Austin Texas Functional Medicine and Nutrition

Recommended Products:

Xlear Rescue Nasal Spray with Xylitol

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Audio Podcast:

https://justinhealth.libsyn.com/recovering-from-the-holidays-cheat-meals-podcast-362

The Top 7 Causes of Why You Are Bloated | Podcast #344

Stomach bloating happens when the GI tract is full of air or gas. Most people describe bloating as feeling full, tight, or swollen in the abdomen. Your abdomen may also swell (distended), be firm, and have pain. Bloating is often accompanied by pain, flatulence, constant burping, and abdominal rumbling.

In this video, however, Dr. J and Evan talk about the other causes of bloating that may be due to medical conditions. These include irritable bowel syndrome and disease, bacterial overgrowth, altered gut motility, aging and stress, and many more.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:41: Bugs and gut infections

2:58: Low Enzymes, acids, and bile salts

3:45: Aging and stress

5:29: Adrenal stress and food allergens

8:43: Mold toxins

10:29: Low thyroid hormones

12:55: Gut autoimmune disease

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

Evan Brand: I’m doing well. We’re ready to talk about like, the mainstream topic. Like, sometimes, you and I, and we go into some of these nuances, that unless you’re into functional medicine or natural medicine, you may just be like, what the heck are you talking about? But every single human being, man, woman, baby, they can already relate to bloating. So, let’s dive in. You came up with the magic number of seven. So we’re going to riff on who knows, could be 7 or 17 different causes that we see clinically from bloating. Let me start off with number one. Gut infections which if open that can of worms, we can do five to twenty infections, and then get to that magic seven number right away. But I’m just gonna go ahead and say…

Dr. Justin Marchegiani: 100 percent.

Evan Brand: Bacteria and Candida-those are probably like, two of my biggest smoking guns. I, I know parasites cause a lot of gut damage but I’ll say personally, when I had parasite infections, I don’t think I had much bloating. I think it was more of my dysbiosis, my candida problem driving the bloating than the parasites.

Dr. Justin Marchegiani: You know, when people have parasites, there’s a lot of issues happening so it’s really hard to know like, is the parasites alone the root cause why you’re having these issues. And it’s hard to know that. I mean, parasites can definitely do it because they can affect you body’s ability to generate stomach acid, and enzymes, the bile support. Obviously, they can eat a lot of these foods and they can be fermenting, and creating gases being released from them, you know, they’re pooping in their, you know, um, farting inside your intestines and creating gases and things, and obviously, they’re creating information which then can affect digestion so parasites, we can just kind of lump bugs all the same bucket if you will. So we could say bugs, parasites, H.Pylori, fungal overgrowth-we can say small intestinal, bacterial overgrowth, or SIBO, or candida overgrowth, or fungal overgrowth. All those things kind of go in the bucket worms kind of goes in that parasite bucket as well. Anything else you want to highlight there before we go number two?

Evan Brand: Yeah, how about, uh, you can call it SIFO too. We haven’t hit that term but, just, just in case people aren’t clear on it so when we talk about fungal overgrowth. You can literally have what’s called SIFO. So this means you can have SIBO but, you can also have SIFO, and as you mentioned, it’s rare to see these things in isolation. So we’re often going to be using broad spectrum herbs, or antimicrobials, anti-fungals, antiparasitics all at once to try to knock all these down.

Dr. Justin Marchegiani: 100 percent. So regarding, um, bugs, SIBO, SIFO, and fungal overgrowth, or candida that are kind of all in the same bucket there. Uh, I would also say, diff kind of isn’t that bucket too, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Um, you know. You can almost put some of the mold, um, the colonized mold, uh, fungal critters in there as well. Some of the aspergillus and things like that potentially, they may have different root cause of why they’re there but, that’s something that should be looked at. Next thing, is um, low enzymes, low acid, low bile salts. And again, some of these things are caught like they’re connected. So like yeah, HCL, enzymes, low bile salts if we are, aren’t able to break down those foods adequately, they can ferment, they can acidify, they can create gases; and of course, those bugs on step on can also create low stomach acid, low enzyme and bile salts. So everything is kind of connected in this web here. So I would say, the digestive secretions I think would be there. I’d also throw in, maybe some lifestyle things like not chewing your food enough, and maybe drinking too much water which shifts the pH in the stomach from a two-ish to closer to a seven which water is, and those would be the things I want to highlight. What do you think?

Evan Brand: Yeah, good call. And I’ll also point out just age and stress, not chewing some of this lifestyle measures you mentioned. That could be enough to create the bloating. As we know, the infections are going to drive some of this too. So kind of like, chicken or the egg, and it is possible that just age alone by the time you’re 40, 50, 60 beyond, you’re going to be making less stomach acid and Dr. Wright’s book. He had an amazing graph in their age and stomach acid levels. So if you’re one of the lucky few that are 40, 50, 60 with no gut infections, you simply just have an aged-induced low stomach acid. Well, that’s cool but, the low stomach acid will eventually drive some sort of infection, right? Now you’ve got this fermentation and purification of the food. So even if you’re like, somehow magically clear on stool or urine, and you just have low stomach acid, it won’t be that way forever. Eventually, stuff will pop up.

Dr. Justin Marchegiani: 110 percent. Now, everything’s connected right? So of course, if we have fungal overgrowth and bacterial overgrowth, well that can affect stomach acid but, now that also can affect motility, and so if we have slower motility, right? On the faster motility side, like diarrhea and such. You know, that can really cause a little bit of bloating but tends to be more on the slower stool side because, the stool is just sitting in your intestines longer, and maybe getting compacted. Maybe it’s taking you two to three days to kind of move that stool out. That may give you a sense that you’re feeling more bloated more as well. So I would say now that the slower motility, potentially caused by the bugs, caused by the HCL, could now start to increase that feeling of bloat.

Evan Brand: Yeah. So you’re saying like, you’re literally just full of poop as opposed to the infections or releasing gases which make you feel full but that’s a different type of bloat. So that’s a good, that’s kind of a good distinction there.

Dr. Justin Marchegiani: Yeah. It could just be a combination of everything, you got a little food baby inside of you, you know.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s possible. Next, I would say adrenal stress. And so adrenal stress, the adrenals are part of the stress handling system that helps your body manage stress. Whether it’s through making adrenaline to help your body like, get the spider senses going so you can deal with that stress, uh, it could be just chronic low-grade stress where you’re making a lot of cortisol, and or you’re chronically inflamed from foods and emotional, and maybe even physical stressors, where the adrenals are just really over romped up and that’s activating the sympathetic nervous system, and so you have that see-saw, right? And sympathetic is the fight-or-flight, that’s the go-go-go, that’s the gas pedal. The break is the parasympathetic, they’re on a see-saw. So it’s hard to like, double clutch you know, and have a hit the gas and the break at the same time, so usually the sympathetics are up, the para are down. If the parasympathetic’s up, the sympathetics down, and the parasympathetic is to rest and digest. That’s the vagus nerve, right? People are like, “Oh! Gargles, sing”, right? Well, those maybe palliative things but, how about just fix the stress in your food, in your emotional life, in your physical life, work on that first. Uh, that’s going to make a huge difference and of course, gluten and processed sugar, and inflammatory foods, and foods that are nutritionally deficient can drive that kind of stress as well.

Evan Brand: Oh, yeah. Let me piggyback off that then. So you got the food-adrenal connection but how about just food connection in general? I mean, if you’ve got dairy in the system, you’ve got gluten in the system, you’re going to effect the tight junctions in the gut, so you’re going to maybe contribute to leaky gut but, also you may have some bloating from that. Now, there are enzymes, I know you and I, we manufacture some custom enzymes that things that can contain, what’s called dpp4, which is an enzyme that can help break down gluten. There’s also some allergy enzyme type formulas that we use where we can break down the occasional instance of all these types of proteins, dairy protein, and soy protein if people are getting exposed to it but, food allergies are big one, so I know you and I talk a lot about good quality meats, good quality fats, organic vegies and such but, if you haven’t got your diet boring before, I think I would go boring. I mean, look at me, I’ll do like a grass fed steak and a handful of blueberries for breakfast and I feel great. So, for me I would just recommend really, simplifying, trying to get your foods in isolation where you know, what you’re reacting to. For example, let me use my wife as a story. So, we were doing swapples which are awesome! It’s like a healthy waffle-it’s yuca, yuca-based, and she thought those were affecting her stomach but, she was also doing organic coffee, and she was doing eggs, and she was doing pastured sausage or bacon. I’m like okay, well, you got too many foods in here. We don’t know what it is. So we got down to elimination and then boom! We figured out it was the coffee affecting the gut. It wasn’t the food after all. Even the eggs which are common trigger were no problems. So I think you got to dial the food allergies, the food sensitivities, and just try to eat you food in isolation. Maybe do a food journal. Even on your phone, you could do an app, like I use Day Book a lot to take notes and you can just make a note like, :Hey! Eggs hurt my tummy today, or eggs got me bloated”, and then you can figure out what it is.

Dr. Justin Marchegiani: Absolutely! So the food component, just the inflammatory nature of that food. I think is also going to be a big one. Um, like you mentioned, I would say next, mold toxins. I know mold, uh, can do different things, whether it’s, you know, we kind of talked about it as kind of being a bug thing, which I guess it could be connected but, the problem is you may live in a moldy home. You may have things in your environment, whether maybe it’s too humid, right? And there may be a different solution for that than fixing out your bugs, clearing out the bugs in your tummy, so we may have to go about that a different way. So I guess, the mold kind of connects with the bugs but, there’s also a different solution to it. So we’ll put mold as a separate entity on that list, and that could be just too humid of a home. It could a leak in the home that was never fully remediated properly, um, it could be lack of good quality air filtration. All of those things could play out and of course, mold also is a sympathetic nervous system stressors as well.

Evan Brand: Definitely and they’re two different categories because, you can have two different situations you can be colonized for mold, meaning you’re growing in your gut and sinuses. Or you could just be a mycotoxin reservoir and some people are lucky enough to where maybe, their immune system was able to not allow the colonization or maybe the exposure of the mold was not too long-term, therefore, they’re just reservoir of mycotoxins but they’re not growing it. That’s a better situation. It makes out job easier if that is a situation, and yeah for sure, I mean, mycotoxins for me definitely affected my gut, my brain, my stool, consistency, so binders really help. So if you are having bloating but you’re having more IBS type symptoms, you know, of course bringing in the binders; we’ve done podcast on that is going to be the next step. Let’s go back to hormones per minute because yeah, I would consider you one of the best experts in hormones, and you’ve taught me over the years about hormones, and I know that PMS for a lot of women. PMS is a big deal, not only is it mood changes but, it’s bloating. So can you full us in there? What’s the hormone connection outside of cortisol to bloating.

Dr. Justin Marchegiani: Yeah. So I would say out of the gates, um, low thyroid has a string connection with affecting motility. So one of the side effects of low-thyroid hormone. Obviously, can be the conventional hair loss, cold hands, cold feet, eyebrow thinning of the outer third, maybe mood issues, maybe irritability, and obviously some of that overlaps with adrenal and female hormones and male hormones. But low-thyroid also affects motility, and so low thyroid hormone could easily affect motility. And if we slow down motility, that could easily allow more time for those foods, the ferment kind of create that food baby if you will. Just put more bulk in your tummy just make you feel a little bit more bloated and distended so it’s very possible could be playing a role in the whole situation.

Evan Brand: Okay. Well, we talked about thyroid and 90% of hypothyroid cases are hashimoto’s, so I mean, we could just say hanshimoto’s could be a cause. It’s a roundabout way. It’s a long, it’s along route to get from hanshimoto’s to bloating but, it does make sense.

Dr. Justin Marchegiani: Yep! Exactly. Um, so yeah, at this stage of the game, female hormones can plug in. Like if you have estrogen dominance, right? Lower progesterone, higher estrogen. Um, relatively speaking and just lower hormones. That can create potential things that could affect motility via stress, via sleep, and then if those things are compounded, that can create more adrenal stress. So you can kind of like, you know, it’s kind of like, it’s six degrees of bloating, right? It may not be a direct, direct indication but, it can easily, kind of dovetail two or three you know, weighs in and hit a couple of these different factors, that makes sense. So I would say some of the female hormones, um, obviously, some of the cortisol, and adrenaline, and of course the big one that we’re hitting now is the thyroid, the low-thyroid hormone. Evan Brand: Yep! Yeah.

Dr. Justin Marchegiani: Is that number five or six?

Evan Brand: Two… I don’t know. I don’t know. I think we got, we got more of those. So how about just bowel obstruction? I mean, this is not going to be a common situation but, you know, if somebody hasn’t poop in a week, and they’re listening to this podcast, I mean, you have to consider the possibility of bowel obstruction. Unfortunately, this is pretty rare but it does happen.

Dr. Justin Marchegiani: Yep! Yep. 100 percent. Um, so that can definitely happen. An again, all these things that we’re taking about would be contributing factors of that,right? So that makes a big difference on that front. Um, so we hit the enzymes, we hit the food allergens, we hit the bugs, we hit mold,

Evan Brand: That’s five.

Dr. Justin Marchegiani: We hit adrenal stress,

Evan Brand: That’s six.

Dr. Justin Marchegiani: We hit thyroid stress. That’s seven! I think we hit them all.

Evan Brand: All right.

Dr. Justin Marchegiani: Is there anything else you want to add as a bonus or value add for the listeners?

Evan Brand: Uh, yeah. So any kind of autoimmune gut stuff. So celiac, crohn’s, ulcerative colitis. Even diverticulitis in some cases could cause any and all of these issues we talked about in terms of bloating, and stomach pain, and all of that. So if you are seeing more than just bloating, you’re seeing blood in the stool, or you’re seeing floating stool, maybe there’s fat malabsorption issue. We could go into gallbladder potential issues there as well; where we need to use some extra bile salts. So I would just say any kind autoimmune gut stuff is going to be a big one.

Dr. Justin Marchegiani: Yeah, a hundred percent. Autoimmune is gonna just create more inflammation. It’s gonna inflame the tissue to make it more raw, the more inflammation in the tissue, and the more sensitive the intestines are, the more your adrenals, and you cortisol, and your fight or flight system will totally get activated. I think it’s a really good step out of the gates here. I think we really hit a lot of good things here. So, we have food, we have low enzyme, we have low acid, we have bugs, we have mold, we have adrenal stress, right? We talked about thyroid and then the last thing we talked about is just the bowel obstruction and or the autoimmune um, gut stuff. So I think we hit seven to eight there. So a little, a little extra. So guys, if you’re listening.. go ahead.

Evan Brand: Let me, let me do the outro for you today. So today’s shorter and we want your feedback because we’ve done, I, I, lost track, I know my podcast is over 400 episodes. I know you and I have done hundreds together. So we want feedback on this. Is, is this is coming up on 15 minutes. How do you enjoy a 15 minute podcast? Is this all you need? Do you enjoy the 30-45? What do you like, because I mean, we could always go deeper but, eventually It becomes um, maybe rants or tangents. Today is just like, boom boom boom. So please, uh, go on Justin. Look up maybe his Instagram page, just in health or Justine Marchegiani. Look him up there and look up me Evan Brand and send us a message, and let us know. ‘Cause sometimes, we forget to check the reviews but yeah, send us a message maybe on Instagram. That probably the best place. We don’t use the Facebook too much because of some of the censorship going on but anyway, check us out, send us a message. Let us know what you think! Is it shorter, and sweet, and boom boom boom episode, is that good enough for you or do you want deeper dive? Let us know, and if you need help clinically, you can reach out. Justin works around the world with tons of people, thousands of people over the years, and he can run all sorts of labs to investigate these issues. So to reach out to Dr. J, justinhealth.com and for me Evan Brand, evanbrand.com. We would love to help you, we offer intro calls too. So you can book a quick call to discuss your symptoms, your goals, see if you’re a good fit, and we can help you anywhere. So the beauty of these type of symptoms, there are root causes, it’s not a deficiency of some sort of gas x or other thing you’re going to get ate walgreens, you know, there are root causes here that you can investigate and you can reverse these symptoms.

Dr. Justin Marchegiani: 100 percent. And then in regards to the solutions here, the solutions are addressing those root cause. We can go, we can do another podcast in the top six palliative kind of solutions, but out of the gates you know, fixing the bugs, fixing the stomach acid, look at what those adrenal stressors are, getting the food right. I think those would be the big kind of the root cause foundational things today. We’re not going to go too granular into extra protocols but, just kind of more big picture stuff and we’ll do another podcast in the future where we get more into the nitty-gritty in this.

Evan Brand: Sounds good.

Dr. Justin Marchegiani: Awesome! And guys, if you want to leave us a review, evanbrand.com/itunes or justinhealth.com/itunes. We’ll put the review link below. We really appreciate that review, really appreciate your comments below. You guys have an awesome day. We’ll talk soon.

Evan Brand: Take care now.

Dr. Justin Marchegiani: Bye!

References:

https://justinhealth.libsyn.com/the-top-7-causes-of-why-you-are-bloated-podcast-344

Audio Podcast:

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Thyro Replete

The Top 5 Anti-Aging Techniques to Age Gracefully | Podcast #342

Hey guys! In this video, Dr. J and Evan discuss the factors that affect the aging process. They are more straightforward—and less invasive—ways to look younger than mainstream or conventional ways. Dr. J suggests incorporating a few of these habits into your daily routine that won’t just leave you fresh-looking and it’ll boost your overall energy. Watch the video to learn how. Of all the places on your body, your gut is silently receiving different food that can cause the entire aging process. That includes standard precautions such as maintaining a well-balanced diet rich in good fats. But there are also quite a few ways that you may be aging your body without knowing it.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

3:00: Inflammation

7:21: Insulin Resistance and blood glucose

16:59: Sleep in the aging process

27:46: Fasting Techniques

30:26: Importance of movement and exercise

Dr. Justin Marchegiani: And we are Live! It’s Dr. J here in the house with Evan Brand. Today we’re gonna be chatting about natural strategies to help detoxify round ups or glyphosate. Really excited to be chatting with Evan today. Evan, how are you doing today man?

Evan Brand: Doing really well! This is a super important topic.You sea many many lawsuit around the country happen and bayer who bought monsato. They’re really trying to get out of it. I’ve seen several, I’m no law expert but I’ve seen several stories how basically they’re trying to just, throw one lump sum out there for all the cases, as there are thousand and thousand of cases coming at them, because of different cancers like non-hodgkin’s lymphoma that people are claiming that has been linked to their glyphosate exposure. Whether it was like the school grounds worker who was a famous story or other people. They’re really coming at them hard and they’re really really trying to weasel this way out of it and then I saw news just uh, last week actually, that glyphosate is actually going to be phased. I don’t know if you saw this but it said it’s going to be phased out by 2023. So I sent this new article over to Stephanie Synep who I’ve interviewed several times about glyphosate, and she goes “yeah, I saw this. They’re probably just going to come out with another slightly different molecule that’s just as toxic”. So she didn’t think it was that exciting news.

Dr. Justin Marchegiani: Interesting! Yeah, I mean, I wouldn’t be surprised. It’s kind of like a lot of the medication they have many me’s for it right. Something they can re-patent, um, almost the same molecular structure so they know it’s going to work based on the previous medication or compound but they don’t really have to do too much RND on it because, it’s so close to where it was. So yeah, I get that maybe, probably, the same toxicity profile too. So that makes sense, hopefully that’s not going to be the case but either way, we have a lot of toxins in our environment and roundup’s just one that we have a lot of other pesticides, herbicides, or genocides that are out there. Obviously, a lot of potential chemicals in the water, air, and so roundup or we can kind of put roundup of pesticides – all in the same category, I think that’s pretty fair . So you know first thing is, try to mitigate the use of them on your property, I mean, I use a little bit of pesticides in a spot treating, man. Are we trying to avoid anything blanketed or anything just, you know, blanketed across the board, and you know, we don’t really play out in the grass that much, I mean so if your kids are rolling around out in the grass definitely pay extra money and have those weeds picked up by hand. I think that’s a better way to do it but every now and then, there may be a necessity to spot treat stuff but do your best to avoid that especially if your kids are playing near glass like that, or just have a grass in your yard that you know, this is the play area this where the kids go. We put a nice little rock pit in our backyard just because we know that the rock pit’s going to be perfect right? Put some like, soft help you know, small pebbles in there, um, that are you, um, still fun to play in and they have a digger pit and all that so just try to do your best if you have kids that are young that are playing; mitigate any playing on areas that have any pesticides at all; try to mitigate the use of them, 100 percent and try to have safe, safe spaces in your yard that, you know are perfectly clean.

Evan Brand: There is an alternative to roundup. I’m trying to figure out what it was the moms across America did and article on it-I’m trying to fin it here-it was like a non-toxic weed control. I don’t care about weeds; my grass looks cool and it’s got clover. We’ve got many other different species of plants besides just grass. I mean, I think it’s a myth and it’s dumb you have all these neighborhoods where they think you got to have the grass looking perfect, and grass is just like another version of monoculture. It’s like if you go and walk through my yard, you’re going to see so many different types of plants so I just don’t care. I think people have been brainwashed by the mainstream industry. Even our neighbor we’ve seen you know just out in flip-flops, spraying the glyphosate on their weeds. It’s like who said dandelions are bad? Like, that’s the first food for bee so for me, I’d rather see the field full of dandelions. I guess it’s personal preference but I kind of like it.

Dr. Justin Marchegiani: Yeah. It just depends. You know, the biggest problem with weeds in relationship to grass as they grow like, three times the speed, so if you haven’t cut your lawn for a week your grass in this long and your weeds are this long, right? So you missed the nice homogeneous, kind of, clean lawn. I’m a big long guy, I like a nice, clean, homogeneous lawn so I’ll walk out there, you know, halfway through the week if I see any weeds popping up; it’s easy because they grow twice the speed, it’s grass, and I’ll just go and take five minutes, and I’ll just pull my hand. You know, I’m like I like a really nice pretty front lawn. So I’ll go there spend 5-10 minutes a week walking around, pulling by hand, just to mitigate the chemical usage but. First thing is, decrease the chemical usage, decrease the chemical dependency out of the gates. I guess that’s the easiest first step.

Evan Brand: So here’s one. So it’s called, there’s one called Dr. Kirchner natural grass and weed killer. I’m gonna to try to look it up, see what the ingredients. There’s another one, another competitor to it called, Green Gobler. And that’s a 20% vinegar weeding grass killer. And this thing’s got crazy high reviews of it. This Dr. Kirchner k-I-r-c-h-n-e-r natural weed killer . This is just, so it’s four percent sodium chloride, interesting. And they say this ocean water-based product is made for non-selective control of broad-leaf weeds and wheat grasses results in hours. So there you go, I mean it sounds like they’re just using like, concentrated ocean water, they’ve got thousands of five-star reviews on people, people on Amazon are posting their reviews of them in their garden after spraying this stuff and it literally kills it all. This lady said here that it’s magical and safe. So there you go!

Dr. Justin Marchegiani: So we’ll have to put some links down below. So you have what, so what are those two products? Those ones that was an apple cider vinegar-based, what else?

Evan Brand: Yeah, and then you got this other one that’s salt water, it’s literally like, four percent ocean water concentrate, and then you have another one called, Natural Armor which is a 30 percent vinegar concentrate.

Dr. Justin Marchegiani: Okay.

Evan Brand: My wife even saw one at Target recently. She saw like an organic herbicide. I had a picture of it, I don’t know if I could find it on my phone or not but, she sent me a picture the other day. She said there’s no excuse for people using glyphosate; I said I know, I know, and then she sent me that picture-let me see if I can find it.

Dr. Justin Marchegiani: Good. That’s good. I mean glyphosate, what is does is, it it basically is a chelator, it pulls away all the minerals from the soil, and so it decreases the minerals getting up into the plant which then kill it. And so, if you’re using it even worse on food you’re eating, It’s it’s way worse. Because now you’re destroying the quality of the topsoil, you’re destroying the minerals in that soil, and we know that soil requires minerals so that plant can, um, let’s just say express it you know, express it’s full nutritional potential if you will. So if we have nutritionally deficient soil, like manganese for instance, you know, vegetables are going to have less vitamin C in it, right? So we know the minerals have a major role and they and the quality of that soil, plays a major role in the kind of nutrientsthat plants will produce. So you’re gonna have less nutrition in soil where there’s a bunch of roundup that’s chelated out a lot of those minerals.

Evan Brand: Yeah. I was gonna say, let’s hit on the mechanism . So that’s definitely a big important one, and then the other one that you and I test for in the gut is, we’re seeing the glyphosates damaging the beneficial bacteria in the gut. And this is happening at even PBB – parts per billion levels. So once you kill off the beneficial bacteria in the gut, now you see the overgrowth of clostridium, and there’s a famous chart-I know you’ve seen it before and hopefully others have seen it. But you could just look it up, type in glyphosate autism chart, and you can see the correlation where glyphosate skyrockets along with autism rates, and I’ve seen many many autistic children and we test their glyphosate levels and they’re always high. So, this is not saying causation, but this is in correlation; and William Shaw, Bill Shaw-he’s a guy at great plains lab that we, that we use for these toxic chemical tests. You know, he wrote a great paper on this. He had a paper published about the mechanism . Essentially, it was like an order of operations. It was the glyphosate, as you mentioned, will cause nutrient deficiencies but then damages good bacteria. Bad bacteria like clostridium overgrowth. Now you’ve got these organic acids that go high which mess up an enzyme that breaks down dopamine, now you’ve got excessive dopamine, now you’ve got brain toxicity and the you damage the mitochondria. So it’s a long, a long route there but, this is directly damaging mitochondria which is certainly linked to chronic fatigue and other issues so, when we’re looking at someone’s picture of health, and we see they’ve got a major overload of pesticides, and they’re fatigued, we’re not gonna say, “Hey! This is you number one smoking gun of fatigue” but, it’s certainly a big peace of the puzzle; and I can tell you personally but also clinically when we use nutrients which we’ll get into to detox these pesticides-we see that energy levels go up; and you mentioned exposure, so also, you got to consider where you live too. So even if you’re having Joe Bob next door spray, that might not be as big of a deal as more agricultural areas which is you know, partially where I am which I don’t like. There’s a corn and soybean around here. This is just part of the country where I, where this happens and there’s papers on even one mile of pesticide drift. So the question is…

Dr. Justin Marchegiani: Far more worried about you because, just the load, you know, if you look at the, just the load coming through.

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: Uh, and your area is just got to be, you know, orders of magnitude. 10, 100x more than just a general uh, you know, residential person that’s just trying to knock down weeds a little bit.

Evan Brand: Totally. Which, which we’re aware of. We’re working on it and we’ve got, we’ve got an exit, so we’re working on it but, yeah. Luckily, we’ve been doing a lot of things. Are you ready to talk about some of the solutions? Obviously, avoidance, external exposure, trying to stay away from it, watching out for like, playgrounds. You know, a lot of playgrounds, they’re too lazy to pull the weeds so they’re just going to spray it so you’ll see often signs at playgrounds like, “watch out!”, and you can tell that they’ve sprayed on the mulch where the kids are playing, and then you may say, “Well, oh! We’ll just go to a rubber playground”, where you have all those chopped up tires but, those are really toxic too. We mentioned those rubber chemicals on the chemical profile for children too. I had a child, a young child actually, was a client who was diagnosed with a rare type of cancer, and we looked at the levels of 1-3 butadiene and maybe some other chemicals; and these are all from synthetic rubber, and this kid was like a stup, a superstar soccer player. He was playing indoors, like 24/7. This kid was these fake rubber mats and his levels were like a hundred x higher than 95th percentile and that was a known carcinogen so we can’t say the rubber caused it but, man, it was certainly a big smoking gun in this case.

Dr. Justin Marchegiani: What’s the chemical name?

Evan Brand: It’s so, it’s 1-3 butadiene. It’s on the great plains chemical report. It just says using the production. Yeah, just as used in the production of synthetic rubber.

Dr. Justin Marchegiani: Yeah. So it’s definitely possible, right? So, I mean, out of the gates, the first thing is, we look at our food. Right? First this is make sure you food’s organic because you’re going to have major exposure if you’re taking things in, internally. Right? Things on the outside of the world like yeah, if you’re touching it, right? That’s going to be a problem so one try not to use it at your property or if you do you know, like you know, we try to use it more like glyphosate but kind of more natural version in the front yard spot treated. But in the backyard or in the play any area where we know that kids actually play. Like that’s just going to be off-limits. We try to make sure it’s super clean and good there; and then number two is um, you know, air is going to move all this stuff around. So even if you know you yard’s clean, your neighbors may not be clean. So you got to make sure air filtration in your home is dialed in so you can mitigate it potentially being in the home and breathing it in constantly. So air filters in the home, water filer because there’s also the worry about it getting off into the water table, and if we have a well or anything else, very concerning so you want to make sure good quality water filtration and then like I mentioned earlier-organic food and try to mitigate it’s usage around your property, or try to choose natural sources.

Evan Brand: Yeah. I’m glad you mentioned the water too because that’s important. Believe it or not, even glyphosate’s being found in rain water which is crazy. It’s literally raining down glyohosate because it’s evaporating from various farms and agricultural than it’s moving through the wind currents and then getting rained down on people, and you may say, “Oh well, that’s got to be such a trace amount it doesn’t matter. Well that’s the thing, we’re finding that these, these compounds are active against the beneficial bacteria in your gut at these per billion levels. So you really can’t brush it off. People will try to brush it off but, it’s the small levels, and it’s the synergistic effects, right? So you’ve got a little bot of that and then you’ve got it from your diet. Plus you’ve got it from your water supply, plus you’re getting rained on in your organic garden. This adds up overtime and you and I see bacterial overgrowth everyday, all day; and we know that this is certainly linked to the disruption of the gut-these chemicals. So it’s too important to ignore the air filters is a tough one. I asked Stephanie Synep about that I said, “Hey! What is the actual size of glyphosate? I can’t find it. I’m trying to figure out because you’ll see air purifiers talk about a one micron or a three micron filtration, and she said “Oh, no. There’s no way you’ll be able to filter it. It’s too small so that’s what she said bit, I can’t find anything about the size of it. I’ve asked a couple of companies about is and they say, “Oh, yeah. NO problem. Our air filter will take care of it”, and another company said, “Oh, yeah. Our air filter should destroy the molecule” but, I don’t know how you would yest that. You’d have to like, I don’t know; Have somebody spray a bottle of glyphosate into a room and then run the purifier and see what happens but, it’s removed so many other things that it’s a non-negotiable us, and I know you do the same like, air purifier…

Dr. Justin Marchegiani: Yeah. It’s moving a lot. I mean, you know, we like the Austin Air just because they have the 30 pounds of activated charcoal and zeolite, and those binders, you know, would have a positive effects, binding up these things and so it’s definitely going to decrease the load for sure. If it’s blowing through a hepa filter and also through the 30 pounds of zeolite and activated charcoal. It’s going to have mitigating effects. It’s going to be better off, you know, on when it’s out than, than before, right? So I think it’s still a good thing to have to what degree, um, I don’t know but, in general, it’s good to have, of course the water is a big one. So I try to have all my water that I drink personally-reverse osmosis, so we have a whole house filter that’s carbon-based that filter a lot, and then I have a under the counter filter where I drink my water, and like you know, make smoothies from, or make my coffee from, or use for cooking like that’s all RO. And so we have a little mineral support supplement that will add minerals back in. Because the biggest problem with RO water is the depletion of minerals but, um, I’d rather always have the water cleaner and then add minerals back. It’s always easier to add minerals back than take toxins out.

Evan Brand: Right. Yeah.

Dr. Justin Marchegiani: Always easier.

Evan Brand: For sure, for sure. I mean, yeah…

Dr. Justin Marchegiani: So like, Oh my God! The minerals In the water. There’s no minerals. Like yeah, but there’s no toxins are way less, so now I’m okay with way less toxins and just being able to add a good trace mineral support back into the water.

Evan Brand: Yep! Yeah, and people…

Dr. Justin Marchegiani: And you can do like, a redmond. You can do like a redmon’s real salt, you could trace mineral support with some extra potassium and magnesium-all that’s fine.

Evan Brand: I’ll do some of the sea water too. Like some of the sea water like, quinton and there’s a couple other professional brands we use of sea water, that stuff. I tell you, I was kind of skeptical. I’m like how is adding like, basically salt water going to help me bit, it sure did. I mean, it definitely is like a thirst quencher. So it’s pretty remarkable the difference.

Dr. Justin Marchegiani: Well, yourself, your cells need uh, they run on a sodium-potassium pump. There’s this gradient of minerals on wither side of the cell. I think it’s what sodium, sodium is on the outside, potassium’s in. It does a little switcheroo. Sodium goes in, potassium goes out, and you need that gradient to happen for the cells to communicate properly. So it you’re low in sodium or potassium, that sodium potassium pump is not going to work optimally.

Evan Brand: you can feel it. I’m telling you. It’s, it’s significant. All right. Let’s hit on some of like, the detox strategies if you’re ready. I think the easy one…

Dr. Justin Marchegiani: So the first thing is all the lifestyle stuff. That’s foundationthat we stack up. So easiest thing out of the gate is going to be glutathione. So glutathione, whether it’s s acetyl, lyposomal, reduce, whether we do, whether we’re making it with all the precursors like, NAC, ALA, glycine, collagen, right? All these things are going to be really important to help make your master antioxidant out of the gates-that’s probably the big one first.

Evan Brand: Yeah, glycine’s huge, and there’s actually some papers just on glycine by itself in isolation helping with glyphosate which is awesome. So I actually take glycine before bed. It really helps sleep too. So that’s another cool benefit but…

Dr. Justin Marchegiani: Yeah, you can mix collagen, peptides, like I use my TrueCollagen with a little bit of magnesium powder before bed. That knocks it right out and glycine’s helpful with other toxins like strippers like xylene and things like that. It will, it will detoxify xylene-thses kind of chemicals too. So glycine is excellent, and then of course um, you know, roundup’s very destructive on the gut and so if you’re doing glycine, it’s very helpful to kind of heal the enterocytes and repair those too.

Evan Brand: Yeah. I would say probiotics are somewhere on the list now. I don’t know in terms of priority and the mechanism is the same as it is for mycotoxins. There’s some cool research coming out about probiotics actually being able to convert toxins into less toxic forms, and then that makes them more water-soluble, and able to excreted from the body. So there’s some cool mechanism involved with probiotics and of course, if you’re working with a practitioner like us, we’re going to coach you through when and how, and what we’re going to use. But that another cool piece of the puzzle. I’d say my next one is going to be micronized chlorella. There’s a couple professional that we use of it, and this is better than the broken cell wall chlorella because, it’s smaller molecules, and then that’s going to allow better transfer across the blood-brain barrier to get some of these heavy metals out. So we’ll actually use some products that are basically designed for heavy metals but, we’ll use them off-label for like mold and chemical detox.

Dr. Justin Marchegiani: Yeah, and so like I have a heavy meal clear product that has some of the, some of the chlorella in there. It also has some of the sodium alginate, and then also some of the modified citrus pectin. These are really good binders that will help with metals and they’ll also help with uh, pesticides too which are great, and then, um, some of the research you’re talking about probiotics actually converting some of the mole toxins and also, they also have an effect binding them too. It’s that what you’re saying too?

Evan Brand: Yeah. I know it’s a conversion. I don’t know if it’s actually binding but, there’s a lot of like great planes they’re doing a lot of work on like promoting the idea of probiotics being like the universal mold detoxifier now – even better higher rated that charcoal for example, which is crazy .

Dr. Justin Marchegiani: That’s why we always talk about dealing with the gut and working on the gut before we push any crazy detox because we know, the gut’s so important. It’s like a lot of these functional medicine principles are like you know, they’ve tried and true but, if you look at the science, like you find more little nitty-gritty within the science of what’s happening, why that is the case like we just kind of know clinically, you get better results doing it so we kind of go that way, and then we just see more data kind of just supporting that hypothesis.

Evan Brand: It’s cool. Yeah, it’s fun because you and I have been basically using the methods we use for years, and then new stuff comes out that’s like, “Oh, cool!” Well, we were doing that already; now we know that it was actually doing other things that we needed it to do for. It’s like get rid of toxins. So that’s, so that’s awesome. How about sauna too? I mean, sweating has been proven to help excrete so many things. I’ll tell you, you know, I had a lady that was in her 70s. We ran a chemical profile test on her. This lady’s test was so clean, I was almost in disbelief because I’ve seen 5, 6 year-old children that are just off the charts with chemicals, and then we have this lady in her 70’s who you think just lived through all sort of different eras of toxicity. Man, I tell you, her chemical tests were as clean as a whistle. I said, “What are you doing?’, and she was in a sauna three to four times a week for half an hour. I said “Wow!”, I said, ”You are living proof that the sauna works and that sweating is an incredible detox pathway.”

Dr. Justin Marchegiani: I see a lot of women, too. Like “Oh, man! I’m pregnant.Like, what’s the best way to detoxify when I’m pregnant?” I’m like, well number one, we don’t want to really push any detoxification. The only thing I may gently recommend is maybe a little bit of a, kind of a natural fiber, eating organic, drinking lots of water, and maybe a little bit of an infrared sauna. But you have to shower right afterwards just because you don’t want to move toxins to the skin, and then have them reabsorb back in. So you want to make sure you use a good 10 sulfur soap, break up that film of toxin on your skin so it flushes off your skin. So would you agree that you know, potentially doing a little bit of sauna therapy as long as you’re not depleting yourself, dehydrated, is probably a safe, probably one of the more safer, gentle ways to detoxify if you are pregnant?

Evan Brand: I guess it depends on temperature. Like I’m not going to put a lady in like, a hundred and eighty, like a hot rock one.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I think an Infrared one…

Dr. Justin Marchegiani: It can be infrared were it’s lower temperature.

Evan Brand: Yeah. I think if you’re probably at like a 125 degrees or something. That’s somewhat natural that you could experience on the planet. I think would be no problem; the chlorella should be no problem, too. You know, we’ve actually…

Dr. Justin Marchegiani: Stays in the gut. It stays in the gut. You’re probably okay, I mean, chlorella, some kind of a gentle, more food-based binder is probably okay. I mean, if you’re gonna do some kind of a sauna and you’re pregnant, one, make sure you’re hydrated, make sure you have minerals. Start with like, three or four, or five minutes, and just kind of add like a minute of two every time so you don’t overdue. I always rather know you go at a lower level where you’re confident- you can handle it, and gently nudge it up, and just make sure you shower right afterwards. It’s probably the only detoxification means that I would really push outside of a gentle binder. Uh, that’s food-based for my pregnant females. Back on that, would you agree?

Evan Brand: I would say, I, I don’t see a problem with charcoal and chlorella during pregnancy because, you have to kind of weigh the pros and the cons, right? And we know that for example, these toxins go through the placenta. We know they go through breast milk, so here you are, willingly letting this toxins go through the unborn baby, when you could simply use a gentle binder to try to mitigate some of that or even detox; that there’s actually been crazy stuff being done behind the scenes. I won’t go into too much details because I don’t think it’s published yet but, showing that these micronized chlorella molecules can literally detox the baby before the baby’s even born. So you can actually have a baby come out cleaner than it would’ve been, chemical wise, by being detoxed throughout the pregnancy by the transfer of the chlorella from mom to baby; and then of course, once the baby’s born, through the breast milk, also there is some transfer of chlorella. So there’s some crazy, crazy stuff coming out on that but, too soon to say exactly.

Dr. Justin Marchegiani: Very cool. I like that. So, yeah. We have our binders, we like the binders, and again, talk to your, your OB if you’re a person that wants to look into that. When you’re pregnant, just be careful. I always recommend do all this stuff before but, if you waited and you have issues, and you got to do it now, talk to your OB, talk to your functional medicine doc before you ever do that. We typically don’t push any hard detoxification when uh, patients are pregnant just because we’re mobilizing a lot of toxins unless, we do it very very gentle-way like we mentioned before. Uh, outside of that, I would say we talked about all the big binders of water filtration. We’ll put some links down below with some of the RO and whole house activated charcoal, carbon-based filters that I personally use and Evan uses. We’ll put some recommended links that you guys have that. That’s going to be really important. I’d say air, water, organic food-those are going to be big, and then we can set them in on top of that. So uh, in my line I use heavy metal clear, my detox aminos that have calcium gluconate, and all the sulfur aminos, and reduced glutathione. Evan has some similar glutathione, and sulfur, and mineral-based products that are mineral, that are like our binders, like fulvic minerals or things that help bind up some of this things, too. So we’ll put some links down below if you want some recommended products that we personally use, and we’re kind of gave you some of the big mechanism, right? One’s binding, right? You’re binding some of it up, and the other one is you’re working on enhancing your own detoxification pathways, so they can excrete them. And then of course, low-hanging fruit, right? The solution to pollution dilution. You take any toxins, you hydrate well enough, good clean water and minerals, the more you hydrate that mineral, that toxin becomes less potent, the more it’s diluted. So that’s, it’s low hanging fruit. It’s easy to forget but, solution to pollution is dilution.

Evan Brand: Cheers! Yeah, and this is real stuff. I mean, we’ve seen many, many, I mean, hundreds of this point; before and after case studies of measuring these chemicals. It’s absolutely remarkable what can be done. So if you’re just like, “Oh, toxins are bad.”, and that’s all you get from this podcast, no. Remember that goes deeper than this. We’re talking the way you perform in terms of your mitochondreal function, your energy levels, the health of your gut. Whether you have bacterial overgrowth which then leads to bloating, and burping, and gas, and issues with your joints and potential autoimmune issues because now you’ve got chlostridium overgrowth. So if you hear this, all you think is” toxins are bad, I need to detox.”, no. Remember, this goes into every body system. This goes into adrenals, mitochondria, liver, gallbladder; I mean, the whole system is involved so don’t just blow this thing off. I still see people-I won’t name her but, there was a lady I knew from my, my town. Now she’s super big and she’s got a supplement company that’s like all these vitamin shop stores and everywhere, and she did a Q&A, and I mean this lady is a multi-millionaire, and people asked her, “Do you eat organic?”, and she said “No. I think it’s a waste of time.” It’s like you’re just, you’re just, uh, what’s the word? Not dumb, that’s the rude word. Uh…

Dr. Justin Marchegiani: Ignorant.

Evan Brand: Ignorant. She’s ignorant. Yeah, that’s the word. She doesn’t know what that means. Like how important that truly is and how that’s changing everything from her offspring, and the health of her babies to her own health. So to people out there, if you’ve got the means to do it, which hopefully everyone can, I can see people have that brand new iphones but then they say they don’t have the extra dollar to buy the organic strawberries. You got to make thins thing a priority or you’ll see a brand new Mercedes SUV in the McDonald’s parking lot, like you’ve got to make organic a priority.

Dr. Justin Marchegiani: Yeah. Absolutely. So you git to make it a priority. It’s shift that for sure, and again, people’s say organic’s a fad. Well, again, before 1950, everything was organic, right? That’s where the pesticide kind of fertilizer industry came kind of post-World War II, and so, everything was organic before that point. And again, like first thing I recommend in the order of priorities is, make sure your meat are organic and pasture fed first, okay that’s the first order of, um, let’s just say investment. The second thing is, eat from the clean 15-these are pesticides that have, these are foods that have a pesticide load; and then, avoid the dirty dozen. That’s kind of environmental working group thing. So we’ll put a link for the clean and the dirty dozen; and then from there, you can start getting organic vegetables that are frozen; that’s cheaper. And then of course, start to buy them, you know, more fresh and organic across the board but, that’s kind of the progression. So just try to at least start with the meats because the meats hold the most toxins, and so fats are in the toxins. So you want to start with meats first, and then you can work on going to clean 15, avoid dirty dozen, frozen organic, and then full fresh on organic. That’s kind of the algorithm there. Anything you want to say about that Evan?

Evan Brand: Yeah, local too. I mean, if you can get local beef too, where it hadn’t traveled thousands of miles from Brazil, and they didn’t cut down the rain forest to get that grass fed beef, then I would totally do that. I get my meat from 15 minutes down the road. It’s just hundreds, and hundreds of acres of beautiful chemical-free pastures. So I feel really good about it.

Dr. Justin Marchegiani: That’s great! I love it. Well, very good. So out of the gates here also, one last thing, if you don’t have good gallbladder function, or good digestion, right? You’re constipated, you’re not pooping everyday, you’re having a hard time digesting food, not breaking fat down or protein adequately, your stools are floating, excessive skid marks streaks-those kind of things that means you’re not breaking down fat, you’re not breaking down protein adequately, you’re not moving toxins through your bowels adequately, you’re gonna be reabsorbing that, you’re gonna, you’re not gonna have good gallbladder flow to push that out in the stool. So you’re potentially reabsorbing or not eliminating toxins via your digestive tract. And so if we have digestive issues, we got to have some stool testing, we got to fix whatever is going on from a microbial imbalance or gut infection in the intestines. That’s really important. Got to work on live, gallbladder, and making sure enzymes and acids are adequate to break everything down.

Evan Brand: Yep! Good call. And if you need help, you want to get some of this testing done, investigate your gut, look into your chemical toxicity, you can reach out to Dr. J or myself. This website is justinhealth.com if you need to reach out, it worked worldwide (facetime, phone, skype) any way you need to connect there. So justinhealth.com, and for me Evan, it’s evanbrand.com. We look forward to helping you. Also reach out. We offer intro calls too! You can chat with us and figure out exactly what’s going on, symptom wise, we’ll see if you’re good fit for care, and look forward to helping you out.

Dr. Justin Marchegiani: Yeah. We’re here for you all, guys. Awesome! And if you enjoyed it, thumbs up, comments down below, and um, we’re here! Justinhealth.com, evanbrand.com, and write us a review too! We appreciate it.

References:

https://justinhealth.libsyn.com/the-top-5-anti-aging-techniques-to-age-gracefully-podcast-342

Audio Podcast:

Recommended products:

Austin Air Health Mate Plus

Organic Grass Fed Meat

Air Doctor Air Purifier

Magnesium Supreme

How Your Diet And Blood Sugar Can Weaken Your Adrenals | Podcast #340

Changes in blood sugar levels may be a sign and symptom of adrenal fatigue. In the early phase of adrenal fatigue, you can see hyperglycemia (high blood sugar) and, in an advanced phase of adrenal fatigue, hypoglycemia (low blood sugar) is the usual presentation.

The thing is, you may not notice a problem with your blood sugar levels, but that doesn’t mean it’s terrific. It is essential to monitor and know the symptoms of having a diet full of food content that send your blood glucose on a roller coaster ride of high and low levels. These glucose level swings can result in damage to your blood vessels, raising your cholesterol, and put you at risk for heart disease.

Dr. J and Evan recommend having yourself tested (not guess) and checking the food you include in your food template because they can be the reason for your chronic issues for so long.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:47 Adrenal Blood Sugar Physiology

9:26 Intermittent Fasting, Carnivore / Keto Diets

18:45 How Intermittent Fasting Helps

24:43 Hypoglycemia and Adrenal Stress

31:08 How Mold Affects Adrenals

35:00 An App that Helps Monitor Your Diet

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today we have an awesome podcast topic on the queue here, we’re going to be chatting about how your blood sugar can weaken and negatively impact your adrenal glands, we’re going to be talking about blood sugar, how it affects your immune system, how it makes you either strong or weak, we’ll be talking about nutrient supplement changes that you can do to help with that, as well as diet and lifestyle changes. So I’m excited to dive into this topic. This is a relevant topic that we are applying and seeing with our patients every day, especially ones that have adrenal issues, or adrenal and cortisol imbalances. So really excited to chat about this. And what’s happened today, man?

Evan Brand: Hey, not too much. Let’s dive right in. So let’s set the stage for people. This is a conversation that maybe didn’t happen. Historically, we didn’t have the chronic 99% of the time, we’re stressed and 1% of the time we take a vacation, we didn’t have that kind of lifestyle historically. And so I think now, you’re kind of talking about this with me, before we hit record, the average person is just so toxic, they’re so stressed. They’re sleep deprived. They’re on stimulants like caffeine, and they’re having these spikes and crashes all throughout the day, pretty much everyone is on both the stress rollercoaster. But they’re also on this blood sugar rollercoaster too. And that really affects the adrenals over time. So that’s where I want to set the stage with people is that we’re in a society that’s doing quick fixes. When we feel a blood sugar crash, we go when we eat the organic cookie. Now it’s an organic cookie instead of an Oreo, or it’s a gluten free cookie instead of an Oreo, but it’s still a cookie, and then you end up crashing again. So I want to set the stage of even though you could be doing paleo or similar diet, a lot of people are still having issues of blood sugar regulation, and we think adrenal is is is one big part of it, which is then connected to the gut. So really, we could make this thing like a three hour episode, but we’re going to try to condense it to half an hour.

Dr. Justin Marchegiani: Absolutely. So let’s kind of do like an adrenal blood sugar kind of one on one physiology review for people just kind of coming into this. So your adrenal glands produce a hormone called cortisol, right, which is a glucocorticosteroid. Big word right, the first half of that word is glucose, meaning it helps pertain to blood sugar and energy. And so the more your blood sugar debates goes up and down, the more hormones have to be produced to buffer the highs and lows. So the more we keep our hormones snaking along, or we keep our blood sugar at let’s say in this example snaking along or stress snaking along throughout the day without big up and down spikes. Our hormones are called to the rescue far less. So. If I eat, let’s say one, I’m not eating at all. Let’s say I’m fasting, right and I’m not really good at being fat adapted, your blood sugar is going to drop and when your blood sugar drops, that creates a stress response. The first thing that happens on this low blood sugar drop is going to be a spike of epinephrine or adrenaline. Right? So epinephrine or adrenaline is like the key catalyst to wake up and call cortisol. So you get this epinephrine or adrenaline or catecholamines surge again, they are all the same thing. You have epinephrine, norepinephrine, you have adrenaline, you have noradrenaline, you have catecholamines. They’re all the exact same thing, same name. They’re just meant to confuse people. So just kind of put that out there. If I use these words, they’re 100% interchangeable, okay. So you’re going to have this surge and adrenaline. And that’s going to bring up your blood sugar when it brings that blood sugar up. This is when you may feel anxious. heart palpitations, this is May when you get a little bit dizzy, nervous, sleepless, irritable, right, sweating, you know. So when you start to have when you’re on those blood sugar rollercoaster, when this blood sugar drops and starts to come back up, you may have symptoms that make you not feel that well. And so then, of course, what comes up after that adrenaline surge is then cortisol is now going to help bring it up the rest of the way. So think of adrenaline is the it’s the, it’s the first responder, right. It’s the person on the operator line, getting the police ready to come to your home and then the police to come 1020 minutes late, that’s cortisol. Okay, they come a little bit later to the show. And so that’s important. So when you understand your physiology, that’s, that’s good. The next component is when your blood sugar goes back up on the high side, that’s where you make a whole bunch of insulin. So insulin can make you feel tired, it can make you feel fatigued. Insulin activates a lot of lipo Genesis, that’s fat storing lipo, meaning fat Genesis, creating and so when you start to have when you’re on a blood sugar roller coaster of high to low blood sugar, okay, this creates this high level of insulin, a lot of label Genesis that creates fatigue. And then of course, when you have a high level of insulin that brings your blood sugar back down, because insulin is opening up the cells trying to get blood sugar into the cells to either burn it or store it. And if you’re not active, and your cells are already full of glycogen, and you’re not actively doing something like walking or running or lifting guess what your body then shunts and partitions that fuel into the storing phase. So if you’re active, great, you’ll burn it. If you have muscles that have glycogen storage, you’ll convert it to glycogen which is glucose. Storage sugar storage. And if those two capacities are tapped, then we start going to fat storage starts going more to life with Genesis. So we’re on this blood sugar rollercoaster. So high blood sugar up high blood sugar up, a lot of insulin drops it down, right, then we have this, this really high drop high to low drop, this then stimulates a lot of adrenaline, catecholamines and then cortisol in the app, this is called reactive hypoglycemia. And then the other type of glycemia issue that we’re going to see is going to be usually fasting too much not eating enough low calorie diets, skipping meals, that’s more like this, that’s your blood sugars like this. And it just starts to drop into this hypo category, you know, maybe below 75. One goes up first. That’s the reactive, it’s reacting going high and then dropping, that’s reactive hypoglycemia, that’s typically going to happen due to poor diet, too much sugar, too much carbs, not enough protein on a fat. And then we have just general run of the mill hypoglycemia, usually from poor meal timing, skipping meals, too much fasting, typically low calorie dining. And again, if you’re doing a lot of intermittent fasting, but you’re low calorie in general, throughout the day, that can easily drive low blood sugar too.

Evan Brand: Wow, well said so the average American, they’re experiencing more reactive hypoglycemia because they’re on sodas, they’re on the Milky Way bar and hiding in their desk drawer at lunch, the person listening to us who’s hopefully relatively dialed in, they’re going to just be more in the standard, we’ve just called to us maybe a standard hypoglycemia situation. And then how do the adrenal is play into that? Because what you’re saying is happening is that, let’s say, and this happened to me, I can tell you firsthand what happened. But what kind of open it up. So intermittent fasting, you’re saying that could could drive that and you’re saying there, you’re kind of hinting at the fact that maybe the adrenals are too weak to help you’re seeing the adrenaline can be released, and it’ll crank it up. But you’re saying, Okay, I got like a recording, stop and start. So just making sure we’re good. Okay. So you’re saying that, in a normal situation, the hypoglycemia can start to happen, adrenaline should come up, kind of bump you up, give you the little nitrus booster, but you then you need cortisol to push you to the finish line. But you’re saying in the case of adrenal stress, the cortisol may not be able to get you up to the right amount. And that’s how an intermittent fasting situation could be not good for you. Is that right?

Dr. Justin Marchegiani: Yeah. So then if you don’t have good adrenaline output, or catecholamine, output, like so how do we know that as we look at organic acids, if we see imbalances and vandal Amanda later home of anolyte, these are amino acids that are precursors for dopamine and adrenaline. And again, dopamine is a precursor to adrenaline. So when you’re constantly stimulating adrenaline, you’re actually pulling dopamine down. And dopamine is really important for satisfaction, mood focus, right? So if you’re chronically stimulating adrenaline, you’re going to have adrenaline issues, you’re going to have dopamine issues that can create a whole bunch of problems. We’re going to know that because we’re going to see an organic acid test showing a lot of imbalances in those catecholamines. And if our blood sugar, if we have very low cortisol, we run a good quality Dutch test we see chronically low free and total cortisol, it’s going to be hard for our body to bring that blood sugar back up and we can kind of stay a little bit more hypo. And that can cause that irritability, that faintness, that fatigue, cognitive issues, mood issues, brain fog, it can create all those problems. So if we don’t have good when people talk about adrenal is people mostly just think about cortisol. When it comes to adrenal, they don’t think about the adrenaline catecholamine dopamine connection. And so when we talk about adrenals, we have to really look at the outer part of the adrenals. That’s the cortex. That’s where cortisol lives, that’s where aldosterone lands because we’ll talk about it in a minute. aldosterone plays a big role with minerals and holding on to minerals. And if our minerals go low, like we see in pots, right, which is a postural orthostatic tachycardia syndrome that has to do with minerals being low sodium chloride, potassium, right, that can create a lot of symptoms similar to hypoglycemia. And so we have to look at the the cortisol component, but also the adrenaline the adrenaline tends to happen more in the medulla medulla M for more middle part of the adrenal gland. So it’s good to look at both and that’s where having a high quality adrenal test that looks at free and total cortisol, as well as an adrenaline, dopamine via the organic acids to look at what’s happening with the catecholamines and neurotransmitters.

Evan Brand: So how would this work? Let’s say if you weren’t doing intermittent fasting, let’s say you switched off of that maybe you were having these hypoglycemia episodes, the adrenals. were too weak to give you the cortisol output you wanted. So instead of intermittent fasting now you’re just doing like a carnivore breakfast, maybe you’re going to do a grass fed steak or maybe you’re going to do some pastured eggs or some pastured bacon. Is that enough to pull you out of that? Are you going to need some support? Would you recommend we throw in like a little bit of honey, some blueberries, you know, maybe something else to pull you out of that spike like is meat is meat enough? I guess is the simple question.

Dr. Justin Marchegiani: So what happens with proteins that you’re consuming is your body is going to be able to one, it’s going to be keto adapted. But again, not everyone’s keto adapted, you have to be metabolically flexible to be keto adapted, where you can actually take a lot of the fat, right, you have a glycerol on a free fatty acid, and you’re able to break that down, pull off some ketones and start burning more fat for fuel. A lot of people just can’t transition to that, because they’re very metabolically inflexible. And so protein and fats not going to be a viable source unless someone’s really dialed their diet in for two to four weeks, and really had that metabolic adaptation. Now, some people, their their insulin levels just dropped to low, and let’s say maybe below four or so or even below two on a fasting insulin test, they may need more carbohydrate. And, again, if they’ve been doing the diet for a month, and they’re in there, they’re having good proteins and good fats at every meal. And maybe their carbs are really low, we may want to add a little bit more starch in because sometimes they feel better doing that because it actually blunts the cortisol spike or the adrenaline spike that the body is trying to create to mobilize that glucose. So it’s like, we can add a little bit more carbs in via healthy, safe starch. And that blunt some of the cortisol and the adrenaline is being produced to mobilize that internally, some people, their insulin levels are really high. And by keeping the carbs super low, they’re bringing their insulin back into the sweet spot, and they’re actually good. And then when they add more carbs in, they actually feel worse, because their insulin is going out of balance, and they’re starting to get more into fat storage mode. So most people I find tend to be more on the insulin resistance side. So I always default to lower carbohydrate out of the gates, and then fine tune later once they kind of hit the wall. And you know, a good way that to see how you know, if you’re hitting the wall or not, is get to a place where you’ve been doing it for a month or two, make sure your body is pretty good at burning fat, right? So you’re eating good proteins, you’re eating good fats, that initial keto flu is over right, that first couple of weeks of getting fat adapted headaches, mood issues is over, then you can try adding a little bit more carbs in maybe at night. Have a sweet potato, a little bit of white potato, a little bit of a say starch, see if you feel better or not. If you sleep better, if you have more energy, if your workouts are better, recovery is good, that’s a good sign that that’s better for you if you don’t feel better. Or let’s say you’re you know, you’re very overweight, and you probably want to work on keeping the carbs in check longer, again, the benefit that you have with good fats and proteins, it’s hard to over eat when you’re eating good fats and proteins, because there’s good satiation signals to your brain that tell you to be full. That’s like peptide yy, adiponectin. coli cytokinin. There’s really good feedback regulations, people are like, well, it’s all about calories in calories out, it’s like, but not all calories, tell your brain that you’re full the same way. So you have to look at the the epistatic regulation of appetite, right and certain neuro peptides are going to be produced with certain foods, you’re not going to get that same stimulation, eating pizza eating Pringles drinking refined sugar, you’re not going to get it. And that’s why it’s so easy to overeat those foods, and you never really feel satiated, try eating you know, half a dozen eggs with you know, cooked in butter, it’s gonna be really hard to still be hungry afterwards. As long as you don’t eat things too fast, where people really go awry with proteins and fats is they eat things too fast, is about a 10 to 20 minute delay in those kind of chemicals telling you you’re full. And you really have to give your body that 10 to 20 minute buffer time. So eating slower, chewing your foods up really well, not overly drinking, when you consume those foods, giving yourself five or 10 minutes once you finish your meal before you get seconds. That plays a big role, because it’s really easy to overeat with these foods, when you don’t give it enough time.

Evan Brand: Yeah, look at the marketing of potato chip companies, veggie candy, just one, they know that you’re not going to get leptin and all these other beneficial compounds and tell your body your full. So the marketing companies know what they’re getting into, they know you’re going to eat a whole bag of chips, because you’re never going to get that signal that you’re satiated. And that’s where you’re going into trouble. So let’s go back to the adrenals for a minute. So you mentioned running a Dutch panel looking at low cortisol. So what you’re saying is if you’re going to see a flat panel, or maybe just maybe it’s not flat, maybe there is some sort of peak on the cortisol in the morning, but it’s very weak. So overall, you would just say there’s a low cortisol output, you’re saying those people are going to tolerate intermittent fasting less, those people are going to tolerate very low carbs less so they may need a little more bump while they get their adrenals back on board. Is that safe to say?

Dr. Justin Marchegiani: If their cortisol is really low? Yes, it just depends kind of where they’re coming from. Right? If they’re coming from being overweight, being more insulin resistance, being more tired, being more fatigued out of the gates, always in a default to lower carb. If they’re coming from already being at a reasonably healthy weight and being pretty active already. Then I’m going to default to adding a little bit more carbs and so it just depends upon where someone’s coming from. So it’s always good to look at someone’s Samantha type right? ectomorph endomorph mesomorph right. endomorphs like The linemen write in football. And again, this can be like any one, but they’re just have a larger, higher propensity to put on weight, write the message, or then they have the ectomorph. This is more of the natural kind of basketball player type, they’re just more taller and more leaner, hard to put on muscle, hard to gain weight. And then you kind of have a blend between an ectomorph and an endomorph, called a mesomorph. Think of that as the M for middle, right. And this is kind of more like your linebacker in football, right. And again, these are extreme examples, but helps to kind of tell the tell the story, right? Not everyone’s a 300 pound lineman, I get that, right. But people have this propensity to put on more weight. But a mesomorph, someone that’s kind of more in the middle, like they could be taller and leaner, but they also can be bigger as well, they’re kind of in between. So usually, people are in one of the three of these categories. And usually, if you’re more on the ectomorph side, you’re going to be able to tolerate carbs pretty well. So that you have to just kind of like you know, see kind of where, where you feel best. And there’s a lot of people out there like let’s just say let’s people on the diet side, I’ll just I’ll call Chris kresser out, right? Chris? kresser is a ectomorph. Right? suit. You know, Paul jammin a ectomorph. A lot of people out there that like recommend more carbs, more higher carbs, more whole food, carbs? And it’s like, well, of course, you’re going to recommend that because you’re an ectomorph, of course, right? So you have to look at the people that are recommending certain things and look at what somato type they are because certain somatic types are going to have a propensity to handle macronutrients differently than someone else. So it’s good to look at that as a general template. But in the end, you got to fine tune it, you got to look at it, my default way of looking at because of insulin resistance is being so prone, because refined and processed foods have been eaten ubiquitously, you know, over the last 20, if you look at the macronutrient trends over the last 20 or 30 years, right, its proteins gone down a little bit fats has actually gone down a little bit. And actually cards have gone up. So when you look at that general trend, we can just assume out of the gates that most people are going to have carbohydrate problems, not protein and fat problems. And if they do have protein in fat problems, it’s usually from junky trans fats and or junky omega six refined vegetable oils, not healthy animal fats.

Evan Brand: Yeah, very, very great points. And that’s important for people to listen, I mean, you’re hearing a clinician speak, you’re hearing the clinicians brain, because as you mentioned, if you get into some of these other people that may not be practicing clinically with people, they’re going to be able to give you a cookie cutter answer and you did not I was kind of probing you to give me some like buzz wordy, you know, like something I could post on Twitter type answer, but you gave me a clinicians answer. And I hope people appreciate that. Because there’s a lot of variants with this. And I know it’s frustrating, because when you listen to a podcast, you’re like, I just want to be told what to do how to do it. Give me the sparknotes? And your answer is there’s not really a sparknotes there are some categories, if you will, that we can put people into I’m definitely probably closer to ectomorph. And so I do better. Like if I do a grass fed steak and I throw some extra organic wild blueberries in with that for breakfast, I feel so much better with that extra little blueberry hit, as opposed to just the steak versus let’s say, my grandmother who had an high a one c score, she’s going to do much better with just the steak and she’s going to go but better lower carb overall.

Dr. Justin Marchegiani: Exactly. So it’s good to know, I’m kind of more of a mesomorph I’m kind of in the middle. And I just I look at you know, the problems that we as society have as a whole, generally speaking, and I kind of just create my recommendations to have the largest bang for the buck regarding the average person. And then of course, when patients come in, then you kind of look at them, you kind of look at their height, their weight, you know, especially you see a lot of women, you know, in their 40s. I’m like, well, where were you in high school in college it regarding your weight? Oh, I was 80 pounds lighter. Okay, so we know there’s some metabolic damage there. If you put on 80 pounds since that time, right. So then, then it’s good to really make sure we we support them being better fat burners, I think the next step I wanted to hit would be intermittent fasting. So someone in the comments here will talk about this, they talked about omad, or one meal a day, I’m not a huge fan of omad. Now people can do it, if they’re wanted, they have pretty good adrenals their diets really good and they’re very metabolically flexible. Okay, with omad. It’s one meal a day. So you need all of the calories that you need in one day in one meal. So number one is you’re going to be eating a meal that’s like two to three times bigger than what your typical meal would be. Because if you need, let’s say, you know, I’m six to 2015 pounds, right? I need like 3000 calories a day, if I’m you know, relatively active, well, 3000 calories is a lot of food at one meal. Okay, it’s a lot of food. Because you need your your micronutrients, you need, you know, your amino acids, I need probably at least half a gram per pound of body weight minimum for protein. So I need at least let’s say 110 grams of protein, that’s a big meal. So one, you need really good digestion, you probably needed over an hour to sit down and actually eat that meal if you’re not going to be sick because that’s a lot of food to eat at one time. So you probably need an hour to eat it. You need really good digestion really good enzyme and acid secretion. You need an hour to sit down and be able to handle it and you probably can’t move much for an hour afterwards because the meal so big, it’s it’s the equivalent of a Thanksgiving Day dinner. Right? And so you got to be careful with that.

Evan Brand: I think let me just give you a little I’ll give you some numbers real quick just to show how hard what what you’re describing would be. So for example, I love bison. So if you were to do a which this is going to be your fattiest cut, if you could do a bison ribeye, a 10 ounce bison ribeye, you’re going to get roughly less than 500 calories, maybe like for something like 450 to 480. So if I just did it as 10 ounces. So I mean, God, let’s say you did 20 ounces, which would be very hard for me to do a 20 ounce bison ribeye, you know, you’d be maybe close to 900 calories.

Dr. Justin Marchegiani: Yeah, and so you’d probably need at least you know, if for me, right, you’d probably want about 25 to a third of your calories coming from protein right around there. And so you’d probably want about that steak would probably have to be about 20 ish, maybe a little more ounces than that. That’s a lot to do at one time. And that’s not including the six to seven servings of vegetables that you may want to do with that as well.

Evan Brand: And then what Yeah, I was gonna say, and then what else are you going to do? Let’s say you did like a cup of broccoli, that’s like 40 calories.

Dr. Justin Marchegiani: Exactly. So you need like literally eight cups of that or like, you know, 60 it’s becomes really hard.

Evan Brand: Yeah, cuz I see why you don’t recommend it. So so your overall, your overall messages, you think maybe two meals a day, you could get away with a one meal a day you think for this type of conversations can be really tough.

Dr. Justin Marchegiani: Yeah, two meals is good. Two meals, you can do it in the morning, I mean, you may want to have like a little bit of bone broth, or something very gentle on the liquid side. Again, if you’re just trying to do intermittent fasting, it’s easier to do one, I don’t recommend it every day. But it’s easier to do like, you know, keep your eating window between 12 and eight, or let’s say two and eight, I think it’s easier that way gives you enough time to have a meal at two o’clock, five o’clock, or let’s say to, let’s say two o’clock, six o’clock, and maybe a little snack before bed, if you’re still hungry, you want to fill in the gap, right? So it’s a little bit easier from a nutritional standpoint to get your needs met. Again, if you’re having a lot of hormonal issues, I don’t recommend doing a lot of fasting out of the gates. Think of fasting as a stressor, it’s a stressor on your body, just like exercise is a stressor. So imagine your personal trainer, someone’s like super unhealthy. They’re out of shape. And you’re like, hey, come to my CrossFit class tomorrow, I’m 100 pounds overweight, come come across it, it’s like well, you know, with their weight being where they’re at, and how inflamed they’re at, they’re gonna be like, literally in bed the next week, with sore joints sore back totally hurt. So you have to make a recommendation based on what’s best for them. So you may say, hey, let’s just do like a 10 minute walk tomorrow, right? So a 20 minute walk, let’s say a five minute walk after every meal, that may be a better recommendation, right? So think of like the Oh, Matt, or like a lot of this intermittent fasting. That’s the equivalent of jumping a very overweight, unhealthy person into CrossFit. It’s the equivalent, it’s still a stressor on the body. Now, if you’re healthy, guess what? It’s a stressor that you can adapt from and get up and get stronger. But if you’re not healthy, that stressor is going to break you. And so you kind of have to know that, hey, this is an application of stress. And the question becomes, does your physiology have the ability to adapt to that stress based on where you’re at now? And for most people that are that we see clinically? No, that’s not gonna be the case. Yeah, there’s always weather. Yep. I always weather under Should I rather undershoot it have that person feeling better, less or less tired? And kind of in kind of gauge up then overshoot and make them feel worse?

Evan Brand: Yeah, well said. So this is the anti boot camp podcast. You see those boot camp signs? It’s like, they’ll just come in and they’ll just kick your ass on day one. I mean, they don’t care. You’re 300 pounds five foot tall. 300 pounds, haven’t walked a mile in 10 years and they’ll just come in and throw you down. Give me 50 them Yes. Boom, boom.

Dr. Justin Marchegiani: Yeah, I mean, if your life if you can come home and just like recline back and chill and read and watch TV or just hang out all day, you’re not doing much. Okay, fine. But most people have like, have to work they have to do things, they have to do chores, they have kids and family and responsibility to take care of so it’s like their life can’t revolve around that right? So obviously with the TV show and that’s what their life is, you know, you can get away with stuff when that’s what all your focus is. But for most people, you know, that’s not the reality that we’re in.

Evan Brand: Yeah, and if you want to go another direction with this, please do but I just wanted to bring up one question here that came in the live chat. And for people listening if you want to join us at the time of this recording, maybe we change the schedule but for now we go live every Monday somewhere around 11am Eastern on Dr. Jay’s Justin health YouTube channel so if you want to check them out, that’s how you can join us in the live chat question here. Does sugar or caffeine effect? I think they meant effect. The sugar caffeine weaken the adrenal is the most. I don’t know if they’re saying like either one. I would say both are a factor in people going to Starbucks and getting their dessert in the cup, which they call coffee. That sugar caffeine combo, I would say is a super big issue with hypoglycemia and adrenal stress. What would you say?

Dr. Justin Marchegiani: I think it depends if someone’s doing a cup of coffee or two in the morning and they’re consuming it with some fat and some protein like maybe they’re throwing some collagen MCT oil in there. That tends to time release, the caffeine tends to not be as big of a deal because the caffeine is going to be out of their system, you know, by the time they go to bed. So if they’re doing a cup or two, as long as they are not getting anxious, anxious or irritable, or Moody, or any of those negative symptoms afterwards, I’m okay with a little bit of caffeine. And again, if you’re on the fence, just pull it out or choose something that’s more decaffeinated. Choose a coffee substitute, like to Chino, or do a decaf, kameel or decaf green tea. See if you feel better if you don’t notice a difference where you’re not feeling worse with caffeine, a little bit’s okay. And if you want to time release it, a little bit of fat in there and a little bit of collagen, will time release it and just do it in the you know that first hour or two getting up, don’t do it in the afternoon hours. If people that get in trouble are the ones that do it usually after lunch, and they’re trying to get at that second when between three and five. And then it’s it’s causing a second cortisol surge at night because that caffeine still in their system around 10 to 11 o’clock at night.

Evan Brand: So what you mentioned is good, but your average person’s not doing what you’re you’re doing. They’re wrapped around the Starbucks drive thru, they’re gonna go get a venti caramel frappuccino with frickin whipped cream and six pumps of syrup.

Dr. Justin Marchegiani: Yeah, so what we’re talking about zero sugar in the coffee, we’re talking totally black with the exception of maybe some MCT or, or a heavy coconut cream. Or if you can handle dairy, maybe a heavy whipping cream, some kind of a good fat in there that you can tolerate. Maybe it maybe it’s just MCT oil, maybe it’s some collagen as well, because that time releases it and really allows it to go in your system slow. Someone on the chat talked about using glucose and sugar to keep their blood sugar stable throughout the day. Like that’s literally like going camping and keeping your fire going all day with paper and kindling. It’s just it’s not practical, because you’re never going to get keto adapted, you’re never going to become a fat burner, when you’re literally relying on glucose to keep your blood sugar stable all day. That’s the problem. And that’s like, you know, physiologically, the antithesis of health. Because really be healthy, you really want to be fat adapted. So you can help burn can help get energy from fat, it’s the most stable energy source, that’s not going to require up and down dips. So the equivalent of that is getting energy from logs in a campfire, which burn a lot longer and stronger than let’s say kindling a paper. So you just have to look and say, if I’m camping, the goal was I want to really get my heat from those good logs, not killing your paper because I don’t have to be feeding it all day long. That’s the difference.

Evan Brand: Yeah, and some of this biochemical talk people may dislike to now and like, turn into a zombie. So if you’re listening to this, you’re like, well, how does this actually change how I’m getting through my day. So that example that Justin’s mentioning with the really good fatty coffee versus the really sugary coffee. So this is the person who, like I know, you’ll do fatty coffees, like during our podcast, so you’re going to be burning clean, and you’re going to have a good energy burn throughout the entire morning, versus the person doing the sugary caffeine, they’re going to crash Two hours later. And then they’re going to go for maybe as this person mentioned in the comments, or they’re going to go for fruit or fruit juices or something else, they’re going to get that quick hit of kindling again, and then they’re going to crash. So when you’re at work that you’re not going to be performing at your best. I mean, if I were in charge of like a massive company, and I had the ability to give people support, I would say, hey, look, everybody can do a nutritionist console, let’s say you had like a warehouse worker. And we found that the output of the warehouse workers were 20% more efficient, if we all had them on more animal based higher fat diets, as opposed to these people. You know, when I used to work at UPS to pay for my college, you’d have these guys who on a four or five hour shift, they pull out two or three candy bars just to get through the shift. And here I was eating just my grass fed ground beef before I went in, and I was stable the whole time. These guys could work for an hour, they got to go do a bag of chips, they go to the vending machine, get the coke, and then they go do the Cheetos. I mean, it was literally it was crazy to watch.

Dr. Justin Marchegiani: Yeah, exactly. And there’ll be a lot of people out there. And this is why I talked about this amount of time to people that you’re going to see breaking all the rules that I’m saying these are going to be the vegan vegetarians, the high carbers. And when you’re an ectomorph, you can handle lots of carbs your body has the ability to take those carbs shunted in Burnet right away. And then these are the people that get energized with more carbs. Like if I if I give you a glass of orange juice and a bunch of carbs, these are the people that want to go out and literally run a marathon because their body handles carbs, and it just fuels them up and makes them so energized. And so we all have vegan vegetarian friends that just literally eat carbs all day, right? You know, you see the fruitarians that are out there. This is a big thing. I think in the 80s. at Apple, there was a big like fruitarian called they all ate fruit was like unbelievable. And you see people that are energized, energized. These are ectomorphs these are people that can handle that I still don’t think it’s healthy, I think as long term ramifications with insulin and oxidative stress. But people can do that based on kind of their natural genetics, metal type and how they can handle fuel. Most people aren’t at that place. And so you kind of have to really look at getting good proteins and fats in there and manage your blood sugar accordingly. And so, the only other thing I wanted to highlight was oh yeah, let’s say let’s say you’re doing a fast like a two day course. free day fast if it’s a punctuated fast, and most people want to faster, they’re keeping their stress down, they’re not going to go work 12 hours a day and deal with stress, because when you’re fasting, you’re not getting nutrients in your body via vegetables, or fruit or protein. So you’re relying on primarily your fat for fuel. And obviously, protein, you’re doing what’s called cellular autophagy, where you’re recycling proteins. And ideally, you’re recycling some of those, you’re getting some of those for fuel, you’re also getting a big bump of adrenaline and cortisol for those couple of days. So you may feel pretty good and pretty alert if your adrenals are strong. And then of course, you’re you know, you’re getting a lot of the fat because you’re tapping into fat, but long term, that’s not good, right? Because we know, any person that’s been on a long term starvation, like diet, you know, you just look at people will were to post concentration camps that were starved, but no one walks out of that healthy, right? It’s impossible. But for a short two to three or four day period, you definitely can. And the key is you have to keep your stress down and under control, maybe do some bone broth, or do some minerals as well to keep your minerals and your electrolytes up. But most people that will still be the equivalent of a CrossFit workout. And if they’re metabolically unflexible, that could break them as well.

Evan Brand: Yeah, well said another question here, I have a friend that lives in mold and is super stressed. How does mold affect the adrenals? Well, it is a huge cause of adrenal issues, mainly because it’s creating this alert response, it’s creating a sympathetic stress, the body’s trying to react to it, hopefully, the body’s reacting to it, meaning that there is some sort of immune response. And maybe there’s some antibodies that come in, maybe there’s some detox pathways that are ramping up. So hopefully your body has a reaction, but it’s a huge adrenal stress. And I would say, even if they’re not living in mold, and you just have mycotoxins in your system, that can be an adrenal stress, or two, I know for me, I had a lot more baseline anxiety when I had just mycotoxins in my system, and I wasn’t being exposed to mold, my wife experienced the same thing. So we were doing adaptogenic herbs to help regulate the adrenals. But once we’ve detox quite a bit using binders, when we’ve done many podcasts on that, my baseline anxiety is back to the way it was before, which was I didn’t have baseline anxiety. So yeah, I can tell you firsthand, it’s a big, big factor.

Dr. Justin Marchegiani: Yeah, I mean, the first thing we have to do, if we have issues with mold is you one, you got to get your environment more stabilized, make sure you’re able to digest and break down foods and get good proteins and good fats in there. Also, on the flip side, right, I’ve talked about, you know, some of the fasting benefits and stories, we have a lot of we have a large group of people out there that are carnivores, like they literally just eat meat all day long. And they do amazing, right, and so like, you have to look at both sides of the camp, because their success stories on both sides of the camp. And so you have to understand why someone may have a success story over here, and not over there, or why someone over here has one but not over there, you have to look at it in a kind of non dogmatic type of, of mindset, right? People kind of have their camp and say, Well, this person over here has to be lying. It’s like, Well, probably not. And, you know, we’ve seen 1000s of patients. So I’ve been able to kind of understand why certain people on the high carb get great success and why people on the extreme low carb, and why somewhere in between tends to be the biggest bang for your buck, right and, and then who are those people that way you can make recommendations and push people to either direction, so they can get better results. Because it’s like you’re either you either have like my allegiance is to getting the patient the best result not to using a tool to get them to the result, I put enough tools in my tool belt so I can be non attached to the tool because I want the result to get happen for the patient. Some people are really, they’re really attached to the tool, and they want this tool to be what gets them the result. And you really have to, as a patient, find doctors that are unattached to the tool, they really just want to get you the result that you’re looking for.

Evan Brand: Yeah, well said and, you know, me being an ectomorph, you would think I wouldn’t do well with just tons of meats and fats. But I do great, really low carb and there is some discussion of mold and fungal infections and candida overgrowth and CBOE and CFO and some of these things, that people will do better. And I definitely had a history of a lot of gut issues. So I think for me, that’s part of the reason I do so well low carb as an ectomorph. But I certainly feel fine on starch and white rice and berries and, and all of that. And I’m kind of lucky, I guess I think it’s a blessing to be able to do both, it’s a blessing for me to have a grass fed steak with just blueberries for breakfast and feel fine all day. But it also be cool to do some rice with some dinner and have no issues with it.

Dr. Justin Marchegiani: You have enough of a solid foundation with your proteins and your fats and your nutrient density. Where those those a little bit of carbs, it’s not gonna be enough, it’s kind of like you have a fire going you have a good log already in there. If you throw a little bit of kindling extra in the fire, it’s the fire is still gonna be there, right still gonna be strong. And so that’s kind of where you’re at and the more metabolically flexible you get, you know, but in the end, you got to listen to your body, right? We got we got to be we got to be data results driven, not not dogma driven. And if you feel great doing something, and you know your nutrient density is up and you’re in you feel good and you feel energized and you feel flexible and you don’t feel inflamed. That’s really important.

Evan Brand: Here’s what I recommend this podcast is brought to you by Daybook. No, it’s not actually brought to you by Daybook. But Daybook‘s a cool app that I have on my phone. And I love it, because I’ll pull it up real quick. I love it. I wish I could share my screen on my phone somehow. But anyway, I love because I can just scroll through it. So people don’t audio, you’re not going to see this at all. And I apologize. But anyway, it’s cool, because you can look at it. And you can go may 27, may 25, may 23. And you could just scroll through and you could be like, oh, look on May 3, I wrote here that I did a grass fed steak and a big old bowl of white rice, and my blood sugar crashed. So it’s fun to be able to report back. I know there’s a million apps out there. But that’s just one that I like, because I like to be able to hit the plus button, start new notes, do voice to text, whatever I can and then boom, I can look back, and I’ll just be like, oh, here, here’s where I messed up. And so I think people have to track this. You’re mentioning that listening to your body. If you’re busy, you got kids, you got a job, it’s tough to know, oh crap, what day was that, that I did the rice and then I did the grain free this and the gluten free cookie or whatever. If you can track it in the app, you can report back, so picking out but that’s what I like.

Dr. Justin Marchegiani: I like that. Also, just for my autoimmune patients listening I see a lot of patients that have thyroid issues hashimotos other autoimmune issues, blood sugar fluctuations high to low can definitely increase immune activation. I have a couple of studies here. I’ll just kind of give you all the overview just so you could take on what sticks was study right here talking about the effects of hyperglycemia on an inflammatory response. Another one here, the effects of induced hypoglycemia on inflammation and oxidative stress with patients that have type two diabetes that they made diet changes where they restricted calories and gave them Metformin to cause low blood sugar levels. And they saw an increase in immune response, they saw an increase in monocytes, and platelet aggregation, a whole bunch of things right. And so you know, we’re talking about inducing low blood sugar in a in this could get out of a study on this directly. But we could do this with a bad diet with hypoglycemia from a reactive hypoglycemic diet, like someone consuming a Starbucks macchiato with extra pumps of Carmel in there and you create a low blood sugar response. That way, you’re going to activate interleukins cytokines monocytes immune responses that are not going to be helpful and may even flare up your autoimmunity. And so the more you can snake your blood sugar along throughout the day, with good proteins, good fats and the right amount of carbs for you and your activity level versus up and down swings, the better it will be we know the data on on low blood sugar and the immune response is profound and people that have autoimmune issues, you really have to work on that. Yeah, right here. Although the underlying mechanism remains unclear, increase inflammatory cytokines and leukocytosis are reported after hypoglycemia, suggesting a link between hypoglycemia and in formation. And again, this hyperglycemia will be a little bit different than let’s say intermittent fasting, hypoglycemia, but the faster your blood sugar drops, right? The more inflammation, the more your body’s gonna create a hormonal response, that’s not going to be helpful.

Evan Brand: Makes total sense. Here’s a lady grace left the comment for it. She said she used to do one meal a day and two meals a day. And it felt like a badge of honor when I could fast for longer, but I realized it was stressing me out and not optimal for digestion. Probably meaning saying she’s not optimal for digestion. Yeah, it’s just too much too much at one meal.

Dr. Justin Marchegiani: So you know, if you do that, you know, I think you come at it a couple days a week, make sure you’re relatively healthy. Make sure you take some extra HCl or enzymes, make sure you carve out a little more time to eat that meal, so you’re not stressed. Also, just just go and run your food through chronometer. Like, if you’re getting two meals a day, you know, go go carve out what that meal has to look like you’re gonna find it’s about 50% bigger on average. And that’s just a lot more food and a lot more time and you got to make sure you’re not stressed because we all know what happens when you eat a big meal and then you’re stressed you feel even worse you feel totally weighed down, you feel nauseous, then your next meal you don’t even want to eat it because you’re still just upset. So yep, I think we hit today really good. I would just say like understand the connection between cortisol, adrenaline, your immune system, why some people get great results doing different diets and other people right read between the lines be results driven, not dogma tool, modality driven. It’s really important right? Check your biases at the door. Outside of that I hope this podcast resonates with different folks if you want to reach out and you want to get individualized help from Evan, EvanBrand.com you can reach out to Evan. Dr. J here JustinHealth.com. You’ll see schedule links. We’re happy to work with patients worldwide. You know we are in the trenches rolled with our sleeves rolled up dealing with people every single day so we’re here to help outside of that if you enjoy the content, put your comments below let us know what you liked the best and please share with family and friends that could benefit it really helps propel kind of our life’s mission to help more people every day. Appreciate it. Anything else Evan?

Evan Brand: No that’s it Take good care and yeah leave us a review on your Apple podcast app we’d love it if you’re on Justin health show or if you’re on my show and brain show, give us a review, we’d love to see what stars you think the show deserves. We’ve got hundreds and hundreds of five stars we’d love to add to it that helps us in the rankings so more people can hear us. So thank you so much in advance and take care yourself.

References:

https://justinhealth.libsyn.com/how-your-diet-and-blood-sugar-can-weaken-your-adrenals-podcast-340

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Recommended products:

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Genova NutrEval® FMV

The Top 5 Nutrients to Address Gut Inflammation and Leaky Gut | Podcast #339

Whenever you are worried about your gut health and having inflammation, Dr. J and Evan are here to share five essentials that may help you.

Lessen your intake of highly processed foods, refined carbs, sugar, artificial sweeteners, and alcohol. Opt instead for anti-inflammatory foods like fruits, vegetables, spices, and healthy fats but, if you suspect that several foods are triggering inflammation in your gut, it might be worth giving an elimination diet a try.

It may require removing foods from your diet that you suspect are connected to your gut problems for roughly two to three weeks at a time. Inflammation in your gut may cause a host of harmful health symptoms, from fatigue to irregular periods and chronic constipation. However, a few changes to your diet and lifestyle might be vital to helping you control these symptoms and improve your gut health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:48 Looking into the Gut Deeper

3:53 Good Foundations

6:26 Chewing is Important

8:22 Mushrooms as Anti-Inflammatory Properties

16:00 Probiotics

Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Hey, you’re doing really well. And you know, we always come up with a title. And then we over deliver on that title. So we’re calling this something along the lines of top five nutrients to help your gut or to heal your gut or support intestinal permeability, but maybe we end up going over five. So I’m just gonna go straight to my favorite because it’s so easy. It’s so broad spectrum in its use. And it’s so safe for people across the board to use it, whether it’s kids, adults, the elderly population, even people that don’t have testing, you know, our philosophy is test don’t guess we want to have the data, we want to have good stool testing, and good organic acids testing to look into the gut deeper and figure out what’s going on under the hood. But there is usually a three, sometimes four week timeline between talking with a client or a new patient and then getting the test results. So what do we do to help these people in that in between time before we can do the real work based on the data, I’d say my favorite is probably aloe, and specifically you and I use an aloe extract. It’s a 200 to one, so it’s 200 pounds of gel converted to one pound of extract, and then that’s encapsulated. We had a young boy, not super young, maybe 16 17. But he was diagnosed with autoimmune gut issues, Crohn’s all sort of colitis, actually pan colitis where the whole digestive tract was affected major bleeding in the store. We got him on simply a 200 to one extract of aloe. And within three weeks, we did a new gi map stool test, and we dropped his calprotectin levels, which is his gut inflammation by 1000 points, just by aloe alone.

Dr. Justin Marchegiani: Unbelievable. Yeah, it’s powerful what nutrients can do now I always tell patients, if you’re trying to come in and make some changes out of the gates, I mean, your best bang for your buck would be fixing the food, because the food is constantly getting your body getting your gut in flames. So the first thing we can do is look at the the the inflammatory food that could be coming in this could be gluten or other technically gluten free grains like corn, oat, rice, those kinds of things. So you want to really get the grains out, you want to really get a lot of the poly polyunsaturated omega six vegetable oils. And again, the reason why vegetable oils tend to be more, let’s say poor is because they’re highly processed to extract the fat. And the processing actually damages the fat and creates free radical stress within those fats. Because the more you take in damaged fats, your body has to utilize antioxidants to stabilize the fats. So they don’t create free radicals. And so it depletes a lot of your antioxidants. And then those fast take on and become part of your cell membrane. And to have healthy cells you have to have good membrane. Because the membrane essentially is the brain of your cell. It provides a lot of good cellular communication happens with the membrane. So if you have junky fats, whether it’s omega six junky fats, or trans fats like hydrogenated soybean oil, right, those kinds of things, canola, you know, safflower, those are going to be more junky omega six, and they’re going to really not make the healthiest cell membranes, they’re going to deplete your antioxidant reserves. And if they’re on the trans fat side, they’ll make your cell membranes very inflexible too.

Evan Brand: Yeah, good point. And I apologize for skipping over the diet piece, you know, you think of the typical American person, they think, just give me the pill. Give me the magic remedy. So we’ll talk about some of those remedies. But yeah, you make a great point, you can’t go out to Pizza Hut for dinner, and then just take an aloe capsule, and everything’s going to be okay. Correct.

Dr. Justin Marchegiani: Yeah. So that’s it’s good to look at the foundation out of the gates. I’d also say like, I’ll just kind of put this next category into a broad category and just say, amino acids. And these amino acids could be things like an acetylglucosamine, NaG that could be things like glycine, which are going to be very high in collagen or bone broth. And they could also be things like glutamine, so I kind of put these in the amino acid bucket, when they tend to be very good support for the entire sites of the gut lining, that can be used as fuel for the gut lining, they also can help with gut permeability. And, and glycine is a really good backbone for connective tissue. So it can be very helpful for that lot of that connective tissue healing out of the gates.

Evan Brand: So how about enzymes? When you hear nutrients to heal the gut or support the gut, you don’t necessarily think about enzymes, you think of more like you mentioned, the glutamine, Aloe, the kind of calming, soothing things, but I would argue enzymes have a role in helping with reducing gut inflammation simply by improving digestion and reducing the putrifying and fermenting of foods because I know my gut was Super inflamed. If I look back at some of my original stool tests, when I had gut infections, yes, I was doing things to soothe my gut, but simply just treated, the infections alone got the inflammation down. And part of that process of treating the infections was using enzymes, because my digestion was so terrible, I would get exhausted after a meal. And that was a sign that I had low stomach acid. So I would say the enzyme should be on our list here, because so many people do to age due to stress. Maybe you’re eating in a loud restaurant, like you’re on your lunch break for work, and you’re listening to us or there’s music, boom, boom, boom in the background, and you’re sympathetically stressed while you’re eating enzymes, to me would be a good insurance policy to help break down your foods and then therefore reduce inflammation.

Dr. Justin Marchegiani: Yeah, foods are not broken down properly, they’re going to sit, they’re going to ferment, they’re going to purify, they’re going to read certify also, those foods are more likely to create hydrogen and methane gases because they’re fermenting, and those gases can throw off your motility, motility and how you move the bowels. And if the bowels are one too short, or should take too fast on the diarrhea side, you may not absorb those nutrients well. And if they’re too long, on the conservation side, you may reabsorb fecal toxins. And so you know, long or short on the bowel motility can definitely affect absorption or create more toxins in the body. So I think that’s a big one. And then just kind of connecting the enzymes and we could throw HCl in there too, because HCl helps activate enzymes, I would say chewing, chewing and and really just the mastication and healthy eating habits because chewing your food up really fine, allows more surface area for those enzymes and acids to work. So you can have a good amount of enzymes or acids, you only have a couple of chews. you swallow your food, those enzymes and acids aren’t gonna work as good as you really chew it up, you know, 30 to choose one chew per tooth, you know, ideally like an oatmeal like consistencies and allow those enzymes and acids to work better.

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Evan Brand: It’s hard. I’ve tried to do that I’ve tried to do that many choose, oh man, my jaw gets tired. So and that’s the that’s the problem too, that we have with our food is like you go to Chipotle, a for example. Everything’s really soft. Like if you get rice if you get like carnitas. Or if you get the chicken, you barely have to chew it. It’s almost like mush. So I try to personally seek out occasionally I will seek out whether it’s like beef jerky, or no bison jerky or even just a steak, you know, I try to really get something that works my job because I just feel like in America, our food is so soft and easily digestible, that we don’t have to really chew anymore.

Dr. Justin Marchegiani: Yeah, so if you have a nice steak or a nice whole chicken, just make sure you chew it up. Same thing goes with over hydrating, you know, try to get your first thing I do is and I get to go eat a meal, I kind of go to the reverse osmosis filter, get a nice big glass of water to add some minerals, one, two, and then I get my meal going that way it gives me 10 15 minutes or so for everything to absorb. And of course the colder the water you got to take a little bit longer because your body holds that water in your stomach, heats it up to about room temperature and then passes it through. So the colder that water is, the longer you should wait in between the meal

About mushrooms. This is something that you know, just doing a little bit of research before we hit record, that this is something that I don’t necessarily go to right out of the gate but I’ve been using mushrooms for a long time. I know you and I personally have been taking mushrooms for a long time. And it turns out that for example, Lion’s Mane mushroom has some really, I would say probably just as impressive as some of the other herbs you’re mentioning, whether it’s like dgl, licorice or marshmallow kind of the conventional gut healing ones. Lion’s Mane has some really awesome anti inflammatory properties. There were two papers that we had found here on Lion’s Mane mushroom being shown to protect from and shrink gastric ulcers. Also, Lion’s Mane was shown to significantly improve symptoms of two major inflammatory disorders of the digestive system. And so that’s cool, because normally we’re using Lion’s Mane for cognitive problems. I know for me, my brain is much more clear. I’ve got Lion’s Mane mushroom in my system right now. I took two capsules this morning, and I certainly feel it mentally. But I did not even think that I was feeling it in my gut. So that’s cool.

Totally. Yeah, that gets really important. Again, a lot of gut issues, the immune system can be a big player at it. And so of course, if you’re able to modulate the immune system with the medicinal mushrooms, or immunogenic compounds that are going to be in those mushrooms, whether it’s beta one, three, D glucan, whatever that is, it could have an effect on gut permeability and improving digestion. I think all that’s very, very important. Also, just kind of one pet peeve of mine. Someone in the comments was chatting about this. A lot of people when they talk about leaky gut, they talk about leaky gut like like it’s the cause of Problem. leaky gut is the effects of on what’s happening with the gut. So the more inflamed you are, the more you’re not breaking down your food. The more crappy The food is, the more inflammatory The food is, the more dysbiosis we have, the the lack of certain nutrients we have, the more stress we are right. All that then creates and increases the chance of gut permeability. Gut permeability isn’t the cause unto itself. It’s the effects of a lot of other issues happening. So when people talk about Oh, you gotta fix the leaky gut. It’s like, not necessarily, you know, it’s like, it’s like saying, Oh, we have to fix. Imagine you have a leak in your roof and the waters pulling on the carpet below you. So we got to fix that water on the floor. It’s like, No, no, you fix the hole in the roof. And again, it may be semantics, but we got to call a spade a spade. If the water’s coming into the roof, you talk to them, we got to fix the hole in the roof. You don’t say we fixed the the water on the ground, right? So I just want everyone I want to train everyone to kind of get thinking about things from a root cause standpoint, versus labeling the damage at the end result conventional medicines really good at labeling damage down here and not talking about the effects of top that should the cause up top there labeling the effects down here. So we want to go root cause?

Yeah, that’s great. And I’m sure we could come up with other analogies on it. But that makes a lot of sense. It’s kind of like, okay, we need to come in with the towel. Oh, no. Now we have this super absorbent towel, this towel is going to absorb 1000 times more water on your floor than any other towel. And then yes, this, this carpet is mold resistant. So if you use this carpet, that water in your carpet won’t create mold, but you’re still missing the frickin hole in the roof roof.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

Well, let’s call it out. Let’s call out why that happens, though. It’s simply money. And it’s the supplement industry. There’s a lot of money. Yeah, it’s marketing. There’s a lot of money made on leaky gut this and this leaky gut book and this leaky gut protocol and this leaky gut practitioner. The problem is you could take all these leaky gut support for a decade and never treat the infections like if you just went and did like you mentioned glutamine, and we hit the zinc carnosine and the dgl. And we did the aloe, like we talked about in the beginning, none of those are going to erase a blastocyst is hominis, parasite infection, none of those are going to get rid of Giardia. None of those are going to treat the H pylori, they may help. But they’re definitely not going to eradicate the issue causing the leaky gut in the first place. So that’s just marketing. It’s money involved in this. And, you know, as practitioners, I think it’s really smart of you to call it out like that, because it’s, it is frustrating for us because we’ll look on a new client or new patients intake form. And they’ll be taking all these quote leaky gut supplements. Yeah, I found this leaky gut protocol online, and I still have all these digestive problems. And it’s like, well, yeah, look at your stool test, you have all these issues. And you could do that for 20 years and never fix it. So I could rant on that all day.

Yeah, other thing I would just say out of the gates is it’s okay to palliative Li support the leaky gut, we just have to make sure when you’re palliative Li supporting something we’re also root cause supporting it as well root cause fixing it. Palliative support, totally fine, right. Nothing wrong with that we just got to call a spade a spade and and not pretend the palliative leaky gut support is root cause support. Yeah, long as we can do that, then I think we’re pretty good. Next thing I would highlight out of the gates and you see this herb being listed as being very helpful for the gut permeability, but it’s also very helpful on the adrenal. So that’s licorice. And so when we use licorice is a lot of licorice being used in leaky gut supports. That’s that’s d glycerides. And this is the glycerides component of the licorice is pulled out. And the glycerides component of a licorice is is the component that slows the breakdown of cortisol, I think it’s the 11 beta hydroxy steroid dehydrogenase to enzyme. The licorice inhibits that enzyme. That’s the enzyme that helps break down cortisol. So we know cortisol too low, we need healthy levels of cortisol to actually build up the gut lining. It helps with building up the gut lining. Of course, if our cortisol levels are too high, and we’re chronically stressed, right, that can also break down the gut lining. We know that with people that are chronically stressed getting ulcers, right, we know that as well. And so when we look at licorice, it really helps with cortisol improvement. So if we do a cortisol test, and we see chronically low cortisol, that can actually help with the gut lining with the mucosa with the stomach with the duodenum. And that can actually help with the cortisol bringing that back up. And that can help build back up that gut lining. And so we like licorice, that’s non diglycerides for the gut and Nanda glycerides licorice, we give it typically orally sublingually, to our patients, that will eventually trickle downstream to the gut as well. And so licorice can be a powerful thing. You just have to be careful if you’re giving a non diglycerides version that people that have already higher level of cortisol, that may make things worse. So we just got to make sure we’re testing that to know what kind of pattern we’re seeing.

Yeah, that’s a good point. So we could do a whole part two on that. If you want. Give us some feedback. Like maybe the gut hormone connection. And we could hit that in detail. But yeah, you highlighted a very important point, which is that cortisol is involved with this whole process. And it really is a Goldilocks zone. If you have too little cortisol, you’re exhausted. And you’re probably going to be dependent on stimulants and caffeine and sugar and things that are going to damage your gut. But then simply, you don’t have enough to build up the gut. And then if you have too much, now you’re catabolic, you’re breaking down your muscle tissue, and you’re breaking down your gut barrier. That’s probably part of the reason that I lost a lot of weight and a lot of muscle. When I first moved to Texas, I had gut infections, and I was incredibly stressed, just moving and leaving my family behind, you know, emotional stuff, homesickness gut infections, I had the perfect storm to tear up my gut. So I can tell you firsthand that adrenal supports did help. And that was probably because it was helping regulate the cortisol levels, which then in turn, took the load off my gut, so to speak.

100% Yeah, I like that. And so it’s good to really make sure that’s under control.

Evan Brand: How about probiotics? I think it’s worth mentioning. These are totally valuable tools that can help regulate histamine. Yeah, and regulate bacteria with it. So let’s dive into that.

Dr. Justin Marchegiani: Yeah, so you have to you I said you have three to four big families. Okay. So you typically have your lactobacillus and bifidobacterium, which are typically come together and usually a good high quality broad spectrum probiotic. So my line we have one called profile, Florida doesn’t have a lot of the different lactobacillus whether it’s kci acidophilus Bulgaria’s brevis, rhamnosus. And then of course, you have a lot of the bifidobacterium whether it’s bifidobacterium, bifidum, longum, brevis, right. So those are your broad spectrum lactobacillus or bifidobacterium. Probiotics, lots of good data, lots of good research anywhere from food poisoning for inflammation reduction, gut permeability reduction. nutrient absorption is all kinds of different studies connecting the dots on those so that’s kind of the bifidobacteria, lactobacillus Of course, we have more of our spore based or soil based probiotics. These are going to be a lot of your bacillus strains, right, whether it’s bacillus, subtlest class ei coagulans, like Informix, right. These are the bacillus strains. These are really good if you are very much cebo sensitive, fodmap sensitive, we may use some of these over a bifido lactobacillus species. And then of course, I’m a big fan of the probiotic that’s kind of more of a beneficial yeast called Saccharomyces boulardii in my lammie, one called sacral flora, again, we’ll put the links below for for all y’all so if you want to see it, we’ll put the links below sacral Flora Saccharomyces boulardii is very helpful a lot of studies on it, helping to improve immunity in the gut IGA IGA levels going to get low and just gut inflammation or gut stress. Of course, it’s going to help with food poisoning a lot of studies on it helping with H. pylori, C. diff, Clostridium difficile, blastocystis hominess. It also helps crowd out yeast and Candida so there’s a lot of excellent benefits with saccharomyces we love it and it’s usually going to be a core part of my probiotic, my fifth r which is repopulation re inoculation on the good healthy probiotics, once the fourth hour is done right fourth hours and to be removing the gut bugs removing the gut infections. Fifth hour, we come in repopulate re inoculate with good bacteria. Most people kind of sweet they want to start probiotics sooner, and that may not be the best step. Not saying it may not help. But some people have just found one that’s just a lot of pills. And two, if they have a lot of bad bugs in there. It’s like going and getting a whole bunch of good fresh grass seeds throw down on a lawn full of weeds, right? You got to get the weeds done before we throw down the seeds right got to get the car washed or we get waxed.

Evan Brand: Kind of like that. Yeah, we had a lot of good feedback on the podcast we did remember we were talking about probiotics and how a lot of new research is showing probiotics are being used to help with getting out mycotoxins and we know that mold toxins damage the gut. So yes, so I have been I’ve honestly been working in probiotics into the protocol sooner and most people do well. There are some like you said that just don’t you got to pull the weeds before you throw the seeds. But there are a lot of people doing really good with throwing probiotics and sooner in the protocols now. So like you said, if they can handle the amount of pills, maybe we try to sneak one or two in or we could do like powdered versions, typically, it’s like a quarter teaspoon, we could throw in a blend like that sack be you could you could do powder and maybe throw it in a smoothie or something. So we are trying to integrate those a lot. And I’ve had amazing success personally with probiotics. So I think it’s interesting, there’s still a lot of people that poopoo probiotic probiotics I know you and I we kind of get, you know, so caught up in the clinical trenches that we may miss some things, but I do get a couple of emails, you know, here and there from from people, clients sending them like, hey, this guy like says probiotics are a waste of money, and you know, that they don’t work. And I would just say that’s not true. We have so much clinical data personally.

Dr. Justin Marchegiani: It’s all about context, right? It’s like if someone comes in, they have chronic gut issues, and they’re just taking a probiotic thinking that that’s going to be the answer to their gut problems. It’s probably not right, and that’s where we’re trying to have a comprehensive functional medicine plan. That’s root cause and not just trying to Pro supplements at the wall thinking that that’s going to fix it. So yeah, I understand if that you know where that person is coming up with that, that bias that biases from not having a comprehensive root cause plan with a functional medicine practitioner, they’re just trying to throw stuff at them instead it hoping it will fix the symptoms, not fix the root cause.

Well, here’s Yeah, good, good point. Here’s the other thing, too, it’s even some probiotic companies will say that about other companies, it’s more of a marketing thing like, hey, their probiotic is crap, or it doesn’t work because of X, Y, or Z. But I will just say with what you and I use, clinically, we’re using professional supplement manufacturers exclusive only to health care providers. And a lot of the stuff we use, we have extended release technology. So when arguments like probiotics are going to die in the stomach, they’re not even going to make it to where they need to. But a lot of the new technology we use, they’re not even going to break open, they’re going to be resistant to the stomach acid. So that’s another problem too, when you hear these little like, super sometimes buzzworthy type articles. It’s not taking into consideration the quality, the quantity, the purity, the potency, the technology involved, it’s like probiotics, they get the label, and then that’s it. And that’s just not a fair classification.

Correct. And then also consumer reports that a study on probiotics a couple years back maybe 5 10 years ago. And what they found is most probiotics that they put a number on the outside of the bottle, hey, this is how many colony forming units. And what a lot of the cheap companies do is they say, Okay, this is how many should have been in this probiotic at manufacturing of this product. Let’s say it’s 20 billion. Now, what the professional companies do is, right, when you’re buying high quality, professional ingredients, they’re gonna say this is how many colony forming units should be in this capsule at expiration. And so you’re looking at something like two to three times the amount of those that species that CFU on the bottle colony forming units, is going to be typically in there. So when you see like, in my probiotic, I think it’s 40 billion per two capsules, right? That’s going to be what’s in there two years from now at expiration, right? And so obviously, it’s going to be two to three times the amount of that before. And so you want to use professional companies. So what you see on the label is always worst case, scenario, number one, and then also how products are stored by professional companies is very important. So like, where we have our warehouses, like everything is stored in an air conditioned or a refrigerated environment for a lot of our probiotics, some don’t necessarily need that. But which we value, the the scenario and how that store because that really increases potency, too.

Evan Brand: Yeah. And the funny thing is, too, we’ve seen some papers on supposedly expiration dates, you know, this is something that you and I are forced to do with the professional companies we work with. But you know, we’ve seen some research on supplements from 2030 years ago, still being viable, meaning they still had some potency and purity to them. And obviously, they still had a biological effect. So to me, I would if I had to pick like a consumer shelf bought probiotic, or a suppose that expired professional product, I’m going to go for the supposedly expired product, I’d go for a five year old professional probiotic, then, you know, on the shelf today consumer level.

Dr. Justin Marchegiani: Yeah, exactly. And also a lot of the probiotics or supplements that require refrigeration on the warehousing side, a lot of times you’re just not going to get that on Amazon, you’re not going to get that level of specificity just because that’s not how their warehouses are set up. And so with ours, we make sure that that refrigeration components is there because we’re working with patients and we need we need that potency, because we’re trying to get clinical outcomes, right. We’re trying to sell and provide a clinical outcome for the patient. And if we’re just providing products that aren’t meeting that standard, we’re not going to win. And of course, we want to be successful on that front.

Evan Brand: Yeah, yeah. Well say Well, I think we covered a lot of it. So the mushrooms are beneficial Lion’s Mane the mushroom is amazing for the brain, but for the gut also Chaga mushroom would be great reishi mushroom could also deserve a good mention, you hit upon the amino acids. So the glutamine or the various types of glucose amines involved. We love amino acids, we use those all the time you mentioned like collagen also being you know, part of that makeup, we hit on some of the herbs like the the licorice, or the dgl version of it, the marshmallow, we like to use a lot, we hit upon the aloe, and then we hit the probiotics, I think those are the big categories. And then the enzymes we hit that too.

Dr. Justin Marchegiani: I think we did a really good job hitting a couple and I just I really want to plug in concepts, right? Like a lot of people, they just try to throw information at people and and try to memorize that. I think that’s not beneficial. But if you can just understand concepts, right? A concept is just something that sticks. You either get it or you don’t. And so we try to use a lot of analogies and understand we try to plug in a lot of the concepts of root cause versus palliative cause. We try to get you to think about, hey, if this helps, why does it help? is it just an anti inflammatory? is it helping just improve better digestion? is it helping your immune system? is it helping your adrenals and helping you that your body’s natural process to build back up that gut lining? What’s the underlying mechanisms if you understand that, then you see how it plugs into the greater matrix of healing.

Evan Brand: Yeah, I mean, I agree 1,000%. So, I think the big concept of today is Yes, here are some things here are some nutrients you can use. However, we really want to make sure you’re testing, not guessing. So if you do need the aloe to calm the gut for now, you need the enzymes to help improve digestion. For now, you notice that HCl is helping with your heartburn or you notice that the enzymes are reducing your bloating, or your burping or your gas. Great, but what led to all that in the first place? What led you to need the aloe because you had gut inflammation, what led you to need the enzymes, that’s where somebody like us can come in and help you figure that out and plot it on paper. And, you know, we’ve been through the trenches personally. And clinically, we’re always improving upon herself. You know, I work on my children, I know you work on your children, we’re giving our kids things to help their guts, I mean, so this is like a, there’s no finish line, I don’t want people to think, Hey, I just do this aloe for a month, and then I’m done. You know, there’s not a finish line with the gut, we’re constantly being exposed to new toxins and new pathogens. We’ve even seen with the virus that’s been going around a lot of issues with the gut there, we’ve seen a lot of issue with tissue destruction in the intestinal tract. So who knows? Right now with the 5 10 year outlook of the GI health in the US is right now, our guts are notoriously bad, due to glyphosate and other things, damaging them. So just a quick note, you kind of started with the diet all and with the diet 100% organic is important, if you’re going to go buy all these probiotics, but yet, you’re going to eat strawberries with an average of 22 pesticides on them. If they’re not organic, you’re wasting your frickin time and your money because we know all those pesticides are just killing the beneficial bacteria in your gut that you’re trying to re inoculate or repopulate with. So please go organic, you know, before you spend money on probiotics.

Dr. Justin Marchegiani: Exactly. And then also how long do these probiotic strains last in your gut, I mean, a lot of times, you’re going to see the data show in about one month or so. So that they don’t stay forever. So when you take a probiotic, it’s not like it’s there forever. So it’ll it’ll hang around typically for a month, it’ll help with a nutrient synthesis, it’ll help with nutrient absorption, it’ll help with inflammation, modulating the immune system, there’s some data that maybe the spore based probiotics hang around a little bit longer, and they may help proliferate the growth of other beneficial species. So just think when you take a probiotic, it’s not forever. Now the goal is that we’re getting some level of fermentable foods in your diet, whether it’s from sauerkraut, or low sugar kombucha, or some kind of fermented pickle or something, or, you know, cultured coconut milk or potentially high quality raw milk if you can tolerate it. So you know, that’s typically how we’re getting exposed to probiotics more on a day in weekend kind of situation. If you’re someone that can’t get that level of exposure with fermented oils from food, then you probably want to be on a probiotic a little bit more frequently, if you’re not getting those fermentable. So we just got to plug and play where we’re at. I think our ancestors probably did more fermentable foods, which is ideal. But if we can’t we plug in a good quality probiotic, or at least throw in something every couple of months, just to kind of fill in the gap to make sure we’re getting exposed to those good for mandibles.

Evan Brand: Yeah, great point, I just want to highlight what you said too, which is like your gut bacteria are actually going to help you with your health in other ways. So once gut bacteria optimize your healing the gut, you’re making neurotransmitters the way you should you’re making serotonin, you’re making things to improve yourself, you’re making B vitamins to help your energy and your mitochondria. So this is why I really the gut, I mean, we just we can’t stop talking about it because it literally is the foundation.

Dr. Justin Marchegiani: Exactly. So just kind of want to make sure that is understood. And that makes sense for everyone. We’ll put a list of recommended products down below. So you guys have access to those you want to support us support the show, we appreciate it put those down below. Also, if you guys want to reach out to Evan brand, head over to EvanBrand.com, Evan is there for you guys worldwide. And again, I’m there for you as well, justinhealth.com, Dr. J myself, there’ll be a little link button, you guys can click and reach out to us we are available worldwide to help you guys help you help support y’all. We want to make sure they have the support you need. And you have a good comprehensive plan to get what’s going in the right direction if you’re not having success. And then also just try to apply one thing today as well. If you’re having if you’re overwhelmed, and you’re having a sticking point great to reach out, if not just try applying this information, we want to really help as many people as possible. And we know we’re going to help many more people than we actually see in person with this information. So just make sure you’re applying it. And if you are enjoying it, share it with family and friends that could also benefit put your comments down below. Let me know the best part that you liked about this what resonate with you the most. And give us a like and share as well. We appreciate it.

Evan Brand: Yeah, and if you’re on the apple listening, if you’re on your Apple podcast app or Stitcher or wherever else, give us some stars, let us know what you think the show deserves between us both we have I lost count, but it was somewhere over 705 star reviews for our podcast in between our various feeds. So please give us some stars. Give us some sentences give us a blurb on whether you still call it iTunes or Apple podcast. We’d love to beat out people that are not clinically oriented. There’s still like top health podcast out there that it’s just theory theory theory theory. And then we have to like recalibrate people’s theories because they’re not clinically based. So we would love to beat those people. How do we beat those Before we go higher in the charts, how do we do that? With your reviews! So we have a some stars.

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take careDr. Justin Marchegiani

Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

100% Yeah, I like that. And so it’s good to really make sure that’s under control.

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take care.

References:

https://justinhealth.libsyn.com/the-top-5-nutrients-to-address-gut-inflammation-and-leaky-gut-podcast-339

Audio Podcast:

Recommended products:

Amino Acid Supreme

TRruKeto Collagen

The Root Cause and Solution of Your Stomach Burning and Upper Left Quadrant Pain | Podcast #355

Pain in your upper left (UL) abdomen under your ribs can have a variety of causes. Several vital organs exist in this area, including the spleen, kidney, pancreas, stomach, colon, and lung. One of the most common origins of these issues is due to digestive problems. Heartburn typically happens when acid comes back up from the stomach into the esophagus. It can result in discomfort and a burning sensation in your chest. The pain can feel burning, sharp, or cause a tightening sensation.

Additionally, Gastroesophageal Bowel Disease, commonly called acid reflux, is a condition that occurs when you experience heartburn more than two times each week. Irritable Bowel Syndrome is also a chronic condition that involves a group of intestinal symptoms that usually occur together. The symptoms can differ in severity and duration from person to person. Inflammatory Bowel Disease (IBD) also includes any disorder that can cause inflammation in your gut; the most common of these conditions is Crohn’s disease and ulcerative colitis. Dr. J and Evan emphasized that having your daily food and environment checked. Possible modification is a basic essential thing to do to avoid gut issues that can compromise overall health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:32 Stomach Burning and Irritation

8:48 Causes of Stomach Cancer, General Inflammation

14:27 Herbs

19:26 Bacterial Overgrowth causing Stomach Problems

27:41 Mood, Stress, Depression and Anxiety Conditions

Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan brand. Evan, how are we doing today, my friend?

Evan Brand: I’m doing great. You ready to dive in and talk about heartburn? One of the most common issues one of the trending issues that’s always trending because us as a modern society, we have a lot of issues with hypochlorhydria, which is the technical term for low stomach acid. And so you and I are going to break down some of the reasons some of the root causes some of the triggers, and then some of the solutions. So where do you want to start?

Dr. Justin Marchegiani: It’s a great question. So out of the gates here, we’re chatting about what h pylori stomach burning stomach irritation, so there’s a lot of root causes here. I would say out of the gates here, let’s hit H. pylori first.

Evan Brand: Let’s do it. So I had H. pylori. So I’ll tell you from personal experience, and you and I clinically have seen many, many, many cases of H. pylori, let’s start with a conventional approach to it. So first of all, the testing for H pylori is not very good in the conventional world. And there’s an issue with false negatives. Luckily, the DNA stool test that we use is very effective, and we can find it very accurately. And conventional treatment is going to be what’s called triple therapy, or sometimes quadruple therapy, which is three or four antibiotics at the same time to try to kill this helicobacter infection, which if you look at the microscopic photo of it, it kind of looks like a jellyfish, it’s got this creepy little look to it with a creepy little tail. It’s not a pretty little bugger, but man, it causes damage to those parietal cells which secrete stomach acid. And this is something that was very controversial for many times until the researcher actually infected himself with H. pylori and gave himself an ulcer. Right? You and I talked about that story before.

Dr. Justin Marchegiani: Yeah, that was Dr. Marshall. I think in the in the mid 80s. He couldn’t get funding for his research. So he’s like, hell, let me be the subject. And so he just infected himself with it. And h pylori, like you mentioned, is that he had a co shaped helix shaped kind of bacteria that kind of burrows into the gut lining. This it’s controversial because, well, I shouldn’t say it’s controversial, we know that it can cause ulcers and stomach inflammation, we know that it can affect acid secretion. Now, a lot of people complain that it’s an increase your acid levels, H. pylori tends to actually decrease acid levels. It creates an enzyme called urease, which takes the metabolite from urea protein metabolism, it turns it into co2, and then also ammonia and ammonia is got a pH of 11. So in the typical urea breath test for H pylori, they give you a bunch of urea. And the whole thought process is if you have h pylori, you’re going to have more of that urease. And that urease is going to convert that urea into ammonia and co2, then thus a positive co2 level is going to be give you the H pylori indicative for a breath test. Now that ammonia has got a pH of 11. So it will start to neutralize and start to move your stomach pH in the more alkaline direction. So kind of one to six is going to be your acidic scale, okay? One is going to be 10 times more acidic than two, two times 210 times more acidic than three, and then you get to seven, which is going to be neutral, that’s your water. And then everything above that base are alkaline, right? And so ammonia is that 11. So you’re taking that pH in your stomach that should be around one and a half to two and a half and you’re moving it more neutral. And so of course, that can affect a whole bunch of problems in your stomach from indigestion, dyspepsia, you’re not breaking down your proteins, you’re not activating your enzymes. And also H. pylori can thin out that gut lining. So part of the reason why people feel like it creates more acidity is because your gut lining gets thinner, your gut lining gets thinner that’s making you more sensitive to acid in your stomach. It’s kind of like if I got a sunburn, right? If I got a sunburn, and I went out the next day in the sun, did the sun get hotter? Well, it feels harder when I’m in the sun with a sunburn, right? Did the sun get hotter? No, it is your skin’s more sensitive. That’s when you’re out in the sun. It feels like it’s 150 degrees out but it’s not. It’s the same thing with your intestine you got a sunburn got that feels more irritated. Thus that acidity the acid that you’re putting in there may cause some irritation just like going out with a sunburn.

Evan Brand: Yeah, that’s great analogy check your microphone to it sounds like it may switch to your headset, make sure it’s on your USB and I’m going to riff on h pylori for a minute because my personal experience with it was not fun. I lost a lot of weight and I was kind of freaking out honestly like I lost so much weight and I couldn’t stop it and no was no shortage of calories. I was eating plenty of good meats and good fats and I just kept losing weight and I think h pylori is really one of those big stepping stones or maybe the better analogy is the domino effect. And once the age polarize there, as you mentioned, it kind of in activates your enzymatic process. So your pancreatic enzyme function, the release of the stored bile from the gallbladder is going to slow down or be reduced. So this is what I think leads to a lot of the SIBO or the bacterial overgrowth dysbiosis problems that you and I see clinically because when we find h pylori, we go down to page three of the stool tests and then boom, now we see Prevotella and klebsiella and Pseudomonas And all these other bacteria that are thriving so many people have heard of SIBO because it’s trendy, and they’ll come in and they’ll do SIBO protocols. But if they don’t get rid of the H pylori, I’m convinced that’s one of the smoking guns that allows the dysbiosis to take place. So, long story short, if you’re someone listening, if you’ve treated your gut before using antimicrobial herbs, or possibly even antibiotic therapy, and you didn’t get better, or maybe you got better and you relapsed, consider that you’ve missed one of two things mold toxin, which is weakening the immune system or number two h pylori, and it could be coming from your spouse. So if your spouse is not being treated, they could have reinfected you and that’s why you’re on the merry go round and you can’t get off.

Dr. Justin Marchegiani: 100%. So h pylori is one of the first things now, people say, well, a large percent of the population has h pylori, and that that is true. And so the question is, are you immunocompromised with that h pylori is an issue we’re not. There are a lot of people that can survive on four or five hours a night sleep. But once you become stressed, and your adrenals become dysfunctional, and your diets been poor for a while, that four or five hours of sleep may not be enough. So you have to look at the context of the person for sure.

Evan Brand: Yeah. It sounds decent. It could just be the bitrate or something I do believe you have it on your USB now. It just sounds like it’s a little grainy, but it I know on our local and it will be just fine. So it’s, it’s plenty good enough for today.

Dr. Justin Marchegiani: Okay, excellent. All right. So out of the gates here, just kind of hitting all the right things that we’re chatting about. So we talked about the susceptibility for H. pylori, right. h pylori is going to be one of these things that may be a problem in people that have symptoms. So if you have symptoms, if you have issues, we want to look at that and the gates for sure. I think that’s gonna be a top priority. Anything else you want to highlight regarding other infections? I know SIBO was another one that could potentially affect digestibility and your stomach cebo is going to hit more of your small intestine, but some of that bacteria overgrowth can move its way and migrate to the stomach as well for the gastric area.

Evan Brand: Yeah, well, I think H pylori is probably the biggest smoking gun but like you’re not talked about many times, you can have permission to have multiple things wrong with you. Right? You said that so it’s funny because we’ll see Candida will see bacteria will see H Pylori, which is bacteria will see parasites will see worms. So the cool thing is when we come in with the testing, we’re often using full spectrum herbs. And what I mean by that is we’re going to try to knock out Candida bacterial overgrowth, the H pylori, the parasites, often we can do it in one fell swoop. And it’s really fun to do this in children or young adults, because they tend to get better faster. Like if I see a five to 15 year old kid and we’re working with them. It’s amazing how much faster they get better than like a 70 year old adult, for example. It’s something that I think shows the immune system being weak long term, this can be a bigger problem. So when you hear about stomach cancer, and the ulcers and esophageal problems, and GERD and some of these more scary diagnosis, these, these are likely more long term infections, or it could be the virulence factors, which are something that we test for if you look into the research, H. pylori by itself is not going to cause a ton of problem in the short term. But when it has these virulence factors that essentially strengthens the disease, the way I think about it is like the little whale shark, or actually, whale sharks are huge, but the whale shark with the little fish that kind of swim under its fins, to me, those are the virulence factors, they kind of strengthen the main host there, they’re allowing the H pylori to thrive, they’re allowing that shark to do what he needs to do, they’re helping to maybe eat parasites off of the shark, so they’re kind of helping him hang around. That’s how I think of these virulence factors. It doesn’t change the protocol much, but when we see a ton of inflammation or when we see a ton of gut damage, it’s good to be able to link that back to a stool test.

Dr. Justin Marchegiani: 100% here, the virulence factors are going to look at those cytotoxic proteins and it’s a genetic susceptibility of this H. pylori is going to produce more toxins that are going to increase your chance of ulceration increase your chance of stomach cancer, increase your chance of just overall general inflammation. So it’s nice to look at the virulence factors. Now we have a couple we have like Virdi, VagA, iSay, these different virulence factors, these are cytotoxic proteins. And so it’s good to look at that. Now one of the things we’ll also look at in regards to intestinal inflammation to kind of make correlations is we’ll look at calprotectin. Calprotectin is another systemic marker that’s excellent to look at, because it plays a major role with inflammation in the gut as well. And so that’s a really good one. So it’s like a C reactive protein for your gut. CRP is a basically an inflammatory marker for the body. C reactive protein. calprotectin is a protein produced by the white blood cells in the intestine. So when there’s more inflammation, more cytokines, more interleukins, nuclear factor, Kappa beta, all these inflammatory presence, it’s going to give you more of a window that that’s happening now. It doesn’t tell you what the cause of it is. So you need to do detective work and get to the bottom it’s going to be usually one to four or five things. Something of infection, some type of food allergy, some type of immune stressor, whether it’s exposure to mold or heavy metals, okay? It can also be gut permeability where things are getting into the bloodstream and you’re having this, I mean, a logical reaction, those would probably be the big four out of the gates. And then I think, also just if you’re eating a lot of junky inflammatory foods, omega six grains, a lot of pro inflammatory foods, those could also drive it too.

Evan Brand: Yeah, I would say there’s probably an autoimmune component to right if you’ve got Crohn’s or ulcerative colitis or something like that, that may elevate that. And I know some of the stuff we talked about, if you try to take our conversation and put it in front of your GI doctor, they may not follow us on some of this stuff. But they will follow us on the calprotectin. I mean, that’s a pretty common marker that it’s going to be tested in conventional gastroenterology. So if you’re trying to like educate your doctor, if they’re willing, enable cool, you know, send them this podcast, hopefully, they’re open to integrating some of these things into their practice. But often, we’ve had many people that have been the GI doctors, 5 10 15 doctors before they come to somebody like us. And unfortunately, they’ve had very poor testing, and they’ve had very poor treatment. That’s why they’re still needing help. And we’re usually at the end of the rope, which you would think puts a ton of pressure on us, but I think you and I are used to and I actually enjoy it. Because in contrast, what we do makes the other people look silly, and our success rate is so good that it’s really it’s a blessing to be able to have some of these tools on hand. And it’s really fun and inspiring to be able to give people hope. And some of these chronic gi issues like heartburn or reflux or GERD, or some of these esophageal problems like what they call like issues with the LES to lower esophageal sphincter that can become very traumatic. And people think that surgery or drug is the answer. But we don’t have to go there in the majority of cases.

Dr. Justin Marchegiani: Yeah. And also, when you start to have you know, a lot of dyspepsia, that’s like the bloating, that’s the nausea, the burping the belching, when you start to have that, right, that lack of acidity in the intestines, if you have a lack of acidity, you also have a lack of enzymes more than likely because acidity is an important trigger for enzyme activation, right, because a lot of our enzymes are pH sensitive. So if you don’t have a nice low pH, they’re not going to activate and also that bacterial overgrowth, and you can look at bacterial overgrowth in the stomach usually be a glucose breath test. Now, the conventional breath test that we use for like SIBO is we’ll use a lactulose blood test, or lactulose breath test where you swallow a lactose solution. And then you’re gonna, you’re going to blow into a bag, and you’re going to get a baseline and then you’re going to swallow the lactose solution, and you’re going to blow every 20 minutes. And you can sometimes see an increase in gas that first 20 to 40 minutes, usually being reflective of the stomach area, usually in that first 120 minutes gives you more of the small intestine. And if you do a glucose breath test, that’s going to give you more of a window into what’s happening in the stomach. Now, typically, what we do is i’m doing more of a store test and I’m getting a global look at bacterial overgrowth in the intestinal tract as a whole. Obviously, when we’re testing stool, it’s all moving through the intestine. So you can’t say Oh, that bacteria is in that part of the intestine or that part of the colon or that part of the stomach, you can’t really do that because it’s all moving its way out and getting mixed up, right. So a breath test could be helpful for that. Now, for me, it doesn’t necessarily change a lot what I’m going to do, because if I see him does a lot of klebsiella or citrobacter, or I see some h pylori or I see a lot of organic acids showing him parade or fenzbenzoate right are two three phenolacetate, right different markers indican. And that tells me we got some problem especially indicate indicates one of those bacterial overgrowth markers that also has to do with more increased putrefy protein. So that’s going to be a good indication that there’s some stomach issue going on and dyspepsia issue going on. So if I see that that’s going to gear me in that direction to be focused on addressing the stomach. And when we do herbs, guess what you can’t just target one part of the intestine, when you give these herbs is going to move its way through. Some of these herbs are going to target things more specific to h pylori like mastic gum or bismuth. But obviously, some of those are still going to have general antimicrobial benefits that will move down the entire intestinal tract. And some even have anti parasitic benefits too. So it’s hard to just target things we do know there’s a history of herbs that tend to be more selective to certain things in the intestinal tract.

Evan Brand: Yeah, great, great, great segue to into the herbs. So let’s go into that now. And we’ll be providing some links, we’ll put them in the show notes. We’ll put them in your podcast app. So if you’re listening on your iPhone, you should be able to check if you’re on Justin’s podcast listening, you should see some links for his products. If you’re on mine, you should see mine we have custom formulas that we’ve created in partnership with professional healthcare company so we don’t use any kind of consumer manufacturing. Most supplement companies, they gather products from around the world and they just label them up in a warehouse and ship them out. But they’re not professional. So there’s typically not as much tests. If any testing at all purity potency, those kind of things are not well tracked, we’re very anal about what we do, because we have to get results clinically. And if we don’t, then people don’t get better, and they don’t come to us. So we have a legitimate reason we have to be of the utmost quality. This is stuff that you can’t get through consumer, like Whole Foods, places, or Amazon, these are professional so that that’s, you know, just a little bit about quality. But in terms of the stuff we’re using, as you mentioned, we have different blends. So sometimes we’re going to go with more of like a mastic gum, clove berberine, Wild Indigo blend, these are things that can be both anti inflammatory, anti microbial, anti antifungal, anti parasitic, and then we have some where we’ve got a little bit of gut healing nutrients, like we might throw in a little bit of some dgl into the blends. So now we’re doing two things at once, which is great, we’re killing but we’re also soothing the gut lining, which is probably so irritated, as you mentioned, this thing is thinned out from the infection itself. And then we go into more of the antifungals, too. So we may stack. If we see on the organic acids, you’ve got an anti fungal need, then we’ll throw that into on top of the anti microbial need. And that’s where the magic really happens. There’s a synergistic effect. So rarely Are we going to come in with just oregano oil or just garlic, we’re likely going to use a combination of possibly 510 or even more herbs. And then if you want to comment on that, and then let’s get into the the question of like, where do probiotics fit into this equation? What about digestive enzymes and increasing stomach acid? Where does that fit into this equation? So if you want to hit on the herbs at all, then let’s transition.

Dr. Justin Marchegiani: Okay, so first off, I think people come in with stomach issues saying, Hey, I have an H. pylori issue. And that’s it. So I think, one you have the right to have more than one infection or gut imbalances happening at the same time. So it’s really important don’t get myopically focused on one infection, there’s probably multiple issues. You could have h pylori, you could have some level of bacterial overgrowth that involve other types of infections, like klebsiella, or Pseudomonas or citrobacter. You could have a fungal overgrowth, you could have a parasite infection, as well. So all those things can be present. And also, you’re probably going to have a lot of dyspepsia where you’re having bloating, nausea, indigestion because you’re not breaking down your foods adequately. So you’re going to need to follow my six R’s right and moving the bad foods and again, that could be different for everyone. Some people that could be a paleo template, others it could be an autoimmune, it could be a low fodmap template as well could be a low histamine could be a gassers SCD template. So there’s different templates we’re going to plug in, depending on how sick or how chronic this issue is. And then number two, we’re working on enzymes and acids to really work on digesting things better. And again, acids tend to be anti microbial. Also, bile acids, which are produced by your gallbladder are also anti microbial. So if you have biliary insufficiency, you’re not breaking down your fats, inadequate levels of bile salts will create a a more hospitable environment for bad bugs to grow. So that’s the second are placed enzymes, acids, bile salts, third are repairing the gut lining and supporting the adrenals and the hormones because the adrenals help really provide a good anti inflammatory environment. So if you have imbalances in your cortisol function, you may have a lot of inflammation that’s not being managed by your adrenals. And then of course, on the repair side, you kind of hit it earlier. Some of the repair nutrients that we’re going to use maybe glycine could be L glutamine, it could be zinc. Zinc is very helpful. A lot of studies showing that to be very helpful with gut permeability. I would say DGL licorice, aloe okra, vitamin A. These are really important nutrients that come down the gut lining early I also like ginger and manuka honey. Manuka is used in hospitals in burn units, because it’s very anti inflammatory. So I like a little bit of manuka honey, and my ginger juice tea recipe is wonderful. Any comments on that?

Evan Brand: Yeah, that’s delicious. I’m a huge fan, too. And the good news is, depending on what’s going on, you could start soothing the gut a bit early. So as you mentioned, there is kind of an order of operations. But depending on the case, if someone’s in real bad shape, we may come in with some of those soothing nutrients early. Let’s talk about probiotics, too, because this is a confusing one for a lot of people. They just hear online, a podcast, a blog, a website, they’ll hear probiotics, probiotics, I think it’s time to just throw it in. And a lot of people have a bad reaction to that. I think we actually did a whole podcast on this, like when and why probiotics may make you feel worse, but why don’t you give us just some sparknotes on that, when and why and how do we integrate probiotics entities.

Dr. Justin Marchegiani: So people tend to have stomach issues in general because they have this bacterial overgrowth in the gut, that’s going to affect the esophageal sphincter from closing. They also have a lack of enzymes and acids. So the food’s rotting, it’s putrifying, and transfer defying and creating lots of different gases as a result. Now, people tend to have a lot of bad bacteria in their gut, they tend to be very sensitive to fodmaps fermentable carbohydrates, fructose, oligo, disaccharide, mono and polyols. And again, probiotics tend to have fodmaps in it because probiotics are inherently fermentable right fermentation breeds bacteria, good bacteria growth, they can also breathe bad bacteria growth, right? And so if you’re consuming a lot of probiotics and you have a lot of bad bugs, it can really create a feeding frenzy just like throwing chum in the water. When there’s sharks around. It creates a feeding frenzy. If you go to your local Lake, I go down to Lake Austin and start chumming the water, right? Well, there’s no sharks down there. So you’re not gonna see any sharks come in, right. And so think of probiotics and a lot of fermented bowls. They may be reasonably good and healthy for you. But if you have sharks in that water, and you chum the water, you just create a feeding frenzy.

Evan Brand: Wow. And that you’re saying, with probiotics, you’re not necessarily even talking about prebiotics?

Dr. Justin Marchegiani: Correct. Again, people that have more extreme fodmap and SIBO sensitivity. That’s where probiotics start to become more of an issue. You can still have some SIBO and fodmap sensitivity, and you may not get rise to the level where probiotics are problem, right? So people that are out there and having problems with their kombucha or their sauerkraut, you know, it could also be a histamine issue, because probiotics and fermentable are also high in histamine so they could dovetail and be a couple of different things happening at the same time. Either way, if that’s the case, we still have to work on fodmap restriction, because when we deal with gut bacterial issues, we starve on one side with diet changes. We kill on the other side with specific antimicrobials, and then we crowd out and overpopulate on the last component so we we starve kill and crowd.

Evan Brand: Yeah, that’s great. And then the saccharomyces comes into the equation too, right? Which is kind of marketed and sold as a probiotic, but technically is a beneficial yeast, I love saccharomyces it’s something-

Dr. Justin Marchegiani: It crowds out it crowds out so it has beneficial effects of crowding out and also is shown to be very anti cdiff. Anti h pylori, anti blasto and it has immunomodulating benefits increasing IGA levels too.

Evan Brand: Yeah, we love saccharomyces it helps them mycotoxins too. I’ve seen it in a lot of people. And when I talk with Dr. Nathan, who is a guy who treats a lot of mold patients, he talked about saccharomyces being great for specifically, I think it’s actually metabolizing, or changing the structure of the mycotoxins to make them more water soluble, but there may be sort of a crowding out effect with the mole too. So it’s just a great overall thing. So if you’re working on a gut healing protocol, and you haven’t used saccharomyces, that may be something to chat with your practitioner about, it may be something great to add in.

Dr. Justin Marchegiani: Yep, I like it, that makes a lot of sense to me. So when we have that upper left quadrant pain, right, your stomach for the most part is going to be just right in usually this area here. So this is kind of your, this point right here is your HCl point. And this points more of your enzyme point. So like pancreas, small intestine is like really right here, stomach’s usually going to be right in this area here. And then you have the esophagus, going up here, obviously, right, and then this esophageal sphincter can stay open. When we don’t have enough acidity and we have bacterial overgrowth, then you can have a lot of that regurge of that reflux happening when we have inadequate levels of assets. So one thing if you kind of take your hand right here, and you follow the sternum down, right, we’re kind of tucks into the left, if you rub it a little bit, and it’s a little bit sensitive. That points normally sensitive anyway, but if it’s really heightened, is a chance there’s inadequate levels of HCl in the stomach. So that’s a good little kind of pressure point there.

Evan Brand: Yeah, and people listening that can’t see he’s showing this down right there at the sternum, and then you can follow the rib line down to the left, or you could follow it down to the right, and you could check both sides. That’s a really cool thing that you can do in person when you’re working with the practitioners, you can palpate these points. And I remember when I was in one of my schooling lessons, we were with the teacher, and we had a lady who lay down on the table and everybody was coming up and palpating and man, this lady about jumped off the table when we hit that HCl point. So of course, we didn’t have a stool test on her but man, I bet she had some infection going on.

Dr. Justin Marchegiani: Yeah, and it’s good to rub that and then you can kind of rub a couple other spots to see if it really is heightened and then you can also start start treatment. Right, make diet changes, add in support, right? start addressing microbials down the road and see if that changes but again, the biggest thing I really want to highlight for people listening, we live in this antibiotic culture today, right you have an infection, antibiotics, antibiotics, antibiotics, and so what tends to happen as people are in kind of my six are step right the fourth are is moving the bugs right? replace the net or remove the bad foods replace the enzymes and acids and bile salts, repair the gut lining and the hormones remove the infections, repopulate good bacteria, pre probiotics, retest that fourth Rs a movie infections, people go to this first. We live in this like, antibiotic generation people are programmed Kill, kill, kill, kill, kill, it’s the biggest mistake you can make. Some people can get away with it. If you’re really healthy and you don’t have an overabundance of inflammation, you can get away with it. Most can’t. And they end up creating a whole bunch of problems. And I tell my patients the first rule of functional medicine right the first rule of Fight Club is don’t make yourself more sick. It’s really important So that’s why that fourth R where that remove that second remove right the first removes the food. Right. The fourth R the second remove is removing the infections, we do it in that order, because we’re trying to calm down the immune system, trying to support our anti inflammatory system so they can deal with inflammation and stress better. We’re working on digesting and breaking down our food or working on motility that allows us set the table so we can come in there and wipe out the bad bucks.

Evan Brand: Yeah, he kind of alluded to it. But just to make it clear, you’re actually improving your immune system by clearing out these infections. And some of these herbs we’re using may have immune supportive benefits too. So that’s just the real joy of what we do is you’re boosting the immune system, you’re letting the gut heal by removing the infections. It’s just amazing. And when you get the spouse involved too, like if you’re seeing a rebound case where husband feels great and then the wife sick and back and forth, you know, they may be passing the H pylori between each other even children who I mean I was sharing water bottles with summer my daughter when she was two, I tested her when she was two she had real high H. pylori. So I’m convinced I may have given it to her, I don’t know. But luckily, we did herbs and she’s in good shape now. And when we retested her the H pylori is gone. So I’m glad that we’re able to get it resolved. But this is a problem that affects kids. So like when someone hears heartburn, they automatically picture old Betty sitting in the wheelchair with the gray hair and she’s got indigestion she’s got her santech in her hand. No, it’s not just her. I mean, this could be two years old, this could be 10 15 20 30 40 years old. So don’t discriminate. This bacteria does not care what you look like and how big or small your or anything. This is a bacteria that affects all people across the population. So if you have these issues, get tested, don’t guess. And if you need help clinically reach out we work on this issue all the time, it’s one of my favorite things to do is work on these gut infections. So if you need help clinically, we work around the world with people we send testing to your home, you do the labs, we get them back to the lab for reporting. And we jump on a call like we’re doing now and we talk about it and we help you make a protocol help you fix your issues once and for all. So if you want to reach out to Justin, you can have his website, JustinHealth.com. If you want to reach out to me, EvanBrand.com and like I mentioned, we’ve got some links, we’ve got some gut healing products and some things that we’re okay with you guessing on, there are a couple of things you could do out of the gate. But ultimately, you need to know what you’re up against. Because as we alluded to, you may not have just h pylori, you may have other infections. So coming in with the glutamine, the zinc carnosine, that lm that kind of stuff that kameel, the ginger, the Manuka, it’s awesome. But that may not be the right order of operations, it may help you by some time, but you got to clear the bugs.

Dr. Justin Marchegiani: 100% and there’s a lot of studies out there looking at H. pylori, for instance, with a lot of mood and stress and depression and anxiety related conditions. And they find that when a lot of the H pylori is addressed, some of these changes occur as well with these issues improve or they talk about antidepressant drugs working better now. Now, why is that happening? Now, I believe the reason why it’s happening is because when you address some of these bacterial overgrowth, you’re absorbing your nutrients better, you’re absorbing your protein, you’re absorbing your fat, and in some cases, probably absorbing their drugs better, so they work better because they’re in their system. Now, I personally believe if you’re not breaking down your proteins and your fats, these are functional building blocks for your neurotransmitters, that you’re going to have some issues in regards to your mood and your cognitive function and potentially energy because a lot of the nutrients and minerals and B vitamins have to get absorbed that way too. So if you have issues with your gut, don’t just think hey, this is just a gut issue. Therefore my only symptoms are dyspepsia bloating, gas, nausea, constipation, depression, diarrhea, you could have fatigue, you could have cognitive issues, you could have mood issues, depression, anxiety, sleep, right. So we have to get kind of outside of the we have to go into the extra intestinal world meaning symptoms outside of just your gut related symptoms. And so it’s possible if you’ve h pylori, you may only have fatigue and mood issues, and sleep and it’s very possible. So you don’t want to just get hung up on the digestive symptoms thinking I’m okay. You could have things outside of the gut area.

Evan Brand: Yeah, and you don’t even recognize it. And the psychiatrist is certainly not going to suggest that our anxiety and depression is an H pylori infection. And that was it for me. I mean, I had panic attacks and anxiety. I mean, I was a wreck when I had gut infections. I will tell you personally, and clinically, I’ve seen the link between mood issues and gut issues. And I had a lady that I had maybe the last two months, I did not give her any anti depressant herbs at all. All we did is work on her gut and within six weeks, she said her depression was 90% better. And she just said it kind of nonchalantly and I’m like you said you were depressed for 20 years during our initial call or you’re not realizing what we’ve done in six weeks just by working on your gut. We’ve as you self reported a 90% reduction in depression which you’ve had for 20 years. That is insane. That should be on the Billboard. That’s Beyond the headline news, but I think there’s just some ignorance about the link between gut and mood issues. So hopefully the psychiatric world and the gastroenterology world can start to get more integrated because right now they’re still very, very separate which is no good for the population.

Dr. Justin Marchegiani: Yeah, here’s an article in the get the Journal of gastroenterology research and practice. It’s called the rule of H. pylori, and regulating hormones and functional dyspepsia. So if you get right to it, it says H. pylori strains have been shown to affect the secretion of several hormones including five five hyphen ht or five HTP. That’s the serotonin melatonin precursor ghrelin which affects mood and appetite, dopamine gastrin, which affects HDL levels. So and then has, it might be the cause of psychological disorders of functional dyspepsia. So, essentially, there’s a strong connection with H. pylori hormones, and a lot of the neurotransmitters and appetite regulating compounds so really important, right, H. pylori, we have to go above and beyond just thinking this is a digestive issue. It can affect mood, energy, sleep, and of course, hormones as well.

Evan Brand: You and I talked about this kind of like we’re just like tying our shoes and cooking some breakfast. Would you have for breakfast today? Oh, I had some pastured eggs and bacon and sausage. What about you? Oh, yeah, handful of some avocado because, like we talked about it, like it’s just so nonchalant. But I mean, if this were to be the headline news, like you and I, this podcast we just ate if this were to be like, the trending thing of the week and 300 million people heard this. I mean, we could put a huge dent in the world, I think we’re doing a great job. We’ve got good numbers, but my God, if this was like the trending interview of the week, I mean, just imagine people would have so much more hope for their mental health, their physical health, their heartburn. This is empowering stuff here.

Dr. Justin Marchegiani: Yep. And don’t expect your conventional medical doctor to know about this stuff unless they’ve gone through more integrative kind of nutritional, natural, functional type of continuing education. Most dermatologists don’t even understand that your skin has a direct connection with your diet, right? They still have pamphlets in the dermatologists office saying what you eat has nothing to do with your skin. Most people that have eaten crappy and change their diet to be much more healthy, they can tell you one of the benefits you see is your skin, right? We know inflammation, and oil secretions all have a major effect with inflammation, grains and six junky carbs. While Same thing with our gut, there’s that same level of disconnect all throughout medicine, because each, let’s say medical specialty only knows their thing. And you know, when you’re working 60 to 80 hours a week, you’re not going to have the time to really keep up with the literature and what’s happening. And, you know, if you’re relying on your medical school training, well, typically that information has to be around for 20 or 30 years before it gets into a medical school curriculum. So what you’re getting in medical schools, and they’ll be 20 to 30 years behind probably at least 20 years behind time. So don’t expect your doctor to be in the loop on this thing. So you got to really go outside of the box and, and educate.

Evan Brand: Yeah, I mean, I’ve got a very close family member who has a nanny for a well respected neurologist, and the neurologist home is filled with frickin mold. And no wonder the kid has a lot of issues and no wonder the mom has gut issues and the dad has brain fog and everyone’s exhausted and they don’t sleep good and they have skin issues. It’s like your neurologist, those are mycotoxins. Those are killing your brain. Do you not know it? Nope. She doesn’t know. It’s crazy, man. So hopefully we can continue to do good work like we’re doing and spread this word because man. Yeah, we’re still in the stone age’s and a lot of aspects.

Dr. Justin Marchegiani: Yeah, no, I think we’re on top of it. Well, if you guys enjoy today’s podcast, we really appreciate it, head over to EvanBrand.com or JustinHealth.com. You can subscribe to our email list. You can become a patient we work with patients all over the world happy to help you. Especially in the day and age the last year how things have gotten more virtual. It’s great to have access to good clinicians and doctors, virtually so we can provide that for you. And if you enjoyed today’s podcast, write us a review. Click Below the link you’ll see a link for a review, write us a review. And also share this with friends and family. We appreciate it Sharing is caring. If you enjoyed it today, apply one thing, share it with one person that you love that could help them. Evan anything else?

Evan Brand: No, that’s it. You did a great job and we’ll be in touch next week. So take it easy and have a good one.

Dr. Justin Marchegiani: Have a good one y’all. Bye now.

Evan Brand: Bye bye.

References:

https://justinhealth.libsyn.com/the-root-cause-and-solution-of-your-stomach-burning-and-upper-left-quadrant-pain-podcast-355

Audio Podcast:

Recommended products:

DSL GI-MAP Genetic Stool Test

International DSL GI MAP Genetic Stool Test

Genova Organix® Dysbiosis Profile

GI Restore

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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:36 Common Mistakes in Using Digestive Support

12:03 Healing Gut Lining

15:39 Sex Drive and Libido Effects

17:59 Bile Support

21:48 Higher Fat Diets

25:09 Cooking our Food

31:04 Food Quality

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References:

https://justinhealth.libsyn.com/the-top-5-common-digestive-supplement-mistake-hcl-enzymes-and-bile-support-podcast-338

Audio Podcast:

Recommended products:

Genova SIBO Breath Test

DUTCH Adrenal Test

Organic Grass Fed Meat

Betaine HCL Supreme

Multi Nutrient Supreme

Digest Synergy

Liver Supreme

Enzyme Synergy

https://pomeroyinstitute.com/

Why is My Digestion Broken – Lab Test Interpretation of GI MAP with Lisa Pomeroy | Podcast #335

The digestive system is a winding and extensive part of the body. It ranges from the mouth to the rectum. The digestive system assists your body in absorbing vital nutrients and is responsible for getting rid of waste.

Because there are so many types of digestion issues, you might mistakenly dismiss them. Dr. J and Lisa emphasize that it’s essential to understand the root cause of digestion issues — as well as emergencies — so you know when to talk to a functional doctor and have yourself tested.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction

3:31 – GI MAP Interpretation from a sample patient

Dr. Justin Marchegiani: Hey guys it’s Dr. Justin Marchegiani here. I am with Lisa Pomeroy. Really excited to have her on today’s podcast. We’re gonna be chatting about different kinds of lab tests. Everything labs really. Our goal today is to show, we’re gonna be really diving into the gut tests, really looking at gut function. One of the big tests we’ll look at is the GI map and how to interpret that and some of the big take-homes as we go through that to you know pull out action items as we address patient concerns. And the next one we’ll go into is the ion panel where we’ll get a really good window into mitochondrial function, neurotransmitter function, overall nutrient absorption, gut function, etc. So, really excited to have Lisa on the show today. Lisa, how you doing?

Lisa Pomeroy: Doing good! How about yourself?

Dr. Justin Marchegiani: Hey,doing wonderful. Really excited to, uh, chat with you, very good.

Lisa Pomeroy: Yeah.

Dr. Justin Marchegiani: Awesome. So, why don’t you let people know a little bit more about yourself me, you’re a clinician as well.

Lisa Pomeroy: I am yeah. I am a traditional naturopath. Um, I’ve done a bunch of differential functional medicine training programs. So, you know like, you I’m a graduate of Dan Kalish’s, uh, Kalish spectatorship. So, I love learning and a lot of the learning was something I had to do to try to get myself healthy. Because when we talk about gut issues, I had major gut issues. I mean, as young as seventh grade, I was having ulcer-like pain and unfortunately, no one I went to, knew about H. pylori, knew about testing for H. pylori, treating H. pylori, so I had to suffer in silence for another 20 years with severe stomach pain before I run the test on myself, found I had H. pylori and got rid of it.

Dr. Justin Marchegiani: Wow! That is crazy. What a story.

Lisa Pomeroy: Yeah, I come home from school and drink cabbage juice. I mean, I was that devoted because it’s the only thing that would help.

Dr. Justin Marchegiani: Yeah, intuitively you knew the vitamin you in there was helping.

Lisa Pomeroy: Exactly!

Dr. Justin Marchegiani: Yeah, so you really had to wait a long time, so that’s crazy because you must have so much appreciation for what we all do today. You have a lot of empathy for your patients. That’s great! It’s important to have that.

Lisa Pomeroy: Yeah, I talk to people and we’ll talk about like a five-year-old child or something and I just, you know, I’m just so grateful because it’s like I’m so glad that they have that the parents know enough to be getting this child help so they don’t have to suffer like I did for another 20-30 years with severe gut pain. You know, we find out that they have a nasty parasite in their gut and we get rid of it and they’re not gonna be nutritionally deficient and have all these gut symptoms for decades.

Dr. Justin Marchegiani: Oh, totally. Yeah. And it’s important, I mean obviously out of the gate, the labs are important to give us a lot of information that’s clinically actionable but you know diet and lifestyle, foundational things, a lot of these, you know, we probably don’t need a lab test per se. I mean, it’s good to have it right? I t’s nice to know, like okay, maybe there’s some gluten sensitivity, maybe there’s some inflammation, maybe there’s some immune activation and we should kind of start some diet changes and there’s some foundational things that you tend to find that just generally help most people out of the gates, you know, maybe sugar or gluten. What things you specifically utilize?

Lisa Pomeroy: Yeah, exactly! I mean, we look at the top pro-inflammatory foods in the diet. Most people say gluten, dairy, white refined sugar and ultra-processed foods. You know, those are gonna be some of your top things, where a lot of people will notice a difference, where you can pull it out, you know, you can do a trial where you, you know, you eat whole unprocessed foods, your whole fruits and veggies, roots and tubers, you know, that sort of things. You cut out the dairy you see how you do, so yes, testing can be helpful with that, but some of it can just be, you know, take it out and see how you feel.

Dr. Justin Marchegiani: See how you feel

Lisa Pomeroy: Exactly!

Dr. Justin Marchegiani: That makes sense. Oh cool. Why don’t we dive into some of the GI map testing out of the gates. I got a sample patient here, we’ll pull it up on screen.

Lisa Pomeroy: Okay.

Dr. Justin Marchegiani: We’ll kind of whip through it and we’ll try to keep it actionable. I mean, unlike a lot of shows, you know, you’re a clinician, I’m a clinician, you interact with patients and doctors throughout the week and so we’re trying to get people, real actionable information here.

Lisa Pomeroy: Yeah, great!

Dr. Justin Marchegiani: Can you see the screen here?

Lisa Pomeroy: I can. Yeah. It’s coming through nice and clear.

Dr. Justin Marchegiani: Okay, cool. So, we’ll just kind of start off, um right off the bat here, page one. So, we’re looking at a lot of bacterial pathogens, some parasite pathogens and viral stuff. I’ll let you, kind of take it away with the first part.

Lisa Pomeroy: Sure. So, basically what I want to see on this first page is nothing. You know, these are things that really don’t belong there. So, I want to see that less than DL which stands for below the detectable limit for all the things down the page. Now, some of these, we don’t necessarily need to interfere with, like that E. coli 0157, uh, that one is something it’s an acute pathogen. It’s actually, uh, like a foodborne pathogen and we’ve been seeing a lot of these pathogenic E. coli lately. They tend to peak in the late summer months, so July, August, September, we see a lot of them, just because they’re on the fresh produce, you know, the leafy greens, served lettuce, your basil, your berries. So, you pick them up and so we’re looking for symptoms. Now, this case, this is a very teeny tiny little level E0. So, that is something they either just picked up a very small amount or is mostly on its way out. And that’s where an E. coli like 0157, you know, is something that’s considered transient, self-limiting, it’ll go away on its own. Now, it may or may not give you symptoms. If you did get symptoms, they probably last for less than a week, probably get some diarrhea, some cramping, fever, nausea, that sort of thing. So, sometimes we’ll see these on the report and we go, okay, well, that explains why you had diarrhea two weeks ago, you know, you got a hold of this bug, but, you know, it may not be something we actually need to do something about.

Dr. Justin Marchegiani: But every now and then, you see the 01h57, I mean, you see, that with spinach a lot, these people will die every year with it. So, if it can be serious to people are, have a compromised immune system or gut function, right?

Lisa Pomeroy: Exactly! And that’s what especially the elderly, the young children, they are the greater risk of more severe types of infections and that’s where a lot of times people, you know, and a lot of times they know that were, you know, the time say they got some diarrhea, they run the test, they’re waiting for the results to come back. Usually, those symptoms are going to peak, before the results came back, so they know I’m having severe things are coming out both ends basically. I’m puking, bloody diarrhea. They should know they need to go to seek emergency medical care. And that’s something where, you know, usually by the time, we’re seeing people. Now, most people don’t get that severe, but if they would, they would have sought medical attention. So, usually, we’re seeing the side more like, oh yeah, I had loose stools for two days, I just my gut was a little off, you know. So, we may not to intervene, although, I always look for there’s deeper bigger issues because, really, you know, the body is meant to protect us from these infections, so if you were susceptible to picking up the E.coli on your spinach or your lettuce, you know, where was the stomach acid, shouldn’t that come in and killed what, you know, you ate and went through your stomach or what about secretory IgA, this is marker later on the test that tells you about gut immunity. You know, secretory IgA. Yep, there it is, yep. So, that one, if that’s low, you know, that’s a problem because that can actually engulf pathogens, so they can’t attach to the bowel wall, can take them so the immune system knows that’s a bad guy, we got to get rid of it. So, if you have a good stomach acid, good bile, those are antimicrobials to kill things, if you have a good secretory IgA, that’s your gut immunity, that’s gonna protect you, it’s our first line of defense. So, again, if I see an E. coli, I may not need to do some protocol to get rid of it, it may just go away on its own. But I’m looking for the deeper issues. You know, if you don’t have good stomach acid, you’re probably gonna pick up E. coli again next summer or whenever you again eat something that has it on it.

Dr. Justin Marchegiani: That totally makes sense. I’ll scroll back here to page one, so we can go in order, uh, and then obviously we have some other food poisoning types of bacteria here Campylobacter, uh, Salmonella, we may see in chicken. Do this change anything for you if someone still has something lingering and some gutted gut issues, I mean, you’re still going to try to address it with some herbals when it’s appropriate.

Lisa Pomeroy: Exactly! Yeah. Some of these and there is, you know, research keeps coming out where we’re thinking something like Campylobacter, you know, we think it’s something that just temporarily stays in the gut and then it’s gone. It’s kind of like a hit and run, where it does its damage and then it leaves the gut repairs. But, in some people, they’ve actually done some duodenal aspirates and find that, you know, they can actually find it still in the gut and the person hasn’t had that recent food poisoning incident. So, there is a little bit of a question with some of these, could they actually stick around a little bit longer and that’s definitely a problem too. So, if they show up on a single report, you know, say Campylobacter, shows up, my initial assumption is yeah, you probably ate some chicken or something lately that had it, but if I’m seeing repeated tests, maybe it’s a chronic colonizer or maybe you keep getting food poisoning, maybe you’re eating at some local fast food chicken place that maybe doesn’t have the best quality chicken or again, you have low stomach acid. It takes very few organisms to infect you if you have low stomach acid, so again, we need to look at, is this a chronic issue for repeatedly seeing it. Is this low stomach acid, low gut immunity, something’s wrong.

Dr. Justin Marchegiani: Exactly. And then same thing here, we have different types of sugar toxins which are, these are toxins actually produced by the E. coli, is that correct?

Lisa Pomeroy: Yeah, E. coli was kind of unique in that there’s, they’re all pathogenic E. coli. You can kind of lump them all together that, but they have different mechanisms of actions, different toxins they produce and so they kind of each got their own special name even though you can all just lump them all together, they’re just food borne pathogenic E. colis.

Dr. Justin Marchegiani: That are gonna produce different toxins that would create inflammation.

Lisa Pomeroy: Uhum, yeah.

Dr. Justin Marchegiani: So, either way, you’re gonna be, you know, trying to clean out the diet and use some kind of herbal to kind of knock it down so to speak.

Lisa Pomeroy: Yep, and I look at food quality, I also, you know, because something like, you know, again, chicken could be a source of Salmonella, Campylobacter. If you’re eating conventional chicken versus organic chicken. They found, you know, when they’ve actually done research studies on this the non-organic ones are more highly contaminated with these bugs than the organic plus they tend to be more antibiotic resistance. So, say, if you do get Campylobacter, Salmonella, chances are it’s going to be a very nasty type that’s not going to respond to treatment, if you did need treatment. Um, and then certain, techniques too like, you know, personally I get organic pastured air chilled chicken because there’s again how is the chicken processed, they can put it in a chlorine bath which is just essentially like a fecal soup, they have all of these chicken carcasses just in this big tub of chlorinated water. And so, if you have one contaminated chicken carcass in this big pool, it can contaminate other ones. Versus air chilled, they’re kind of, you know, just single hanging on their own, so again, they’ve done the research where air chilled is less contaminated with these microbes. So again, whether you’re susceptible or not, I mean, I still don’t wanna, you know, I do my best cleaning my produce, you know, buying good quality food. So, we’re looking at food hygiene, food quality, but you know, you do things the little things that you can do, when purchasing these things to prevent your exposure.

Dr. Justin Marchegiani: Okay, cool. We also skipped, I think C. diff out of the gate so C. diff is a bacterial infection, it can, it’s common in hospitals. High levels of antibiotics can mess up your gut and create an imbalance there, um, obviously toxins A and B together tend to be more synergistic and worse than just one. Do you want to add to that at all? Comments to that?

Lisa Pomeroy: Yeah, so a lot of people see this test and they panic when C. diff comes up because we know that C. diff can be a nasty infection. However, we have to keep in mind what this test is measuring, is the bacteria not the toxins. So, what this tells you is that, there’s C. diff bacteria in the gut that carries the gene that would allow it to produce toxin A and or toxin B. Whether it’s actually doing that at the moment is the question. So, what’s defined as C. diff infection is the bacteria are there actively producing the toxins and the toxins are whether damaging the gut causing the diarrhea, the classic C. diff presentation.

Dr. Justin Marchegiani: What is that?

Lisa Pomeroy: Now, a lot of people are actually colonized with C. diff, where the bacteria is there but maybe you have some good guys that are keeping it in balance preventing it from turning on those genes and producing the toxins and so that’s where it’s important to have the good bacteria there to not wipe them out by antibiotics or other things. So, we can’t differentiate between infection or colonization here, you know, this is just telling us, C. diff bacteria is there and you know, we don’t really want it there. Now, if someone does have symptoms that indicate a possible infection, you know, we certainly could do further testing and actually test those toxins to confirm. But a lot of people, if they say, well, I’m constipated, you know, probably not a C. diff infection, you know it’s, if they don’t present like those classic symptoms, it’s probably more colonization which is far more common but I still don’t want it there because it’s essentially lying in wait, waiting for the opportunity, you get a UTI, you take around antibiotics, now again, you killed the organisms protecting against this, so now, you do turn on the gene, get the toxins, get the C. diff infection.

Dr. Justin Marchegiani: So, we have the bacteria that has potential to make this toxin but it’s not necessarily show that the same toxin, they are b is present. It’s more the potential of it based on the bacteria.

Lisa Pomeroy: Exactly! This tells us about the bacteria and not whether toxins are actually being produced.

Dr. Justin Marchegiani: And this Clostridium, isn’t the same as on page two. This one is a little bit different but this is a kind of more the overall class where this is more of the specific type of Clostridium within that class. Is that correct?

Lisa Pomeroy: Exactly! So, C. difficile is a pathogenic organism that’s part of that large group.

Dr. Justin Marchegiani: That family.

Lisa Pomeroy: Yeah, but Clostridia actually has a lot of beneficial butyrate producers. So, this is just picking up, there’s a very small subgroup of maybe more pathogenic potentially harmful ones within the group.

Dr. Justin Marchegiani: Okay. Very good! Excellent! Anything you want to see down here? I mean we have you mentioned a kind of Salmonella, more connected to chicken and eggs, things like that, uh, cholera more waterborne. Anything else you want to say about Cholera or Yersinia?

Lisa Pomeroy: Yeah, so, Vibrio in the U.S. the most common source is actually seafood. So that’s what I’m checking to see if it’s like, okay Vibrio comes up, which doesn’t all that often but once in a while it will. I just check, you know, did you eat seafood recently and it’s always, oh yeah, I had some shrimp and you know, again, may or may not had those acute symptoms but you know often there’s recent seafood consumption. Now, in other countries, it’s more through the water, through, you know, just dirty water that has fecal contamination, here it’s usually seafood.

Dr. Justin Marchegiani: Okay, very good! And then, um, Yersinia, you said, is that seafood as well? That was just the vibrio?

Lisa Pomeroy: That’s just a vibrio. Yeah.

Dr. Justin Marchegiani: How about Yersinia?

Lisa Pomeroy: Yeah, that one can come through many different sources, um, sometimes it could be, you know, even raw dairy products, could be pork, you know, many different sources for food, uh, but this one actually can be a trigger for Hashimoto’s. So, it doesn’t show up.

Dr. Justin Marchegiani: It can.

Lisa Pomeroy: It can, yeah. So, it doesn’t show up all that often but if it does, I’m looking at the thyroid antibodies and other testing or seeing if there’s already a diagnosis of Hashimoto’s.

Dr. Justin Marchegiani: Very good! And then parasite wise, we have Crypto, E. histo, and Giardia, which definitely are the big three, right, um, Crypto primarily found in water, E. histo is going to be nasty little amoebic that people don’t know it’s in the top three to five causes of death in third world countries. It’s a nasty little bugger.

Lisa Pomeroy: It is!

Dr. Justin Marchegiani: And then Giardia, as well, which loves to hide in the gallbladder. I’m gonna let you kind of go into those one by one. Quick question, why do they have these parasites here and then on page four, a separate section for parasites? Why don’t they put them all in one spot?

Lisa Pomeroy: Yeah. My thought is that, you know, within the medical community, certain pathogens now are widely accepted as disease causing. So, like, pretty much, I mean a conventional doctor, a functional medicine doctor, they’re all going to say, you know, Crypto, Giradia, E. histo are bad. You know, we don’t wanna see those. Now, Blastocystis hominis, you know, most functional medicine practitioners will say that, that has a lot of potential to cause harm, linked it with Hashimoto’s and you know, hives and IBS. But from the conventional standpoint, they’re not entirely convinced because some people can have Blasto and not have symptoms. So, the ones on page four, there is research supporting that all of them have pathogenic potential but they’re not as widely accepted as a 100% pathogenic unlike the ones on page one.

Dr. Justin Marchegiani: Makes sense. I know a lot of people like Mayo clinic are starting to say, hey if you have Blasto and have some level of symptoms, well, you probably should address it, you know, most people that we see the problem is. Well, what constitutes a symptom from Blasto for instance we know a lot of gut issues can cause extra-intestinal symptoms like fatigue, brain fog, mood issues, sleep issues. So then, how do you really connect the dots? Obviously, we have diarrhea, constipation, acid reflux, bloating, right? But sometimes you get these extra intestinal ones which are a little weird.

Lisa Pomeroy: Exactly! Like Blasto, people say, oh well I have no gut pain, and then I start asking more about their symptoms like, oh well, I do have chronic hives, and I have joint pain and I have, you know, these other symptoms, it’s like. Well, I can show you research study that’s linked that to Blasto. Yes, it’s not a gut related system symptom, but it’s been linked to blasto.

Dr. Justin Marchegiani: 100% Yeah, very good.

Lisa Pomeroy: Yeah. Yeah. So, going over the page one pathogen, so yeah, Cryptosporidium, Giardia, those are actually both small intestinal infections, whereas the E. histo is a large intestine infection. Um, but Crypto and Giardia, often can be from the water, so we do have to look at drinking water and for Giardia, recreational water can be a big source too. So, again, a lot of these pathogens have their seasons. So Giardia, we can see more prevalent in the summer months because people are going in and swimming in lakes and streams and rivers and swimming pools and you know, or going water rafting or you know doing things recreational water parks and you just get a mouthful of water and chlorine doesn’t consistently kill it unfortunately. So, you still could get it or it could be your well water so I was always look to if we see Giardia, what are you drinking, you know, are you drinking well water, is it filtered, you know, are you, do you swim in lakes and streams, ponds, you have a swimming pool, so we always want to look at that because sometimes if there is, if it is well water and it has Giardia and you can often test your water for these bugs too, you know, we wanna make sure we’re getting rid of that source. Um, but yeah, I mean that could be, these can be nasty again. You can pick them up on the food. All of these have what they call the fecal oral route. So basically, if you know, again, it could be animal poop and stuff that just gets on your leafy greens because your cattle farm is next to your lettuce farm. There’s a little runoff and yeah, it’s hard to wash your produce. I mean, I still recommend soaking fresh produce in water with a little vinegar or hydrogen peroxide in it to try to kill those bugs. But even still, I mean, lettuce has so many little nooks and crannies, it’s hard to get it all killed.

Dr. Justin Marchegiani: Absolutely! And we probably want to make sure every patient that we see, the clinician that we see is recommending a good quality water at least a carbon-based one or ideally even at reverse osmosis just really make sure we filter out all those potential parasitic cysts plus water’s got a whole bunch of nasty things in it, like chlorine, like potential fluoride and pharmaceuticals that you want to filter out as well.

Lisa Pomeroy: Exactly! Clean water is a must whether it’s the bugs or the toxins.

Dr. Justin Marchegiani: Exactly! Any other comments on the viral pathogens here?

Lisa Pomeroy: Yeah again, those you know, again, tend to acute rather than chronic colonizers. Although, again, Norovirus, there is some evidence, it could be a chronic. But you know, these will feel often like a stomach flu. So again, you usually pick it up more your food like poisoning. But, some of these, you could pick up, like Norovirus, say you go to a public restroom, you touch the faucet handle and then you eat your lunch without washing your hands. You know, if you touch something with the virus, you put your hands in your mouth, you could pick up something like Norovirus from touching objects too. But, usually feels like a stomach flu.

Dr. Justin Marchegiani: Okay cool. Well, let’s drive into H. pylori here next, um, and also just a little reference range, um, tidbit for a lot of folks here. If you’re trying to figure out the reference range, you see, I don’t know, let’s say. Let’s go on to see where’s a good example.

Lisa Pomeroy: Well, H. pylori, it’s a big one too.

Dr. Justin Marchegiani: Yeah, but if you look at E. coli, you’re trying to figure out where this fits in the reference range. If the exponent is below the reference range, then you got to move to the left. So, this really is .00860 and then if its above, like this, this is e to the five, right, then you have to move to the right to make it just to make it equal, um, the exponents kind of throw a lot of patients off that I, I find when we go through them all.

Lisa Pomeroy: Yeah. Exactly. Yep. And it’s just, it’s in scientific nomenclature, yeah, it’s just otherwise, you have a ton of zeros. Yeah. It just cleans up the report.

Dr. Justin Marchegiani: Exactly!

Lisa Pomeroy: And there’s nice, like these are powers of ten, so you can get like powers at tens chart like e3 is a thousand. So, you can go, oh, that’s e3 is a thousand, take the 2.9 multiply it, that’s 2900 cells.

Dr. Justin Marchegiani: Exactly! Exactly! And then really quick here with the H. pylori. I haven’t seen the last year so a ton of virulence factors come back on my patients. Have you seen that as the lab kind of tone down the sensitivity with that? Have you noticed?

Lisa Pomeroy: It depends. Fortunately, we don’t see them often, which I mean the problem with virulence factors is they’ve been associated in the literature with higher risk of gastric cancer, gastric ulcers, cardiovascular disease. So, if you have H. pylori that has these attached to it, it has more potential to cause harm and disease. Now, I just saw one yesterday, where she has a history of H. pylori and unfortunately, she got it back again and she had it pretty much looked like this one. It had like four or five virulence factors, which is what she was dealing with before too. So, we do still pick them up, you know, again, fortunately, it’s not as often because this is the really nasty type of H. pylori, you don’t want to see.

Dr. Justin Marchegiani: Exactly! And then, regarding the reference range, this is above one. If someone is borderline or a little bit below, would you typically want to treat them or let’s say if they had symptoms, would you still want to treat them?

Lisa Pomeroy: Yeah. So, it becomes more of a clinical decision if it’s below that of a thousand cell threshold. But we have had people have like, this is a 2.9 e3. We’ve had people like a 2.6 e2, which is just 260 cells. They’ve had endoscopies and have been told that their stomach was covered in H. pylori and highly inflamed. So, sometimes, this can be the tip of the iceberg. We have to remember where is this infection located. This is a stomach infection. So, something in the stomach, you know it depends on how much is being shed into the GI tract that day. It’s got to travel 20, 22 feet through the intestinal tract to come out the other end. So sometimes, this is going to be heavily diluted from what we started out with. So, this could, yeah, so this could be a glimpse of what’s there. So that’s where there I, you know, it comes down to the clinical decision, does this fit. If someone comes in and they have gas and bloating and GERD and reflux and stomach pain and I see a borderline level, a moderate positive, I’m probably gonna do a protocol because it fits. Now, if this was a very low level and they had absolutely no symptoms and I looked through the rest of the report, their microbiome looks good, their enzymes look good, their gut immunity looks good, maybe it’s okay. Maybe they have good Lactobacillus and things keeping it in check. But I wanna see signs that it’s not causing any harm so that’s where I look at the symptoms, the history, the rest of the report.

Dr. Justin Marchegiani: That makes sense. And then with these cytotoxic proteins, are these more genetic type of risk factors because of the, because of the genes or are they specifically connected to the H. pylori and if you knock down the H. pylori, will knock down these cytotoxic proteins?

Lisa Pomeroy: Exactly! So, these are genes attached to bacteria. They’re not related to the person. So, as you kill the bacteria, the virulence factors go with the bacteria.

Dr. Justin Marchegiani: Got it! You can clear them as the bacteria gets knocked down. You can, you can knock down the bacteria that has those genes attached to it.

Lisa Pomeroy: Exactly! Like, if you have babA that just allows the H. pylori to stick to the stomach a little bit better. So, we have to, we might bring a little cranberry juice because that has an anti-adhesive property to it. So, we just try to undo that little trick that the H. pylori has which here, the babA allows it to stick so we’re going to do something so it can’t stick.

Dr. Justin Marchegiani: Oh, would that be a good recommendation if you had H. pylori without the babA?

Lisa Pomeroy: You could actually because there is research that shows that cranberry juice seems to kill H. pylori and just prevent it from ticking to the stomach wall. So, with babA, I definitely would include it but I also often include it just with H. pylori.

Dr. Justin Marchegiani: And then, if you address someone like round one and there’s still some H. pylori left or you didn’t move it a ton, are you gonna try a second round with different herbs and just kind of mixed them up? How do you address patients where you don’t quite get the result you want the first round?

Lisa Pomeroy: Yeah, and this is when we’re using herbs, especially the herbs we traditionally use things like mastic gum, DGL, Licorice, they don’t have the major impact on the beneficial flora. So, it’s not like we’re going in there with some really super strong herbs a lot of times that will just knock out everything and so we can often use repeated rounds of some of those herbs safely without disrupting everything else. But I have had people were, especially skin conditions where until we get that H. pylori less than DL, their skin won’t clear up. So, for me, I looked to see now if they’re feeling great if we knocked it down and there’s a little bit again, it’s always a judgement call but I’ve seen people with acne, with eczema, where until it hits a less than DL, they have the symptoms, the second they hit less than DL they’re gone.

Dr. Justin Marchegiani: So, are there any other herbs that you’ll pivot off the mastika or that you use synergistically with it or that you’ll rotate in if first round didn’t work that you’ll pivot on the second or third round with?

Lisa Pomeroy: Uhm. Yeah. So, a lot of times other organisms can actually promote the colonization of H. pylori like yeast is a big one I look for because there’s, yep yeah, and there’s actually research that yeast and H. pylori have what researchers call an intimate relationship. So basically, if there’s yeast and H. pylori together in the mouth or the stomach, the H. pylori can go and hide inside of the yeast and kind of seek refuge inside of it and then later come out when the coast is clear. So, if I see a bunch of yeast on the next page, I may need to bring in some antifungals at the same time trying kill H. pylori or it’s just gonna hide out and just come out later. So, that can be something we miss, you know, H. pylori can produce biofilms and hide inside a yeast. Some bacteria can produce hydrogen and that hydrogen also can fuel the growth of H. pylori. So, that’s where sometimes I do look at. Okay, let’s bring in some Berberine, some Oregano, some Neem, some Pau D’Arco silver, something that’s gonna also address the bacteria or the yeast or some biofilm disruptors like NAC, and acetyl cysteine, can break down H. pylori biofilms. So, I’m thinking about all of those things because those could be what we’re running into a wall.

Dr. Justin Marchegiani: Makes a lot of sense. Very good. Any of the comments on the H. pylori and then also like what are the big virulence factors to look out for, like a top three?

Lisa Pomeroy: Yeah, I mean, some of the nastier ones we’re thinking more like gastric ulcers, gastric cancers, cagA is one of those big nasty ones. Um, dupA, the dup is duodenal, so that one’s a little more duodenal ulcer. VacA, that again, is another one, where ulcers, cancer. So, I’d say, the three worst one, the cagA, dupA, the vacA. I mean, yes, babA is not a good thing but it’s more allowing it to stick to the stomach a little bit more, it’s gonna be a little bit invasive, a little more inflammatory. But, you know, those other three are just especially nasty.

Dr. Justin Marchegiani: Got it. The cag, the dup, and the vac?

Lisa Pomeroy: yeah

Dr. Justin Marchegiani: Okay. Very cool. And now we go into the normal bacteria. These are commensal flora, normal flora in the gut but we can kind of gain a little bit of insight what’s happening in the gut based on these imbalances. I mean, out of the gates we have, you know, just out of the gates, we have Lactobacillus, which is a beneficial flora that’s low so we’re certain starting to see low levels of beneficial bacteria. Anything you want to say kind of from this section down?

Lisa Pomeroy: Yeah. And again, we can tie this with other sections too like Lactobacillus actually lives in the stomach and it’s very antagonistic towards H. pylori. So, if I’m looking at this and going well, we have a nasty H. pylori and infection, we have low levels Lactobacillus, I’m gonna get, get a lactobacillus probiotic in here, to try to help not only get more Lactobacillus in the system because it’s clearly lacking but it’s gonna help push out some of that H. pylori from the stomach. Now, in general, I look at, you know, do we have highs, do we have lows, because even though these are good guys, too much of a good thing is a bad thing. So, I still don;t wanna see highs or lows. Now, lot of times, when things are low, it’s often something killed them. So, I look for a history, did you take antibiotics recently or things like artificial sweeteners, like you know, splenda, sucralose, it’s a chlorinated sugar, chlorine kills bugs including the good bugs, so we need to be looking at agian the diet. Are you doing something that’s killing these, do you eat GMO foods, food sprayed with glyphosate? Glyphosate is patented as an antibiotic, again it’s gonna kill your good bugs. So, are you doing something that’s killing them or are you starving them, you gotta feed your bugs, they like fiber, so if you’re restricting fiber in your diet, if you’re not eating lots of whole fruits and vegetables and beans and nuts and seeds and you know maybe some gluten-free grains. I mean all of these things have the fibers that these guys love.

Dr. Justin Marchegiani: 100% and so a lot of fibers, a lot of fruits, a lot of vegetables. If someone were to go carnivore, would you see a lot of these commensal flora drop typically?

Lisa Pomeroy: You do, unfortunately. Yeah. Unfortunately, we have seen some reports for people who are doing carnivore and especially if there’s low stomach acid, especially if there’s H. pylori, you’ll see, a lot of the ones, the opportunistic ones on the following page go really sky high and you’ll see lots of low levels here because these guys like their fiber. Now we don’t test some of the bile loving bugs here but you know if you were testing those, we would expect to see some of the protein degrading, you know bile loving ones, those are the ones that are gonna go up but they’re also ones that produce things like hydrogen sulfide which can be very pro-inflammatory in excess. So, while it may relieve some symptoms, I’d rather look at why can’t you digest your foods and vegetables and carbs and that kind of stuff. You know, there’s probably an infection like H. pylori or some dysbiosis instead of restricting your diet so severely and starving your good bugs, let’s get rid of these bigger issues, get you digesting better so you can have those foods again.

Dr. Justin Marchegiani: Very good. And so, out of the gates there, any specific changes that you’re gonna see, you’re gonna make outside of those recommended diet or lifestyles? Things for like Faecalibacterium prausnitzii, Akkermansia, any specific changes there?

Lisa Pomeroy: Uhum, yeah. So, Faecalibacterium prausnitzii is the major butyrate producer, so butyrates are very anti-inflammatory in your gut but it also has an effect in the brain. Butyrate produced in your gut will cross your blood brain barrier and have an anti-inflammatory effect in your brain, stimulates BDNF – Brain derived neurotropic factor, can help with anxiety. So again, we’re not just looking a gut impact here, we may see this is low with skin conditions and anxiety and all these other issues. But this loves fiber, loves resistant starch, so I might suggest, you know, let’s eats some, you know, rice that’s been cooked and cooled or some potatoes or roots and tubers that have been cooked and cooled because if you cook these foods and then you cool them it creates resistant starch. So, like something, like potato salad would, you know, Faecalibacterium prausnitzii would really happy with some potato salad. But also your fibers, you know, fruits and veggies, roots and tubers, all of that stuff but it wants fiber.

Dr. Justin Marchegiani: Very good. And what if some of those foods cause people to get more bloated or gassy like let’s say they have issues with nuts or have issues with legumes or lentils, would you suggest they continue to eat that even if they feel bad or listen to their body in that?

Lisa Pomeroy: Yeah. We always want to listen to the body, you know, some foods are just harder to digest than others so some people especially if your gut is very damaged and inflamed, maybe you can’t handle the beans, legumes, lentils right off the bat. So, we find different foods, you know, other fiber-rich foods that don’t cause that discomfort and sometimes it’s about portions too, so something like an apple. Maybe you can’t have a whole apple because it has a lot of fermentable carbs but you can have two apple slices or you can’t have a whole plate of asparagus but you can have two spears of asparagus and a stir fry. So, we’ll always look at those things but I also look at enzymes. You know, if you don’t have enzymes to break down these foods, you’re probably gonna feel too good with them. So, I’m always looking at elastase, one again later in the report if that’s low. I’m bringing in a pancreatic enzyme supplement because that not only helps with your gas and bloating and you know all those digestive symptoms but also helps of the dysbiosis because if you’re not digesting your food, your bugs will, so you’re giving them all you can eat buffet if you don’t digest your food. So, enzymes are really key and they’ve actually done some really cool studies finding that, that low elastase one is actually a more influential on your microbiome than your diet and all these other factors. You know, having poor digestion will highly influence what’s growing and not growing.

Dr. Justin Marchegiani: Very cool. Anything else you want to say about, um, the different families of bacteria so the conventional thinking is Bacteroides is very helpful very important to have in your tummy in good amounts, uh, Firmicutes the high levels of this one tends to so that you know the B for Bacteroides, B for beautiful, very beneficial. Firmicutes, one of these ones where high levels increase calorie extraction which potentially some correlation with weight gain in the literature. Any comments on these?

Lisa Pomeroy: Yeah, so again, it’s all about balance. So Firmicutes is actually where a lot of those butyrate producers are. They’re in this category. So, both, you know, we can’t say that either one is good, one is bad but good guys and bad guys in both categories so it’s just all about having that balance there. And yes Firmicutes, they can, you know, make you retain more calories from your food so you could gain weight, if they’re abundant but I’m looking at if your Firmicutes is getting too high it’s probably you’re eating too many carbohydrates or you’re not digesting them. So again, if I see this high and your enzymes are low, I’m getting those enzymes in there and we’ll often see this balance out.

Dr. Justin Marchegiani: Yeah. And then, you may want to address either fermentable, FODMAPs or even go lower carb as well?

Lisa Pomeroy: Yeah, depending on it again, I look at symptoms, I mean I don’t want to starve the colonic bacteria, so I’m just, you know, a lot of times just finding which fibers are triggering symptoms, can we get some enzymes in there. There’re actually enzymes now that are specific for digesting high FODMAP foods and so I’ll bring in something like that where you know they’ll say, we’ll I love onions, but you know I just get such terrible gut pain afterwards. You take this enzyme, you can eat onions. So, your microbiome, loves onions, you know. Yes, they are highly fermentable they can cause more symptoms but if you get the proper enzymes in there, a lot times you’re fine and your gut microbiome will thrive on those foods. So, I’m very careful about what I take out, because you know, I don’t want to trigger symptoms but I also don’t want to starve bacteria.

Dr. Justin Marchegiani: Um, very good. And then what about increasing Bacteroidetes, is anything specific to help with that?

Lisa Pomeroy: Yeah, so maybe again, it’s something you know, if they’re low we think about, you know, fiber again the whole like more plant-focused foods but something too we know about Bacteroidetes, they don’t like excessive fermentation, so that’s where again, I look and connect the dots here. H. pylori showed up, H. pylori in most people causes low stomach acid. If your acids low, you’re probably excessively fermenting your food. Bacteroidetes don’t like the pH shift that occurs as a result of that, so they’re just not going to do well. You know a lot of these bugs what’s growing is going to be determined by pH and oxygen levels. So, chances are, you know, if you get some plenty of fiber in the diet get rid of that H. pylori that’s suppressing the acid causing excessive fermentation, these again could just balance out.

Dr. Justin Marchegiani: Very good. Excellent. And anything else? Let’s hit the dysbiotic bacteria section. So, these are quite frequently going to be found in general dysbiosis or SIBO right? Um, Bacillus is kind of this beneficial spore like probiotic that you get in megaspore or thrive or lot of these newer probiotics that are out. Why don’t you take it from there so with this one there’s a certain threshold that you like to see it stay below but if it’s a little bit high, is that okay?

Lisa Pomeroy: Yeah. So, bacillus actually, a healthy gut should have some Bacillus in it so this is one we actually see a number next to that Bacillus species on every single report. So, an e4 e5 is actually pretty typical. With this one, I’m actually more concerned if I see a less than DL. To me, that’s more of a deficiency of this. So, you know, if it’s low, I mean, again we think about the diet and all those things we can supplement since we do have them available in probiotic form. Now, if it’s high there’s been a link between poor digestion and excessive levels. So, if it’s going high, I tend to think, okay what’s going on with stomach acid with enzymes with all of those things. So, that’s what I’m usually supporting if it’s getting high.

Dr. Justin Marchegiani: Very good. Excellent. Probiotic, enzymes if it’s getting high. Anything else with restriction of carbohydrate or FODMAPs at all?

Lisa Pomeroy: With that one, I don’t usually do too so much. It’s more just uh focusing on if something’s causing low stomach acid like H. pylori. We need to deal with that bigger issue but it’s often more just poor digestion, digestive dysfunction.

Dr. Justin Marchegiani: Very cool! Anything you want to say about the general dysbiotic bacteria below? We can start with the despotic section. I mean, is there any rhyme or reason of why one may proliferate in someone’s gut over another or is it just kind of the dumb luck of you know, too much sugar, too much carbs, antibiotic exposure, not cough beneficial flora to compete? How does like, why would one proliferate over another?

Lisa Pomeroy: Yeah, so there’s definitely certain conditions that will promote some over others. Like we see, Klebsiella there in that bottom section. It not only causes inflammation but it loves inflammation. If your gut becomes inflamed, it’s going to bloom. So, with this one if your gut is inflamed because you have a, you know, crappy diet because eating a bunch of food additives and proinflammatory foods. You’re lacking those good butyrate producers. You know, all of these things have changed in your gut to make it inflamed that’s gonna make your Klebsiella very happy and it’s gonna become overly abundant like this or things like, you know, certain things have been tied in the research with low stomach acid. So Streptococcus, you know, one of the top things, you’re going to see with low stomach acid again this individual is dealing with H. pylori. So, we’re probably going to see some high Streptococcus, which we do. Besides Streptococcus, Staphylococcus tends to show up with low stomach acid. Again, right above that there it is and Enterococcus. Now, Enterococcus here was more a moderate overgrowth but still it is showing up a little bit which it’s fitting with this pattern. The more things that you have showing up that fit that pattern the stronger it is. So, I’d say, the enterococcus, the Staph, the Strep, Klebsiella will see more with low stomach acid and even Pseudomonas. Pseudomonas thrives when there’s a lot of undigested protein around. So that’s another one where, this page to me looks like a classic consequence of having low stomach acid. So again, we have to think upstream what’s causing them, that correct that but we also may bring in some antimicrobial herbs because this has gotten to such a state where we may not be able to just get rid of these by dealing with those bigger upstream issues like H. pylori and low enzymes at this point.

Dr. Justin Marchegiani: So, the Enterococcus, Staph, Strep, and Klebsiella, when you see them elevated, there’s going to be more of a connection with low stomach acid and probably low enzymes too because those are connected as well right?

Lisa Pomeroy: Exactly! We often call this the digestive dysfunction pattern.

Dr. Justin Marchegiani: Okay. How do artificial sweeteners impact this or even things like pesticides will they have a kind of negative impact like an antibiotic. How does that work?

Lisa Pomeroy: Yeah, they can. That’s what they find a lot of the artificial sweeteners they find that they tend to kill things like Lactobacillus and Bifidobacterium, and yet they promote a lot of times it’s this one other phylum which is called Proteobacteria, so Klebsiella is a member of Proteobacteria. Pseudomonas is a member of Proteobacteria. But they’re really virulent, more proinflammatory organisms that will tend to bloom again with more inflamed conditions higher oxygen and they also tend to go up when we have food additives and chemicals and pesticides and all of that. So, you see a lot of the research, it’s kind of like the, the bad dysbiosis pattern you’ll see is these high Proteobacteria, like again, high Klebsiella, high Pseudomonas, with low butyrate producers like for Firmicutes, low Clostridia, low Faecalibacterium prausnitzii. So too many proinflammatory bugs not enough anti-inflammatory bugs.

Dr. Justin Marchegiani: Got it. And so lower butyrate, uh, not enough anti-inflammatory bugs and that’s more with what Provatella, Proteus, Fusobacterium, was the big ones there?

Lisa Pomeroy: Those are gonna be your more proinflammatory ones again. Yeah. Anything in your potential odder will trigger susception.

Dr. Justin Marchegiani: with low butyrate

Lisa Pomeroy: With low butyrate, yeah. Because that’s going to change the environment that will promote their growth.

Dr. Justin Marchegiani: And so, when you are working on producing butyrate, can things just like butter which is butyric acid, can that have an influence? Are you trying to also add in potential resistant starch or probiotic fibers or adding just actual Butyrate in there? What are, what are your thoughts on each one of those and what do you do to try to impact butyrate?

Lisa Pomeroy: Sure, yeah. I mean, butter or ghee it does have some butyric acid or butyrate. It’s just, it’s so small, it’d be hard to get therapeutic amounts plus a lot of people are dairy sensitive especially when their gut is damaged and leaky.

Dr. Justin Marchegiani: Can be for sure

Lisa Pomeroy: Yeah. So, if I’m going to supplement or try to get more butyrate in, I look at, I mean, we could use a tributyrin supplement, you know that can be really great like if I see, if all the butyrate producers are low and their calprotectin is high which is telling me their gut is inflamed and they have a lot of GI discomfort and they also have a lot of food sensitivities. Getting that butyrate in there directly can often calm things down or diarrhea. Butyrate can be terrific for diarrhea. We’ve seen chronic diarrhea that’s been going on for years or decades. Stop within a week of giving some tributyrin. So, sometimes I do give butyrate directly or IBD I’ll often use some butyrate directly because the gut is so inflamed that can be really helpful. But a lot of times, you know, people don’t necessarily want another supplement. You know if I’m not seeing those major signs where I definitely want to add it in, I may just be let’s feed the butyrate producers. Yes, we can give the end product but you’re still not feeding them, you know, I always think of like the butyrate is more like giving you healthy soil that’s going to promote their growth but you still got to feed them. They’re not gonna grow if you don’t feed them. So, you got to get the fiber in there, so I look at, you know, you can feed them with the fiber, you could get the butyrate in there and maybe you want to do both. They find that actually giving the butyrate and the fiber which is promoting the environment and giving the fertilizer to feed them, you get an even stronger impact. So many different options what we may do, any combination of those.

Dr. Justin Marchegiani: So, if it’s only those bacteria are in the lower sides. If they’re higher, would you also still want to do that?

Lisa Pomeroy: Depends what we’re seeing, I mean, again, if the gut is highly inflamed, I may bring it in or there’s terrible diarrhea, I may do it more for symptomatic relief. But, you know, if those bacteria are in good shape, you know, we don’t necessarily need to do that to encourage them to grow by shaping the environment but there’s still other reasons, we might use butyrate.

Dr. Justin Marchegiani: Is it more of a concern when they’re higher or lower?

Lisa Pomeroy: It’s low that it’s more there’s usually a deficit of the short chain fatty acid butyrate if they’re low because if there’s low population, they’re not making enough butyrate

Dr. Justin Marchegiani: That’s less than DL you’re looking at, right less than DL

Lisa Pomeroy: Yes, these aren’t the butyrate, those are on the previous page, um.

Dr. Justin Marchegiani: You’re talking about the commensal stuff here.

Lisa Pomeroy: Yep. Yeah. So, the three markers that represent them are the Firmicutes phyla, at the very bottom. Yup, the Clostridium class and then Faecalibacterium prausnitzii.

Dr. Justin Marchegiani: Okay, got it. These are the big three, Clostridium, Faecalibacterium and Firmicutes, these are the big butyrate producers.

Lisa Pomeroy: So, there’s low, if they’re low you just could try feeding them or if the guts really inflamed again, they don’t like an inflamed environment so you may bring the butyrate in to try to take down some of the inflammation and then give them the fiber and now they’re really gonna grow.

Dr. Justin Marchegiani: Got it. Okay. Very cool. Anything else you want to say about the like Citrobacter or these despotic bacteria individually, I mean, a lot of these are gonna be commonly found in SIBO right, but because it’s a stool test and all of it, it’s moving through the intestines, we wouldn’t necessarily say this SIBO unless we had like a breath test but we could say that’s a kind of a generalized dysbiosis.

Lisa Pomeroy: Yeah. And some of these bacteria we look at like Klebsiella, Pseudomonas, they just live in the small intestine that’s just their area that they hang out but it’s not necessarily SIBO, you know, yes, they’re in the small intestine but SIBO is when there’s too many overall bacteria in the small intestine, sometimes you just have a dysbiosis. You know, it may just there’s not, overall, it’s just Klebsiella and Pseudomnas are too high.

Dr. Justin Marchegiani: And so, you’re gonna utilize like a breath test, a lactulose, where you’re looking at hydrogen and methane gases and see if they’re really elevated to really know that.

Lisa Pomeroy: Yeah. If you wanted to see more of that SIBO picture, is there too many bacteria in the small intestine because maybe you had food poisoning incident before and your migrating motor complex that kind of that street sweeper isn’t working well to push the bacteria out. But if I’m looking at these, yes, these are in the small intestine, they’re overgrowing you know, maybe there’s other things overgrowing in the small intestine with them but you know to me it’s something, I’m looking at, you know, low stomach acid, low enzymes, is a huge factor with bacteria in the small intestine. So many cases, we can work on digestion, H. pylori, get some antimicrobials in there and often takes care of those whether even though, they’re in the small intestine versus a colon.

Dr. Justin Marchegiani: Cool. Anything else you wanna say about these individual dysbiotic critters?

Lisa Pomeroy: Yeah. Well, Klebsiella, since this one shows up, these are, you know, besides being very proinflammatory, they are putting, you know, putting you at increased risk of perhaps developing autoimmune condition. So, like Klebsiella is something that’s been linked with rheumatoid arthritis, ankylosing spondylitis, IBD. So, if you had that perfect storm, if you have the bacteria which is your trigger, you have a leaky gut and you have the genetics that make you predisposed to getting say rheumatoid arthritis. It could lead to that down growth. So that’s we’re seeing signs, you know, maybe you don’t have rheumatoid arthritis now, but 10 years, 20 years, 30 years from now, if you don’t do anything about Klebsiella, it could turn into that. So that’s where again we look from a functional medicine perspective, you know, we wanna try to head off a lot of these symptoms too and that’s where we can get a glimpse into that now, with the stool testing to try to get rid of this. Now, so it doesn’t become a future problem.

Dr. Justin Marchegiani: Very cool. Anything else you wanna say on these down below the Proteus or the Fusobacterium?

Lisa Pomeroy: Uhm. Yeah. Now, some of these actually live in the mouth, so Klebsiella lives in the mouth, Provatella lives in the mouth, Fusobacterium lives in the mouth. So, we can’t forget other microbiomes too. So, they’re part of the oral microbiome. And there’s actually a lot of overlap. I think it’s like 45% of the microbes are similar between the two. So, we always have to look at oral health, dental health, if someone has issues in their mouth maybe they need to get their teeth cleaned, get an infection dealt with. Because if you’re swallowing these bacteria every day in your saliva. Now, if you have low stomach acid, you don’t kill them very well as they pass through the stomach so you could get too many in your intestinal tract because there’s low stomach acid but you could also too many in your intestinal tract because there’s too many in your mouth. So, we have to be always looking at the health of the mouth too and what’s coming above the GI tract.

Dr. Justin Marchegiani: I’m a big fan of flexing either with colloidal silver or hydrogen peroxide and if you’re sensitive you can always dilute at 3%, that’s very helpful at knocking down some of those bugs, do you agree?

Lisa Pomeroy: Exactly. Yeah. Exactly. A lot of people like water picks and they’ll do different things and mix and sometimes they’ll alternate too and yep and even the nasal, I mean you have to figure, you know, what’s you know, is being swallowed there from the nasal passages.

Dr. Justin Marchegiani: Post nasal drip stuff

Lisa Pomeroy: Yep, we’ll squirt some silver or something up to the nose too to try to kill something that’s in there, that’s being swallowed and getting down in the gut.

Dr. Justin Marchegiani: Very good. Let’s dive into yeast. I typically don’t see a lot of yeast come back on these labs. When I do it’s usually beneath the reference range sometimes it’s positive but a lot of times I tell patients, if I see it here and it’s not DL then it’s probably a concern. I mean on the organic acid testing which we can talk about at a later point we’ll see things like D-arabinitol or D-arabinose, which is a really good yeast, uh, marker which does, I do find that tends to come up a little bit more frequently than, uh, this test. What’s your take here?

Lisa Pomeroy: Yeah. So, yeast again, we have to keep in mind, it can grow lots of places. You know, it can grow in the mouth, in the stomach, in the small intestine, in the large intestine

Dr. Justin Marchegiani: Skin, Fingernails

Lisa Pomeroy: The skin, yeah. So, I mean of course, anything outside of the GI tract is not gonna show up in the stool. If you have a toenail and fun-fungal infection a scalp fungal infection. It’s not gonna come out in your poop unless it’s also in your gut. So, we always have to keep in mind people say oh I have a yeast problem at my toenail, why didn’t it show up. It’s like probably localized to your toenail. Now, of course, again, we have the dilution factor. If you have thrush, if it’s more in your mouth and not so much in your colon, we may not see a hug amount in the stool or even in the stomach because it’s gonna be diluted out as it travels, so this is really good at looking at like especially the lower bowel because it’s right there ready to exit. The higher up in the GI tract you get, the more dilution is going to play a role into it. Where sometimes maybe you will see it more in organic acids in a urine test than in the stool. If it is a little more upper GI. although, I mean we do pick up DNA that’s coming down from the mouth, the stomach as H. pylori shows up small intestine. But this is something where if it’s detected at all to me that’s a problem because yeast overgrowth tends to cause a lot of symptoms especially hits the gut and the brain. So, a lot of people will say yeah, I have the gas the bloating, you know, the constipation, the diarrhea but it’s also the brain fog, the memory loss, I can’t remember where I put my keys, it’s no cognac, I just, my brain doesn’t work like it used to.

Dr. Justin Marchegiani: The acetaldehyde produced from Candida right?

Lisa Pomeroy: Exactly. Candida produces so many toxins, a lot of those affect the brain or they have the, the sugar cravings so it’s like, I want to get healthy and I want to stop eating all these carbs and candy bars and everything but I just can’t, you know, It’s the Candida calling out for. So, you gotta knock out the Candida.

Dr. Justin Marchegiani: On the extreme side, you could have auto brewery system, um, syndrome, when you’re actually creating your own fermentation with it. The story of this is true, a gentleman got pulled over and he was tested being drunk on the breathalyzer but it was actually yeast in his gut that like made their own little brewery in there and created alcohol from that metabolism that got him drunk and a lot of cognitive people that feel drunk, feel brain fog, it could be from that yeast and all that fermentation happening

Lisa Pomeroy: Yeah, and other organisms can do that too, Klebsiella, another one that could do that too.

Dr. Justin Marchegiani: Ah, interesting. Good, very cool. And then, does it matter, I mean obviously Candida tends to be the bigger yeast most people know about that and you have some subspecies here. Any difference is it, does it matter, are you treating them the same way? Do they differentiate in symptoms at all?

Lisa Pomeroy: Yeah. It’s hard to say in symptoms I mean a lot of the yeast behave the same, a lot of times we’re doing similar protocols anti-fungal, you know, fatty acids like caprylic acid, undecylenic acid, herbs like Pau D’Arco, berberine, oregano, so we’re typically addressing them the same. Now, these are all can be normal inhabitants of the gut like Candida, it’s, you should have Candida in your gut. You know, it has a purpose, the whole thing is it’s all about balance. You get too much of it creates all these toxins and excess you can get symptoms. So same thing with these and some of them are actually in your environment like Rhodotorula is something that we sometimes see a little bit of that showing up and certain areas of the country seem to have it more just in the environment. It’s kind like a pink colored fungi. So, I tell people like do you have like a pink colored ring around your toilet or your tub something like that in your bathroom, it could be Rhodotorula.

Dr. Justin Marchegiani: Interesting. Anything else in this?

Lisa Pomeroy: That’s the main thing with the yeast there. Yeah.

Dr. Justin Marchegiani: How about the viruses?

Lisa Pomeroy: Yeah. So, the main reason, the viruses are on the panel is when these viruses are reactivated in the colon, they’ve been linked with IBD. So, we’re looking for that association there with you know colonic viral reactivation. Now of course we know that these viruses can live in many organs and tissues like Epstein-barr virus and the thyroid gland. So, it doesn’t mean if these don’t show up that you don’t have the virus somewhere else in your thyroid, liver but this is looking more of the IBD colonic link.

Dr. Justin Marchegiani: Very cool and we have different parasites as well, we kind of already chatted about Blasto earlier, but can you give us kind of the reader’s digest from on the critters here, on the bugs.

Lisa Pomeroy: Yeah, so again, all of these can cause symptoms in some cases very severe now these the ones I’d say tend to cause the worst symptoms, would be the Blastocystis hominis and Dientamoeba fragilis. Especially in kids, we can see, you know, kids with just terrible tummy aches and pain and issues maybe failure to thrive they’re just a little underweight for their age and you know, just a lot of behavioral issues. We see Dientamoeba fragilis come out a lot. Both the Blasto and D. fragilis have been linked with IBS and studies. So, we do often see some quite significant symptoms with them. Uh, now some of the oddball things, extra intestinal you may see, you know, with like joint pain, I think, Blasto and Endolimax nana is another one. I’ve had a lot of people where it’s like I think I have Lyme disease and so we’ve run a lot of good because Lyme disease, you need a good test because it’s hard to find. But if you do a good Lyme disease test, you know, when it comes up negative, you know, we’ve had people do that and it’s like, we’ll it’s negative what do I have, I mean, this joint pain is awful and it’s Endolimax nana, so it has affinity for collagen related tissues, so you can see some pretty nasty joint muscle tendon, ligament issues with that one.

Dr. Justin Marchegiani: This is more collagen based huh?

Lisa Pomeroy: That’s the Endolimax nana.

Dr. Justin Marchegiani: Oh yeah.

Lisa Pomeroy: Yeah, yeah so that’s what I look for with that one well I’ll, you know, if I see it show up and they’ll say well I have no gut symptoms. It’s like, well when you work out at the gym, do you see an injury prone where it’s like oh I was lifting weights and now I twisted my shoulder and oh, now it’s trying to run and now my ankle hurts and you know or they just go I’m you know 29 and I work out, I go for a run and I’m so sore and stiff in the morning. I don’t think I should feel like this for 29 years old.

Dr. Justin Marchegiani: Exactly.

Lisa Pomeroy: Yep.

Dr. Justin Marchegiani: Very cool. Anything else on these Pentatrichomonas at all?

Lisa Pomeroy: Yeah, I mean again, some of these just vague, just general gut related symptoms. You know, any of these really could cause gas bloating, abdominal pain, discomfort, constipation or diarrhea. So you know, just general like IBS type symptoms.

Dr. Justin Marchegiani: Very cool. Anything about the worms? I don’t see the worms come back as much. I really don’t. Do you?

Lisa Pomeroy: Well, we don’t see a lot of worms, you know, fortunately because they are a little trickier, you know, we often do recommend deworming medications because it is very difficult to kill them with natural means. But yeah, worms can be quite nasty, um, you know, some of these are, you know, small intestine too, and things like the you know, Ascaris is a roundworm, you know, it doesn’t, you know, some of these worms like the, the hookworms and things, they actually attach to the bowel wall, so they kind of stay in place, I mean, they could, you know, suck your blood and stuff, you know, get the nutrients from the blood. But Ascaris is kind of free-floating there and the problems is because it’s free-floating, it’s not attached, it sometimes gets into places where we really don’t want it and so they found it migrating into things like your gallbladder and you know, your lungs and other places so that one, I mean the big issue with these worms are they can create blockages in some cases with those big worms, you know, sometimes, there can be blood loss, nutritional deficiencies too because if they’re you know sucking your blood and damaging your gut, you could have impaired nutritional absorption. Now, in the U.S., we typically, don’t see these massive infections where there’s like a big ball of worms but you could have a couple worms and they could be causing a lot of issues. Yeah.

Dr. Justin Marchegiani: Interesting. Very good. And then anything else with the, I think, the Trichuris, that’s the whipworm, right? Um, Nicator, is that a hook I think, not sure hook or whip but either way. Different, different, other different worms there, which we’re gonna treat either with, you know, typical medication like Mebendazole, Albendazole, Vermox, or higher dose wormwood or Artemisinin, also tends to be very helpful with some of these too.

Lisa Pomeroy: Yeah. And again, some of these, they all have different ways you can get infected, like some of them it could be walking barefoot on a sandy beach, you know, others it could be. Yeah. some of those worms

Dr. Justin Marchegiani: Trichuris

Lisa Pomeroy: Yeah. And in others you could be, you know, you’re exposed to it through like there’s pork tapeworms and you know beef tapeworms and stuff so again it’s looking at food quality and making sure that it’s cooked thoroughly. You don’t want to go to a restaurant and get the rare hamburger or be eating, you know, a rare

Dr. Justin Marchegiani: Make sure, its good restaurant, make sure the quality is good.

Lisa Pomeroy: Exactly.

Dr. Justin Marchegiani: Make sure it’s like Wagyu from like a five-star restaurant at least. Yeah, for sure.

Lisa Pomeroy: Yeah.

Dr. Justin Marchegiani: Cool. And then down below, we have a couple of markers here out of the gates. The steatocrit right, which is the marker for maldigested fat, so if we see a lot of fat in the stool we’re thinking of potentially either gallbladder flow issues, maybe stones that are affecting the flow maybe we don’t have enough acids because acid is really important for the gallbladder to trigger and contract make CCK, elastase and another marker for the pancreas and enzyme production and again if you have low enzymes, um, HCl or acids is an important stimulator for making and activating enzymes. Any comments on those?

Lisa Pomeroy: Yeah. So exactly. Yeah. so steatocrit has to do with fat malabsorption. Now ideally, I’d like to see a less than DL here. So, I really don’t want to see malabsorbed fat showing up in the stool. Like this one. Isn’t terrible at six so six percent of the stool was some undigested fat but it’s still it’s not ideal, I’m looking for signs why might that be, is there a bile issue, is there a lipase issue. Those are the major things that are digesting your fat, your bile from them you know, produced by the liver, secreted by the gallbladder or lipase is a pancreatic enzyme so for me then you know, if I see this, I look at the elastase one to go, okey what’s the lipase looking like. Elastase, one healthy control usually above 500. So, this individual, I’d say okay, Lipase is probably a little low because were only 388, so chances are if we get a good pancreatic enzyme in here with a nice amount of lipase, will clear up this fat malabsorption too.

Dr. Justin Marchegiani: Very cool. And then any feedback on the Beta glucuronidase, well that’s a, I mean, we’ll just like talk about it out of the, out of the bat. This one has a major effect from dysbiotic bacteria producing it right and so but it also can affect hormone metabolism so you have these bad bugs maybe it’s Klebsiella or gram-negative bacteria like Proteus or Citrobacter. It’s gonna make this enzyme that is going to take conjugated estrogen and it’s gonna deconjugate it and allow the estrogen to go back into the circulation. Comments there?

Lisa Pomeroy: Yeah. Yeah. Exactly. We look at sources. Now, bacteria is the number one thing I look for. Do we have those species over growing that produce it so then I go flip back to page two and three and go, do we have E. coli, do we have high Bacteroidetes or Bacteroides fragilis, uh, do we have

Dr. Justin Marchegiani: So you may look here, so you may look at Bacteroides, you may look at E. coli or what else? Anything else?

Lisa Pomeroy: Uh, the Bacteroides fragilis, Bacteroides fragilis at the top there. Um, Clostridium class and Firmicutes phylum some species, I mean those are large groups but there’s some in there, if those are high it may also be coming from there.

Dr. Justin Marchegiani: Now, this person doesn’t have a lot of those either and they still have it.

Lisa Pomeroy: They don’t, yeah.

Dr. Justin Marchegiani: Again, it’s a sample but

Lisa Pomeroy: Yep. Now the next page do they have Staphylococcus. Uh, they do and really high, yeah, we have Staphylococcus species. Staphylococcus can also produce it. So, this person, I’d be going, okay maybe the Staphylococcus is the where it’s coming from so if we get the staff down, we could bring this down. Yeah, the problem is especially we look at you know say this is a you know a menstruating female. You know, she’s producing a lot of estrogen and she can’t get rid of that estrogen so they say beta glucuronidase kind of comes around like a pair of scissors so say you know your toxin your estrogen goes to the liver goes through glucuronidation which is a detox pathway and the body kind of packages it up nice and neat for elimination so it puts the estrogen in a box puts the lid on the box ties and nice little bow around the box. Well, your beta glucuronidase comes around like a pair of scissors snips of ribbon, lifts the lid, let’s the estrogen out so now estrogen gets to get reabsorbed recirculate and now you get estrogen dominance so now you have PMS and menstrual cramps and breast tenderness and all of those types of symptoms. So, yep.

Dr. Justin Marchegiani: Very good. And then occult blood, we could see this potentially from blood in the stool, ulcerations, could be ulcerations in the stomach working its way down a lot of times I find It could be from hemorrhoids. It’s a common one too. The outer veins and the rectum area. They’re just, they’re dripping a little bit or the women out there on their menses too that could potentially drive that you’d be back there

Lisa Pomeroy: Exactly, yeah so ideally, I like to see under five that would be considered negative. 5-9 that’s where we often think oh, did you collect during your period, are you constipated, do you have hemorrhoids, no, that’s a typical range, anal fissures, maybe a constipated there’s a little tear or something. Above a 10 that’s our red flag because above a 10 we have to consider that you know this could be IBD, colorectal cancer, polyps and we just don’t want to miss any kind of pathology here. So, this is where we look to see is there something that makes sense or a diagnosis that makes sense say I see an occult blood of 35 well the person has ulcerative colitis. Okay now, we know why there may be blood it makes sense. But if it’s a 35 and there’s no known reason for this to be then we may need to repeat it, you know some of the acute pathogens again. If we go back to page one that E. coli, you know, uh, the 0157. That one can cause bloody stool. So, say that they got this nasty E. coli from a hamburger. Yep. And the, the EHEC, the enterohemorrhagic E. coli. Yeah. So, they could cause bloody stool so maybe, if there was a little bit of blood it was from an E. coli or something just passing through. So, if it’s above a 10 we often start by just repeating the occult blood to see was it some fluky thing where it was an acute pathogen or something but if you get two positive occult bloods it’s often referring out to see, you maybe need a colonoscopy because again we just don’t want to miss, we’ve caught early-stage colon cancer by catching some of these, you know, occult blood levels that are creeping up.

Dr. Justin Marchegiani: uhum, absolutely. And then we have IgA which is gonna be an immune marker that’s you, your kind of your mucosal membrane that kind of hits all the mucuses, so mouth, intestinal tract, vaginal canal, urinary canal, so if we see something high, that could be some kind of an immune stress. Your immune system is fighting and going after, if it’s low it could be just chronic stress that’s depleted that immune system that made you more vulnerable. Any thoughts on that?

Lisa Pomeroy: Yeah, exactly. I mean for me, low is a much bigger problem than high. High means the immune system’s working.

Dr. Justin Marchegiani: Working, yeah. It’s good.

Lisa Pomeroy: yeah. It’s attacking some microbe or some food but I mean that’s what it’s supposed to do, if something’s threatening it, it should go up, it should try to resolve it. Low means that it’s just it’s burnt out from wear and tear that constant assault and it just can’t mount a response and when it’s low you’re going to be more vulnerable to the E. coli and the Yersinias and the H. Pylori and the parasites because this is our first line defense, you know, we got to have this nice and robust.

Dr. Justin Marchegiani: Absolutely and then gluten antibodies, how often do you see this positive and I find it’s gonna drop if someone’s on a healthy diet they could still be gluten sensitive but it will go down so it may not be the best indication of hey, you’re gluten sensitive, um, and you may get a false security because you kept your guten out and then you’re thinking, you’re okay and you can add it back in but it’s gonna be kind of exposure based, right?

Lisa Pomeroy: Exactly, yep. In order for the body to produce antibodies to something, it has to have that current exposure. Now, gluten antibodies can last three to six months in the system from a single exposure, so if they’ve had gluten in the last three to six months it could still be elevated from that but if someone if say they come in and they say I’ve been gluten free for five years, I shouldn’t be seeing elevated antibodies. If I am, there is a problem, it’s sneaking in somehow and we do often see this. I saw, I think two people earlier today who were diagnosed celiacs and it was high. That’s not good. That means that they’re still having that exposure so we’ve got to figure out where it’s coming from that is not a good thing and they’re telling you, really have to

Dr. Justin Marchegiani: Yeah, and what do you do when people are like, no I really haven’t been getting exposed. I tend to say well, is there cross contamination, is it potentially going high because maybe there’s an egg allergy or they’re eating some rice that’s technically gluten-free but could still react or is it still dairy thing what other foods could trigger that?

Lisa Pomeroy: Yeah, so first I look for actual gluten cross contamination because most cases it’s actually gluten, they didn’t realize that the oats, oats will be contaminated with gluten unless they’re certified gluten-free so it could be they’re eating their regular old quaker oats, you know, they’re gonna have gluten, so we gonna look for those or they’re sprouted bread. Yeah, it’s Ezekiel bread. It may have less gluten but still has gluten so we gotta look for that or oh my boyfriend eats gluten and I kiss him right after I, you know, after he eats the hamburger. That’s gonna be a step.

Dr. Justin Marchegiani: That’s possible.

Lisa Pomeroy: Or they kissed their dog, they feed their dog, regular gluten kibble and they kiss their dog. So, I looked at all of those, um, and they found that you know, eating out in restaurants. They did this great study a couple years back and they said about a third of all restaurant meals that you’re being told are gluten-free tested positive when they’re actually tested and that went up to 50% for gluten-free pizza and gluten-free pasta. So basically, if you go out to a restaurant, you order the gluten-free pizza or pasta, it’s a 50 50 shot whether you’re actually getting gluten or not.

Dr. Justin Marchegiani: Yeah. It tends to be, usually if you’re going out, if you’re getting like a steak or some steamed vegetables, usually you’re okay tends to be more in the sauces, the thickeners or even a spice and so worst case you just, you season it yourself with your own sea salt at the table or something just to make sure it’s its clean.

Lisa Pomeroy: And some things too, I mean I actually you know because I am gluten sensitive, you know, gluten triggers Hashimoto’s for me. So, I went gluten-free like 14 years ago and my antibodies dropped and never come back because I’ve stayed gluten free.

Dr. Justin Marchegiani: That’s great.

Lisa Pomeroy: But I do test. I have this little testing device and you could put a pea sized portion of the food in the device, it takes about three minutes and it’ll tell you if it had gluten or not. So, I will test if I buy some new food, especially if it says manufactured in the same warehouse with wheat, dairy and all that kind of stuff or if I don’t know say if I want to eat, I can put the food in the device and know if its gluten-free or not. So

Dr. Justin Marchegiani: Wow, so what’s this device called?

Lisa Pomeroy: It’s called Nima. It’s N-I-M-A. So, it’s a Nima, Nima Partners Company, you can buy it through. It’s cool little device, you have to buy these capsules that are one-time use but you put the food in the device, so anytime I buy anything new any packaged food, even supplements, I run it through my Nima. Because, I was being glutened by a cinnamon powder like I run one of these tests on myself and my anti-gliadin was a little high and I thought was a test wrong that this is impossible I’ve, I’ve been gluten free for over a decade this got to be wrong so I bought a Nima then this a few years back and tested everything I was eating and an organic cinnamon powder the company grinds fresh in their facility tested positive and I was eating this almost every day. I stopped eating it, seven months later retested, antibodies gone.

Dr. Justin Marchegiani: Wow, okay. We’ll put a link up on screen put it on the show notes that’s uh, that’s crazy, very cool.

Lisa Pomeroy: If I’ve ruled out that, that’s the first thing I look for because the majority of people, it is just gluten contamination. Now if we’ve ruled that out then I looked at okay there’s about six foods that are cross-reacted with gluten, there’s dairy, there’s yeast, there’s corn, there’s millet. So, then we start to look at

Dr. Justin Marchegiani: other things

Lisa Pomeroy: Yep. Other things that you know if you’re continuing to eat dairy then maybe there’s an issue there. Yeah, it’s, they recently changed the website, I think it’s Nimapartners.com

Dr. Justin Marchegiani: Okay cool. I’ll put it below in the show notes. Anyone’s listening back and you’ll get that. That’s great.

Lisa Pomeroy: So sometimes we have to remove cross-reactive foods so there can be other factors but you know, the problem is once you’ve lost oral tolerance to gluten, you can’t get it back. It’s the only food we know of that your body creates memory B cells to so, it is something like for me being gluten-free for like 14 years I shouldn’t have antibodies but if I start eating gluten again, I will have antibodies because I’ve lost oral tolerance.

Dr. Justin Marchegiani: That’s why I like the genetic test because you don’t have to necessarily challenge it or know you, if you have the HLA DQ2 or eight or you know one alpha, one beta, one or three then it’s a good chance that you have that those gluten sensitivities and you should probably stay away from it.

Lisa Pomeroy: Um, yeah.

Dr. Justin Marchegiani: Any feedback on the genetic testing for the gluten.

Lisa Pomeroy: Yeah, I think it’s helpful, I like all these tests, I mean they always give you a little different piece of information so I think it’s helpful, you know a lot of times correlating the genetics with what we’re seeing here. So, I mean the genetics don’t tell you, you are having a problem versus this tells you are having a current problem. So, I like both and sometimes people need the information from both because just seeing the genetics, you know, they go, well I could have a problem but is that enough you know, a motivational factor to keep me from eating gluten versus I see this and it’s high then I know, okay, my body is really not happy right now because of the gluten I’m eating. I definitely need to go gluten-free. So, it depends what motivates someone and again if they haven’t eating gluten for a while, I don’t want them challenging it, you know, they could certainly again run this as is like myself eating the cinnamon, I though, I was gluten free but I was being glutened so it showed up. So, I tell people run the test as is look at your genetics and I’d rather you do that than reintroducing gluten and now starting that inflammatory cascade that’s going to last for three to six months.

Dr. Justin Marchegiani: Very cool. Well let’s just wrap this up, your last couple of markers and by the way, I know we chatted about, uh, probably a little bit ambitious wanting to go into the, uh, the ion panel but I’d love to have you back soon, Lisa and really dive into the ion panel. Would you be open to that?

Lisa Pomeroy: I would, I love talking lab test interpretation.

Dr. Justin Marchegiani: Very cool, so out of the gate here, calprotectin, really good tests for inflammation produced by the white blood cells in the intestinal tract, it’s a protein and of course, Zonulin is that protein, that’s a sign that those tight junctions are being unzipped in the intestinal tract and potential gut permeability. Comments on that?

Lisa Pomeroy: Yeah. So, calprotectin is a kind of a general marker for intestinal inflammation. Now with IBD, we can see this exceptionally high. Usually, yeah, the two things that are going to cause your highest levels are acute pathogens so again something like that nasty food poisoning E. coli or something like your IBD type thing. You could see upper hundreds or even thousands with that.

Dr. Justin Marchegiani: Yeah

Lisa Pomeroy: Ideally, I wanna see under 50. So, a lot of people will see things like an 87 or a 120 where I go that’s higher than I’d like, so again, we start looking at, okay, what’s causing this colonic inflammation, again, are you lacking butyrate producers, do you have too many of these proinflammatory bugs, do you have a parasite like Blasto hanging out in your colon. So, we’re looking at all those other factors that could be causing inflammation. Or again, some of the food additives, you know, maybe you like to go your grocery store and get rotisserie chicken. A lot of rotisserie chickens have Carrageenan in them. Carrageenan is a known proinflammatory food additive. So, there’s little things we can sometimes do to bring down our gut inflammation but yeah, so that one’s gonna tell you about if your gut is inflamed or not, Zonulin tells you if your gut is leaky. Now Zonulin will, you know, go up, you know, it’s triggered by things like gluten and gram-negative bacteria. They have an endotoxin, LPS in them. So, gluten and LPS are the top two triggers for Zonulin, so again I’m looking for is antigliadin high, do you have a lot of these bacteria that are overgrowing or again do you eat GMO foods like glyphosate is another trigger for Zonulin. So, if this is high, we need to look for, what’s triggering it and then we’re probably gonna need to do some gut repair, you know, maybe we want an L-glutamine based powder, you know, because we want to make sure that the gut damage is being healed up the tight junctions are restored, the integrity of the gut barrier is restored.

Dr. Justin Marchegiani: Very cool. And then Lisa, you’ve given us so much information here. This is excellent. I’m going to recommend this to my patients here to get a kind of a little bit more of a deeper dive, if they want more intel. This is excellent. Um, if people wanna find out more about you, where’s the best place to go?

Lisa Pomeroy: Yeah. So, I have a couple different websites, I work with practitioners and right now I’m, you know my practice is closed to taking in new clients but, you know, may open up in the future, so my more client website is my last name Pomeroy, so pomeroynaturalhealth.com. Now, if there are practitioners who want more, you know, help on lab interpretation for their patients or if they’re interested in the different training courses I created, that website for practitioners is pomeroyinstitute.com

Dr. Justin Marchegiani: pomeroynaturalhealth.com for patients. pomeroyinstitute.com for practitioners. We’ll put the links below here, so people can get to that faster. Anything else you want to leave listeners today with, Lisa?

Lisa Pomeroy: Um, I guess, just you know, they say all health begins in the gut and I’m a believer of that because I had so many issues, I mean, you almost name a pathogen on this report I’ve had it. Everything from roundworms to just about every Protozoa to H. pylori. You know, I’ve had it all and I know how much, you know, it just wreaked havoc on my gut for decades so starting very young. You know, my parents would always think she’s coming down with a stomach flu because she just puked out of the blue. You know, it was just the H. pylori and everything else, my low enzymes. So, I had just terrible terrible gut and so I mean for me was the functional lab testing that found these issues. I mean, that found the H. pylori, the parasites, the low enzymes, everything else and I just think you know for me it’s just so important on why I get so passionate about this. For me, it was giving me the answers that I needed to restore my health. So

Dr. Justin Marchegiani: Excellent. Well, you have a great story at least, you did an excellent job for sending me information and I think uh, people that are watching are getting a lot of information out of it. So really appreciate it, look forward to have you back on the show real soon.

References:

https://pomeroynaturalhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/why-is-my-digestion-broken-lab-test-interpretation-of-gi-map-with-lisa-pomeroy-podcast-335

Recommended products:

DSL GI-MAP Genetic Stool Test

International DSL GI MAP Genetic Stool Test

Glyphosate and Chemical Detox | Podcast #334

Most people don’t realize that glyphosate is not just found in farm fields and on GMO crops but is lurking in your next-door neighbor’s garage and your neighborhood park, on the local golf course, or in your kid’s playground. You can find glyphosate on nearly 100 non-GMO food crops, including vegetables, fruit, nuts, seeds, and cereals like wheat and oats. You can find it in wine, beer, ice cream, and pretty much everything else. Also, you wouldn’t imagine in a whole host of ingredients, such as corn starch, beet and cane sugar, and even honey!

Glyphosate interrupts the body’s ability to turn natural sulfites from food into sulfates that the body needs to detox and stay healthy. High sulfate levels heal the gut while supporting the absorption of many vital nutrients. Sulfates assist in clear brain fog and improve memory through increased blood flow.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

1:27 Glyphosate (what it is, how it works)

8:42 Clean Water, Osmosis Water Filter

17:12 Powerful Antioxidants

23:23 Water Plunge, Saunas

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan, Evan, how we doing today, my friend? Really excited to chat with you.

Evan Brand: Yeah. Likewise, and this is a big topic. So Huh, you got hundreds of millions of pounds of glyphosate being sprayed on our beautiful Mother Earth every year. It’s terrible, how much is being sprayed. If you look at the stats, they just go up and up and up and up and up. And we have GMO corn and soybean accounting for the major places that people are being sprayed. So if you’re simply just cutting out, yep, those foods from your diet, and you’re eating animals that don’t feed on the soybean and corn, you’ve already done a great job. But but that’s not enough, because I recently spoke with Stephanie senath, who’s been educating and researching about glyphosate. And she’s talked about which you and I’ve known for a long time, but it’s good to hear somebody else validate the research is, it’s in the water supply, it’s in the food, it’s in the air, it’s everywhere. So you really have to put in a detox protocol on going to be able to deal with this because even parts per billion levels of glyphosate act as an antibiotic and will kill beneficial bacteria in the gut. And you and I, we don’t necessarily call ourselves gi specialist, but we are when it comes to naturally approaching gut infections and restoring gut integrity and gut health. And part of that is getting the glyphosate out of the system. So we can truly allow our beneficial bacteria to thrive. So that’s kind of the setting the stage of where we’re where we’re going today.

Dr. Justin Marchegiani: Exactly. So glyphosate is essentially roundup. Right? It’s essentially Roundup, it’s a pesticide. And so essentially how it works, it’s a mineral key later. So what it does is it basically thrips away or, or kind of as a magnet of all the key lay of all the minerals away from the plant. And so essentially by robbing the plan of all those minerals that essentially kills it is that the major mechanism and how that works.

Evan Brand: Yeah, it inhibits the photosynthesis, I don’t know the full chemistry behind it. But yeah, basically it starves the plant to death, and then the the byproduct, the byproduct or the the process of doing that, you’re robbing and basically cleaving off these amino acids. And that’s the problem. And that’s why it’s going to end up in joints and everywhere else in the body. Because the body’s trying to basically absorb the minerals, if you will, but by accident, it’s absorbing the glyphosate. So it’s number one thing is you got to go organic to get away from it. But the problem is, if you’re not filtering your water, if you’re not filtering your air, you’re probably still getting exposure there. Or if you eat out at restaurants, which even I and you and I, we try to do the best we can if we eat out, but we may get exposed to trace amounts there. And kids too. I mean, you send the kid with a school lunch, that’s organic, but if you don’t, they’re probably getting exposed to it there. And this stuff accumulates over time. And as Stephanie was talking about with me, the individual parts meaning like a little bit of glyphosate here, it’s a problem. But when you mix it with the dicamba and the 24D and all these other chemicals and the xylene and the gasoline additive chemicals and the plastics and the Falaise in the BPA and the other endocrine disruptors, that’s when you really get into trouble. So it’s important to hyper focus on one chemical like this, but I want people to just know, it’s the sum that really creates the problem. And you and I measure for this on the urine. So if people listening like, Well, what do I do? How do I investigate this problem, you simply do a urine urine sample. And we can measure this. And the fun part is when we get people on a detox protocol, and we retest, you can see the levels go down. And a lot of cases, we get the levels to nd non detected non detectable limits, that is the most exciting part. So I want to inspire hope with this too some of the stats are really depressing on it. But there is hope that you can get this stuff out of your body.

Dr. Justin Marchegiani: 100%. And so the mechanism how it works is it’s a key later pulls that away, and also affects the protein synthesis of the plants. There’s a pathway there, it’s called the shikimic. It’s kind of a funny name, the shikimic pathway that affects you know, essentially the the protein synthesis of these plants. So it disrupts that it does it by disrupting protein synthesis. And it does it by collating away a lot of these important minerals. And I think that’s part of the reason why a lot of foods that are grown in Roundup, or glyphosate is used on them, I think you’re gonna also see a decrease in nutrient levels. Part of the means why is because it’s creating a lot of those minerals away from the plants. And the plants don’t have adequate minerals in the soil. And others there’s data on it like when there’s less manganese in the soil, the vitamin C production in that plant is less for instance. So we do know there’s a disruption, there’s a correlation with low minerals in the soil can have a major impact on the nutrient production by that plan as well. And so there’s a nutrient issue on one side, and then there’s also a toxicity issue. And we can go deeper into that. Any questions on that?

Evan Brand: So the the big, the big problem with people is, here’s one of the mechanisms and people can check out the podcast. I mean, we don’t have to get into the the advanced chemistry. I mean, some of the stuff even goes over my head. But basically, one of the big problems is glyphosate is pretending to be glycine. And that’s what she talked about. Basically, it’s your body-

Dr. Justin Marchegiani: it’s just an amino acid.

Evan Brand: Right? So it’s looking for glycine, but then it sucks up glyphosate in place of it, right? That’s where you get into trouble.

Dr. Justin Marchegiani: Yeah, you kind of similar to what may happen in your body with iodine, and fluoride, for instance, or bromine, right, it’ll it’ll suck up your thyroid will suck up a lot of those nutrients which can impact its function because it’s not the primary nutrient it’s looking for.

Evan Brand: And then here’s what it says advocates claim that glyphosate is not harmful to humans, as the shikimate pathway does not occur in humans. But the truth is, glyphosate enters our gut and primarily targets the good bacteria, and then that’s when you get the bacterial overgrowth. So that’s kind of what the industry will will counteract on let’s say, well, humans don’t have chicken meat pathways. That’s why it’s not dangerous. But the mechanism is that it’s killing the good bacteria in the gut. And it’s really an antibiotic that, you know, disguised as an herbicide. And so that’s the problem.

Dr. Justin Marchegiani: Yeah, I think the big thing that if you look at some of the studies on the topic, where they look at glyphosates impact on the gut lining and the brush border, in the small intestine, the brush borders, what secretes a lot of enzymes and aids in digestion. And if you just look at the thinning out of the gut lining in the small intestine, and you look at the increase in gut permeability that can happen from that. All of those type of mechanisms are part of what’s driving a lot of autoimmunity. So when you have increased gut permeability, weaken gut lining, you have a imbalance in the healthy bacteria in the guts all of those tilts your immune system in the direction of autoimmunity, it tilts your immune system in the direction of lack of nutrient absorption, which then affects the immune system as well. So all of these things compound right gut in bad gut bacteria and balanced dysbiosis. Right, more bad bacteria than good gut permeability, increased autoimmunity, increased food allergens, less nutrient density, obviously, you’re eating plants that have a lot of Roundup, there may be less nutrients in those plants, right. So all of those things just kind of spiral out of control. And, and typically, if you’re consuming the big foods that are going to have the highest residue, they’re going to be a lot of your grains, right grains, and soy and corn and wheat and all those things. So if you’re eating a lot of those foods, that’s a lot of processed food anyway.

Evan Brand: Yeah. And that’s why you and I talked about, a lot of people feel so much better on like grain free or more paleo template, because not only are they getting rid of the allergenic foods, but they’re getting rid of the chemicals too, because everything is so heavily sprayed. Now one of Stephanie’s arguments, which was interesting was that the people are having so much gluten sensitivity is because of the glyphosate. And so she told me she actually eats organic wheat, and she feels totally fine. And I said, Well, what about gluten and zonulin? And all that? And she goes, I don’t know if that’s the full story because I feel fine. But feeling fine. I don’t know. I’d like to see like a stool test, right? And look at gut inflammation and all that and try to confirm because and look at gluten antibodies, because I still even if it’s organic You and I are still not going to recommend people going into the grains.

Dr. Justin Marchegiani: 100%. And then also the other element of this whole thing is what about glyphosate, when it’s heated up? What if you have glyphosate residue on certain foods, and then you’re cooking, you’re heating those foods up? What does that do to it? Because I know, there’s some data out there showing that a lot of these pesticides become more toxic when they’re heated. So that’s another area another avenue of discussion, probably not a lot of data on it, but definitely a lot of theoretical, what well, you know, what if that does make it worse, and so that’s definitely a concern. So, you know, out of the gates, I think the big thing people can control is going to be water and runoff. So everyone should have at least a reverse osmosis water filter to filter a lot of the roundup glyphosate out of that, so you’re not getting exposed via water. And then number two is do your best to eat organic or if you’re on a budget, try to do at least clean 15 these are going to be the foods that are going to have a relative peel over it right avocado, banana, those kind of things that will decrease the amount of residue because as a peel, and they just going to have less of the glyphosate anyway, and so try to do at least clean the clean 15 and then avoid the Dirty Dozen if you will, but try to go organic free range as much as you possibly can. Because it’s not just the nutrient density that’s important with organic it’s the decrease in toxic load. There’s both you win twice you you win with nutrient density, and you decrease toxic load. I think it was um, I had Joel Salatin on my podcast last year. And he talked about his eggs that are pasture fed, and he sent a bunch of conventional eggs to the grocery store. And to a lab Actually, I’m sorry, to a lab. So conventional eggs he bought at the grocery store to his own pasture eggs in his backyard, his farm, right. And he compared the nutrient levels of it. And so he just compared one nutrient full eight. And he found that his eggs had 19 times more full light than the conventional x 19 times. So if you look at it, it’s like wow, I’m getting 19 times a day. An important nutrient. And maybe the eggs cost twice as much. What’s kind of a pretty good deal? That’s a pretty good ROI on your investment there.

Evan Brand: It is. Yeah, I love that. Yeah, I need to interview him. He’s awesome. And I love his books and love seeing the farming videos. A lot of people I know he has like students, though, they’ll do all the work for him. He’s got an amazing setup, because he pays like zero labor costs, because everybody wants to learn. So he’s got all these people like harvesting his chickens for him.

Dr. Justin Marchegiani: Yeah, it’s a pretty sweet gig. So yeah, it’s really interesting. I think it’s good for everyone to understand that to know about it to be on top of that, and to look at your food differently, right? You got to look at it like, Alright, I’m decreasing the toxic load. So that’s one important big vector. And then I’m increasing the nutrient density side. And if you look at it like that, I think you go into the grocery store and you make different food choices. I think it was Michael Pollan talked about this in his book Omnivore’s Dilemma, as a society today, we allocate way less of our income towards food, I think it’s today, it’s like 9% of our income goes towards food. As a society, I think about I think it was 50 to 100 years ago, it was twice that was 18%. And so people prioritize food a lot more. From an income standpoint, you know, they’re willing to put more of their money where it counts. And today, that’s not the case. And so I just think it’s really important that people really look at allocating their money towards food, because that’s the foundation of everything, especially once you get sick, you’re going to really wish you did.

Evan Brand: Well, let’s take it a step further to so you got the glyphosate in or out of the picture in your diet. And now, not only are you getting, as you mentioned, potentially 19 times more folate and who knows a lot more B vitamins and other nutrients. But now you’re also getting all these different amino acids, which are going to fuel your neurotransmitters. So you’re going to be happier, yep, you’re going to be able to tolerate stress better, you’re going to be less depressed, you’re possibly going to have better sleep, you’re going to feel better, you’re going to have more energy, so you’re going to perform better at work, you’re going to be a better parent, because you have enough nutrients to stabilize your blood sugar. So you’re not hangry. So I love how you kind of illustrated that you’re not just getting less toxin, more nutrition, you’re really getting a whole better human. And that’s going to extrapolate that out to your friends, your family, your boss, your spouse, everything gets better. So it’s tough when you see people that like even the other day we drove past a Popeye’s chicken. And that’s probably like the lowest quality fast food you could get. Maybe there’s something worse McDonald’s or something. But we’ll see like a brand new Range Rover, you know, $100,000 vehicle, and they’re in the drive thru parking lot getting like a $2 lunch, but they’ve got $100,000 car, it’s like, you got to just focus on the good good stuff. I’d rather drive. You know, like I did for years, a 1990. When I had my 1992 Honda Accord, I was still buying the pastured bison, grass fed beef, steaks, all organic vegetables, you know, even though I had a $4,000 car, I probably spent 4000 a year on high quality groceries.

Dr. Justin Marchegiani: Yeah, exactly. So it’s a lot of it is an education thing, getting people to reprioritize kind of where they’re at and it gets number one out of the gates. And then two is just really educating people on the benefits, right? It’s like it’s all about value. So the big thing today that we’re kind of hammering on is the glyphosate component, how that affects your gut lining how that affects dysbiosis, how that affects nutrient absorption, how that affects your immune system, because 80% of your immune systems in the golf and the malt in the stomach and the small intestine. So all these play a major role. And we know that autoimmune conditions are on the rise right there massive amount of increased, not all immune conditions, 150 least different conditions that are out there now. And we know gut permeability plays a major role. We know gluten, we know Roundup, we know gut bacterial imbalance plays a major role. So if we know the mechanisms, then we can work on creating an execution plan to help believe that.

Evan Brand: Yeah, there are several charts online, you could just look this up yourself. You could type in autism, glyphosate, and you can see some of the correlation not necessarily causation. But definitely the correlation charts, where you’ll see the autism rates skyrocket exponentially, along with the exponential use of glyphosate. And, you know, Stephanie’s talked about this many times. Dr. Kurt Waller, he’s hit on this. He’s done many great presentations on autism, and has some courses all about that one of the integral pieces of his protocols I know is detox. So let’s talk about that. What do you actually do? You and I have many, many before and after on ourselves personally, but also clinical case studies where I’ve seen literally 1000s of percent off the chart, I mean levels so high that the lab can even give you a range for it. And we’ve been able to take those people and significantly reduce it, especially in children. I’ve seen kids that are four or five, six years old, off the charts with two four D glyphosate and many other of the organophosphate pesticides and holy crap, it’s scary when you first look at it. You look at the symptoms, you look at the gut, you look at the skin, you look at the behavioral problems, but man within six months to a year I’m confident most people listening could clear out 90 plus percent of their chemical load.

Dr. Justin Marchegiani: Yeah, 100% I think it’s, it’s super important to be empowered like that. So, so you hit a couple of the big mechanisms there. So I think one of the first things people have to look at is when there’s stress, there’s going to be indigestion, right, there’s going to be some level of bloating or gas, we’re just not breaking a lot of the nutrients down. And we have to look at what are the nutrients, we need to run a lot of these pathways, you kind of hit some right there. But we need amino acids, we need a lot of sulfur, we need a lot of the sulfur rich cruciferous vegetables, we need a lot of B vitamins, we need a lot of antioxidants. So for eating nutrient poor food, we’re not going to get those we also need a lot of good high quality sulfur based amino acids. And when you know from our healthy pasture fed eggs and animal products, and if we’re not eating those things and breaking them down optimally, then we’re gonna have problems, we’re not gonna be able to get the amino acids to make our powerful glutathione to help with our B vitamins, and our methylation and acetylation glucuronidation are phase one cytochrome p 450. Or phase two cytochrome p 450. oxide pathways that require on the phase one B vitamins and antioxidants, phase two, all the sulfur amino acids to run those pathways.

Evan Brand: Yeah, and the glyphosate messes up that P 450 cytochrome p 450 pathway too, so that was another mechanism that gets screwed up. And even if you have the nutrients and to fuel that pathway, if you’ve got a big Roadblock, there are you mentioned the glucuronidation pathway. That’s another issue. We’ve done podcast on this but the the spark notes the long story short for people listening is when you have bacterial overgrowth in your gut, which could be traced back to glyphosate exposure, damaging your good bacteria, therefore allowing the dysbiosis to happen. That then messes up this enzyme, which is the beta glucuronidation enzyme which we test for via stool now your re circulating hormones and recirculating toxin. So, like, you know, Justin and I will do protocols where we may throw in something like calcium D glue gray to inhibit that enzyme, but we have to work backwards and fixing the gut. So all this could be traced back to your glyphosate exposure sounds get reference. Sounds crazy to think like, wow, me eating conventionally sprayed toxic strawberries lead to my depression and my anxiety, but there’s the link of how it can all go down.

Dr. Justin Marchegiani: Correct. So we talked about a lot of the key nutrients, right, we talked about the gluten, and we talked about the antioxidants. Also, if we have a lot of inflammation happening in the brain, what do we do? So of course, we have powerful antioxidants like glutathione we have, which is it’s twofold, right? Because it also helps with the pathways of elimination, but it’s also a powerful antioxidant. So it deals with a lot of the oxidative stress that happens from these toxins. We also have things like vitamin D, we have things like curcumin, curcumin, like compounds, or is bare trawl gingko bacopa things that have anti inflammatory cognitive enhancement benefits. Because a lot of times what we have is we have this immune response that’s over reactive that’s stimulated in the brain, we have our immune cells called microglial cells in the brain that are overstimulated. And so a lot of times, we have to attenuate that and get that kind of calm down and relax because it’s in this positive feedback loop is once it starts getting ramped up and ramped up and ramped up and ramped up, it’s kind of at this arching level of it’s just it’s continuing to increase, increase, increase. And if we can calm that down what’s powerful antioxidant compounds, while we also stop adding fuel to the fire with a lot of these toxins and pesticides, that’s going to help us a lot.

Evan Brand: Yeah, absolutely. And the big heavy lifters, we won’t say the names because who knows in the future, our ideas and thoughts may change. So we’ll be putting some links in the show notes on your app to where you can view these products. But let’s break down some of the nutrients at least in the products in case we come out with our own or we come out with better versions in the future something the biggest heavy lift or I would say is definitely going to be chlorella. And specifically, as opposed to the conventionally sold mass marketed what’s called broken cell wall chlorella, which is decent, we like to use one that’s called a micronized chlorella, which is extremely small molecules of chlorella, that is able to get across the blood brain barrier. That’s the magic sauce that most chlorella products fall short. And I literally have 100 case studies where I could show you a before and after of getting children and adults on these products. And we’ve been able to massively reduce the levels at a woman in Canada just last week, she was off the chart with nearly every chemical gasoline xylene validates pesticides, herbicides, two, four D glyphosate, the whole nine yards. And within six months to a year of doing some of this stuff. Her levels are now non detected in a lot of categories. She’s not fully out of the woods, if we could get her in a sauna, which is another way to help with glyphosate. I think she would speed it up but just the chemical detox alone using nutrients massive success.

Dr. Justin Marchegiani: I love that. I love it. Yeah, like you mentioned binders we have different chlorella we have different maybe activated charcoal or bentonite clay compounds we have a kind of our own formulated products that we love. We’ll put the links down below, we have a lot of the glue defi on or solidify on sulfur amino acid precursor building blocks, those are really powerful. We have a lot of liver tonifying and supporting herbs to help the liver and gallbladder whether it’s milk thistle or, or, or dandelion or phosphatidylcholine. We have a lot of those nutrients that we’ve kind of formulated up. And I think that outside of that would be we get some of the B vitamins, the binders we hit some of the tonifying herbs. cloudify owns sulfur amino acid, I think we hit all the major ones out of the gates, I would just say there’s some different lipidsoma curcumin, and resveratrol and anti inflammatory compounds that the we’re looking at that really have great clinical benefits. Also binders on the activated charcoal a zeolite, citrus pectin side. So we’ll put some of our links to products that we’re personally using with ourselves, patients and family and clinically every day. And we’re kind of looking at the results that we’re getting and trying to always adjust it. So it’s the best. We’ll put those down below. Anything else Evan, you want to add today?

Evan Brand: Yeah, so the MCP, the modified citrus, pectin, that’s something we can use, we’ll often use that in a blend, and then fulvic and humic acids, those tend to do really, really good too. I don’t like those in isolation. So a lot of people have really jumped on kind of the fulvic acid train, I think it’s smart. I think they’re great. But I’ve seen, you know, before and after test results, and I haven’t been super impressed in isolation. So we might use those foam fulvic and humic acids quite a bit. But it’s going to be in a blend, it’s not going to be by itself. We’re gonna have the chlorella, maybe the cilantro. As you mentioned, milk, this whole other liver support, maybe lymphatic support thrown in there to infrared, sauna, rebounding, anything you can do to sweat hot baths, Epsom salt, where you can boost that sulfur pathway, fixing the gut getting the gut infections address, so you can get that glucuronidation pathway working better, doing the testing on your stool to see where your gut is, if your systems even working properly, to do the detox, and then obviously doing the before and after chemical testing. And I will tell you, there’s not a single non toxic human on the planet unless they’ve done a really great job with chemical detox. But just coming in your average person coming into us with complaints doing the testing, you’re going to have chemical levels off the chart, I only had one guy who came to me over hundreds and hundreds of chemical profiles who didn’t have much of anything. And this was a guy who was doing a sauna for almost an hour, five times a week. And I was like, Whoa, you’re proof that Asana excretes a lot. So everyone else they were pretty much off the chart.

Dr. Justin Marchegiani: And I had a patient just recently to did a sauna session. And this person had eye level of mercury. And the kind of one of the biggest things I preach is you have a good sulphur soap, that’s going to decrease that lipid barrier and get a quick shower right afterwards. So you can get all the chemicals and stuff off your skin that are fat soluble metals and such toxins, make sure you do that as soon as possible. This person waited think 10 to 15 minutes. And during that timeframe that next day, they had a major herxheimer or issue. And my concern is if you don’t get those toxins off your skin fast, there’s a great chance you’re going to reabsorb them, and then you’re going to reabsorb met a very high level. And that can create a lot of herxheimer. So you got to be very careful. If you’re using an infrared sauna, you won’t want to flush those toxins off your skin fast and make sure you’re really hydrating well, and you may even want to go into that sauna session with binders and solidify them before and during just in case you reabsorb some of those toxins.

Evan Brand: Yeah, that’s great advice. And that’s why a lot of people recommend like a cold like water plunge or a cold shower afterwards. So you can really just seal up get those goosebumps get your pores sealed up to where everything is off. I know for me, it was crazy, because I was kind of skeptical. I thought is that really are you really reabsorbing stuff. So I did kind of a warm shower. It was soap and then I did a cold shower. And who knows maybe it was all the benefits of cold in general. But I tell you I feel so much better with a cold shower after the sauna. as brutal as it is to put that thing all the way on cold, especially in the winter. It’s cold, but man, I feel like a million bucks after that.

Dr. Justin Marchegiani: Yeah, no, I think that’s that’s smart. So I urge patients if you’re going to do an infrared sauna, which I think is powerful, just kind of start with five or 10 minutes, do a quick shower afterwards have a good soap ready that can kind of cut that lipid by layer. Because remember, a lot of these toxins are going to be they’re going to be fat based. They’re going to be what fat soluble toxins. So it’s like imagine cleaning a pan that you just had bacon in right? With just water. You need that emulsifying dawn soap or whatever organic soap to kind of cut that friction off the pan and allow that grease to kind of come off you right? If you don’t, you’ll feel that greasiness afterwards. Well, it’s the same thing with these fat soluble toxins. You really want to use that soap emulsify what’s on your skin so it’s flushed off so you don’t reabsorb it later.

Evan Brand: Yeah, and you made a good point. I’ll just take a step further on the hydration piece and the mineral balance piece. If you’ve got adrenal issues, mineral imbalances, electrolyte problems, you know, thyroid issues, sleep issues, you’re chronically sleep deprived, you know, you’re just kind of a weak constitution. You got to be careful and go slow and steady with the sauna. If you get woozy, you get lightheaded, if you do pass out or you feel like you’re gonna pass out your heart’s racing uncontrollably, you’re getting heart palpitations, you’re gonna know you’re mobilizing too much. So when your body’s saying stop, stop, don’t push through. I made the mistake of pushing through one time. It took me like two to three days to recover. So don’t don’t do that.

Dr. Justin Marchegiani: Yep. 100% Well, I like it. Guys. If you enjoyed today’s podcast, please feel free put it down in the comments. Let us know what you liked about it. Let us know your own experiences dealing with chemical detoxification. And a lot of the pesticides and chemicals we chatted about today, we’ll put links down to our favorite products, detoxification, support water filters, things that are going to decrease toxin load in your body and things that are going to help your body expel toxins better. And it guys if you enjoy today’s podcast, feel free head over to EvanBrand.com or JustinHealth.com. We are available worldwide to help you all out if you need that extra functional medicine, nutrition support. We are here as well. Anything else?

Evan Brand: No, that’s it, you covered it all. And thanks for listening.

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