What are the Natural Anti-Inflammatory Agents for Pain Relief

In general, we have our COX pathways. Now, Arachidonic acid can feed those pathways. A lot of excess, junky, refined Omega-6 from animal products can definitely feed those pathways. That sets the table like gas in the kitchen where a little spark can take it off.

Click here to consult with a functional medicine doctor for recommendations on natural pain relievers.

Where to find anti-inflammatory agents:

  1. Natural herbs like ginger can help with COX-1.

  2. Fish oil is excellent for COX-2 at high doses. If you do high doses of fish oil, you can increase what’s called lipid peroxidation because fish oil is a polyunsaturated fatty acid. It’s more unstable. It’s got more double bonds in it. Omega-3 means three double bonds. The more double bonds that are they are, the more unstable the fatty acid is to heat things like that and the more, let’s say it can be oxidized. So, having extra vitamin C or extra vitamin D on board when you’re taking extra fish oil just to make sure you don’t have oxidation is great, and we already talked about things like systemic enzymes.

  3. There is also curcumin but liposomal curcumin is better due to the absorption or something with black pepper in it helps with absorption, too.

  4. Frankincense or Boswellia.

  5. White willow bark which is kind of how aspirin is naturally made though aspirin works more on COX-1. So, aspirin can be your other natural source and you can do white willow bark which is the natural form of aspirin.

  6. There are things like Tylenol but Tylenol works more on the central nervous system perception. So, it decreases the nervous systems’ perception of pain. Note: We have to be careful of Tylenol as it can actually chronically reduce glutathione. So, if you’re taking Tylenol longer-term, you definitely want to take it with NAC and/or some glutathione, just to be on the safe side.

  7. At the extreme example, we have opiates which block pain receptors in the brain, the opiate perception of the brain. It’s not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive.

  8. We can block some of these natural pain perceptions with CBD oil. So, CBD is another great way to reduce the perception of pain.

In general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation.

If you have osteoarthritis, rheumatoid arthritis, sports injury, or you’re just trying to heal maybe postoperation, these things may be something to implement and then obviously work in all the other root causes, too. You are not just what you eat. You are what you digest from what you eat.

So, if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair or falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place.

If you need to reach out to talk about your pain and inflammation issues, click this link to schedule a chat with me!

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

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

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

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

How do you take collagen?

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

Where can you get collagen from?

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

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

Nutrients to Help Make Serotonin to Help Improve Mood and Sleep

In today’s blog, I am going to share with you the natural ways to boost your serotonin levels and other alternatives. Let’s talk about nutrients to help support serotonin levels.

Click here to consult with a functional medicine doctor to learn more about boosting serotonin levels.

Serotonin is a really important neurotransmitter. Its building block comes from protein and amino acids, particularly 5-HTP (5-hydroxytryptophan) but serotonin has a lot of important roles in regards to mood, well-being, sleep, stress reduction, and happiness. So, all these things play a major major role in helping you feel good. If we have inadequate serotonin levels, that’s going to create a whole bunch of things. Once you start having sleep issues, mood issues, or stress issues then stress starts to hitch a little more. You don’t quite sleep as well. You don’t adapt to or deal with stress, not quite as resilient as well, and then a lot of times you’re just not going to heal and recover well either because serotonin is a precursor to melatonin. Melatonin helps you sleep and it’s also a very powerful antioxidant. So, a lot of good benefits there.

Serotonin is made from tryptophan and/or 5-HTP which is 5-hydroxytryptophan. Now, I personally like using 5-HTP better because there is an enzyme that’s kind of a governor on tryptophan converting downstream into serotonin. The 5-HTP bypasses that enzyme, so you can therapeutically bump up serotonin a little bit better with 5-HTP. So, we use 5-HTP and B6 that can really significantly improve serotonin levels. Anywhere between 100 to 600 mg per day can be very helpful. There are important cofactors that will also add. B6 is an essential B vitamin that helps with the synthesis. You may also want to throw in B12 or methylcobalamin, ideally methylated because these neurotransmitters need to be methylated. B12 makes a huge difference.

In the podcast, we talk about a study where they used antidepressants, not that I’m a huge fan of those, but they found that an antidepressant plus a methylated B12 improves depression symptoms by 20%. So, we know B12 and that methylation process is very important for your neurotransmitters. Also, we can throw folate in there because folate works a lot like brother and sister with B12. So, B6, B12, and folate (or B9 for short for folate) are really important. Those are your key methyl groups in regards to your B vitamins. They have a lot to do with methylation.

Of course, vitamin C can be very important because the adrenals play a major role in serotonin and stress. In that sympathetic fight or flight nervous system response, the adrenals play a big role in making cortisol and/or adrenaline to help manage or deal with or adapt to that response. So, for chronically firing our adrenals, whether it’s cortisol and/or adrenaline, and we start have HPA access issues meaning brain-adrenal communication feedback issues, that can make it hard for us to kind of calm down from stress and/or even ramp up to deal with stress. So, it’s kind of like it being really cold out, you put your heater on and you can’t quite mount the heater or mount enough of a response to create heat and warm your house up or vice versa if it’s cold. You need to be able to adapt and modulate to our environment. So, we need healthy adrenal function. A lot of times, I’ll add in things like various adaptogens like Rhodiola, Ginseng, Ashwagandha, and Eleuthero. These are great adaptogenic herbs to help us modulate and deal with stress better.

And then, of course, a good healthy diet is essential because inflammatory foods, food allergens, processed junk, grains, and refined foods are going to stress out our body. The problem with refined processed foods like grains and sugar is they can, in the short run, increase our serotonin and allow us to feel good. So, people say, “Oh, I’m an emotional eater.” What are you doing? You are essentially trying to artificially boost your brain chemicals up with junk food. It’s like whipping a tired horse to perform better. It’s like trying to drink coffee at midnight to get work done. It’s going to just throw off your sleep and you’re going to be tired the next day.

So, of course, there are always what I call constructive vehicles versus destructive vehicles. Destructive vehicles provide a short-term gain and long-term destruction if they are habitual. Constructive vehicles are not quite as an impactful short-term gain but long-term restoration, long-term healing, and long-term performance enhancement. So, that’s good digestion, eating protein, balanced blood sugar, and we can utilize amino acids like 5-HTP, B6, folate, B12, vitamin C, and adaptogenic herbs. These are very helpful in modulating our stress response. They also modulate how we perceive stress. The more you can perceive stress better, you don’t mount as much of a cortisol or adrenaline response because your perception of it is much better.

Things like magnesium can also be very helpful as magnesium kinda plays into GABA. GABA has a major role in the inhibitory neurotransmitter. It’s the downshift or it helps hit the brake, so things like GABA by itself and things like L-theanine are excellent. Adaptogenic herbs like passionflower or Valerian can be very calming. Even things like Kava or CBD could also have a very calming effect. So, there’s a couple of different things that we can throw in there.

When I’m working with the patients, I’m always saying to myself, “What’s the root cause?” Let’s set the foundation and make sure the root cause is supported. Let’s make sure able to break down and digest and absorb all the nutrients and make sure there are no underlying bottlenecks in regards to low enzyme, low acid, and gut infections. Let’s make sure we’re managing our lifestyle stressors and we’re doing our best to sleep good. Food is good, food quality is good, and hydration is good. I make sure those foundations are solid and then we can kind of get in there with other supplements and nutrients to help support those pathways.

If we wanted testing for neurotransmitters, I’ll do things like organic acid-based tests. Then we’ll look at a lot of the metabolites for these neurotransmitters, whether it’s serotonin where we will use 5-hydroxyindoleacetate (5HIAA) or we will use Vanilmandelate which is a marker for adrenaline or Homovanillate which is a marker for dopamine. Again, dopamine is a precursor to adrenaline, so it’s phenylalanine, tyrosine, dopamine, L-dopa, and then it can go down to epinephrine/norepinephrine or adrenaline/noradrenaline. It’s the same thing. So, these are catecholamines and they can convert a lot of these upstream neurotransmitters down. There’s some overlap in dopamine and serotonin symptoms. A lot of people that think they have serotonin problems may actually have a dopamine problem. So, it’s good to get tested as well. It’s good to look at the symptoms, make sure the foundation is set, and then you can dive in deeper to look at a lot of these nutrients.

Now, in my supplement line, we use things like Brain Replete which has an excellent 10:1 ratio of tyrosine or dopamine to serotonin. That’s a good combo product. It has all the precursor nutrients, too. Also, I use a product called Serotonin Replete which is excellent with 5-HTP with B6. I have a product called Dopa Replete which is just a tyrosine product that is nice for lower dopamine issues and for higher dopamine, there is a product called Dopa Replete Plus and that helps bump up dopamine more. It has got Macuna pruriens in there plus a couple of other compounds that are very helpful. It has L-dopa, tyrosine, EGCG, and of course, B6.

If you’re overwhelmed with how to increase serotonin levels, then click this link where you can schedule a chat with me!

Low Serotonin Signs, Symptoms and Natural Solutions | Podcast #325

Serotonin deficiency has common symptoms, including low mood and poor sleep quality. Most of the time, taking antidepressant medications called selective serotonin re-uptake inhibitors (SSRIs) can improve serotonin deficiency symptoms. So in this podcast, Dr. J and Evan talk about the root causes and presentation of this condition. 

Our serotonin helps regulate a wide range of bodily functions, including sleep, bladder and bowel functions, orgasm, and emotions. It plays such an essential role in the body, it can be hard to determine whether low serotonin is causing a problem. 

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:22        Serotonin Neurotransmitter

5:17        PMS for Females

9:00      High Serotonin Symptoms

15:13     Neurotransmitter Nutrients

19:42     Herbals

25:47     Products for A Better Serotonins

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Dr. Justin Marchegiani: We are live! It’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about low serotonin signs, symptoms, and natural functional medicine root cause solutions to get to the root of why everything’s happening, why these mood issues, energy issues, cognitive issues could be a play, Evan, how you doing today, man? 

Evan Brand: Doing really well. I’m excited to dive in with you here. This is an issue that I suffered with when I had gut issues. And, you know, once I figured out the connection between gut and mood, it was a game changer because I was focused so much on mood supplements, right? I would take like rhodiola is a natural antidepressant helped to boost energy. I would take ashwagandha to help with hormones and adrenal support. But I didn’t realize that I was missing the smoking gun, which was all the gut infections I had. So I was playing with adaptogenic herbs, long before I had the knowledge I have now about gut infections and serotonin. And so what I first want to tell people is that you can come in and you can spot treat things like you can use different nutrients and amino acids to help serotonin. But in reality, we really need to be focusing on the gut you and I’ve discussed this many times, but a large percentage of serotonin is going to be made in the intestines. And if you’ve got bacterial overgrowth are parasites or other infections, that pathway is not going to be working as optimally and no, this is not a deficiency of antidepressant drugs. 

Dr. Justin Marchegiani: Exactly right. So serotonin neurotransmitter helps a lot with motility helps a lot in the digestive tract, right. Also, a lot of serotonin supposedly does not cross the blood brain barrier. There’s a lot of people that talk about this, a lot of the precursor amino acids like five HTP, or even dopamine or tyrosine, the precursor amino acids can actually cross the blood brain barrier and then also convert. So of course, there’s some people that say like, like Kevin just said about the serotonin being made in the gut really important, helps motility probably does have some mood influences just because the guts so important for absorption of all these nutrients, and we need serotonin for reasonably healthy gut function. But we also need to be able to break down all of our protein and amino acids because all these amino acids are the building blocks for all of our neurotransmitters, whether it’s serotonin, dopamine, glutamate, GABA, whether it’s our beta endorphin, all these are really, really important and we have to be able to break them down. So of course, things like low stomach acid, low enzymes, gut inflammation from food allergies, gut bugs, infections, being overly stressed over a sympathetic nervous system output, adrenal dysfunction, high chronic, higher, low cortisol, all of these things are going to shift our nervous system, it’s going to act our activate our fight or flight, nervous system response. And those things can play a major role, and being able to digest, absorb and assimilate. So that’s like kind of a foundational thing, I want to just kind of start with off the bat because we need that to be in place. And then once that’s in place, that gives us a good neurological foundation to not overly activate our sympathetic nervous system response, have the enzymes and the acids. And then of course, we’re making an assumption that we’re eating really good foods that are anti inflammatory, nutrient dense and low toxin to kind of provide those building blocks out of the gates.

Evan Brand: Yeah, well, you just highlighted something important here, which is this serotonin issue. And other neurotransmitters too, can be a vicious cycle, in the sense that if you have gut infections, reducing stomach acid levels, now you’ve got this malabsorption issue, so you’re not going to get the amino is any way to manufacture the neurotransmitters. So you could come in, and you could use amino supplementally to try to spot treat. But in reality, if you don’t fix the infection, creating the malabsorption in the first place, it doesn’t matter how well you do on the diet. It’s not about what you eat. It’s about what you digest from what you eat. And I think that’s the important piece of the conversation that’s missing with people is they focus on do this food do that food, but it doesn’t take into account Are you actually absorbing and assimilating that and we know based on Dr. Wright’s work in his amazing book, why stomach acid is good for you that by age 30 40 50 60 and beyond you make less stomach acid just with age alone. And that doesn’t even account for the fact of modern life stress, circadian rhythm issues adrenal issues not chewing your food, that kind of stuff. So your regardless of the lifestyle factors just age alone is enough to create a bigger problem. So let’s just run down the list real quick together here of too low of a level of serotonin. Now you may see various lists across the internet, Justin and I found one that we like from a respected source. So I’m just going to kind of run down the list here of two low serotonin. Course depression. Everyone thinks about that, but also anxiety, insomnia or sleep problems, nervous or worried, poor response to stress, negativity or pessimism, irritable or impatient, self destructive, potentially even suicidal thoughts, low self esteem or self confidence you feel worse in the winter. So you could call it a winter depression if you’d like younger, rage, explosive behavior inflammation. Here’s one that’s interesting. We need to, I think, talk about this further PMS. And then OCD or eating disorders as well have a link to serotonin. So the PMS is interesting. What do you think the meccan mechanism is there? 

Dr. Justin Marchegiani: Well, a lot of female hormones like progesterone, for instance. And or just healthy progesterone, estrogen balance, have major effects. Basically, they’re like mono amine oxidase inhibitors. So essentially, they almost are like mini antidepressants, they help kind of keep a lot of the neurotransmitters in between the post and presynaptic synapse. So you kind of have this presynaptic synapse, we have a postsynaptic synapse. And this is what’s called the synaptic cleft, right? This is these are where the neurotransmitters accumulate between the two. Okay? And things like progesterone, for instance, they have a mild serotonin reuptake inhibition effect. Now, when you do medications, the problem with medications, the longer you keep those neurotransmitters between the synapses here, the faster those neurotransmitters are recycled and broken down. That’s why over time, people that are on antidepressants, or SSRIs, their dose has to go up, not down, especially if you don’t fix like underlying root issues. So I think a lot of these hormones like progesterone, we know is a GABA chloride channel inhibitor. So GABA is big, because it promotes relaxation, the more relaxed and calm your nervous system is, the less chance you’re going to be burning through serotonin because you’re less stressed. And there’s a mono amine oxidase inhibition effect, right, MAO, inhibitor, so it’s almost like a mild antidepressant in a way for sure. 

Evan Brand: Oh, cool. Totally interesting. Yeah. So I mean, it sounds like, you know, part of the protocol could be both, it could be using potentially some hormones, like maybe some progesterone, but also coming in with the amino acids. And then once you figure out what’s going on, after you test, then you could come in and start fixing the infection. So let me just tell just a brief story. I think people relate to the stories here. So I just remember, you know, when I was down in Texas, and I had gut infections, I had just a baseline anxiety level that was so high. Now granted, I was away from home, I had some homesickness, I missed my family, that kind of thing. But this was different. This was related to my gut, because as soon as I was doing no microbial herbs, the anxiety was 25, maybe 50, maybe even 75% better. So I can just tell you, personally, you know, you and I’ve seen it clinically as well. But just personally for me, you know, I was doing supplemental gabbeh, I was doing motherwort passionflower, all the calming herbs. But it didn’t matter how many calming herbs I did, it was just a band aid. It wasn’t root cause. So I just want to make sure people understand that there’s a difference between natural and functional. So natural medicine is like, hey, you’re anxious take passionflower functional medicine is like okay, fine, take passionflower. But why are you anxious? And that’s the secret. The secret sauce?

Dr. Justin Marchegiani: Correct. I think with you mean, part of the underlying reason was you had multiple gut infections that were not being addressed. Yeah, there was there was that kind of thing in the background, I think that was really important. And so fixing that played a big role, you had some potential mold stuff that was hiding as well. I think there was also some blood sugar stuff that was happening with you as well, that we were looking at, I think you also had like really low blood pressure, too, didn’t you? 

Evan Brand: Yeah, my blood pressure was like, maybe 100 over 70. 

Dr. Justin Marchegiani: So on the lower side, so there was definitely very weak adrenals where your mineral corticoids were paying a price and you weren’t able to hold up a lot of the holding a lot of the minerals that your blood pressure was dropping, and so you weren’t able to really perfuse blood flow adequately. Right. So yeah, all these things play a big, big, big, big role. 

Evan Brand: I was peeing a lot too. So I was up in the middle of the night, three, four or five times to pee. I now know that that was related to mold, because since using appropriate binders, I no longer wake up in the middle of the night to go pee. So just folks listening, you know, could be an adrenal component as well. But, you know, for me, the excess urination was definitely a mold thing, and it’s luckily resolved. 

Dr. Justin Marchegiani: Exactly. So you already kind of talked about a lot of the symptoms. Let’s just kind of go over those real quick. So we have our high serotonin symptoms just briefly here. Let’s hit them again. So too high depression, anxiety, nervous being a worrier. 

Evan Brand: And these are low stress. These are low. You said to- 

Dr. Justin Marchegiani: I’m sorry. Yeah, I’m sorry. These were too low depression, anxiety, nervous worry. Anger, PMS, right. And then on the high side, let’s go over the high ones again, briefly. There’s no high Okay, there’s no high for those. Okay, so those are the big ones with the seratonin. Right. Now, we already talked about the foundational things. So when we talk about nutrients, just kind of make sure everyone that’s listening understands Foundation has to be in place, good foods, good digestion, good hydration management of stress, and we can talk about different techniques that help decrease stress. I won’t go into specifics but I’m a big fan of EFT, EMDR, NLP a lot of times techniques or eye movement techniques that can help rewire the nervous system that can help dampen sympathetic nervous system responses. There’s another one that you like Evan, that you did that does a lot of rewiring as well. Which ones that? 

Evan Brand: You talk in the brain retraining? 

Dr. Justin Marchegiani: Yeah, brain retraining, a lot of that requires NLP? 

Evan Brand: Yeah, I’m playing with a couple of them. Yeah, some of it is kind of NLP strategy. There’s one called gupta. There’s another one called dnrs. They’re just doing our online one. Yeah, they’re online brain retraining, I’m gonna work through the Gupta, the one and I’ll have feedback for people, but I have done the dnrs. It’s basically just trying to rewire your brain, right, you’re trying to tell your brain that your issues are fine, and all of that. So I like it. But I personally, I think EFT is better. I like the tapping aspect of EFT tapping is nice-

Dr. Justin Marchegiani: You can feel a nice reduction of that nervous system response. It’s like when your brains are used to firing a certain way. It’s like, if you have a big backyard and you go on a hike or you go for a hike, where your local park, there’s a path kind of carved out when you go into the woods and that paths there. Where do you go, you naturally walk on the path, you don’t just go randomly go in the woods with all the sticks and trees and ticks, right? You kind of go on that carved out path, your brain kind of works the same way. So when it’s used to thinking about something a certain way, it carves out a path. And when you jump on that when you jump in the woods and you see that path, you naturally go down that way. And so essentially, the tapping is kind of like it’s a way of like pulling out the machete and kind of carving out a new path in the brain to fire a little bit differently. 

Evan Brand: That’s that’s a great analogy. Yeah, that’s a great analogy. You’re saying how basically with this low serotonin that you can get stuck in these pathways of like, pessimism and negative thinking and all of that. So it’s harder to break out.

Dr. Justin Marchegiani: Yeah, I’ve listened to Julia Ross lecture one time, because she does. He’s an MFT marriage family therapist. And she has done counseling on lots of people. And she has had clients and patients for decades, where they just couldn’t get over certain issues. And she just started utilizing nutrients and amino acids and these problems that were problems, just naturally, were non issues, they they just became they just people were able to get over them so much easier. And a lot of that is is you need the mental neurological equipment to be able to process and handle them. You know, my my analogy, I get patients, it’s like staying up all night and then trying to do your taxes the next morning, like you just may not be able to have that mental capacity to handle it. And so I look at neurotransmitters, it’s giving you the equipment, you need to deal with these issues, it’s like giving a child adult level problems like they just going to be overwhelmed, they’re not going to be able to handle it and process it. And so if you have the right neurological equipment on board, that gives you the ability to handle it. And then also having these extra strategies in our back pocket. Like I mentioned with the EMDR. EFT Now the easiest thing is you just talk about the problems and you just kind of tap all the different EFT spots, side of the eyebrows, middle of the eyebrows underneath the eyes, underneath nose and chin, collarbone, underneath the nipple area, under the armpit, right. And those are just those are the really good spots you can do you can do right in the parietal line in the center of the brain here. Those are all good spots. And you can just kind of talk about the problem, whatever the problem is, let’s say you’re at a seven out of 10 and 10. Being you know the most sensation or irritability or emote, you know, palette of emotion that you could feel, ideally you want to get below five. So I always just say talk about the problem, talk about the fear, talk about the emotion you’re feeling and try to get it below a five. And ideally, if you can get below a three even better. And so you just keep on doing that it’s a good way out of the gates. And then also NLP kind of comes in where you you really are focused on the pictures that you have in your brain, right? That the pictures that you have in your brain are very important. So you really want to put pictures of yourself succeeding doing the thing, right? And then an easy kind of NLP technique is you can do the stop sign. Have that stuff sign flash in front of your, your, your mind’s eye when you start thinking things that are negative or you can do no stop. Right you there’s a DNR s one that you can tell about to. 

Evan Brand: Yeah, yeah. And then that’s what they do. You basically just kept pace. tell yourself that your brains sending your body false messages. So it’s like this negativity, it’s this fear. It’s this hyperstimulation it’s the overreaction, you’re trying to just shut that down. And the mind is powerful. And I think it’s I think it’s an underappreciated thing. Now, you made a great point, which is that you got to have the fuel in the fuel tank, right. So you could do all the the physical tapping and all that stuff. But if you simply just don’t have any neurotransmitters in the tank, it’s going to be tough to focus on this, it’s going to be tough to have drive to get this done. So that’s where you and I are going to come in. And you know, let’s talk about some of the testing now. So we’re going to be looking at like an organic acids testing. And we’re going to look and measure some of the various aspects. We did a podcast recently on low dopamine, so check that out if you’re interested. But in that same category, we’re going to be able to measure the serotonin marker. And once we look at that we can see where people are at. And then of course, we’re going to factor in what’s going on with the gut to because rarely is the serotonin good To become a dysfunctional problem, unless there’s a gut issue as well. So we may see Candida bacterial overgrowth parasites, H. Pylori, gut inflammation and low serotonin. It’s rarely just low serotonin by itself.

Dr. Justin Marchegiani: 100% and so it’s good to have the foundation it’s good to have some tapping techniques. Now let’s go talk about some of the other nutrients. So we know things like five HTP, or triptophan is a precursor to serotonin and serotonin. You know, obviously, that neurotransmitter that helps with focus and feeling good. It’s a very, you know, happy neurotransmitter. A lot of times dopamine can overlap because dopamine helps with focus, it’s an I love you neurotransmitter. So a lot of times there can be an overlap in those symptoms. And a lot of times people that have low serotonin could have low dopamine as well. And also the enzyme that metabolizes serotonin that metabolizes five HTP, and converts it downstream to serotonin is the aromatic decarboxylase enzyme. And that enzyme also metabolizes dopamine. So if you constantly take five HTP support chronically, you probably want to have a little bit of dopamine tyrosine support as well, because you can create some functional deficiencies long term. So just kind of keep that in mind. Like in my line, we have a product called brain deplete that has a 10 to one balance of tyrosine to serotonin. And if you’re taking a lot of serotonin, it’s probably okay especially if you’re testing it on the organic acid, but just long term, you probably want to throw a little bit of dopamine, whether it’s tyrosine in there to provide some building blocks, that’s excellent out of the gates. And then there’s a couple of really important methyl support that needs to be there, B six and B 12 are very, very important. B six is incredibly necessary for the synthesis of neurotransmitters, we need B six is an important cofactor and so is b 12. b 12 is methylated B 12. Really important for the methylation of these neurotransmitters. Well, we attach a carbon and three hydrogen to it. That’s methylation. Very important. Also, vitamin C is very important because vitamin C tends to be burnt up and overly utilized when there’s a lot of adrenal stress as well. We talked about five HTP, we talked about some potential tyrosine. And then it’s also nice to throw in a little bit of an adaptogen. Because adaptogens help with the stress response, they help with perceived stress. So even if you’re stressed right now, just giving you some support on the adaptogenic herbal side, will change your perception to it. And so things like rhodiola or ashwagandha, or ginseng, or eleuthero are amazing to help kind of or even macca, especially women do very well, macca are very good for stress perception and stress modulation. 

Evan Brand: Yeah, great, great calls. So just to back up what you said, there was a trial done. We’re not fans of drugs, we prefer to try to come at it the natural functional way whenever possible. However, there was a study done that compared antidepressant use, and just in a depressant by itself, compared to antidepressant plus b 12. And 100% of the subjects that got the B 12. And the antidepressant showed at least a 20% improvement with their symptoms compared to the antidepressant alone. So just to tell you one more time, and a depressant plus b 12 20% improvement in the outcome, as opposed to just the antidepressant by itself. And then also Foley, same thing. There’s a paper on Foley, and how that also boost things up. And then I don’t know if you’ve, you’ve played with this one much, but have you seen some of the Selenium extracts? You’ve got some of these saffron and selenium blends like this? Yeah, so it’s pretty cool. I’ll put it in the chat for you. So you can look at this tech sheet, you might have to log in, but I’m gonna send it to you. 

Dr. Justin Marchegiani: Yep, I’ve put those links to the studies. And we’ll put it in the description notes after the show. So you guys can take a peek at it. 

Evan Brand: Yeah, but so just, I just put it for you in the chat. If you want to see, like I said, you may have to log in to see this tech sheet. But this is a cool product. And I’ve used it with some people that were previously on antidepressants, and they got off of it. And many of them reported they felt just as good. And so the Sceletium plant, it’s kind of an indigenous South African plant. Indigenous people used it says for relaxation, stress reduction, calming thirst and hunger prior prior to long hunting hunting trips, which is pretty cool. And it acts like an SSRI. So the Sceletium binds to the serotonin transporters inhibiting the uptake of serotonin from the synapse, resulting in increased serotonin concentration in the synaptic cleft. That’s the same mechanism of prescription SSRIs. So this is a game changer, potentially. And like I said, I’ve had clients that were previously on the pharmaceuticals, and then they did this one, and they like this one much, much better.

Dr. Justin Marchegiani: That’s good. Yeah, there’s a lot of good options. It’s nice to have some herbals, whether it’s adaptogens or the sceletium, whether it’s the saffron and I think in that the important cofactors need to be there B six b 12. You can maybe even throw in some full weight in there because full weight tends to interact. So I tend to have you know, products that will Be six, we’ll have the seratonin have the dopamine support. And then we always like, I think you’re in the same place always having a really good molti there in the background just to make sure all those cofactors are there. And then of course, having a really good solid diet as a foundation that kind of gives you that insurance policy that the building blocks are there, the cofactors are there, and then you can really hit things more therapeutically after. 

Evan Brand: Yep, absolutely. Now, have you played with any of the other testing? You know, we already hit on the test. But there are some companies that do just neurotransmitters Have you ever played with those at all? 

Dr. Justin Marchegiani: Well, the whole idea with some of those is that you may not get a good window, what’s happening in the brain, right. So supposedly, you have the idea one is going to be some kind of like a spinal tap, right, where you really get a window into what’s in the cerebral spinal fluid, which is kind of flowing to the brain, that’s kind of like your ideal, obviously, that’s invasive. And then the urinary metabolites, I think, are pretty good. Because you kind of get a window like, if someone’s buying a whole bunch of food, you kind of get a window by going into their trash what they bought last week, right? It’s kind of like that. So you get a pretty good window of how you’re doing. So if we don’t see a lot of stuff in the trash, or we see too much stuff in the trash, that gives you a window what your body’s utilizing. And so that’s organic acids, we’ll look at with serotonin and we’ll look at five hydroxy and dolo. Last day five HIIA. So that’s helpful to give it give a window into it to know what’s happening. And then we’ll apply some of those nutrients, maybe 100 milligrams of five HTP at a time. And we’ll kind of go out from there. And I like doing it more, you know, at the last half of the day, especially if it’s more calming and relaxing, because some people they may get too tired because of it during the day. So you got to individualize it. And if you’re on a medication, it’s really important if I’m having people that are on meds like SSRI medications, amino acids will help the drugs work better because these drugs work by blocking re uptake ports. And if you’re blocking a rehab, take a port and you’re providing more substrate. Well guess what happens that substrate now is going to increase the symptoms or the potential effects of the drug which can also increase the potential side effects. So I always tell patients, look at the medication that you’re on, make sure you know what the side effects are. And so if we add things in, we look for those side effects to occur. If they do, we go back to the prescriber, and we gently nudge down the dose of the medication under the prescribers controls, we got to look at what those side effects are. That way, if it happens, great, we adjust or we just go slower to so my goal is if we’re going to adjust medication, we’re always doing it from a point of stability, not instability, and we’re always utilizing the prescriber that prescribed it. And if you’re on some of these meds long term, whether it’s an SSRI, or maybe even benzos are the worst, we may need a very, very long term taper, it just really depends. Could be six months up to a year, depending on what the medication benzos tend to be worse, SSRIs tend to be less. And it depends on how long you’ve been on them for Okay, so But either way, we don’t touch medication dosages, unless we have everything in order, we’re stable, and then we have a prescriber that’s involved in the prescription of the medication, monitoring and tapering the dose. 

Evan Brand: Well said and there’s a link between antidepressants and gut bacteria to if you just look up and depressants, microbiome, you can find some studies on this. But we now know that these antidepressants are negatively affecting the gut. And we’re seeing changes with bacteria. And in particular, we’re seeing clostridia and other pathogenic organisms that we test for via stool and urine. We’re seeing these pathogenic bacteria overgrowth. So there is a link now between antidepressants and bacterial overgrowth in the gut. So just keep that in mind. If you’re somebody who’s been on these prescriptions for a period of time you’re having gut issues, maybe you’ve worked through some protocols, whether it’s with us or other practitioners, maybe you’re not to the finish line yet, you know, consider the drug could be a contributing factor, I’m not telling you stop the drug, I’m telling you that it needs to be factored in, and we got to try to counteract what that drug is doing. And we’ve seen cases like that, where clostridia just keeps coming back. And the drug, if the doctor was able to remove it from the protocol, then boom, they were able to get well and stay well.

Dr. Justin Marchegiani: Yeah, totally. I mean, my personal opinion on medications like SSRIs, or drugs like that. The only, you know, real good application, in my opinion, is some kind of a short term where someone may commit suicide or harm themselves. That’s the only I think, you know, valid reason to be on it at all, is for just pure stabilization. And then working with someone with various therapies, whether it’s talk therapy, whether it’s then I think, combining EFT or EMDR, with that to kind of calm everything down and then utilize the diet and nutrients and then get off the medication. The problem with most medications is once you’re on it, you kind of get stuck, and the prescriber doesn’t want to take you off and they’re also not fixing the underlying root issue. So, you know, my general application is if something’s incredibly acute, that may make sense. But outside of that, you want to always try to work on coming off that way responsibly with all the foundational support underneath, and with the prescriber involved. So if anyone’s listening and they’re on a medication like that, and they just want to come off, don’t do that work with the functional medicine doc, and then we’ll also work with your prescriber to get you off because there’s always going to be some kind of a relapse that happens. And we don’t want anyone to be in a position where their neurotransmitters just really go wonky with a major, something they regret. 

Evan Brand: Yep, absolutely. Well, I think that’s all I have to say on it. So if you have any more than let me know, otherwise, we’ll give people some info here where they could reach out if they need help, I know you’ve got some products to mention, I’ve got some too as well. So in your show link in your show notes on the podcast app, you should be able to click there and then boom, check out some of these products. You know, if you’re on drugs, you know, consult with us or consult with your practitioner, how you may work some of these in. 

Dr. Justin Marchegiani: Yeah, the big ones that I use in my line, of course, a good multi multi support pack excellent brain repletes to have that 10 to one ratio of tyrosine to serotonin with some of the cofactors there I’ll also use serotonin with B six. So in my line, serotonin replete or dopa repletes, are going to be the big ones and the dope replate Plus is my bigger l dopa, which is a it’s let’s say, a little bit more down the line in regards to dopamine synthesis, so it can have a better effect on improving dopamine levels. So those are my big ones. We’ll put the links down below. Evan, what are some of the ones that you have in your store that you use with patients? 

Evan Brand: Well, a lot of them I’m ordering through third party, so I don’t have any on my store right now. And we’re moving warehouse. So I don’t have any right this second. But you know, if you’re working clinically with me, I will definitely educate you on those. And then some of the Zimbra and some of those, there’s different professional manufacturers that will use so there’s a couple different brands. But either way you could reach out and we’ll we’ll let you know what we’re going to use. 

Dr. Justin Marchegiani: Yeah, maybe a good idea. You have a category on your website, like say, like maybe neurotransmitters so people are listening to this down the road, maybe look for a category on brain nutrients, or neurotransmitters. And some of those will be there too. I have a category on brain nutrients too. So we’ll try to make it easy for you all to navigate. If you need support, we’ll put links down below. 

Evan Brand: Awesome. If you need help clinically, you can reach out Dr. J works with people worldwide via phone, FaceTime, Skype, however you need to chat. So please reach out to him at JustinHealth.com. And if you need me, Evan Brand, EvanBrand.com is the website. And we love working with this stuff. I mean, we’ve been able to transform our own lives with these products, we’ve been able to transform 1000s of other lives. And so this is really just a sigh of relief, when you can fix these issues. And you can help people take back not only their mood, but take back their life. I mean, when you optimize these things with brain chemistry, you can allow people to become more focused, you can allow them to become more calm, they can sleep better, they become better parents, they become better husband, better wife, better workers, better CEOs, better entrepreneurs. So it’s just incredible what you can do when you optimize this stuff. And so we want to test not guess, figure out what’s going on, look under the hood. And you can help modulate these things. So please reach out if you need help. 

Dr. Justin Marchegiani: Yeah, and if someone’s coming into this, they don’t know where to go. They’re not quite sure where to start, keep it really simple. Start with the food. Start with a good healthy paleo template out of the gates, maximize your ability to break down protein with HCl, good digestive acid enzymes just start there out of the gates because that’s the building block for everything. And then from there, definitely get a practitioner in your corner to really work on all the building blocks, all the supplements support all the other precursor support so you have that good foundation, and then maybe also dive deeper into a lot of the gut, which could be a lot of bottlenecks. If you have chronic digestive issues. That’s gonna be an important part of the equation as well. 

Evan Brand: Totally, totally Well said, well, always fun. I love these brain neurotransmitter episodes. They’re always a blast. I think they’re very helpful, very empowering for people. So please give us a review. We would love it. If you can review Justin’s show on iTunes or my show on iTunes. We really appreciate it. Give us some stars. Let us know what you think. Share it with your friends and family people who are dealing with issues we know that depression anxiety issues are massively increased over the last year. So the thing that we can hope here is that this is a beacon of light to help people know that there is solution to this problem.

Dr. Justin Marchegiani: 100% we’ll put some review links below so you guys don’t have to hunt it down too far to do that. We really appreciate it guys have a phenomenal day. Take care y’all. 

Evan Brand: Take care. Bye bye.




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Audio Podcast:


Fatigue, Tiredness, and Lethargy: Link to Gut Infection | Podcast #311

Tiredness is not a symptom that defines any one particular disease. Rather, tiredness can be a symptom of many different diseases and conditions. Causes of tiredness range from lack of sleep and over exercise to medical and surgical treatments. The lack of energy (lethargy) associated with tiredness can sometimes cause difficulty with normal daily activities, leading to attentiveness and concentration problems. 

Dr. J suggested considering to support protein breakdown by extra amino acids and enzymes. Dr. Evan also added that if you have issues, always reach your conventional Dr. or functional Dr., be tested, find the root cause and guide to fix possible infections that cause you to feel tired before you reach a crisis level.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:10      Mechanisms to Gut Infection

4:05      Where Gut Stressors Come From

12:12     Infections that causes Fatigue

17:41     Probiotics and Beneficial Bacteria

22:32     Supplements to Gut Infection

24:18     Immune Issues

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Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about your gut infections may be making you tired. Many people don’t think about how their gut maybe having an impact on your energy, your mood, your emotions, but it’s totally true. Most people think, oh, if I have a gut issue, I’m just gonna have bloating or diarrhea or constipation or acid reflux. Oh contraire. We’re gonna dive into that today, Evan, how are we doing today, man? 

Evan Brand: Doing really well. How about should I just go straight into my story, then? I mean, I suffered with this thing firsthand, as you know.

Dr. Justin Marchegiani: Yep. Let’s do it. 

Evan Brand: So when I was down in Austin, I was losing weight. And I didn’t know why I was losing weight. And turns out and I was exhausted. That was that was the main thing. I mean, I was drained, like, it was really tough for me to get through the day. I mean, I was to the point where, at some point, it’s kind of embarrassing. I mean, I was like, okay, am I do I have enough energy to cook a meal at night, you know, for dinner, like, the workday just drained me. And so fortunately, after I got the gut infections resolved, I mean, the story is not much longer than that my energy came back online. So I mean, we can say clinically, and personally, that this is a big, big smoking gun for anybody who’s been dealing with chronic fatigue.

Dr. Justin Marchegiani: Oh, totally 100%. Now, let’s talk about some of the mechanisms why like, you could have constipation, you could have diarrhea, you could have all these digestive issues, that’s fine. And it makes sense why some of these issues may be causing problems. Because if you’re going to digest a lot of the nutrients that energize you, right, B vitamins, your amino acids, your essential fatty acids to burn them in the mitochondria for fuel, all of these things require optimal absorption, right? So if we don’t have adequate enzyme, or acid level or biliary level to break down fats, proteins, and carbohydrates, we’re going to have a problem with those nutrients getting into our bloodstream and making their way to ourselves and our mitochondria to be burned for fuel. So that’s one big mechanism. And the other big mechanism out of the gates, and we’ll kind of expound deeper into each one is the fact that your immune system sucks up lots and lots of resources. So think back to when you maybe got the flu or had some kind of illness. Were you energized? Are you tired? Most people were very tired. Now, why is that? It’s because your immune system allocates lots and lots of resources when it’s stressed. And it will make you tired, because it’ll pull some of those energy resources to put it towards fighting an infection. All right. So if your immune system is caught chronically in that state of trying to fight something, whether it’s a gut infection, cebo, or parasite, or just gut permeability issues that are upregulated, due to bad foods, and food allergens, you’re going to be really over stimulating and over allocating resources to deal with whatever’s happening with the immune system, aka the gut. Don’t forget 80% of your immune system is located in the gut, people forget that so important. So if you’re over stressing your immune system, you’re gonna have problems. 

Evan Brand: Yeah. And so for me, I was taking some immune support, but it was all just kind of a bandaid, right? Because I wasn’t focused on the underlying infection. So this time of the year, we’re, we’re talking in the fall here coming up on winter, you have a lot of people that will say, Well, you know, I really just want to strengthen my immune system. So they’ll go and do maybe some extra vitamin C, maybe some medicinal mushrooms, or maybe some other herbs, astragalus, things like that. But it doesn’t matter if you do all those if you don’t address the infection. So if someone’s like, tired and they feel weak, they feel depleted. They feel like they’re possibly immunocompromised. Sure, you could do some of the tools, like we talked about those herbs, but really, you got to test first of all, figure out what kind of infections you have. And then step two, is you come in and make a protocol to fix those infections. And not to mention, you know, like h pylori is super contagious. So, I mean, you and I’ve seen hundreds and hundreds of cases where, you know, husband and wife have reinfected each other. And so we’re not doing this to try to make more money. We’re doing this to help the family when we say, Hey, what about your husband? What about your wife when we try to get them on board? It’s because we know about this potential, you know, cross contamination.

Dr. Justin Marchegiani: 100%. So we kind of look at the gut, and we’re like, Alright, where are the gut stressors coming from? So the first stressor we look at are food allergens, because if your immune system is kind of responding negatively to food, that could be a big a big issue, right? And what happens is, when food allergens kind of come in, whether it’s gluten or dairy, or just you know, processed grains, or sugars, or even things like nuts, or seeds, or just more allergenic foods, soy those kind of things. Your immune system is upregulated dealing with those foods, and that’s going to suck away resources. And also, these foods if you have an allergen to them, if your body’s hyper allergenic, meaning your immune system is over responsive. There may be some gut permeability. And gut permeability is like these little tight junctions in the epithelium in the small intestines. They’re like this. So imagine you’re putting your hands together like you’re saying a prayer now, start pulling your fingers apart a little bit, you see the little gaps that happen that’s happening at a microscopic level with the tight junction cells in the small intestine. So the more you’re stressing your gut lining, these tight junctions open up, like I mentioned, the fingers come further apart. And then food particular we call it antigens, right? These foods aren’t supposed to be in the bloodstream at the size they’re in. Now you start having these antigens go into the bloodstream at a larger level, and now the immune system’s going to start going after it with full force. And that’s gonna start sucking up a lot more of your resources. So the first thing when we’re working with patients worldwide, we’re trying to cut down the food allergenicity we’re trying to decrease the immune response by helping the foods not become so bad or stressful on the immune system. So some people coming in on a standard American diet, a paleo template, maybe enough. Some people that are really have an autoimmune issue or Irritable Bowel Disease, we have to go to a paleo template where we’re cutting out extra allergenic foods, some we have to even go to a carnivore or some kind of an STD low lower fodmap diet because the bacteria is overgrown, and it’s reacting to even fodmap foods like broccoli and onions and garlic like healthy foods, were reacting to it. And so it this whole thing becomes a little bit more nuanced with food, the more unhealthy you become, or the longer your conditions progress. So as a practitioner, right, we’re trying to meet people where they’re at some people come in at a really easy phase, they’re just diets crap. And we can just make a simple change with the Paleo some we have to get a lot more nuanced. 

Evan Brand: So let me ask you, you brought up garlic. I had a woman last week, actually. And she was complaining that garlic was a big issue for her. So we’ve already cleared out gut infections, and we’ve done a great job. We’ve retested we’ve confirmed that we got rid of all the gut infections, we are doing some leaky gut support, but she says every time I eat garlic, I get really bloated. What would you What would you do? What would you say to that garlic person? 

Dr. Justin Marchegiani: Well, it could be a SIBO thing. So I’d want to test other fodmap foods. So if there’s some kind of a gut issue or like a bloat or a motility issue, or a diary or a constipation issue, we’re going to be cutting out fodmaps fermentable carbohydrates, fructose, oligo, disaccharide, mono and polyols. And we’re going to do that and then we’ll eventually do a reintroduction. And when we reintroduce foods, we’re going to start with moderate fodmaps first and then go to higher fodmaps. Last, so those foods are higher fodmap. So the question will be How did she do adding in the moderate ones? First, I want to know how she did incrementally adding things in.

Evan Brand: So like apples, she does fine, which was interesting, because to me, I’ve had a lot more people have issues with apples than I have with garlic. So I thought Hmm, you know, is it really a bacterial overgrowth thing? The stool test didn’t really show much in the in the bacterial category. So it’s kind of like, well-

Dr. Justin Marchegiani: when people like that, I just want to see is it a one off? Is it just garlic? Or is it other foods like onions and broccoli and avocado, which is a moderate or sweet potato, which is a matar, I want to test more of the moderate fodmaps? Maybe add in some fermented foods like a kombucha or a sauerkraut? Did it happen with those two, if it’s just a one off, then it could be some die off, it could just be she’s having an issue with that food. So if it’s a one off, I don’t really worry about one offs, I look for patterns, like patterns or like part of being a good functional medicine doctor, it’s pattern recognition, you’re looking for patterns, like some patient that can be Well, last week I had this happen or that like, we got to look at bigger picture, we got to have enough data points. So we can look at patterns. Anything can happen one off due to stress or a poor night’s sleep, or you got exposure to some bad foods. And now your guts a little bit rocky for a few days. So we got to look at longer trends and really have a lot of good pattern recognition. Part of what we do, we’re kind of CSI detectives, and we got to look for things repeating itself, because anything can happen one off, we don’t want to change what we’re doing, or the programs that people are on, off of just a one off issue.

Evan Brand: And that’s what it was, it was a one off and it was kind of, you know, frustrating for me because I’m thinking well, crap, you know, everything else, she’s tolerating good and any other problematic foods, I’d kind of put in that same category that we thought would be a problem. They’re not a problem. So I’m sitting here thinking, Okay, well, what kind of explanation Can I give her? Because she wants some kind of good functional medicine answer for me, right? And so that’s what I told her. I’m like, well, this sounds like just Oh, to be honest, kind of like a food sensitivity, particularly to the garlic. You know, I don’t looking at the testing. I told her I didn’t really see anything that was compelling to indicate any other sort of issue and all the other foods were tolerated. So I kind of just gave it like a political answer. It was like, wow, hmm. You know. 

Dr. Justin Marchegiani: Yeah, well, we’ll come it’s possible there could be just a, her immune response is just a little bit more sensitive to if we don’t see extra data points correlating to it, then I just tell patients, hey, let’s just we’ll come back. We’ll work on probiotics. We’ll work on good re inoculation of good healthy bacteria while adding some prebiotic fibers every month. We can try testing it again. But as long as there’s no yeah, as long as there’s no, let’s just say, family of other foods that are interacting like this, then we’re not going to really worry about it too much. But you can always retest, make sure that gut’s doing good, but it’s possible you have one off allergen issue that’s possible. But every month, we can always retest it and see.

Evan Brand: Yeah, good point, I did end up throwing in a high dose, multi strain probiotic. So we’re with a high amount of bifido. So we’re gonna see what happens. 

Dr. Justin Marchegiani: Yeah, and this person could tolerate fermentable carbohydrates, like sauerkraut and, and maybe a little bit of kombucha it’s probably not a fodmap issue, because those things are very, very high in fodmaps. It could be she’s killing some stuff off. It could just be she sensitive to garlic. It’s possible. Yeah. And so I mean, I just tell patients, hey, you know, that’s an artifact, we just kind of make a note on it. When we follow it down the road later on. If things kind of connect back to it down the road. That’s nice. But if not, things that are one offs. You don’t want to you don’t want to one off to derail your whole investigation. 

Evan Brand: Yes. Yes. That’s a great point. You know, it’s like you’re, you’re you’re like, you know, investigating a crime scene, and you have his weird piece of evidence. That does not make sense. 

Dr. Justin Marchegiani: Yeah. Right. Okay. Well, we’ll make a note on that. And we’ll come back to it if there’s any patterns that they point back to it down the road.

Evan Brand: Yep. Yep. Great. So so small tangent, but really helpful. I think it’s, it’s helpful for people to see how do you have to think when you’re approaching these issues, it’s not always black and white, you know, we try to refer back to clinical experience, we kind of sprinkle in some of the data sprinkled in some previous case studies that we’ve done with people. So it’s really fun. But back to the fatigue piece. 

Dr. Justin Marchegiani: So I just wanted to highlight one component, because while you’re on it, is when we are talking about these things, because we’re clinicians, and we see thousands of patients, we’re operating more off of clinical concepts than like rote memorization of like, a fax. And so when people listen to our podcasts, we really want them to understand the overarching concepts of health. If you understand a concept, you don’t really have to memorize it, if you’re trying to memorize random facts and randomness, and that becomes a little bit convoluted and a little bit stressful. So just try to get the overarching concepts that we’re talking about here. Once you get the concept, you never have to worry about memorizing, and it’s just there. 

Evan Brand: Yeah, yeah, good. So I just wanted to go back to the to the fatigue piece, because for certain people, there may be multiple layers of infections that are causing your fatigue. So for me it was H. pylori, and then once I got rid of the H pylori, then it was the parasites that were still causing me to be tired. And once I got rid of that, then I did have some Candida that I had to address. So what I want people to know is that if you double down or triple down on something, you know, the guy tells you it’s parasites, or the girl tells you it’s this, and you pursue that, and you’re not better, it’s possible that you’ve, you’ve missed something. And so I just want people to wrap their head around you, like you say, you have permission to have multiple things wrong at the same time. So you could have a bacterial issue, a parasite issue, a Candida problem, all at the same time. And so you got to make sure you get all the data if you just run a stool test. Candida rarely shows up on the stool test, you and I’ve talked about this many times. So the urine test will often fill in the blank. So if you had one test done, or your doctor ran this or that, and you feel like you’re missing something you probably are so keep, keep digging. 

Dr. Justin Marchegiani: You also there’s one study here just looking at h pylori and mitochondrial function, I’ll put it up on my screen. But this is important, right? And the reason why it’s important, I’m going to just I’m going to do a share here. So if you guys are listening to the podcast on YouTube, you’ll be able to watch the video. If you’re on iTunes, you know, you have to just click the YouTube link, and you’ll be able to see what we’re talking about. If not, I’ll try to describe it pretty well. But you can see my screen you see my screen. 

Evan Brand: Yep. h pylori affects the mitochondrial function. 

Dr. Justin Marchegiani: So this is important right here. So mitochondria are the powerhouse of the cells. This is really important and the powerhouse of your cell generates ATP for energy. Now, if you look here at the bottom they talked about, they wanted to investigate whether there’s an increased mutational load and mitochondrial genome and what they found was there believe that the there’s a downregulation in the mitochondrial DNA repair pathway? What does that mean? It means how your mitochondria are repaired and regenerated. It’s going to be down regulated, so you’re not going to be able to repair your your mitochondria as fast. It’s believed to be involved in mitochondrial base excision repair. Our results suggest that these genes A p one and y b one, just know that their DNA is that are involved in mitochondrial DNA repair. They’re they’re demonstrated to be involved and they’re demonstrated to be down regulated when there’s an H pylori infection. So it just means that your body’s ability to generate ATP which has decreased respiration coupled aptr. So you’re not able to generate as much ATP and repair your mitochondria as well when you have an H pylori infection. And this is something that we think is there with a lot of gut infections. It affects your mitochondria. Your ability to repair it, which then affects your ATP synthesis. 

Evan Brand: That is pretty crazy. I mean, especially if we’re talking about an athlete who wants to perform right you’ll have all these big celebrity personal trainers and stuff and they’ll just get people on different diet changes or no, you need to do this exercise or this exercise and they missed the boat. They don’t have a clue about H. pylori being the root cause of the of the fatigue or the exercise performance. So yeah, it’s just crazy. 

Dr. Justin Marchegiani: And then also, there’s a lot of right here, right here one study, I’ve already looked at it before, if people are having gut issues, and they go to their conventional gastroenterologist, what are they typically prescribing? Well, a lot of times they’re prescribing antibiotics, right, and there’s a lot of data, bacterial Seidel, antibiotics induce mitochondrial dysfunction and oxidative damage. And so we know this is something that’s actually present, where there’s damage to the mitochondria with antibiotics. 

Evan Brand: Well, and and, and to be clear, for H pylori, it’s not just one antibiotic, it’s three or even four, they have what they call quadruple therapy now, which just the name of it scares me, it’s literally four antibiotics at the same time. And you and I have both seen patients that have had triple or quadruple therapy done and guess what we retest them, and unfortunately, due to antibiotic resistant bacteria, the infections are still there. So now we have to come in, repair all the mitochondria that were damaged, plus use herbs, which are much, much safer, and in my experience, just as if not more effective, and then we actually get rid of the bugs. 

Dr. Justin Marchegiani: Yeah, she’s a summary of your mitochondria dysfunction and oxygen damage induced by bacterial Seidel antibiotics, which is interesting, because bacteria, all antibiotics are bacterial Seidel, so interesting. They use that description. It’s mammalian cells. I’m not sure which mammals they use. But they talked about that it’s alleviated by antioxidants. Well, guess what, when we use a lot of the clearing herbs that we use, guess what they’re rich in, I mean, tons of antioxidants, polyphenols. And that’s the benefit, a lot of the herbs that we use, they have a lot of antioxidants in them to help buffer the oxidative stress. Because remember, oxidative stress is part of what happens with the antibiotics. And we have a similar effect with herbs. But the herbs have a lot of antioxidants, which is helpful. Any comments on that? 

Evan Brand: Well, what you’re saying makes us look really good, because not only are we giving nutrients that can effectively get rid of the infections, but we’re also protecting the system or even replenishing antioxidants, because in general, and the oxidants are going to be reduced because of all the oxidative stress from the infection in the first place. So it’s literally like a win win, for us and for the person under the protocol. 

Dr. Justin Marchegiani: Yep. And there’s lots of different studies here as well on probiotics and beneficial bacteria, correcting mitochondrial dysfunction with probiotics. There’s there’s definitely studies on this as well. And again, you know, these are things that we’ve seen in our practice, like when you see someone get better. So protection of hepatocyte mitochondrial function by blueberry juice probiotics. So there’s lots of studies on this, because when you see patients get better with certain beneficial bacteria, after you do an elimination, you’re like, why does that work? And so what happens is you see a clinical outcome, patient getting better when you do something. And then you’re like, Huh, what could the mechanism B and then you chase it down online? And you’re like, oh, maybe that’s it? You know, maybe it has to do with the fact that it’s helping the mitochondria and people’s feel better afterwards? Maybe that’s the mechanism. It’s possible, right? 

Evan Brand: Yeah. 

Dr. Justin Marchegiani: We have to comment on that. 

Evan Brand: Well, it’s a lot of good things happening. And then you mentioned the probiotic piece. So that’s going to help even more. So after we get someone on a killing protocol, there’s going to be good benefits there, your energy is probably going to get better just based on doing that. And then when you go to the next phase, if we’re going to come into the gut healing phase, you’re going to get even better than so it’s it’s really fun for us to kind of paint the picture here of just how how is someone going up, up up up better, better, better? And you’ve just outlined how so pretty I talked about it right here. 

Dr. Justin Marchegiani: They talked about a collusion the studies show this is BP stands for blueberry juice and probiotic exhibit a synergistic effect preventing the development of a and that’s non alcoholic fatty liver disease by protecting mitochondrial function, suppressing the damage of mitochondrial ultrastructure by reducing mitochondrial swelling, right. So mitochondrial damage by antibiotics, as well as we could do the same thing when we search, let’s say pesticides, or heavy metals or mold toxins, so we know that gut plays a big role and one helping to absorb those nutrients. But number two, also helping to have beneficial bacteria that modulate these, this inflammation and mitochondrial damage as well. 

Evan Brand: Yeah, yeah. Well said. Excellent. 

Dr. Justin Marchegiani: Well, it’s good that just a couple of studies. I mean, when we look at like we look at research a lot differently, so just kind of everyone there. We look at clinical outcomes in patients. And then we chase them back to what the literature says. The problem is a lot of people who are clinicians, they’ll look at the literature, and then they’ll try to then come up with a clinical like decision based on the literature. And that’s sometimes it’s really hard to do, because a lot of the PhDs and a lot of the research out there isn’t necessarily clinically driven, and maybe driven because someone has a PhD in this area. And they’re just they’re just studying that topic, because or maybe it’s an NIH funded study. Who knows, right? So we’re looking at things that are clinically driven, not research driven, because someone has decided to dedicate their life to this topic. And this is the study they’re choosing right? 

Evan Brand: Now. It’s good that we can kind of pull out some studies to help backup what we’re saying. But it’s not like we go into PubMed to try to figure out exactly what we’re going to do the clinical stuff is really that’s where all the magic happens. 

Dr. Justin Marchegiani: Yeah. And some may say we have a confirmation bias and how we look for these things. But we’re not looking for out of the blue we’re looking for, because we’ve seen clinical outcomes support something is happening in that direction. And then we use the data, the research to say what could be if positive things are happening in this direction? A to B, what could be the mechanism of why that is? And so we kind of chase it backwards. versus the other way around? 

Evan Brand: Yeah, yeah. And it’s just it’s a blast. It is fun for you to pull that stuff up. Right? Because, you know, we get we get used to our our methods, we get used to our results. But when you get to see in the literature like that antibiotics, causing mitochondrial damage is like, Oh, yeah, I forgot. That’s why we do this. It’s Yeah, we’re Exactly. We don’t want people to get damaged. 

Dr. Justin Marchegiani: And you get confident when you see things repeat itself. Clinically, you’re like, Okay, something’s happening here. Now what? So you’re going at it with a lot more confidence versus like, Hey, I think maybe, you know, I’ve heard this, it’s a hearsay kind of thing. No, you’ve seen it, you’ve seen it clinically? Well, here’s the confidence.

Evan Brand: Here’s the thing that’s always fun for me is when we’re on the topic of fatigue and gut infections. And so when you have a case where you do the follow up, and someone is reporting that they have significantly more energy, and you didn’t give them any energy supplements, you just fix their gut, you just gave them some liver, maybe some enzyme support, some gallbladder support, and then you killed the infections and all the sudden, boom, I’m 20% more energetic. I always smile and laugh simultaneously. Because it’s like, This is so fun. We have 20% more energy. And we did zero energy supplements. That’s just super cool. 

Dr. Justin Marchegiani: Yeah, it’s powerful. Now, if people start feeling a little bit worse, then we got to be very careful. So when people start feeling worse, I’m like, all right, we got to spend more time building up the adrenals, we got to make sure the diets clean, because if someone’s got his or, like, if you’re putting lots of bad foods in and you’re inflaming the gut, then your immune system and also your adrenals may be making more resources to deal with the inflammation in your gut. So we have to decrease the inflammation in our gut and support the adrenals by calming it down. Now, the adrenals have more resources. And of course, we always like supporting the adrenals ahead of time. So then you have natural, your more of your natural anti inflammatories, because conventional medicine when there’s serious gut issues, they’re going to give prednisone cortisol, well, let’s just support your body’s ability to make that naturally. And then when we go into a gut clearing phase, then we have more of those resources on board. And then patients are sensitive. I’m titrating the herbs in there slowly so we’re not overwhelming the system by killing more, you know bacterial toxins, LPs endotoxins, mycotoxins, we’re not overwhelming the lymphatic system that a toxification immune system. So we’re going to kind of really titrate things in a little bit slower if you’re more sensitive. And we may even add things like binders and glutathione too. 

Evan Brand: Yeah, yeah, the glutathione is good for me. I had to take a break from it for a little while. It was just too strong. It does mobilize toxins to so this is all case by case basis. But yeah, I love glutathione when it works. But when you take too much, that’s no good. There’s always a right dose. 

Dr. Justin Marchegiani: Yeah, if you’re slow, if you’re like more sensitive, always start low, work your way up. And then if you’re sensitive, you can always start with just a gentle binder first, as long as you’re not getting constipated. That’s a good first step on increasing things. 

Evan Brand: Yeah, that’s great. So let’s see here. 

Dr. Justin Marchegiani: Um, the other component, I would say is people that have got issues tend to also have immune issues. We already talked about why 80% of your immune systems in the Galt, that’s the gastric associated lymphoid tissue that’s in the stomach. And then also the model that’s the mucosal associated lymphoid tissue, lymphoid meaning like lymphocytes, white blood cells, and that’s in the small intestine. And so if you have a lot of gut permeability issues, if your guts over responding well, what’s the most common autoimmune condition that affects people and mostly women, five times more women is autoimmune thyroid. And so if you have an autoimmune thyroid, that could also be affecting your energy because you know your thyroid gland is being attacked and your body is ability to generate thyroid hormone may be decreased. And it’s possible that your conventional doctors overlook that. And so knowing that there’s an autoimmune thyroid could be affecting your energy too. And if you have an attack, you could feel hyper where you’re like anxious, can’t sleep irritable, sweating, right? first and then you go into a hypo where you’re like tired, fatigued, depressed, right? So you could easily be going hyper and hypo swings based on autoimmune tax of the thyroid. 

Evan Brand: Yeah, and once again, the hashimotos could be a side effect of something else. So even if you go to the endocrinologist, let’s say they were a more advanced endocrinologist, for example, hopefully they’re running thyroid antibodies TPO, TG maybe TSI. And they’re looking at that and maybe they’re treating your thyroid giving you desiccated glandulars, or nature thyroid, or just Synthroid or side ml. Even then you see how people can fall between the cracks and not get better. Because yeah, you’ve kind of cranked up the thyroid that was hypo due to autoimmunity. But you still never got to the gut infection that started at all.

Dr. Justin Marchegiani: BINGO, BINGO, BINGO, BINGO 100%. That’s what we got to look at always the root cause. So anything else you wanted to talk about here on the gut and fatigue I did, we hit the thyroid, of course, I alluded to the adrenals earlier, because they play a huge role in regulating inflammation. And we know acute gut issues, they may be, they may be given a corticosteroid to calm down the gut inflammation, that’s possible too. So we want to support your body’s ability to do it naturally. I would also say supporting protein breakdown. So with maybe adding in free form amino acids, because protein can be very hard on the body to break down. So of course, dialing in enzymes and acids and maybe giving extra free form amino acids. So it’s taking stress off the digestive system to be able to access those amino acids as well. 

Evan Brand: I think I think you’ve hit it all. I mean, I would just say, kind of where do you go next is you really have to get the data. I mean, we’ve talked about a lot, right. But if you don’t have the data, you don’t know what you’re up against. You don’t know what you’re doing. So, you know, I think the best advice I could give is if you’re dealing with these issues, test, don’t guess. And so, you know, feel free to reach out to Dr. J. Justin at JustinHealth.com. And he can run labs on you anywhere in the world and send them to your door and jump on a call and discuss it make a great protocol to help you to get better. Same thing for me my website, EvanBrand.com. And we’re available we love helping you all we’re grateful to be in this position. So you know, sure you know a lot of you listening or kind of do it yourselfers. That’s what led you to be smart and find a podcast anyway. Because you want to kind of educate yourself, but there’s a certain point where it’s okay to reach out. And I tried to fix myself for a long time. And you spend more money and you spend more time doing that. So you know, feel free to reach out and get a guide.

Dr. Justin Marchegiani: 100% and then you’re available at EvanBrand.com worldwide. We’re available worldwide and we’re clinicians, we have our sleeves rolled up and we’re in the trenches every day, dealing with patients. Also, if you’re listening to this don’t just kind of glom on to one thing. So we see lots of people they’re like, they come in like Oh, I know what’s h pylori or I know it’s Candida or I know it SIBO keep an open mind on what’s happening because you have the right to have more than one issue going on at the same time. And for instance, Evans original story was Evan had not could have it wrong if you had h pylori, Giardia and crypto. That’s correct. Yeah, yeah, h pylori, giardia crypto, those are some serious infections. Any one of those infections is serious and could could have created the symptoms Evan was having yet he had all three at the same time. So if Evan was like, Oh, it’s only H. pylori, you know, he may have missed the fact that grd and crypto were involved too. So go into with an open mind and you have the right to have more than one infection happening at same time. Sad but true. But either way there are solutions to work on it and fix it. 

Evan Brand: I was tired. Man, I was tired. Now that was a that was a that was a level of exhaustion that just doesn’t even seem real. I mean, that’s how you know something’s wrong when you’re that tire. But you know, hopefully, with this education we’re providing people can reach out and work on this before it gets to that crisis level because it’s much easier to pull you out if you’re not that deep. 

Dr. Justin Marchegiani: Now Evan can you go to your conventional medical doctor or a gastroenterologist and typically get these infections picked up on? 

Evan Brand: No, definitely not the testing is just so outdated, you know, it’s not sensitive, like the DNA stuff we’re using. So that’s the downside is if you go to the gastro doc down the road, say, Hey, I think I’ve got Giardia, I heard these two guys on the internet talk about it. They’ll probably just laugh in your face and say, Well, you didn’t travel to any third world countries. So you don’t have it. But if you if you really want to Sally, I’ll test you on they’ll run the outdated test and then everything comes back negative and then we’ll say see, I told you it was all in your head, just, you know, take an acid blocker. 

Dr. Justin Marchegiani: So yes, my opinion is very similar. So the more acute you are, especially with typical gastrointestinal symptoms, the greater chance they’ll pick you up, especially if you came back from like Mexico or some kind of a country like Bali where infections are probable, right? But now what do you do? If your infections aren’t really gut based symptoms, they’re the fatigue or the brain fog, well, then how does that get picked up, you’re typically never going to get picked up for that you’re more than likely to, to get a psych referral for an antidepressant, right, then to get a gut test, and Evan already alluded to some of the technology they have isn’t going to be as up to par. So we have a little bit you know, more access to the DNA technology a little bit more sensitive. And then also like H. pylori testing that they may run a breath test, right? Urea breath test and look for elevated levels of co2, it’s possible, but that may miss an infection. And if it’s more subclinical, you may need a more sensitive test to pick it up. So if you’re listening, and you’re like, Hey, I’m gonna go to my MD that may not be the solution, I may not get you the answers you want. And if you don’t have the typical gut symptoms, diarrhea, bloating, gas, a lot of stomach discomfort, and irritability, you may not even they may not even want to run a test, because those symptoms don’t match with what they think the problem could be. 

Evan Brand: Yeah, yeah. And you know, it sounds like we’re like picking on him. Right? And we sort of are and that’s fine. I love picking on them, because they’re failing people. And it makes me sad. Because I was there I was sitting in the doctor’s office trying to get help. And I was told that I just needed an acid blocking medication. I told the doc, no, I feel better when I take it. enzymes that actually increased my stomach acid, I think you’re wrong. She said, That’s not possible. You’re gonna hurt yourself, you need to stop taking supplements stop all dietary supplement, the FDA, blah, blah, blah, blah, blah. And and that was it. And that’s when I signed off and said, No, I’m done. 

Dr. Justin Marchegiani: Yeah, and I do recommend, and I think you’re in the same way, I do recommend patients that have chronic issues, or acute issues, at least go see your conventional medical doctor just to get checked off that there’s nothing glaring that’s going on. And that that way, if you work for someone like myself, for you, and then they’ve kind of already been looked at, and they’ve kind of already know, okay, conventional medicine is kind of done all they can do. And, you know, functional medicine is the next best option at that point. 

Evan Brand: Yeah, I’m not saying we’re the all knowing at all, if you’re bleeding out of your butt, you need to go confirm you don’t have some type of a bleeding ulcer or colon cancer or you have some type of a polyp issue or diverticulitis and you need colon surgery. I mean, there are certain things that we can’t help with. But for these more functional, non pathological issues, we’re definitely going to be able to help. 

Dr. Justin Marchegiani: And we can help with all those issues. Once they’re stable. If they’re unstable, though, conventional medicine does a really good job on stabilizing very sensitive issues. But once they’re stable, now what because for the most part, it’s going to be just symptom drug management for the rest of your life. Right? If you look at what they talked about, it’s, hey, we’re managing your gut issue versus let’s actually get to the root underlying issue. And sometimes management’s good when things are acute and flared. But now when they’re stable now what we want to go beyond just who wants to just manage their diarrhea for the rest of their life? That’s crazy, right? 

Evan Brand: Oh, God. Well, that happens every day, doesn’t it? It’s happening today while we’re doing this call somebody is in the doctor’s office right now about to get an antispasmodic drug for their diarrhea. 

Dr. Justin Marchegiani: Yeah, and that may be fine acutely, but then what’s next? So get your health issues under control from a you know, stable standpoint, and then work on the next step with a good functional medicine doctor. Well, everyone was excellent chatting with y’all anything you want to leave us with Evan? 

Evan Brand: No, that’s it. We’re just ranting at this point. So if you need help, please reach out. JustinHealth.com, EvanBrand.com. Take great care yourself. We’ll be back. Have a good one, y’all. 

Dr. Justin Marchegiani: Take care. Bye now. 

Evan Brand: Bye.




Audio Podcast:


Staying Fit with Adrenal Dysfunction and Chronic Fatigue – Is it Possible? | Podcast #308

If you have adrenal dysfunction and chronic fatigue, exercise is probably the last thing you feel like doing. Your adrenal glands are responsible for keeping the well-being of your body in balance through hormones. These glands also produce the hormone cortisol, which is released during your fight-or-flight response. As you can imagine, cortisol is beneficial when you need to be alert and escape danger.  For more on exercise with adrenal dysfunction and chronic fatigue, listen to the entire podcast!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:38        Exercise Movements, Use of Bands, Etc

9:06       Rowers

15:37      Hacks to Increase Exercise Performance

18:53      Post Recovery Stuff

29:39      Why Exercise is Important

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

Evan Brand: Doing really good, excited to dive into this topic, I’ve suffered tremendously with exercise intolerance for a while, and luckily have pulled myself out of it. And I can empathize with people that want to exercise, but they literally physically can’t. Or if they do, they crash out, which is what was happening to me. So let me just share a story just for a minute, and then we’ll dive in some to the details of it. But there are different things that can make people exercise intolerant. For me, I think it was a combination of factors like everything, but I was to the point where, if I did try to push myself, it would take an extremely long time to recover, you know, two, three, sometimes four days, I would still be recovering from the the workout and I thought, Okay, well, as you and I talked about, we got to adjust the levers, I got to lower the intensity, I got to lower the duration and the frequency. So I did, but it wasn’t enough, I still felt like no matter if it’s a 10 minute or 30 minute, I was still drained. So for me, I think it was detox, I think it was getting my mitochondria working better, definitely getting adrenals working better. I think neurotransmitters played a role too, because, you know, you could have low motivation and low drive if dopamine is effective. So we’ll go into that. But that’s, that was my story. 

Dr. Justin Marchegiani: Very important. I think anyone that’s health conscious, right, like you’re moving a couple of levers when you’re health conscious, right, you’re really working on drinking clean water, you’re working on improving your food quality, maybe adjusting your macros, maybe you’re taking some supplements. And of course, the The other thing you will be putting a lot of focus on will be movement, right. And I just call exercise movement. So like the first met, the three levers that we can move we already kind of highlighted is frequency, how many times per week we’re exercising intensity, could be how intense the movement is a compound movement that uses multiple joints, like a front squat, or a single leg deadlift with a row kind of component, or something like a bicep curl, that’s like, you know, just your elbow joint, that kind of a single joint movement, that’s more bodybuilding based, and, and less kind of metabolism based, right full body bass. So we have frequency intensity, the type of movements and that also can include the rest time between sets, too, right. So you can also increase, you can do more intense stuff, and then just have more rest time to kind of be back to baseline in between. And the last is duration, how long your workout is, that’s helpful, too. So some data by Charles poliquin, who talked about cortisol really starts to increase, you know, 45 to 50 minutes in. And again, that’s gonna be for someone that’s more on the healthy side. So I always tell people, like keep your workout, if you’re more stressed, keep it under 20 minutes, that’s a pretty good rule of thumb, you know, and just try to do more circuit movements, where you do movements back to back to back, that can be helpful. But then we kind of have to gauge and how your body is adapting to the exercise. It’s all about adaptation. And so exercise is a stress, and we want our body to be able to adapt to that stress, so we grow stronger. Now, if that stress is too much, where our body is not able to adapt to it, meaning we’re getting weaker, we’re getting more tired, that defeats the purpose of exercise, we want our body to positively adapt to that stress. If it can’t, then we have to move those three levers frequency, intensity, duration, and we may even have to switch out of certain movements, we may have to switch into more yoga or more walking or more, you know, Tai Chi types of movements in the beginning and just kind of go from there. So there’s a couple different levers. And so there’s three questions I always ask my patients, my patients that are listening, they know this, do you feel better after the workout than when you started, you want to always feel like your exercise is energizing you. That’s a good place to know that you’re adapting to your exercise you’re able to adapt to it. Number two is you can emotionally repeat the exercise afterwards. Once your heart rates kind of brought back down to the baseline after you stopped your movement. Can you emotionally do it again? Are you like, wow, I’m done. Right? And then number three is going to be last question is how do you feel later on that day, if it’s a morning workout, or that next morning, if it’s an afternoon or nighttime workout? Do you feel overly tired hit by a bus overly sore? Now if you’re adding in a front squat or a deadlift for the first time, you may feel a little sore. But in general, how do you feel? Do you feel overly tired overly sore hit by a bus? If so we want to adjust some of those movements for sure.

Evan Brand: Yep, good, good points. For me. I don’t have to count or measure or anything like that or time to workouts. I just get to a certain point with lifting weights. I primarily lift weights. I mean, I do like to go on bike rides, I’ll take the kids that’s pretty hard work with the legs. I do like my roll machine. So I’ll do that. But I don’t really measure count or anything I get to the point in the workout where my pump goes into more of like you can just feel that you’re becoming catabolic, you feel like your muscle tissue is now being used as an energy supply. Now, people that are new to it or if they haven’t been exercising for a long time. They may not be that in tune with their body. But for me, it starts out with the heavy lifts, I’m getting the pump, I feel good, I feel the blood flow. And then it gets to the point where I feel like I don’t want to say I’m hurting myself. But the dumbbell that used to feel pretty good and challenging now just feels like a frickin rock. And I’m like, oh, okay, I think that means I’m done now, and then I end the workout. If I go past that point, then it’s too much. 

Dr. Justin Marchegiani: Yeah, exactly. So that that’s a really good place, you can also incorporate bands, what’s nice about bands is the loading is the highest at your concentric phase, right? Imagine I’m doing a dumbbell curl, right? At the highest point, the The band has the most force in it, right the most intensity or force. And then as I lower right, this is the East centric face. I’m Ilan gating my muscle, so in a bicep curl, I’m moving the bar down to the dumbbell downward, the load is actually decreasing as I’m lowering it. So you have a decrease in force on that essentra curve, where like, if a dumbbell or barbell was there, it’s the same the whole way, like, so the benefit of the decrease in load is most of your muscle, shredding, or depletion happens in the E centric. So what does that mean? That means you can focus on really light, really nice, slow lowering phases that those two things, it burns more muscle, right. And then number two, most injuries happen, because people are bouncing the weight, or in that lowering phase, they kind of have a jerky move where they kind of relaxed the weight, and they catch it at the bottom of that movement. And like what sofa benchpress, that’s on your chest or military press that’s on your shoulder. Or if it’s a bicep curl, it’s at the bottom right, and you’re kind of bouncing that way, or a deadlift that’s at the bottom right where you bounce. So when you do a nice lowering phase, you prevent that bounce from happening. And that’s where almost always all the injuries happen. So if you do a nice lowering a nice slow lowering phase, maybe a three to four second, he centric think he centric he long gait. So have a nice, slowly centric, you’re not going to hurt yourself as much. And then number two, you’re still burning a bit of a bit of muscle. And number three, if you’re still really sore excessively, one, you can switch to more bands, and the bands will give you that decreased load. As you as you kind of move, which is nice, it really helps the muscles give it a little more recovery, but still gives you that increased load at the top, so you have more concentric load, right? So when your muscles the shortest, right that benchpress at the top position, the loads the highest, and it’s going to be even more than a weight would be right. And then it drops off on the lowering. So it’s a little bit safer. And you’re not going to overly kill your muscles in that lowering II centric phase. 

Evan Brand: Yeah, that’s safer, too, if you don’t have a spotter, right? If you’re trying to do all this stuff at home, I mean, I’ve been guilty before of wearing myself out getting past a point of fatigue, where I’m like, Oh, I could really use a spotter right now. But I don’t have one. So the bands would be safer in that aspect too. 

Dr. Justin Marchegiani: Yeah, bands are safer and are of course, just using like a dumbbell is going to be helpful too. Because dumbbell obviously there’s no bar across there. So you’re not gonna expect to fixate yourself, your lower too much. And then you’re going to get a lot of fatigue on the lowering. And that’s what helps. But the bands do help for sure. And it gives you that really good ability to generate a lot of force. And also it’s safer. So I do like that as a good option. 

Evan Brand: Yeah, and someone’s listening and they’re gonna say, well, bands where the heck do I get them? What strength? Do I get them? They usually come in variety packs, don’t they? Like there’s going to be like a black one, a green one. And they’re going to be different like intensities, right? 

Dr. Justin Marchegiani: Yeah, I mean, I like the X3 bar for some of the some of the the bigger bodybuilding movements because the band’s really thick and it can generate hundreds and hundreds of pounds of force. So I like the x3 bar for that. So like for deadlift, that bar that that strap or that a cable is going to create a band. I’m sorry, that band will generate hundreds of pounds of force. Same thing on the bench, same thing on a tricep extension. And so it’s very helpful. So I do like that. 

Evan Brand: Cool. Any updates on your rower? 

Dr. Justin Marchegiani: Oh, yeah, it’s coming. I got the concept D rower. So I try to do a little bit more of the rolling for my aerobic stuff just because I like things that bring me into extension so much cardio is like your inflection, whether you’re on elliptical or riding a bike or whatever. I like kind of bringing more extension into my body so… easy! Sorry. That’s my dog. That’s my dog. We’re live here. 

Evan Brand: I love it. I love the rower. I mean, to me, it’s, it’s, I feel so good on it. And I never really thought about what you’re saying. But yeah, most exercises are you’re kind of like going into monkey mode, you’re not really pulling back and stretching. That is like one of the only things that and the seated row, like on an actual machine with weights. Those are probably two of the only things that really kind of pull you pull you out and stretch you out like that. 

Dr. Justin Marchegiani: Oh, totally. Oh, by the way, I have my my natural pesticide guy here, which is kind of cool. So he’s actually spraying essential oils around my perimeter. So he’s spraying cedar, some citronella, some orange peel some olive leaf, just to keep some of the bugs down. So and then we found a bee’s nest in the back on the ground. So we’re putting a little bit of boric acid in diatomaceous earth in there to kind of to knock that out. So we try to, you know, just a little education here, we’re trying to do some natural kind of insecticide solutions, because a lot of those toxins can be very harmful to kids and, and women and children, especially guys, too, because they’re very estrogenic. So we try to use natural solutions here. So you guys see that live in the flesh here. 

Evan Brand: Yep. And if you are exposed to all that crap, whether it’s from you spraying it or hiring somebody else to spray and you’re getting exposed to it, that’s going to affect mitochondria. And that’s going to affect energy. So when you get into this whole thing of chronic fatigue, adrenals exercise and tolerance, a lot of it has to do with toxicity, I will tell you 100% with confidence, when I’m doing binders, I’m stronger when I’m on detox support chlorella, whether it’s charcoal, Clay zeolites. I’m always stronger with some binders in my system. So for me, the toxins and for everyone really, the toxins are kryptonite. And that’s just a fact of the modern world. So wherever you can reduce those, reduce them, I mean, think about your kids, right? You go to a playground, my wife took my kids to a couple playgrounds over the summer, and the guy shows up with a huge tank of glyphosate on his back and just bombs the whole playground, because there were weeds growing up in the mulch and it goes up, well can’t go to that playground anymore. So it’s annoying that we have to be this observant, but it’s kind of what it takes in the modern world. I mean, unfortunately, in the 21st century, everywhere you look in turn, whether it’s the the air, or the water supply, or the ground, or the dirt or the soil you’re eating food out of there are chemicals that are disrupting your mitochondria, they’re disrupting cell membranes that are affecting your gut bacteria. And so I get annoyed with just the diet and exercise conversations that you see in the mainstream because they make it just like it’s that like, you’re not motivated enough. You just need to be strong pain is weakness, leaving the body push through, push through, it’s you literally from a biochemical, mechanical, mitochondrial perspective, neurotransmitter perspective, you can’t push through, you can’t so you know, you got poor Jane Doe, at the at the fitness class. And you know, she’s 50, or 100 pounds overweight, and she just thinks that she’s just fat and lazy. And that’s why that’s her problem. But it’s like, no, you’re toxic. Let me show you on paper. And I’m going to explain why your personal trainer doesn’t have a clue why you can’t tolerate the exercise and why you’re sore for a week. He just thinks you need to just quit being a sissy and drink another protein shake. No, that’s not the answer. So I love that we can intertwine the functional medicine piece into the exercise piece. Because the mainstream fitness community, it’s sad, it’s all this boot camp, you know, military CrossFit mentality. But when someone doesn’t perform like everyone else, those people get ostracized, and they don’t have a clue what’s underneath the hood. 

Dr. Justin Marchegiani: Yeah, I mean, everyone, you got to treat everyone like an individual. And everyone’s coming at this a little bit differently. So you want to meet people where they’re at exercise, you know, and a lot of these things is going to be a stressor, so you want to apply the appropriate amount of stress. So you give your body the chance to adapt, it’s never the the exercise, it’s the ability for your body to adapt, and you have to kind of meet your body where it is. So if you’re someone that’s obese, it may just be walking a couple thousand, maybe 1000 steps or just squeezing your muscles doing an eccentric movement, you know, that may be enough based on where you’re at. So you got to figure out where you’re at and try to go maybe 10%, above where you’re at, on a day in day out basis.

Evan Brand: Yeah, and I’m not trying to poopoo personal trainers, I used to do some personal training, I had some certifications in different movements, kettlebells and things and I helped a lot of people but so so you can tweak the exercises, meaning you can tone things down for those people. But there’s at a certain point, you at a certain point, a personal trainer has a limit to what they can do for you. Meaning if you literally have so much toxicity that’s affecting mitochondria, you literally can’t build up your your weight, you can’t go 10 minutes longer. You can’t, you know, do three more planes, you just can’t. So then that’s where you got to come in. And we look at the labs to try to figure out what’s under the hood with these people. Why can’t they Why are they such a poor recovery. So like, well measure lactic acid on organic acids testing. And we know that when you have bacterial overgrowth, for example, that it produces lactic acid certain species do. And so if this person is sore without even working out, they’re going to be really sore when they work out. So we’ll focus on the gut, we’ll get that the production of lactic acid down from the gut bugs, and then boom, now they can handle that lactic acid bucket is drained now they can handle the exercise and the production there. 

Dr. Justin Marchegiani: Oh, exactly. You know, I’ve taken personal training sessions as a personal trainer for a long time and I’ve been trained by people where I feel too sore for a couple days afterwards. And usually if you feel too sore, it’s you put too much intensity in it. The dose wasn’t dialed in for you because you’re Giving your body the chance to heal and recover because you get stronger on the rest time. And if you created so much damage for 234 days later, you’re really excessively so you did too much you’re creating scar tissue in the muscle. And that’s not good. So you really want to individualize this. And I, you know, I see patients from all different walks of life from chronic fatigue autoimmune patients that are bedridden to people that are professional athletes trying to perform at the highest level, and you want to meet the demand where that person is at because it’s all about getting their body to function just a little bit better every day, and everyone is at a different place on their journey. So I think the individualization is so important. 

Evan Brand: Do you want to get into some of the hacks at all like some of the things we do to kind of increase exercise performance? Because I’ve got several ideas at the top of my tongue here. 

Dr. Justin Marchegiani: Yeah, sure. I did a video on this last week where I talked about some of the ideas in regards to movement stuff like exercise stuffs, I think the easiest first thing for is really good lowering or good eccentric movements, I think are a great way to burn a whole bunch of muscle and, and allow you to use more weight and not get hurt. Because I mentioned earlier, it’s the lowering phase, the centric phase where people get hurt. And when you do a nice low, slow movement on the centric, you’re less likely to get hurt. And number two, you’re going to create more burning of that muscle, more depletion of that muscle. And as long as you don’t overdo it, it’s a good first step. 

Evan Brand: I was into bodybuilding in high school. So I was doing a lot of those pre workout drinks. And they were just so bad for you. I mean, it was all just hundreds and hundreds of milligrams of caffeine, artificial colors. I’m sure there were sucralose and aspartame and potentially other garbage in there. And it just wasn’t good. I tried to pick clean choices. But you know, at the time, there weren’t that many good clean products on the market. So now there are there are some professional companies that you and I use that have some pre trained type nutrients, things that have some creatine, some tyrosine, some acetyl, l carnitine, can be very helpful. A little bit of like green coffee bean extract for caffeine can be good. There’s actually a nutrient called peak ATP, it’s a company and they’ve make so much like literally just straight ATP, and you can actually take it in powder form so that for me really, really helps. And then I like all the nitric oxide stuff. So I’ll do like a teaspoon of beet powder. I’ll do before the sauna, but also do before exercise, the beet powder is awesome. And then I like a lot of the adaptogen. So rhodiola makes me feel really good. As a as an endurance support. We use it for athletes, as you mentioned. And Holy basil’s is good. B vitamins a course that’s always low hanging fruit, there’s some good really good forms of creatine that we use, those can be helpful. And I think that’s about it. Are there any other like pre train nutrients that you like or that you use? 

Dr. Justin Marchegiani: So you kind of hit a bunch of them. So off the bat, you know, creatine and branched chain amino acids are wonderful, and it gets great, a little bit of caffeine can be very helpful to kind of mobilize free fatty acids. So whether you’re doing like a cold brew, coffee in your smoothie with the amino acids can be great. I do my Mito synergy support because it’s got some extra carnitine, extra ribose, a little extra creatine in there, some HLA some B vitamins, just those low hanging fruits are wonderful before workout. But I’d say creatine, branched chain amino acids, maybe a little bit of caffeine, especially if it’s a morning or afternoon workout, don’t do that, if it’s a nighttime workout. That’s a good first step, I think, to really hit it out of the park. And then we talked about movement patterns, I like really focusing on the centric, I also like focusing on circuit. So doing two to three movements back to back to back can be very helpful, because you can get a lot of volume done meaning a lot of reps and sets in, you know, smaller amount of time. So that’s great, because you can have a 15 to 20 minute workout that may have may have taken you 30 or 45 minutes if you did it one exercise at a time. So it gives you the ability to to make it more practical, which is great. 

Evan Brand: Yeah, I think the next thing we should hit on is kind of the post recovery stuff. So what about the person who is getting into the exercise? Maybe they’re not tolerating it? Well, maybe their recovery time is a bit too long the wanting to shorten that I think the bcaas could be great before and or after. And then I’m a huge fan of like a Grass Fed Whey Protein Shake, but make a smoothie out of it. So there’s a couple grass fed ways that you and I use it are super good quality, and we’ll throw in like a scoop of coconut butter. If you can tolerate nuts, maybe a scoop of almond butter may be good. And then I’m a big fan of some of the Oregon meats too. Whether it’s actual Oregon meat or like some organ meat capsules, those can be really helpful for recovery and just making sure your body has the role nutrition it needs. And then good sleep. I mean, you can’t forget about good sleep. I mean, I see so many people who are moms that are trying to hit the gym or do whatever, five times a week, but they’re up too late. And they’re up too early. You know, they’re up at 430 in the morning to go hit the treadmill. It’s like ah, I’d prefer you sleep in until 630 or seven. Do that workout later and not miss your cortisol peak because the problem is if you’re up too early to exercise, you’re really missing that cortisol peak. It’s kind of like you took your iPhone off the charger when it was only at 50%. We’ve seen based on thousands of reviewing labs that the cortisol doesn’t really peak until around sunrise or so. And if you’re up at 430, the battery is not fully charged. So now that cortisol is going to just halfway peak, and then it’s going to crash much sooner, so you’re just not going to get the best bang for your buck, if you’re doing those super, super early workouts now isn’t better than nothing, probably. But I’m just giving you a couple details that we’ve, we’ve seen. 

Dr. Justin Marchegiani: Yeah, when your nervous system is a little bit more fragile. When you have more adrenal issues, doing a later workout in the day is probably not the best, because that’s going to get more of that sympathetic nervous system kind of stimulated. And it made the the more unhealthy or the more out of balance your adrenals are the harder it, it takes your adrenals to wind down and kind of downshift from that sympathetic adrenal stimulating workout. So there’s going to be some adrenal stimulation, of course, right, which isn’t bad thing. But the question is, Do you have enough time to adapt and come down from that workout before bed, and that’s where it may affect your ability to repair before bed. So that’s why doing a workout, let’s say before two o’clock is ideal, you know, and again, the healthier you are on, the more you can downshift, the better, right, I typically recommend try to give yourself at least two to three hours to come down. So if you want to be in bed by 11, you want that workout to be done by eight for sure. That way you have at least three hours to come down from it, and try to do it more in the morning because you have that natural cortisol peak. And if that cortisol peak is going while you’re stimulating cortisol, you’re just more in harmony with your natural rhythm of cortisol going up. And adrenal stimulation going up, it’s kind of like, hey, more light at night. And when when melatonin goes up, are they’re not going to work because cortisol is going down at night. And light goes up at night, which can stimulate cortisol. So you kind of have the inverse thing happening with lights. And with cortisol at night, it’s the same thing with exercise and cortisol. So you rather do it when you have more harmony going on. But I understand some people that may not be an option. And if that is just try to give yourself more time. And really try to make sure that it’s not throwing off your sleep rhythm. And if it is adjust the frequency, the intensity and the duration, so you can recover from it and not mess up your sleep.

Evan Brand: And this is tough to do a podcast on because there’s so many different people with different work schedules. And well, my, my kids are with me on these days. So I can’t work out in the morning on these days. And I take my kids to school on this day, you know, so obviously, what we’re saying these are generalities, I know you have to work it into your schedule. But yeah, if you could do like a morning workout, I think that’s smart. But not an early morning workout. I don’t think people should be setting an alarm to get up at 4am to go jump on the treadmill at 4:30am. I just don’t think that’s smart. But if you were up with the sun at seven, and you could do it, that would be good. 

Dr. Justin Marchegiani: Yeah, ideally, for sure. Now, if someone visits us their work schedule, and they can get to bed by between eight and nine o’clock, so they they’re still getting at least seven hours of sleep. Sure, that’s at least better than nothing. So you just got to make sure the sleep is is compensating for the time getting up early for sure. But I agree, you know, the more you’re in harmony with the sun, the more your body likes that. 

Evan Brand: Yeah, ashwagandha can be used in the evening, I remember I would do that if I had some late workouts that would kind of stimulate me. If I did like some ashwagandha at night, it would help help kind of calm it down you and I’ve talked about many times how it helps to regulate cortisol. So that’s what adaptogens do. If you’re too low, it kind of brings you back to balance if you’re too high and can bring you back to balance. So let’s say you did a eight o’clock workout tried to go to bed at 930 You’re still kind of ramped up maybe capsule or two, I like to use some liquid gel caps of ashwagandha tincture, and that really settles you down pretty quick. 

Dr. Justin Marchegiani: 100% agree. Yeah. 100%. Great. That makes a lot of sense. So I think we hit some of the exercise kind of options, right? We talked about amino acids and nutrients pre post during we talked about different styles of exercises. I would say one thing in there, if you don’t have a lot of time to BOD or some kind of an interval on the cardio cardio side, whether it’s like an elliptical or treadmill or or bike, we’re a bigger fan of the rowers because you’re getting more extension in your body and there’s tends to be less extension with cardios and we tend to be more inflection throughout the day right at a keyboard right typing, all that stuff brings our body more into flexion. So using more extensions stuff can be really helpful. So I like more extension movements like we already chatted about. And I like a rower for that and you can do a 32nd 20-20 or 32nd high intensity movement followed by a Tabata which may be a 10 second rest period all the way up to a peak eight which may be a 92nd rest period. And you can just adjust the rest period and the exercise period to kind of suit your body so anywhere between a 10 to 32nd. High Intensity full out, you know as fast as you can go followed by a 10 second to 92nd rest period. That’s very helpful for increasing your metabolism and putting on muscle too. 

Evan Brand: I tell you on that rower, what I’ll typically do is I’ll do 500 meter sets, you know so typically with like weightlifting in regards to building muscle people, you’re going to want to be looking for around three, maybe four sets of 10 to 15 Just depending on how you know what how you’re feeling what your goal is, but with the rower, I’ll do 500 meters as a set. And it’s give or take around two minutes to do that, man, I’ll tell you, you want a full body blood flow, that rower does it because you know your legs, you’re pushing to kind of slide yourself back, and then you’re pulling, and then hopefully, you’re, you’re fully pulling back, I think a lot of people stopped too soon. But if you’re pulling that bar all the way back to the chest, and then you go back in, and man, I feel great on it. So it’s-

Dr. Justin Marchegiani: Yeah, it’s using your hamstrings to kind of bring yourself back closer to the machine to so you’re getting a little bit of extension on the quads, a little bit of flexion on the hamstrings, and then you’re getting some bicep and some and some rhomboids and some upper back, which is really nice. So I agree, I think it’s really good movement pattern. 

Evan Brand: I put it on Max, I mean, you know, it’s, it’s kind of hard. Like if I was on a desert island, would it be the only piece of equipment No, I’d probably bring like a kettlebell maybe, or a dumbbell on the desert island. But it, rowers pretty dang close to the all in one solution, if you’re somebody who’s just looking to get your heart rate up, but also you could build some muscle, I put it on the max setting. So it is it’s the most resistance. And then if you pull on that thing really hard or really quick, you increase the resistance more. So yeah, I mean, you can get a pump, you can build some, some good back muscles and arms and deltoids using that and some traps. I mean, you’re gonna hit your traps a little bit on the road. So I’m a huge fan. 

Dr. Justin Marchegiani: Yeah, I like kettlebell swings as well. I mean, the only issue with the kettlebell swing is when you go into the East centric on the kettlebell swing, there is no low, slowly centric, it’s gonna be fast. So you’ve got to make sure you’re in a little bit better condition on the kettlebell. So you can go you know, have a really good explosive, ie sedgewick. And concentric because that eccentric when that kettlebell is coming down, you’re not you can’t lower that speed, it’s coming down at full speed, which is great, because you have to absorb it and use those hips to kind of soak in and grab that momentum, which is great. People that are beginners, they tend to use their back more and they can get hurt. So kettlebells I think there’s a really simple movement where you can kind of walk by it a couple times a day, and do you know some sets to failure on it, just make sure you know how to do it right. You have some good forum, find a trainer that can kind of walk you through the movement pattern, so you feel comfortable and confidence you don’t get hurt.

Evan Brand: Yeah, I was gonna say I probably in a kettlebell situation, I’d probably pay for a couple hours of training on it, because I definitely hurt my back. When I first started. I didn’t know what the heck I was doing. I just looked at some videos, I thought, Oh, yeah, this seems about right. Now, there’s some minor tweaks that can really affect how that load bearing hits your back. So for people, you know, that are not, you’re not an athlete, I would not go straight to a kettlebell. 

Dr. Justin Marchegiani: Correct. Yeah. 100%. And then I’d like a lot of body weight stuff. So I have like the push up bars I like just because I can get a really good deep push up most people, man, they do have push ups, right? They do have push ups. I like the bar. So I can just get really in deep, get a good full range of motion. And I keep my wrist kind of in a neutral format holding the bar versus like this, which I don’t I don’t think it’s the best thing. You know, it hurts the wrist. Yeah, it hurts. So you can kind of keep it nice and neutral. You can go nice and deep. And that can have a nice, good eccentric on there, which is wonderful. 

Evan Brand: Yeah, so you’re using the like, the handles, yeah, like here, we have each handle for the, for the push ups. Okay. 

Dr. Justin Marchegiani: Yeah, like that. And it goes really good. They have some that do a rotation thing, which is okay, too. I mean, you can hit the packs pretty good there too. But just to be able to go deep in there and be able to keep your wrist neutral, I think is wonderful. 

Evan Brand: I love pull ups. I mean, I tell you, I got extremely strong doing pull ups. But for people that are beginners pull ups, you might not even be able to do one and that’s okay, what you could even do is use like a little step stool, and just jump up there and just hold yourself up and the pull up position. That’s how I started out was just holding at the peak of the pull up. And then eventually I just let myself down slowly, and then pull up again. And then I was to the point where I could do three sets of 10 on pull up, I swear to you, man, that’s exhausting. 

Dr. Justin Marchegiani: If you go search online, like pull up assist, you can get bands, they kind of hook around and there’s like three or four bands. And then you can add a band for the for the intensity on the assist. And so what I’ll do is I’ll go in, I’ll do as many pull ups, which is you know, palms facing you or chin ups, palms facing away, right chin ups, more lat pull up more biceps, and I’ll do as many as I can the failure. And then I’ll go in and then put the bands on right after my knee and then I’ll go do it again to failure. So that’s a pretty good kind of a nice drop set where you go as much as you can bodyweight. And then you jump in with a little bit of help. And that can be super, super helpful. Just just people don’t people aren’t used to controlling their body weight like that. And it’s really functional to be able to move your body in a way where you are, you know, in control of your body from a weight standpoint, like you’re able to, to move and functionally manage your body in space and time without any extra stuff on there think it’s really functional. 

Evan Brand: Yeah, I mean, that’s the thing that people listening if you’re like, I just don’t like exercise. I hate exercise. I’m not into it. I’d rather go hiking Look, I hear you. But the benefits are not just in and out of the workout. The benefits apply to picking up your kids the benefits apply to playing with your grandchildren, the benefits apply to doing yard work. Bringing in heavy bags of groceries and you don’t want to make multiple trips, you can grab all the groceries in one trip. And so it’s just awesome to be able to to build muscle. If you’re climbing ladders, if you’re in construction, I mean just that, as you’re mentioning, it’s functional, this stuff applies. This is not just for vanity, this stuff really applies to everything if I weren’t in decent shape. my four year old, she’s heavy. When I go to pick up that kid, it’s awesome to be able to have the muscles to just make her a dumbbell. I just pick her up like a dumbbell. You know, it’s it’s fun. If I were in bad shape, you know, I maybe hurt my back, just bending over to pick her up. So this stuff is the stuff is great. And especially as you get into 60s and 70s. I mean, we know that with bone density being a big issue, we have so many clients with osteopenia, osteoporosis issues, yeah, we can give you supplements for that. But the best free thing you can do is to do weight bearing exercises to really preserve your bone health as you age. 

Dr. Justin Marchegiani: Yeah, I always look for movements that translate to me living my life better. So anytime you can move your body, you know, in a way where you’re managing the weight of your body, that translates to you managing the weight of your body when you’re, for instance, roughhousing with your kids in the pool or something like or like I’m throwing my kids up in the air, like one handed like, you know, one handed, like, Where did that get shot, put kind of thing. It’s like, I need really good shoulder stabilization and really good lat strength, and core stabilization to be able to make that happen. So it’s nice to do movements that can translate to you being able to play with your family or friends or do your sport or do your hobby. So that’s really important to think of like, what movements do I want to do in my workout that will translate to me living my life better. So always kind of think a little bit deeper. Most people just think like, hey, what movements to make myself look better naked. That’s cool. I have to run with that. But now we got to think a little bit deeper now.

Evan Brand: Yeah, I think if someone’s listening, and they’re like, well, I’m pretty much disabled. In terms of my physical performance. I’m just super weak. I would try a plank. I mean, a plank is a game changer, where you’re just getting on, you’re kind of resting on your elbows and forearms. And you’re just holding yourself even if you can only do a plank for 10 seconds. My Lord, I can’t tell you core strength, you hear about this term core strength, it really does apply, I just got back into doing some planks pretty regularly. And even just sitting in a chair, I sit better in a chair now having more core strength. Yeah, I think it’s great. You just don’t fold in, you know, if you have no core strength, you just like you said you fold in, you get into the turtle the turtle position on the computer, and it’s just not good. The next forward and get the core strength, you’re more just confident with the way you sit. 

Dr. Justin Marchegiani: Yeah, also just just get a stand desk that allows you to stand throughout the day, like I’m standing right now, I’m using core strength just being able to stand right, that’s super helpful. Or let’s say you sit a lot and you don’t have the money to invest in a state that’s well, let’s just try to invest maybe in a Swiss ball, a physio ball or Swiss ball that will allow you to sit but now you have to engage your core a little bit so you don’t fall right. That’s a good first step. And then you can move to a stand desk where you’re upright, and you can kind of move and like look at my body posture throughout the day, I’m pretty upright, I have to pull my backpack, pull my arms back. So I’m in a much better position to be more athletic. And to get my my cold body activated versus in this like sitting down position, which is totally unhealthy. 

Evan Brand: Yeah, I kind of bend my legs a little too, I’m standing down too. And so you know, I mean, my hamstrings are pretty flexed right now just standing here talking. So that’s pretty cool. 

Dr. Justin Marchegiani: And you can buy an anti fatigue mat, which is fine, you can do that too. I’m kind of moving a lot. When I’m standing I’m on a treadmill, so it’s not necessary. For me I like to move a little bit. So that’s helpful. And then it kind of have a slight bend my knees, take the stress off my my lower back so that I think those are really good first steps. And I also have some QB pedals when I sit down, I can also pedal a little bit. So it’s good to have a lot of unstructured exercise that you’re doing throughout the day where you’re getting some movement and it’s not yourself being in the gym doing this workout, you’re kind of adding some movement here adding some movement there. And it’s it’s nice to be able to get that 10,000 steps or so a day, just to make sure your body’s moving. You’re not overly sedentary. Because if you’re getting 2000 steps a day, but you’re in the gym for 30 minutes. Is that really healthy. I mean, you definitely want some steps, you definitely want some movements as well. 

Evan Brand: Yeah. Now, if you just want to opt out of the whole thing and just become a farmer, then that’s an option too. But if you’re like a farmer that’s just sitting on a tractor, you’re not getting much exercise, but think of our ancestors, right? I mean, they didn’t have to think about exercise the way we do. It just happened. It was a byproduct of surviving. And now it’s optional. So it’s funny, we have to have this conversation versus even just a couple hundred years ago, my grandparents, grandparents, you know, they’re out in the field. They didn’t even have mechanical equipment. They had horses and plows. Oh, my God, I bet you those people were getting 10,000 steps at least per day and sunshine and fresh air. They didn’t have to think about it. 

Dr. Justin Marchegiani: Yeah, I 100% agree, you know, but we got to adapt and we got to create artificial stress through our workouts to keep our muscles and our body strong. So I think that’s great. Is there anything else you want to add today and I think we hit all the really good stuff. Maybe people that are really having a hard time adapting and figuring out the next step they can they can reach out to us here below EvanBrand.com to reach out to for you worldwide. JustinHealth.com for Dr. J myself. And also we may have to dive in deeper and test your adrenals test your hormones, get your gut, maybe give you more nutritional support, hormone support adaptogenic stress support to get you all to the next level. And that’s going to be a thing for most people, depending on how good or bad they you know where they’re at, and how much they want to improve. That could be something that we consider to be an accelerator to get you to the next level. So that’s always an option for y’all as well. Anything else you want to add, Evan? 

Evan Brand: No, that’s it. You mentioned the links JustinHealth.com EvanBrand.com we’re happy to help people. We love this stuff. I mean, it’s, it’s such a great thing to be able to take a woman who’s exhausted trying to keep up with the kids, we get her mitochondria working better, we get her gut working better, she’s able to exercise and perform and then boom, it in turn makes her a better parent. She’s able to keep up with the kids now or the grandparents are able to run around with the grandkids. So you know, remember what this is all for. At the end of the day, it’s for you to be able to function through you know, on planet earth through your body in a better way without being injured. So it’s awesome. 

Dr. Justin Marchegiani: I love it Evan, excellent point today. It was a great podcast. Hope you guys enjoyed. Thumbs up really appreciate it. Comment down below. We really appreciate it. There’ll be a link below if you guys enjoyed it. Shoot us over a review. We’d love to hear your thoughts and feedback. Evan, you have an awesome day, man. You take care. 

Evan Brand: Take care now. Thanks bye bye.




Audio Podcast:


Essential Blood Tests to Analyze Your Health | Podcast #305

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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

3:12       Conventional Side of Blood Works

12:14     Thyroid Panels

17:56     Blood Glucose

23:50     Adrenal Issues

29:33     Lipid Panels

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Yeah, both. 

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

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

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

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




Audio Podcast:


Natural Hacks to Improve Sleep | Podcast #303

Everyone experiences occasional sleeping problems, so how can you tell whether your difficulty is just a minor, passing annoyance or a sign of a more serious sleep disorder or underlying medical condition?

As humans transition from the waking state to drowsiness and into sleep, parasympathetic vagal tone (responsible for downshifting) increases, and sympathetic tone (the go, go, go!) decreases. Many of us experience trouble sleeping at one time or another. Usually, it’s due to stress, travel, illness, or other temporary interruptions to your normal routine. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder. Here are Dr. J and Evan taking us to another perspective of ways to help better our sleeping patterns.

Since electronics and the bulbs that we have to use artificial lights, some suggestions are the use of blue lights and dimmer lights. It helps lessen or prevent too much cortisol (steroid hormones formed in the adrenal glands) and assist our melatonin is kicking in and put as to sleep. Intake of magnesium, holy basil, and ashwagandha are also useful for bringing the body to a lower gear as well as regular exercise to keep our body in good shape. Watch the full podcast to know more ways to manage your sleep!

Dr. Justin Marchegiani

Dr. Justin Marchegiani


In this episode, we cover:

2:31       Blue lights, Dimmer lights

09:15    Sleep Mechanism

18:04    Gut Inflammation

25:05    Sleeping Drugs

27:49    Supplements

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

Evan Brand: I’m doing well. I’ve got an article here. We’re gonna start the show off. This is all about sleep today, issues that affect sleep. How do we mitigate the effect of stress on sleep and gut and all of it. But first, Pepsi, good old Pepsi Co. They’re launching its newest beverage, the de stressing and relaxation promoting drift. Well, this is just all about, what’s my point of this, that becoming healthier is becoming mainstream. So anyway, they’ve created a sugar free non carbonated water flavored with a hint of blackberry and lavender with 200 milligrams of L theanine, which you and I’ve talked about for years and years and years and years and years, DNA being an amino acid that helps to increase GABA comes from green tea. But you can also take it in supplement form. Here’s the thing I don’t like about this thing, though. Number one, it’s seven and a half ounces, I don’t really want to drink seven and a half ounces right before I go to sleep, if I’m going to take theming, I would much rather just take a capsule of 200 to 400 milligrams at the end and go to sleep. And then the second thing is there’s they’re wanting to sell this thing for $18 for a 10 pack that’s $1 at a dose basically, versus you and I if we’re gonna get a professional grade theanine, we’re probably getting what maybe 100 or 200 capsules for 20 bucks. 

Dr. Justin Marchegiani: Yeah, it’s definitely a little bit more on the expensive side, kind of per dose, but you’re definitely paying confer convenience. So like I’m all about if a company can create a product like this without the artificial sweeteners, dyes and colors, and it’s using a clean water, you know, reverse osmosis kind of water source, and it has some of these nutrients in there. And it makes it convenient, because it really comes down to can people do it right? If you don’t do it, if you don’t apply it, you don’t get the benefit. So that’s a really good first step in the right direction. I mean, I’ll still take the supplements, you know, from a raw material standpoint, like you mentioned, but if we can get some non healthy minded people to jump on board that train, that’s great.

Evan Brand: Oh, yeah, I mean, imagine if we could get people to switch over from, I don’t know, doing a nightly beer. You know, let’s say they do beer at night. But instead, they could just do this, you know, themed drink, that’d be a hell of a lot better for their gut and their brain. And you know, theanine has benefits for the brain to it’s not just the sleep, they’re kind of promoting it as a relaxation drink. But I take theanine daily, and it definitely helps to buffer stress. It’s just something that it’s not like a sedative. I mean, it’s not a chill pill. It’s not like a passionflower would do for your sleep. But it, it definitely just kind of settles the mind a little bit. 

Dr. Justin Marchegiani: Yeah, I agree. I mean, my nightly routine is typically some magnesium and some vitamin C. And then if I if I’m going to do any alcohol or any like cheating, kind of things, food wise, I’m going to be doing some load of iron ore and acetylcysteine and maybe some charcoal as well. And then if you have any issues ping before bed, just try to drink that an hour or two before bed. And that kind of sets in. And then you know, one of the nice thing people are doing today, a lot of the glasses have a blue light filter. So I have I upgraded my glasses that I typically use when I watch TV to a blue light filter. So nice blue light, really nice. And then, of course, one easy investment we all can make is just get dimmer switches on all your main lights that you’re going to have on at nighttime. Just kind of get those dimmers down 80% or so that’s going to help a ton. If you were reading glass or a glass for reading or TV, get a blue light filter in there, or just get like one of those nice blue light glasses that you can put over on anyway without a prescription on there. And that’s very helpful to kind of get your body in that parasympathetic state that we talked about so much. 

Evan Brand: Yeah, I use Iris you can check it out, get Iris if you just search that you’ll find it. Iris tech is a company who their competitor to flux it’s better because it does have some supposedly has some anti flicker built in so it can help reduce the flicker rate of your screen. So smartphones, Windows computers, Macs, you can use Iris, I’ll leave it running 24 seven I have it on right now. So what I’m looking at Justin on the screen here, he’s a nice tan golden color to me, which looks good and it definitely reduces eye strain my eyes at the end of the day. You know, we’re looking at labs all day. So you know what we do is hard on the eyes and my eyes would just be exhausted. But once I run it at a more warm color, I definitely have less fatigue at the end of the day mentally.

Dr. Justin Marchegiani: Yeah, I’ll put the link to some of the things that I do. I use the viewsonic monitors that have a low flicker and low blue light naturally in there. And you can still run an iris in the background as well but I highly recommend I noticed my prescription. The last year two is actually gotten better. It’s actually improved my stigmatism which is the shape of the eyes also shifted as well. And I talked about it with my optometrist and he said you know it’s possible that just you doing the blue light at night and you shifting over the monitors last year or two could have helped with that so I mean outside of nutrition being stable lutein all of the vitamin A precursors, I think shifting over the monitors if you’re someone that’s on a computer all day, invest in really good blue light protecting technology and or good blue light monitor. Yeah, well blue light, low flicker very important. 

Evan Brand: That’s good advice. Yeah. So nighttime we talked about that a little bit. You mentioned dimmer switches, blue light glasses, I’m using just salt lamps at night we have probably six or seven salt lamps. We have some that are just salt lamp night lights that are plugged into the bathrooms. That’s pretty convenient. Brush your teeth with just a salt lamp, it’s just a nice, pretty warm glow. I haven’t actually used a color, you know, like a color device to check if there’s blue light coming off of it, but it’s a pretty darn warm color. And it’s a little like couple watt incandescent bulb incandescence are going to have less blue in them naturally. So we like to use a lot of the Edison bulbs, a lot of the Edison bulbs now I’ve turned into LEDs though, they’ll look like Edison shape with the filament inside, but it’s led, which is so annoying. So make sure you’re actually getting the true Edison bulb, I use a company called Hudson, Hudson lighting, they make great Edison bulbs, and they’re going to be around 2700 Kelvin, which is a really nice amber color. When you get up to the 456 thousand Kelvin. Those are like your fancy car, ah ID headlights that are going to be really really blue kind of whitish, bluish color. That’s not what you want at nighttime. It’s amazing. You know, I’m rarely out at night. But if we’re out on the road, we’ll drive past someone’s home. And we’ll just see, like science lab lights on at nine o’clock at night. It’s like, No, those people aren’t sleeping good tonight. Some people will argue with me like even my grandparents, I tried to get them off of the TV in the evening or to wear blue blockers. And they’ll say, Oh, I sleep fine. And it’s like, Yeah, but what’s the quality of sleep? You’re saying you’re waking up three to four times a night to go pee. You’re not well rested in the morning when you wake up. So yeah, you may say, quote, you sleep fine. But what’s the quality? What’s your energy level? Like? What’s, you know, are you crashing out by 11am? Because that would tell me your sleep is not so good after all. 

Dr. Justin Marchegiani: 100%. Yeah, I 100% agree. So I think it’s a good investment where if you wear glasses or contacts, look at getting a night per night glasses to have the blue light filter in there. And some brands don’t have a good blue light filter. So you know, you can get a blue light where it tests the actual wavelength going through. I’ve seen some of these glasses really only filter out the violet, which is interesting. So they’re kind of having a marketing ploy on it. So you’d want to go look at some of the reviews online, make sure you find a review where someone actually test those glasses, and sees if the blue light is blocked. But if you can get a significant amount of blue light blocked, you know, even if it’s 50% or so. And you get the dimmers on Well, that’s a good first step for sure.

Evan Brand: Yeah. And people listening may say, you know, any kind of skeptics listening, which most of those weed themselves out, so most people that listen to us love listening to us. But any skeptics may say, Well, why our ancestors, they didn’t have blue light blocking glasses. Yeah, but they didn’t have LED lights, they didn’t have electricity. In general, there was no artificial light at night. So when the sun goes down, and up, and the moon Yeah, when the sun goes down, and the sky is turning red and orange, the sun, the blue light can’t get through, when the sun’s at a low angle, the blue light doesn’t come through as much. And you naturally have a blue light filter, it’s the atmosphere. And so at nighttime, when you have a fire, which is the only source of light you would have had at night, look at a fire. I mean, you may have a tiny bit of blue if you’ve got a really, really hot fire, but it’s nothing. It’s it’s not going to impair melatonin production at all. And that’s the issue here is the artificial light at night is elevating cortisol, which is down regulating melatonin. And of course Melatonin is not just your sleep hormone. It’s very important as an antioxidant too, Melatonin is something that’s been shown in several studies to have some cancer protective benefits.

Dr. Justin Marchegiani: 100% and I’ll put up I’ll put a couple of links in here for people that are listening. Regarding my favorite monitors, I use the eye care monitors, and I think those have really been super helpful for me. So I’ll put a link down below people can access that. Okay, that’s good. We talked about some of the blue light glasses, there’s the the Swanwick glasses, there’s the true dark glasses. Those are some good ones off the bat, you can jump on Amazon and look for some ones that have good reviews on there. I think those are great. There’s some blue light glasses that that go over glasses. So if you wear glasses, you can look for a pair of blue lights that go over that that’s on top of that. But if you want extra protection, you’ll have that there. That’s a good kind of first step in the right direction. Why don’t we talk about mechanism? I think this is important. So we talked about like the parasympathetic and sympathetic nervous system. This is important. So the sympathetic nervous system is kind of controlled by the adrenal gland. So the sympathetic is the gas. It’s the Go, go, go go go Stress, Stress, Stress, Stress, Stress, and the adrenals kind of are the gateway between the nervous system and the sympathetic response because of the cortisol response and the adrenaline response. So typically, when there’s some kind of a stress, adrenaline is the first thing that comes to the table. And then cortisol comes a little bit later. So think of think of adrenaline as the primary it Prime’s the pump and then once the engine is going, now cortisol is flooding the zone afterwards. And so when you have a lot of these stress hormones going, you’re number one going to be shunting blood flow to the arms and the legs to fight and flee, you’re going to be making less enzymes and acids and digestive juices so your digestion won’t be as good. So if you’re eating healthy, you’re more likely to get bloated and gassy and have indigestion. And you’re less likely to absorb a lot of those nutrients. So if you’re eating lots of good amino acids and minerals, you won’t be able to ionize them and absorb them properly. And so we want to do natural strategies that decrease that sympathetic nervous system response which is going to help modulate adrenaline and modulate cortisol. And part of how we do that is we have to stimulate the parasympathetic side. So for instance, this new Pepsi product you mentioned, we don’t I’m not supporting Pepsi, but I’m supporting the mechanism. l theanine is a good precursor that Evan mentioned to Gabba, gamma amino butyric acid, and that’s a inhibitory neurotransmitter, think of it as the brake, it’s the stop the slow down. So think of the sympathetic nervous system response is it’s the shifting gear going from first, a second, third to fourth, fourth to fifth, it’s going faster, faster, faster, the parasympathetics. And the inhibitory response is down shifting, it’s going from 5 to 442-332-2221. And then park in that car. And so things like GABA can be helpful. passionflower, magnesium are excellent things. There’s different adaptogens that we use, like holy basil and ashwagandha that really helped decrease and help down shift that stressed out engine and bring it to a lower gear where you can slow down and relax.

Evan Brand: Oh, speaking of ashwagandha This is funny to man, a lot of the things we’ve been talking about for a very long time are becoming more mainstream. I never have the radio on because I’ve got streaming radio in the car, so we never have the real radio on. And so the this advertisement comes on, and it’s you know, the typical radio announcer voice, it’s this lady. And it’s this. It’s just talking about sleep and stress and all that and the lady’s like introducing ashwagandha gummies, an Ayurvedic herb that’s been used for thousands of years, it can really help you relax, and I thought, wow, a radio commercial for ashwagandha. This is hilarious times are changing. So it’s funny. This is something that you and I use all the time clinically And personally, and it really does help you can take ashwagandha during the day to help blunt stress but you can also use it in the evening, take a dose before bed, Stephen buehner, the herbalist I really love because of his books online, he talks about ashwagandha being very, very helpful in terms of calming down like brain inflammation, which can impair sleep associated with Lyme, so people that have that sleep, or if you’re waking up at two or 3am and you’re kind of bolting awake or having nightmares. You know, ashwagandha may be something to help. I’m a big fan of Magnolia Magnolia is a bark that can be very helpful. You and I’ve talked about relora. In the past relora is actually a blend of two different plants. I believe it’s two barks that are combined to create the patented relora. That’s something clinically shown to help modulate cortisol at night. You mentioned the passion flower, I like to mix passion flower with motherwort, especially if it’s a monkey brain situation. motherwort can really help calm the the racing thoughts, the racing mind motherwort, something that Rosemary gladstar and many other famous herbalist, they recommend keeping it in your first aid kit or in the car. So if you get in a car wreck, or if you have a traumatic experience, you could take a dose and mother would never really settle you down, you know, with all the shutdowns and a lot of our clients that are running small businesses and other things that I’ve had massive amount of reports of stress issues happening over the last six months. And so I really think the time that you and I are putting this out is important. It’s always important, but it’s more important now. Because once your sleep quality goes out the window, what happens then well, you have a shorter fuse, you are going to be more irritable, you could be more anxious, you could be more depressed, you may have cognitive issues. So you may not be making good decisions as a parent or as a boss or as a CEO. So I mean, this affects every aspect of your life, you really cannot ignore this and just go pound the coffee. First thing in the morning, you can do the coffee, but you’ve got to be making sure you’re doing all the nighttime strategies as well. 

Dr. Justin Marchegiani: 100% I love it really, really good points off the bat. Also a couple other strategies I want to highlight is exercising too close to bed. So exercise, it’s a stress it does activate the sympathetic nervous system because that’s how you get blood flow to the arms and legs into the extremities. And then of course cortisol and immobilize glucose in the muscles and such. And so that is part of the stress response. So you got to make sure the more your parasympathetics are stressed right your rest digest part of the nervous system. The less strenuous the less sympathetic stimulating exercise you should be doing. And of course, you need to allow more buffer time to transition back into the parasympathetics at bedtime. So if you’re working out like at six or seven o’clock and then you’re trying to wind down At nine or 10, asleep by 11, that may not be enough time. So the more stressed you are you want to look at doing exercise first thing in the morning, and you always want to answer my three questions appropriately. Alright, you want to answer positively to these three things? Number one is do I feel better after the workout than when I started? Number two is, can I emotionally repeat the workout? Do you feel so depleted afterwards? Where you just you couldn’t emotionally do it, like, you may like have that high where you’re like, Oh, I feel good. And then like, you catch your breath, like 10 minutes, and you’re like, Oh, thank God, that’s done. You want to feel that sense of like, no, I could do that. Again, like I could do it again, you want to feel that kind of a sense of accomplishment. And then number three is you want to feel not excessively sore or beaten up afterwards. So that next morning, you wake up, you know, barring the fact that you slept good and all that’s okay, you didn’t drink alcohol, you want to feel not excessively sore with the exception. If you throw in maybe a new exercise you haven’t done in a while maybe some lunges or a deadlift, outside of something that’s a full body movement, you shouldn’t feel overly beaten up. 

Evan Brand: Yep, good points, good points. And it’s possible, you could use some of those herbs to try to calm down that response. Right? If your work schedule just doesn’t allow it and you have to do a six 7pm workout. Like you said, maybe it’s not too intense. So you still could settle down, but maybe you, you do take a dose of some type of an adrenal cocktail, after the after the workout, I think that could be really smart. And then let’s go into a couple other mechanisms.

Dr. Justin Marchegiani: Just to highlight one thing before we move on topic. So if that’s the case, that’s the only window there’s three major levers with exercise frequency, intensity, duration. So frequency is how often you work out. Is it every day, you taking a day off in between Monday, Wednesday, Friday, Saturday kind of thing. And then of course, that’s frequency intensity is how hard Are you working out as well as the rest in between? So like, a compound lift like a a deadlift or a front squat, right? Isn’t it be a lot harder than like a bicep curl or military press right, the more you activate, the more joints you activate, the harder it is. So you could shift away from multi joint stuff. Or you do multi joint stuff with less weight, okay, and provide more rest time between sets. And then duration, of course, is going to be how long the workout is right? Instead of a 45 minute workout, you go to a 30 or a 20. So you just keep on frequency, adjust the frequency, how many days intensity kind of workout lifts, you’re doing the weight as well as the rest time. And then the duration is the overall length of the workout cutting that down so you can move the lever on those. And I always recommend the easiest first thing is allowing a day off in between to recover. And then keeping the workout shorter, right, Charles poliquin did research on this finding that the cortisol response starts to significantly elevate once you go longer than 45 minutes. So keeping the workout under 45 minutes. And if you’re really stressed probably 20 to 30. And just rely on more circuit type of workouts to get the exercise done. So do three movements in a row, upper lower upper or front back front, however you want to pair it. That way you can get a lot more volume and and exercise accomplished in a shorter amount of time. 

Evan Brand: Yep, that’s good advice. I wanted to talk about the gut. And we could probably mention blood sugar, too. I know that when I had gut infections, my sleep was terrible. Now the mechanism of it. I mean, that’s debatable, you and I could try to tease this apart together. I think ultimately the answer is getting rid of gut infections is going to improve sleep in many ways. But I think one of the mechanisms is probably some of the gut bugs possibly affecting blood sugar because the gut bugs are eating and they’re feeding on your nutrition. So I definitely had more hypoglycemia issues. And hypoglycemia, if that blood sugar’s crashing, blood sugar gets too low, you and I’ve talked about this, the adrenals have to pinch hit, basically, and try to help out to get that glucose regulated. So if blood sugar is crashing, maybe you’re not eating enough with meals, maybe you didn’t have enough fat or protein with dinner, or maybe you ate too early. If you ate at five and you’re going to bed at 10 that’s already five hours and the blood sugar may be dropping to a level that’s too low. And then if you compound that with having gut infections, then you really could get into trouble. 

Dr. Justin Marchegiani: 100% and like you mentioned earlier, the stress and the inflammation from a gut infection. We see it when we do adrenal cortisol rhythm testing, is we’ll start to see a premature elevation of cortisol in the morning. Now what does that mean for you? Well, we have this natural cortisol rather than people watching on video, I’m going to do some demonstrations. But cortisol comes up in the morning, and then it comes up in the morning but it really increases that first hour of waking isn’t a double from when you woke up to one hour later. So it starts to here’s waking, here’s one hour later and then it gently curves, here’s bedtime and then as you sleep it’s kind of flat and then gently starts to go up like this. So when you have gut infections and inflammation in the gut, and a lot of most infections are on an opposite sleep and wake cycle then we are so the more active they are means more inflammation. More inflammation means Is what more of a cortisol response so that cortisol prematurely starts to rise in the middle of the night. And then that can start to take you out of deeper sleep and cause you to wake up earlier. So, by addressing gut infections, you’re naturally supporting that healthy circadian rhythm. And of course, if we can support natural and influence, natural anti inflammatory support, that also takes stress off the adrenals because the adrenals are one of your number one, anti inflammatory mechanisms, right? cortisol, aka cortisone, and then pharmaceutical, prednisone, are all anti inflammatory mediums that conventional medicine uses for topical skin or asthma inhaled are injections in the joints, right for inflammation. So we have our natural anti inflammatories that we want to work on supporting and utilizing.

Evan Brand: Yep, and we’ve mentioned this, but just to repeat, so the cortisol is downregulating melatonin, that’s the mechanism. So people that just go take melatonin, that may help but I would argue that it’s not necessarily root cause. And so that’s why we’re going to be running these panels to look at the hormones, we’re going to be running testing to look at the stool, we’re going to be running panels to look at the urine and try to confirm what’s going on. Just to be clear for people listening or that are not aware, we’re clinicians, we deal with this stuff every day all day clinically. And so we have thousands and thousands of, you know, case studies that we can report back from and tell you what’s worked and what hasn’t worked. If you go to your conventional doctor in you talk about sleep issues, just to quickly compare and contrast. It’s going to be something like possibly a Lorazepam if it’s an anxiety based sleep issue,

Dr. Justin Marchegiani: -like a benzodiazepine that works on gaba.

Evan Brand: Yeah, exactly. So you’re going to get a benzo which are highly, highly addictive and habit forming, or possibly, you’re going to get something like an Ambien, which in terms of pharmaceuticals, I will tell you some of the hardest drugs for people to get off of are the benzos and the Ambien, which I don’t even know what category Ambien is in, but man, people really, really struggle to get off of that one.

Dr. Justin Marchegiani: 100% so you’re going to have Ambien, right, you’re going to have Lunesta, you’re going to have your benzos They may even be using some SSRIs to increase serotonin, which then increases melatonin. There’s, I think it’s rozerem rwhich is a gaba kind of in that gaba benzo family. So rozerem. You mentioned I mentioned Lunesta, and Ambien, what else is there, I think there’s trazadone is another one that I think is used sometimes for sleep as well. So those are a lot of the common sleep medications. And they don’t really address a root cause. And that’s the problem. And a lot of the sleep medications, like we mentioned, the Ambien or Lunesta, they don’t allow deeper restoration of sleep. So you kind of have like your four phases of sleep, right phase one, phase two, phase three, phase four. And then you go from phase four to three, two ones. This is like once, one cycle is 1234, phase 24321. And you don’t really get to go into these deeper three and four levels, where REM sleep and deep restoration happen. So we want to avoid medications that prevent us from getting into deep sleep. So that being said, we want to make sure we sleep. So we want to utilize every natural mechanism possible. So with sleep 10pm to 2am is that deep physical restoration, where you have good physiological repair, and that’s where growth hormone increases. That’s where we repair structural tissue, and such and bones and joints and ligaments, Hair, Skin nails. And then we have the psychological emotional repair, typically between two and 6am, where a lot of our neurotransmitters and hormones kind of turnover that help us with mood and energy and emotional stuff. And supposedly, a lot of our dreams are us processing a lot of our emotional stress throughout the day, right? So we want to make sure we get to sleep on time, that’s really important, right, the hours before midnight are really important. And we want to make sure that we’re getting the good time of sleep, we want to make sure that we’re decreasing light exposure, which it takes away from our melatonin. And then we want to make sure that we are just having good nutrients on board. So when we’re sleeping, we have the raw materials, amino acids and fatty acids to provide the building blocks to assist in the repair process. Yeah, vegetarians, vegans, they have a lot of sleep issues historically. And I would argue it’s due to the lack of these amino acids that you need to really help fuel some of these neurotransmitters. So back to the I want to just hit that because you hit something really important. And then when vegetarians and vegans get a lot of the amino acids, they’re not really bioavailable. So if you go look at the bioavailability of amino acids in vegetarian vegan foods, they’re not very bioavailable. Now, vegans and vegetarians can get by with free form amino acid supplementation, a high quality pea protein, maybe a rice protein, so they can get by with amino acid supplements, but it’s very hard from a raw standpoint, meaning you’re just relying on Whole Foods to get those amino acids and when you typically do combine them appropriately. You get a ton of carbohydrates. So if you’re more insulin sent or resistant or more Carbohydrates sensitive if you don’t do well with carbs that could cause more blood sugar issues and more sleep issues with that. 

Evan Brand: Yep, yep. So back to the drug. The drug name is zolpidem sold under the brand name Ambien anyway, we talked about alcohol A while ago, we talked about like, some of the date rape drugs and some of the bad stuff that people do. Apparently this GOP. Yeah, apparently this drug actually was used or has been used as a date rape drug as well. And so it is a non benzodiazepine. But guess what, it’s a GABA receptor agonist. So it works by increasing GABA binds to the same location as benzos. So tricky little varmints. It’s a non bidco but it binds to the same GABA receptor as a benzo. So to me, it’s a frickin benzo, you know, not not technically but in terms of the addiction potential and the withdrawal and the adverse effects and the dependency it’s it’s no good. 

Dr. Justin Marchegiani: So yeah, same thing with Lunesta here, I’m looking at some of the the mechanism of action on the nessa same kind of thing. It has a coupling interaction with the GABA receptor sites. So kind of it’s coupled with like a benzo. So it’s kind of very similar to a benzo and then the rozerem. It works on some of the m two receptor sites, I think some of the same receptor sites that work on melatonin, so I’m pretty sure it’s like a melatonin kind of agonist, if you will. And yeah, right here. rosarium is a highly selective melatonin receptor site type one type two agonist. So what does that mean? agonist means it helps the melatonin in those synapses to be it increases it stimulates it with a little bit and kind of gets a little bit more into gear, if you will. Now, my whole I’d much rather be using melatonin as a whole as I rather just provide more of that building block or more of that raw material to help right and gets more natural than just being an agonist and upregulating the receptor sites to it. And of course, even before that, I’d much rather use a lot more of the amino acids like five HTP, and B six, and providing more of the building blocks. So we don’t disrupt too many feedback loops, or the herbs just to help regulate the adrenals. And then you stay away from this crap completely. But why is how bad it is. So we kind of always start low and then work our way up. So there’s always kind of like a, an algorithm and how we are applying things and even natural we want to do the least invasive to the most invasive if we need it. But of course sleeps is such a huge tenant in our body’s ability to heal. 

Evan Brand: Yeah. And why is this not on the nightly news? Well, I mean, Big Pharma is highly involved in the media companies, right? So they’re, they’re not interested in melatonin, which is what maybe a quarter or maybe 50 cents per dose, they want pharmaceuticals, because there’s a lot more money involved. And you can’t patent it, you and I’ve discussed this patent issue many, many times. So they can’t patent anything. 

Dr. Justin Marchegiani: When you just look at the mechanisms, right, like, look what they’re doing, like with rozerem, it’s just it’s an agonist on the receptor site. So what they do is they kind of skate the surf, they kind of tiptoe around it and try to figure out, Okay, this is this mechanism is important, how can we monkey around with the receptor site and adjust that and make it better or over, you know, stimulate the receptor site to be more sensitive. So they’re kind of looking at what the the actual mechanism is, and then they try to just skirt the the periphery on it to make it work better, right, which a lot of times have side effects, because that’s what typical drugs, do they have side effects? That’s right. That’s right. So I mentioned the I got into the nutrition piece a little bit talked about kind of the the fat and then just one thing, sorry. And they have to do that. So people thinking, well, I don’t understand like, what’s the point of that? Well, you can’t patent a natural compounds. So when you have things like melatonin or natural amino acid compounds, you can’t patent it. So they know these mechanisms are already helpful. So you hire a whole bunch of chemists to go in there and biochem people to go in there and figure out okay, this is the mechanism, what can we do to create a synthetic compound, maybe we just create like an isomer, or something that looks very similar, that buffers or adjusts receptor sites, but is synthetic enough where they can patent it. So that’s why they they can’t patent natural things. That’s why they they look at already known mechanisms, and they try to adjust it and author it just a little bit. So they can patent it. And it never works as good as the natural stuff. And never will because of the fact that you can’t. You can’t improve upon Mother Nature. You just can’t. 

Evan Brand: Yep, I know. I love the herbs. I love them. So I hit on the whole, like, not enough fat and protein piece. And I see that a lot. Like I mentioned the vegetarian vegans. I mean, typically these people are depressed, they’re anxious and their sleep is crap. Now, the one happy vegan listening, good for you, but talk to me in five years, and I’ll be curious to see what happens. But back to the blood sugar piece. So there are some things that you may need to do to help with the blood sugar. That could just be something as simple as eating like a little fat bomb before you go to bed. I mean, it could be like a little piece of some coconut oil or some coconut butter or maybe grass fed butter or maybe I don’t know a couple macadamias are pecans are something that can help just kind of throw a little bit of fat on the fire before you go to bed. Now it can do a huge, huge thing. 

Dr. Justin Marchegiani: Correct. Some also do better do really good with a little bit of fat and maybe a tiny bit of carbohydrate, whether it’s a handful of berries, or a little bit of like, honey. And sometimes that can be helpful because the little bit of glucose can help those with the amino acids cross the blood brain barrier. So if you go so low carb at night, sometimes those amino acids can’t cross. And so I kind of go both ways. Try with less sugar. And if you need a little bit of sugar with a little bit of fat and protein, and you can always add a little bit of sugar just to help the amino acids cross that blood brain barrier. 

Evan Brand: That’s smart. You know, I’ve tried that like doing a chamomile tea, which is another easy good strategy. I’ve tried chamomile just by itself, and then chamomile with honey. And I will report with a little bit of honey, delicious, but it does help a little bit with the sleep.

Dr. Justin Marchegiani: Yeah, and just kind of just try it on both sides. Because too much sugar can also create blood sugar swings and cortisol spikes when your blood sugar drops. And that can cause problems. So it’s all about finding that right balance. So I always recommend start with none. And then add just a little bit in incrementally. 

Evan Brand: Yeah, and we through a lot of people. So where do you start with all this? Well, I think the blue light, the lifestyle stuff, not exercising too close or too intensely before bed. I think all those things are great, getting your bowels regulated, making sure that you’re testing yourself for gut infections and getting those things addressed. And then reaching out to a practitioner like Dr. Justin or myself, because we deal with this stuff. Personally, we deal with this stuff clinically. We’ve done it countless times. And it’s incredibly rewarding what we do, because we’re showing you on paper, where is this issue coming from? You know, some people blame it on their genetics, like oh, my mother, she never slept good. Or my dad Oh, he had terrible insomnia. He’s on antidepressants that are okay, genetics are not your destiny. So I don’t care how your parents sleep or not sleep. That is not your destiny. There are root causes that we can identify. And we can address these we can get them on paper, and we can retest and show you look, your basics is back up great because you needed that because you were also low in serotonin, which you needed more of because both of those ingredients, boom, make melatonin, you didn’t have that recipe. And now on paper, you’re reporting improve sleep, hooray. But look at the labs, we can confirm you fix the mechanism of these neurotransmitter issues and these nutrient deficiencies. And that is just why we do what we do. 

Dr. Justin Marchegiani: Exactly. The other thing I would say is going to be female hormones. female hormones play a big role, especially progesterone, because progesterone is a natural gaba chloride channel opener opens those gaba chloride helps flood gaba into the zone, which helps you relax. So female hormone issues, especially for menopausal women can be a big ones, we got to look at estrogen, estradiol and progesterone that’s really important. I would also they’re also kind of like their modulating supplements that can be helpful that may not plug into the root cause. So when I’m with the patient, I’m working them up. I’m trying to figure out what’s the underlying mechanism? Or is it multiple systems meaning is there poor digestion, indigestion, poor gut issues, and then autoimmune stuff with adrenals and thyroid, and maybe some detoxification issues, we try to focus on each of those systems, work on the diet like nutrient dense anti inflammatory, low toxin, get digestion, good, stabilize blood sugar, flood nutrients into the zone. And then we’re going to run organic acids and we’re going to see neurotransmitters, we’re going to see be six amino acid status, we’re going to look at serotonin and dopamine, adrenaline, that can help on the amino acid side. We mentioned things like melatonin, that’s always a later stage always want to do the amino acids first. But then there are things like California Poppy, or like you mentioned lemon balm, or Valerian or CBD as other like natural compounds that are out there that can be helpful, that may help either kind of attenuate that sympathetic response, and may help just kind of upregulate GABA a little bit. It may just have a very kind of sedative kind of relaxing effect, usually working as a natural kind of benzo right and flooding with gaba. So if you plug one of these natural things in, don’t just think that that’s it. Always try to trace it back to the mechanism that drove the issue. To begin with. You really always want to think root cause and then expand out. And if you find a supplement that helps try to always trace it back to what the original mechanism was. Does that make sense? 

Evan Brand: Yeah, does man you just like opened up a whole new can of words here. So I’m going to take a few minutes on packet. You mentioned thyroid you mentioned autoimmunity. So hashimotos it’s really common to have sleep issues, because if that immune system is attacking the thyroid, all of a sudden you’ve got some of this hormone leaking out into the bloodstream. So some of the things that you and I will do, yes, we can use the herbs. But one could argue that even the herbs are not root cause because if the antibodies are attacking the thyroid, yeah, it’s great to go and use mother work to calm the heart down. But the tachycardia that’s causing the insomnia is coming from the thyroid and this person is eating gluten. They’re doing sandwiches for lunch, so We got to work backwards on getting those thyroid antibodies down. So that- not so. So that’s my comment there. But then you opened up a whole nother can of worms, make sure I circle back to mold and Lyme and co infections real quick, but go ahead. 

Dr. Justin Marchegiani: So just to highlight one thing, when we’re working with patients, we’re always thinking that way, we’re always thinking, Okay, we’re going to try this, try this, we’re going to connect it back to the mechanism of action. But I know a lot of people are going to be listening, they’ll be like, Oh, I’m going to try this supplement or that and they’re writing their list down and what things are going to try, that’s cool. But just you know, if you don’t have that clinicians mindset, you may ignore the root cause. So if you have an issue where you’re trying a couple of things, and you’re not quite getting the results, or it’s a steady issue that’s continuing to happen over the years, make sure you reach out to a good functional medicine doctor, like myself, or Evan, the we can kind of work you through that. But at least try a couple things on your own. But don’t ignore that root issue and get a good functional medicine person to help you. If that issue is more chronic. 

Evan Brand: Yeah, because it’s not a deficiency of passionflower. Right, right. So it’s not just like we joke on drugs, it’s not a deficiency of those either. Now, let’s just briefly open up a whole nother can of worms here Lyme mold, co infections, mast cell issues, these things very, very, very much affected my sleep. And so Lyme really affects sleep. So make sure if you have a history of tick bites, or if your partner has it, because it can be sexually transmitted, that you address it, you either test for it, or you just try to go after it using herbs and see if you have a positive or negative reaction. I can tell you with confidence just using Japanese knotweed, for me improves my sleep quality. What’s the mechanism? Well, Japanese knotweed is anti inflammatory because of the resveratrol, but it does help to kill the spire Riki borrelia burgdorferi, which causes Lyme. So so that’s that, and then mold. Mold really, really affects the nervous system. And it will down regulate melatonin, Dr. Shoemaker. He’s kind of like the main medical doc that’s talked about mold for many years, he discusses all the hormones that get affected, your testosterone can go low, you can have issues with Msh. So then you start to burn easily and you can’t get a good tan, and you can get your antidiuretic hormone is messed up. So now you’re up in the middle of the night to go pee three, four or five times a night and people report Well, I sleep fine. But if I didn’t have to pee, I’d sleep better. It’s like, well, what’s the mechanism of the peeing? Is it a prostate? Is it a mold thing? Is it a toxin thing? metals? Yeah, adrenals heavy metal dosterone.

Dr. Justin Marchegiani: You can’t hold on to your fluids. So you’re dumping your minerals all the time. 

Evan Brand: So if you’re supporting adrenals, and aldosterone can come back up, right? 

Dr. Justin Marchegiani: It’s Yeah, it’s very possible. So supporting the minerals will help because you’re just not going to have the loss of the minerals. So the minerals are really important for your cells to work well, sodium, potassium, and for your electrolytes and for your heart. So those are really important things to kind of keep in, keep in mind, for sure. 

Evan Brand: Babesia bartonella, co infections, any can any kind of CO infection, those can affect it. Chronic pain, of course can affect sleep. So if you’ve got some type of an issue like mycoplasma that’s affecting the joints, or maybe you’ve got prepatellar, some kind of bacterial infection attacking the joints that causes pain that causes sleep issues, this is why you need help. You can’t just go by passionflower and assume all your problems are going to go away. 

Dr. Justin Marchegiani: Yep, a couple other questions are coming in here live on the chat as we go. Yes, low thyroid hormone can cause sleep issues I’ve seen reports of and some patients who have low thyroid will even add one of their thyroid doses a little bit before bed. And that can help as well. So it just depends if you actually have low tea, you want to take it during the day, but then also sometimes at night, it can be helpful, sometimes just supporting it during the day is enough to spill into night and help asleep. And yeah, things like pregnenolone right before bed can be a little bit stimulating. So anyone that has sleep issues will try to do their last dose of pregnenolone like around 3pm da ga less stimulating, but if you’re on the fence, you know, always do it really early, just to rule that variable out and see if that’s a problem or not. 

Evan Brand: Yeah, that’s good. Yeah, progesterone, I experimented with a little bit of that before bed. Wow. You can tell it hits the GABA receptors. I mean, well.

Dr. Justin Marchegiani: Progesterone is great, like a lot of my female patients that need it will do that, you know, an hour or two before bed, and it really opens up the gaba. And if we need we can throw in some extra l theanine along with it, or some gaba itself. And that can be very helpful and really promote a lot of relaxation. 

Evan Brand: Yep. So the toxic thing is just the toxin piece. You know, I think it’s something that we didn’t get into much till the end here. But it is something that would be in our standard workup where we’d be looking for these these kind of hidden, more nuanced root causes. And, you know, just to restate, you could go from referral to referral in the conventional medical world, and you’re never even going to get close to the conversations or information that we just provided you today. 

Dr. Justin Marchegiani: No, I mean, it’s hard. The conventional medical model is a three to five minute visit. They’re just trying to collect just enough symptoms to figure out what drug they’re going to prescribe whether it’s a rosarium or a benzo or an SSRI or what whatever other kind of mini me new drugs that are out there many meaning it’s very similar to an old drug, just the new name, new Patent so they can re up that seven year patents. And that’s kind of how a lot of conventional medicine works. They’re not really diving in deep, they’re not even really thinking about deep root cause mechanisms. They’re just trying to get you to sleep. And it’s sad, but it’s system that we’re in. And I’m glad that we have information like this. It’s out there at your fingertips so you guys can be more informed and take some action to get to the root cause.

Evan Brand: Yeah absolutely. If you need any help please reach out to Justin or myself, his website is JustinHealth.com, my website, EvanBrand.com. And we love that you guys are here with us so more to come.

Dr. Justin Marchegiani: And put your comments down below. We really appreciate you guys listening, and I want to get some interaction about what you think works for you. I read the comments. So when I get feedback, like oh, this worked or that work, it really helps me because, you know, when you see thousands of patients like myself and Evan have, that’s really how you get good. Like when you start off in this field, you get a really good base of physiology and biochem and nutrition, you apply it with yourself and your family and then patients around you. And then you grow as you get more patients and you get more data points. So it’s very helpful. And then if you enjoyed today’s podcast, please leave us a review, we’ll put a link down below where you can click and you can leave us a review on iTunes, we really, really appreciate it. 

Evan Brand: Yeah, share this with all your friends and family on sleep drugs, we can’t legally tell them to get off of it, but we’ll show them a different path. 

Dr. Justin Marchegiani: Yeah, and if you’re on benzos really important, that’s a very, very, very slow taper. So if your doctor decides to take them off fast, be very careful. Sometimes these things have to be tapered over the course of a year. So just be very careful. If you’re on drugs and very dependent. You want to do it responsibly and very slowly with the prescriber as you kind of taper down and as you fix the root underlying issues. 

Evan Brand: Yeah, well said I mean you’ll listen to this podcast you’d be like well screw those drugs I’m stopping! Bad idea don’t do that same thing with like hypertension medications. I mean, we’ve done podcasts on naturally regulating you know blood pressure and some people, Oh my god, these drugs are terrible. I’m getting off of them. You can you could get rebound hypertension Same thing with the sleep drugs, you know, you can have a lot of issues with the GABA receptor I mean being so saturated with the drug and then you just going cold turkey, these are not cold turkey drugs. 

Dr. Justin Marchegiani: Yeah, my general recommendation is get a good foundation, diet, lifestyle, sleep, movement hydration, get that there. Before you go in and ask that prescribed or start dropping the dose slow. So get the foundation right before you make any changes. 

Evan Brand: Yeah I mean look, we want people to be healthy, we want them to be drug-free, if possible. And if that’s our goal ang long term plan, we love it but there’s a time and a place. So just hang in there, i know it sucks, people get so mad. I dont wanna be on this drug! They say that so often but they have to. That’s okay, i’m not judging you, it’s okay if you need it know. Let’s get you healthy.

Dr. Justin Marchegiani: Every now and then I find 1% of people having a hard time getting off of it or just can’t get their sleep right, but I would say 99% people are gonna be able to address significantly and improve their sleep. So stick at it, you have a really high percent, so keep it up and goodluck for everyone listening.

Evan Brand: Yep, absolutely. Well let’s wrap this up. JustinHealth.com for consults around the world, and EvanBrand.com. We look forward to helping you. Take care we’ll talk to you later.

Dr. Justin Marchegiani: Have a good one ya’ll. Bye.




Audio Podcast:  


Can Functional Medicine Manage Headaches? | Podcast #301

In this podcast, together with Evan Brand, we’re going to be talking about functional solutions to headaches. We’ll be looking deeper into what we can do to headache issues. 

Our diet can be the first one to consider and ergonomics to keep our body structures relaxed and align, therefore, maintaining our good posture. But how can these factors connected to headaches? Since many people are experiencing headaches, let’s talk about the things we can work on before we go straight to taking medications. 

Dr. Justin Marchegiani

Dr. Justin Marchegiani

On this episode, we cover:

0:59      Why Headaches Occur

4:27      Diets and Supplements

13:11    Possible Root Causes

18:52    Food Allergies

24:55    On Nutrition and Blood Sugar, Dehydration   

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. I am with Evan brand. Today we’re going to be talking about functional medicine solutions for headaches. Evan, what’s happening, man? How you doing?

Evan Brand: I’m doing really well, we were looking through some little papers here on headaches is a big problem. I remember when I was actually working out of a chiropractor’s office, which feels like a long time ago, and it was a pretty long time ago, there were so many people that would come in there, and they’d have headaches, and the chiropractor would lay the patient down on the table, and he’d do the adjustment and they’d say, Oh, my God, I feel better. But then guess what, they came back next week for the same adjustment for the same headache. And this guy never got to the root cause and then when I started bringing just simple nutritional strategies into the clinic, all of a sudden the people that need the adjustment every week for the headache anymore, and of course, that quickly affected his his bottom line, and he’s like, Hey, stop getting my people off gluten. You’re fixing their headaches, and I thought, Well, isn’t that the goal of what we’re doing here? So now funny little backstory on headaches for me. 

Dr. Justin Marchegiani: It totally I mean, there’s definitely a mechanical structural aspect to headaches. So if the joints in the spine aren’t moving properly, if there’s a subluxation, or a fixation, they’re just not good movement. That can be a problem, right? Especially like if the, the Atlas that c one and C two aren’t moving properly, because your head sits on top of that, that can create a lot of neurological imbalances and muscular imbalances, of course, and then just people sitting all day, right, what does that do, that’s going to just create this forward head posture, and that takes these muscles here and makes them really tight. And then you have a lot of these muscles, they can create trigger point pain referral, up the side of the neck, so like trigger points in the SEM, this muscle here, the sternocleidomastoid, or the upper trapezius, or the give us plenty of capitas muscles in the back that go up and that hit right in the back of the occiput there. These muscles get tight or they have trigger points they can cause referral into the face so you have subluxation joint issues, and then those can cause neurological disturbances. And blood flow issues. And then of course all the trigger point referral from the muscle. So good chiropractic care can be helpful on the structural side. Ideally, you want a chiropractor that one can either do some kind of myofascial release or active release therapy, some kind of a soft tissue or refer out for it. And then also taking a look at the postural stuff like you mentioned, like making sure like I’m at a stand right now so I can stand half my day. I have a really good chair that has really good lumbar and cervical support. So you want to make sure postural is good. You can do good exercises like the foundation training. Eric Goodman does that he does a lot of these the founder exercises like this, I love-

Evan Brand: Cobra training is a game changer for the back. People that are on audio that they’re not seeing him the founder pose is pretty cool. You basically put your arms up like you’re praying to the sun Gods above your head and then you end up bending over and then you open your chest up and then you kind of stand up. It’s a very, very good. Oh, it feels great. 

Dr. Justin Marchegiani: Yeah, basically, it’s just putting stress on that whole posterior chain and working that whole post. exterior side together in unity. So, some structural standpoint soft tissue, make sure joints are moving properly. And then of course, look at the trigger point referral, the adhesions. The problem with chronic muscle pain is you have poor movement, poor movement in the joints means poor communication to the brain. You have lots of postural disturbances and people sitting all day. And if you sit, invest in a good desk, a good good desk as well as a good chair, spend a couple hundred bucks, get a really good chair that has cervical and lumbar support. That’s huge. Don’t don’t get a cheap thing like that. And then also soft tissue chiropractic, and then good exercise support to really make sure that whole posterior chain is working well. 

Evan Brand: So you’re saying the the experience I was witnessing where the chiropractor was adjusting someone that could have been legit in terms of the therapy meaning if someone was sitting on a terrible chair all week, every week they come in Friday for their headache adjustment. The headache goes away for the weekend, and they’re back next week for the headache you’re saying yeah, look Gently that could have been a structural postural thing that he was addressing. But then at the end of the day, maybe it was the the diet piece. Like I mentioned, even just simply getting a lot of these patients off gluten, they noticed that they only had to come in every two weeks or every three weeks. So is it would you then say that the the food allergens were contributing to increased inflammation, maybe triggering these nerves to be more sensitive? Or what do you think the diet? How would that link into the structural components? 

Dr. Justin Marchegiani: Yeah, so the diet is two things right? The diet one increases an environment of inflammation, the more inflamed you get the the the the least amount of blood flow, less blood flow, you get to the muscles, less blood flow, you get to the nerve, so there’s going to be less communication, right? It’s like, it’s like you’re on a microphone and you start to get in your static, right and you start getting static. It’s kind of like that. So if we have a lot of inflammation, what starts to happen is the muscles start becoming more less pliable, more like beef jerky, versus soft and supple. And then that affects the nerves as well because the more inflammation there is that’s going to affect nerve communication. And then of course, the more inflammation there is. And if we have bad posture we don’t move, then the joints can become a little bit stuck, and maybe out of a line or subluxated. So it can aid to the inflammation, which then makes it harder for the muscles to work, thus harder for the joints to work and the nerves to work. That’s number one. And then number two things like gluten have shown to actually decrease blood flow to the brain to the frontal cortex. So you have blood flow up the garden hoses on the side of your neck called the carotid artery. And there’s studies on this talking about gluten decreasing blood flow and and creating inflammation in the brain. So one, it’s going to do it via structural mechanisms of the nerves and muscles and joints. From an inflammation standpoint, structural to it’s going to affect blood flow, and drive up inflammation to the brain which then can create more neurological activation, immune activation in the brain, which can create symptoms. Have head pain there too. 

Evan Brand: So if you want to be smarter and make better decisions, make sure you’re not eating gluten. That sounds pretty convincing to me. Also, let’s get into the nutrient deficiency piece. If you’re eating a meal, let’s say you’re eating pasta and chicken, you’re probably not going to be getting much magnesium. And you’re probably not going to be getting many B vitamins that are going to be essential. Magnesium is probably the most famous mineral for headaches and muscle cramps and things like that. And we could pull it up, but it’s very easy to find in the literature, the link between magnesium deficiency and headaches and of course, the muscle cramping too. So, I mean, that’s an easy one to from the diet perspective. It’s not just the inflammation piece, it’s the absence of the nutrition that you need to help, you know, fuel these these pathways and then also what about like fatty acids? So you know, I remember several people were all we did is give them a high dose omega three couple grams a day and their headaches were gone, just based on adding in some omegas. 

Dr. Justin Marchegiani: Yeah, so there’s a couple other components with headaches, right? So of course, like you’re just highlighting nutrients like your brain needs certain nutrients to run and function. So if you look at a lot of these migraine, these natural migraine supplements, you’ll see a couple of common things. You’ll see like B vitamins, especially like nice and in there, you’ll see things like magnesium in there, you’ll see B six in there, these are really important things. Also koku 10s very important for headaches and migraines. So just from a nutrient standpoint, the more nutrient dense anti inflammatory low toxin your foods are, the more these nutrients are going to be present. Okay. And the other component is, the more refined and processed your foods are usually there’s gonna be okay and then also the fat start fats are also anti inflammatory. So remember, inflammation affects the muscles, the nerves, the joints, and the more of an anti inflammatory environment you create with good fats like you just highlighted, that’s going to help. And the other component is blood sugar. So the more poor diet is, usually there’s more processed food, you’re lacking those nutrients but you’re also typically eating more processed refined carbohydrates and junky fats, which causes your blood sugar to go up and down. And these ebbs and flows of blood sugar, especially on the way down, can really create headache issues. So this reactive hypoglycemia kind of blood sugar issue response can create surges of adrenaline and cortisol and those things can definitely create headaches too.

Evan Brand: Yeah, and that could be it could be shakiness, right. It could be irritability, there could be some mood changes, there could be possibly fuzzy thinking, you know, from a cognitive perspective, too. So people may not connect the dots like oh, I had oatmeal and a banana for breakfast. And now here it is. 10am Three hours later. My blood sugar’s crashing. Not only am I irritable and anxious, but all of a sudden I’m getting a headache. What is it? Is it the fluorescent lights in my cubicle at the office? Which Yes, it could be fluorescent lighting is a big trigger for headaches. So it could be some environmental cause too. Is it the moldy office building you’re sitting in is causing the headache maybe? Or is it simply just a blood sugar crashing and it could be all of it. So that’s the thing that you and I do really a good job at is we try to look at all the variables because if you go to like a conventional doc for a headache, maybe they give you an ibuprofen recommendation, or if it’s bad enough, they’ll give you some type of prescription medication, if it’s to the migraine level, like a topamax or something like that. And then you get stuck on these medications. There’s not really any sort of root cause game plan. But if they referred you out to possibly an allergist, if they thought that your headaches were from an allergy problem, the allergist is likely going to recommend some over the counter anti histamine or some type of drug like that or possibly a prescription. And once again, they’re not addressing any of the root cause stuff and you could have gone to several practitioners and no one brought up magnesium deficiency. No one brought up vitamin D, which is critical. No one brought up getting off gluten, getting off grains, getting rid of potentially nuts and seeds if you have histamine type issues. So it’s just amazing how far you could go down the conventional rabbit hole with this issue and still not even get close to the root cause. 

Dr. Justin Marchegiani: Yeah, that’s the hard part. Like any Functional Medicine world everything’s like three dimensional right? So you have medications that are like anti inflammatory you have SSRI medications that are affecting serotonin or dopamine or adrenaline. I’ve had really great success using amino acids for headaches too. Now, why are there amino acid deficiencies? Usually it’s a combination of stress burning up serotonin, and dopamine, or it’s a combination of not breaking down and digesting good amino acids, right? So you can see amino acids play a very powerful role. I think you also see it with DLP as well. And headaches. These are all amino acids and if we have poor digestion, and we have poor nutrition to begin with, we got one deficiency coming in, but we also have a deficiency on being able to digest assimilate and utilize these nutrients as well. 

Evan Brand: Yeah, so you’re typically going to be using like a complex right, you’re probably not going to spot tree where you’re going to come in with like just the LPA by itself. You may come in with like a, maybe a good quality protein or like collagen or some type of amino acid blend. When you’re talking about amino is correct? 

Dr. Justin Marchegiani: Well, it depends. So if I have organic acid testing showing serotonin and dopamine is off, we may spot those with specific amino acids. And then of course, you got to have B six there with that and those other nutrients in the background. So, of course, we’re going to be doing a good quality multi, and then we’ll be hitting those amino acids up for sure, especially if we have lab data on it. But we’ll be like, we’re never going to go all in on one thing, right? We’re going to do a good history. And then we’re going to make recommendations. Maybe there’s some structural stuff we got to look at, maybe there’s some diet stuff we got to look at, maybe there’s some supplement stuff we have to look at. And we will kind of get a plan for all three of those things going at once. If we see those issues could be active. 

Evan Brand: Yeah, what we do is so fun. It’s not just fun. It’s very effective, because as you mentioned, we’re going to be looking at organic acids testing to try to investigate this issue. We may be looking at stool testing, too, because I know you and I both seen countless times where we’ll see gut inflammation, and that may manifest in terms of headaches too. So gut inflammation is not just Hey, my gut feeling inflamed or irritated? It could be the whole system. You could have headaches, you could have increased fatigue, you could have increased joint pain, and depending on what kind of infections you have, whether it’s I know when I had parasites and H. pylori, I had headaches. Now, what was the mechanism? Well, hard to say. But I would say one mechanism was my digestion was terrible. I had diarrhea, I, you know, you could diagnose me with IBS. That’s what the conventional doctor actually said was, Hey, this is just IBS. Of course, that doesn’t address the infection. So I think that’s one other thing that we should bring up is that if the diet style then we’ve got someone listening saying, hey, look, I’m doing paleo or autoimmune paleo or I’m doing magnesium supplements. My vitamin D is good. I’m off gluten. Why do I still have headaches? Well, you know, then I would look at the gut and then I would look at some of these environmental causes as well because we do know the toxins of various types whether it’s mercury, cadmium, aluminum, any kind of heavy metals, those can affect the brain. Those can affect headaches, mold, toxin, mycotoxins lines. co-infections them opening up a lot of can of worms here, but this is what we do, we try to get all of the potential puzzle pieces and then arrange those in the right order to get you feeling better. 

Dr. Justin Marchegiani: Totally, totally 100% agree. So you got to look at everything kind of get to the roots. The root cause for sure. So very important. So in regards to different headaches, of course, we have like cluster headaches, we have regular headaches, which kind of you know, cause pain in the head, upper neck. Of course we have migraines, which are more going to be extremely painful headaches, right? Usually there’s gonna be more intense, there’s gonna be kind of that open book kind of sensation, maybe you’ll have a little bit of an aura, there’ll be some eye issues more intense. Obviously with women this can be a big issue when there’s ebbs and flows and estrogen in your cycle. Or you can see it premenstrual Lee, especially when there’s a big premature drop and progesterone or inadequate levels of progesterone. You can see it hormonally. So when you have headaches too, if you’re a female listening, make sure you see if you time it up in your cycle if it’s happening at around simulation, we’re at a specific time. Your cycle. Typically it’s gonna be preventively right before you bleed or right at around menstruation there’s probably ebbs and flows with the hormone. So, you know, we may use herbs to help modulate the upstream signaling from the brain to the ovaries. And we may use some specific hormones that kind of buffer out the ebbs and flows. And then of course, we’re trying to get the adrenals and the HPA g t access all better. So those symptoms are going to be less prevalent.

Evan Brand: Yeah, and you’re saying this could be related to the progesterone dropping too much or prematurely that would also then assume that that’s an estrogen dominant situation going on too, right. So maybe something like calcium D glucerate, which we use, not only for mycotoxins and other things that could also help with the hormonal piece and therefore potentially help with headaches. 

Dr. Justin Marchegiani: Yep, that’s correct. 

Evan Brand: Glutathione’s have been very helpful for me. I don’t want to divert too quickly away from the hormonal thing because I think you brought up a big smoking gun for a lot of women. But you know, Glutathione did a lot of good for me when I first was dealing with headaches and it related to toxicity, just two to 300 milligrams a day, and it would significantly help However, if you do too much I know you remember that night I called you I’m like, Hey, I took a double dose of glutathione My head is frickin killing me remember that? Yeah, I was just experimenting and and I messed up and I mobilized too many toxins. So that could be something to talk with your practitioner about as well as, Hey, are you doing binders? Are you doing some type of collation? Are you doing Glutathione because if you’re pushing too much out, that can also overwhelm this detox system, and it’ll result as a headache.

Dr. Justin Marchegiani: Yep. 100%. I don’t love like classifying a lot of these headaches because, okay, whether it’s a cluster headache or attention, headache or a migraine headache, it doesn’t really tell me a lot about the root cause, right? Like someone could have a hormonal issue and could have just a general tension headache while someone else could have like kind of a migraine headache, right. And so it doesn’t tell you like a whole bunch about the root cause. So like, I just kind of when I deal with patients I kind of make a note of what’s going on, I try to connect it to things that are happening day in, day out, like meaning if we see it happen like right after a meal, we may think blood sugar. If we see it happen at things throughout the cycle, it could be if we it could be more hormonally base. If it’s just kind of random. Then I’m going to be asking about physical what’s physical stress look like in regards to posture in regards to muscle tone in regards to seeing a chiropractor in regards to what your office life like is like, when you’re sitting in a chair, like, I’ll try to connect the dots with those things. But the kind of headache you have, for me, doesn’t matter as much, but try to connect it to the onset. For me, that tends to matter a little bit. But even if we can’t really get a big connection there, I just still do all these things that I mentioned and I still get amazing results. 

Evan Brand: Yeah, that’s the fun thing is we kind of fix stuff by accident sometimes meaning we’re going to run you through our protocols and procedures to get a good workup on you and then oh Hey, by the way, look at these major deficiencies and B vitamins. Oh hey, look at these neurotransmitter imbalances. Oh hey, look at the hormones. Oh, hey, look at the gut infections. We need to fix all this and then boom, guess what? The headaches went away. Now I agree with your comment about we don’t really care about where or what the category or classification of the headache is. I would agree except for the occipital, the back of the head headaches because for me that definitely is 100% linked to bartonella which is a type of infection that you can get from fleas. So if you have cats, if you have dogs, if you’re not keeping up with their flea preventatives, and you get a flea on you, they do transmit bartonella mosquitoes, there is some talk about mosquitoes transmitting bartonella. And then, of course, most infamous, are ticks transmitting bartonella. And I can tell you on the back of the head, man, it gets really tender. Unfortunately, I’ve had a lot of issues of bartonella. And I will notice just it’s it’s tender back there and I haven’t really linked it to to anything else. No, maybe it’s structural. Maybe I’m talking to you, right Now and I’m kind of turtle heading forward by accident to make sure I’m talking into the microphone. But I think, I think part nail is definitely a big back of the head. 

Dr. Justin Marchegiani: Yeah, it’s good to know, it’s good to know that’s good to have that history. I mean, you could have back of the head issues, though just from, you know, forehead posture, and then these muscles, these capitas muscles that connect in the back could also get overly tight as well, just from poor posture. So it’s good, it’s good to kind of look at everything right? And then who knows, right? It’s kind of like with gluten, when you have an infection like that it can drive more inflammation, when there’s more inflammation, you’re going to have less blood flow to the muscles, the muscles are going to be less pliable, and they’re more easy to get, you know, taut and tender fibers and develop trigger points because of the inflammation. So everything’s connected, but I think it’s good. You know, it’s something that you add to like kind of your differential diagnosis as a clinician. Okay, good back of the habit. We’ll keep an eye out for co infections. We’ll keep an eye out for these underlying issues as well. I get smart. 

Evan Brand: Do you want to talk about any of the other food allergies I mean, we’ve seen people with like Nightshade issues where peppers tomatoes could cause some issues, potentially headaches. What about dairy? Do you want to talk on those at all? 

Dr. Justin Marchegiani: Yeah, I mean, I see dairy, I see potential nuts and seeds. I see all those things as as a potential driver. It’s unbelievable. Because like having done you know, this job for over a decade and seeing thousands of patients, you have common things that are just like the most common like gluten and dairy right? And blood sugar issues been there. Sometimes there’s just weird things like, okay, eggs, eggs cause a problem. While eggs are a really awesome kind of Paleo Food. You know, it’s sucks that you can’t eat eggs. But eggs are a great food. And that’s crazy that that’s causing your headache. Wow. Okay, so we’ll just keep an eye on that. That’s why, you know, we have a pretty strict elimination diet that we follow in the beginning just to rule out those variables. Because even things that I want that patient to be able to consume, and I’m like, and I wish I could have eggs, but sometimes they can’t. And that can get better over time as we heal the gut. And as the immune system gets better, and the gut gets better, so even that can still be healed over time for sure. 

Evan Brand: Yeah, I don’t know. I don’t know if you remember you and I talking about this, but For a while I was doing avocados like every single day. And then all of a sudden I just had major pressure in my temples. I mean, it was like my head was being squeezed in a vise I thought, oh my god, what is this? So I just went through the diet and started tracking things and discovered it was avocado. So I think I was just doing too much histamine. 

Dr. Justin Marchegiani: Yeah, you have you’ve tired mean stuffing is like chocolates and wines and cheese, right? The tire mean kind of amino acid compound can drive headaches in some people as well. Right? And so that’s where it’s nice to do that kind of investigation. Hey, is it connected to avocados? Is that a food allergy thing? Is it a histamine thing? Right? Could it be a histamine, right? We know headaches. You would think there’s a lot of constriction in the brain vessels, right? with headaches. It’s actually the opposite. There’s a lot of vezo dilation in the brain vessels and things like histamine actually Dr. Faisal dilation that’s why like when you bump your elbow, right, well, there’s a histamine immune response happening Well, does your elbow become more swelled or less well when you bump it or more swelling or Why is that? Because histamine is actually a strong vezo dilator. It opens things up to help get those immune cells in there to go after the inflammation. So, you know, if we see things like histamine being a driving factor, we’ll keep an eye on that. I mean that that’s important to look at. Anything else you want to add about there? 

Evan Brand: Yeah, let me comment on that. So that would explain why. Back in the day when my wife and I first got together, she had major, major headaches, you know, and we were trying to track it through the diet. And at the time, she was using the excedrin which was that pain medication with the caffeine? 

Dr. Justin Marchegiani: Yep, that cause constriction. 

Evan Brand: And that was the only thing that helped her with the headache. And then Luckily, she finally listened to me and we got her off gluten and got her diet dialed in and got her got taken care of and cleaned up all of her personal care products and Hooray, no more headaches. So.

Dr. Justin Marchegiani: Exactly. Exactly. Exactly. So that’s a big thing. So if you’re doing caffeine and you have a headache, could it help? Yes, definitely could help may not be your root cause and it may be A palliative thing, right? But definitely can help.

Evan Brand: On withdrawals too right caffeine withdrawals if you were on a bunch and then tried to get off caffeine that would also cause kind of a rebound headache as well. And then what about blood pressure? For a while, you know, I was noticing blood pressure spikes, and that was directly linked to headaches. I mean, that’s an easy one. If you’re walking around with 145 over 95 or higher as your as your blood pressure and you’re in kind of a stage one or stage two hypertension, that’s a big, big thing. And that’s easy, low hanging fruit to address as long as you can find the root cause of it.

Dr. Justin Marchegiani: Exactly. Yep. So that’s really important to look at. Also, um, just minerals like hydration and minerals are a big thing. I did a big long fast I fasted for two days, and when I was about 36 hours into it, I really had a strong headache like really bad headache. I was doing minerals, I was doing hydration. I was even testing my blood sugar like my blood sugar was around 80 By the way, but I personally Believe I felt an inner tremble and inner bit of jitteriness, so I believe my blood sugar was lifted to 80 by adrenaline and cortisol. So that’s the thing like fasting could create a blood sugar issue may not show on it like I got my keto Mojo, like meter right here. So I was like testing my blood sugar and I’m sitting around at like, that’s not like 60 or 50 like, and I even tested my ketones. My ketones were like around point five to one millimoles so that- 

Evan Brand: -was that was that where you would expect to be or the ketones lower indicating that the body with the stress response kind of kick you out or prevented you from being in a deeper? 

Dr. Justin Marchegiani: I think it kicked me out a little bit because I’m typically at about point five anyway without fasting. So and I tested you know, I tested every now and then I was at point 5.7 last week. Now I keep a very low carb high fat breakfast, right? And I’m typically around point five 2.7 and I was over a day in and I was around point five 2.7 I didn’t see a huge Drop. Now, in two days, I dropped six pounds of weight just from water and not having any anything on my body. So I was losing a lot of weight on that side of the fence. But in general, fasting could potentially be a blood sugar stressor, even if it doesn’t show up on the meter. Because you could have other hormones picking it up. Yes, and adrenaline and then that could potentially cause more issues. neurologically, 

Evan Brand: That’s a super, super good point that 99% of people don’t know. Hey, wait a second. I don’t have a blood sugar problem. But you didn’t see it. You didn’t see that on paper unless you had like a continuous monitor. Right? And then it crashed and then you saw the spike later. That would have been interesting. 

Dr. Justin Marchegiani: Yeah. And I broke my fast with bacon and eggs and within one to two hours, headache gone. 

Evan Brand: Cool. So what do you think I will what what was the magic remedy and the bacon and eggs that cured the headache?

Dr. Justin Marchegiani: Oh, I mean, it’s gonna be nutrition and blood sugar. Yeah. I mean, it’s just stress response if your body isn’t getting nutrition for two days, like actual nutrients, your body’s gonna be like what’s going on here. So there’s gonna be a stress response there, especially when I’m used to having a nutrient dense diet. So just getting lots of good fats, lots of good proteins in there. Just stabilize things out. So that’s why if you’re going too fast, you know, if you’re going to do a fast also, I worked for two days when I fast it. So I generally recommend keeping your fast on non stressful days where you can relax and chill out. That way, you’re not under as much stress. And you’re not because the fast is already a stressor. So you don’t want to add more stress to that. And so ideally, finding days where they aren’t that stressful if you’re going to do a 24 or 36 or 48 hour fast, if not intermittent fast, are probably the best because then you can still get all your nutrients in like a six hour window and still have a lot of that those fasting benefits, which is probably better. It’s more it’s easier to do.

Evan Brand: Yep. And it would be nice if we could get everyone to somewhat of a stable level. have health because since fasting has become kind of a popular, I guess you’d call it a trend. I hate to call it a trend, but I guess it is. You’ve got so many people doing it as a starting place. Like they’ll go from a conventional diet and then they’ll just start doing fasting. It’s like, Ah, you’re already nutrient deprived, you really need to get like healthy with your diet first and then do it. 

Dr. Justin Marchegiani: Yeah, this is 100%. Like, let’s say the average person is eating this many calories, right? And the nutrient levels are here. So I’m kind of making hand gestures, high amount of calories, low amount of nutrients. What’s the easiest first step here is let’s just increase the nutrients right and balance the macros. Like why are we going to cut all the calories, aka nutrients down? If they already have a lot of calories, and they don’t have a lot of nutrients, but doesn’t make sense. It’s not the low hanging fruit. Right? It’s like taking someone who has an exercise in a while and just throwing them into a CrossFit class, but gonna be overly sore, overly achy, and they’re gonna have an aversion to it in the future. 

Evan Brand: That the aversion is key because then they’ll say, Oh, my God, fasting was terrible. It’s like damn, Well, how do you? That’s kind of you got to you got to break that down for me. What do you mean? What were you eating before then? What were your stress levels? Like you said, were you working? Was this on the weekend when you weren’t stressed? What was your blood sugar? Did you did you write before you fasted? Did you do a reset cup? You’re like, I’m gonna have one last piece of cake. And then I’m going to do a three day fast. I mean, what was it.

Dr. Justin Marchegiani: So, I mean, like, my favorite kind of fast day in day out is I’ll have like a simple something kind of fat in the morning and then I won’t eat till like five or 6pm that night. And I’ll just do a little bit of bone broth at night or I in the afternoon. I like just something simple like that kind of rest my tummy for eight to 10 hours have a nice bigger dinner. So if I’m going to go out to eat, I’ll do a lot of that sometimes just so I can get my appetite up. And if I consume a little bit of extra calories at night, it’s okay because I’ll have a little more metabolic flexibility to handle it. 

Evan Brand: We’ll do a all about fasting podcast soon. If you have questions, specific concerns, experiences you want to share about those. Please if you’re watching on Doctor Justin’s YouTube channel, let us know. But we should do a whole thing on that because I think there are good ways and bad ways to do it. I think we have before but it’s always good to do to do updates on those.

Dr. Justin Marchegiani: 100% totally agree. So blood sugar stuff. nutrients, right B6, B vitamins riboflavin, niacin, thionine, herbs, ginger, feverfew, we already talked about magnesium, I think. And then of course, things like five HTP and tyrosine can be really helpful, but again, not for everyone. Those are really good things out of the gates, kokyu 10s, and other important nutrient keeping the inflammation down via some of the bad foods. We chatted about gluten and dairy and refined sugar out of the gates and then look at some of the structural components, you know, is the structural component a root cause thing, or is it or is it an association with other inflammation stuff happening hormonally or in your diet, so you got to connect the two and sometimes you may have two issues you have to address at the same time. You may need to see the chiropractor or the massage or the soft tissue or make the postural changes while you change your diet and do other things. Sometimes you have to do both. So it’s never just like a one off kind of thing. It’s always good to do both, especially if you want results faster.

Evan Brand: Yeah. Yeah, well said just a couple quick things, dehydration, I mean for all my clients out there listening that are doing binders, charcoal and seal lights and clays, whatever else. I mean, when you’re pulling out toxins, we you and I’ve said this a million times we’ll say it a million in one today the solution to pollution is dilution. So aka drink more clean, good filtered water, whether it’s a Berkey or ro with minerals, whatever you can do to get good filtered water, you got to drink, drink, drink, drink, drink, most people are chronically dehydrated. If you and I look at blood work, we’ll see this all the time. And then peppermint lavender essential oils, those are easy, low hanging fruits. I’m not one of those people that thinks the essential oils are going to cure everything. However, there were times in my life where I had miserable headaches and I would do a couple drops of lavender essential oil on my temples and it would help or I would do a little bit on the wrist and breathe it in and that would help or if it was a tummy ache and headache I would do a little topically on the stomach with the peppermint and that reduce the headache. So those things can be helpful too.

Dr. Justin Marchegiani: 100% Yeah, totally appreciate that. So anyone listening to this, try to you know, grab hold of some of the simple actionable information that we kind of outlined off the bat. If this issue has been going on for a while, feel free to reach out to Evan, EvanBrand.com or Justin, got myself, Dr. J. at JustinHealth.com you’ll see scheduled links where you can reach out to both of us we are available worldwide to provide your functional medicine natural health needs. Also, if you guys enjoyed it, share it with friends and family put down below in the comments, your own experiences with headaches and what’s worked and what hasn’t worked, what things that really move the needle for you. And we really appreciate a review and iTunes review from y’all. So EvanBrand.com/iTunes, JustinHealth.com/iTunes for review. That’d be amazing. And anything else you want to leave us with? 

Evan Brand: No, that’s it. You did a great job. Thanks for the conversation. It’s always a blast and we’ll be back next week. 

Dr. Justin Marchegiani: Excellent chat. Give a good one. Take care. Bye.




Audio Podcast:


The Top 5 Causes of Chronic Headaches

Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.

Click here for a consultation with a functional medicine doctor if you are experiencing chronic headaches!

So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.

1. Food Allergens

Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain.  Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.

2. Food Additives.

These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.

3. Blood Sugar Fluctuation.

We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings.  This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.

4. Gut Infections.

Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.

5. Hormonal Issue.

A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues.  That low level of oxygen may also cause some headache issues as well.  Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.

If you have any questions about headaches, please reach out to a functional medicine doctor to find a way to fix your issue.

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