Dr. Kelly Brogan – A Mind of Your Own – Podcast #165

In today’s video, Dr. Kelly Brogan, an accomplished doctor and author of the New York Times bestselling book “A Mind of Your Own”, joins Dr. Justin Marchegiani as they both discuss the link between gut issues and mental health. Get some useful tips on how to keep your mind clear and active without gut issues hindering it. Get your own mind back with the help of functional medicine. Let’s watch and listen!

Discover some natural ways to be more productive and learn about the different ways to address brain and gut inflammation. Also, stay tuned for some more information about Dr. Kelly’s bestselling book, “A Mind of Your Own” and viral articles.

In this episode, we cover:Dr. Kelly Brogan - A Mind of Your Own - Podcast #165

02:41   Depression: Illness of Modern Civilization,

Not a Chemical Imbalance 

04:53   Animal Model of Depression

08:20   Multiple Different Lifestyle Pillars

12:00   Meditation and Productivity

16:42   Supplemental Ways to Address Brain Inflammation

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Dr. Justin Marchegiani: Hey there. It’s Dr. Justin Marchegiani. Today’s podcast, we have a great guest.  Dr. Kelly Brogan in the house. Kelly is wicked smart. I’ll bring up my Boston ex. You went to MIT Undergrad in Cornell from Medical School. So, it’s a privilege to have her here. She has a New York Times bestselling book, “A Mind of Your Own.” Did I say it correctly?

Dr. Kelly Brogan: That’s right? [crosstalk] You got it.

Dr. Justin Marchegiani: A Mind of Your Own, really looking at natural solutions to get your brain back on track and move back on track. And one of the things about Dr. Kelly that I love so much is she looks at how mood is connected with the gut. Because most people, they just want to throw a medication to fix the brain. They fix the symptoms but not actually get to the root cause, which can be in the gut. So, Dr. Kelly, welcome to the show.

Dr. Kelly Brogan: Thank you. Total pleasure to be here.

Dr. Justin Marchegiani: Excellent. Well, tell us a little bit more about your self, ‘cause you went down this conventional medical rabbit hole, right? MIT, Cornell– You’re diving in deep– you do your residency, uhm– and you’re kind of learning all these conventional treatments for Mood disorders, etc. How did you come out of that alive? And how did you get your training to get to the real root cause and the functional medicine side here.

Dr. Kelly Brogan: Yeah. So, you know, I come from a very conventional mindset, and I was raised by uhm– an immigrant mom. And anyone who has immigrant parents knows that, basically, you follow the rules; you become a doctor, a lawyer and you’re supposed to be making a lot of money.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: And that was essentially, you know– My effort uhm– was to become a doctor. I thought, you know– I figured out through my work on a suicide hotline, actually, at MIT, that we’ve cracked the code of human behaviour. We know that these are genetic illnesses that are reflected as chemical imbalances that require pills for lifelong management. Cool! You know, I’m gonna participate in that model. And so, it really wasn’t into my own, sort of uhm– health journey, which is what you’ll all hear from any turncoat doctor. We had a personal experience where we bumped up against the ceiling of what conventional medicine has to offer. And we learned a broader version of the truth. And uh– you know, I’ve always been a Science Nut. I’m very comfortable on pubmed.com, and I went and researched for myself, you know– the truth about everything I learned in medical school and residency and fellowship. Uh– and what I learned was pretty jaw-dropping. I was ready to hear it though because I had already had my own uh– experience of putting an autoimmune disorder into remission through nutrition. And so, you know– what I learned is that depression, for example– Let’s just talk about depression because it’s a– It’s a emblematic of these more systemic issues in our medical system. But, uhm– it’s not a thing. It’s not a disease in a way we were told it was. And, you know, what I– what I learned through my review of the medical literature is that in six decades, you know– we’ve been trying to validate this idea that depression is a chemical imbalance. The science just isn’t there. I was shocked because I can’t tell you how many hundreds of patients I’ve sat with and I said, “You know, you have a chemical imbalance. It has something to do with Serotonin or Dopamine or Epinephrine, and you know– you need to manage it. And the sooner you accept that, you know– the easier your life is gonna be.” So patronizing. You know, I’ve said that to countless patients. And when I looked to the Science, it just wasn’t there. But, what is there, interestingly, is a science that frames depression as uhm– an illness of modern civilization, right? So, it’s a response on the part of the body, mind and spirit, uh– you know, to the kinds of stressors, exposures, triggers, toxicants that we are encountering today, that we just haven’t evolved to accommodate. And perhaps, we never will. Perhaps we’re not even meant to, right? Because…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …of– of wrong living today, and– and the way that the natural world will ultimately ask us to get back in line. And– and one of the ways that– that asking happens, that– that invitation’s delivered is through symptoms. So, uh– you know, I found  that there are actually a lot of reversible causes of what we are calling depression.

Dr. Justin Marchegiani: Interesting. Very good. And I see a lot of patients, clinically, right? ‘Cause I’m working with patients making diet changes or cutting out gluten, grains, refined sugar, a lot of the inflammatory foods, or cutting out a lot of the bacteria in the gut that has this compound called LPS or lipopolysaccharide. And, you’ve talked about that kind of getting into the bloodstream and making its way to the brain, and creating mood issues there. Can you elaborate more on that?

Dr. Kelly Brogan: Yeah. So, you know, I think it’s fairly intuitive for most people– you know, that the gut and the brain are connected, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: You felt nervous about giving a speech and maybe you lost your appetite or you have diarrhea, or something like that. And that makes intuitive sense. But, the other direction– you know, the gut to brain direction, is really something we’re just beginning to develop scientific comfort with. Although it’s been actually several decades since it’s emerged in the literature. When it comes to depression, it’s interesting because the animal model of depression– There is such a thing. In the animal model of depression, the way that they induce it is to inject– Systemically, right?– in these rodents, LPS, as you mentioned. So this– this compound in a grand– grand negative bacterial balls. And the deal is that it’s not meant to be sort of circulating around. So, once it’s breached that gut-brain uh– Sorry– that gut barrier..

Dr. Justin Marchegiani: Yes.

Dr. Kelly Brogan: …then it can alert the immune system to the need of greater inflammatory response at the gut level. It’s all by design. Everything that the body does makes sense if only we have the mindset and framework to, you know, receive that uh– information. So, you know, through this lens, uhm– the inflammatory response that ultimately results in the symptoms of depression, which are what? Sleep disturbance, social avoidance, changes in appetite, for example, changes in  motivation, fixation on very specific thoughts, uhm– you know, the– the– the driver of that perhaps could be reduced to a gut insult. So, where do gut insults come from? Most of the time, through what we put in our mouth…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …right? So that means that we are empowered to make changes to our brain behavior and cognition through diet, you know. And of course, now we have science that shows that within seventy-two hours of changing your diet, you change that ecology in your gut, your microbiome. Uh– and so, I totally agree, you know, that there are certain foods that really moved the needle quickly. They also happen to be foods that are very addictive in nature, right? You know, things like, wheat, dairy, sugar, alcohol. I actually stored coffee in that mix. I know that’s little controversial.

Dr. Justin Marchegiani: Hm– Mmhmn.

Dr. Kelly Brogan: Uh– but, you know, so– so, not only are you seeing what you look like without these addictive foods, but you’re also engaging in a pretty deep exercise of changing your gut ecology. And, you know, we could talk about the role perhaps of certain kind of starches in, you know, feeding gut bacteria, ‘cause that’s, you know, part of my approaches to restrict those for the first month.

Dr. Justin Marchegiani: Got it. Interesting. And what’s your experience treating patients ‘cause, clinically, I treat– well, fifty patients a week in my virtual clinic here in Austin. And I’m running Stool test–  sometimes, even multiple Stool tests on different patients, and I’m saying, you know, obviously, “Your SIBO type of overgrowth.” “You’re Methane and you’re Hydrogen overgrowth”. And then, I’m seeing infections like, Blasto, Giardia, and Cryptosporidium, E. histo and H. pylori. What are you seeing in your patients? Are you kind of seeing a similar imbalance of those creatures.

Dr. Kelly Brogan: It’s interesting because I– you know, when I departed conventional medicine, my first deep dive was into functional medicine.

Dr. Justin Marchegiani: Mmhmn.

Dr. Kelly Brogan: Uhm– and that’s, you know, uh– I was certified through ADIHM, and I was very interested ‘cause this is how my mind works…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in quantifying every aspect of my patients’ existence, right? So, I wanted blood and saliva. I wanted hormone testing. I wanted Urine analysis and I wanted Stool analysis. And I did that for several years– yeah, almost a decade, into this work. Uhm– until I came upon uhm– a deep desire to bring this opportunity to more and more people. Perhaps you couldn’t necessarily afford all that testing, or for whom it was just overwhelming, right? And so, somehow, I arrived at the point today, where my approach is actually quite simplified. Such that, I actually come to believe that if you recruit the synergy of multiple different lifestyle pillars. And they’re pretty basic, right? Pretty familiar, too, obviously. So, detoxification…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …looking at daily contemplative practice. Of course, I’m– have my specific opinion on what I believe is one of the more powerful types. I’m Kundalini Yoga uhm– Instructor.

Dr. Justin Marchegiani: Nice.

Dr. Kelly Brogan: And, also the role of a strict commitment to a therapeutic diet for the space of the month. So, in working with these pillars, even without testing at all– So, in my online program, we don’t do any labs. The outcomes that I have gotten actually more rapid and more robust than when I was mired in the weeds of testing. But when I was, I actually found that there are some common uh– reversible drivers of diagnosis of anxiety, of depression, even OCD, panic attacks, ADHD, Chronic Fatigue– In my practice, the one of the most common ones was blood sugar imbalance, so…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …big one, right? Uhm– so you could test for that. You can diagnose reactive hypoglycemia, or you know you can just do a dietary intervention for ten days and see if that was part of the deal for you, right? So, another big one is wheat and dairy indigenousity. So again, you can test for that or you can just take it out and see how you do. Another big, big, big– big one, probably upwards of 80 percent of my patients have a diagnosis of Hashimoto’s, often…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …perhaps driven by mimicry like you’re talking about e– Epstein-Barr, uhm– for example, uh– you know, infection. Uhm– Hashimoto’s, Graves, Postpartum Thyroiditis are big– what I call, psychiatric pretenders, right? If you do not know that you have this going on, you could land your self on Zoloft and Lithium, or more. And that’s why this kinds of testing– unless you’re really committed and you just know, you’re not gonna go the medication route– you know, this kind of testing can really– potentially even, you know, save your life. I’ll be that dramatic about it. Uhm– and, you know, and then, of course, I’d become very passionate about the untold side effects of other common medications, right? So, as drivers of psychiatric illness, so things like birth control pills and acid blockers, statins, antibiotics. Uhm– so, you know, sometimes it– it– it needs to be looked at through the eyes of an expert like yourself. Uhm– but sometimes it’s really simple. You know, and– and engaging in this kind of uhm– you know, pillar approach can– can be really all you need.

Dr. Justin Marchegiani: Very cool. Just curious. Can you give us like uh– a day in the life of Dr. Kelly. What does your diet look like, Breakfast, lunch, dinner?

Dr. Kelly Brogan: Yeah. So that’s the interesting uhm– part about this kind of like holistic medicine, if you want to call it that, is the power of your potential to influence and heal patients, I believe, is in direct proportion to your ability to walk the walk, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So, you know, you transmit something to the people you are looking to help, simply because you’re living that life. So, I– you know, I walk the walk completely, you know. I asked many of my patients to do coffee enemas, for example, which I learned from my mentor, Nick Gonzalez. And you know, if II didn’t do them, how would I ever convince someone else that it’s effective? And this is why meditation is a tough one for me because I follow the literature on meditation for many years and I never did it. I was too busy. Meditation was for other people. And everytime I sat down to do it, I hated it. I hated the experience of just being with myself and being with my crazy mind, right? So, until i broke through that barrier and actually committed to a daily practice– Now I have a pretty strong 45-minute daily practice…

Dr. Justin Marchegiani: It’s great.

Dr. Kelly Brogan: …predawn. But, you know, until I did that, I didn’t– I don’t think I convinced a single patient to meditate. You know, we both sort of thought it was a good idea. They weren’t doing it. I wasn’t doing it. So, you know, the real game changer for me, personally, ‘cause I heal my Hashimoto’s mostly just through dietary change uhm– in almost eight years ago now. Uhm– and my life really changed. I’ve really rewired my nervous system and my productivity performance and aligned it with my flow, changed dramatically when I started meditating every single day. And, specifically, when I started meditating before sunrise, uhm– everything changed. You know, I used to be up until 2 in the morning, working. I’m a total workaholic.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I wake up everyday dying into this work. I love this work. I– I would do it for free, forever. You know, this is what I’m here to do. But, I would work ‘til two in the morning regularly. And you know, in New York, that’s– it’s the culture here.

Dr. Justin Marchegiani: Totally. [crosstalk] Hustle and bustle.

Dr. Kelly Brogan: Totally. Exactly. Totally sanctioned. So, you know, I uhm– When I started meditating at 5:30 in the morning everyday, which I started after in the setting of grief uhm– you know, after my mentor died. It’s the hardest thing I’ve ever dealt with…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in my life.

Dr. Justin Marchegiani: Roger that.

Dr. Kelly Brogan: I was desperate.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. I was totally desperate, and I did it. The nest day, I woke up and I have never missed a day since. Uhm– but, if you’re waking at 5:30, you can’t go to bed at 2:00 AM, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Or you’re gonna be in trouble [inaudible]

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So now, I go to bed at nine. Do you know how revolutionary that is for a New Yorker…

Dr. Justin Marchegiani: It’s amazing.

Dr. Kelly Brogan: ….to go at bed at 9:00 PM? And–  and you would think, “Oh, I’m missing– you know, what is that?– five hours of productivity.”

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Like, how do I even keep my business afloat. Uhm– but my performance– and again, sort of alignment with– just things unfolding, everything happens exactly, you know, the moment I need to. I don’t need to drive this ship. You know, that’s one of the sort of secret pearls in self-care that you wouldn’t otherwise believe unless you’ve had the experience. So, i’m a big believer in foregrounding self-care as being really my only responsibility. All I have to do every single day is make sure that I have committed, again, to taking care of my self. And the rest is gonna. Is gonna be exactly how it needs to be.

Dr. Justin Marchegiani: Very cool. So, I think I missed it. What was breakfast again, typically, for you?

Dr. Kelly Brogan: So, I have this uhm– smoothie often. It’s so funny because sometimes I’ll write a blog that I, you know, spend weeks and weeks and weeks researching. It’s like, you know, ten, 15, 20, 30…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …represent it. And like four people will read it, right?  

Dr. Justin Marchegiani: Mhmmn.

Dr. Kelly Brogan: And then, one day, I just decided to write uh– the ingredients of the smoothie that I put uh– together. Okay, it’s like egg yolks, coconut oil, uh– plus/minus coconut oil. Uhm– nut butter, frozen organic cherries. It’s collagen powder, uhm– coconut water.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Just, yeah. Basic– basic stuff, but it’s not a green smoothie, right? Uhm– it’s not a ton of Kale and Spinach or anything like that. And it was– It’s like, to this day, the most viral thing I’ve ever written. [laughs] It’s just breakfast, [crosstalk] right?

Dr. Justin Marchegiani: Love it.

Dr. Kelly Brogan: Because if you struggle with blood sugar stuff, like I did, uhm– like many of the people I work with do, It’s like, within the day resolution. Like within one day, you can turn that around. You’ll feel what it is to put, you know– It’s two tablespoons of ghee. Put that much fat into your body for breakfast is an unusual thing uhm– for most people, and it tastes delicious and you actually feel full for some times, double-triple the amount you would have otherwise. So, that’s why I’m actually big– I’m glad you asked– big believer in just beginning with changing your breakfast. Like if you are not ready for the rest of it, just start with there. And see…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …how different you can feel.

Dr. Justin Marchegiani: I love it.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: ‘Cause stabilizing that blood sugar is so important. ‘Cause when your blood sugar goes on highs and lows, you get the Hyperinsulinism, which is gonna create all kinds of problems in your hormones. If you’re a woman, it will turn you into a man, uh– by getting the PCOS stuff going, and if you’re a man, it will turn you into a woman by upregulating aromatase. So, you have that side of the fence. And the blood sugar swings. When they go low, you’re gonna get a lot of Cortisol and Adrenaline, which can create mood issues and create that anxiety and that may be the reason why you’re on the Xanax. [crosstalk] So the other moods stabilizes, right?

Dr. Kelly Brogan: Exactly. [crosstalk] You said it so I don’t have to. That’s exactly it. It’s powerful. I mean, I have patients who’d have six panic attacks a day. They’ve had three medications heading to Electroconvulsive Therapy. And all that was going on was Dysglycemia.

Dr. Justin Marchegiani: Huge. [crosstalk] Huge. Now we have these cells in our brain, also called the glial cells, and a great portion of the cells in our brain are actually immune cells, which is interesting. And once these cells get activated from stress or inflammation– it’s like  positive feedback loop. It just gets more and more and more. Uhm– what do you do to help decrease brain inflammation? I think you’ll talk about the gut, but is there anything you do supplementally to help decrease that brain inflammation?

Dr. Kelly Brogan: Yeah. So that’s where I am a big believer in this multi-pronged approach, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: Because, if we’re– if we’re looking at an anti-inflammatory diet, the typical template of a diet I recommend is not gonna be any major surprise uhm– to anyone– but, the Vegans probably, because it’s uh– you know, a classical sort of ancestral diet. You know…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: It was animal food. You know, the nuts and seeds– all vegetables…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I restrict resistant starch for the first month. Uhm–

Dr. Justin Marchegiani: like a Paleo template, basically.

Dr. Kelly Brogan: It’s a Paleo template, basically. Includes, uhm– some starchy vegetables, but not uh– white potatoes. So, just to restricting…

Dr. Justin Marchegiani: Nitrates.

Dr. Kelly Brogan: …they always– Nitrates are included, so tomatoes are fine. Eggplants are fine. You know, mushrooms are…

Dr. Justin Marchegiani: Just the potatoes, okay.

Dr. Kelly Brogan: Just the white potatoes. And uhm– and you know, otherwise, my patients do always reintroduce things like white rice, gluten-free grains, uh– legumes. So, it’s not a long-term Paleo diet. It’s just restricted for that first month. Uhm– so that we can understand what resistant starch does to your microbiome, basically, because when you reintroduce potatoes– Do you have gas and bloating? You know, Are you super tired after you eat white rice? We just want to know that, right, for these potent starches. Otherwise it’s not that uhm– dramatic, but it is– just have this anti-inflammatory effect, ecologically rebouncing at the gut level. And then the meditation components, I just think, as one of the meditations I often recommend is called Kirtan Kriya Carer or _____[18:13]. It’s been studied in  randomized trials, actually, for changes in brain level profusion. Uhm– and the subjective outcomes in terms of resolution of cognitive impairment and Dementia patients, who we have nothing to offer, you know, on a pharmaceutical level. So, literally, all they did was 11 minutes of this meditation every single day.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: So, i’m a big believer in the potential of this ancient  technologies to send that signal of safety at the brain level. And then, of course, you know, when you’re engaging in detoxification– even if it’s as simple as taking the pesticides out of your diet.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Uh– You know, we’re fundamentally changing the way the immune system is being triggered. And as you said, you know, we have evidence that from a gut level, and also from a psychosocial stress level, we could mobilize the immune system in the– in the systemic circulation. That then tracks back to the brain. And like you said, kicks off that alarm. You know, when i was in med school, we don’t even know that the brain had an immune system. We thought that it was a privilege region.

Dr. Justin Marchegiani: It’s crazy.

Dr. Kelly Brogan: We didn’t know that what’s inside of the brain. You know, we’re just discovering basic anatomy, still, at this point. So, it’s important to work with the tools that do the least harm.

Dr. Justin Marchegiani: Very good. Now, I’ve seen you write this, and I may be off in a little bit. I’ll just throw it out there and you can correct me.

Dr. Kelly Brogan: [nods]

Dr. Justin Marchegiani: You know, you’ve talked about the brain-gut connection with mood. Now, being a functional medicine physician, I’m addressing everything: diet, lifestyle, blood sugar, [crosstalk] all the body system, hormone, detox. So, we’re never ever putting in on one magic pill.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: But as we fix things, I do see certain amino acid nutrients with certain nutrients, like B6, and certain B vitamins. I have seen that significantly helped a lot of people on the mood side, not every time. So, I know the SSRIs and some of these medications, we think they work by just blocking reuptake of some of these chemicals but that may not be the case. So, what’s your take on the amino acids? I do see benefits, but I know, you–you’ve talked differently about that.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: Things like 5-HTP, tyrosine, ___[20:09], L-dopa; those kind of things.

Dr. Kelly Brogan: Exactly.

Dr. Justin Marchegiani: Yeah [inaudible].

Dr. Kelly Brogan: Yeah. You know, listen. I am a passionate supporter of natural medicine. You know, and there are many, many, many, many different approaches. Uh– I mean I had patients who’d come– not patients. I know of people who come up of psychiatric medications using flower remedies. So…

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: …you know, i know that there is not one path here. And that’s the beautiful thing. Uh– but, in my approach, I use no supplements at all for the first month.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: Uhm– when– I don’t begin medications taper, for the first month either. So, in a context of medication taper, then I actually do use amino acids. Uhm–

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: I use things uh– you know, the ones you’ve mentioned in particular as a compliment to the purported mechanism of the given medication, and I aIways use a general mix of amino acids. And I find them to facilitate the process. Uhm– I don’t use any supplements as a replacement for medication because it’s not the contraces we’re going for, right? We’re going for uhm— you know, trusting the body, trusting it’s uhm– responses, curiosity about what the body is meaning to tell you. And then also working through a lot of uhm– sort of indoctrinated fear around emotions like, you know, deep sadness, rage, grief– You know, this kind of pain that we are uhm– not, in any way, making space for. You know, to– to investigate with any degree of curiosity because, you know– one of the greatest uh– most meaningful lessons I’ve learned is that on the other side of that process of personal encounter with your deepest, darkest uhm– experience of your mind and body, is a kind of expansive, you know, exposure to these exalted emotions: gratitude, joy…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …even bliss. You know, that becomes available to you when you have the courage to sort of walk through that dark night. So that is a big part of my uh– approach.

Dr. Justin Marchegiani: So, some free-form amino acids which is great. What do you do with adaptogenic herbs? I mean, I use Ashwagandha a lot. I find that really help modulate Cortisol, which can thus help along with anxiety and even sleep. What’s your take on adaptogens, and what are your top three favorites?

Dr. Kelly Brogan: Uhm– I would say, I have a top one favorite. [laughs]

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: Because I’m a big Rhodiola fan.

Dr. Justin Marchegiani: Uhh– love it.

Dr. Kelly Brogan: And had been for many years. And it’s one of my first introductions to the power of herbal– you know, herbal approaches and herbal medicine, personally. And, You know, I find that it’s a really powerful compliment, not only to support in cognition at the time when many of my patients have been injured by medications on the cognitive front, uhh– but also that inevitable, you know, exposure to stress. I think it’s a really magical plant to dance with. So, I’m a  big fan of it.

Dr. Justin Marchegiani: What about nutrients? And I say, BC– uh– B6, or P5P, Pyridoxal-5-Phospate, really essential for helping these neurotransmitters activate. What’s your take on the most important nutrients for you that you see makes the biggest bank for your back and also a B6, too.

Dr. Kelly Brogan: Mm– I– I would– In my experience, the most profound single nutrient– because, you know, most of us do offer that as uh– you know, sort of a compliment…

Dr. Justin Marchegiani: Uhmn–

Dr. Kelly Brogan: Uhm– in– in the entire birth.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: But the one that I had the most miraculous outcomes with is actually B12.

Dr. Justin Marchegiani: Yes. Huge.

Dr. Kelly Brogan: And, you know, through my work with Nick Gonzalez, I’ve had a better ability to contextualize why– that is, in the patients that I work with. They are what he would call parasympathetic dominance, and so they respond especially well to animal-based nutrients, particularly white B12. You know there are cases in the literature of one woman, in particular, who was diagnosed as uhm– having psychotic depression. She was given Electrocompulsive Therapy…

Dr. Justin Marchegiani:  Totally.

Dr. Kelly Brogan: …and uh– multiple medications, and all that she was going on was a B12 deficiency. So, I actually used– have my patients inject themselves uhm– with something like a Hydroxyvaline in a pretty generous dose. Sometimes like 5mg, sometimes several times a week uh– initially, which is obviously considered to be rather aggressive. But uh– it seems to be, you know, quite effective in a short period of time, particularly for uh– you know, cognitive and energy-related impairments.

Dr. Justin Marchegiani: You know, Dr. Brownstein’s also a big form of the hydroxyl form. Why do you like the hydroxyls so much– let’s say, over the methyl or the adenosyl?

Dr. Kelly Brogan: Uhm– I had– I started with a Methocarbamol form.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan:  I just had a couple patients who uh– felt overly activated by it. You know, like whose are wired by it. And– and again, I’m using large doses, so it could have just been that. Uhm– so I– the hydroxyl form is just a– a way to thread the needle, you know, for those patients who might be susceptible to the– the methyl as [inaudible].

Dr. Justin Marchegiani: And then, do you have any opinion on GABA as well? You know, some people say the molecule’s too big to cross the blood-brain barrier. Others are coming out with liposomal forms. What’s your take on GABA?

Dr. Kelly Brogan: Yeah. I have gone very comfortable using a form called PharmaGABA. [crosstalk] It’s a–

Dr. Justin Marchegiani: PharmaGABA, yeah.

Dr. Kelly Brogan: Yeah. Fermented…

Dr. Justin Marchegiani: The science got it.

Dr. Kelly Brogan: …form

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. And, you know, it’s uh– when it works, it works. And who knows if that’s, you know, Placebo. Otherwise, I don’t really care, because if it’s as benign as it is, I’ll apply that Placebo Effect all day long. But I, It’s a fan favorite– you know, of my patients, uh– particularly during the process of moving through a medication taper. It’s a very important uhm– tool.  

Dr. Justin Marchegiani: And then, when you’re dealing with people that are on these medications, whether they’re Benzos or SSRIs, or even Lithium and such. How are you dealing, like– Does every– Can everyone have the ability to get of those medications at some point, and who are the patients you don’t want to like take them off. Where it’s really you got to be super, super slow.

Dr. Kelly Brogan: Mm– Well, it’s my passionate belief that every single person should be offered the opportunity to come up with psychiatric medications.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I’ll even go farther to say all medications, period. What the most critical ingredient is uhm– is the mindset, right?

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: So, believe that it’s possible. It’s the readiness to commit uh– to lifestyle, medicine and to self-care. Uhm– which, of course confers the type of empowerment that’s very necessary to move you out of the dependent and helpless position that you are put in as a psychiatric patient. Uhm– but I had taken patients off of– you know I have videos of my website to prove this, so to speak. I’m publishing cases in the purity of literature. Uh– taking patients of up to medications they’ve been on for 25 years. Uhm– I have patients with histories of Schizophrenia, psychotic mania, suicidal depression. And over and over and over again, they’re shedding their diagnosis and they’re completely and totally off medication. I have yet to fail. Uhm– and I don’t expect to. But, I always screen my patients. I have a very skew population, because of these two criteria– the mindset and the belief.

Dr. Justin Marchegiani: Totally. And then, we’ll put a disclaimer. We don’t want anyone getting after uhm– psychiatric medication on their own. We want them to go back to the Prescribing Physician. But on average– just in general, are you typically tapering off about one to two-month timeframe? Is that generally, where you’re at?

Dr. Kelly Brogan: Oh, wow. No. It can be years.

Dr. Justin Marchegiani: So, years or so?

Dr. Kelly Brogan: I’m glad you asked, because…

Dr. Justin Marchegiani: Good.

Dr. Kelly Brogan: I think I forget sometimes that that’s not uhm– you know, uh– an assumption. So, I don’t touch uh– medication until my patients, in my online program– until they have gone through this month-long commitment.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Meditation, detox and diet. Literally, I won’t touch it. It’s a total requirement. Because I used to do it before I require that, and it was kind of a nice idea. We’ll start looking at your diet now. It’s non-negotiable. Okay? So, that happens first, and then the taper is around 10 to 20 percent of the total dose per month is a typical pace. So, it depends on…

Dr. Justin Marchegiani: Got it.

Dr. Kelly Brogan: …what you’re taking. It’s one medication at a time. The process can take years. And, you know what? If you want it to last, and you want it to be a permanently chaptered for you, you have a right with that. You know, because it’s an investment in this being, not just a revolving door where you’re back on meds in a couple of months. Uh– but I– I absolutely do not recommend that anyone consider coming off medications, particularly until they have uh– initiated this kind of self-care and physical healing regiment. And you know, in my program, I have an entire module dedicated to tapering, because it’s not a science, unfortunately. Uhm– and there are very few practitioners who know how to do it. And that’s why patients actually become more educated. Then their provided about how to do it. Uhm– it’s a bit of the wild west at this point.

Dr. Justin Marchegiani: And, is that course over at kellybroganmd.com?

Dr. Kelly Brogan: Yes! We– It’s called, Vital Mind Reset.

Dr. Justin Marchegiani: Vital Mind Reset. We’ll put all the links below. We’ll put the links to the Amazon Book as well, “A Mind of Your Own.” So, everyone that’s listening and finding value. Go support Dr. Kelly by getting that book. That’s great. Now, one last thing here before I let you go, Dr. Kelly. Uh– when I use certain amino acid with patients, even some of the free-forms, I’ll start to notice the patient is starting to have some of the– the side effects, as if the drug’s too much. Do you see that at all? And then, do you start to gradually taper if those higher side effects from the amino acids are making the drug work better? Do you notice that at all?

Dr. Kelly Brogan: That uhm– is possible. I don’t often encounter that for whatever reason, uh– but  that’s absolutely possible. And in fact there’s a proprietary formula called uhm– EMPowerplus by TrueHope. It may [inaudible]

Dr. Justin Marchegiani: Yes. TrueHope, yeah.

Dr. Kelly Brogan: Yeah. And, you know, they counsel about that– you know, that it’s very possible that in the setting of uh– nutrient repletion, that medication could become actually almost quasi-toxic uh– so that you would need to begin to ramp down on the dose of medication at that point. So, it’s– it’s highly possible and that’s an incredible reminder. You know, that nutrients are– are very powerful uhm– tools to be used with strategy.

Dr. Justin Marchegiani: Awesome, Dr. kelly. I think you’re changing the world. I appreciate you coming on the show. Last question for you, “If you’re on a desert island and you can only bring one nutrient, one supplement, one herb– whatever it is, what would that be for you?

Dr. Kelly Brogan: Oh, turmeric, of course. [laughs]

Dr. Justin Marchegiani: Turmeric. Okay. Got it. [crosstalk] Crucumin?

Dr. Kelly Brogan: Yeah, Crucumin.

Dr. Justin Marchegiani: Can [inaudible] can the anti-inflammatory on?

Dr. Kelly Brogan: It’s everything. You know, it’s like a miracle. It’s a miracle herb, and you know the research on it, of course had– had my skeptical mind convinced. You know, with the catalog research on Crucumin, which is one isolate of this…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …very complex herb, is astounding. You know, head to head against medications like Cox-2 Inhibitors, antidepressants. It’s extraordinary. So, I think of it as a, you know, the– the power performer, for sure.

Dr. Justin Marchegiani: I love it. Now, is there anything else you want to let the listeners to know? Any new books, products, online things coming out for you that people should be aware of?

Dr. Kelly Brogan: No. Just you know that we’re here to support your journey. If any of these is resident, it is one hundred percent possible for you. I see it every single day. And so, just to make sure that I plant that seed of potential. And oh, you know, we’re here to support. We have tons of free information on this site, and of course, greater uhm– complex products if needed.

Dr. Justin Marchegiani: And let’s hear those links one more time. kellybroganmd.com– the second one was?

Dr. Kelly Brogan: That’s it. You know…

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: …all the information’s there. So let’s just keep it simple.

Dr. Justin Marchegiani: And then the book– if you guys love it, go get that book on Amazon. Dr. Kelly, we really appreciate you coming on the show.

Dr. Kelly Brogan: Thank you so much.

Dr. Justin Marchegiani: Awesome. Take care.

 


References:

www.kellybroganmd.com  

“Vital Mind Reset Program,” by Dr. Kelly Brogan

New York Times bestselling book, “A Mind of Your Own” by Dr. Kelly Brogan

https://www.amazon.com/Mind-Your-Own-Depression-Reclaim/dp/0062405578

“Increase your Brain Health by Changing Your Breakfast: The KB Smoothie” by Dr. Kelly Brogan

https://www.truehope.com/effectiveness/ingredients EMPowerplus by TrueHope

 

Top Anti-Aging Foods

Top Anti Aging Foods

By Dr. Justin Marchegiani

Everyone ages, the question, therefore, is not will you age, but how will you age? Will you suffer from chronic pain and inflammation, develop diseases such as dementia, diabetes, and cancer, lose your mental capacities or your ability to walk and run? Or will you remain in good health with good posture, retain a great state of mind and mental clarity, keep balanced hormones and healthy relationships?

The truth is, the choice is yours, and it is exactly that: a choice. If you are determined to live a long life with your body and energy at their fullest potential, you can do so! However, there are no magic creams or pills that will prevent you from showing signs of aging. The secret to aging gracefully and successfully lies in a series of healthy diet and lifestyle choices which we will outline below.

What is Aging?

What is Aging?

Disease, dementia, cancer, loose saggy skin, slowed brain function, slow and weakened body: these are NOT predetermined signs of aging! These are the consequences of the Standard American diet (SAD) and lifestyle that have been normalized by our society. Recent discoveries have shown that inflammation, the shortening of your telomeres, and  mitochondrial deterioration are what control the aging process.

Click here to schedule a consult with a functional medicine doctor to determine your personal causes of inflammation and illness!

What Causes Aging?

What causes aging?

Inflammation causes the diseases and health decline that are hallmark symptoms of aging, which can eventually lead to autoimmune disease and cancer. This can be combated by finding the root cause of inflammation (commonly diet-related) and taking steps to prevent it.

Telomeres sit at the end of our DNA, and their length is related to our biological age (different from our chronological age, which counts birthdays, your biological age is how old your body is in relationship to your health). Telomeres are shortened by unhealthy habits such as smoking, and eating inflammatory foods.

Our mitochondria produce 95% of our energy, in the form of ATP, but the byproduct of the energy production is harmful free radicals which cause damage to the mitochondria. Science has shown certain foods, as well as the enzyme CoQ10, to be powerful in defending against free radical damage.

How to Age Successfully

How to age successfully

We are able to curtail disease, wrinkles, and a general decline in health through taking proper care of our bodies. A big part of preventing disease and deterioration as you age is dependent on your diet. The following foods are just some of the many healthy options we have that are full of the nutrients and minerals vital for good health and longevity:

Bright colored fruits and veggies provide beta-carotene and vitamin A, which protect against cellular damage and premature aging. They are also great for your skin and eyes, meaning less wrinkles and better vision. These include: bell peppers, carrots, sweet potato, and broccoli.

Leafy greens, such as spinach, collard greens, lettuce, and kale, contain several top antioxidants. Lutein and zeaxanthin have been shown to reduce the risk of cataracts and macular degeneration. Beta-carotene, vitamin C, and sulforaphane are cancer-fighting antioxidants present in leafy greens. The folate in spinach improves your short-term memory and might even lower the risk of developing heart disease and cancer. Vitamin K1 is found in collard and salad greens, which is linked to vascular health, strong bones, prevention of heart disease and Alzheimer’s disease, and can treat certain cancers.

Eggs also contain lutein and zeaxanthin, making them an unexpected friend of your eyes. They are a natural source of vitamin D, as well as choline, which protects your brain, nervous system, and heart. Be sure to buy organic, pastured eggs for all the benefits they have to offer!

Blueberries are chock-full of antioxidant power. By fighting oxidative stress, blueberries can help neutralize the damage caused by free radicals. They help reduce the risk of cancer, heart disease, stroke, and arthritis while boosting your vision and immune system!

Citrus contains vitamin C, which helps your body produce collagen. Collagen is responsible for healthy joints as well as tight, healthy skin. The quercetin in citrus has anti-aging properties and also helps fight inflammation.

Takeaway

Takeaway

You are what you eat, so if your goal is to be healthy and thriving in old age, the food choices you make today need to be healthy ones. Luckily, these foods are not only dense in important nutrients, they are also delicious!

Click here for a consultation with a functional medicine doctor and a personalized health plan!

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370421/

http://www.cell.com/molecular-cell/pdf/S1097-2765(16)00081-2.pdf

https://www.jci.org/articles/view/64125

http://enews.tufts.edu/stories/101399BlueberriesMayImproveMemory.htm

Beating Brain Fog

BEATING BRAIN FOG

Beating Brain Fog

By Dr. Justin Marchegiani

Chances are you have experienced brain fog at least once in your life. It’s hard not to suffer from the brain sluggishness brought on by our modern world full of processed foods, sugar overload, and high-stress lifestyles. But fear not: if you are tired of the mental slowdown that is brain fog, we are going to discover some of the common causes and ways to banish brain fog for good.

SYMPTOMS OF BRAIN FOG

Brain fog can manifest itself in many ways. Most commonly, signs of brain fog include:

  • Low energy
  • Headaches, trouble concentrating
  • Low motivation
  • ADHD symptoms
  • Anxiety
  • Irritability
  • Insomnia
  • Forgetfulness
  • Depression

SYMPTOMS OF BRAIN FOG

CAUSES OF BRAIN FOG

Lack of sleep: Brain fog often leads a person to feel tired, and when addressing the cause of brain fog, it’s important to first ensure that you are sleeping enough.

CAUSES OF BRAIN FOG

Nutritional deficiencies: Paired with overconsumption of sugar, alcohol, and refined carbs, a poor diet lacking in vital nutrients is going to have a negative impact on your brain function.

Hormone imbalance: Our cortisol, serotonin, and dopamine all keep each other in check. When even one of these hormones rises or falls by too much, the whole system is thrown out of balance. Working with a functional medicine doctor can help you determine where your levels are at, and how to get them in a harmonious balance.

Inflammation: Inflammation, at the root of most modern diseases, is once again a leading culprit behind brain fog. Inflammatory molecules stimulate microglia activation, which is commonly found in brains of those with psychiatric diseases, such as those of children with autism.

Lipopolysaccharides (LPS), or endotoxins: Bad gut bacteria produce toxins, LPS, which trigger inflammation. These bacteria can make their way to the gut lining and cross the blood-brain barrier, causing brain fog as well as a host of other issues.

TREATMENT FOR BRAIN FOG

Diet: Avoiding processed sugar and artificial sweeteners, eating healthy fats, ensuring you are well-hydrated, and eating anti-inflammatory foods will all help keep you and your brain in top shape!

TREATMENT FOR BRAIN FOG

Supplements: Magnesium helps your body keep its internal clock in check, which in turn helps regulate proper hormone production throughout the day.

Adaptogens such as ashwagandha and holy basil lower cortisol, reducing fatigue and stress.

Curcumin Supreme is a powerful antioxidant containing three different bioactive forms of curcuminoids from the spice turmeric, which is very anti-inflammatory.

Our Brain Support store holds a host of brain power boosting supplements, such as Brain Replete, which contains powerful vitamins and amino acids, like B vitamins and 5-HTP.

Brain Replete Supplement

 

Lifestyle: We know that getting good sleep is vital, as is keeping stress low. Getting exercise and getting vitamin D straight from the source (the sun!) are also important in maintaining a healthy brain and body. Avoiding EMFs will help reduce brain fog, as will grounding, by walking in the earth barefoot, or with a pair of grounding shoes such as Earth Runners.

Get tested: Hormone imbalances, food allergies, and infections are all hard to detect. With the help of a functional medicine doctor, you can test for food sensitivities, hormone levels, and address any parasites or bacterial/fungal infections that might be dragging you down without your awareness.

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

itune

 

 

youtuve

 

 

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.

Natural solutions for high blood pressure – Podcast #117

Dr. Justin Marchegiani and Evan Brand dive into a discussion about high blood pressure, something everyone is all too familiar with, and they explain what the root causes are and how you can manage it conventionally and with functional medicine.

Find out what nutrient deficiencies can be caused by blood pressure medications and what you can do about it. Discover how you can manage your blood pressure in the long-term with functional medicine. Also learn some tips on what to eat during the holidays and how to get that mouth feel while eating good food when you listen to this podcast.

In this episode, topics include:

01:45   High Blood Pressure Overview

05:39   Blood pressure myths

10:46   Mechanisms

12:04   Nutrition and stress

20:10   Lifestyle

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Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin. Evan, how are you doing today, man? It’s almost Christmas.  December 23rd here, really excited for the holidays. How you doin’?

Evan Brand:  I’m as excited as you are.

Dr. Justin Marchegiani:  Great! So the question is have you been a good boy this year?

Evan Brand:  I’m on—I’m on the good list.

Dr. Justin Marchegiani:  Good, awesome!

Evan Brand:  What about you? Are you on—are you on the nice or the naughty list?

Dr. Justin Marchegiani:  Of course, I’m on the nice list. Now the question is, are you gonna leave some Paleo cookies out for—for Santa, or are you gonna leave some—some glutinous cookies out for him?

Evan Brand:  We actually did buy some organic Annie’s cookie for a Christmas party. I will probably not be partaking in them even though it’s organic which is great there’s the wheat, so I will be avoiding the wheat. I’ll probably buy Miracle Tart for myself for Christmas since I’m part Santa.

Dr. Justin Marchegiani:  Yes, exactly. That’s the—the Hail Mary tarts, right?

Evan Brand:  Yes, those are so good. There’s only one place in the whole city you can get them here and so that’s where I go to—to get them.

Dr. Justin Marchegiani:  Do you guys have a Whole Foods down there in Louisville?

Evan Brand:  Yeah, we got Whole Foods. They don’t stock them there though. They stock them at this little local place called Rainbow Blossom. They have random things like Epic. They have Epic products. They have their pork rinds and that’s the only place you can get him.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  And they’re really darn good.

Dr. Justin Marchegiani:  Wow. Very cool.

Evan Brand:  You know what I’m talking about? Epic?

Dr. Justin Marchegiani:  Yeah, the Epic bars you mean?

Evan Brand:  Have you seen them?

Dr. Justin Marchegiani:  The Epic bars?

Evan Brand:  No. Yeah, but they have pork rinds now. Have you seen them?

Dr. Justin Marchegiani:  Oh, I have seen them. I have patients that just got some recently/.

Evan Brand:  Yeah, the pastured pork rinds. They’re really good.

Dr. Justin Marchegiani:  Gonna have to get them for sure. I love pork rinds.

Dr. Justin Marchegiani:  Love it. Well, we talked pre-show that we were gonna chat a little bit about blood pressure. We really haven’t gone into that so much.

Evan Brand:  Yeah, I mean this is common. Just some statistics at a glance, you got 70 million Americans and 1 billion people worldwide with high blood pressure, and if it’s left untreated you run into many, many, many issues. The biggest one that people probably know of is a stroke, and one time probably 25-30 years ago my grandmother had high blood pressure so high that she felt a shooting pain in her brain. So she went to the emergency room. She had my grandfather take her in and her blood pressure was over 220 by maybe 150, 220/150 something like that, just insanely high that so high that the nurse freaked out and immediately, immediately took action to get the blood pressure down. So this is not always the way that people find out they have high blood pressure issues. This could be going on behind the scenes for decades, but there are some simple strategies that we can talk about that can help to reduce the risk of high blood pressure. It goes up naturally with age, right? But that still should not be over 200. That’s just mind blowing.

Dr. Justin Marchegiani:  Oh, absolutely. So when you look at blood pressure medications, you know, for the most part, that’s a chronic type of ailment. It tends to happen over a long time and it’s—for the most part, it’s something that’s chronic and that the blood pressure medications aren’t gonna get to the root underlying cause.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Now if your blood pressure, you know, you’re upwards of 160—that’s the systolic number. That’s the—the pressure that your heart creates in the blood vessels when the contracts and the bottom number, that’s called the diastolic number, like D for down, it’s the bottom number and that’s kind of where the pressure is in your arteries/heart when your heart’s kind of relaxing. So you pump—the lub dub—that’s the heart contracting and where it’s pressing down, that’s the top number, systolic, and then where it’s relaxing, that’s the bottom number, the diastolic. So when you get about 160 with the systolic, that can kind of be what I call the danger zone. So if you are at that level and let’s say, you haven’t quite made the diet and lifestyle changes, I do think being on a medication at higher levels until you get to the root cause is better because you wanna avoid a stroke or some type of a heart attack, right? So we want to make sure that if it’s high and you’re not doing anything about it, getting that blood pressure down is better, but in the long run we don’t want that to be the only answer.  We wanna look at getting to the root cause and we’ll kinda go over some of the root causes here in just a bit.

Evan Brand:  Great point. So just to be clear if someone’s listening and they have high blood pressure but they’re scared or they do not like conventional medicine you would still advise that person to go get on the drug even if it is short-term because you’re safer on a drug with side effects that lowers blood pressure than having high blood pressure and doing nothing.

Dr. Justin Marchegiani:  Exactly, and you were talking–

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Upwards of above 160 and let’s say you already have a lot of a healthy—or sorry, unhealthy habits going on, poor exercise, sugar, inflammation, all that and you don’t quite know where to go yet, again I just would hate to see someone, I’m—I’m a little more concerned and I hate to see someone go and have a cardiovascular incident that could’ve been prevented with some blood pressure medication in the short-term but in the end, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We wanna get on board with the functional medicine coach/doctor that can get to the root issues because the nice thing about blood pressure, it’s easy to monitor. You get one of these $30 Omron blood pressure cuffs, the self ones on Amazon you can monitor it multiple times a day, and then you can see the number go down and guess what? You just call up your doctor. “Hey, Doc, I’m doing some natural things to help lower blood pressure. My blood pressure’s dropping naturally. I like to taper off the medication.” And most medical doctors, if you’re being responsible and monitoring it and you’re telling them you’re doing things they typically have no problem with that if you show them that you’re responsible by keeping track of it.

Evan Brand:  Yup, well said.

Dr. Justin Marchegiani:  Yeah, so off the bat, anything you want to comment on that?

Evan Brand:  Well, so with blood pressure, you know, there’s tons of things that can cause it. I would say we should probably dispel the myth of the salt high blood pressure, I mean, kind of—part of it’s true if we’re talking about the garbage salt, right? The iodized salt, the sodium chloride plus iodide, but with like a good pink salt or a good Himalayan sea salt, there’s so many different options with black salts, there’s volcanic salts, the sodium is not gonna be the problem there, it’s the inflammation combined with a low-quality salt that could be the problem, right?

Dr. Justin Marchegiani:  Yeah, they’ve done studies I think it’s in the Journal of the American Medical Association where like salt even, they—I don’t think differentiated the quality of salt, probably your regular table salt that’s not so nice. I think it increased like maybe 2 mmHg, right? Two or three, that’s like the top number. That’s like going from 120 to 122, 123.

Evan Brand:  Why did that—why did that become such a popular widespread myth do you think?

Dr. Justin Marchegiani:  That’s a great questions. There’s a lot of things in conventional medicine that are that way. I mean, you can look at grains, you can look at sugar, you can look at trans fat. I mean, you can look at cigarette smoking. You can look at so many different things–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Of how they kinda got that way but for the most part the only reason, the only, you know, motivation to avoid salt is if you already have severe kidney damage, maybe the only reason why you’d want to decrease salt consumption is because you have active kidney issues right now. But if you didn’t have that, getting high quality minerals on board will be helpful and again, if your blood pressure is excessively low, salt will help bring your blood pressure up kind of in a modulatory way, but it won’t make it go excessively high. You won’t have high blood pressure because you have more sea salt intake. You will have higher blood pressure but higher and high are two different things. Higher meaning a couple millimeters of mercury bump, that’s where we’re looking at.

Evan Brand:  Makes sense.

Dr. Justin Marchegiani:  Except if it’s low—if it’s low, it’ll bring it up much higher because you know, let’s say your adrenals are really key at holding on to minerals and if you’re decreasing your mineral retention because the aldosterone that your adrenals make is low because of the adrenal dysfunction that’s happening, you will pee out more minerals and that—that’s important for regulating blood pressure and that’s also important for their sodium potassium pumps, so if we don’t have enough high quality sodium, those sodium potassium pumps kinda that creates the gradient and how things go in and out of the cell, now if don’t have adequate sodium on board, that can definitely be a stressor for the body.

Evan Brand:  Yeah, makes sense and you and I hear this all the time with people with adrenal problems, if you stand up quickly you may get lightheaded or woozy, you’re not regulating your blood pressure. You may not have high blood pressure, you could actually have low blood pressure in some of those cases, but either way your body’s ability to regulate blood pressure does decrease if there is adrenal stress which definitely there’s gonna be adrenal stress of there’s infections and inflammation, and all the things that you’ve already mentioned, maybe other things like insulin resistance. How do you know if you’re insulin resistant? Well, if you look into—well, there’s—there’s calculators and all of that to look at, what is it? Waist to hip ratio and all of that. But if you look into the mirror and you see that you’re overweight, it’s likely that you have some level of insulin or possibly leptin resistance problems which can then cause blood pressure to go high.

Dr. Justin Marchegiani:  Absolutely so when we look at blood pressure, one of the biggest things that will throw your minerals off and cause a higher than normal blood pressure is increased fructose consumption, i.e. sugar and just increased elevations of insulin. Insulin will cause a retention of sodium. That’s why one of the first things you notice, you cut out sugar for 2 or 3 days, you lose like 3 or 4 pounds weight, maybe even more. Now you’re not losing 3 or 4 pounds of fat. You’re losing 3 or 4 pounds of fluid because as the sugar goes down, right? One molecule of sugar holds on to—to I think 3 or 4 molecules of water, something like that. So as the sugar goes down, so does the sodium and so does the water. So what happens is you flush out a lot of fluid when you cut down the carbohydrates and cut down the sugar, and with fructose—fructose, high amounts of fructose inhibits this enzyme called en—endothelial synthase. Endothelial synthase is a nitric oxide-based enzyme that’s really important for vasodilating, and dilation means opening up those blood vessels. So if we decrease the enzyme that opens up those blood vessels, it’s like clamping down on that hole. It’s like going out in your garden taking the hose that’s putting out water and putting your thumb over the edge of it to make that stream go stronger and stronger.

Evan Brand:  That’s a trip. Now let me stack on another idea here. If there is adrenal stress, someone’s also gonna be dumping a lot of magnesium which you need that to help relax the blood vessels so you’re compounding the issue and if you are adding the fructose or the high fructose corn syrup or sodas in there, that’s gonna cause blood sugar issues which is gonna create a bigger crisis and the adrenals are gonna have to be more stressed if they’re not already. They’ll be more stressed because they’re having to kick in as the backup generators because then the pancreas and the liver not being able to keep up, so the whole cascade really kinda falls apart at sugar it sounds like.

Dr. Justin Marchegiani:  Exactly. So we have a couple of different mechanisms. Let’s break them down. So we have just the—the general sugar kind of mechanism with it’s table, you know, your sucrose, fructose, kinda glucose thing that’s increasing insulin and that’s gonna hold on to more fluid and more sodium, and that will increase blood pressure via that way. We have the fructose mechanism that will increase or decrease the endothelial synthase enzyme which will decrease the vasodilation, i.e. cause constriction of the blood vessels, and we also have plasminogen activator inhibitor mechanism. So the higher amounts of insulin we have, our plasminogen activator what that does is it—it decreases or I should say, it decreases clots, i.e. it increases fibrinolysis. So -lysis means to cut. Fiber means like a clot. So it’s breaking down blood clots. So imagine little occlusions from cells sticking together, fibron, it’s gonna decrease those clots and allow smoother flow in the plumbing in the cardiovascular system. So if we decrease the clots, that means the plumbing flows smoother and that means we’re gonna have less pressure to have to push through those clots. So we have the plasminogen activator inhibitor-2 mechanism that also gets drained with higher levels of insulin.

Evan Brand:  Make sense. Should we talk about nutrition now?

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  So Omega 3 deficiency is huge, I mean, if you look at hunter-gatherers or if you even just look Ennuit studies, you’ll see that the average Ennuit was consuming anywhere depending on what you look at, but on the low end 10 or 15g, sometimes 20g of Omega 3’s per day and we’re lucky if we get someone to take a 1g or maybe 2g supplement of Omega 3’s. So there’s a huge, huge deficiency and when you look at research linking Omega 3’s to blood pressure problems, what you’ll find is the people who have the lowest blood pressure readings have the highest blood levels or serum levels of Omega 3’s. This is a huge find and this is why I’m very, very passionate about getting people to supplement with some type of Omega 3. We’re gonna assume that most people are not eating enough wild caught fish and also then you run into the issue of the methylmercury in certain bigger fish like tuna. So for me I’m more pushing people towards a supplement because I know a lot of people don’t want to cook fish multiple times a week anyway, so you can look at like a fish oil or a krill oil, but at the end of the day, could you still get some fish into your diet? For sure, a cod or a wild caught salmon would be good, but your—what is it called? StarKist tuna that’s probably sitting in genetically modified soybean oil. You want to stay away from that.

Dr. Justin Marchegiani:  Absolutely, and fish oil also is a natural blood thinner. It keeps the cells of from sticking together. So it’s kind of a natural thinner, kinda like a Coumadin or a warfarin, but without the side effects. So it does thin out the blood a bit for sure.

Evan Brand:  Great point. Yeah, that’s why we gotta tell people if they’re going to get surgery you would think, “Oh, man, supplements are fine.” That is one case where we would say, “Hey, look, why don’t you stop taking your fish oil for now if you’re going to get surgery, because we don’t want your blood too thin.” So it is very, very effective for that.

Dr. Justin Marchegiani:  Absolutely. So we talked about vitamin D. There’s also other natural blood thinners like ginkgo which help increase oxygenation by increasing blood flow. Even things like systemic-based enzymes taken on an empty—empty stomach especially serratiopeptidase. So if you have various clotting or you have occlusions in the coronary arteries, taking some of these enzymes on an empty stomach they’re gonna be enterically coated so they’re not gonna be used for digestion. They won’t get exposed and degraded by stomach acid. Ideally they’ll make its way into the bloodstream where these guys can hit areas of plaque or occlusion and break up any fibrin or scar tissues that may be hanging out in there.

Evan Brand:  Here’s another—you—you brought up vitamin D. Here’s a good—a good hack and obviously it may take money if you’re somewhere closer to the polls and it’s wintertime, you’re not gonna have as much sunlight but there’s definitely some research that shows that if you exposed your skin to sunlight, that it’s gonna increase the level of nitric oxide which is isn’t gonna naturally help you to dilate your blood vessels and then, therefore, reduce your blood pressure. So you could be taking a fish oil supplement, you could be going to the beach and getting some sunshine, and then what about stress? We should probably mention stress, too, because a lot of this is we’ve already talked about stress, right? Nutritional stress, mineral stress, but emotional stress, too, if that goes unaddressed and people are harboring anger and negative emotions, that’s not good. That cannot—it’s definitely not helping your blood pressure. Put it that way.

Dr. Justin Marchegiani:  Well, all of that will basically increase cortisol and adrenaline which does have a vasoconstricting. It’ll—it’ll put that thumb over the water hose a little bit tighter, incre—increase that flow because of the stress hormone. So stress emotionally knocks over a domino cascade of adrenaline and cortisol, which does have a big impact on the vascular system.

Evan Brand:  Which would be good if you and I were running from a bear, right?

Dr. Justin Marchegiani:  Yeah, totally make sense, right? Because we gotta get blood flow to those extremities, the toes, the fingers, the arms, the legs, so we can run and fight and flee. But if we’re just sitting on their desk or like, you know, driving to work and we’re just boiling and we don’t—necessarily don’t need that type of blood flow. You can see the stress on the vascular system that is caused by that type of hormonal cascade.

Evan Brand:  Yeah, so I mean this is another example where the ancient wiring system really does try to benefit us but when it’s chronic acute stress which sounds like an oxymoron but you’re dealing with acute stressors like a cell phone notification—ding! And that goes off all day, that’s a chronic acute stressor. Your body doesn’t know the difference, so I encourage people if you have it, get rid of your notifications. I promise the world will not fall apart if you have your phone on silent or even airplane mode most of the time, and then you can get back to life on your terms. Because what I find with people dealing with emotional stress, and—and hypertension is that many people feel like there’s never enough time in the day. They’re always playing catch up and I found personally, if I get up a bit earlier I feel more in control of my schedule. You and I are very, very, very passionate about calendar software, so we love our calendars and couldn’t live without them.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So that—so that’s another helpful thing. But for me, it’s also focusing on the most important things in the morning. You gave me some really good advice when you talked about kind of the morning visualization and all of that. I’ve— I try to do some type of morning meditation, visualization exercise, that helps to increase the amount of control and at the end of the day, the goal is just to reduce your perceived stress. Justin and I can’t wave a wand and say, “Okay, look your stress is gone.” But if we can fix or improve the way that you respond to what you have on your plate, at the end of the day, you’re gonna be much healthier. You’re not gonna releasing cortisol all day. Hopefully, you’re gonna have less food cravings. You’re gonna be less dependent on glucose because you’re gonna be burning ketones and fat, and you’re gonna be in a much better place, mentally, physically, cognitively, blood sugar-wise, everything.

Dr. Justin Marchegiani:  A hundred percent and just piggybacking on what you said, just a little bit of sunlight makes a big difference. They’ve done some studies and again a lot of this is correlation not causation, but you know there are some potential mechanisms there, like with the nitric oxide and potentially with the kidney and how vitamin D can really help blood pressure, one study talked about a 10 ng/mL increase, so you know, if your vitamin D’s 30, that’s like taking it from 30 to 40, and someone who’s vitamin D levels are lower can have a 12% lowering of their blood pressure and also people who had the highest vitamin D levels had a 30% lower risk of developing hypertension. Again not causation but correlation but there are some hypothetical mechanisms that we just mentioned that could be at play so a good rule of thumb here especially in the winter months, get your 25-hydroxy vitamin D looked at and if you haven’t gotten it tested yet or you don’t have the ability to test it right now, a good rule of thumb is 25 for every 25 pounds of body weight, you have 1000 IUs of vitamin D is fine. So I’m a little over 200 pounds so I would do about 8000 IUs of vitamin D, maybe round up to 10. Someone who’s half that, obviously 4000 is a pretty good starting point if you’re just trying to figure out, hey, how can I take this vitamin D to lower my blood pressure?

Evan Brand:  Yeah, some people worry a lot about the vitamin K because we’ve talked before about the whole traffic cop analogy of vitamin K helping to direct and keep calcium where it belongs and not into your arteries and things like that. Do you worry much about vitamin K1, K2 supplementation or you just focus on getting plenty of good butter?

Dr. Justin Marchegiani:  If we’re going vitamin D on a high, if we’re using vitamin D and we’re going with it for a long period of time, we’ll make sure there’s a couple hundred micrograms of the MK2 in there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Right, MK—I think it’s MK4 and MK7.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Let’s see, I’ll have to look at my bottle over here, but the vitamin K 2, the X factor, the activator, that’s what we’ll use and that will significantly help keep the calcium where it needs to be in the bones, and also just getting high quality grass-fed and essential fatty acids, a little bit of liver, all that stuff’s gonna be phenomenal for vitamin K.

Evan Brand:  Excellent. Now I wanted to get back to more lifestyle things. We talked about vitamin D. We talked about Omega 3’s. Exercise is a good one for sure, I mean, the—the basic part of it is just that you’re becoming more insulin sensitive. I mean if you think about how hungry your appetite is when you get done with a good high intensity workout. Oh, my gosh, you can just feel amazing, and if I do a protein shake after an intense workout, I feel like it’s going straight my bicep. I love the feeling but now—

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  After super high blood pressure, would we want to tell people, “Look, start with just walking.” You probably don’t want to put somebody on a high intensity interval training if your blood pressure is already 150-160. You might not be able to handle it. You might get dizzy and—and more stressed out than—than we want you to be.

Dr. Justin Marchegiani:  Exactly so you have, you know, the mechanism you just mentioned by having the insulin receptors be more sensitive. That means your pancreas has to produce less insulin to get the sugar into your cell, so it can be burned up. Number one. You’re obviously you’re burning—you’re putting less sugar into your body so you’re using more ketones for fuel. So we’re being more fat or keto adapted at that time, and then also the heart just gets stronger. As the heart get stronger, it needs less force to pump. It has a higher stroke volume so it can push out more blood per pump and that obviously will have a—an effect of decreasing the blood pressure and then also growth hormone and/or just exercise will increase nitric oxide. And that will have an effect of—

Evan Brand:  That’s—that’s so cool.

Dr. Justin Marchegiani:  Vasodilating and opening things up, too.

Evan Brand:  Yup. That is so cool. How about—what about indoor—indoor air pollution. You know, the EPA talks about 10 or 100 times more toxic exposures inside your home than outside. So air purification could be a good idea because if you’re breathing in these different toxins, that’s also an invisible stressor that’s gonna be elevating that whole nervous system sympathetic, fight or flight response, which we really don’t need to press that button anymore.

Dr. Justin Marchegiani:  Exactly, so anytime you put a stressor on your body, whether it’s physical, chemical or emotional, and this kinda fits into the chemical realm, i.e. toxin realm, that can be a stressor on the body and your adrenals and your fight or flight system may respond. It may put you into a sympathetic type of stress response and again we already know what happens with that cortisol increase that’s gonna create constriction. Why? Because the stress response pushes blood flow to the extremities, right?

Evan Brand:  For survival—survival over I don’t know what the—the other side of the coin would be. But your body goes for survival any day.

Dr. Justin Marchegiani:  Yup, exactly. Surviving over thriving. The problem is thriving only happens after the survival mechanism is turned off, but most people are constantly living with that survival mechanism turned on and activated.

Evan Brand:  So now this can get a little bit complicated.  So I know this may be tough for us to cover this, but let’s say we have someone that is already on a blood pressure medication like a lisinopril and we’re wanting them to go the natural route or they have intentions to go the natural route. How does that work? Do we bring the doctor on board and we have to say, “Look, you know, I’m working with a functional medicine practitioner. We wanna start using some natural things like Hawthorne or other blood pressure modulating herbs. Can you help me to lower my medication?” You know, how—how should that relationship happen between the prescribing doc and then someone like us trying to help to switch them to something natural or just get them off any type of meds completely?

Dr. Justin Marchegiani:  So what I typically tell patients, I say, “Are you interested in getting off your blood pressure medication? Do you wanna get off them?” And almost anyone that’s seeing someone like us, they definitely wanna get off them.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Again, the biggest problem with a lot of the blood pressure medications is they actually perpetuate the need for more blood pressure medications. So what I mean is they actually create nutrient deficiencies. Things like potassium which are really important for blood pressure, magnesium which is a natural beta blocker—these little receptor sites in the heart that the nervous system activates and it creates, you know, more excitability in the heart and that can cause the—the heart to have to pump harder and that can increase the blood pressure in the arteries. So magnesium’s a natural beta blocker, really important for relaxation. People that take it, one of the first thing they notice is they start to relax and wind down. That’s why Epsom salt baths are so popular with people that are stressed. So magnesium, potassium, calcium, various B vitamins, so all these nutrients become more deficient in these types of medications. These medications are known to create these nutrient deficiencies. So like I mentioned before acutely if you’re not in good place, you wanna be on one of these medications until you can get your—your lifestyle and everything in order, and you find a good nutritionist and/or functional medicine doctor to work with, that’s when you can start to move forward and the nice thing is it you just monitor it. You can tell your doctor, “Hey, we’re gonna be doing some things to help lower it naturally. A lot of times they think there’s nothing you can do. I mean, they may be keen on the whole diet and lifestyle thing. They may think that you can’t get down to the point where you are off the medications, but a lot of times they’ll entertain the idea. “Hey, let’s monitor it. Let’s see where you’re at out and you can go from there.” The biggest though misconception you gotta be careful of if you’re only testing your blood pressure during the day when you’re at the doctor’s office, we called The White Coat Syndrome. Just being around the doctor in the office and all the, you know, “Hey, am I gonna get a shot today or a needle or give blood, whatever,” so it’s a lot of stress about getting poked and prodded when you go to the doctor’s office. That can increase your blood pressure as well. So I tell my patients, first thing you get up in the morning. You’re still horizontal. You’re lying down. Take your blood pressure there. Take it at random intervals throughout the day and just kinda make some notations of how your blood pressure ranges. It may be 20 or 30 mmHg higher when you’re more active, but when you’re more relaxed, it maybe 20 or 30 lower, and if you’re sleeping—

Evan Brand:  I had my grandfather—

Dr. Justin Marchegiani:  Yeah, go ahead.

Evan Brand:  Sorry, I didn’t—I didn’t mean to interrupt. I had my grandfather do that because he went to his doctor, which he doesn’t like his doctor anyway, and I tell him, “Look, you can—you can get a new doctor.” I don’t—he feels so tuck. I don’t know. It’s just that mindset. Anyhow, 40 difficulty—40-point difference from morning when he first got up, took his blood pressure—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Compared to at the doctor’s office. I mean, we’re talking a difference of 120 to 160. I mean, that’s insane, 40 points. So here you go and it’s not like the doctor is going to monitor you and say, “Hey, let me check your blood pressure again next week.” If they see that high once, they’re gonna put you on the drug.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  And write that prescription that quick.

Dr. Justin Marchegiani:  Exactly and the insurance base model for visits with your conventional MD, there’s just not time to talk about diet nor do they even—are they even educated about it? There’s virtually zero nutritional education and if there is any, it’s based on a pathological level, right? Vitamin C causes scurvy, B1 deficiency causes beriberi, or it’s the food pyramid—eat your 10 to 11 servings of grains a day.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Let’s not talk about the GMOs or the carcinogenic pesticides sprayed on the food daily.

Evan Brand:  Oh, my gosh. I know.

Dr. Justin Marchegiani:  So you don’t like get the best perspective.

Evan Brand:  I was watching a video by Eric Berg, you know, Dr. Berg?

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Watching a video of him talking about glyphosate which I already knew most of it, but it’s just mind blowing that now research is starting to look at how small of glyphosate exposure it really takes to disrupt this whole hormonal health cascade. I mean we’re talking points, parts per billion or are parts per trillion in some cases, I mean, here you are thinking, “Oh, the 80-20 rule, 80 organic, 20 not.” I wanna be as close to a hundred as I possibly can.

Dr. Justin Marchegiani:  Exactly, a hundred percent, and again glyphosate a.k.a. Roundup, right? That’s the major pesticide sprayed on a lot of these Roundup resistant crops, basically allows them to not have to do any weeding at all, because it kills everything except the plant, i.e. kills the weed and it’s the chelator. So it pulls away minerals, so guess what? It’s pulling away a lot of good minerals, some of the ones I mentioned that are really important for healthy vascular health and controlling blood pressure.

Evan Brand:  Yup. Wow. That’s a trip and you combine that with 24/7 technology, that Fight or Flight mode is going.

Dr. Justin Marchegiani:  Exactly. So obviously getting the adrenals under control, getting the diet under control, getting the—your glycemic load under control, meaning keeping the carbohydrates within range for you. If you’re overweight, getting them close to 50 and getting more to a ketogenic approach starting out is gonna be a great starting point and then getting some of the extra nutrients back in like magnesium, zinc, potassium, folate, B6. These are common nutrients that are deficient in people taking blood pressure medications, right? We’ve talked about the nutrient deficiencies caused by these medications and then also adding things like Hawthorne or a.k.a. foxglove. I think there’s a medication made after these herbs, too.

Evan Brand:  Yeah, I think—

Dr. Justin Marchegiani:  That are—that’s conventionally used.

Evan Brand:  I think they’re—they’re rooted from that. I think they come from the plant.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And of course, they patented and changed it to where it doesn’t resemble the plant anymore but—

Dr. Justin Marchegiani:  That’s it. So some medications are actually made from those types of extracts. So we kinda reviewed the diet and lifestyle things, and that these drugs work a couple different ways. You mentioned the lisinopril or the hydrochlorothiazide. These are like water pills. They just cause you to pee more and lose more of the fluid then you have ones that affect the angiotensin-converting enzyme that affects—it’s in the lung

area menu of ones that affect the receptor sites in around the heart whether it’s the beta blockers or the—these adrenergic receptor blockers that affect heart contractility, so there’s a couple different ones there and again in the end, we want to get to the root cause of why you have these blood pressure issues to begin with.

Evan Brand:  Yup, absolutely! I’m sure we can make this an hour—an hour-long show but it always is going to end. You got—you gotta dig deeper and figure out. We could talk all day about the lifestyle and all that, but in some cases, people are doing everything right or what they think is everything right and they still have high blood pressure so there could be some other type of infection or something deeper that is causing the sympathetic stress and we just have to uncover it and I don’t know if I mentioned it to you. I ran a 401H and a GI MAP side-by-side on a female, let’s see about two weeks ago, and the GI MAP showed up with seven infections including two parasites and the 401H showed up with nothing.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Is that not crazy?

Dr. Justin Marchegiani:  That is pretty crazy. The other one was–

Evan Brand:  So I sent over—

Dr. Justin Marchegiani:  Was the other one the GI Map?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Okay. So we got DNA technology on one versus the antigen-based under the microscope technology on the other.

Evan Brand:  Yeah and I have to go on symptoms because I mean those a lot of symptoms, so get tested but—

Dr. Justin Marchegiani:  Well, you know my—yeah.

Evan Brand:  What were you gonna say?

Dr. Justin Marchegiani:  You know my method on that. If anyone has got symptoms we always wanna cast a bigger net because we have the possibility for holes in one, so 2 tests as a minimum when we’re looking at gut infections for sure.

Evan Brand:  Yeah.  Yup.

Dr. Justin Marchegiani:  And again the nutrients that are so important for heart contractility where we’re always trying to—if we go off on a tangent everyone, we’ll pull it back in and try to relate it, but the nutrient deficiencies caused by some of these infections, these nutrients like the magnesium and the B6 and the folate and all of the other minerals, potassium, magnesium, etc., zinc are really important for heart contractility and blood pressure, so if we have holes in our intestinal tract metaphorically, where we have a decrease in the absorption of these nutrients, that can affect our vasculature and our blood pressure for sure.

Evan Brand:  Yeah, so we’re talking SIBO, other you know, any type of bacterial overgrowth problems, yeast problems, parasites, things that are stealing your nutrients basically you’re referring to where you’re not getting fed yourself because you’re starving from the inside out because you’re feeding something else and not feeding yourself or hydrochloric acid levels are low. I mean, could we go as far as to say—

Dr. Justin Marchegiani:  A hundred percent.

Evan Brand:  This cascade could start by having heartburn and then getting put on PPIs which then reduces hydrochloric acid, which then reduces absorption, so then the nutrient deficiencies cause the hypertension.

Dr. Justin Marchegiani:  A hundred percent and I’ve seen so many patients that are adrenally fatigued or have adrenal dysfunction per se, and they can’t really regulate their blood sugar. They have to eat every two hours and their blood pressure gets super wonky, right? It goes down below 90 sometimes and we have to flood their body with extra minerals, enzymes, and hydrochloric acid and eat every two hours just to be able to maintain everything because the glandular system is so out of whack, which again correlates back to blood pressure. Now in this side of the fence, we’re dealing with the lower side which can still create just as many issues, not as quite dramatic as the high blood pressure ones with stroke and heart attack, right? Heart attack is occlusions and blockages in the heart. Strokes obviously conclusions and blockages in the brain. So we wanna do our best to avoid the high stuff and make sure we adhere to as many of these natural strategies as possible.

Evan Brand:  Yup, absolutely. Well said. So if it’s high, implement the stuff that you can, take the free information, and then if you need to work further, work further. Reach out to Justin. Reach out to myself. Get help. Get this taken care of. This is something that is so common, but that doesn’t make it normal. So many people can relate to high blood pressure, maybe you’ve dealt with it or you have a family member that’s dealt with it. I could think of a dozen people off the top of my head and they just get put on the drugs, nothing ever changes with diet and lifestyle, they continue to suffer and will get more symptomatic as time goes on. So don’t be in that statistic. You can—you can get healed and you can reverse this without too much hassle and a relative amount of time.

Dr. Justin Marchegiani:  Exactly, so if someone’s tuning in now, maybe they fell asleep the last half hour, well, shame on you. No. But here’s the general gist, okay, here’s the gist. If you fell asleep and you’re waking up now, diet—get it in order, just what Evan said, get the carbohydrates dialed in. If you’re overweight, start with just vegetables and maybe add in a small amount of low fructose types of fruit. From there, optimize fat, become a fat burner, and then on top of that, look at the adrenals, look at your stress, make sure that’s dialed in because of the cortisol response. And then off top of that, look at the nutrients—magnesium, zinc, hydrochloric acid. Look at blood pressure medications, potential being—

Evan Brand:  Omega 3’s.

Dr. Justin Marchegiani:  Omega 3’s. You can look at herbs that can help, the foxglove/Hawthorne types of medications or herbs I should say, which are based off of medications as well.  Omega 3’s, blood thinning, gingko, systemic-based enzymes, Hawthorne. These are all really good things to help kind of support and address blood pressure and then get to the root cause, work with a functional medicine doctor that can help you put—put it all together because it could be a little overwhelming if you’re walking into this and you’re like, “Shoot! Where do I start?” And then also a little bit of exercise and then really look at the fructose, because how that has an effect on the endothelial synthase and the blood pressure via the contractility in the arteries.

Evan Brand:  Yup, well said. And I have heard people say that they like listening to us because it’s relaxing. So you did a great job! In case I did fall sleep for the last 35 minutes, you summed it up. So good job!

Dr. Justin Marchegiani:  Perfect! Excellent and again most people that come and see me at least and I think it may be for you, most people are coming because of a whole bunch of other symptoms, and then blood pressure is kinda like a—an artifact there sitting in the background.

Evan Brand:  Agreed, yeah, that’s exactly the case. They’ve been through 10, 20 people. They’ve been going for fatigue or joint pain, but “Oh, I happen to have high blood pressure, too”. And it’s something that gets thrown to the back burner and I don’t think it should be on the back burner.

Dr. Justin Marchegiani:  Exactly and most people there are just seeing their medical doctor, and medical doctors are more than happy to manage it which we mention is great in acute cases, right? But long-term, that’s not gonna be the best option because of the nutrient deficiency. So in the end, you know, don’t look at your medical doctor as the long-term person to give you the answers to fix it. They’re just there to help manage it and again, I mean, who wants to manage, I don’t know, diarrhea forever? You want the diarrhea fixed. Who wants to manage a headache forever? You want the headache fixed. So management’s okay in the short run, but in the long run, it gets pretty frustrating and you want to get to the root cause.

Evan Brand:  Amen. You can only put so much duct tape over that—that red light on your dashboard and you just gotta fix what the problem is. Why is that light on in the first place?

Dr. Justin Marchegiani:  Exactly, yeah. Well, this was a great holiday show. I mean, everyone is probably—well, I shouldn’t say everyone but a lot of people are gonna be getting their carbs and the refined sugar and gluten on on this holiday season. I will not be or if I do, it’s good to be in a—a way that is ideally grain-free and lower sugar, so I get the mouth feel effects, i.e, the food tastes good but I don’t get all the collateral damage later.

Evan Brand:  Agreed. So what if you wanted to do like some mashed potatoes and gravy, would you do something like that and try to get a wheat-free gravy taken care of like a slow-cooked turkey they would have some natural gravy coming off of it or what? How would you do it?

Dr. Justin Marchegiani:  Oh, yeah, some mashed potatoes, I mean, loaded up with some good butter, heavy cream, and then for your gravy, you just throw some of the drippings from the turkey in there with some celery and I use carrots, and I blend it up just like that and it’s just super thick. If you want to make a little thicker, you can add a little bit of coconut flour and that’ll give you a nice thick gravy there, and if you want you know, don’t go to the potatoes, go to the sweet potatoes that have a little bit of a lower glycemic index, i.e. they don’t—

Evan Brand:  Yup.

Dr. Justin Marchegiani:  They don’t go and then will convert to sugar in your blood as fast, so that could be a good move or you can do the white potato. You can do 25% white potato, 75% cauliflower mash, and you mix it in and it gives a—a pretty similar mouth feel mall feel you won’t really know that much if you’re not using it another glycemic load is decreased by 75%.

Evan Brand:  I know.

Dr. Justin Marchegiani:  That means less insulin.

Evan Brand:  That’s excellent. Excellent. Yeah, I got my wife converted over to sweet potatoes now. She’s like, “Wow, these are so much better than white potatoes..” I’m like, “I’ve been telling you that for three years.”

Dr. Justin Marchegiani:  Exactly. Anytime I’m dealing with patient’s—the key thing with dealing with patients when you’re making diet changes, the first thing that they go to in their head is like, “Oh, crap. I gotta remove these foods.”

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That creates a stress response. So I’m like, “No. We gotta be solution-oriented.” What’s the substitute? Because there’s tons of substitutes. So if we get them thinking about what’s the substitutes? How can I create the mouth feel? How can I get that taste in my mouth that I want that I’m missing by eating the bad food? How can we get with the good food? So like last night, I wanted a whole bunch of pasta. I’m like, “Oh, I really want pasta.” So I got some miracle noodles which are made from glucomannan, a fiber, basically has zero calories and zero sugar, and I did a whole bunch of butter noodles and I had it with some rotisserie chicken, and it was phenomenal, and I felt like I was eating pasta, but no sugar, no grains, virtually no calories which obviously calories don’t matter but it’s nice that you can eat a lot of it and it’s not gonna impact your insulin levels.

Evan Brand:  That is so cool, yeah, and I’ll speak for—for myself and possibly you, too—put it this way. I love eating if this way of eating was horrible, I wouldn’t do it. I mean, I am not missing out on taste or pleasure from my food at all. I’m more satiated than ever before. I feel so much better. My brain works so much better. The—there is light at the end of the tunnel for sure.

Dr. Justin Marchegiani:  Yeah, my favorite line is nothing tastes as good as good feels.

Evan Brand:  Say that again.

Dr. Justin Marchegiani:  Nothing tastes as good as good feels.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Meaning, it—for me it’s more rewarding to feel good later than to get that short taste in the moment of some crappy inflammatory foods. Because in the end it’s great but then I just feel crappy. I’m bloated. I’m gassy. I got brain fog. So you gotta weigh in that, you gotta weigh in the deleterious side effects with that short-term thing and a lot of times, there’s a risk for more analysis you can do where you can do where you can pull out some sugar, maybe use some Stevia or Xylitol or cut down the carbs or do a different source there that’s less inflammatory where you feel good and then honestly, if you’re like, “Screw it!” Well, throw in some charcoal. Take a whole bunch of charcoal to help decrease the toxins. That’s another good Plan B.

Evan Brand:  Yeah, I feel like we’re rambling at this point. I feel like this is the talk after the first cider has set in—

Dr. Justin Marchegiani:  Yes.

Evan Brand:  After the main conversation.

Dr. Justin Marchegiani:  Yes. I know. Nice little tidbit for anyone listening though. These are all gems I think though.

Evan Brand:  Yeah, I agree. I agree. Well, let’s wrap this thing up.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Go check out Justin’s site. Justinhealth.com and then check out NotJustPaleo.com. You could reach out to one of us, get help, get to the root cause. Justin’s got some free thyroid videos. I’ve got some videos on my site as well you could check out. So plenty of information. There’s no shortage of—of clinical pearls at this point I don’t think.

Dr. Justin Marchegiani:  Absolutely. Anyone that’s—well, everyone that’s getting ready to celebrate their holidays, I wish you a Merry Christmas and Happy Holidays, and if you’re kinda on the fence here trying to figure out when’s a good time to make changes in your health because you’re struggling, now’s always a great time. The New Year is coming up, so feel free and reach out to Evan or myself. Info is below and we wish you a super happy and healthy new year.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Thanks, Evan. You, too.

Evan Brand:  Bye.

Dr. Justin Marchegiani:  Bye.

Putting together the optimal functional medicine program – Podcast #116

Dr. Justin Marchegiani and Evan Brand discuss about effective functional medicine programs and how they create and follow protocols. This interview goes in-depth about the world of functional medicine practice.

functional medicine programsFind out why you shouldn’t wait for something to happen before doing anything about it health-wise. Discover the differences between Body System One and Two and how optimal health can be attained. Learn about the various tests you can take and the right tools that are available to further achieve better and more effective results with functional medicine.

In this episode, topics include:

01:26   Get help as early as possible

07:00   Body System One

10:19   Diet and lifestyle

17:16   Body System Two

38:22   Tests

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youtuve

 

 

Dr. Justin Marchegiani:  Hey, Evan, it’s Dr. J in the flesh. How we doin’ this Monday?

Evan Brand:  Hey, man! I’m doing great. How are you?

Dr. Justin Marchegiani:  I’m doing great. Can’t complain. It’s a little rainy Monday here in Austin. The grass is getting plenty of water which is great. I got the fireplace on behind me, so it’s got that wintery Christmas feel a little bit.

Evan Brand:  Nice. Excellent.

Dr. Justin Marchegiani:  Can’t complain. How about you?

Evan Brand:  Doing well, man. Hey, we were trying to record this thing, and then we had choppy audio so I wanna repeat what my little rant was because I thought that was important. I’m always curious about what is the catalyst for someone to work with yourself or myself, and I had a lady this morning who had been listening to us for six months and she knew that she had problems. She had a lot of gut issues going on but she continued to just listen to try to fix herself, and then she got the diagnosis of alopecia and now she’s lost over half the hair on her head, and now she’s figured out that that’s the time to come and get help. And I just want that to be a fire under people’s butts listening that you shouldn’t wait until things are so bad that you’re at rock bottom before you get help and unfortunately, that’s the conventional system that we’ve all been brainwashed to do which is we wait until we’re really bad, we absolutely need a doctor or practitioner and then we go get help. And my advice, get help now. If you have symptoms and things are off, and this is something you’ve—you’ve trained me on so much. It’s like, “Evan, look, these issues are not gonna resolve themselves. You have to resolve issues now. They’re not just gonna magically disappear.” Did you wanna speak on that a little bit about people just waiting too long or people just not having enough reason so they think to get help?

Dr. Justin Marchegiani:  Yeah, well, there was an interesting scenario just the recently. There was a plumber in my house a few months back and he was doing some work, and there was just like a leak on the faucet, and for some reason the leak went away the next day. So there were two plumbers there and he goes down and looks, and he couldn’t find the leak. And he goes, “Well, maybe it just went away,” and then his partner, the plumber next to him spoke up and said, “You know what? Leaks never go away on their own. If there’s a leak, it’s gonna get worse.” So he went down there and he looked, and he said, “Okay, well, we just need more flow and if you had more flow coming, it would start to leak.” And he looked a little deeper back and he found the leak and just the environment wasn’t quite right enough for the leak to be expressing itself but the whole idea was that these problems don’t ever tend to go away by themselves. So that was kind of the moral of the story and connecting it to your patient, let’s say if you have these symptoms, they’re gonna get worse and the question is, how long do you wanna wait until those symptoms, right? Pain, pay attention inside now—that’s what symptoms are—whether it’s aesthetic, whether it’s inflammatory, whether it’s mood or energy. How bad do they have to get before you start getting a—a fire under your butt so to speak.

Evan Brand:  Right. Well, and my grandparents, their old house, you know, they had issues with their plumbing and they had to wait until their entire basement was flooded and thousands and thousands of dollars’ worth of carpet and furniture was ruined due to the flood before they came in and got the issue. So maybe they saved, you know, a couple hundred bucks in the beginning, but then it cost them likely $10,000 or more in the long run because they waited until things just hit an absolute worst-case scenario. So you know, I know there’s a lot of people out there listening that are trying to fix themselves and you and I certainly applaud that. I mean that’s what this is all about, right? Taking your health into your own hands and us teaching you how to fish, but at a certain level, you really just have to reach out and—and don’t be afraid to get better and—and don’t be afraid. You know, we’re real people. We don’t bite and we’re here for you. That’s what this is for. The show is to inspire you and to help you, but there’s nothing that’s gonna replace a one-on-one, you know, with one of us because there’s so many courses and online things, and things that you can look into, but it’s not specialized and I’m against specialization if you only look at one person. But you know, something we’re gonna talk about today is functional medicine is a specialty but we’re breaking that down. We’re—we’re looking at someone. We’re casting a net wide enough to look at every body system, so that we’re gonna figure out what in the world going on with somebody.

Dr. Justin Marchegiani:  100%. And so the template for how we treat patients is pretty unique for—for us as functional medicine clinicians, right? There a lot of nutritionists out there that will primarily just focus on the diet piece. There are a lot of medical doctors out there that I find that will a lot of time skip the diet, maybe focus on more of the hormones and ignore the gut. You have other people that will only work on infections, whether it’s Lyme or a gut doctor. They’re only focused on the infections. So the question is, how do we become the general or the ultimate general practitioner, where we can pull the key issues from the infections, from the hormones, from the diet, from the lifestyle, from the digestive system, and combine them together and mesh it? So we put it all together in a way that is holistic, that represents the underlying cause from each person, because that underlying cause percentage-wise may be different for each, meaning one person that may be 60% diet, 30% infections, and 10% hormones, and others it may be 30% diet, 50% hormones, 20% gut. So you gotta look at it from the perspective of what piece may be the bigger player, and it may not be the same for each person. So we may not know, but if we hit them all in the order that we consider to be the order of priority, that’s gonna give us the highest chance of hitting all of those key issues and not missing them.

Evan Brand:  Right, and during the free calls, you and I block out just a few hours each month for free calls, which we’re always booked up for those and it’s a true honor to be able to offer that to people.

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  A lot of people ask us, “Hey, Justin or hey, Evan, you know, can you just tell me right now what tests we’re gonna need to run.” And we can’t because that involves a case review, that involves looking at your history, looking at the fork in the road when did things get bad, how long have things gotten bad, what else was going on at that time in your life in terms of stress and travel and relationships and moving. You know, so there really is no one-size-fits-all program. Now there are similar tests that we run on nearly everyone, but at the end of the day, it’s so case-by-case and I know people wanna just get put into a box because it makes them feel comfortable. I mean, think of like Weight Watchers, right? You know, it’s a point system and you can buy their little hundred-calorie snack packs of pretzels. But that’s a horrible box to be in and you don’t wanna be confined there. So it—it’s a box of functional medicine but it’s a box without boundaries, too, because we never know what toolbox or toolkit we’re gonna need to reach into to pull something out specifically based on—on your symptoms.

Dr. Justin Marchegiani:  100%. So we wanted kinda get things dialed in, and we have like the pallet of our tests that we may choose from for body system one. That’s like the hormonal system and we break that up into ATF and ATM, adrenals, thyroid and female hormones for our female patients and then our ATM, adrenals, thyroid and male hormones. And depending on how deep we go is depending upon what kind of symptoms present themselves and how long the patient’s been sick. Typically, the longer someone’s been sick, it may be better to get more data so we can fine tune the plan better, more specific to what’s going on. If someone’s been maybe not feeling good for just a little bit of time, maybe only a few years or a few months, we may run less off the bat because we don’t need as much data. Typically, the low hanging fruit tend to work on people that aren’t as chronic. So that’s kind of a good rule of thumb. So our body system one test are gonna typically include high-quality adrenal tests. Well, and that depends. I know we’re going back and forth and testing, you know, the new Biohealth saliva test that’ll be out soon. We’ve been using the Dutch for a bit of time. We have been using the old Biohealth 201. I have lots of patients that come in with other subpar salivary hormone testing that—that come in. We also look at the DHEA sulfate, which is an adrenal marker of sex hormone precursors from the adrenals, DHEA sulfate. And then we’ll also add on female and male hormones to those tests, whether it’s female hormones, progesterone, estrogen, estrogen metabolites, the different kinds of estrogens, estradiol, estrone, estriol, whether we are looking at the DHEA metabolites like androstenedione or etiocholanolone. Those also get factored in, maybe even melatonin as well. So we’ll look at all these different metabolites on the hormone side and then depending on if they’re showing with thyroid symptoms, we may even run a thyroid blood test or we’re looking at all of the thyroid markers, TSH, T4 Free and Total, T3 Free and Total, reverse T3, T3 uptake, and thyroid antibodies. So those are kind of all of the hormonal tests that we may run. And we even have some different. We may even time it up on day 20 of a female cycle if they’re—if they’re menstruating to get a window into where their hormones are tapping out. We may even look at a full month long panel, testing hormones every other day for a full month, so we can get a window of ovulation and the ebb and flow of the hormones throughout the month, just to make sure it’s optimal for fertility.

Evan Brand:  Yup, well said. So body system one. I mean, this is the foundation, you know. You talk about these people that just focus on the gut and we’ve dealt with that. I mean a lot of times and I know you hear this just as much as me if not more, “Oh, I’ve already been to 10 specialists or 20 specialists or 20 doctors. They all think I’m crazy or they said it was just the gut. They gave me antibiotics.” If you don’t get the hormones aligned and checked out, you’re kinda wasting your time really because if you have cortisol issues, you’re likely gonna have leaky gut issues which is gonna leave you susceptible to infections. So it’s like if we come in and just hit the gut, which we’ll talk about in a minute, body system two, it’s not really worth it, right? Because if you get the infection gone, but the leaky gut’s still there due to the cortisol issues, I mean, that’s kind of a bigger top of the food chain issue, right?

Dr. Justin Marchegiani:  100% and just backing up one bit, everything sits on a foundation. So the introductory foundation for everything is diet and lifestyle.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And we’ve talked about this before, but just to make sure we don’t miss it, the foundation is gonna be what you eat, when you eat, the quality of food that you eat, how you sleep, how you move, how you deal with stress, and hydration. So that’s gonna be a really important piece of the puzzle. Making sure we’re eating nutrient-dense, anti-inflammatory, low toxin foods. Making sure the diet is dialed in for you. Now what does that mean for you? Well, if you’re just a little bit sick, maybe you’re kinda in the middle, it’s not too bad, a Paleo template may be good to start with. Alright, no grains, no legumes, no dairy. If we’ve been sick for longer, maybe we have a history of autoimmunity in the family, or there may be known autoimmunity in yourself or known autoimmune symptoms, well, the next step may be an Autoimmune Paleo template where we go to the next step which is cutting out nuts, nightshades, and eggs. And then from there if there’s excessive gut issues, we may look at specific carbohydrate diet where we cut out salicylates and phenols and peel our vegetables and—and make sure everything’s well cooked and mash our foods. We may even look at a GAPS approach where we focus more on bone broth and soups and—and the same type SCD stuff, more in a liquid, palatable—a liquid, more palatable type of form. And we may even go to a low FODMAP diet where we cut out the fermentable carbohydrates–fermentable oligo-di-po—let’s see, fermentable oligo-di-mono and polysaccharides. So it’s your—your fermentable carbohydrates, your fermentable sugars. So we may add that piece onto it just to make sure that we’re taking as much stress off the body. We’re stabilizing blood sugar. We’re not adding toxins from the pesticides and chemicals and GMO and Roundup and—and the glyphosate and we’re stabilizing blood sugar. We’re not skipping meals and we’re making sure that we’re sleeping good at night and we’re hydrating appropriately in between meals or 10 minutes before, so we’re not diluting digestive enzymes and hydrochloric acid.

Evan Brand:  Well said and there’s a ton of overlap in all of those, too. I mean–

Dr. Justin Marchegiani:  A ton.

Evan Brand:  You’re going to be omitting gluten. You’re gonna be omitting–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Many of the dairy components, the inflammatory component, then you’re going to stay away from pesticides and chemicals. I had a guy the other day. He asked me. He said, “Well, I’m not sensitive to gluten. So do I still have to avoid it?” I said, “Absolutely.” There’s no deficiency of gluten ever and just because you don’t think you’re sensitive to it, some of your skin rashes and all that is probably caused from some type of food intolerance. You know, you don’t have to be doubled over in pain from eating a bagel to—to necess—you know, to necessarily have to stay away from it, right? You don’t have to be falling over, needing a morphine shot due to the pain from gluten if you—if you have anything, any symptom, headaches. I mean I had a lady who had migraines for 20 years and it was amazing how simple it was just to get the diet and the gut cleaned up and the migraines went way. So I think people expect massive, massive symptom sometimes to be caused from gluten and otherwise, they don’t wanna get rid of it but you should just get rid of it.

Dr. Justin Marchegiani:  Yeah, my thing with grains and gluten is if you’re gonna cheat and you’re gonna do grains, number one, the safest grain for most people tend to be white rice. So that’s tends to be an okay alternative if you’re gonna do a grain, if you’re gonna cheat. White rice tends to be okay. Even better, try doing the safer starch. You know, yucca, plantains, sweet potatoes, let’s see—I said plantains, yucca, sweet potatoes,  squash—those type of safer starches tend to be a better alternative for most. Go ahead.

Evan Brand:  Yeah, I was gonna say taro, too. Some people talk about that.

Dr. Justin Marchegiani:  Taro, arrowroot, yeah, and then also if you’re gonna—like let’s say you’re like, “I’m gonna do bread.” Well, sourdough bread has actually shown to have less gluten because of the fermentation process that gliadin protein tend to be more dissolved in the fermentation process. So if you’re gonna go get all glutened out, take a look at the good, better, best side of it, right? Good or best would be abstaining and doing zero grains. Good may be doing like white rice or better—sorry, better maybe doing like white rice or something that’s fully gluten-free. And then third would be, alright, fine. You’re gonna do a gluten bread, well, it’s gonna at least be fermented, i.e. sourdough bread. It’s fermented, so the gluten and the compounds in there that may be more allergenic are decreased. But the other things–

Evan Brand:  Right.

Dr. Justin Marchegiani:  That Evan and I still wanna touch upon are the lectins, are the phytates and the oxalates, the mineral disruptors, the protein disruptors, and the high amount of pesticide and Roundup that are on some of these products. So you can at least reduce it by going organic and by going the sourdough method so it’s at least fermented and soaked, so the grains are gonna be more palatable and not have the mineral and enzyme disruptors. But again, better, right? Good, better, best. Best is gonna be at least keeping the grains out. Good or better part is gonna be in between, going like a rice protein and then like, you know, good would be doing the fermented sourdough bread option like I just mentioned.

Evan Brand:  Yeah, and put it this way, it helps me sometimes to understand kind of the ancestral or the planetary perspective on this. These plants and these grains, they don’t want to get eaten–

Dr. Justin Marchegiani:  Oh, yeah.

Evan Brand:  And digested, right? I mean, they want to pass seed on through an animal and then it come out fully digest—or un—you know, undigested, fully undigested, so that that seed can go back into the ground and grow more grass or grain. I mean, that’s the goal with birds and humans, too, if it goes through and it’s not getting digested, the goal is for that seed to be intact enough to grow more plants, and they don’t wanna get eaten.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So that—that’s enough reason there that—that makes sense and really help me. But like, “Oh, man. Wow. Okay.”

Dr. Justin Marchegiani:  And it’s pretty simple, right? You know, from evolution standpoints our role, I mean, it sounds crude is just to be able to pass on our—our seed to our offspring, right? That’s pretty much it. You know, be able to survive enough so you can procreate and pass on your DNA to your offspring. That’s pretty much it. Now there’s two ways of doing it. There’s having claws and weapons and tools and teeth, so you can prevent getting attacked on or preyed on, right? That’s like the wolf or the fox, or maybe us with our weapons as humans. And then there’s the, “Okay, I’m gonna get eaten, right?” Berries, grains, but there’s gonna be seeds and things that are gonna keep the seed and the DNA intact, so eventually maybe it will go back and be able to grow again and pass on its offspring so it can live again, right? So there’s two methods. It’s either you’re gonna fight now or you’re gonna basically submit but live the fight another day by passing itself back into the soil again so it can grow.

Evan Brand:  Yup, yup. Should we move on to body system two?

Dr. Justin Marchegiani:  Yeah, and then last piece that is the foundation with the diet, I’d say is also the emotions. So if there’s a lot of emotional stress, like there’s an active serious relationship issue. You know, not just like hey, you know, you had a fight here or there but you have active relationship problems. Maybe there’s an active divorce issue. Maybe you’re real problem with the child or a family member or maybe a death of a loved one or serious work stress, or stress at your church or where you go to—to have a spiritual connection, or you excessively exercise a ton, right? Those kind of things need to be looked at because they can provide a lot of stress underlying. So we wanna make sure there’s not an active emotional issue because it affects the timeline in which we expect healing to occur. If you’re actively going through a divorce or you’re having serious work issues, we may say hey, our goal is gonna be just to dig out feet in and prevent us from sliding downhill, and we may not be able to gain a whole bunch of ground going uphill.

Evan Brand:  Well said, yeah, and I’ll also mention the electromagnetic fields which I’ve done–

Dr. Justin Marchegiani:  Oh, yes.

Evan Brand:  Countless podcasts on. I had a lady the other day. She heard a podcast about EMF that—that was on the show and she bought a meter online and anything above 1 milligauss, a measure of magnetic field is bad, right? And this lady had 50 milligauss in her bedroom. And so she lives in San Francisco. She didn’t believe it. She called the power company as I told her to do and they came out and they measured, and sure enough, it was about 25 or 30 milligauss. So her meter was pretty inaccurate, but it was accurate enough to detect a problem that warranted further investigation. And even the power company was like, “Well, this is insanely high.” I mean, you’ll see some people that say anything above 3 milligauss of magnetic fields which comes from power lines is—is bad, but either way, 20, 50, that’s insane and so she’s moving immediately and she said she hadn’t slept well for months and kinda like my story that you and I chatted about when I had to move. I was measuring 7 milligauss in my office and I feel like I didn’t sleep. So I mean, that’s another cause of adrenal hormone issues that you and I are discussing and talking about with people because it’s—it’s an invisible smoke, right? If you had glasses that you could wear and see this stuff, everybody would freak out. But it’s invisible. And like my friend Eric Windheim says, “It’s like fighting a ghost.” So you have to measure this stuff and—and mitigate it, and there’s more. We won’t go into more detail today, but just check out EMF in the search bar on the website, and you’ll be able to find, you know, more episodes.

Dr. Justin Marchegiani:  Absolutely. So we addressed the foundational pieces, diet, lifestyle, emotional stress, meal timing, nutrient density–

Evan Brand:  Environmental.

Dr. Justin Marchegiani:  Toxins from the chemical. Toxins are essentially—the electromagnetic toxins, right? That’s kinda in that toxin realm.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We hit that. We talked about the hormones, ATM, ATF. And then next step is gut function/gut infections. Now typically when we start out with the diet piece, depending on what’s happening symptomatically, if we see a lot of reflux, a lot of bloating, let’s say we have a history of vertical ridging in the nails or we see a lot of undigested food particulate or the stool looks grayer or the stool floats or we have poor hair quality or very dry skin, these are all symptoms that we’re not digesting our food optimally. So to support the diet piece, we may bring some of the digestive support up forward, and bring it into intro phase. What I mean is we may bring in some of the hydrochloric acid, some of the enzymes, some of the bitters, some of the digestive support to help stimulate digestion because we see that as supporting the intro phase. We’re working on digesting foods and making sure that piece is dialed in. So that may have to be brought up forward because it’s—it supports the foundation. That’s number one. Number two is we have to knock out the infections. So as we look at body system two, we really break it down into 5 steps. So number one is remove the bad foods. Number two is replace the enzymes and acids like I mentioned. So that’s the digestive support to make the intro diet piece work better. Number three is repair and repair means repairing the adrenals because we have to make sure that piece is there. because we don’t wanna work on really healing the gut, until we have the hormonal environment dialed in to help reduce inflammation and help heal the gut lining and help improve IgA levels, which is the localized immune system in the digestive tract. We also wanna make sure healing nutrients are present for people that have extra gut inflammation or extra gut irritation. Things like L-glutamine and the healing nutrients, the licorice root, deglycerized licorice root, maybe slippery elm, maybe cat’s claw, maybe some gentle amino acids like L-glutamine, and Jerusalem artichoke, etc. These are healing nutrients that help that gut lining. Number four is the removing of the infections and we’re able to remove the infections most adequately because of the 3 phases before it. Because of the removing the foods, the replacing the enzymes and acids, the repair in the gut lining and the adrenals, now we can come in and we can start working on removing the infections, and the infections are gonna be specific to the stool test we recommend to pick up the infection. So the H. pylori comes back or fungus comes back or various multiple parasites come back, those all need to be specifically addressed with unique protocols for each. And then number five is going to be the re-inoculation with robotics, really receding all of the good seeds after the weeding’s been done. And then number six is gonna be the retesting to make sure one, infections are cleared and two, there are no new infections as last podcast talked about, making sure there are no resistant infections that were burrowed in deeper that are showing their ugly head, and the only exception will be adding probiotics in the repair phase. Because sometimes probiotics can have an anti-inflammatory effect, and depending on how bad the gut is, we may add some probiotics in the ref—the repair phase as well as the reinoculation phase to help support gut healing and inflammation.

Evan Brand:  Well said. I wanna speak just for a minute and see if you wanna add anything to it about the topic of antibiotic use and infections. There’s a lot of hate on the Internet about herbal remedies for infections, you know, whether it’s an M.D. or a naturopath or someone. You know, getting in an argument about saying, “Oh, herbs don’t work. You have to use triple therapy or this antibiotic or this antifungal prescription.” And there’s very, very, very, very few cases where it takes us more than one or two rounds to get rid of an infection using just herbs, no prescription. So could you add something to that conversation, too? I would 95% of patients can address their gut function and their got infections with herbs alone. 5% of the time we may have resistant bugs that we’ve treated, re-test, still there. Treated, retest, still there. Treated, retest, still there. And it’s 2-3 times and we’re not able to knock it out. But I’ve had people go and on the third time, we knock it out. So the antibiotics may be an option for some people. The conventional antibiotics that are typically run like the metronidazole, the Flagyl, which are the most commonly prescribed ones for these infections tend to miss the infection about two-thirds of the time. And then a lot of times the antibiotics prescribed for your typical triple therapy for H. pylori like clarithromycin, amoxicillin, and/or omeprazole like Prilosec, acid-blocking medications, tend to do the same kind of thing. They’ll miss the infections a third half the time.

Evan Brand:  Well, what about this, too? What about creating more resistant strains due to the antibiotics that have been so overused? Which then makes our job a little bit tougher because people have gone through rounds and rounds of this crap and it’s done nothing.

Dr. Justin Marchegiani:  Exactly. That’s the problem is you run the risk of having these antibiotics not work in the time where maybe you really need them, like you get in a car accident or you step on a—a rusty nail or some, some kind of infection that’s more acute and more severe based on the exposure of the microbes. So I’m always about conservative to invasive, right? What’s the most conservative type of care off the bat? It’s always gonna be diet. It’s always gonna be lifestyle. It’s always gonna be using antimicrobial herbal medicines that have been around for literally thousands of years to have a strong safety profile, to have the ability to use them long-term without resistance–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And also aren’t gonna wipe out a—as many other microbes, any other beneficial microbes the may be present that are helpful for your gut. We won’t wipe those out and create more problems. I can’t tell you how many patients I’ve seen that have been on antibiotics and had devastating side effects, and now we’re treating them from the damage caused by the antibiotics in the beginning. I’ve seen it so many times. Don’t see it with herbs though.

Evan Brand:  I know.

Dr. Justin Marchegiani:  But I see all the time with antibiotics so I’m always very conservative and we go up in—in gradations on what step one is. Herbs. Step two. Herbs. Step three. Maybe herbs. And then if we’re still having issues, then we go and we lean towards the antibiotics, typically on step three most of the time.

Evan Brand:  Yup, yup. Well said. And just the fact that this has been used, the herbs that we’re talking about. They’re been used for thousands of years before antibiotics were invented. To me that says something about the success rate and the safety. So when people read concerns about herbs. A lot of times the concerns are unwarranted unless you’re talking about mixing herbs with pharmaceuticals, like you know, 5HTP and SSRIs and stuff like that. Yeah, you can get into trouble. But generally, there’s really nothing to be concerned about compared to the tens and if not hundreds of thousands of people dying due to medical error. That’s now the third leading cause of death. Did you know that? Medical error.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  So—so this—this is real. This isn’t something were just saying on our—on our high horse. You know, this is for real. Look at CDC death or medical top causes of death. You’ll see medical error and this is from the proper, you know, or this is the prescribed rather is what I meant to say, the prescribed dose of a medication is still causing third leading cause of death, is medical error.

Dr. Justin Marchegiani:  Yeah, I know. I know Barbara Starfield has her prized article in the Journal of the American Medical Association 2000, all on how much medications and surgical procedures done correctly, right? Hey, the surgery was a success but the patient died. Hey, the prescription was—was perfect according to what the patient’s symptomatology was, but the patient had an ulcer and died, right? Just like that happens with ibuprofen 19,000 times a year according to the New England Journal of Medicine. So we know there’s a risk with conventional treatments. So we wanna be as conservative as possible, so we don’t have to go to those type of higher risk procedures.

Evan Brand:  Agreed, agreed. Well said. So yeah, the infections are huge. I mean, Justin and I, we have more podcasts on that talking about our own history with infections. So not only are we in the trenches helping others remove them, but we’re doing it on ourselves, too. So this is—this is a huge piece and has been instrumental for me to get my—my weight back when I’ve lost, you know, 20 pounds of muscle from infections. So this is a real big deal in something that has to be addressed.

Dr. Justin Marchegiani:  Correct, and I think the key thing, too, is we’re not anti-medication.

Evan Brand:  Right.

Dr. Justin Marchegiani:  We’re all about using the correct tool at the right time, but also weighing the pros and cons. Like if we’re, you know, we got our tool bag on or our toolbelt on, right? And we have all these different tools in our tool bag, alright? And we look at this screw and it’s the flathead groove in it, so we know I gotta pull my Phillips head out, right? I’m not gonna look at that screw and be like, “Screw this, my dog must not gonna allow me to use this flathead, throw it away and then try to pull it—the Phillips in there and try to work it.” So let’s say it’s a—a flathead groove, I’m not gonna look at flathead screwdriver and throw it away, and say, “I’m gonna try using a Phillips, right?” I’m gonna go and say, “Well, this is the right tool for it. So I’m gonna put it in and I’m gonna use the correct tool based on what’s presenting itself.” That’s like if you get in a car accident, we’re not gonna look at the patient and say, “Great! Let’s just throw you on some turmeric right now and call it a day.”

Evan Brand:  Right.

Dr. Justin Marchegiani:  No. We’re gonna say, “Go to the ER. Get the correct test to make sure there are no fractures, no bleeds, no hemorrhaging.” You may even want to be on some higher dose pain meds. You may want to avoid the opiate ones, right? Because of the addiction, but maybe some higher those pain meds acutely just because you’re in severe trauma and pain. And then we’ll get you stabilized and then we’ll get you on a really good routine after. So we look at the right routine. If we see that flathead groove, we’re reaching for the flathead screwdriver. We’re not reaching for the Phillips.

Evan Brand:  Yeah, absolutely. And if you break your arm, yeah, you don’t go take a dose of turmeric and fish oil. I mean, you need to get that checked out and make sure there’s no internal bleeding, etc., etc. So there’s no trophy for—for trying to be a hero and dismissing the acute, incredible trauma medicine that—that is offered. You know, it’s just the things we’re dealing with, their 1, 5, 10, 20, 30-year chronic issues and that’s where functional medicine tends to have far superior success rates. You know, 90+ percent success rates that you and I both have.

Dr. Justin Marchegiani:  Exactly, and some of the things that are talked about regarding antibiotics, and I’ll put some of the research in the show notes, but antibiotics can create oxidative stress and mitochondrial dysfunction. That’s a big issue, so the mitochondria is gonna be the powerhouse of the cell which is gonna help generate ATP which is like the fuel currency for energy, and also creates oxidative stress which is just a way of breaking down your body, right? Oxidation, you leave a rusty nail in the rain, it gets all rust or you leave a nail out in the rain, it gets rusty because of that oxidation process. We have internal rusting. Doesn’t quite show itself like that, a brownish rust, but it happens—it happens internally and that creates a depletion of a lot of your antioxidant reserves. So your body has to use up more vitamin C, use up more vitamin E, use up more nutrients that would typically be used for other healthy functions. So oxidative stress and mitochondrial dysfunction are a side effect of some of these antibiotics use. So we really want to make sure if we’re using them—excuse my frog on my throat—we wanna make sure they are used appropriately for the right situation.

Evan Brand:  Well said. Yeah, and I’ll briefly mention, typically for body system two, we’re gonna be looking at comprehensive stool testing. We’ve discussed that. So whether PCR-based testing or otherwise, and then also the organic acids testing. So you hear us talking, maybe it sounds fancy, mitochondrial issues, amino acid metabolite problems, etc. but we can see and I see it all the time. Vitamin C levels, very, very, very low across the board most time on organic acids which is a urine test that you do at home and then you send that back to the lab and then we go over the results and then stool testing, you’re gonna be able to find infections. You’re gonna go through the protocol and then you’re gonna retest and the infections are gonna be gone. So that’s—that’s it for body system two. Let’s go on to body system three, Justin. So detox, methylation, making sure that people are able to actually do things at the end of the line. Once everything has happened, once a good digestion has happened, you’ve absorbed your minerals, your colon’s helping to produce vitamins for energy, your probiotics are doing the things they should be doing, now it’s time to get the stuff out of the body. We’re hoping the liver is gonna be able to do what it can do. We’re hoping you’re pooping, right? I mean, people buy all these fancy detox powders and teas, but it’s like if you’re not pooping but once a week, that’s a huge issue. That’s a great way to detox, poop and pee. How simple and revolutionary is that?

Dr. Justin Marchegiani:  100%. Poop, pee, breathing, and sweating. It’s like un—unreal. So looking at a lot of the detox things, certain nutrients are required to detox. So you can see why number three, why detox is put number three. Let’s just break that down so everyone can get the—understand the concept. Again in this show, we’re really committed to being able to teach concepts because if you get the concept, there’s zero memorization involved in it. Once you get the concept, it’s like riding a bike. You get back on—Boom! You never have to go to that learning curve of falling. So what’s the concept? So number one, if we’re poor foods and eating toxic foods, and foods that are nutritionally poor, what happens to detox? Automatically impaired.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? So why are we gonna work on detox off the bat? Because if we just get that first phase done, we’re starting to work on detox even though we’re not working on it directly, because it’s body system three, we already worked on it in the intro phase. Number one. Number two, we actually start breaking down the foods. That means we start breaking down the proteins into their smaller amino acid constituents and we know how important the sulfur based amino acids for operating phase 2 detoxification. Phase 2 is like the n-acetylation, hydroxylation, the glutathione production, the methylation, and we need methionine and we need cysteine and glutamine and glycine and taurine, and all these really important sulfur aminos, and if we can’t break down our protein constituents into those smaller products, you know? Ripping off the pearl necklace and pulling off the individual pearls, that’s what it’s akin to. If we can’t do that, we’re not gonna be able to run phase 2 and then frankly we need lots of antioxidants and B vitamins to run phase 1. So if we have SIBO or dysbiosis, well, our probiotic production internally from our gut bacteria is automatically forwarded or downregulated because we know good bacteria in our gut produces a lot of those nutrients for us, right? Good bacteria eats poop and poops nutrition, B vitamins, antioxidants, nutrients. Bad bacteria eats nutrition and poops poop. Bad bacteria makes you more toxic. So what is the more toxicity from the bad bacteria due to body system three? It decreases its function. So you can see how we lead up to diet and lifestyle. We lead up to digesting food. We lead up to healthy gut bacteria, knocking out infection, addressing the flora, because all of that sets the stage for body system three, so we can come in there and really support the nutrients that are missing, the pathways that aren’t working properly, and we can potentially even knockout specific heavy metals if we see heavy metals are in there with other types of chelators and compounds that pull the metals out. And some of the test we do—well, I’ll take a breath there, Evan. Any comments?

Evan Brand:  Yeah, I mean, well said. I wanted to mention this comes at the end because we want to make sure that everything else has been addressed upstream. I mean we’re not going to go straight to detox if we know that you have infections and we know that you’re still getting, let’s say artificial sweeteners in your diet which can be placing a burden on the liver, right? So we want to see the liver and your detoxification abilities, methylation, this includes anybody with like MTHFR genetic defects. This includes you, too. All that other stuff’s gotta be taken care of first because we want to see what the actual baseline is. Not the baseline when you are doing so much sugar and alcohol and bad fats and artificial sweeteners and all of that that’s got the burden on the liver. So once we get all that stuff out of the way, then we take a look at body system three. It’s the, “Oh, okay, so this is the true baseline,” and then yeah we can look for heavy metals, from dental fillings, amalgams, you know, bad food, bad water, too much tuna fish, other environmental exposures, and then we can start helping to get the detox system working better because if you’re not pooping well and you have an overburdened liver, you’re just gonna be recirculating all these toxins. So then you’re gonna get the joint pain and the allergies and the asthma, and the skin problems, the headaches, the brain fog, alcohol intolerance, I mean, we could go on and on but you gotta get all that other stuff taken care first, so if you go straight to detox or somebody tries to sell you on some detox protocol first when you don’t even know if you have leaky gut or not, I would be cautious and maybe you have more to say about that, but I don’t like the idea of pushing stuff out of people’s body if they don’t even have enough trash men to come gather all of the trash at the end of the road.

Dr. Justin Marchegiani:  Yeah, 100%. So we have everything lead up to it and I think you emphasized the whole leaky gut part right because the leaky gut as you mentioned is really the consequence of all of the inflammation, the inability to break down food, the compromised immune system, and then the infections. All of that will lead to leaky gut. So leaky gut isn’t necessarily a result. It’s more of an effect of all of the inflammation and the damage.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? The gluten, the bad foods, all of the inflammation. So that’s kind of the end product that you get there is leaky gut. So looking at everything that you mentioned. How do we quantify it? Because you put some really good points out there. How do we actually know what’s going on from the detoxification side? Well, we’ll look at an organic acid test. Typically as a good starting point because we’ll get a window into various detoxification pathways, whether it’s pyroglutamate or other types of organic acids, sulfate—these are organic acids that will give us a window into how those sulfur aminos are doing. If the demand for them is higher or if they’re depleted. And we’ll also get a window into B vitamin status. We’ll get a window into methylation and we’ll also get a window into oxidative stress by looking at the 8-hydroxy 2-deoxyguanosine for instance. Again, these are all like jeopardy words but these are organic acids that give us a window into all these systems, whether it’s simply xanthorrhoea for B6, whether it’s the amino acids for the brain with vanilmandelate or homovanilate or 5-hydroxyindoleacetate or whether it’s markers for gut bacteria like hippurate or benzoate. So these—these markers give us a big window into what’s happening and the organics can really help tell us what’s happening there from some of those detox nutrients, and we may even look at like a SpectraCell or a NutrEval as well. Again, I lean more towards the organics because that’s my baby.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  The NutrEval combines the organics with another blood test for nutrients, too. So that’s a—another side option which at least does contain the organics and that gives us a good window into what’s happening but we always go back to intro, body system one, hormones, ATF, ATM; body system two, the ability to digest, removing food allergens, healing the leaky gut, repairing the gut lining, removing infections, adding in probiotics, and retesting because we gotta make sure new infections aren’t there and the old ones are gone. Number—body system three is gonna be detox nutrients and that’s typically where we follow suit, and we reserve the right to kinda move some things in. Like if I know someone has a ton of oxidative stress, I may throw some extra vitamin C that we may discover on an organics test, I may throw it in with the adrenal protocol. So we do things and we mix-and-match outside of that box a bit, so if any patients are listening, they may think, “Well, Dr. J gave me some detox support in body system one,” and that’s gonna be dependent upon how that person’s presenting, how sensitive they are, and how bad their detox is. We may add some small things in with body system one, because maybe the adrenal support is too much for their liver, and we need to give their liver just a little bit of support so they don’t have a lot of those hormone side effects.

Evan Brand:  Totally, well said. I’m gonna mention two things and then we can wrap it up.

Dr. Justin Marchegiani:  Cool.

Evan Brand:  One for me on the organics, which I just love is the quinolinic 5-HIAA ratio–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Looking at inflammation because you could go on and on and sound fancy, but when someone sees inflammation and you’re like, “Look, here it is.” It’s like, “Oh, crap.” Because inflammation, you know, even a conventional physician is gonna talk about inflammation as a cause of disease, right? And so when we can actually prove that to a client or a patient, it’s incredible and it’s very profound to be able to do that and then whether it’s 3, 4, 6 months later when the retest comes, and you can see that that number’s gone down, it’s very, very rewarding for both of us, and lastly, the toxin piece, too, something that Justin and I have been talking about a lot and—and I’m running on—I’m running this test on nearly everyone I possibly can–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Including myself is the GPL-TOX so I can look at the toxic load because I bought a sauna based on my toxic load of insecticides, and this is not a challenge or a push test so even the sickest people, we don’t have to worry about doing any type of chelation which may push some stuff out. You just urinate in—in the morning in a cup and you send it off. And the cool thing is you can run it side-by-side with the organics, so it’s literally the same urine sample. All you have to do is spend a little bit extra investment to get both test run organics and GPL-TOX at the same time, and I had insecticide levels in my body that are known carcinogens that were higher than they should be. And so for me, this is a huge, huge, huge new realm of opening up this. Look, we know there’s detox problems. Let’s fix it, but what are we actually fixing. You know, that had always been the question, right? Ooh, there’s detox problems. Man, you got headaches. You got chemical sensitivity. You can’t handle perfumes, gas fumes. Look, here’s why. And oh, man, is there anything more fun in the world than this? I mean, I—I don’t think so.

Dr. Justin Marchegiani:  Yeah, I agree. I mean, it’s like we’re CSI detectives without all the—the murder and blood, right?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  We’re trying to put together the—the puzzle piece that’s really getting people’s quality of life back. So just summarizing those tests. We run the organics test. We run maybe the OAT, which is the—the Great Plains Lab organics. We run the GPL-TOX. We may run the NutrEval, the SpectraCell and then we have the heavy metal challenge test where we challenge, with a chelation compound, like DMPS or DMSA or EDTA to get a window into the toxic burden of metals because metals don’t want to stay in systemic circulation. They don’t wanna stay in the blood. They only go on the blood acutely in that first 24 to 48 hours, then they go into the tissue.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Whether it’s the brain or the individual tissues or even bones when it comes to lead. So we gotta get a window into it so we have to do a challenge, a provocation agent that can go in into the tissues and really kinda pull things out. It’s like, “Hey, you go outside. You look for bees. There may not bees swarming around, but if there’s a beehive there, well provocation agent’s throw rock into the beehive, right?” You know those bees are in that beehive when those—when that rock hits it and those bees come out, that’s the provocation agents. So we use that same kind of methodology with the heavy metal test. The rock is like the chelation compound that we use to see what’s coming out in the urine and a lot of times we see aluminum, we see arsenic, we see cadmium, and we see a whole bunch of mercury and lead, and it’s different for each person.

Evan Brand:  Yup, absolutely, and then you got blood metals, too. Quicksilver’s Blood Metals is cool.

Dr. Justin Marchegiani:  Yup.

Evan Brand: There’s the Mercury Tri Test, too, for hair, blood, urine. There’s so many different things out there. A lot of them are good. A couple of them are bad, but you know, we’ll help you to make the distinction what is right for you and this is case-by-case. Some people they may not need to investigate metals. Other people they’ll come to us and they’ll say, “Evan or Justin, man, I got metal problems.” And they just have a gut feeling and in those cases, I say, “Okay, cool. Let’s get you checked out.“ It’s not gonna hurt. It can only help you to investigate. So if you have a gut feeling and that gut feeling can be disrupted obviously if you have got problems, right? Because the inflammation in the gut, you might be getting mixed signals, but if you have a gut feeling, ask us, and let us help you to investigative. If it’s something we didn’t bring up yet or maybe it’s early in the game and we wanted to do it later, just bring it up because you never know. You could be onto something that we just haven’t got to yet and that may save us, you know, a month or two of—of time.

Dr. Justin Marchegiani:  Absolutely. And again, we’ll the show notes for everything, the full transcription, again in my new Thyroid Book that will be coming out very soon, just putting the finishing touches on it, we’re gonna have a chapter in the book all on this type of discussion, putting it all together because I feel like this is probably one of the key pieces that most functional medicine practitioners and doctors really, it—it’s very esoteric. It’s kind of in the ether. Like how does it all look?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Like what does the whole plan look like? And it just kinda like, you feel like almost like they’re making it up as they go and I think is really important if you’re gonna hou—you know, you’re gonna hike Mt. Everest so to speak, I wanna see that map. I want to know how we’re gonna go up there. I wanna know how we’re navigate that crevice and—and get across that—that ledge or that cliff. I wanna kinda feel like it makes sense when we get directions. So I think that’s a really important piece that we’re adding, is that clarity and that, you know, what’s our fu—future pacing vision? How are we getting to the top?

Evan Brand:  Yup, amen.

Dr. Justin Marchegiani:  Anything you wanna add there, Evan?

Evan Brand:  I don’t think so. I think this was great and fun as always, real honor. If people want to schedule, go to justinhealth, J-U-S-T-I-N, Justinhealth.com to schedule with Justin. If you want to schedule with myself, go to notjustpaleo.com and like I said, we both block out a few hours, so you know, if there’s a spot available, you wanna grab it for the 15-minute free call. See if we’re a good fit, you know, discuss your options together. Justin and I are happy to do that and we look forward to helping you all out. You know, listening to this is one thing. Getting in the trenches with us is another, and I mean without functional medicine, I would likely still be dealing with depression and irritable bowel syndrome and skin issues and fatigue and insomnia and adrenal problems. I mean, every aspect, everything that could’ve gone wrong was wrong in my body systems and just one by one, plucking these things off the list, and there’s never a finish line, right? I mean it’s always a continual journey. So you’re just always pushing to the next step ahead and this is your time. You know, you don’t have to suffer.

Dr. Justin Marchegiani:  Love it. I appreciate the hope and the inspiration, Evan.

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:  Great chat. Great chat. Look forward to chatting with you very soon.

Evan Brand:  You, too. Take care.

Dr. Justin Marchegiani:  Have an awesome day!

Evan Brand:  You, too. Bye.

Dr. Justin Marchegiani:  Bye.

Coffee, Caffeine and The Adrenal Fatigue Connection

Coffee, caffeine, and the adrenal fatigue
By Dr. Justin Marchegiani

Today’s video is going to be on the truth about coffee. If you want more info on this, check out my recent podcasts on this topic over at beyondwellnessradio.com

We have some of the benefits of coffee up top. We’ll break them down and we’ll make sense of it all. Also, we will talk about some of the negative aspects of coffee or how coffee could be or caffeine can be taken in a way that’s negative. It could hurt your physiology.

Again, some people take caffeine in a way that can exacerbate their thyroid or their adrenals or affect their appetite. Also, we’ll talk about how caffeine can be applied and coffee can be applied in a way that optimizes mental and cognitive performance. So let’s kind of weigh out the pros and cons on each side here.

Coffee and Adenosine

Let’s discuss some of the good things here. We have this inhibitory neurochemical called adenosine. Adenosine is an inhibitory compound, so it helps kind of dampen and relax and decrease energy in your body and how you function and feel. This is kind of like GABA, if you will.

So it’s like, if you have like a calming tea like a chamomile or a flower-based tea, that’s kind of really dampening and causing your body to relax. Typically the exact opposite of why you want to take in coffee. You want to take in coffee so we can actually dampen this adenosine response. This is helpful if we’re looking to get some work done; focus; get some energy going; increase cognitive performance because we’re learning; or we’re taking in new information; or we have to be focused dealing with people all day.

It is very helpful to be able to decrease that adenosine, dampen that. That’s why coffee is better in the morning, in the first half of the day, not taken after the noon time. This is because caffeine has an 8-hour half-life. So we want to work on metabolizing that coffee before it’s time to relax. If you’re drinking coffee too late in the afternoon, it’s going to be hard to shut down.

 

Find out if coffee really is good for you or otherwise from a functional medicine expert by clicking HERE!

 

Benefits of Coffee

The benefits of coffee

Fat Breakdown

One of the benefits is this dampening effect which can help us with energy and focus. Caffeine that’s in coffee, about 150mg to 300mg of caffeine per cup on average increases lipolysis. What is lipolysis? Let’s break it down. Lipo- means fat. -lysis means to cut or to break. So it’s fat breakdown. It’s the fancy word for fat breakdown. Having coffee and/or caffeine before workout can actually be very helpful at breaking down and increasing free fatty acids in your body. This is so you can start burning more fat for fuel, really helpful.

Nutrients

Coffee actually has a lot of B vitamins, a lot of alkaloids, a lot of antioxidants that are very beneficial for your health. People forget that. If you’re doing instant coffee or Maxwell House or Folger’s, or maybe some of these cheap brands, there’s a good chance that that may not be the case.

Antioxidant

What’s an antioxidant? Well, stress oxidation causes your body to basically lose electrons. So if you have this electron right here, which is like a negatively-charged compound and basically oxidative stress comes in and it pulls away your electron. Antioxidants basically take that and prevent this from happening. So antioxidant is anti-loss of an electron. It keeps those electrons paired together versus being broken up. That is kind of how that works. Oxidation is a loss of an electron, so it’s the anti-loss of an electron.

Positive effects on Cognitive Diseases

There are lots of studies on coffee and its effect on decreasing Parkinson’s, also decreasing Alzheimer’s or dementia-like memory symptoms. There are also some studies on coffee not affecting cardiovascular disease, not attributing and not affecting cardiovascular conditions.

My clinical opinion, if you stimulate the body too much because coffee is a stimulant, that activates the sympathetic nervous system. And part of what happens with sympathetic activation is increased heart rate because that’s part of what happens when we’re stimulated. Heart rate goes up to increase blood and increased oxygenation. So that can put extra stress on the heart. If you do have a heart condition, too much caffeine may be an issue for you. We do know that there are some benefits cognitively, which is great, really good stuff.

 

Disadvantages of Coffee

Disadvantages-of-coffee

Adrenal Stimulation

We know coffee does have adrenal stimulation. What does that mean? It’s going to stimulate adrenaline. We have a couple of different words for adrenaline: catecholamines, norepinephrine, epinephrine. Medicine loves to confuse us, so we have lots of different words that mean the same thing.

So in here, we have cortisol and then we have adrenaline. Those are our big things that are happening. Now these can be okay if we’re healthy and we have healthy adrenal function; it may not be a bad thing per se. It’s getting a little cortisol or adrenal push that may help performance. This may help this increased lypolysis, so that may be beneficial.

Sleep issues

Your cortisol rhythm is like this—here’s your AM, here’s your morning. Here’s your PM, in the afternoon. So typically, you wake up and your cortisol goes down like this throughout the day. If you’re adrenally stressed, and you’re doing coffee too much later in the day, it will have a negative effect on your sleep. Let’s say your coffee happens lower in the day; and then what happens relatively-speaking at night, you start going back up and this can be where sleep issues start to happen.

So I typically recommend not consuming any coffee after eleven or twelve o’clock. I always do it with the good high quality fats in there to time release it. And just make sure if your adrenals are messed up or your rhythm is switched, make sure you go and get your adrenals looked at and supported with a functional medicine doctor. You need to get them back in cycle and then cutting coffee out maybe the right thing for you. It may be. So this is the whole cortisol rhythm thing.

Cognitive Performance Issues

This is a big thing. Dave Asprey has kind of made this famous where coffee is known to have a lot of mycotoxins in it; so you want to avoid crappy coffee that can affect cognitive performance. You want to use coffee that makes you feel good and perform better. So the good sources like I mentioned.  The mycotoxins, the pesticides, the chemicals—so you want to avoid all those and choose high-quality coffee. Mix it and blend it in with fat so you have that time release effect that I mentioned earlier.

Jitters, Anxiety, Tachycardia

The CYP1A2 gene is a specific genotype that has evolved into an enzyme. If we don’t have this gene here, we can have a decrease in the enzyme that metabolizes caffeine. So if we have this enzyme that has decreased activity, we have decreased enzyme activity. That means that we are not going to be able to metabolize caffeine because that’s a poor caffeine metabolizer. This may make it hard for us to metabolize caffeine. So what happens is that caffeine sits in our system longer. That half-life of 8 hours is going to be much longer, maybe 10, 12, 15 hours. A half-life is how much it takes to take the caffeine in your system and cut in half. So if it takes 8 hours to cut in half, every 8 hours we continue to cut that caffeine in half. We want to make sure we’re able to metabolize it fast. If we’re not able to, doing any caffeine at all may cause jitters, anxiety, and tachycardia. This feels like the heart is beating out of your chest.

CYP1A2 genotype

So you got to be careful. This CYP1A2 genotype, if we have that we’re going to have decreased enzyme activity for breaking down caffeine. Now should you go and get a genotype test, personally don’t waste your money. Everyone here who has this issue knows it. They’re sensitive to coffee. They have it –there’s caffeine from tea or coffee, they are sensitive. If that’s the case, definitely you want to avoid caffeine. If you have energy issues, though; and you’re using that to help increase the energy and it’s too stimulatory, then you got to go get your adrenals looked at. Have it checked and assessed, and get on a functional medicine program.

Click here for a consultation with a functional medicine doctor!

Recommendation

Recommendations for coffee drinking

Now when I do my coffee, I mix it with butter, grass-fed butter, and MCT oil. If you have autoimmune conditions, you may want to do ghee or not even use coffee. You can maybe do a chai tea instead, if you’re sensitive.

MCT gives you these various ketone precursors that are about 6-8 times higher than in your typical coconut oil where MCT is extracted. And then also using good quality butter, we have butyric acid, these short-chain fatty acids that are really helpful. The goal is it kind of time releases the caffeine.

Essentially, if here’s the caffeine coming down the pipe here, it basically time releases it. Now the caffeine comes in much slower. So instead of having this really big bolus of caffeine, when we have the fat in it, you’re going to see what happens is this. We have what I call the magic carpet caffeine ride experience. We now have the fat and caffeine together having this gentle up and down type of effect. This is much more gradual which is nice. You don’t have the up and the down, and you’re also getting a lot of good fatty acids which can help your appetite which is really good.

Coffee and Hydration

You just got to be really careful because when you do too much caffeine, it also put your body in that sympathetic state which can shut down your appetite. This is especially true if you’re doing a lot of ketones. It’s going to cause to pee out a lot of water, so you got to make sure you’re staying hydrated with good water that has sulfur and minerals in it. Whether it’s a Pellegrino, or a Topo Chico, or a good clean filtered water that you add minerals to, it can also affect your appetite.

Coffee and other nutrients

And remember, just because you have a whole bunch of calories of good healthy fats in that coffee, people call it Bulletproof coffee or butter coffee, your body still needs nutrients. That means you’re still not eating grass-fed meat, Omega 3’s, nutrient-rich antioxidant vegetables or low sugar fruit. You’re not eating those because your appetite’s now gone south. So we got to make sure we’re not affecting our appetite so much where we’re missing the other amino acids and nutrients. Our body still needs those for optimal health. So be careful of too much appetite suppression. Ketones can do that. You just got to be careful of it. And also if your adrenals are fatigued, you may not be able to handle that stimulation.

Decaffeinated Coffee

A couple of things you can do is have decaffeinated coffee which could be helpful. You got to be careful because caffeine is a natural pesticide in coffee. Typically, decaf coffee is sprayed in a much higher rate with various pesticide compounds because the coffee doesn’t have that caffeine; so it can be attacked by mold and other things. If you do get caffeine or decaf coffee, you got to make sure it’s a Swiss water process, not the benzene or methyl chloride process that’s involved in decaffeinated coffee in the past. You want to make sure it’s the water-based Swiss water process that just involves water and no methyl chloride or benzene since benzene is carcinogenic.

Quality Coffee

So we got to make sure, if we’re going to do it, have good clean coffee. Try to make sure it’s small sources, make sure it’s roasted. Central American’s pretty good, higher altitude coffee. Don’t go for the blends that can have a lot of different bad beans. Go for a single source if you can. A couple of my favorite coffees are Bulletproof, Premier, Research Labs makes a great coffee; and there is a handful of good coffees that you can find at different shops. Just try to go for single source. Try to go roasted and try to go for companies that have a good reputation, organic if you can. Some places are organic but they don’t pay for the label. You just got to know which ones are of that organic quality standard. So be careful of the appetite.

What’s the Verdict?

So in the end, is coffee good or bad? It really depends. Choose quality. Prepare it the right way with healthy fats. If you have an autoimmune condition, cut the coffee out and use some very benign sources like a chai tea or even do nothing in the morning for a period of time. If you’re going to use butter, use ghee if you’re autoimmune, then progress to the healthy grass-fed butter. Well, if you have adrenal or thyroid issues, and you feel that caffeine is exacerbating things or your problems or your health issues; or it is abrasive on the gut, pull it out for a period of time. Add it back in. Get your adrenals and your thyroid and your hormonal system working better.

So again, this is the truth about coffee. I hope I instilled some really good info. If you feel like you’re having some issues with coffee or with your energies or your adrenals or anxiety or mood stuff, and coffee could be connected, click on screen or reach out below and make sure you subscribe to get access to more great videos coming your way.

 

Torea Rodriguez – Toxins, infections and autoimmune disease – Podcast #112

Dr. Justin Marchegiani interviews autoimmune specialist, Torea Rodriguez, in this episode where they talk about autoimmune diseases and how these can be exacerbated by toxins and infections in the body. Find out how one thing leads to another and what types of lab tests are vital in helping to get to the root cause of issues. 

Torea Rodriguez Discover what supplements can aid in fighting autoimmune conditions. Learn how important it is to deal with stress or avoid it completely to be healthy along with making diet and lifestyle changes, as well as find out about healing pathways that worked for some people which may just work for you, too.

In this episode, topics include:

13:55   Infections

16:35   Stress

24:42   Biofilms

30:58   Supplements and Herbs

36:26   Toxins

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Dr. Justin Marchegiani:  Hey, there, it’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio. Today we have a functional medicine practitioner. Her name is Torea Rodriguez and she’s right out of Santa Cruz. Right, Torea?

Torea Rodriguez:  Yeah, Santa Cruz is it.

Dr. Justin Marchegiani:  Awesome! And you’re an autoimmune specialist, correct?

Torea Rodriguez:  I am. I do functional—err—functional medicine specializing in autoimmune. That’s how I got started. I got sick with autoimmune Hashimoto’s and it’s what I’m most comfortable with and it’s what I understand the most. So that’s what I focus on.

Dr. Justin Marchegiani:  What an epidemic autoimmune conditions are today, huh?

Torea Rodriguez:  Absolutely. I was reading in the Autoimmune Fix, Tom O’Bryan’s new book.

Dr. Justin Marchegiani:  Yeah, uh-hmm.

Torea Rodriguez:  And he was explaining that, you know, most autoimmune diseases, what we know now is that it’s more of an autoimmune spectrum–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  As opposed to a specific disease, and so while there’s—I don’t know—there’s over 135 classified autoimmune diseases, it’s probably even more now and that all of those are just what’s known to us right now. Like there could be so many other ones and so it’s really the spectrum effect that happens, and yeah, it’s really prevalent.

Dr. Justin Marchegiani:  Yeah, it’s really interesting because with autoimmune conditions. If you really look at what the conventional medical establishment has to offer, I mean, it’s not too much. I mean, they have your immunosuppressive medications, corticosteroids like prednisone. I mean, there’s not really even a diet shift or diet modality when it comes to autoimmune conditions, even though we know the research and the literature’s so, you know, rich with that type of information and also the idea of leaky gut really isn’t even talked about. What’s your take on the conventional medicine approach medicine offers—mainstream medicine for autoimmunity?

Torea Rodriguez:  I think that they are in a very unfortunate situation to be honest. They’re behind in terms of research. There’s not one doctor that I know, you tell me if I’m wrong–

Dr. Justin Marchegiani: Uh-hmm.

Torea Rodriguez:  But there’s not one doctor that I know that has the time in between their 15-minute consults to also go and read the PubMed and the medical literature to stay up on what’s going on, so I think they’re in a very unfortunate situation. And then the other part about the traditional medical establishment is that they’re focused on special areas. So we’ve got the cardiologist for the heart health and we’ve got the endocrinologist for, you know, the endocrine system and the different hormone systems and all of those different things–

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  And they’re looking at it from a very specific point of view from that organ if you will, when really autoimmunity needs to be that 30,000-ft view, big picture view because it’s the entire immune system. It’s the entire body that is having a problem. So yeah, I think that it’s just they’re in an unfortunate situation.

Dr. Justin Marchegiani:  100%. I mean, I see that every day. It’ s like unless you have a clinical framework in which you operate in, I mean, you could skim through articles but it may not mean much to you because where do you plug that clinical piece of information into how you treat patients because typically it’s 3- to 5-minute consult, right? With the pat–

Torea Rodriguez:  Yup.

Dr. Justin Marchegiani:  With the patient. You have a prescription pad. For the most part you’re looking for a diagnostic code that justifies, you know, you to make money off the patient because they are—they are business and then typically that involves a prescription, right?

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  Or some type of procedure for the most part and that’s it. I mean, that’s—it’s really about managing that condition and the whole idea about addressing it or fixing a root causal issue really isn’t even there. I mean, it’s—it’s amazing that people can go to physicians where their goal really is just how can we prevent the symptoms from getting worse down the road versus let’s fix this.

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  It—totally different mindset.

Torea Rodriguez: Yeah. Complete different mindset and that was my exact experience when I was diagnosed with Hashimoto’s back in 2009 and I started working with an endocrinologist because that’s where people go who have thyroid issues. They go to an endocrinologist and start working with them and you know, he prescribed me medication after medication and it’s not working and I can’t get my labs stable and it’s still not working, so we’d switch it or we’d double the dose or, you know, we kinda got to a point where I challenged him because at that the time I needed to pass an aviation medical and I challenged him and I’m like, “Look, I need to pass this exam in a month. We’ve got a month. What do you got for me? Like we gotta do this, otherwise I have to stop flying for a living.” And he just kind of put his hands up and he was kinda like, “Well, you know, the next thing I know to do is to radiate the thyroid and cut out the rest of the tissue.” And I was just like, “Whoa! Whoa! Whoa! Whoa! Brakes on full.” Like that’s not the path that I wanna go down.

Dr. Justin Marchegiani:  Right.

Torea Rodriguez: And that was the real foray for me to start looking into functional medicine and to start looking at alternative solutions because I knew that it—there was something else going on. It wasn’t just the thyroid. I mean, there’s countless people out there with thyroid issues and they feel fine. So what is going on? And I wanted different answers.

Dr. Justin Marchegiani:  That’s great. This is a great segway into kind of let the listeners know a little bit more about you. And most people, they kinda walk that, most practitioners are physicians—they walk the journey of the wounded healer. Right? They have some type of health–

Torea Rodriguez:  Oh, yeah.

Dr. Justin Marchegiani:  Ailment themselves, they bump their head against a wall a few times—that wall being conventional medicine, and then was able to find a path that actually worked that—that really was focused on root causal health information.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  So why don’t you share your story—I know you mentioned you were a pilot. I think you also have a biochemistry background, right?

Torea Rodriguez:  Yeah. Yeah, my undergrad degree is in Biochemistry–

Dr. Justin Marchegiani:  Oh, great.

Torea Rodriguez:  And you know—and I worked in the technology industry so I’ve kinda bounced around and cruised a little, but at the time I was a professional pilot, I wasn’t feeling good. I mean, I knew something was wrong and when it came time to really decide, “Am I gonna go under the knife to try and fix this? Or am I gonna try and find alternative solutions?” I really knew in my heart of hearts that I needed to find an alternative solution.

Dr. Justin Marchegiani:  By under the knife, you mean getting your thyroid removed, right?

Torea Rodriguez: Yeah. I mean–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  He wanted to give me a radiated thy–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Iodine.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  And then cut out the rest of the tissue and I did not wanna have surgery to be honest.

Dr. Justin Marchegiani:  So–

Torea Rodriguez: I just did not.

Dr. Justin Marchegiani:  Uh-hmm. So it sounds like you were diagnosed with Graves’? Is that what happened?

Torea Rodriguez:  No.

Dr. Justin Marchegiani:  Or was it something else?

Torea Rodriguez:  Hashimoto’s.

Dr. Justin Marchegiani:  So this was Hashi—yeah.

Torea Rodriguez:  This was Hashimoto’s.  Yeah.

Dr. Justin Marchegiani:  Okay.

Torea Rodriguez: And most, for our listeners who don’t know, usually you take out the thyroid when it’s Graves’ which is the opposite, the hyperthyroid situation, and he just didn’t—he didn’t know where else to turn. These were the tools that he had and that’s why–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  I had so much compassion for them. It’s that they—they have the tools that are in their toolbox and they’re not necessarily applicable to the types of diseases that we are seeing right now.

Dr. Justin Marchegiani:  It totally makes sense and that makes sense, too, because Hashimoto’s in the early stages can seem like Graves’ because the antibodies are different. They’re not the same kind of antibodies once thyroid stimulating immunoglobulin and TA—TSH receptor antibodies, the one for Hashi’s is TPO and thyroglobulin. So different effect–

Torea Rodriguez:  Correct.

Dr. Justin Marchegiani:  But in the early—in the early inflammation response, thyroid hormone spills out and can create that hyper kinda symptoms, so that makes sense.

Torea Rodriguez:  Yeah, yeah, absolutely. So I started searching for anybody that knew anything about thyroid and natural healing and I had stumbled across Chris Kresser’s writings–

Dr. Justin Marchegiani:  Mmm, yup.

Torea Rodriguez:  And this was back early in the day when he was just writing about stuff and he said something that really clicked with me–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Which was that we’re dealing with autoimmunity and we’re dealing with a disease of the immune system.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Not a disease of the thyroid, not a disease of–

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  The myelin sheath of your nerves. It’s a disease of the immune system and that we need to really focus on the immune system itself, and that just lit a lightbulb. It was an epiphany moment. It’s like, “Of course! That makes total sense.” So let’s go down that path. So I pretty much didn’t know where he was, didn’t care, was gonna get on any plane to go see him, begged myself into his clinic and he took me on as a client, and that’s when I really started to understand the multiple layers that had come into play to cause me to get sick and the work that I needed to do to start healing. Yup.

Dr. Justin Marchegiani:  Very cool. So with your working with Chris, I mean, he’s kind of a—a Paleo template guy. I’m a big fan of a Paleo template, right? Where we kinda can adjust the macronutrients and—and dial things in according to what works best for you, the patient. Just curious, if you could lay out just you and your experience as the patient, what worked best for you. What are those top 3 things that really were game changers in your case?

Torea Rodriguez:  I think the very first game changer was taking a different perspective on my diet. I had always felt that I was healthy and that I was eating very healthfully and to stay healthy on the road I was keeping to a vegetarian diet and with a lot of healthy whole grains, right?

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Right? And so taking a different perspective and really taking a look at what it was that I was eating and what more importantly what I was missing in the diet. There were a lot of nutrients in my diet that were missing from that and so switching to a whole food Paleo type template was exactly what my body needed at the time and I would say that that in itself gave me a huge boost and huge stair step of healing right away.

Dr. Justin Marchegiani:  So you were eating a lot of grains back then or were you eating any meat as well?

Torea Rodriguez:  I was not.

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  I was trying to stay healthy on the road.

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  So I was staying vegetarian because of course, we were eating out all the time.

Dr. Justin Marchegiani:  Got it.

Torea Rodriguez:  So yeah, so I was just like, “Oh, I’ll just stay vegetarian. That’ll keep me healthy.” And then you know, in hindsight, looking back the other time I experimented with being vegetarian was in college and I got very, very sick in college. And I know now–

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  That for me and my body type, I—I need to include animal proteins in there. That’s the only way I feel really great. So yeah, so I would say food was the other thing and then rest. Not really rest—how should I say this? I had to take a very serious look at my Type A hyper-overachiever lifestyle.

Dr. Justin Marchegiani:  Right, right.

Torea Rodriguez:  And that was really, really hard to do as a pilot. You are used to achieving every 6 months and passing check rides and switching to the next airplane and all of those things, and that was something that was really driving my nervous system into sympathetic fight or flight all the time.  And I had pretty much activated it all the time and I really had to take a serious look at that. So that was one of the other things that was really, really key in healing but expressly difficult to adjust to.

Dr. Justin Marchegiani:  So you sound like you had some adrenal dysfunction there, too?

Torea Rodriguez:  Oh, yeah. They were–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Pretty much—the way Chris put it—and I don’t know if he was trying to scare me or not, but he basically said that you are one step away from Addison’s disease. You need to do something different.

Dr. Justin Marchegiani:  And were those initial tests that you ran for adrenals, were those on—on the BioHealth 201 adrenal panel?

Torea Rodriguez:  Correct.

Dr. Justin Marchegiani:  Okay, cool.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Do you remember what your total–

Torea Rodriguez:  That was my first panel.

Dr. Justin Marchegiani:  Cortisol was?

Torea Rodriguez:  I think it was like 12.

Dr. Justin Marchegiani:  Wow, that’s so low!

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  How about your DHEA?

Torea Rodriguez:  I don’t even remember. I’d have to go take a look. But yeah, I mean, it was pretty much tapped out. I mean, I was—I was tapped out. This was—I was sleeping 14 hours a night and feeling like I was–

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  Hit by a Mack truck the next morning. Like I was not feeling rested ever.

Dr. Justin Marchegiani:  And so recapping, you were eating a vegetarian diet. So I typically hear that. I think low protein, I think ex—probably excessive carbohydrate, probably lots of anti-nutrients.

Torea Rodriguez:  Oh, it was all carbohydrate. Because in addition to flying–

Dr. Justin Marchegiani:  Yes.

Torea Rodriguez:  The other thing that I loved to do was long distance cycling.

Dr. Justin Marchegiani:  Running–oh yeah, there you go. So that your–

Torea Rodriguez: Yeah.

Dr. Justin Marchegiani:  You’re carb-loading, right?

Torea Rodriguez:  Pretty much sugar all day long, every day.

Dr. Justin Marchegiani:  How about fat consumption? Were you doing pretty low fat consumption? Were you doing a lot of nuts back then?

Torea Rodriguez:  Probably.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Yeah, nuts and you know, a little bit of olive oil here and there–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  But butter wasn’t in the profile at all. You know, so I was very fatphobic at that point.

Dr. Justin Marchegiani:  So we had blood sugar issues, we had nutrient density issues, you probably had a lot of anti-nutrient issues, adrenal dysfunction–

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  And then autoimmunity which probably was exacerbated by all of the—the grains that you were consuming, too.

Torea Rodriguez:  Oh, yeah.

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  Most definitely, and there was pretty extreme iron anemia–

Dr. Justin Marchegiani:  Oh, wow.

Torea Rodriguez: That we discovered and which explained a lot of the issues that I was having. I was getting hypoxic at very low altitudes at work and hypoxy is the term for when you are lacking oxygen at altitude and usually you’ll feel hypoxic anywhere between 8,000 and 12,000 feet. Everybody’s a little bit different.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  But I was feeling very hypoxic at 5,000.

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  And the cabins are pressurized at 8,000 so I was even more fatigued at the end of my shift because I was constantly “at altitude” all day long and getting really sick from it.

Dr. Justin Marchegiani:  And so you were an airline–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani: Pilot where you like flying major airlines or–

Torea Rodriguez:  No, I flew charter and–

Dr. Justin Marchegiani: Charter.

Torea Rodriguez:  Corporate aviation. Yup.

Dr. Justin Marchegiani:  Got it. Now I’ve heard that—I’m not sure if this is true—but I’ve heard that pilots aren’t able to fly while consuming aspartame, is that true?

Torea Rodriguez:  I would have to double check what the regulations are with the FAA–

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  But at the time when I was flying–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez: Aspartame was fine.

Dr. Justin Marchegiani:  It was fine. Okay, I wondered if that’s something new.

Torea Rodriguez:  Yeah, it wasn’t a regulated substance, but I’d have to check. That’s curious.

Dr. Justin Marchegiani:  Okay, alright, very cool.  And then let’s dive in. There’s one piece of your autoimmune puzzle that I think may have been an issue but you didn’t allude to it yet. You didn’t mention anything about infections. Were infections a piece of the puzzle for you getting your thyroid and your autoimmune situation under control?

Torea Rodriguez:  They were definitely a piece of the puzzle but they came later.

Dr. Justin Marchegiani:  Ahh.

Torea Rodriguez:  Like we really started with diet, lifestyle stuff first.

Dr. Justin Marchegiani:  Yeah. Yeah.

Torea Rodriguez:  Started focusing on healing the gut a little bit–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  And then also the adrenals, like I was just–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  So tapped out, right? Getting some–

Dr. Justin Marchegiani:  Totally.

Torea Rodriguez:  Support there, but later on we started to find the GI pathogens for sure and I tested positive for H. pylori and then later on tested positive for a—another one that I can’t even remember the name of it and you know, as we started to treat those and heal those, you know, we’ve kinda talked about lingering symptoms like what’s left, what else is going on?

Dr. Justin Marchegiani: Right.

Torea Rodriguez: You know, and—and sure enough we found Giardia but it took–

Dr. Justin Marchegiani:  Wow!

Torea Rodriguez:  A number of tests and a number of passes at that for it to finally reveal itself and that Giardia had gotten—I’ve had it for so long that it had left the intestinal tract and actually had gone into the gallbladder.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  And so I had all these crazy gallbladder attacks that I couldn’t explain and ultrasounds to make sure it’s not stones, like it was kind of a little bit of a crazy path but we finally found the Giardia and treated myself for Giardia and that was another huge stair step is to finally get rid of that pathogen.

Dr. Justin Marchegiani:  So 3 major parasitic infections—H. pylori, something in between was a Blasto? Blastocystis hominis or Crypto?

Torea Rodriguez:  No, it wasn’t Blasto. My husband’s had Blasto. It was Crypto.

Dr. Justin Marchegiani:  Crypto. Okay.

Torea Rodriguez:  Yup, yeah. Yeah.

Dr. Justin Marchegiani:  Wow. That’s—that is nasty. Yeah, that’s a Blasty-Cryp—I call that the Three Amigos by the way.

Torea Rodriguez:  Yeah, definitely felt like the Three Amigos were having a party, that’s for sure.

Dr. Justin Marchegiani:  Right? Now when you went to go attack the Giardia, did you have to do a gallbladder flush to get the gall—to get the Giardia flushed out?

Torea Rodriguez:  I didn’t. Actually–

Dr. Justin Marchegiani:  Okay.

Torea Rodriguez:  I was pretty lucky with the anti–

Dr. Justin Marchegiani: Uh-hmm.

Torea Rodriguez: Pathogens that we used.

Dr. Justin Marchegiani:  Okay.

Torea Rodriguez:  Actually it turned out to be fine. But yeah–

Dr. Justin Marchegiani:  Got it. So we have adrenal issues and that—you know, in your situation, it’s kinda unique in how it unfolds and what stressors happen in your life but how things break down is pretty consistent, right? There’s some level of–

Torea Rodriguez:  Oh, yeah.

Dr. Justin Marchegiani:  Dietary stress and that’s unique for person, right?

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Whether it’s vegetarian side, whether it’s the standard American diet and lots of conventional meat and grains. You have the adrenal stressors, right? You have imbalanced amount of macronutrients, so I call that blood sugar stressors. You have infections and then you had the autoimmune—the whole immune system all revved up–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Because of everything else, because all of the—the things I already mentioned.  I see that

Torea Rodriguez:  Yeah and–

Dr. Justin Marchegiani:  I see that with most patients.

Torea Rodriguez:  There’s—there’s another thing in there that kinda added to the whole perfect storm which is what I now call acute stress events.

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  There was a period of time between 2008 and 2009 when I was being diagnosed where I had lost a parent suddenly.

Dr. Justin Marchegiani:  Wow.

Torea Rodriguez:  I had gotten into a cycling accident and pretty severe physical injuries and I had an emergency at altitude and was the only pilot on board to deal with that emergency, so there was a huge amount adrenalin that got pumped out that day when I was dealing with that—that actual emergency, and those 3 things all happened within months of each other.

Dr. Justin Marchegiani: Wow.

Torea Rodriguez: And that pretty much a perfect storm on the stress side of things to completely cause additional leaky gut and cause additional food sensitivities and everything else that just kinda added to the whole picture.

Dr. Justin Marchegiani:  Yeah, you really—you really hit a point there that I wanna emphasize. You talked about the leaky gut and the food sensitivities and I think a lot of people at home, they—they hear stress but they don’t really think about how stress really impacts our digestion or impacts our gut lining.

Torea Rodriguez:  Oh, yeah.

Dr. Justin Marchegiani:  Because the biggest thing that really revs up this autoimmune cycle is stress and what it does to the gut lining and then what that does to undigested food particles and then what that does to the immune system as they slip through the tight junctions to get into the bloodstream.

Torea Rodriguez:  Yeah, absolutely. And you know people hear stress, stress, stress, yeah, yeah, yeah.

Dr. Justin Marchegiani: Yeah.

Torea Rodriguez: I get it, but what they don’t understand is that in the lab and I think this was Dr. Fasano’s work–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Is that in the lab one of the ways that they would introduce leaky gut is hitting these poor rats over the head and causing head trauma.

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  And that’s a physical injury that you know, resulted in leaky gut. So when we have a lot of stress whether it’s physical injury or not, that will cause leaky gut.

Dr. Justin Marchegiani:  And is that mechanism through the head trauma is after decreased activation of the—the vagal nerve?

Torea Rodriguez: That’s my guess.

Dr. Justin Marchegiani:  Yeah, that’s what I think, too.

Torea Rodriguez:  That is definitely my guess. Yeah, vagal nerve is so huge in recovery and, you know, stimulating the parasympathetic side of the immune system and nervous system.

Dr. Justin Marchegiani:  Yeah, I was reading an interesting study just last week on petting animals and it stimulating the vagal nerve.

Torea Rodriguez:  Really? I definitely need a dog again.

Dr. Justin Marchegiani: So I—you think—I know. I practice next to my dog, Butter, all day so I, you know, pet her. I’m like, “Yeah, I’m getting my vagus nerve going.” You know, I’m—I’m practicing what I preach here.

Torea Rodriguez:  Excellent.

Dr. Justin Marchegiani:  So nice little fun fact there.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Very cool.

Torea Rodriguez:  Yeah, I look for all sorts of different ways to simulate vagus nerve when trying to heal autoimmunity because so many of us get kinda stuck in the cycle of the sympathetic side of the nervous system and it’s very hard to start to retrain the body to start activating the parasympathetic side. So I’m always looking for tips like that.

Dr. Justin Marchegiani:  Yeah, that’s good. And now because you’ve had this history you’ve been able to effectively treat it, which is great, what are you seeing in your patients? Are you seeing similar type of events kind of cascading or what kind of infections are you seeing, too?

Torea Rodriguez:  Yeah, so lots of GI pathogens.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  I’ve seen the gamut of them. I’m also seeing patients who are attributing some of their getting sick like how I had that perfect storm of stress events to receiving tetanus vac—vaccination—

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  Vaccines, right?

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Vaccinations.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Or you know, some other kind of trauma.  Usually it’s a trauma that can start the whole ball of wax to unravel, and so I see that quite a bit, so I pretty much apply the same technique is to let’s get an understanding of what’s going on. Let’s look for some of those co-infections and start dealing with those, so that I pretty much equate it to the immune system as pretty much over—overloaded at this point. It can’t really deal with these things effectively. So we have to help it to get rid of those things so it can become stronger to be able to keep this things at bay. So it’s, yeah–

Dr. Justin Marchegiani:  Yeah, I totally see that as well, where like the immune system is compromised. It can’t quite get rid of the infection on its own and it needs just a little bit more help with whether a specific protocol that you create to help kind of knock that infection out, right?

Torea Rodriguez:  Yup, absolutely.

Dr. Justin Marchegiani:  And then you went—you said something about five minutes ago. I wanna kinda come back to it because I think, just through the lens of the patient right now, from a patient talking to you. The biggest thing I see patients that have chronic health issues is when they have multiple infections layered up and they—they get their stool test back or their infectious panel back and they find there is one or two infections. We treat those infections. They come back negative, but a new one comes back. And that’s a really frustrating thing that I let my patients know that there is probably a 20% chance that may happen. And we call it you know, I refer to it as crypt hyperplasia where the infection burrows deeper into the gut lining and it makes its way out as we kinda clean through all the crud if you will. What’s your take on it? How do you explain that or educate your patients about that?

Torea Rodriguez: There’s a couple different analogies that I use for that.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  One is that, you know, we are basically going after the bad guys that we see in the beginning of the forest–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  But not the ones that are deeper in.

Dr. Justin Marchegiani:  Deeper in, right?

Torea Rodriguez:  And so you have to kinda keep retesting for that and then of course, I’ll get a little technical with them and talk to them about biofilms and how biofilms –

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Can get you know, resistant to things like oil of oregano and you know, that kind of thing, so you kind of have–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  To play around with some of these agents that we use to get rid of the stuff to actually get after it, and then you know, the other part, too, is that if—if they’ve done a lot of antibiotics, traditional antibiotics, or they’ve done a lot of use of these herbal antibiotics, often times what doesn’t come into play is the re-population of the gut and so basically we leave this like five-star resort open with neon signs that says, “Bad guys, move in here.”

Dr. Justin Marchegiani: Yeah.

Torea Rodriguez:  And then they’re easy to pick up on something else. So sometimes they pick up something else–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Through their travels or whatever but sometimes it’s just really just uncovering it and exploring deeper in that forest.

Dr. Justin Marchegiani:  And this is helpful because I think a lot of people that expect you know, let’s say they have a couple of infections, they expect that once those infections are gone that they’re gonna feel 100% better. And in your situation what percent better were you after those two infections, the H. pylori and the Crypto?

Torea Rodriguez:  At that point, you know we had done a lot of the diet-lifestyle stuff–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  So I would say 60% but getting rid of those only got me about another 10%.

Dr. Justin Marchegiani:  And then so it was the last one?

Torea Rodriguez:  Then it wasn’t until–yeah, it wasn’t until we found the—the Giardia–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  And start treating the Giardia that things really started to fall into place and then looking at my final lingering symptoms, those are all Epstein-Barr related.

Dr. Justin Marchegiani: Uh-hmm.

Torea Rodriguez:  And so now that’s my focus personally and like I still work on the stuff.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  I’ve been working on this since 2009, you know, so it’s—some of my clients are like, “When does it ever stop?” And it could stop now but I refuse to accept mediocrity and you know, I wanna feel good all the time so I will always pursue it, but some people choose to stop when they feel 80-90% better.

Dr. Justin Marchegiani:  Right and I guess it depends, right? Because everyone, you know, when do you stop eating healthy? When do you stop exercising? When do you stop going—getting good sleep, right? It just—people, it’s very easy to get addicted to feeling great and then the potential of “Can I feel 5% better this year? What do you think? Is it possible?”

Torea Rodriguez:  Exactly.

Dr. Justin Marchegiani:  So it can gets exciting, right?

Torea Rodriguez:  It totally gets exciting and you know, the thing is that that things will change. You’ll start to feel better and then you’ll decide that you wanna go travel to Nicaragua and you get a really nasty bout–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Of food poisoning. Well, guess what?

Dr. Justin Marchegiani: Yup.

Torea Rodriguez:  You probably just picked up something that you should test for and see if it’s still hanging out in your gut after you get back. So, I mean, we pick up stuff like this all the time.

Dr. Justin Marchegiani:  And what are you doing right now for biofilms? You brought that up earlier with antibiotic resistance, people taking in the past. What are you doing for that with your patients?

Torea Rodriguez:  Biofilms, I mean, you can use several different agents–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  I like to use interface. There’s a couple other things–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  That I’ve used in the past. Not BiotaGen, that is a prebiotic powder.

Dr. Justin Marchegiani: -Biotic, yeah.

Torea Rodriguez:  It’s the Bio-Botanical Industries, do you know which one I’m talking about?

Dr. Justin Marchegiani:  Oh, there’s a couple out there–

Torea Rodriguez:  Oh, shoot.

Dr. Justin Marchegiani:  The big ones that I know for my biofilms are—are ginger–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Silver and cat’s claw or Samento. Those are my–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  My favorites to use for the biofilms. Ginger tea is like mandatory for all patients to sip on, you know, for the first few weeks because ginger—there’s a lot of studies on it on helping biofilm reduction.

Torea Rodriguez:  Oh, that’s fantastic! Yeah. Biocidin–

Dr. Justin Marchegiani:  Oh, Biocidin.

Torea Rodriguez:  It’s the other one that I’ve used.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Yup. And that seems to do a really good job with people who have been on the Interface for too long and then all of a sudden you’ve got something that’s resistant to that—but ginger is new for me. That’s really fascinating. I’d love to see those papers.

Dr. Justin Marchegiani:  Yeah. I mean, you just go ginger and biofilms. There is just dozens of them.

Torea Rodriguez:  Excellent.

Dr. Justin Marchegiani:  There—there was one cool paper where it showed like a Petri dish of like all this resistant bacteria or biofilms, and then like they introduced a small bit of ginger to it and it was like gone. So a big fan of juicing–

Torea Rodriguez:  Fantastic.

Dr. Justin Marchegiani:  I’m a big fan of juicing it though, like fresh juiced ginger, like just kinda throw it in your Vitamix or Magic Bullet if you don’t like the pulp–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Which I don’t like the pulp. I strain it through a French press, and–

Torea Rodriguez:  Okay.

Dr. Justin Marchegiani:  There you go. Add a teaspoon of honey especially if you don’t have any fungal issues, you could do it. A quarter of a lime and you’re good to go, and it really helps reduce those biofilms.

Torea Rodriguez:  Yeah, ginger is amazing stuff because not only do you have biofilm disruptor, but you’ve got some really great probiotics that are on the ginger root itself.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  So yeah, pretty amazing stuff. I like it.

Dr. Justin Marchegiani:  Also anti-inflammatory and anticoagulants. So keeps the crud that gets you know–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Stuck or sludgy moving along, right?

Torea Rodriguez:  Yup. Absolutely.

Dr. Justin Marchegiani:  Cool. So with the patient’s right now, would you say the most common autoimmune condition you’re seeing is Hashimoto’s or thyroid autoimmune disease?

Torea Rodriguez:  You know, honestly I don’t see a lot of Hashimoto’s clients–

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  I just see autoimmune diseases.

Dr. Justin Marchegiani:  In general.

Torea Rodriguez:  They’re all over the place. Yeah.

Dr. Justin Marchegiani:  What—what are the big five for you?

Torea Rodriguez:  Rheumatoid arthritis.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Hashimoto’s is definitely in there.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  But then I’ve gotten some really strange ones that, you know, that are skin-related.

Dr. Justin Marchegiani:  Yup, scleroderma or–

Torea Rodriguez:  Yeah, that sclerodermas and those kinds of things.

Dr. Justin Marchegiani:  Psoriasis.

Torea Rodriguez:  Yup, psoriasis for sure. Those are the big majors really.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  I don’t see a lot of people with MS and I don’t see a lot of people with Crohn’s. I thought I would. I had one client with Crohn’s, but that was it.

Dr. Justin Marchegiani:  Are you seeing a lot of multi-glandular autoimmune syndromes like more than one autoimmune condition with the same patient?

Torea Rodriguez:  Almost everybody–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  I’ve known that’s been diagnosed with our immune has been diagnosed with two if not more.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  I—I’ve two that I know about. I’ve had psoriasis in the past–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  That’s been healed and I know that’s autoimmune. It was never diagnosed by a medical professional but I also have Raynaud’s in the hands–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  That’s fun. Yup.

Dr. Justin Marchegiani:  I see that exact same pattern. Raynaud’s, Hashi’s, and some type of either eczema or psoriatic skin condition is like super common.

Torea Rodriguez:  Yeah, yeah, very common for them to go together.

Dr. Justin Marchegiani:  And for listeners, Raynaud’s is just a condition where you get these vasospasms in the—typically in the extremity tips that can cut off blood flow in circulation and create that cold kind of feeling.

Torea Rodriguez:  Yeah, it’s pretty freaky when you look at your hands and your entire fingers are white.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  From the base of the fingers to the tips. The first day that happened to me I kinda freaked out. I was on the bike and couldn’t figure out how to get the blood flowing in the fingers again. It was kind of scary.

Dr. Justin Marchegiani:  Yeah, I totally hear you. And then talk about the Epstein-Barr in the—I wanna say mono or chronic fatigue that tends to happen from that. How are you diagnosing? What are you looking on lab work to pick up EBV?

Torea Rodriguez:  So I’m a big proponent of the Immunoscience’s panel. They’ve got a viral panel and if you want we can link to it in the show notes.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  But they’ve got a really great comprehensive viral panel that you can run or you can ask your doctor to run the markers for you if you want, which will take a look at whether or not you’ve got past exposure or current exposure. Most people who are dealing with chronic EBV have had a past exposure, and my theory is that our immune system is just not as strong as keeping it at bay as somebody else. I mean EBV is so common that we think that nearly 95 to 98% of the population has been—been exposed. It’s just most of them can keep it at bay. So a lot of those types of symptoms are fatigue, feeling like you’re getting the flu but never really coming down with the flu, light sensitivity in the eyes, tinnitus in the ears, pain in the lymph nodes underneath the ears, those kinds of things, maybe a mild fever but hardly ever fever associated with it.

Dr. Justin Marchegiani:  Yeah, that is super common and the three major things I looked that—I just pulled up the Immunoscience panel and that’s exactly what I run, Viral Capsid Antigen, Nuclear Antigen and Early Antigen.

Torea Rodriguez:  Uh-hmm.

Dr. Justin Marchegiani:  IgM and IgGs. Any IgM, that’s a sign of more of an acute or—potential active or reactive infection. And any IgG for the Early Antigen–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Is a sign of a potential reactivation. Is that kind of what you go by, too?

Torea Rodriguez:  Exactly. Yeah and you know, when I was first starting to look at this at myself I did this with my naturopathic doctor and we ran the whole lab, and while I didn’t have any IgM for active–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Infection, I have had in her opinion the highest titer she has ever seen for IgGs so I—I got the Gold Star award for that. So it definitely tells me that that’s something that my body has been dealing with for a very long time.

Dr. Justin Marchegiani:  Absolutely and what are you doing right now from a supplement or herbal standpoint with Epstein-Barr?

Torea Rodriguez:  Yeah, so I am making sure that I stay as far away from sugar as I–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Possibly can because sugar will break down the L-lysine in the body and L-lysine–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Is the amino acid that we need to keep viruses at bay–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  At the most, which ironically now that I know that information is why after I eat a bunch of sugar I feel like crap for three days afterwards.

Dr. Justin Marchegiani: Totally.

Torea Rodriguez:  And I take L-lysine as a supplement. I’ve also been experimenting on myself doing an n=1 experiment with using supplemental BHT.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  And some people don’t like that approach. Some people love that approach. And that seems to be helping with the constant symptoms that I was having, and not as often anymore. Whether or not it is the BHT or the L-lysine, I don’t know because I’m testing two variables are once. But those are the two things that I’ve been doing and then just making sure that I don’t have a lot of stress, because stress will set me back faster than anything,

Dr. Justin Marchegiani:  Love how foundational things are right at the forefront. That’s I think so important. I think a lot of people miss that.

Torea Rodrigue:  I think—I think we want to throw them in the back corner to be honest –

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Right? It’s like we want the easy button sometimes, and sometimes the easy button is just making sure that you’re consistent with the foundations.

Dr. Justin Marchegiani:  I see so many people that come in or have seen me before other doctors and they come in, we have a whole bunch of infections, and the doctors they previously were with just threw a whole bunch of things at them–

Torea Rodriguez:  Uh-hmm.

Dr. Justin Marchegiani:  Didn’t really get lifestyle changes dialed in. Didn’t really get the diet. Didn’t really get blood sugar. Didn’t really get the adrenals or any thyroid or hormone stuff. And they just went after the infections right away and they just shut down.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  And I think echoing on what you said the lifestyle piece and the diet piece, and even the hormonal—hormone piece before that is so important as a foundation so you can go after these infections and not create a healing crisis.

Torea Rodriguez:  Oh, absolutely. Like I see this quite often. Of course, everybody wants to end the pain, like I get it. I totally get it.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  And you know, we want those results right away but I have seen clients do the same approach with other practitioners and you know, they get thrown a whole bunch of antimicrobials for example. Yeah, that practitioner didn’t look at the liver function and didn’t realize that there are liver wasn’t ready to process all those toxins that are created when we go after the microbes.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  And yeah, and they completely shut down so that’s why I do a bunch of labs upfront so that I can see like what’s the status of the liver, what’s the status of the neurotransmitters, like let’s look everywhere and then figure out a strategy, and it does take time for sure.

Dr. Justin Marchegiani:  And you mentioned earlier, the butylated hydroxytoluene, the BHT.

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  Can you talk more about that?

Torea Rodriguez:  So yeah, so butylated hydroxytoluene which is a mouthful–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  BHT—that is the same BHT that used to be in breakfast cereal when you and I were young.

Dr. Justin Marchegiani:  Yeah, is that–

Torea Rodriguez:  Like it’s the same stuff.

Dr. Justin Marchegiani:  Got it.

Torea Rodriguez:  Yeah, it’s the preservatives. So there are–

Dr. Justin Marchegiani:  It keeps it crunchy when it sits in the milk for a while, right?

Torea Rodriguez:  That’s right. Totally.

Dr. Justin Marchegiani: Yes, I noticed.

Torea Rodriguez:  Capt N Crunch, in fact.

Dr. Justin Marchegiani:  Yes.

Torea Rodriguez:  So it—there’s research out there that says that it’s a neurotoxin. There’s research out there that says it’s not a neurotoxin. And as you know when you read PubMed research you are always gonna find both sides of the picture.

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  But what they have found is that with lipid encapsulated viruses, so the herpes style-type viruses of which EBV is one. It’s actually herpes simplex virus IV. That it has a really good ability to disrupt that lipid bilayer of the viral body and help keep the actual attack of that virus down. And so you know, there—there’s a lot of research out there. There is a lot of anecdotal evidence out there that it works which is why I decided to do an n=1 experiment on myself and it seems to be definitely helping; whether or not I wanna do it long term, I’m not certain yet.

Dr. Justin Marchegiani:  I will.

Torea Rodriguez:  If I wanna do it long term. But that’s the only—the only negative of it.

Dr. Justin Marchegiani:  I will put a link to the show notes. So if anyone that wants to get more intel on that they will have that at their fingertips. That’s great.

Torea Rodriguez:  Yeah. I’ll also send you a link to include in the show notes. There is a PDF or an eBook out there called the—the BHT book I think is what it’s called, and it was written by a biochemist by the name of Stephen Faulks and he put together a bunch of the research on its effect on lipid encapsulated viruses.

Dr. Justin Marchegiani:  I know Steve. He wrote the book on smart drugs, right?

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Yeah, okay.

Torea Rodriguez:  He is also known for a—what is it? Aspartame, no, not aspartame. Araspid—araspertam?

Dr. Justin Marchegiani:  Oh yes. Yeah, the—the various racetams. Yup.

Torea Rodriguez:  Yes, those. Yup.

Dr. Justin Marchegiani:  Yup. Big—yeah, he’s a big fan of those. Very cool, awesome.

Torea Rodriguez:  Brilliant biochemist though and he really knows his stuff.

Dr. Justin Marchegiani:  Yeah, I met Steve over at the—I think it’s Smart Life forum down in Silicon Valley over at Palo Alto.

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  Yeah, he’s a big guy over there. He gives a lot of informative talks.

Torea Rodriguez:  Yup, yup, really nice guy.

Dr. Justin Marchegiani:  Very cool. Now you’ve kind of alluded to something earlier. I’m gonna go back to it.

Torea Rodriguez:  Great.

Dr. Justin Marchegiani:  My—my brain thinks. It kinda scatters a little bit, but I—it’ll all make sense at the end here. You talked about toxins and being able to check liver functions. So are we talking about just like in an ALT, AST liver enzymes on a blood test, or were you talking about organic acid testing for the liver?

Torea Rodriguez:  I use both.

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  I wanted to take a look at both. So when I take on a client we do a full blood chemistry workup.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  And an organic acids, and a look at both. I wanna make sure that both phase 1 and phase 2 processes are functioning properly. If they’re not, then I probably won’t go after microbials or pathogens or environmental toxins right away because we want to make sure that the body has a—an appropriate way of clearing this stuff. We don’t want to just add a whole bunch of extra burden to the liver if we can help it.

Dr. Justin Marchegiani:  And what you’re cut off for the ALT and AST on your lab test?

Torea Rodriguez:  Umm.

Dr. Justin Marchegiani:  Less than 20?

Torea Rodriguez:  Pretty much, yeah.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Yeah, I wanna make sure that, you know, it’s—it’s not too high. We want to make sure that it’s working efficiently. So–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:   That’s exactly what I do. Now let’s pivot here. You mentioned in our pre-interview, you talked all about the organic acids. You talked about, and I love the organic acid test, I know there’s—I do the Genova testing in my office. I know you mentioned you do the—the GPL, the Great Plains Lab testing–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  And he also mentioned about their tox screen, which I’ve—doing more and more frequently. I’m actually gonna be doing a panel of myself as well as the one for the Roundup, the—the glyphosate, too.

Torea Rodriguez:  Oh, yeah, yeah, definitely.

Dr. Justin Marchegiani:  So—so let’s pivot there. Talk to me more about the organics and how you’re using it with your patients and then kinda stack on how you’re interchangeably using the toxic screen, too.

Torea Rodriguez:  Yeah, sure. So organic acids, I was taught by another practitioner how to interpret organic acids, and I’ve—I’ve used the Genova as well as the Great Plains and–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  The thing that I love about the organic acids is we’re looking at metabolites of various different biochemical processes.

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  And when there’s a problem with one chemical changing form to another chemical in that cycle–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  It will kinda spill over, just like if we had dammed up a reservoir; it kind of spills over and it gets into the urine and this is how we can see where there are problems in those functions in the body. And I think I love it so much because it’s one, simple collection for the client–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  And there are so many markers that look at so many different areas, so we can see bacterial overgrowth in the body pretty easily. It’s super, super sensitive for yeast. Whereas in any kind of stool test, like if you find yeast then you know you’ve got a raging yeast infection.

Dr. Justin Marchegiani:  Absolutely.

Torea Rodriguez:  Yeah. So I like that it’s super sensitive for yeast. You can look at neurotransmitter balance. You can look at–

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  You can look at methylation, nutritional deficiencies, like there is so much information in the organic acids that–

Dr. Justin Marchegiani:  Mitochondria.

Torea Rodriguez:  It’s just really—yeah. Mitochondrial function which is huge–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  For people without immunity like of course, you’re feeling fatigued because your mitochondria–

Dr. Justin Marchegiani:  Huge.

Torea Rodriguez:  Are not generating energy the way that they should and they are the energy powerhouses of the cell. So you know, knowing that allows me to be able to fine tune somebody’s wellness plan so that they can start feeling better sooner in looking at those kinds of things. So I love the organic acids for that reason.

Dr. Justin Marchegiani:  What major areas of the organic acid test are you seeing out of balance in your patients right now?

Torea Rodriguez:  Oh, gosh.

Dr. Justin Marchegiani:  Just myself, I see them all–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  But there are certain ones I see more frequently. I’m just curious just kind of like your intuitive guess.

Torea Rodriguez:  In the—yeah, in the last year there’s been a lot–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Oxalate and yeast issues.

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

Torea Rodriguez:  I’ve seen not so much neurotransmitter imbalance but definitely mitochondrial malfunction.

Dr. Justin Marchegiani:  Got it.

Torea Rodriguez: And then the rest is the bacterial overgrowth.

Dr. Justin Marchegiani:  Yeah is really nice because it gives you that extra net to pick up gut issues outside of what you may miss on a stool test.

Torea Rodriguez:  Exactly, which is, you know, we were talking about that forest, right?

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  And trying to find the bad guys in the forest, this gives us another way to do that with a different method which makes it a much better sweep of that forest.

Dr. Justin Marchegiani:  Totally. And what about the tox screen? What kind of toxins are you seeing? How much Roundup, how much benzene, toluene? Whatever else you’re seeing there–

Torea Rodriguez:  Yeah, I really like it. I mean, there’s 172 markers on the—the labs. So it’s–

Dr. Justin Marchegiani:  Unreal.

Torea Rodriguez:  It’s pretty comprehensive but, you know, that is allowing us to not only look at what somebody is biologically infected with like a co-infection but the environmental toxins from everywhere. So if you are getting exposed to lots of gasoline or gasoline exhaust fumes for example, maybe your work is—maybe you’re the person that holds the construction sign on the highway, you know, and you’re breathing in fumes all day long, or you’re a dental hygienist in Europe being put in the face of chemicals all day long, like we get to see those things but more importantly we are seeing pesticides that are used either in the yard or in the garden. We’re seeing the chemicals that are used for cleaning in the house or you know, the insecticides, right? In the house and cosmetics. I have to say it–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Cosmetics and you know, self-care products, the shampoos, and the soaps, and all of that stuff that we put our skin shows up in this test. So I really love it because it—this is what hammers down the lifestyle piece of it, right? Making those changes to make sure that you’re not getting exposed to plastics for example.

Dr. Justin Marchegiani:  Yeah, and what are the top three toxins you’re seeing come back on that screening?

Torea Rodriguez:  Honestly, they’re all over the map. I’ve just started running it–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  And it seems to be a little bit different for everybody.

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  So I haven’t seen something that’s very common. Now the glyphosate that you had mentioned–

Dr. Justin Marchegiani:  Yes. The Roundup. Uh-hmm.

Torea Rodriguez:  Yeah, so that’s pretty much coming back on almost everybody.

Dr. Justin Marchegiani:  I know. It’s scary. It really is scary.

Torea Rodriguez:  Yup. And that one, you know, not only is it Roundup but that’s—you know, people hear about GMO versus organic food—GMO, 9 times out of 10 is a plant that has been modified to be able to be a Roundup-ready or Roundup resistant.

Dr. Justin Marchegiani:  Exactly.

Torea Rodriguez:  Right. So they’re spraying it, like this is the whole deal with GMOs, is like there is spraying it with pesticides, folks, and you’re eating it.

Dr. Justin Marchegiani:  Tons.

Torea Rodriguez:  Like that’s what’s happening. Yeah.

Dr. Justin Marchegiani:  Like billions of pounds a year. I just got my—my whole lawn in my yard here in Austin replaced. We put down sod, and before they were saying, “Oh, typically the protocol is you know, we’re going to throw down a whole bunch of Roundup.” I said, “Nope. You’re just gonna—you’re gonna, you know, go and scalp it. You know use the bulldozer, whatever, do what you gonna do. No Roundup.” They say, “Oh, everyone does it. It’s innocuous. You know, turns into a sod, goes away.” But I’m seeing exactly what you’re seeing, lots of glyphosate or Roundup is found in people’s urine. So it’s obviously getting extracted or it’s coming out but the question is, I mean, “I’m not eating or—you know, pesticides and things like that. How are we getting exposed to it?” So it’s—it’s gotta be ubiquitous in the environment.

Torea Rodriguez:  It is pretty ubiquitous and I’ve talked to the folks at Great Plains and they’re seeing it in almost 100% of samples.

Dr. Justin Marchegiani:  Scary.

Torea Rodriguez:  I mean, it’s—it is really scary.

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  And thank you for putting in sod and not turf.

Dr. Justin Marchegiani:  Yes. You got it.

Torea Rodriguez:  Thank you.

Dr. Justin Marchegiani:  You got it.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani: Try to be–

Torea Rodriguez:  Because I can only imagine the amount of plastic chemicals that I’m gonna find in somebody’s tox screen, then they tell me that they have a turf lawn.

Dr. Justin Marchegiani:  I know and I called up the people over down here at—at Chem-free Lawns in Austin and I was talking to them about chemical-free fertilizers. They use a lot of probiotics or they’ll use–

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Natural herbs. They’ll even use various Helminths or worms to kill various infections.

Torea Rodriguez:  Oh, cool.

Dr. Justin Marchegiani:  And—and we were chatting about that for a bit and they were talking to me about the demand to switch away from these more carcinogenic conventional pesticides to these more natural ones, how it’s just the demand is out of this world, and I think people are catching on, you know, if you follow The Truth About Cancer series that was out again this last month, a lot of these chemicals are associated with various lymphomas and leukemias and cancers that are carcinogenic and hormone disruptors. So I think it’s great that people are—by and large are starting to get exposed to this information.

Torea Rodriguez:  Yeah, yeah, absolutely. And it—you know, it’s one of those things that can—can contribute to autoimmunity.

Dr. Justin Marchegiani:  Huge.

Torea Rodriguez:  Because, yeah, it’s huge. So super important.

Dr. Justin Marchegiani:  Well, was there anything you wanna just kind of leave us with here? I’m gonna go onto my last question that I ask every guest, but is there anything else you wanted to share with the listeners that you find just really impactful or you’re just really passionate about right now that you wanna share?

Torea Rodriguez:  Yeah, you know, I think one of the things that I found in my practice that has been extremely powerful is not only is it diet, lifestyle factors, looking at the functional medicine piece of it, but it’s also really taking a look at your life and what’s important, and sorting through what matters the most, and once you identify what matters the most, like get rid of everything else that doesn’t because it’s just added stress, and we don’t need it, right? So really kinda coming—becoming clear with that, and I think a lot of times people feel like they are expected to have this career, do the—be the perfect wife, you know, all of those things and it’s—it’s really fascinating to determine that sometimes I end up counselling people through career changes–

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  And relationship changes like those are really key parts of health so don’t ignore the emotional side either. That’s my point.

Dr. Justin Marchegiani:  I think that’s really important. Where can our listeners find out more about you?

Torea Rodriguez:  So they can go to my website which is ToreaRodriguez.com. We’ll include that in the show notes because that’s a handful to spell out.

Dr. Justin Marchegiani:  That’s only one R. T-O-R-E-A Rodriguez.com. We’ll put the link–

Torea Rodriguez:  Correct.

Dr. Justin Marchegiani:  For it below. Anywhere else? Do you have a YouTube channel? Do you have a podcast? Do you have anything else going on?

Torea Rodriguez:  If they subscribe to my newsletter and blog, I do a video blog every week, so they’ll be able to get that in the newsletter, and then the other thing that I’m working on right now is the five-week course that’s gonna launch in January. That’s an environmental toxin course, so it’s five weeks to help clean out the home and the body without getting overwhelmed, and that’s gonna include that environmental tox screen that we talked about.

Dr. Justin Marchegiani:  Love it. I’m doing that more and more–

Torea Rodriguez:  Yup.

Dr. Justin Marchegiani: I got one on my test, sitting on my desk here that I gotta get done soon on myself, so I’m excited.

Torea Rodriguez:  Excellent.

Dr. Justin Marchegiani:  So last question. If you are stuck on a desert island and you only could bring one supplement with you, what would it be?

Torea Rodriguez:  Supplement.

Dr. Justin Marchegiani:  It could be like an herb. It could be like coconut oil. It could be like anything. Just supplement or compound or tincture or whatever you want.

Torea Rodriguez:  Well, the first thing that came to mind is what I’m gonna go with. I’m gonna say an avocado tree.

Dr. Justin Marchegiani:  An avocado tree, there you go.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani: Okay, so essential fatty acids essentially.

Torea Rodriguez:  Essential fatty acids, lots of fiber, it’s–

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  You know, it’s awesome. So I love avocado. That would definitely be it.

Dr. Justin Marchegiani:  Got it. Getting our monosaccharide fats going. Very cool.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  And also fun fact about an avocado. Avocados have more potassium than bananas. Everyone thinks, “Oh, you know, potassium. Leg cramps, right? Grab a banana.”  Well, actually avocados have more and less sugar.

Torea Rodriguez:  Avocados, awesome.

Dr. Justin Marchegiani:  Very cool. Awesome, Torea. Great chatting with you and well, look forward to have you back on the show soon.

Torea Rodriguez:  Yeah, thank you so much. Super fun.

Dr. Justin Marchegiani:  Thanks.  Take care.

References:
http://www.immunoscienceslab.com/Viral/Viral%20Comp%20Panel.pdf
http://www.torearodriguez.com/
https://en.wikipedia.org/wiki/Butylated_hydroxytoluene#Applications
http://www.growyouthful.com/remedy/BHT-butylated-hydroxytoluene.php
http://www.torearodriguez.com/
Detox course: torea.co/WholeLifeDetox
December’s Webinar on the course (06 Dec): torea.co/WLD-DEC6
BHT Book: http://www.projectwellbeing.com/wp-content/uploads/2011/02/BHTbook-StevenWmFowkes-100903.pdf

Testing and tracking your thyroid health – Podcast #111

Dr. Justin Marchegiani welcomes Dave Korsunsky of Heads Up Health back to the show to talk about assessing the thyroid. Listen to this podcast to learn more about the complete thyroid panel and how you can organize your lab test data. 

thyroid testingFind out exactly what you can do about all the information that you get from your thyroid tests in terms of keeping track and charting your own data to look at patterns. Learn how these can be very useful when compared to other variables such as sleep, blood sugar or even the steps you’ve done in a day. Discover why you should get a full thyroid panel and how or where you can get it.

In this episode, topics include:

02:29   The role of the thyroid and hormones

05:26   Components of a full thyroid panel

09:48   Supplementing the thyroid

21:22   Thyroid antibodies

26:10   How or where to get full thyroid panel

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Dr. Justin Marchegiani:  Hey, there, it’s Dr. J. I’ve got my good friend here, Dave Korsunsky. We’re gonna be chatting about how to measure—how to assess your thyroid. Dave’s got some great technology called Heads Up Health, headsuphealth.com. We use this software a lot for—to help patients kind of chart their lab data so they can follow it, create graphs, compare it to other variables like sleep or blood sugar or how many steps you’ve done in a day. So we’re gonna really dig into how to look at and how to assess your thyroid and what numbers and lab values we look at. Dave, how are we doing, man?

Dave Korsunsky: Doin’ great, doc. Thanks for having me. I can see on Skype here that you’re sitting in your home office and I remembered that just a few months ago I was over at your place and we did a—we did a show on testing ketones which went great and happy to be back and actually talking about something that I see coming up all the time. Heads Up Health is pretty active online in a lot of the different Facebook groups and different communities on Ketogenic Diets and Paleo Diets and this—this question of the full thyroid panel comes up all the time. So I’m glad we can dive into it. It’s also something that was personally relevant for me and you may recall when I was your patient, that was one of the things you helped me fix. So I can throw in some of my own personal experience here as well.

Dr. Justin Marchegiani:  Absolutely, that’s great. I was going to do a nice live on-screen recording here of a—with my ketones but my battery is dead. Damn it. I hate wasting these strips. They’re so expensive.

Dave Korsunsky:  Where do you get yours from? It’s 4 bucks a strip here in the US. I know there’s cheaper sources out there.

Dr. Justin Marchegiani:  Well, I got it from the person that you told me to get it from over in New Zealand.

Dave Korsunsky:  That’s right.

Dr. Justin Marchegiani:  On eBay.

Dave Korsunsky:  Actually, it was Australia.

Dr. Justin Marchegiani: Australia.

Dave Korsunsky:  Yeah, it was Australia.

Dr. Justin Marchegiani:  Australia. Yeah, that’s it–.

Dave Korsunsky:  But they’re clamping down on that now. They—I think it’s illegal for them to ship to the United States now. So they’re getting harder to find on eBay.

Dr. Justin Marchegiani:  Yeah, I hear you. There’s still there a little bit though, but today for lunch I had—I had a collagen bar. I had tuna with a little bit of like Mark’s Primal Mayo so like egg yo—like you know, egg, olive oil or egg avocado oil.

Dave Korsunsky:  Yup, I’ve seen that product. Yup, it’s great stuff.

Dr. Justin Marchegiani:  And then like some shreds of carrot in there and like a little bit of cut up spinach, so it’s pretty high fat, very little carbohydrate. So my ketones will probably be around 0.6 mmol right now.

Dave Korsunsky:  Yeah.

Dr. Justin Marchegiani:  Now–

Dave Korsunsky:  Well, as I mentioned to you I don’t have my meter with me, otherwise we could nerd out and do some ketone testing like we did last time.

Dr. Justin Marchegiani:  Absolutely.

Dave Korsunsky:  Another time.

Dr. Justin Marchegiani:  Another time. Absolutely. Well, today we were gonna talk about thyroid and just really put the focus on thyroid and thyroid’s important, right? Thyroid’s that gland that sits kinda right where that bow tie in the neck would, just below and outside of the Adam’s apple and it produces a metabolic hormone called thyroid hormone and that hormone gets produced and it gets converted and activated in the body and there’s a lot of things that are responsible for making thyroid hormone and activating thyroid hormone. Like we’ve talked a lot in the past about ketosis and insulin resistance and having too much or too little insulin can really have an effect on how thyroid hormone gets activated which is really interesting. So with the software that you created over at HeadsUpHealth.com, anyone listening can go head over there and get a free account, but you can plug in your thyroid lab values and–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Let’s kinda just start—well, let’s just start with an anecdote kind of your personal story of us working together with your thyroid and then we’ll dig in to the meat of the matter here.

Dave Korsunsky:  Yeah, so this was back in I think in 2011-2012 when you were still working out of the Cupertino office.

Dr. Justin Marchegiani:  Uh-hmm, yeah.

Dave Korsunsky:  And you may recall you and I met at Asprey’s 1st ever conference.

Dr. Justin Marchegiani:  Yup.

Dave Korsunsky:  In San Francisco and you were hustling there. You had your—your adjustment table out–

Dr. Justin Marchegiani:   Yeah.

Dave Korsunsky:  And you were just—I’m like this guy is awesome.

Dr. Justin Marchegiani:  Mmm.

Dave Korsunsky:  So the first time I started working with you, I—I just brought in all my labs from my conventional doctor and—and I had them in a—a horrendous spreadsheet at the time.

Dr. Justin Marchegiani:  Right, right.

Dave Korsunsky:  I’m sure there’s a lot of people listening who have those horrendous spreadsheets, but as we started going through my numbers and you started looking at stuff, you noticed that the only test I’d ever had one was TSH, and I maybe had 2 or 3 of those done over the course of a lifetime. Maybe this was standard physical, etc., and so that was one of the first things you ordered for me, was—was a full thyroid panel and I guess maybe I think it’s important to talk about the components about the full thyroid panel, also important to address why maybe a lot of conventional doctors only ordered TSH but in any event that was my situation. So as soon we ran the full panel, there were a few things that—that you noticed and that you immediately picked up on. The first is you noticed that TSH actually looked good. It was great actually in range, perfect. But when we looked under the covers a little bit, we noticed, first of all T4, also excellent and—and you were educating me on all these numbers.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  I had no idea what any of this stuff meant as a patient and—and you sat down with me and took me through this whole panel.

Dr. Justin Marchegiani:  Right.

Dave Korsunsky:  And you said, “Hey, T4 is the start of the whole cascade.”

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  That never looks good but then you noticed my T4—my T3 was incredibly low, out of range low.

Dr. Justin Marchegiani:  Right.

Dave Korsunsky:  And my reverse T3 was out of range high.

Dr. Justin Marchegiani:  Yes.

Dave Korsunsky:  And everything else was fine. So that was my situation and then we started working on it and—and we can talk about the treatment protocol later but maybe you can just get into a little bit more about—first of all what are components of the full thyroid panel?

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  Why it’s more important to get that, besides just TSH, and even how people can get that if—if their doctor won’t do it for them.

Dr. Justin Marchegiani:  Right, exactly. So you can use Heads Up Health and just kinda plug your data in there to help keep track of it. Anyone that’s really doing their thyroid testing, they can use that as a technology to help track it and then compare it to sleep or maybe their carbohydrate levels, right? You could plug it up to MyFitnessPal, one of these apps, and then see how your carbohydrates and/or your insulin chart with your thyroid hormone.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  But starting off here, we kinda have the domino rally of our thyroid hormone cascade, meaning the first block that falls over is TSH. Now TSH is a brain hormone so a lot of people really get wrapped up in TSH being too high or too low, but it’s a brain hormone. It’s—it’s not quite like measuring your thyroid hormone. It’s very indirect. So TSH is looking at how the brain is yelling or talking to the thyroid. The whole analogy is if the thyroid’s not producing enough thyroid hormone, it’s like someone across the room that can’t hear you, you instinctively raise the volume of your voice, which is because the thyroid is on the lower side, right? Lower thyroid function, if someone can’t hear you, you raise the volume, the thyroid raises the volume of TSH and just like if you were in a library and—and it’s really quiet and they’re really close to you whisper and you lower the volume because it can—it’s where the thyroid or the person is very receptive to your voice. So think of your thyroid, kinda in those analogies. So TSH too high or too low can mean issues. The problem is if you’re waiting for the thyroid to be assessed and you’re looking at the TSH, it can take a very long time. Some even say 8-10 years to assess the thyroid properly by looking at the TSH because it’s a late stage indicator. It’s not the thyroid, it’s the brain. So if you’re looking and waiting for the thyroid to get assessed, it may take a while, and not to mention it’s—it—either the cut-offs for the reference range are pretty high. I mean, typically in the East Coast it’s gonna be about 5-1/2 on the TSH. In the West Coast, it’s gonna be a 4-1/2 on the TSH, where once it gets to that height, we call that hypothyroidism because the brain’s having to yell so loud that the thyroid is—we’re assuming is not responding well. I’ll just kinda take a breath there.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Any comments on that, Dave?

Dave Korsunsky:  No, I think it makes sense. I mean especially if—if you’re waiting on changes that have to happen in the brain. So help me understand that. That—that’s presumably stuff that takes a lot longer to settle in, and—and it may mean eliminating stress in your life.

Dr. Justin Marchegiani:  Yeah, sleep.

Dave Korsunsky:  It may mean dietary change. It may mean–

Dr. Justin Marchegiani:  Uh-hmm.

Dave Korsunsky:  Also the things–

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  That—that first have to show up at a—at a brain level, like at a neurotransmitter level or at some level in the brain. So that has to happen first before you see change in thyroid. Is that right?

Dr. Justin Marchegiani: Yeah, so when we look at TSH, it can be a really good indicator if something’s really high of diagnosing or picking up hypothyroidism.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani:  Now, the conventional range 4-1/2 on the West Coast, 5-1/2 East Coast, I like it to be around 1,

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Definitely 2-1/2, 1 to 2-1/2 is a pretty good, what I call functional range for the thyroid. That’s a good starting. Again the—where it gets fuzzy is when you start supporting someone’s thyroid because they need thyroid with thyroid glandular or hormone, most docs are basing the treatment off of the TSH.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Not a good way to do it because the brain is very sensitive. It’s more sensitive to thyroid hormone than the actual peripheral receptor sites. So my analogy for the patients is, go outside on a hot day and figure out the temperature by touching the sidewalk. Well, the sidewalk conducts heat much higher than the air, so it’s gonna be a lot hotter.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  I.e., the TSH may respond more sensitively because of the receptor sites, just like the sidewalk would be hotter or be more sensitive to heat than the air. So that’s step 1. Step 2 is then looking at the T4 hormone which is what’s made by the thyroid. So TSH comes down, talks to the thyroid, the thyroid goes through this process called deiode— deiodination where it’s adding and building thyroid and tyrosine and thyroglobulin molecule to build this thyroid hormone, alright? Vitamin A, copper, zinc, magnesium, selenium are also involved in those processes. Vitamin A as well. And–

Dave Korsunsky:  So that’s why you got me on a selenium. Part—part of your treatment then was—was adding some of these supplements in at some point.

Dr. Justin Marchegiani:  Uh-hmm.

Dave Korsunsky:  is that right?

Dr. Justin Marchegiani:  Yeah, exactly. Iodine can be really important, too. You just gotta be very careful with iodine because a lot of people that have thyroid issues, it’s autoimmune in nature. It’s the immune system attacking the thyroid gland. So you gotta be careful because more iodine can be like throwing gasoline on the fire.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  So you gotta be careful in the beginning. I always favor giving selenium in the beginning over giving—over giving iodine as well just because of that inflammatory mechanism. So–

Dave Korsunsky:  Yeah, that’s where you started me off. You started me with selenium and then we added the iodine then later.

Dr. Justin Marchegiani:  Yeah, exactly. So we have our T4, right? We make that through this whole iodination process. Then we convert it or we activate T4 to T3. So when we look at T4, we like our T4 Total being around 6-10, that’s a pretty good range for T4 Total, and T4 Free about 1-1.5 is a pretty good range. Again, go over Heads Up Health to get all these ranges more in depth.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  We then cleave off, right? This is part of the deiode—the—this is the 5-prime deiodinase enzyme, that’s selenium-based, that now cleaves off the iodine process. So it’s iodination is what makes the thyroid hormone then de iodinate, we pull an iodine, we—we grab an iodine off. So instead of being T4, now it’s T3. There’s 3 iodines now and we activate T3 which is the active thyroid hormone. So that’s what’s really having the whole metabolic reaction in the body, increasing our temperature, increasing metabolism, energy, heat, temperature and the selenium enzyme’s really important into that. And when you go on Heads Up, you’ll see T3 Free, we like above 3, you know, above 3-3.8, 3.4, you know, 3.8, 3.4 is fine, pretty good, right in that top 25%, top third of the reference range is great. 3.0 to about 4 is fine and that’s for T3 Free. And T3 Total, we like above 100, 100-130 is fine, and again we fine tune that with objective temperature testing, making sure the temperature is looking well. So typically 97.8 to 98.2 if we’re looking at the armpit or 98.2 to 98.6 if we’re looking at the mouth is a pretty good way to assess that.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani:  And we’ll do that in the morning before we get up and we’ll do it in the afternoon before lunch, because if we increase metabolism, we’re thinking that that’s gonna spill over into objective symptoms like energy but we’ll also see it as heat in the temperature.

Dave Korsunsky:  Yup. So I remember when we’re working on Heads Up, you said, “Dave, you need to have a place to track basal temperature as well.”

Dr. Justin Marchegiani:  Yes. Yes.

Dave Korsunsky:  And that’s part of what you’re doing. Do you use that to diagnose or to zero in on—on thyroid health?

Dr. Justin Marchegiani:  it’s a good indicator to look at side by side. The problem is a lot of people have broken thermometers, and I’m just—I see people coming back with 95 on their temperature and it’s just like they have no—you know, they’re feeling better. Their temperature’s up and then when you tell them to get a new thermometer, and it’s better. So you know, I don’t put too much stock in it, but it’s nice to see it–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  When it starts to change and move in the right direction and it correlates with symptoms and it does that a lot.

Dave Korsunsky:  I know that when you were helping me along those lines, it was specifically recommended to use a mercury-based thermometer, and in that one time you had those on your website and they are—they’re getting increasingly harder to get, so is that still something you sell on your site?

Dr. Justin Marchegiani:  Yeah, I have a couple right here. I’m gonna throw them up on screen. I actually have 4 right here.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  I used to recommend more of the mercury. The problem was I actually dropped a couple and I was just like, “Damn, it’s too dangerous.”

Dave Korsunsky:  I did, too.

Dr. Justin Marchegiani:  And so it’s just—I just said, “You know what, even though it’s —it’s accurate, nice. It’s just not worth the potential of dropping it and having the toxicity of having to clean it up.” So I went away from it just because I’ve met some accidents.

Dave Korsunsky:  Sure.

Dr. Justin Marchegiani:  So what I typically use now is just the highest ranked fertility digital thermometer on Amazon. That’s measured to a 100.

Dave Korsunsky: Cool, yeah, it’d be good—yeah, it’d be good to get that model if you have it. I know, I’m going to get another one.

Dr. Justin Marchegiani:  Yeah, I—I have it in my store over at JustInHealth.com. It just links to Amazon and–

Dave Korsunsky:  Got it. Yup.

Dr. Justin Marchegiani:  And in JustInHealth approved products and then my thermometer’s there. But it’s just the highest ranked fertility digital. Not just the digital but a fertility one because fertility has to be more accurate than—than not because of the nature of hormone testing in temperature.

Dave Korsunsky:  Yup, good.

Dr. Justin Marchegiani:  So that’s where I’m at now. So I do like temperature. It’s nice for patients to see it, to feel it. Also with the temperature testing that’s pretty cool is you can get a window into how the adrenals are functioning, too, because if your temperatures are varying greater than 0.3°F per day can be a really big sign that the adrenals are overtaxed.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  So one of the things we see as people’s thyroid and adrenals get healthier and better, their temperatures get warmer and they’re more consistent. Warmer and more consistent means healthier thyroid and healthier adrenals.

Dave Korsunsky:   Yup, okay, that’s all good. So what’s on the rest the panel? I know there’s a bunch of other stuff that’s included in—in the full thyroid panel where—we’re slowly working our way through it here.

Dr. Justin Marchegiani:  So TSH, we already mentioned.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani:  The T4 Free and Total. Again, the Free represents about 2-5% of the hormone level.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  The Total represents the balance.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  T3 Free and Total.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  T3 uptake. What’s being absorbed and taken up by the receptor sites.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  We like above, you know, upper 20s, 28 to lower 30s, 32, 33, 34 is fine.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  We also like to look at reverse T3. Now this is important because this was something that came up on your test.

Dave Korsunsky:  Right.

Dr. Justin Marchegiani:  You had good levels of T4 but then you weren’t converting downstream to T3, right? We had this high level–

Dave Korsunsky:  Exactly.

Dr. Justin Marchegiani:  Of reverse T3 and just, you know, a sub-clinical low level of T3 but it was me—really going downstream to RT3 or reverse T3.

Dave Korsunsky:  Exactly. Yup.

Dr. Justin Marchegiani:  And reverse T3, it’s like putting—it’s like putting blanks in your gun. You fire the gun off, you hear the noise but no bullet comes out. You got this blank that’s sitting in that thyroid receptor site. It’s supposed be like T3 but it doesn’t quite have that metabolic property so to speak.

Dave Korsunsky:  So do you—do you see that a lot, Doc? Where there’s—where that conversion is just not happening, right? And—and what are the first things you think of when you see that the T4 to T3 conversion is just not uprating right?

Dr. Justin Marchegiani: Great question. So the first scenario, if T4 to T3 is not converting well but we see reverse T3 going high–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  You know, we always think selenium and we always think stress.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  So then when we look at stress, we’re making sure the diet’s good, sleep’s good. We’re looking more at the adrenal to make sure the adrenal function is good as well, and you know, making sure practices of meditation, the right amount of exercise are good, not overexercising or underexercising, keeping all the bad foods out, and then we’ll even use things like selenium to help lower reverse T3 and even things like milk thistle to lower it as well to help clear it out because a lot of that reverse T3 is made by the liver so we can clear it out but we gotta fix the underlying reason why it was getting converted there to begin with. That’s the key.

Dave Korsunsky:  Yup, makes sense. And I think in my case, it was just a combination of things exactly like you described. It was really a stressful time for me personally. You introduced the selenium supplement. I also at that time started moving over to a much cleaner diet, more of a Paleo based diet, coming off of just a standard diet. So I think all of those things helped and then what we were doing was we were—were running the thyroid panel. You’d—you’d give me my treatment protocol in my Word document. I’d—I’d get the intervention. We’d run the thyroid panel 3 months later and we’d—we’d track the numbers and I could get engaged in that process and one of the things—one of the reasons I build Heads Up was because I genuinely believe that when the patient can get engaged with their numbers and understand what they mean, it helps. It just gets—you get better results and so we saw it, right? We’d—we’d run the test every 3-6 months and we’d look at the new numbers together and I just love that.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  It was really, really effective.

Dr. Justin Marchegiani:  Yeah, and I think we also did—we did some milk thistle as well to help. If I remember correctly you were doing those Insanity workouts, an hour–

Dave Korsunsky:  Yeah, I just crushed—I had crushed my adrenals.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  Like just—I was overtraining. I was in a stressful situation work-wise. You know, my diet wasn’t great. You know, having too much fun on the weekends.

Dr. Justin Marchegiani:  Yeah, you were doing that.

Dave Korsunsky:  Yeah. All—all of the ingredients were there for a—for a disaster but luckily we were able to intervene and—and get things course corrected.

Dr. Justin Marchegiani:  Yeah, I remember you definitely made some changes with your diet. You were getting more—more quality fats, better quality fats in there as well that was helping out a lot.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  And then we got you on the adrenal support, too, which I think made a big difference. And I know we also had some gut issues that came up–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Down the road, too, that I think as we addressed those we had improvements there, too. I think maybe a Klebsiella or some kinda bacterial overgrowth.

Dave Korsunsky:  Yeah, these were all important pieces that we had to work on.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  Actually, another—another big one for me was actually just racking my sleep. I know it—it sounds silly but even just getting some basic metrics from like a wrist worn device, a FitBit. In my case, I’m wearing one on my wrist now. Just having some data about when I was going to bed and when I was getting up, and how much sleep I was getting on a regular basis. Until you see the numbers, I didn’t realize that I was maybe 6 hours not getting enough and when you’re overtraining and not getting enough sleep and—and you start to see all of that, and you start to see the information that I’m getting from you that are—that are suggesting lifestyle-related stressors, having that that sleep information was—was really, really helpful and it brought a whole new awareness to my sleeping patterns and help me try to move to a—a more natural sleep-wake cycle instead of midnight or one. For example, going bed at 10 and it takes some time to get your body back on a—on a more normal cycle but there’s so much data we were collecting that was helpful along the process and it’s just part of what we wanted to do in Heads Up is give people a place to track it all, but sleep was really important in addition to all of the things that—that you mentioned that we fixed as well.

Dr. Justin Marchegiani: Yeah, absolutely. So kinda just coming back in line here. We talked about the thyroid conversion piece. Sleep really helps because sleep can help curtail cortisol levels, can also help maximizing growth hormone levels which are important for being anabolic and repairing tissue.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  And also can help with recycling neurotransmitters, right?

Dave Korsunsky:  Yup, and—and there was al–

Dr. Justin Marchegiani:  Yeah, go ahead.

Dave Korsunsky:  There was also some antibodies on that thyroid panel–

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  That you always look at as well.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  You were always looking for autoimmunity.

Dr. Justin Marchegiani:  Uh-hmm. Yes.

Dave Korsunsky:  So maybe what—we could talk about that for a bit.

Dr. Justin Marchegiani:  One step ahead of me.

Dave Korsunsky:  Okay.

Dr. Justin Marchegiani:  Let me just—let me just come full circle on the thyroid conversion piece.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Almost there. So the sleep piece is really important.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  The selenium is really important for all the nutrient levels in helping to convert that downstream.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Also insulin resistance, a lot of people that have high levels of insulin, they may have this hard time converting thyroid hormone or activating it T4 to T3. If they have high levels of stress hormone that may help as well or hurt the conversion. If they’re really have—almost low levels of cortisol because of HPA axis dysfunction.

Dave Korsunsky:  Yup. That–

Dr. Justin Marchegiani:  Where the brain is numb talking to the thyroid that can really help decrease that conversion, prevent the T4 from going to T3. Certain nutrients like copper and selenium and zinc. Also high levels of mercury can also be a big factor. So those are kinda just some—some good generalizations there. Now getting to your next question that you asked—perfect timing was was the thyroid antibodies. So, so many of the thyroid—so many thyroid conditions are actually brought upon by autoimmunity, meaning your immune system is making specific antibodies that are attacking the thyroid gland.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  One is known as TPO or thyroid peroxidase enzyme. It’s an enzyme that puts thyroid hormone together and then the other one is the thyroglobulin antibody which is the surface protein of the thyroid. And if you’re making antibodies and you’re tagging the thyroid then you’re gonna be attacking it and breaking it down and these B cells and B lymphocytes are gonna be getting in there and attacking it.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  And that’s not good because as it’s being attacked, it’s like stag—stabbing a knife into it and thyroid hormone drips out.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  So your TSH and thyroid hormone levels can be off for a long time. You could have hot flashes and anxiety, and tachycardia and be sweating a lot and that’s a really good sign that you’re starting this whole autoimmune progression and again, conventional medicine will not get to the root cause. They ignore the immune mechanism, i.e., the antibodies. They forget what’s driving it and they just say, “Here’s Synthroid,” and they just wanna get that thyroid TSH back nice and low again but we’re not getting with—with the simple things like the gluten and the grains and the inflammation and the insulin resistance and the infections that are so commonly addressing it.

Dave Korsunsky:  Yup. I know there’s a lot of people really close to me that are dealing with autoimmune conditions and so that’s something that—that comes up all the time. You—you’ve worked with many of those people directly.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  And have helped them–

Dr. Justin Marchegiani:  Yup.

Dave Korsunsky:  Make the changes necessary to—to work on those antibody numbers specifically.

Dr. Justin Marchegiani:  And I think that’s why you did really well off the bat, too, because one of the big changes you made, because you were like just starting to get into Dave’s Bulletproof Diet and you were–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Cutting out grains and really cutting out mycotoxins.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  And you were eating more fat so you were stabilizing your blood sugar and getting your insulin better. I think that really helped with calming down any potential autoimmunity that may have been present.

Dave Korsunsky:  Yeah, and if I think back to some of the things that were going on at that time, it was—it was definitely going on to the Bulletproof Diet at that time that helped a lot. That helped with a lot of the blood sugar stabilization.

Dr. Justin Marchegiani:  Big time.

Dave Korsunsky:  And you mentioned that that’s one of the reasons there—there may be T4 to T3. working on stress, getting the GI stuff fixed up. You ran the tests to do that. You also ran the adrenal test which I think just are more indicative that there’s–

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  A stress—a stressor in the system whether it’s physical or mental, so we worked on that and then some—some supplements to help. Selenium being the—the most obvious one, and all of those things worked and then we re-ran the numbers and it was—you know, it took a while. Maybe this was a 12-month process, 18-month process where we worked everything out, but it was great. And there’s that—that functional medicine type process where you’re doing what we just described. I mean, how common is that in—in your practice with patients you’re seeing?

Dr. Justin Marchegiani:  Well, it’s really common especially the autoimmune piece because people are stressed. They’re not eating good—good meals. They’re insulin resistant because of the suppressed immune system of all the things I’ve mentioned, opportunistic infections kinda take hold as well. So that’s a multi-layer kind of system that we’re looking at so you really gotta wade through it systematically so we can get to all of the key lynch pins.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  If you’re just doing one thing to systematically or symptomatically make you feel better, may not be what kinda unlocks the healing long-term.

Dave Korsunsky:  Yup, makes sense. And so just going back to the—to the thyroid panel, I mean, when we first started working together, you—you didn’t see that in any of my previous lab testing so it’s something you ordered right away.

Dr. Justin Marchegiani:  Yes.

Dave Korsunsky:  Is—is that something you like to do upfront with—with all patients? It’s just to see where those numbers are or is it case by case?

Dr. Justin Marchegiani:  It’s case by case. It depends what symptoms are present off the bat. If we’re going to the person’s history and there’s lots of energy issues and lots of mood issues like let’s say hair loss, outer third eyebrows, let’s say cold fingers, cold hands, tingling, numbness, things like that. We will definitely order a thyroid. If we don’t have a lot of the hair loss and the cold hands and cold feet-

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Stuff off the bat, we typically stick to the adrenals first, see how good or bad the adrenals are and then I have them do temperature testing over the next month and we monitor through there.

Dave Korsunsky:  Cool.

Dr. Justin Marchegiani:  And if symptoms are improving on the adrenal protocol and their temperatures look decent, we won’t necessarily jump to the thyroid off the bat. If we’re not quite getting the improvement we’re looking at and temperatures are low, then we’ll go and we’ll dig in to that thyroid.

Dave Korsunsky:  Yup, that makes sense. And I’ve, you know, personally for the last 8 months I’ve been on a–on a Ketogenic Diet and have been doing really well with it but I’d love to run another panel to see how my numbers stack up and that kinda leads into my next question which is a lot of people when they go the doctor, they—they may not be able to get the full panel ordered for—for various reasons. There has to be a diagnostic code of something like that.

Dr. Justin Marchegiani:  Oh yeah.

Dave Korsunsky:  So, I know you have the panel available. Is that one of the panels people can get from you and just go to Lab Corp and get it? I realize you gotta pay out of pocket, but sometimes that’s just the most—the quickest and easiest way instead of having to negotiate with—with your doctor.

Dr. Justin Marchegiani:  Oh, yeah. The panel that we have online, the complete thyroid panel in the store, so justinhealth.com, click on the Healthy Living Store, you’ll see the lab test button. Click it and look for the complete thyroid panel. And that panel I think it’s about $150 and that’s a complete–

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  You can’t run anything for the most part.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  On your thyroid.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  It’s got all of the thyroid markers you need. Typically if that panel is not covered by insurance, right? That’s over a $1000.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  So by just paying cash, you kinda cap—you cap your losses so to speak and that’ll give you everything you need. That’s a really good first line for anyone with thyroid issues. That’ll give you everything you need to—to get a complete picture of what’s going on.

Dave Korsunsky:  Yeah, and I see—I see a lot of people who we communicate with and just a lot of people who are asking questions and stuff who—who may not be making progress as they move to—they make the nutritional changes. They go Paleo. They make the dietary changes. They’ve adopted Keto or some of those principles and they’re not seeing any changes in body composition and so it’s—that’s often something that I think of and are those correlated? Would you start to look at—at thyroid and metabolic if you’re not seeing changes once you make the—the nutritional interventions?

Dr. Justin Marchegiani:  Absolutely. The thyroid can control metabolism, heat and energy, so it’s definitely a place that you wanna look at for sure. When people have their thyroid working better, they tend to be able to have a higher metabolism, burn more calories, burn more systemic body fat which is a really good thing.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  But not all the time. Some people—it’s just, we get their thyroid working better they’re no longer depressed and constipated and their hair starts growing back.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  So I see the thyroid kinda being a different—having different priorities, you know, they may not be the priorities that you want so to speak, fair enough. But it’s—it’s amazing we see different things happen and I can’t tell you how much depression and mood changes with better thyroid.

Dave Korsunsky:  Yeah, and—and a lot of the people, a lot of our users who are on Keto actually, it’s a—it’s a small percentage but they do start to report hair loss in some cases and can you talk about when it may be for example a nutrient deficiency vs a thyroid for example? Is it hard to tell? Any thoughts on that?

Dr. Justin Marchegiani:  So you’re talking about looking at the lab work? How can you tell it’s a nutrient issue?

Dave Korsunsky:  Well, let’s say you were dealing with hair loss for example and you mentioned that thyroid could be one option, could it also be jus due to dietary issues, for example?

Dr. Justin Marchegiani:  Absolutely, absolutely. I mean we need protein. They tend to be all connected because if we have a protein issue, well, if we are having a protein malabsorption where it’s affecting the hair, it’s probably affecting the thyroid because we need certain amino acids that would be in those foods to help make thyroid hormone like tyrosine for instance. So if it’s showing up on the gut level, it’s probably gonna eventually make its way to the thyroid level, too. So–

Dave Korsunsky:  So protein specifically in the diet is what—

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  What we’d be looking for?

Dr. Justin Marchegiani:  Yeah, I mean high quality protein. I mean if we have people with gut issues, we’ll use like various collagen peptides and/or free form amino acid products to deliver the protein in a way where there’s no digestion required to really process it.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  That way it gives the digestion some time to relax while we work on fixing it.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  But I never just isolate variables. If I see the thyroid and I see protein and gut issues, we’re gonna fix everything, you know?

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  As we go through body system 1, 2, and 3 and if it’s something we tr—address in body system 1 with the thyroid, meaning where we’d look at ATF or ATM—adrenal, thyroid and male hormones or adrenal, thyroid, female hormones—and we start to see the hair start coming back with thyroid hormone, that’s a great sign.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  And then it may come back as we start repleting nutrients in body system 2 with the gut.

Dave Korsunsky:  Uh-hmm. Makes sense.

Dr. Justin Marchegiani:  So I mean we’ll trace it back afterwards and kinda use this retrospective look at it and say, “Hey, when we did this, that happened more and when we did this, this happened more.” Sometimes you can’t tell because there’s a delay.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  So we try to do our best and just fix what we find.

Dave Korsunsky:  Yup, makes sense.

Dr. Justin Marchegiani:  But–

Dave Korsunsky:  Well, I know I’m due for a full set of labs.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  Thyroid panel included and—and you’ll be the first to take a look at them once they’re ready, so yeah, I’ve to get working on that and part of—part of what you were helping me with was—was building Heads Up Health to help people track all of this information.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  Particularly when you’re working with health experts outside of the conventional system, just having everything in one place and being able to share it with any doctor you want, so you and I will be working on that together in the near future.

Dr. Justin Marchegiani:  Absolutely and I wanted to touch upon one last thing because I know you’re—we’re really getting out there to the Keto community which I think is great. One situation that I’m seeing is most thyroid conditions, I’d say 99% off the bat, they’re gonna do so much better off the bat especially if they’re coming from a standard American diet going Keto–

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Because that’s gonna help insulin resistance. It’s gonna help this–

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  Kinda numbness to this insulin receptor where–

Dave Korsunsky:  For sure.

Dr. Justin Marchegiani:  You know, we’re not getting the insulin low enough because these receptors are so numb to get sugar into the cell.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Right?

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Insulin’s the—insulin’s the key. The receptor is the lock and basically the receptor site’s not accepting the key so we have to put—put—essentially push more keys into the hole to get that key out, to get that essentially door open to let the sugar in. So we get this insulin resistance where more keys getting into the cell. So that’s not a good thing because insulin when it’s too high can cause lots and lots of hormonal issues. One of them being thyroid conversion or T4 to T3 thyroid hormone activation. So getting on a Ketogenic Diet is gonna be essential because it’s gonna really get that insulin level down. The only thing is I find sometimes when people are long-term Keto, sometimes we may be get a little bit—we may go a little too low on the insulin and if we add just a small amount of carbs even just 10-20g, it can be enough to get your insulin levels a little bit higher and we see an aid in thyroid conversion. We’ll see T3 go up on the lab work. We’ll see hair—hair improved or maybe even temperature improved but that tends to be when people are Keto chronically or long-term. Everyone’s gonna–

Dave Korsunsky: Yup.

Dr. Justin Marchegiani:  Benefit on off the bat and get a really big benefit. It’s long-term afterwards. We wanna fine tune it and I’m totally non-dogmatic about it. If you can keep at a Keto level or—that’s great. If not, we just up it 10-20g to see how we do. I had a patient just yesterday we upped it about—we add about a quarter of sweet potato at night and a lot of her low thyroid symptoms went away.

Dave Korsunsky:  Makes sense. Yeah, well, I mean this is all good stuff, Doc. I think there’s so many people that need the—the full thyroid panel. Maybe have never had it before or maybe they‘re stuck just where they are in terms of their health transformation. I know it was a huge step for me, just seeing these numbers, figuring out how we address them. I know you make the panel available to people who can’t get it from their doctor which is awesome. Heads Up Health has got the software to help people track all of this stuff especially if they’re getting data from different labs and they wanna manage it all in one place. So hopefully there’s some people who can use the information here, get their own panel run and it may be an important diagnostic piece for them as they work on their own health goals.

Dr. Justin Marchegiani:  Absolutely. I’m gonna put the complete thyroid panel in the link below so if you’re interested in it, feel free and click on it. That’ll be a great way to access that panel.

Dave Korsunsky:  Yup, and I can include some information for people who want to start getting all of their health records organized using Heads Up Health. There’s a couple videos we put out there that just showed how to integrate all the medical records, basal temperature, macro nutrients so I can send that along as well.

Dr. Justin Marchegiani:  Great. Any other questions, comments or concerns, Dave?

Dave Korsunsky:  No, this was great. I see this topic come up all the time. So I’m glad we were able to address it and—and provide some information on what the full thyroid panel is and—and what the markers are and some of the things you can start doing to—to fix it.

Dr. Justin Marchegiani:  So anyone listening to this and kinda, you know, has all these labs in front of them and not quite sure you know what to do with it, get over to Heads Up Health. Get it integrated in there so you can start seeing patterns and then it’ll be really fun as you go forward tracking your labs. You’ll be able to see trends that you may have not seen otherwise.

Dave Korsunsky:  Yup, sounds great.

Dr. Justin Marchegiani:  Alright, Dave. Great talk! You have an awesome day.

Dave Korsunsky:  Yup, likewise. Thanks, Doc. Take it easy.

Dr. Justin Marchegiani:  Thanks, bye!

 

Thyroid Test: https://justinhealth.com/products/complete-thyroid-panel/
Heads Up Health: https://www.headsuphealth.com

Estrogen dominance – Podcast #110

Dr. Justin Marchegiani and Evan Brand talk about hormones, their importance and their functions, as well as the symptoms of hormonal imbalance and what causes estrogen dominance. Understanding hormones doesn’t have to be complicated and if you listen to this podcast, you’ll get a clearer picture of what hormones really are and particularly for women. 

estrogen dominance - hormonal imbalanceFind out having balanced hormones is the key to feeling good and having energy. Learn how to avoid any imbalance and how to fix these issues to help you overcome stress. Discover what you can do and gain indispensable knowledge about dealing with hormones especially for females so you can perform at your best and be in optimal function.

In this episode, topics include:

00:42   Hormones

04:30   Symptoms of estrogen dominance

08:13   Causes of estrogen dominance

17:22   Phytoestrogens, stress allocation and avoidance

25:20   Nutrients

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Evan Brand:  Dr. J! How’s it going?

Dr. Justin Marchegiani:  Evan, it’s doing great, man! How you doin’?

Evan Brand:  Pretty—pretty well. I’m glad we got this internet thing straightened out. Let’s hit this estrogen dominance topic. People have been asking via email, social media. Clients of ours have been asking about hormones and trying to understand them. There’s so many things in the environment that impact them. Your lifestyle, your diet can impact those and so you and I wanted to outline all this together and talk about what’s affecting your hormones, why is it so complicated in the modern world, what are the new variables that didn’t exist and then what do we do to fix it. So do you wanna start—start us off?

Dr. Justin Marchegiani:  Yeah, so hormones are interesting, right? Hormones are these messengers, right? They help with inflammation. They help with growth mediation, i.e., healing and recovering, putting on muscle. They help with reproduction. Not only reproduction like in reproducing ourselves so we heal but also having children and healthy hormone balance is essential to us feeling good, to us having energy, to us being resilient and vital as we—as we age and deal with stressful situation. So hormone balance is really, really important. Now as women—women have 2 different kinds of hormones that are constantly in fluctuation generally speaking, right? Men are kind of this foghorn of hormones throughout the month. Again there’s some fluctuations on a daily basis with cortisol, as are women, but on a monthly basis, you know, men kinda have this flat rhythm regarding testosterone. Women have this kind of symphony of hormonal fluctuations regarding estrogen and progesterone. And I tell my patients estrogen is the hormone that makes you grow. Progesterone is the hormone that makes you grow up. Meaning estrogen just causes cells to just grow bigger, while progesterone helps cells to differentiate and mature, okay? This is important so throughout your cycle, kinda breaking down a woman’s monthly cycle I think is really important for the first place of connecting the dots of where abnormalities happen. So first off, women’s cycle begins with bleeding, with menstruation. Typically about 3-4 days, maybe 5 days long in some extenuating circumstances. That happens because of a drop in progesterone and estrogen. So progesterone and estrogen drop, that signals bleeding. So the uterine lining is now shed over that 3 to 5-day period. The next thing is the follicle starts to grow and that follicle, FSH from the brain is starting to be produced and that causes the follicle to grow. So FSH talks to the follicle, the follicle starts to grow. As the follicle grows, estrogen is produced by the follicle. That’s step 3. As estrogen is being produced, it eventually hits a—a toppling, you know, where it hits its highest level around day 6-9 or 6-10. Then progesterone starts to increase as estrogen tops out, alright? Progesterone is increasing due to LH. LH is luteinizing hormone. That’s a brain hormone. The two brain hormones are FSH and LH. As progesterone topples out around day 20-23 or so, that’s where hormones are at its highest regarding progesterone and then day 27-28, progesterone and estrogen fall. So if we kinda recap it real quick, briefly what’s happening is we have brain hormones causing the follicle to grow. The follicle stimulating estrogen. Estrogen stimulating LH, LH stimulating progesterone. Progesterone and estrogen dropping. And that’s kinda the general dr—gist of the average female cycle, right around 28 days or so, and about day 13-15 is where ovulation happens. That’s right where estrogen tops out and progesterone starts to rise. That’s where that 2-3 window of pregnancy happens. I’ll just take a breath and give you a chance to break it down, Evan.

Evan Brand:  Sure, sure, makes perfect sense. And a lot of women that you and I are working with may be perimenopause or menopausal so we can talk about the ebb and flow and things that change there. So basically as you’ve kinda alluded throughout most of the reproductive years, the estrogen and progesterone are in a pretty good balance, but then if you look at all the information with progesterone and estrogen levels changing, then it looks like the gap becomes bigger where there’s a relatively high estrogen compared to progesterone and that’s what we would call menopause, and then that’s when these symptoms can start to occur. So I guess what I should do now is just go through some of these what consider estrogen dominant symptoms. So this could be allergies. This could be breast tenderness. You have copper–

Dr. Justin Marchegiani:  yeah.

Evan Brand:  Excess.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Which I did a video on copper toxicity and everybody’s like blown away by the idea of too much copper. How about cold hands and cold feet? Decreased sex drive, depression with possibly some anxiety or agitation added to it. Could be dry eyes, fat gains especially around the abdomen, the hips, the thighs, fatigue. Could be brain fog, which sometimes that could be yeast-related as well. Hair loss, headaches, blood sugar issues and fertility, irregular periods. You and I have talked about amenorrhea, just missing your period completely before. Irritability, insomnia, mood swings. I could go on and on. I think that’s a pretty good handful of symptoms though.

Dr. Justin Marchegiani:  Yeah, absolutely. So when estrogen’s out of whack, a whole bunch of symptoms happen. The real common ones like you mentioned—most females—these are the ones that I deal with on a daily basis with all my patients, you know, the big complaints. It’s gonna be moodiness. It’s gonna be breast tenderness. It’s gonna be cramping. It’s gonna be back pain. It’s gonna be migraines, moody, sweet cravings or sugar cravings, and I would say like water retention and even weight gain.

Evan Brand:  Yeah, I would say the sex drive one has been something big. I ask that question on my intake, you know. Do you think your libido adequate? And it’s very, very rare to find a women over age 40 who says that her libido is adequate. You know, some women said they haven’t had a libido in 20 years. So I mean, these things can change with hormones and they’re not just gonna magically fall into place by diet and exercise. So eventually you and I are gonna outline what exactly is going on in the external environment that is throwing off this whole hormonal cascade here.

Dr. Justin Marchegiani:  Exactly and typically, as a women ages, menopause is nothing more than the ovaries not functioning like they were when you were cycling and you have a drop in hormones from that. Typically over time, one the big things we see with hormonal—hormonal fluctuations over time is that estrogen drops at about 35% the rate from age 35 to 50, while progesterone can drop at 75% the rate. So this whole podcast is really surrounding the topic of estrogen dominance and part of estrogen dominance is just being exposed to a high amount estrogens in the environment—that we’ll go into in a second. The other half is is progesterone being essentially dropping so fast that estrogen—the ratio of estrogen goes above and beyond what would be normal essentially.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So if progesterone starts to drop faster than estrogen, even though you may have more progesterone as a basic flat line number, that’s still gonna be estrogen dominance. I mean, some people say over the course of a whole cycle you’ll have 300 times more progesterone than estrogen. At certain times of the cycle, like depending on where you’re at like let’s say, in the follicular phase you may have as many—as much as 25 times more progesterone to estrogen. So it’s different from the perspective of where you are in your cycle, but in general estrogen and progesterone—progesterone will be about 25 to 300 times more in relationship to estrogen, alright? So if that skew starts to get disrupted and we start to have less progesterone, let’s say below 20, you know, below 15 on average, that may be a big driving factor of estrogen dominance and a lot of the whole PMS symptoms and the symptoms that you just mentioned as well—the brain fog, the libido, dry hair, dry skin, dry nails, cold hand, cold feet, cramping, breast tenderness, all the things we already mentioned.

Evan Brand:  And let’s talk about some of the causes here. Birth control being a big one that can contribute because with birth control, you’re basically just keeping your estrogen levels sky high and so this is just a common prescription for many teenage girls, I’ve heard of even girls as young as 12 years old now getting put on birth control pills for their periods, you know, if they’re having really bad periods. So talk us through that. What’s going on with birth control pills? Why are these such an issue?

Dr. Justin Marchegiani:  Well, birth control pills are nothing more than like synthetic estrogens. You have like Yasmin and these synthetic estradiol compounds and they basically jack up your estrogen level as a female about 4 to 500%, 4 to 5 times. And that’s a problem because hormones, right? If you look at—go to any opera or any symphony, there’s a specific timing and a volume in which everything needs to operate in. If something goes too—too loud or too quiet or something, the timing’s off, you can easily have a beautiful symphony turn into noise pretty darn fast. Now taking that analogy to a hormone cycle, if those things start to go too high because of synthetic hormone overload or too low because of hormone stress driven by inflammation, that can start to create hormonal symptoms. So that’s the big thing right there off the bat. So estrogens are gonna be jacked up way high. Sometimes with the Merena IUD, that’s inter—interuterine compound that’s put up there to prevent the egg from implanting in the uterus lining, that is—that’s actually using synthetic progesterone. So that’s a little bit different. But most of the birth control pills are gonna be synthetic estrogen-based and basically what it’s doing is keeping the estrogen so high all the time so you don’t have that rise in progesterone happening. You don’t have that cycling of hormones. So basically it shuts the HPA axis and because your hormones are so high, the LH and FSH kinda go to sleep because–

Evan Brand:  So the body eats—the body thinks it’s pregnant.

Dr. Justin Marchegiani:  Well, not necessarily. The body—well, I guess you could say at a certain level. Typically progesterone’s gonna be really high with pregnancy and you’re gonna have HCG off the chart. So you’re not gonna see that because if you ran a pregnancy test while you were on a birth control pill, you wouldn’t come back with a pregnancy test being positive because you’re not making–

Evan Brand:  Right.

Dr. Justin Marchegiani:  The beta HCG. But what it’s doing, it’s shutting down the brain because the brain has this domino rally of FSH raising and then LH raising, so kinda shuts that down, because when the hormones are really high, FSH and LH don’t really have to work as much because the high amount of hormones is just shutting down the whole entire symphony. It’s like going into a symphony and with the foghorn. You just overpower all the instruments, you just can’t hear anything.

Evan Brand:  Makes perfect sense. Let’s talk about the metabolism of these two. That’s something that people do not talk about. There are side-effects that we could go into. We won’t bore you with those today, but there are nutrients—your vitamin C, your magnesium, zinc, and other minerals that are required for metabolizing these pills through your liver. So if you look at someone who has been on birth control for many, many years, mo—more than likely you and I are gonna look at their adrenals. We’ll probably see low function and if we look at like an organic acids test and if we’re looking for vitamin C or other nutritional markers, they’re probably gonna be deficient. Maybe not a—maybe not the only cause would be birth control but it’s definitely a factor. And then now I know we have to mention the environmental part of estrogen still. You know, we’ve talked about adding excess estrogen in via birth control but we have all the xenoestrogens in the environment, and now we’re seeing teenage boys with man boobs and you know, this is not—this is not good. This is not something that would have happened let’s say even 100, maybe 150 years ago with this breast enlargement. Can—can we go through some of those like the, you know, the—the meats, the plastics, the canned goods, all of that stuff?

Dr. Justin Marchegiani:  Yeah, exactly. So again, we already kinda mentioned some of the mild to moderate symptoms regarding estrogen dominance and again people that are listening that are familiar with some of the pathological situations like uterine fibroids, endometriosis, fibrocystic breast, polycystic ovarian syndrome, even breast tumors. Those are ultimate, you know, severe more pathological forms of estrogen dominance in action.

Evan Brand:  Right. It makes sense.

Dr. Justin Marchegiani:  And then—yeah, and regarding some of the underlying environmental causes, too much sugar is gonna drive a lot of this because too much sugar is gonna increase insulin. Insulin resistance drives more fat growth. Because if our cells are saturated and we can’t burn sugar in our muscles, well, guess what happens to that sugar? It goes right into fat and fat actually is its own exocrine gland. It produces a hormone that’s gonna cause fats—it’s gonna basically produce leptin which is another hormone that’s gonna decrease our body’s ability to signal satiation and signal that we’re full, which is another thing, and it’s also gonna produce more sex hormones like estrogen. So if we have more fat cells, fat cells will actually produce more hormones and throw us off even more. So driving insulin resistance, driving fat, fat will then drive more estrogen and then also it’s gonna screw up the whole combination here with leptin which is gonna make us feel hungrier and eat more of that same junk that got us there and to begin with. So a lot of these mechanisms that we overlay, you can see there’s almost like this vicious cycle to them where they kinda repeat itself on a loop over and over and over again.

Evan Brand:  Yeah, and then like you mentioned, they could all start with diet or sugar. So I mean, that’s a—that’s a huge one. It’s not something that we wanna skip over but you and I, we hit the diet piece so much that we’re assuming if you’re listening to this show, then you’re generally closer to like an AIP style diet where you’re not eating gluten. Maybe you’re doing a little bit of dairy in the form of like some ghee or some grass-fed butter.

Dr. Justin Marchegiani:  Right.

Evan Brand:  But beyond that, you—you gotta have that foundation in place, and then we could go on with the personal care products. You got your pesticides and herbicides.

Dr. Justin Marchegiani:  yes.

Evan Brand:  But you’re eating organic, you’re avoiding that. You got your makeup for women. So that—that is in the personal care category.

Dr. Justin Marchegiani:  Huge.

Evan Brand:  But think about women that are lathering themselves a lot of times with heavy metals and phthalates and all that, too, in their makeups.

Dr. Justin Marchegiani:  You also have your pesticides, I mean, a lot of those are estrogenic in origin. Pesticides, fungicides, herbicides. You have a lot of chemicals in the water as well. Remember when you get your water filtered back, the conventional water filtration in your community won’t filter out a lot of the hormones in the water. So you’re getting–

Evan Brand:  Yeah, we—oh yeah.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  The—the trace amounts of pharmaceuticals you’re talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That people flush down the toilet.

Dr. Justin Marchegiani:  Uh-hmm. Absolutely.

Evan Brand:  Fluoride would be another one that we could talk about.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  That’s another endocrine disruptor there.

Dr. Justin Marchegiani:  Yeah, fluoride. Also a lot of these polybrominated diphenyl ethers that are in flame-retardant products and various solvents, definitely not good. Milk if we’re drinking or consuming conventional dairy, a lot of the milks are treated with a Posilac, which is—or similar—no, Similac’s the formula. Yeah.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It’s Posilac. Posilac is the growth hormone given to cows to produce more milk essentially and then we have conventional dairy or conventional meat which could come from cows because cows are gonna be given hormones as well on the meat side, right? You have your Jersey cows which produce the milk. They’re given the Posilac to make more breast milk or make more you know, cow milk, and then we have the cows that are eaten for steaks and meat and those cows are gonna be given more growth hormone and estrogens to make more meat as well. They’re also given mycotoxins, too, to produce more fat to make their meat more marble then they’re given a lot of grains which are loaded with mycotoxins as well to make the meat more marbled. So a lot of different chemical toxins that are coming in on both sides of the fence.

Evan Brand:  Yeah, not even to mention the grain they’re getting fed is likely sprayed with glyphosate or it’s genetically modified grain that these conventional meat products have consumed.

Dr. Justin Marchegiani:  Bingo. Exactly.

Evan Brand:  Yeah. Last thing on—on the, I guess on the xenoestrogen route would be fragrances. So any woman or man wearing you know, perfumes, colognes, air fresheners, using those little trees that people put on their rearview mirror. It’s the worst smell on the world.

Dr. Justin Marchegiani:  Oh, absolute toxins.

Evan Brand:  Don’t use those.

Dr. Justin Marchegiani:  Absolute toxins. I remember in high school, I used to love having those in my car like the—the vanilla scent one. I thought it was so cool but then the more I studied it, it was just absolute toxins.

Evan Brand:  So were you the guy who when one of the trees ran out of scent, did you go to the car wash and buy another tree and stack it on or did you remove the first one?

Dr. Justin Marchegiani:  Well, I—I would remove the first one, but I always keep a tree in there to keep it going.

Evan Brand:  Oh, I—I’ve seen people who have 20 trees stacked on one another on their rearview mirror.

Dr. Justin Marchegiani:  I know.

Evan Brand:  They can’t even see out the windshield.

Dr. Justin Marchegiani:  Isn’t that nasty?

Evan Brand:  It’s horrible. Well, actually, Luke who and I were talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Before the show–

Dr. Justin Marchegiani:  Luke Storey.

Evan Brand:  Luke—he posted something online about he got in an Uber and he posted a picture of a guy who had like 20 of the black trees.

Dr. Justin Marchegiani:  Oh, God.

Evan Brand:  On his g—on his a—and so he had like a little portable ozone generator that he was breathing in in—in the backseat of the car.

Dr. Justin Marchegiani:  Oh, my God. Unreal.

Evan Brand:  Poor Luke.

Dr. Justin Marchegiani:  I know. What you gonna do?

Evan Brand:  Yeah. Let’s talk about phytoestrogens, too, in the food if—I guess we’ll hit the diet piece again. So these are your sources of soy. So mainly we’re talking about soy bean, your tofu, all of that. Something that’s frustrating for me is when you’re looking for a good protein bar, you may—you might find an organic protein bar at your health food store, but typically one of the first ingredients is gonna be soy protein crisp. It’s like come on, that’s not good.

Dr. Justin Marchegiani:  I know. Whatchamacallit, yeah, Clif Bars has got them. Even I think–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  A lot of the Zone bars, too. There’s only a few bars that actually have decent, clean protein in their bars, but that’s a big one. Soy’s a big phytoestrogen. Outside of miso, natto, or tempeh, soy is—for the most part is not gonna be good. Some menopausal females can get away with a small amount of it, if fermented-wise because it can help modulate their hormones when they’re lower in estrogens, right? Menopausal, but for the most part, people should not be doing soy. It’s not a good thing. It’s—and outside of that, too, we talked about the chemicals. We talked the industrial solvents, the hygiene products. You can always go to the website, skindeep.com or org to look up your products that you use on your face, on your hair, on your skin, your makeup, and see how much chemicals or toxins are in them. Oh, stress! Stress is huge because stress will cause your progesterone which is a major building block of your hormones to go downstream. Meaning it will progesterone and shunt it in the cortisol or stress hormones so you can deal with whatever that stressor is, because your body is hardwired to prioritize stress and inflammation first over recovery and healing and fertility second. And it kinda makes sense because if you’re stressed now, the body wants to deal with that stress, get over it and then because able to repair later, because if it doesn’t deal with the stressor, it may not get to that next point of being–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Able to heal and recover. So it’s just allocation.

Evan Brand:  Yeah, maybe you’re—maybe you’re dead and because you got eaten by the bear because your body was trying to repair and run at the same time. It can’t do both, so people who are listening, you know, always have the ancestral lens added as filter on to our conversations because this is very new. All this stuff that we’re dealing with, the environment is so new and we still have this ancient wiring systems that’s thinking–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Okay, there’s a bear coming down my driveway right now, I need to be in Fight or Flight, so recovery is—is not prioritized. And people listening, even just you having a notification sound—Justin and I have talked about this before, but even just having notifications on your smartphone or your computer “Ding!” every time you get an email, that’s triggering a biological response in the brain, that’s a hormonal response. Your body’s thinking, “Oh, what the hell is in that email? Is that a bill? Is that letter from somebody I don’t wanna hear from? What’s in that inbox?” That could be a huge source of stress so you really need to—you could either track your heart rate variability or just track how you feel. If you feel your heart racing or gut hurting after you’re expose to social media, something like that, these are the invisible stressors that can really trigger stuff for people and if you put—well, what does that actually do? You’re just saying this. But what does it do? Well, it inhibits the conversion of—of hormone, your T4 to your active T3, and so then you’re gonna have those hypothyroid symptoms and it could all be due to the stress.

Dr. Justin Marchegiani:  Yeah, and just think about it like this, right? If you’re barely getting—barely making enough ends to meet, you know, you’re barely getting enough money to make ends meet, so to speak, right? Do you have enough money to go and start investing in things in the stock market or real estate? Probably not because you’re just so focused on getting the bills paid. That’s all you can focus on. Once the bills are paid, i.e., once you’re able to manage stress and inflammation in your life, then you can think about investments after that, right? Same thing hormonally with how your body is prioritized to allocate bandwidth to essentially.

Evan Brand:  Right, that—yeah, that’s well said.

Dr. Justin Marchegiani:  You can–

Evan Brand:  Do you want talk about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Do you wanna talk about solutions for this? I think avoidance is kind of the—the big one that we could say in one sentence and be done with that, you know? Getting these things out of your life, making sure that you’re eating organic, making sure that you are staying away from the chemicals as much as possible. You’re looking at your skin care products. You’re looking at the makeup, the mascaras, the foundation, all of that crazy stuff that women put on to, you know, they feel like they have to put that on to be beautiful. I promise most women I see, they’re more beautiful without makeup. You look so much better. I tell my wife, “You don’t need it.” Country singers they say—they sing that in their songs like, “Oh, don’t put on makeup.” But it’s a real thing, especially if you have, you know, freckles and—and whatever natural skin pigmentation, that’s pretty. You don’t have to cover that up. So maybe turning off the TV is the first step to get through that process.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Because women are brainwashed into thinking they have to—to have caked on xenoestrogens to look pretty and they don’t.

Dr. Justin Marchegiani:  Exactly and that’s part of the whole, you know, brainwashing that Hollywood does, is they try to make most people feel incredibly inadequate about themselves so they can go buy some product and you know, frankly, it works. As much as a lot of women don’t like it and they complain about it, but it works and that’s why they do it.

Evan Brand:  Well, because if—yeah, you’re saying because if one lady is gonna wear makeup, then you don’t wanna be the only one without it?

Dr. Justin Marchegiani:  Right. I mean, I—my wife asked me, “Should I wear makeup tonight?” You know, she’s telling—she’s asking me this. I’m like, “No, you shouldn’t.” I like you better without makeup. It’s just—it’s better. It’s healthier.  But–

Evan Brand:  It really is.

Dr. Justin Marchegiani:  But there are some natural things out there. I know there’s a-

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  There’s some—some mineral-based makeups that you can just kinda touch things up and it’s more mineral and more natural-based and it’s easy and you’re not adding a big toxic load. Those will be if you’re gonna use makeup because some people may not be ready to make that switch, but that’s the better next step to look at.

Evan Brand:  I’ve seen a couple organic mascaras. I don’t know how it could be organic. But Hannah’s purchased a few organic mascaras and then also a few foundations. I don’t know if they were considered organic or they were labeled without phthalates. I can’t think of the brand right now. I wanna say it had the name Doctor in it.

Dr. Justin Marchegiani:  Huh.

Evan Brand:  Doctor’s Best or something and it was a brand of makeup. If you look on Amazon, I know there’s a bunch of different companies out there.

Dr. Justin Marchegiani:  Yeah, absolutely. So diving in here, we talked about the stress allocation and how your bodies and your adrenals can be affected by this whole thing, right? Because of the prioritization of progesterone to cortisol. You also touched in on how that cortisol can affect your thyroid because if your hormones start going off, if progesterone starts going off, that can affect thyroid conversion because if cortisol’s out of balance, that can affect T4 to T3 conversion which is your inactive thyroid hormones, so you’re active thyroid hormone. And also progesterone’s a powerful stimulator of TPO, which is the enzyme that helps bind tyrosine and iodine together to make thyroid hormone. So progesterone is really important to building thyroid hormone. So you can see this is why you don’t just get one symptom when hormones go out of balance because it just has this constellation ripple that can happen and many symptoms can occur because of it.

Evan Brand:  Yup, well said. So avoidance. We talked about lifestyle changes, you know, doing what you can whether it’s a floating tank, whether it’s yoga, tai chi, qigong. There’s meditation. There’s gratitude exercises, journaling. You and I have done entire podcasts dedicated to that. I don’t wanna skim over it but I think there’s so much that said about stress that you—you just have to—you have to do it. And if you say that you don’t have 5 minutes to meditate, well, you probably need quadruple that amount of time.

Dr. Justin Marchegiani:  Exactly. Yup, setting a timer like that can be really helpful. Even just sitting and just breathing. Just—just staring literally out—out your window. Just staring and just thinking about the sky or whatever, just clouding your head or just whatever is going on and just think about whatever you’re looking at. That’s why you talk about forest bathing or walking in nature and just being 100% present where you’re at. Oh, look a tree! Oh, look a rock! And all you’re focused on is what your eyes are gazing at.

Evan Brand:  I love it. Yeah, I mean I’m looking outside right now. It’s a beautiful day here. It’s in the mid-60s so it’s getting chilly but the sky is so blue. I mean, I’m so grateful for that.

Dr. Justin Marchegiani:  Love it.

Evan Brand:  To not have a cloudy day.

Dr. Justin Marchegiani:  Love it. That’s awesome.

Evan Brand:  Should we talk about nutrients? You wanna go there in terms of like estrogen metabolism support–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Stuff like that?

Dr. Justin Marchegiani:  Yeah, so let’s just kinda dive in the gut because the gut’s really important to the nutrients getting to where they have to go. Would you agree?

Evan Brand:  I, oh—yeah, 100%!

Dr. Justin Marchegiani:  Yeah, so we’ve kinda talked about it when we did our dry run round 1 on this podcast on Friday that got—didn’t quite go through on our side, so we’re even more polished for this podcast round 2. We talked about estrogen hormone conjugation, and conjugation is nothing more than putting a straightjacket on the hormone. Okay, so, you know, because we’re talking about estrogen here, estrogen begins with E so we’ll use Evan as our form of estrogen in this analogy.

Evan Brand:  Here we go.

Dr. Justin Marchegiani:  Alright? So E for Evan, E for estrogen. I’m putting a straightjacket on Evan so I can escort him out of let’s say the—the rowdy club, right? He’s—he’s going crazy. He’s fist-pumping. We’re gonna put a straightjacket on him, escort him out of the club. That’s kinda like what our body does to estrogen. It’s done its thing. It’s going. It’s getting shot back out the gallbladder into the gut to get metabolized. We bind these proteins to it. It’s called conjugation or in this analogy, straightjackets on Evan so we can escort it out. The problem is back gut bacteria imbalances meaning more bad bacteria in relationship to good bacteria in your gut—this is called dysbiosis—this upregulates specific enzymes known as β-glucuronidase. You know it’s an enzyme because it ends on the word –ase. This enzyme basically comes over and takes the straightjacket off. So imagine Evan being escorted out of the bar, right? The club. He’s being rowdy. Someone clips open the straightjacket and now he’s loose and he’s—he’s running away from the bouncer or the police. That’s what happens. Estrogen gets unconjugated or deconjugated. Boom! It can go right back into circulation and cause tissue to grow, whether its endometriosis or cause fibroids to occur, or create hormonal imbalances and symptoms and mood swings, and affects your mood and—and cause you to gain weight. All these different things can happen when we have gut bacteria imbalances. So that’s kind of the—the estrogen-gut detox mechanism. And then we also have the fact that if we have malabsorption because we have too much gut bacteria imbalance, more bad than good. We have low stomach acid and low enzyme levels, well, we’re not gonna be able to break down a lot of the nutrients we need to be able to metabolize hormones, whether it’s B6 or zinc and magnesium or various B vitamins that, you know, help with phase 1 and phase 2 detoxification, sulfur-based amino acids. All these things have to be broken down into their constituents so they can be absorbed and get into circulation and also we need to ionize various minerals, like magnesium and zinc. These are really important minerals. We have ionize them. That basically allows these minerals to get soluble. It’s solubilized into the bloodstream so it can do its thing and be utilized.

Evan Brand:  Yeah, so I mean we could add another layer on top of that. Parasites, yeast, we know–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  With Doctor–

Dr. Justin Marchegiani:  All these things affect that.

Evan Brand:  Dr. Jonathan Wright’s book, Why Stomach Acid is Good For You. We know that any woman listening over age 30, you have lower levels of hydrochloric acid and enzymes than you did when you were 20. So it’s not to—you don’t have to guess and—and check and think, “Oh, do I low enzymes?” I guarantee it. I would suggest and you tell me if—if you suggest different, but I generally suggest anyone over age 30 especially people that busy or eating in a rush or scrolling–

Dr. Justin Marchegiani:  Big time.

Evan Brand:  Scrolling on their phone while they’re eating which is a big no-no, you gotta have enzymes.

Dr. Justin Marchegiani:  100%.

Evan Brand:  Supplemental enzymes that is.

Dr. Justin Marchegiani:  Yeah, I mean enzymes and/or hydrochloric acid because hydrochloric acid actually activates enzymes.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Hydrochloric acid activates pepsinogen to pepsin in the stomach and also provides the PA stimulation for the pancreas to produce trypsin, chymotrypsin, lipase, a whole bunch of other proteolytic enzymes that are really important. So without HCl and/or enzymes, you’re gonna be in a world of hurt when it comes to digestion. And most women don’t get this, men as well, but they don’t understand the fact that you can have digestive problems and may not actually have digestive symptoms. People think, “Well, hey I don’t have diarrhea or constipation or bloating, I’m not too gassy, I don’t burp too much, I don’t have any acid reflux, and I got to the bathroom every day. Hey, I don’t have a problem.” Right? But a lot of times, their moodiness, their PMS, they migraines, their other issues in their body–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Can be driven by the inflammation going in their gut because they’re not—they don’t or they’re not expressing with atypical—I’m sorry, they’re not expressing with typical gas symptoms, bloating, gas, constipation, diarrhea. They’re expressing with atypical, outside of the norm symptoms that just are really hard to be connected and their medical doctor they go to won’t ever recognize it because they are great, they’re depressed—could be a hormonal issue, could be a gut issue, but guess what? They’re gonna be put on Wellbutrin–

Evan Brand:  Lexapro.

Dr. Justin Marchegiani:  Lexapro, Paxil. Hey, you know they’re feeling, you know, a little bit anxious. Great, they’re gonna get thrown on Xanax.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Hey, you know, they’re feeling like their cycle’s a little unstable, they’re getting thrown on a birth control pill. It could totally be from–

Evan Brand:  That’s horrible.

Dr. Justin Marchegiani:  All the other dysbiosis and the poor detox happening in their gut.

Evan Brand:  It’s horrible, man. It’s horrible. I had a female last week, she asked me—we found Giardia and Blasto—the double, double trouble there.

Dr. Justin Marchegiani:  Double trouble.

Evan Brand:  And she said, “Well, I don’t have any gut symptoms. Do we still have to treat it?” I said, “100%, you can—just because you’re, you know, not running to the bathroom with diarrhea, the typical manifestation of Giardia, it doesn’t mean we can just let it stay there.” Could you—maybe you would have a—a more, a better answer than me. I just said, “Absolutely.” But I know there could be more to that. You can be as long-winded as possible with this.

Dr. Justin Marchegiani:  Well, I tell people that everyone has the right to be infection-free, right? That’s my goal. To make sure everyone’s infection-free. Now the problem is everyone also has the right to have more than one issue going on at once. So a lot of patients, they have hormonal imbalances, but they also have other issues that are driving the hormonal imbalances that don’t necessarily from bird’s eye view connect, i.e., the Blasto and Giardia and this girl’s female hormone or mood symptoms. So–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah, so anytime there’s a stressor, that’s an issue. It’s like you walk into your house. Okay, let’s say you have a couple of guest bedrooms. Let’s say you don’t go in those guest bedrooms for a while. The guest that was in there last left the water running just a bit. You don’t know it. You don’t hear it. But you get this water bill every month and it’s just a little bit higher than you’re used to and you’re like, “Why the heck is my water bill 30% higher? I’m barely even using it. I’m gone half the month. What’s going on?” And then you look over and you’re like, “Oh, the water in my guest bedroom’s on. That’s what it is. I’m gonna turn it off.” Now what’s this equal? Having water in your guest bedroom on is like having a parasite or a bug stealing your nutrition, pooping inside of you, i.e., creating biotoxins, creating inflammation and maybe even creating leaky gut which is stressing your immune system which takes up energy. All of those stressors like that parasite or infections involved in, toxins, malabsorption, leaky gut, immune activation, that’s nothing more than draining your energy. So instead of your energy being allocated to performance and recovery and healing, right? It’s going towards something else. Just like your water bill’s being sucked towards these guest bedrooms that you don’t even—you’re not even aware of them because you’re not there on a day-to-day basis.

Evan Brand:  Now so from the nervous system perspective, couldn’t we say that you’re gonna be sympathetic dominant, more fight or flight?

Dr. Justin Marchegiani:  More, 100%. Yeah.

Evan Brand:  Because you’re fighting an internal battle.

Dr. Justin Marchegiani:  Bingo! And the problem, the sympathetic nervous system, the allocation because we’re hardwired this way and it totally makes sense is when the fight or flight, the sympathetic, that’s like the gas, go, go, go, go, go. That’s the gas, the sympathetic fight or flight nervous system shuns blood flow towards the muscles, towards the outer extremities because we have to fight and flee and we need oxygen and nutrition and glucose to get to those outer extremities so we can perform. If the blood glucose is inside the intestines and inside all the organs where they should be and they’re digesting, you will not be able to run as fast. That’s the main reason why activity after your meal is destructive for your digestion, you get an upset stomach. Remember the old analogy of like, “Hey, you shouldn’t go swim. You should wait, what, 2 hours or an hour after you eat to go swimming.” Why is that? It’s because at some point, someone did that and they got a cramp because there wasn’t enough blood flow or they got an upset stomach and got sick.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So–

Evan Brand:  Because you’re trying to rest and digest and be active at the same time. You can’t do it.

Dr. Justin Marchegiani:  Yeah, and the analogy is this, right? If the sympathetic fight or flight nervous system is your foot in the gas, and if the digestive system and relaxation and repair is the brake pedal, what happens when you hit the gas pedal and brake pedal at the same time?

Evan Brand:  Yeah, it’s not a good—not a good—not a good picture.

Dr. Justin Marchegiani:  No, no, exactly.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  You’re—you’re spending a lot of time going nowhere fast.

Evan Brand:  Yup, so to wrap this whole segment up of—of this part of the—the conversation. If you’re someone listening, especially female, or you and I are working together, you’re working with Justin already, and you tell us, “Yeah, but my life’s not that stressful. I’m not that stressed.” It doesn’t matter because all of this hormonal imbalance and these symptoms that you have could all be going on due to something in your gut. And Justin, you and I both are—we’ve seen false negatives on stool test results. So sometimes it may take one or two or three times to really find what’s going on. So if you’ve gone to your conventional doctor or even the gastroenterologist, the specialist you’re gonna get referred to that’s gonna throw you on prescription acid blockers, if they run tests on you and how up negative, don’t necessarily take their word for it. I hate to say this that these prestigious hospitals and et cetera are missing infections but you and I see it every single day in the clinic and we’re finding these infections. So if you actually get something on a piece of paper, you’re gonna have a lot more room to work with. So don’t just go buy hormone balancing or hormone this or hormone that supplement. You really need to get to the root of the root which in some cases could be the infection route.

Dr. Justin Marchegiani:  Oh, 100%. And again, really looking at everything holistically is really exactly how you have to do it because of the interplay with body systems that may not typically connect to the average person because you know, they’re not a trained functional medicine clinician and definitely will not connect with the average conventional medical doctor because they’re training is drug symptom, drug symptom, drug symptom, and they don’t look at upstream stressors and body systems that may be out of balance.

Evan Brand:  Sure, so I’ll put it even more—even more direct. If you’re going to your OB-GYN or your endocrinologist, they’re not gonna have a clue about you having a cryptosporidium infection in your gut and giving you an herbal protocol to remove that infection so that your hormones come back into balance.

Dr. Justin Marchegiani:  100%.

Evan Brand:  It’s never gonna happen. I mean, I will—I will bet you know every silver bar that exists on the planet that—that you’re not gonna get it. If you do, then that doctor, they—they’ve stepped up their game and they’ve done some functional, you know, they’ve taken some functional courses.

Dr. Justin Marchegiani:  And sometimes it’s good like get that workup done. You know, just you know, go with the low-hanging fruit. I find most of the time patients come to see me and that’s already been done–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And it’s already been missed but hey, always start with what’s the easiest and you know, what I consider to be the low-hanging fruits, that way you know you’ve crossed your T’s and dotted your I’s so to speak and then you can go up the chain regarding the—the functional medicine, you know, ladder so to speak.

Evan Brand:  Sure, and I guess we could briefly talk about, you know, the financial aspect of it, too. If someone does have health insurance or they’re able to go see a doctor through their work and it’s at no charge to them, then you might as well try to milk that for as much as you possibly can, but unfortunately in most cases the lab results that get sent over to you and I that we review, there’s not much evidence there. We can’t really work with that. We really have to do the more functional tests which are an investment but sometimes that’s what it takes.

Dr. Justin Marchegiani:  100%. So looking at this point here. If everyone listening or anyone listening is dealing with a—a hormonal imbalance, whether it’s men and just having low libido and—and poor muscle tone or women having PMS or menopausal symptoms or everything in between that we already mentioned, the whole litany of—of different items there, the next step is gonna be one, digging into the female hormones, right? Testing hormones at the right time of your cycle. We test female hormones typically around Day 20 or so if we’re looking at progesterone to estrogen. Some we even run a month-long cycle to see how the hormones fluctuate every other day. And some will even dig deeper into looking at thyroid as well as a full gut panel. So depending on where you’re at, if you’re having issues and you’ve already kind of ruled out the things we’ve already talked about on the diet and lifestyle, the next step would be to step it up regarding the functional medicine’s options that are available and kind of our—our palette if you will.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So the next step would be to reach out to either myself, to Evan, notjustpaleo, Dr. J myself, justinhealth.com or some other competent trained functional medicine doctor or practitioner to get everything kinda lined up in order based on what we talked about in the podcast today.

Evan Brand:  You hit on the—the last word that I wanted to say is the order.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  You know, something that is very important for anything, you know. If this is just adrenal problems or just hormone problems or just gut problems, whatever it is, it has to be done in the right order. Please, please, please don’t add to your supplement graveyard because you read about some product on Amazon or you saw it at the health food store and it was in the hormone section. Save your money because if you’re doing things in the wrong order, you’re really just wasting your money. Now I’m not gonna say that taking a zinc supplement is necessarily gonna make you worse because we know that–

Dr. Justin Marchegiani:  No.

Evan Brand:  70% of women or more are not getting enough zinc, so yeah it’s not going to hurt you. It might help you but why go and spend all this money if it’s not done in the right order because you’re gonna save so much more money in the long run if you do things in the right order by working with a practitioner.

Dr. Justin Marchegiani:  Well, it’s like baking a cake, right? Let’s just pretend it’s a gluten-free flourless cake for our—for our healthy analogy, right? You have the eggs. You have the—the coconut flour or you have maybe some Stevia in there, whatever else, maybe some grass-fed butter or coconut oil. Well, how we mix things in baking a cake is really important to the outcome of the product, of the outcome of the cake.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So let’s say you—you do start doing a heavy metal cleanse first, gut-killing second. You work on the diet 3 months into it and then you don’t touch the hormones and the thyroid til month 4. Well, you did a lot of things that were supposed to be done but they were just all done in the wrong order. Just like making a cake, you cook it before you mix the eggs and then you add the—the Stevia at the end or whatever. It doesn’t come out to be a nice-looking cake.

Evan Brand:  Yup, yup, Well-said.

Dr. Justin Marchegiani:  Anything else you wanna add, Evan?

Evan Brand:  I don’t think so. I think this is—this has been good coverage. Share this, if you have somebody who’s going through all this stuff. I mean, I could think of 20 people right off the top of my head who I know have problems with estrogen metabolism or estrogen dominance. So sharing is caring. This is the information that has to get out there. We’re gonna continue doing our work, we’ve got, you know, between Justin and I both, we’re over—likely over 6 million. I haven’t counted. I know for sure, 100% guaranteed over 5 million downloads of conversations that we’re having, probably up to 6 million by the 4-year anniversary of my show which is coming up really darn quick. I think it’s November 11th of 2012–

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Would be the 4-year anniversary. So that’s—that’s a lot of people but that’s still not enough. That—I mean look at the suffering out there. Look at the people that are going and they’re spinning their wheels and they’re buying these diet programs and they’re buying these fitness books and they’re not getting the answers and they’re beating their heads against the walls, and they’re buying you know, diet root beers and look at Pepsi. I mean they had to bring back their aspartame version of their Diet Pepsi because so many people complained about the taste, you know? So don’t prioritize the taste. You know, prioritize the—the quality of your—of your liquids, the quality of your nutrition. Prioritize that better over taste and if you ask me, I think aspartame tastes horrible and it’s a neurotoxin, not to mention. So always look at something through the lens of the quality, not necessarily the taste or the cost or—or all of that, because you’re really gonna save yourself a lot of trouble if you start turning around the boat now as opposed to waiting til when you hit rock bottom and then you’re coming to Justin or myself and then you’re saying, “Look, I’ve had this stuff going on for 20 years.” Well, how long have you known something was wrong? “Well, I knew I should have gotten help you know, back in 2003, but I didn’t.”

Dr. Justin Marchegiani:  Right.

Evan Brand:  You know, don’t be—don’t be one of those people. Thousands of people have come to our clinics. It’s your turn. If you’re suffering, stop suffering. You don’t need to.

Dr. Justin Marchegiani:  Bingo. Love it, Evan. Well, feel free and reach out to Evan at notjustpaleo.com, Dr. J myself, justinhealth.com or beyondwellnessradio.com. Subscribe to the podcast and the YouTube channel and we look forward to providing more information very soon.

Evan Brand:  Check out Justin’s videos. He’s over 20,000 subscribers on YouTube. He’s gonna be—I’m telling him, he’s gonna be the King of Functional Medicine on YouTube.

Dr. Justin Marchegiani:  Just able to help more people. I love it.

Evan Brand:  Yes, sir. Take care!

Dr. Justin Marchegiani:  Have a good day, Evan.

Evan Brand:  Bye!

Dr. Justin Marchegiani:  Bye!

 


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