogenesis or if you’re Paleo or Primal.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I think if you—if you stop spiking your damn insulin, and you get a sense of what that feels like when you occasionally go over it, I mean, if you spike it every day you don’t notice it. But if you spike it once a week, you—you know exactly what it feels like to have your insulin go up a little—a little bit above, you know, where you need because you have this drunk feeling and you get a little bit sleepy afterwards, and—but you know, after you adapt to lowish carbs and high fat, energy is rock solid stable. So at some point I figured this out and about the same time we started figuring out as a you know, culture if you will—Westerners how problematic you know, many grains mass produced farm grains at least are—

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  In—in their correct format, you know?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And I started two’s together, I went, “Oh yeah, that’s what my gut feels like, you know, pun intended, feels like crap all the time is because of all this, you know,  inflammation and sludge moving through my system all the time from eating pizza and whatever else I was eating in the 80s and 90’s.” So you know, yeah, it ends up being Paleo or Primal-esque and I—and I would say, I would say that you know, more—more primal blueprint if we have to tie it to an existing pran—plan in Paleo because I do think there’s a place for dairy in humans, or can be at least, not—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Not every human can handle it and we have to make space for inter-individual variability but dairy in a cultured or fermented form, I’m just not willing to give it up.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know? And there’s, you know, we can make a rationale but historically, ancestral health although I don’t generally make that connection because humans are ridiculously adaptable so we can point to any population in history and point out something that they’ve eaten that we couldn’t handle now. You know? People are variable. So whatever works for you is really what’s important. The insulin as a general rule, you know, carb loads are rules, the general—general guidelines are not you know, ironclad what’s gonna work for you, but—but I do think that you know, cheese and cultured butter and—and other fermented, you know, dairy can be fairly beneficial to the body I think it—it can develop in the gut biome can break it down to—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  To useful things. I think it can be a really great source of nutrition and I’m, you know, I’m also of Scotch-Irish ancestry. I’m gonna eat me some cheese.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know, some really sharp, crumbly you know, grab me by the tongue and squeeze kinda cheese.

Dr. Justin Marchegiani:  Absolutely,

Dr. Andrew Hill:  I have to have that. It’s—it’s built into my—into my body.

Dr. Justin Marchegiani:  And if you can do raw cheese—

Dr. Andrew Hill:  So—

Dr. Justin Marchegiani:  You know, obviously if you get more of the enzymes intact so you can break down the casein and protein—

Dr. Andrew Hill:  Exactly.

Dr. Justin Marchegiani:  Which tends to be the more—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Problematic protein out of them all.

Dr. Andrew Hill:  Yeah and—more problematic and it’s also huge again, genetic variability in terms of—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Can you handle that or not? Right? And I am blessed to be able to handle dairy, no problem. I’m cursed so that at least current generation, you know, mass-produced chemical shit storm wheat—I can’t handle and I’m not like half the Americans who seem to have no problem with, you know, mass-produced wheat. I’m of the, you know, at least 40%, 50% that seem to have fairly significant issues with—with eating you know, bread so to speak from commercial grains. So, you know, I was a baker throughout high school and into college.

Dr. Justin Marchegiani:  Huh.

Dr. Andrew Hill:  And I’m a—I’m a nominal cook. I’m an amazing baker.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  I can bake you anything you want, name it. I’ll walk into a kitchen. If there’s ingredients, you’ll—you’ll, you know, be happy but—

Dr. Justin Marchegiani:  Awesome.

Dr. Andrew Hill:  I can’t—I can’t bake. You know, I can’t bake with wheat, with gluten as an adult essentially, as a—as a grown man because of the lack of, you know, ability to handle it and I—and I—this is—this not a new thing. I didn’t know why I had poor digestion as a teen and you know, early 20’s person but I did and it was eventually because of you know, of—of grains. I—I have a hard time wrapping my head around us as a society and human creature, culture, developing this big, fat, greedy, hungry brains that needed high starch to really be fueled with the fact that half the planet seems to be struggling to metabolize starches and grains. These two things are really incongruous to me and I don’t—I can’t quite wrap my head around it. I don’t quite believe the full you know, idea that we’ve distorted the plants you know, too profoundly because—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Humans are adaptable and—and they seem to be able to adjust long-term to re—and quickly to big changes in diet. I just don’t understand why we’re having such a hard time. I—this strikes me as a blind man and elephant situation.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  What I discovered there’s some third factor that’s really you know, causative in destabilizing our ability to handle brains, and you know, 50 years ago that doctor was not present.

Dr. Justin Marchegiani:  I think it is—

Dr. Andrew Hill:  Nowadays it is.

Dr. Justin Marchegiani:  Yeah, I know, if you’ve read Dr. Davis’ book, he talks about the—

Dr. Andrew Hill:  Uh-huh.

Dr. Justin Marchegiani:  Genetic modification of wheat, not like the genetic modification when we’re talking about with like Monsanto, but just we’ve started off—

Dr. Andrew Hill:  With breeding.

Dr. Justin Marchegiani:  With breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Just kinda cross-breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  We have this einkorn wheat that was nine chromosomes and then we—we kinda cross, you know, cross-bred it so it can produce more gluten and you know, we’re res—basically be able to withstand various weathers and conditions. Now part of that from what I’ve seen with the genetic mod—genetic modificaion and the hybridization, the gluten content—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Has gone up significantly. I think 50%, 75%. So part of it could be just the extra gluten that is present that maybe wasn’t there years back.

Dr. Andrew Hill:  Maybe. I think it’s really—it may be due to that or the gluten may have changed in some—in some form. And the reason I think of this is oats. You know, oats do not actually have true gluten. They have only gliadin, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You have other forms of—

Dr. Justin Marchegiani:  Zeen—

Dr. Andrew Hill:  Gluten, gluten-like proteins.

Dr. Justin Marchegiani:  Or avenin, avenin.

Dr. Andrew Hill:  Yeah, but—but exactly. It’s different.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And theoretically, if there’s no cross-contamination, you have gluten-free oats, theoretically people shouldn’t have an issue with them, and you know, I’m about as—as pale as they come as sickly, you know, 23andMe points me at Scotland and Ireland and is not unsure about it at all. You know, I’m like I’m one of people. I’m short. I’m wide. I can climb mountains. I hang out in cold climates and love it. You know, I’m—my people ate oats and I as an adult cannot handle gluten-free oats all that. You know, a little bit but not all that well and there’s not a lot of those proteins in something like oats compared to true wheat, so I’m not sure what it is. I think there’s something else. I think we’ll discover that there’s something unrelated to wheat completely, unrelated to food completely that has changed how we—how we do this and I don’t know if it’s—you know, something in a processing step or—

Dr. Justin Marchegiani:  How about Roundup? How much is the—the glyphosate contributing?

Dr. Andrew Hill:  You know, and maybe—and maybe 20 years of ex—of exposure to that you know, in my traditional western diet has sensitized me forever to you know, those type of proteins found in starchy you know, grains. I held feeds just fine but not—but not grains. So and again—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This is an N of 1 and I’m, you know, just an informed consumer here, but I—I think that those—those glyphosphate and other you know—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Chemically induced problems, we—we know those things cause problems. You know, when I was in grade school, you know, I wrote a paper on how DDT made you know, eggs fragile and it was—had to be removed for the environment in like 70s.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And this is not—this is you know, there’s always things like this. Every year, we go, “Oh, yeah, oh yeah, BPA. Ooh, oh yeah, that, hmm. Okay, let’s get that out of the environment, let’s get that—that out of our diet,” and one of those things is gonna be—is gonna interact the gut environment, the micro via the—the genetic expression of the microbiome, something will—is gonna be manning—there are many, many times the genetic, you know, material load of chromosomes in our gut that are not human DNA—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than—than there are. You know, the microbiome is incredibly more complex than our own genome, profoundly more, you know, many, many, many, many, many, many times bigger in terms of number of actual genes, and you know, I have a hunch that we’re—we’re gonna find something in there is—is you know, thrown off by something we’re doing—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  As a modern people.

Dr. Justin Marchegiani:  And I guess the next will be comes down to how long does it take for our DNA to adapt, because I know where human species have been around at some level at 1.8 million years, but perhaps and what grains have been here about 10,000. So I guess the question becomes are all of us adapting at that same rate to be able to handle grains?

Dr. Andrew Hill:  Yeah, I mean, it’s a bit of—what you mean by adaptation?

Dr. Justin Marchegiani:  Being able to digest. Yeah.

Dr. Andrew Hill:  We seem to very float—yeah, but that—that might happen quickly. It’s—I don’t think we fully understand what it—what is necessary in producing those, you know, old enzymes and ways to break down material. Like for instance, we can’t digest cellulose anymore, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  At one point in our development as—as creatures, we could eat wood pulp and survive off of it probably if we had to. That’s no longer the case. We no longer have those enzymes. You know, that swept through the population probably over many thousands or tens or hundreds of thousands of years, we weren’t quite yet human. But other things, you know, your—your grandparents had an experience that’s affecting your genes right now, Dr. Justin, you know?

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, if your—if your grandparents were at World War II, I’m assuming you’re about my age—

Dr. Justin Marchegiani:  Yeah. Uh-hmm.

Dr. Andrew Hill:  And they experienced trauma or you know, stress—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or anything else, the way your brain and body secrete and respond to cortisol is different than it would be—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Otherwise.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  You know, two generations of epigenetic, sort of cascade—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Have affected you. So the question about you know, how quickly does it take to adapt is unfortunately you know, becoming blurrier and blurrier the more we—we discover about the—the genetic expression or the organism learns and changes and patterns on the environment. You know, the—the gene for sort of modern big brain size that is in humans, I think it swept through the primate population at the time in something like 20,000 years which is absolutely fast. I mean, there’s no way that—that could—that could have happened by breeding pressure. You know, it happened through a combination of a bunch of factors probably including things like natural disasters and isolated certain population.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I mean, who knows what else, but you know, those are individual—actually two or three identified gene based on brain size, and those swept through the population in a—in a blink on an evolutionary timescale. But we talk about evolution as if it’s this massive glacier melting, no—no pun unintended.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Thing.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And it can be, you know, this is why I’m—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  The fact that I’m bald is—is gla—is a function of glacial evolution. It—it took a long time for that to show up, but the fact that I was hyperactive as a kid, the fact that I’m sensitive to gluten and other forms you know, grains. That might simply be a function of my genome going “Dude, that hurt,” or “I gotta respond to that,” or “That’s dangerous,” and I ‘m not sure what it responded to but it’s unfortunately left me unable to you know, enjoy baking or—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Consuming, you know, really good pizza which is—which tragic.

Dr. Justin Marchegiani:  And what’s the evolutionary role for baldness? I know you were kind of touching on that briefly there.

Dr. Andrew Hill:  Ah, you know, I don’t know, I—

Dr. Justin Marchegiani:  A theory?

Dr. Andrew Hill:  I see a few theories including things like it allows radiation of heat a lot better.

Dr. Justin Marchegiani:  hmm.

Dr. Andrew Hill:  Because the brain is ridic—I mean, 90% of body heat is sort of escaping through the head. If you’re bald, you lose more heat through the top of your head. It allows your brain to cool itself more. There’s also some testosterone you know, relationships where it might not an adaptation so much as a you know, epiphenomenon of some other adaptation. Slightly higher testosterone expression or—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or your levels in the—in the skin produce suppression of the follicle which is male pattern baldness, that set link characteristic of male pattern baldness, not all pair of patters in all baldness, but you know, the one that I have is—is probably a high level testosterone that reduced you know, the follicle. I’m not sure it—it produced, I mean who knows? The more I learn about the brain and the body, the more I’m surprised at how damn efficient every adaptation is. Nothing seems to happen by random and adapation is that you think serve one feature, serve multiple often. So I wouldn’t be surprised if at the same the organism was learning to become more efficient or a heat radiator. The same adaptation made it more you know, competitive sexually or something, and that meant the genes proliferating, you got both baldness and higher level of testosterone with some creatures, you know? But for me and I work in EEG which is a mysterious space. For me, understanding plausible is enough.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  If we can tweak a system and they can respond, then plausible is—is good enough as long as we are fighting is what is actual.

Dr. Justin Marchegiani:  Interesting.

Dr. Andrew Hill:  And we’re discovering what is actual in things like follicles. You know, there was a study out a few months ago that showed that—that they’ve figured out why hair goes gray and it looks like the same mechanism actually might be related to the—the key of the suppression of the follicle. There are some—some evidence that they tested but there’s some theory that was generated by this first finding. The first finding was, “Oh, look! Here’s what makes hair go gray.” And that actually explains why thigns like resveratrol may actually reverse—may actually plausibly reverse graying in some people who—who claim that it does, it’s not a wide—widespread phenomenon but it seems to happen. But the same mechanism seems to you know, suggest suppression of hair follicle and so we might be like right around the corner from you know, no more male pattern baldness through cosmetic you know, pharmacology if you will or genetic manipulation or who knows but it seems to be we’re right around the corner from—from solving that if you will. And then I’ll have a very firm opinion about how it works.

Dr. Justin Marchegiani:  Got it. So you’re thinking—

Dr. Andrew Hill:  But right now, you know—

Dr. Justin Marchegiani:  Yeah?

Dr. Andrew Hill:  It doesn’t matter.

Dr. Justin Marchegiani:  So you’re thinking the resveratrol could be helpful?

Dr. Andrew Hill:  I think it probably can be. You know, I don’t—I don’t mind being bald, you know? I—Ia m—I guess I’m blessed in that I have a sort of Patrick Stewart shaped head.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And so I can cool it off—

Dr. Justin Marchegiani:  Love it, yeah.

Dr. Andrew Hill:  it’s fairly, it’s fairly round. There’s not a lot going on up there.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Beyond curve.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I—I can pull that off and I, you know, I wear glasses so doesn’t mean to break in that expanse of flesh but—

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It doesn’t really bother me and I don’t really care too much about it. But yeah, resveratrol will probably or some related molecule probably, you know, unsupress the follicle, I mean, right now resveratrol has other uses, right?

Dr. Justin Marchegiani:  Mitochondria, yeah.

Dr. Andrew Hill:  You’re taking resveratrol for mitochondrial support.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It seems to suppress estrogenation or other Romanization—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Of some hormones, so take it to protect the heart valve. If you’re taking other compounds can be useful. You know, there’s a few other like—like serotonergic but you don’t wanna take 5HTP and—and other serotonin converting things and get peripheral nervous system serotonin, that will do damage. You know, you’ll get peripheral neuropathy and damage your heart valve. If you wanna take you know, resveratrol and things like to suppress Romanization of hormones, but I—I bet we’re gonna discover something else like that, and suddenly sprout big, thick full heads of hair. And—

Dr. Justin Marchegiani: Love it.

Dr. Andrew Hill:  And will I try it? Sure. You know, because I actually have a gorgeous—you wouldn’t know this—but I have a gorgeous you know, reddish blonde Scottish mane.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And you know, it’s been 25 years since I’ve seen it, and you know, I can grow a ground _____ Willy style moustache right now.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And I might, but it’d be kinda fun to go all full like you know, lion again, just playing in my age, so I say, yeah. I—as much as I am sort of laughing about who cares if we cure baldness, I would probably partake if there was a you know, natural-ish substance that I could tweak my—my follicles with.

Dr. Justin Marchegiani:  Absolutely, I love that. Well, kinda finishing up here. I wanna just go through just a—a rapid question round for you. Just kinda hit these next couple things off.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just really quick, sound good?

Dr. Andrew Hill:  Sure.

Dr. Justin Marchegiani:  Alright. ADHD, what are the top 3 things you do for that?

Dr. Andrew Hill:  Meditate, neurofeedback and drop sugar out of your diet.

Dr. Justin Marchegiani:  Addiction.

Dr. Andrew Hill:  Understand why you’re using.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it impulsivity?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it boredom? Is it discomfort with your emotions? Is it brain injury that lead you to behave where you weren’t inspecting. Figure out which it is and solve it.

Dr. Justin Marchegiani:  Got it. You’re studying for an exam. What are the best things to get your brain revved up for that?

Dr. Andrew Hill:  The best thing is to space your practice versus mass your practice first of all.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Short breaks ideally with rest and sleep in between them over many days to ensure consolidation. The other thing is to put yourself in the perspective of get to versus have to.

Dr. Justin Marchegiani:  Love it.

Dr. Andrew Hill:  So engaged with your—engage with your material because it’s fun and find a way to make it so. And the third thing is don’t binge on food when you’re studying. Snack very lightly make.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  To make sure you don’t end up in a—in a bonk, blood sugar-wise which will completely abolish the learning and studying interest you have for that session.

Dr. Justin Marchegiani:  Love it. Top three smart drugs.

Dr. Andrew Hill:  Clearly, piracetam, cito— citrocholine and let’s say DHA.

Dr. Justin Marchegiani:  DHA.

Dr. Andrew Hill:  These are the kinds of drug. Yeah.

Dr. Justin Marchegiani:  Yeah. Basically the 22 carbon fat and the fish oil. Awesome.

Dr. Andrew Hill:  Yeah, it seems to, you know, and maybe even Vitamin D might even fall in that category.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  These things are so profound in—in so many tissues and supporting so much metabolism. I think they upregulate stock even when it’s not noticeable.

Dr. Justin Marchegiani:  Love it. Recovering from brain trauma or a TBI.

Dr. Andrew Hill:  First thing, don’t do anything immediately.

Dr. Justin Marchegiani:  Fast, right?

Dr. Andrew Hill:  Don’t jostle your brain physically or mentally.

Dr. Justin Marchegiani:  mmm.

Dr. Andrew Hill:  For a few weeks then drop inflammation, which means rest, low sugar, and then you can start doing things like neurofeedback and concentration-focused mindfulness to start waking up all that bruised and delta-rich cortex.

Dr. Justin Marchegiani:  I’ve seen a low of stuff on low-calorie diets especially for a couple days after the injury.

Dr. Andrew Hill:  Yeah, it’s just that fasting produces a drop in inflammation, so you know. Yeah, basically you gotta rest and you can’t even think hard ideally. You know, you definitely, you know, the—the damage comes in concussions from the second impact that you get in certainly within 3-5 days but maybe even 3-5 weeks after a first significant insult to the brain. There’s all these inflammatory cytokines that cause inflammation after the first insult that protect the brain in the—in the short term but make it fragile, make the tissue very shatterable for days and if you receive a second impact in that time, the damage—the damage is much more profound. You know, the damage carries through the brain , you know, through a solid almost, the way it would like a block of ice instead of just kinda pushing on a—on a corner like a piece of Jell-O or something, so—

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You gotta let your brain rest for weeks, you know, 3 to 5 weeks if it’s a significant injury, and you can rebuild, you know, if you’re somebody who’s had a lot of wear and tear, brain fog, irritability, wearing out mid-day with cognitive fatigue, those are the—those are the 3 big signs. If you are somebody who’s post-concussive and you—you  realize that you still are, you know, months or years later, do something about it. Get some neurofeedback. You can completely—not completely maybe—but you can certainly affect it positively. And there are some long-term risk for many post-concussive. You know we know now that, you know, there’s a study out a few years ago, not even a few months ago I think or something last year, that showed that high school football players who never played a game but practiced with the team show early signs the chroma—of chronic, or sorry—CT, chronic, traumatic encephalopathy. From beginning brain scan, to the beginning to the end of the season, without ever playing a game—

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Simply doing practice. So the amount of damage the brain can actually shrug off is negligible. It’s not really supposed to be bounced.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Or st—or change direction suddenly at 60 miles an hour. It’s not designed to go 90 miles an hour highway and suddenly stop, you know, or anything else where—where you’re launched through the world and then suddenly stopped. The brain’s great at you know, not that extreme impact, but it fails very quickly over a certain amount of impact. Let’s say it’s not force and we hit that force all the time. A single—there’s a study out 2 weeks ago maybe—a single stocker heading drill, and in heading the ball 20-30 times in a few minutes, memory test before and after showed a three quarters drop in performance, severe hermit.

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Right afterwards. Now, the study didn’t—didn’t look at long-term, it looked at immediate and it found a—and it found massive GABA-ergic, well, they were hypothesizing GABA as an inflammatory response but they found inflammatory markers and they found massive impairments in memory right after drill, and those things we know are things the brain learns from and—and responds to. So there is no safe level of head impact, you know? If I ever have a kid in high school, they are not going to play football or soccer. You know, I—

Dr. Justin Marchegiani:  That was my next question.

Dr. Andrew Hill:  Yeah. Never.

Dr. Justin Marchegiani:  Would you like your kid to play football?

Dr. Andrew Hill:  No, I would not. No, I would not.

Dr. Justin Marchegiani:  And what do you think about what’s happening with the NFL? I mean, do you think this is just like smoking in the 1950s and it’s just, we’re just waiting for enough—

Dr. Andrew Hill:  Yes.

Dr. Justin Marchegiani:  Research to come to a head?

Dr. Andrew Hill:  Yes, absolutely. Yup, absolutely. The—the NFL will become and also ran a small network of people who were the bad boys who still continue to do this thing that leaves people damaged. The NFL will be seen as an organization like Monsanto that has secretly known for decades that they’ve been injuring and killing people and had been doing lots with millions of legal dollars to keep that suppressed.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  And we will discover that if there—it just isn’t. It was never safe. That will be considered a barbaric time in—in 50 years.

Dr. Justin Marchegiani:  I think you’re right. Well, here, last question with you Dr. Hill before we find out more about where everyone can go see you. If you’re on a desert island, what’s the one supplement or nutrient you bring with you?

Dr. Andrew Hill:  Alright, well, does this—does this desert island have coconut trees or not?

Dr. Justin Marchegiani:  It does, so you’re gonna have the medium chain triglycerides there.

Dr. Andrew Hill:  Nice. So if I have coconut meat and—and fat and everything else—

Dr. Justin Marchegiani:  You could probably fish, too, so you’re Omega 3’s and DHA will be recovered.

Dr. Andrew Hill:  I can fish, I got my DHA, you know, okay.

Dr. Justin Marchegiani:  Sunlight, vitamin D, that’s covered.

Dr. Andrew Hill:  I think that—I think that something, maybe beta-carotene.

Dr. Justin Marchegiani:  Okay, so vitamin A.

Dr. Andrew Hill:  Or, no, I don’t know, I may go get astaxanthin from like—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Shellfish.

Dr. Justin Marchegiani:  You probably would.

Dr. Andrew Hill:  So, hmm, what—what can I—what couldn’t I get from a natural, from an island I really needed? Yeah, I would probably have to say something like piracetam.

Dr. Justin Marchegiani:  Okay.

Dr. Andrew Hill:  You know? but not, you know, let me—let me give you a non-standard answer. I—I wouldn’t bring any racetams with me. I’m on a desert island. I’m gonna relax.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I’m gonna fish. I’m gonna you know, I’m gonna get plenty of vitamin D and—and good food and you know, maybe—maybe grow some vegetables. Huh! But if I’m actually on a desert island, high-performance is not my survival. I’m gonna survive and once I’m surviving, I think—I think the environmental press of—of having to live and pry on a desert island would be sufficient nootropic to keep me functioning at my highest level.

Dr. Justin Marchegiani:  Love it. very cool, Dr. Hill. Now people who are listening, they wanna find out more about you and about TruBrain and about some of the services that—that you provide. Where is the best place to find more info on you?

Dr. Andrew Hill:  Yeah, so fols can check me out at @AndrewHillPHD on Twitter. I think I’m also at Instagram, but that’s a pretty anemic page. Peak Brain LA, Peak Brain Institute has a Twitter, @peakbrainLA. We have a website, peakbraininstitute and of course, trubrain.com—T-R-U-Brain dot com is the supplement—it’s the supplement that the nootropic stack that you mentioned that I helped design a few years ago, and you know, I’d love if people reach out and ask me a specific brain questions. We have very unique brains. You put 10 people in a room, there’s at least 11 different brains in that room from my perspective. You really gotta share what’s special about you and celebrate it or take control of it and tweak it and address it. So I’d love if folks have, you know, quirky brains they wanna share to look me up and—and find out what we’re doing and you know, there’s lots of ways to—to take control and change your brain, so give me shoutout if you want one.

Dr. Justin Marchegiani:  Thanks a lot, Dr. Hill. It was a great talk and we look forward to chat with you again soon.

Dr. Andrew Hill:  My pleasure, Dr. Justin.

Dr. Justin Marchegiani:  You take care. Have a good one.

Dr. Andrew Hill:  You, too. See ya.

Dr. Justin Marchegiani:  Bye now.

Dr. Andrew Hill:  Bye.

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