How to Deal with Stress and Feeling Overwhelmed – Functional Medicine Approach | Podcast #380

Let’s get real: there are times when you’re going to feel overwhelmed. Whether with work, school, social obligations or just life, we all feel anxious, overwhelmed, or stressed at some point. In this podcast, Dr. J and Evan discuss that giving yourself grace and patience when you have these feelings is essential as well as your gut health.

Different coping mechanisms work for each person. The following suggestions can help. If one doesn’t work for you, consider trying a different one. The most important thing is to check your diet since what you eat can significantly affect your overall function.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
2:28 – Foundational Physiology
12:51 – Mold and Fight and Flight Response
28:35 – Takeaways

Dr. Justin Marchegiani: Hey guys. It’s Dr. Justin Marchegiani. I’m with Evan Brand today. We are so excited to be back at you with a live podcast. We’re going to be chatting about stress and overwhelm, and how to deal with it. What’s the functional medicine approach? Evan what’s cooking, man? How have you been?

Evan Brand: Oh, really good man. The first thing. Let me make sure my camera looks good. The first thing is like people run to alcohol in modern society, it’s socially acceptable to run to the liquor store, even as a soccer mom, and go buy enough alcohol to just kill your whole family and nobody bats an eye. And that’s like our.Coping mechanism not just as Americans, but other societies too. So I’m hoping today everything people have been through. Overwhelm is huge, man. A lot of people are burned out. A lot of people are frazzled. The stress response is broken. Their fuses are short. They’re nervous systems are stuck in fight or flight. So I was like, man, let’s hit this as a topic because, let me tell you, the pharmaceutical route is nasty too. It’s Gabba like products, but it’s Xanax and lorazepam and all these benzos, which are benzos terrible. They’re addicting.

Dr. Justin Marchegiani: That could be hard to get off. You start at a, you know, 0.25 to 0.5 milligram dose, and then you keep on ratcheting up and then it’s hard to come off it once you start getting really high.

Evan Brand: Now if you saw a VAT of adaptogenic herbs that you and I have consumed in the last decade between us it would be a large VAT of adaptogenic herbs, but that’s what allows us to work hard with sick people and raise children and keep up with animals and wives and houses and all of that. And so for me, that’s my first thing for someone. If I could take someone as a conventional American on the street going to drink alcohol tonight because they’re stressed or overwhelmed. I’m gonna say, hey, instead of reaching for that bottle, reach for the bottle of water or maybe some herbal tea like chamomile if you want. But then let’s hit some adaptogens. Let’s go for maybe some Relora. Let’s hit the passion flower. Let’s hit Rhodiola, let’s hit something that we can do to change the stress response. There’s tons of studies but today’s more free flowing conversation. But if you type in Rhodiola stress, there’s many, many studies done on this and how it literally alleviates the feeling of stress meaning, you and I can’t magically make the stress and overwhelm disappear from someone’s plate. But what we can do is provide their body nutrients so that their brain, their nervous system, doesn’t think that plate is as full as it really is. And that’s the cool thing about these.

Dr. Justin Marchegiani: 100%. So when I look at any type of stress, I always look at the foundational Physiology because if you take someone’s Physiology and you throw it off kilter like for instance the easiest stressor to put someone under acute is acutely is just don’t sleep for a night and then let me just kind of, you know, see you in the morning and list out all my problems and complaints and stressors that you have to then deal with. Well, you’re gonna have problems being able to take that information in and be able to execute. So we have to look at the foundational Physiology. So the first thing is sleep means if you can just get 8 to 10, eight hours of sleep and get to bed on the other side at midnight. That sets your Physiology up in regards to recycling your neurotransmitters having a good healthy cortisol awakening response. That circadian rhythm or cortisol is higher in the morning and lower at night. So then you have this inverse melatonin-Cortisol ratio. Where your cortisol drops at night, your melatonin goes up and then of course, you know, making sure the food is nutrient dense, good proteins as fascinate meal and we’re not overdoing the carbs, what our body needs and it’s anti-inflammatory and we’re stabilizing that blood sugar because people forget one of the biggest stressors on our hormones is that blood sugar fluctuation throughout the day the more this glycemia we have, the more our blood sugar goes up and down, like a roller coaster. We have to make stress hormones to bring it up and then insulin to bring it down, which then causes us to be in a fat storing mode. And so if we can manage your blood sugar, prevent these disc glycemic swings, we can make sure we have good proteins and fats. Stay away from the junkie process, fats, and we manage that blood sugar reading every maybe five hours or so and getting to bed on time. That sets the foundational Physiology and then we can come in there and biohack and add other nutrients and stuff as well.

Evan Brand: Meaning if you’re a vegan, living on date bars and drinking yourself to sleep with wine. Yeah, you gotta stop.

Dr. Justin Marchegiani: Right. Yeah, yeah. I mean, again, like with alcohol, like every now and then is having a little bit of alcohol to kind of distress. Is it OK? Sure. Choose clean organic alcohol, do it after a meal, maybe have some activated charcoal or or some NAC. But that’s like at the end you really want to have the foundational food, the foundational nutrients. Again, if supplementally, the easiest things I’m going to add and I like to stick to nutrients first, so I’m gonna do magnesium. That’s a very kind of sedating, calming, supporting herb. I mean nutrients and minerals. It’s going to have 300 enzymatic roles in the body, anywhere from blood sugar to relaxation, to relaxation in the heart, to vasodilation, to sleep. Very anti-inflammatory in the brain so I love magnesium. You can even do it with a magnesium salt Epsom salt foot bath which is great too. If you have gut issues that help with the absorption you could be doing theanine which is an amino acid that helps upregulate and support healthy GABA levels you can even add-in pharma GABA, maybe a sublingual GABA tablet, that’s excellent as well. So a magnesium, GABA theanine, these are excellent things out of the gate from a nutrient standpoint. Anything else nutritionally you want to highlight?

Evan Brand: Well, I told you, I was texting you over the weekend. I got hit with something luckily I’m back in action. But my resting heart rate was pretty fast, so my nervous system was just kind of boom, boom, pumping, responding to whatever type of sickness I had. And so that kept me up. So I took some motherwort as you know, motherwort is one of my favorite herbs, because it’s great for the heart. We use it for A-fib, we use it for atrial flutter or any kind of heart palpitation type symptoms. It’s amazing, it’s calming that, but it’s great it’s calming emotional stress too. So if you’re overwhelmed, if you’re frazzled, if you’re even getting to the point where you’re like.I’m going to have a mental breakdown. I’m gonna have a panic attack. Somebody put me on some kind of drug. A lot of times psychiatrists will prescribe antipsychotic medications, which are not the answer. They’re not the root cause at all, but motherwort can really calm you. So it’s an emotional support and it’s a heart nervous system support and it’s great if you wake up in the middle of the night and you can’t get back to sleep. Take a little squirt, go lay back down. It’s amazing. Doesn’t taste great, but it works amazing. So I would rate that as more potent than something like theanine.

Dr. Justin Marchegiani: Yep. And then also um ashwagandha I find to be very helpful as well. I’ll take that before bed if I need to, I’ll typically do a magnesium before bed. Ashwagandha can be really good, especially if you’re stressed because that’s going to help modulate the high cortisol, but also can help bring up any of the low cortisol as well, so ashwagandha is excellent. You can easily combine that with the Rhodiola. Two things like ginseng tend to be a little more stimulating so things like ashwagandha are going to be great and even phosphorylated serine. Serine can be very common. What serine does? It sensitizes the receptor sites on the hypothalamus to cortisol. So there’s this natural feedback loop of cortisol circulating in the body. It binds to receptor sites in the brain and the brain is like, whoa, this is a little bit high, let, let’s kind of calm down that cortisol secretion so it helps regulate that cortisol from getting too high, so phosphorylated serines are excellent. PhosphatidylSerine is kind of 1 electron. It’s one step in the enzymatic process backwards. So phosphorylated it’s better because it’s a little bit more activated and activated state. So that’s excellent.

Evan Brand: Man, I’ve been looking at some papers on mold toxicity and melatonin. So mold actually does a couple things. That’s crazy. If you type in mycotoxins, dopamine, you can find papers saying that mycotoxins damage the part of the brain that makes dopamine, so then you’re less likely to have energy and focus and concentration. So I’m sure that brain fog increases your stress and overwhelms you because you feel like you’re less capable of being a parent, being a boss, whatever you got to do at work. So, that’s one impact of mycotoxins and then also it’s reducing melatonin. So, I know when I was out of my house, we were staying in a hotel for like six weeks with the kids. It was crazy, but I didn’t sleep. I mean, it took me 3 different hotel rooms to find one where I could sleep and I just, I’m assuming now it was a mycotoxin issue, screwing up my sleep. I’m sure I was stressed from being out of my house. I mean that was years ago now. But I look back at that time and I go, Oh my God, anytime I’m exposed to mold, like in a hotel, I just don’t sleep. And then the research proves that. So my advice is if someone is dependent upon medication and herbs, a supplement for sleeping. If you are sleep deprived, the first thing you mentioned is the foundation. If you are sleep deprived and that’s creating stress, well, what’s your environment look like? Do you have good air purification? Do you have dehumidifiers? Do you have a mold problem? Do you have water leaks? Are you living in a moldy apt, a condo or townhome? It has water damage because if so even the most perfect supplement protocol can’t counteract us, so you may need to take steps to investigate your air quality, like some Petri dishes. And maybe there’s something there. Maybe when you get out of there, you sleep better. That’s a good clue that you’re onto something.

Dr. Justin Marchegiani: Yeah. The problem is most people, they have issues and they take action, but they’re still kind of anxious about what’s going on. So it’s really important. Action should help with the anxiety. Like the reason why anxiety is there from an evolutionary standpoint is to get you to take action to avoid, I don’t know if there’s someone gotten that woods. Last month they got eaten by a bear. Well, yeah, when you get near that woods you should be anxious because your body’s hardwired and make you more alert so you don’t get eaten by that bear. So you have to understand where the anxiety is coming from and as long as you’re taking actions. And you’re closing the loop, so to speak, on what that anxiety is coming from. You should feel better about it. And so I always say whatever the anxieties are, just try to have one or two solutions for each one of those. Then your brain knows, hey, I’m doing something about it, I can turn down that stress response because action are already being taken. So think about that as well. And then also like you mentioned, hey, if I have, if I’m uncertain about my environment, let’s get that mole test. If the mold test is positive, let’s do at least one thing to make sure that the environment gets better. Are there active leaks? Do I see water stains on the ceiling? Is there a chronic high level of humidity? Let’s work on that.If not, we can always just get in some good air filtration. We can work on fog in that area, make sure there’s no active leaks coming in. Then we’re, you know, getting a dehumidifier in there. We’re taking active steps. So you shouldn’t feel as anxious about that environment because you’re starting to make it healthier.

Evan Brand: And people say, what the heck are they talking about molds for on a podcast about stress and overwhelm? Well, here’s the mechanism. Your immune system responds to the mold as a threat, and it is a subconscious threat, meaning you Evan, or you Justin sitting here, you might think, OK, I’m not very stressed right now, like, I’m having a good time, this is great. But your nervous system subconsciously is running all these programs that are saying, hey, look, there’s actually a toxin in this room I’m responding to. And so you’re amygdala, your fighter flight system, part of your limbic system sends out an alert. Danger, danger, danger. And you may not even know it. So you could be sitting here on your couch, anxious for no reason. And it’s your limbic system. And many, many people report when they improve their air quality. They can settle down. So that’s the mechanism. I want people to understand when you think overwhelm you think just emotions in your head. But no, these external factors, these external toxins and variables can impact you. I mean, what about a bad neighbor? What about every time you see your neighbor’s car pull up, you’re like, Oh my God, there’s John again. And John stresses you out every time he pulls in the driveway because you guys got in an argument, so, you have to.Integrate some four of, I would say trauma release into all of this too. So you and I are big fans of tapping. So I would say if you’re catching yourself in these loops, you mentioned closing, closing the loop, which I think is smart but if you’re stuck in a loop well maybe you could integrate some tapping to pull you out of that. So tapping is basically acupuncture, but without the needles. You tap these points and then you say an affirmation. You know, I’ve done that many, many times here.

Dr. Justin Marchegiani: I think it’s very good. Kind of helps calm down the nervous system response. There’s different programs out there. I’ll put some links down below like there’s DNRS or the Gupta program. These are excellent programs that involve visualization, maybe some aspects of NLP. You really work on controlling the thoughts and the images in your brain, whether you do tapping or eye movement like EM DRI movement, desensitization, response techniques, these things help calm down that fight or flight response and then you kind of allow you to be using more of your frontal brain because the data is when you’re in this chronic stressed out state, the amygdala right that. That forebrain or that hindbrain is kind of more active, that’s the prehistoric brain that is involved in fight flight and that fear response. And so most people are all working from this reptilian brain versus that frontal cortex that involves thinking and looking at your options and coming up with solutions and problem solving and predicting outcomes based on where you’re at, right. We need that frontal brain. But if we’re using our reptilian brain right, then that’s gonna be activated with a lot of these stressors. And so one study right here, I’m looking at, I’ll pull it up here and we can talk about it. I think that kind of supports what you’re saying regarding mold and this fight or flight response, being a big deal. So this one study here was looking at mold inhalation causes an innate immune activation, neural cognitive and emotional dysfunction. And they were talking about intranasally administering different, you know, this is black mold Stachybotrys. And they were looking at, you know, innate immune activation, toxic mold and how it affects your emotions. And of course it’s going to impact inflammation. It’s going to cause joint pain. It’s gonna cause sleep issues. You mentioned earlier, it also has a major effect on dopamine. Can you highlight that again?

Evan Brand: Yeah. Dual control F is dopamine in that paper. It might be a different paper. See if you can find it.

Dr. Justin Marchegiani: Yeah, here you go. So exposing drosophila to 0.5 mil part per million of this chemical causes significant loss of dopamine neurons. So decreased dopamine levels and initiated onset of Parkinson’s, suggesting that exposure to mold produces the chemical that may be another environmental risk factor for Parkinson’s disease. So dopamine is really important for feeling good, for focusing, for dealing with stress. It’s that neurotransmitter that gives you that kind of connection that makes you feel loved, so really, really important and it talks about long term inflammation following mold exposure and autoimmune changes in the brain. So that’s that’s powerful.

Evan Brand: Yeah, this is huge. Uh, trying to get Dale Bredesen on the podcast, he wrote a book called the End of Alzheimer’s. And now he’s really hitting the mold angle as an Alzheimer’s link. I think it’s a huge piece of the puzzle. That and heavy metals but many people may hear this and they may just glaze over what we’re seeing. We’re literally saying that your environment could be contributing to a neurodegenerative disease where your neurologist is not going to have a clue. They’re not going to be testing you for this stuff. They’re not going to ask you about your water leak under your kitchen sink. They’re not going to be running mycotoxins in the urine, they’re not gonna look at the Great Plains or organic acids test. So in terms of. We’ll talk about testing in a second, but I think we should describe to people, how do you know if you’re in a state of overwhelm? Because many people are so used to living in fight or flight that they don’t really know how to downshift. So maybe we should go through symptoms, I will say inability to make decisions or analysis paralysis, like, if you’re struggling just to decide what to make for dinner, or you’re struggling just to decide what to do tomorrow, that’s that’s a huge problem. You can’t comprehend simple decision making, I would say loss of libido, loss of energy, motivation, sleep disturbance, maybe some sugar cravings, brain fog, anxiety, I would say distractibility or escapism, meaning you’re always jumping from like social media app to social media app. Like you just don’t want to live in your reality because you’re in a state of overwhelmed, that’s like escapism. What else would you add to the list?

Dr. Justin Marchegiani: Like, well, I would say it just depends where someone’s at, right? If someones going into an acute exposure or an acute stressor and they have a good foundation. That’s a good, that’s good because a good foundation you know allows you to deal with and adapt to stress. So I always look at it’s always good to model healthy people. So you work on the water, you work on the food, the blood sugar, the good fats, the good proteins, the sleep before midnight, getting enough movement so you feel energized but not tired. That’s a foundation. And then if the stressor comes into your world like mold, right? In this study, they talk about not just mold, but pesticide exposure, smoking. Right. So basically I’m looking at air and living quality. So the first thing I’m going to do is I’m going to just cross things off my list. I’m gonna get a mold test from my house, whether it’s a plate test or an army test. I’m going to make sure I have good quality air filtration because even at my home there is no mold. You’re going to still have some off gassing of some furniture or paint or carpet or hardwoods or professional grade vinyl. There’s something in your air that’s gonna be more stressful and so you want to make sure you have a good quality air filter. Whether it’s an Austin air or an air doctor, you’re going to want to make sure your water is filtered and clean, and then you want to make sure if you’re in a human environment, you know, get a dehumidifier for your home and keep the humidity below 50%. I think that’s really key out of the gate.

Evan Brand: Yeah, yeah. What other symptoms do you think somebody would experience if they were in a state of overwhelm? Well, it depends. I mean, chronic overwhelm can just happen by having a lot of open loops on someone’s plate, a lot of stressors that are in your environment, emotional stressors, and you’re not taking action on them and now you have 2, 3, 4, 5. And so your body is going to cause you to get really anxious, really stressed and really overwhelmed because you’re not closing the loops. And so I just look at what are the top three things that are stressing you out from an emotional stress thing you haven’t taken action on. Just pull out your phone or paper and just write down what they are and write down A&B options for each one. And then say OK, good, I got them down and I’m gonna execute it when the time’s right, but I can at least put that to bed. And so that’s a really important thing. It’s kind of like that. Just trying to think of one situation. We had a, you know, mold issue in my home and it was like, OK, took action on it, got the remediation person out, got the air filtration, did it the right way, did in a negative air containment. Make sure we test it like.I just, I took action. But, you know, when I knew this problem, this environmental stressor was there, it was stressing me out because of all the unknown, right? And so I just said, I’m going to take action. I’m going to handle it the best way possible. I’m going to make sure we test, I’m going to make sure we clean it out. And I felt a lot better about it. But the more you leave these things open, it just kind of gnaws at you quite a bit.

Evan Brand: Yeah, I mean, this applies to the debt too, right? A bill here, a medical debt here, a debt here on the car and then the car is going back like, so those things, you got to try to chip away at those too, I mean, this is in the financial podcast, but I would tell people try to knock out your smallest debts. Because if you’ve got like this bill and this card and that card and that debt, like that really weighs you down emotionally. And I see it all the time with people. It’s a huge piece of the stress. So like if you’ve got a credit card. Let’s say you’ve got an Amazon or Target credit card with 500 bucks. Like knock that one out first and then go to your $5000. One, like you have to chip away at these things.

Dr. Justin Marchegiani: Yeah, I mean, I think biggest thing out of the gate, I mean you can look at some of the Dave Ramsey stuff on that, but if you use a credit card or not, like I use credit cards because they get 2% back on everything, right? So it’s like, OK, I’m gonna get paid 2% for using it. Sure, I’ll use it. The difference is I pay my credit card off every day. And the reason why I do that is running a business and doing all these things. There’s lots of expenses and one if I have hundreds of transactions at the end of the week.What if there’s fraud? What if there’s issues? At least I can see it every day and then I can also monitor it. I can have my pulse on what’s where money’s going in and out. And so it makes me feel on top of it. And I would say just from a stress standpoint, financially, you know, three to six months of living expenses, I think is a good one to have in savings at all times. So if any issues happen, you have that to lean back on too many people. I think you don’t have that three to six month buffer. I think that can be a big stressful thing. That’s just kind of in the background for sure.

Evan Brand: Yeah so even some of I think it was Shaq or someone I saw it’s been some, I think it was Shaq or someone I saw recently an interview, some extremely high level millionaire was saying that every day they still look at the numbers, they still check their numbers, the bills, where the moneys going, where the credit is, where the debt is, they still look at it even though they could buy anything in the world, they still take a look. So if you’re just out of the loop on, that’s a big problem.

Dr. Justin Marchegiani: And with phone apps, you know you can jump on it and you can finalize it and look at it in about one or two minutes. The more you kind of have your pulse on things, the better. I think it’s really good and then you know you could talk about all the inflation that’s happening. That’s a whole different strategy in regards to investment and such like that that you know we do a lot of things on the investing side as well. But I think the biggest thing is to have about three to six months and just be on top of income coming in and expenses going out. So you have your pulse on it.That allows you to pivot and make changes.

Evan Brand: Yep. So that’s the financial piece, to try to get that buffer. The environmental piece, try to have a good clean Oasis where you can properly sleep, your nervous system can calm down.

Dr. Justin Marchegiani: I think a couple of good air filters. Couple of good air filters. Get your home tested. Even if you just get a couple of the plates and you just wait five or seven days and count the spores and make sure the spores are under five or so, that’s fine. You can avoid setting it to the lab that is more than five, then we definitely want to send it to the lab. Um, you know, take a look at your ceilings. Go walk around, make sure you don’t see any spots on your ceiling. You know, go hire someone to come out once a year and just do a roof inspection. Just make sure your roof looks good. Go take a peek in your attic right, get a moisture meter and just kind of test the walls out a little bit and make sure everything looks good there. You know, those are all good simple things you can do out of the gates.

Evan Brand: Keep the exhaust fan on if you’re gonna take a hot shower. I’ve seen many, many people have issues with that just because of that hot steam of 2020 minutes or however long the shower you’re taking, all that steams.Gotta go somewhere. So if you’re not sucking it out with an exhaust vent, it’s gonna have to soak into that drywall so that paper backing on that drywall can get real moist. We see that as a huge problem area.

Dr. Justin Marchegiani: Yep. Or even just get a dehumidifier for your bath or even just a portable one. That’s a big one. If you don’t have an exhaust fan and you get a portable dehumidifier and just keep it on to at least pull that moisture out of the air and think that’s important.

Evan Brand: Yeah, absolutely.

Dr. Justin Marchegiani: And then I would say, I would say message. Get body work done, whether it’s chiropractic, that very coming on your nervous system, having your spine adjusted, that’s where your central nervous system flows from your brain down the spine, making sure your spine and your vertebrae are moving. Make sure soft tissue is doing well, those good pliability in that soft tissue. Making sure that fascia is being manipulated. Myofascial release different things to help that fashion that connective tissue stay soft and supple like a tenderloin versus harden and flame like beef jerky. Chiropractic, I think it’s powerful as well just to make sure all the joints in your hips are moving your upper cervical spine. Really important that that’s all kind of dialed in as well. All these are all really important things that can calm down that nervous system and inhibit the IML, the intermedial, I think it’s the intermedial cell column that kind of stimulates that fight or flight nervous system.

Evan Brand: Turn your screen share off. That way I can see your figure. Yeah, the message is huge. I went to get a massage a couple weeks ago and the ladies like, yeah, we’re all fragrance free. And I went in there and my God, I left smelling like a dryer sheet. Like my wife is ready to kick me out of the car on the way home. She’s like, you reek. And so I guess they’re, they’re sheets at the massage studio just had driver seats on them or something. So that was a stressor for me because here I am going to do something good like call my system and then I leave smelling like a dryer sheet. So double check the head.

Dr. Justin Marchegiani: The best thing you can do, and I told you about it too, the best thing you can do is the cheapest thing is to get washed soda, which is basically baking soda for your washing machine. And then what you do is you do your wash and then you put like a 30 minute soak on there. Or one hour or soak you could do 30 minutes, right? Put a cup of the wash soda in there so you know it’ll sit for 30 minutes. The baking soda absorbs any smell, any stink. I had a little lemon shirt that was moldy. It was so bad because it got washed and then it sat there for a couple of days and it got moldy and the washer, I couldn’t get it out. I washed it like a dozen times. My mom comes into town, she’s like, oh, here, it’s just, it’s an Italian trick here and she will put the arm and hammer in there, do an hour soak, and it literally kills it. It felt brand new and I had washed it dozens of times wiith all these essential oils and anti mold uh, shampoos couldn’t touch the smell. So wash soda, especially if you’re sensitive. Use that to suck all the smell out of what’s in your detergent or anything else. And I’ll use just like the free and clear, no sense. I’m like Evan. I’m very, very sensitive to smell. Just really. It’s really ready to shop there for me, man.

Evan Brand: It was my skin though. My skin ripped. I had to take like 2-3 showers. I still smell. Maybe I should, like, scrub myself with baking soda. It was nice. It was like impregnated into my skin, man.

Dr. Justin Marchegiani: I don’t know what it is, but there’s like a I think it’s like I’m not sure if it’s younger woman today, but it’s like it’s like my parents generation that group wore at least the females a lot of perfume. Like you could literally be 15 feet away from someone and you could smell their perfume, it’s definitely changed. Like my wife’s generation, right, women in their 30s and 40s, there’s a less perfume smell. I think people are using more essential oils and natural things, but it’s funny how generations change how much perfume to last more and but I’m super sensitive to perfumes. We try to keep zero in our home and if we do anything, it’s like an essential oil or like a lavender or like a little bit of cedar or kind of rose. Those kinds of things keep it simple.

Evan Brand: We could hit the smells for a minute too. That is a stress to the system. It’s a big stressor, yeah, especially if you’re burning it. So, like candles, throw them away. If they’re not essential oil based, it’s just garbage.

Dr. Justin Marchegiani: Dryer sheets. Throw dryer sheets away. If you want to get the benefit of dryer sheets, you can get one of those static balls. Just put it in there.It’s like a little ball that knocks the static down. That’s the purpose of dryer sheets mostly, right? But then you don’t have all that scent and smell, so that’s a good way to kind of mitigate the stress from that.

Evan Brand: Yeah, we hit the blood sugar, the sleep, the environment, the smells, the finances, I mean, those are a lot of pieces of overwhelm, really. What else are we missing?

Dr. Justin Marchegiani: Yeah, I mean, I just think, you know, close those loops. Look at what’s on your plate for stressors, what’s bugging you out, what pops into your head. Be on top of that. Also monitor that self talk. Most people, if you look at how you talk to yourself, that inner voice. right? Behind your head that you hear. Most people would not be friends with a person that spoke the same way as their inner voice. So make sure you really upgrade the quality of your inner voice. Having that inner voice really gives you guidance, intuition. But also don’t beat yourself up. I think it’s super important. There was no Anthony Robbins quote that was really important as well. It’s like, you’re going to do so many things right in the day, so many things you’re gonna do right and well. And you gotta give yourself a pat on the back. Because if you’re not watching yourself succeeding and then giving yourself that congratulations to that PAT in the back and you’re looking for your kids or your spouse or your friend to do it all the time, they’re not going to see enough of it. So really make sure you’re catching yourself doing a lot of the good things and pat yourself on the back for it. And you know, take your wins whenever you can take your wins.

Evan Brand: Yeah, no, that’s great advice. The rumination, right this negative self-talk, ruminating about your problems, thinking about your past, the things you did wrong, living with regret. Those are big problems. So someone told me years ago,

Dr. Justin Marchegiani: I want to hit that. It’s really important. So the rumination, I find serotonin and acetylcysteine plays major major role that sulfur and serotonin for me I used to be a little more OCD and ruminating and getting my NAC up and getting my serotonin levels up five HTP and B6 really help rumination. It allowed me to kind of like OK that that’s the issue and then allowed me to disconnect from it and and then just kind of focus on what the next thing is and not have to be playing the loop on repeat all the time, which is very stressful.

Evan Brand: Oh yeah, it’s huge. So people don’t understand that. They think once again negative self-talk, they think rumination they think .We’re talking about these emotional things, but no, we’re actually talking biochemistry. We’re talking neurotransmitters also. So what I was going to say is someone told me years ago, if you want to get out of your head to get into your body. So that’s what I do a lot of. If the weather is decent enough, I’m out there on the mountain bike, I’m out in the woods, I’m hiking, I’m biking and moving among the water. I’m doing something to get out of the head by getting in my body. So do that, and then the testing. Let’s talk about that, because you brought up serotonin and then overwhelmed.

Dr. Justin Marchegiani: Oh, go. Go ahead, go ahead. Hit that part. One more thing that you brought up, I wanna hit it too.

Evan Brand: OK, don’t forget. So if you’re overwhelmed, I would say do the following. Get the urine test, urine done at home. You can order it through our office. If you need help, reach out to Doctor J at justinhealth.com or Evan Brand on evanbrand.com. Let us help you order these at home from the Functional Medicine Lab so we can investigate the cause of this overwhelmed because there could be internal toxins. There could be pesticides, mycotoxins, bacterial overgrowth, parasites, worms, H. pylori, gut inflammation, brain inflammation, low neurotransmitters, nutrient deficiencies, all combining to create these emotional issues. So get the oh, we may want to look at stool, we may want to look at chemicals. But reach out and then we can help you develop a plan to figure this out.

Dr. Justin Marchegiani: Really important one last thing I wanted to highlight too is appreciation. Because most of the time when you’re overwhelmed, you’re thinking about what’s missing in your life or you’re thinking about this problem that you have to address and you’re like, I don’t know what, do I have time to do this? So you’re thinking about this expense that you’re thinking about things that you’re you’re missing or things that you have to expand or you have to lose, but when you appreciate your focusing on all the things that you have and you’re really trying to create context for that and really feeling that sense of gratitude and appreciation and appreciate essentially like if your finances appreciated, if your investments appreciate, they get greater, they get bigger. So you’re taking everything in your life and you’re feeling that sense of gratitude, making everything bigger in your life in regards to how you feel about it and how appreciative you are and having a perspective of, you know, if you live in the United States like you’re, you’re a one percenter just living in the United States, right? I mean I think it’s if you make $19,000 a year, right, which is poverty in this country. You’re 1% in the world. It’s like, whoa. That’s like, that’s perspective, right? Perspective also gives you appreciation.

Evan Brand: Yeah, I mean, I can have dark humor with my grandparents. Like my grandma called me the other day. Apparently my grandpa hit a curb and busted a tire. They were without their car, then the tires on backorder. Nobody has that size in stock. And I was like, well, it’s better than being dead and she’s like, you’re right, you’re right. I’m gonna enjoy this. This is fun. We’re gonna get a rental car. It’s no problem. And so I just tell her all the time, you know, if there’s a complaint, like, at least you’re not dead because, you know, her relatives have disappeared. And you know, she’s one of the last women standing elf, that generation, you know, from the 40s. So I’m like grandma, like, enjoy it, you’re alive. This is amazing. And usually it kind of snaps her out of the funk.

Dr. Justin Marchegiani: Yeah, appreciation is important, right? Because usually you’re just focused on all the things that are going wrong and you’re just flipping that switch. And if you look at NLP and kind of the work of Richard Bandler, he is a really interesting guy, but he would always take a look at successful people and he talked to them. He’d want to know what’s the image in your head when you’re in this peak state and you’re succeeding and you’re doing well, what are the images in your brain look like at the time? Meaning like, what are you thinking of? What’s the picture real in your brain look like when you’re achieving and doing these things? And almost always it’s in the positive, almost always it’s showing in visualizing the outcome and you’re already seeing it happen multiple times already before you actually do it. And versus it’s the negative, it’s the worst case scenario. So really be aware of the picture screen on your brain almost like go within, pretend like you’re in a movie theater and you’re literally seeing the picture screen, which is what you’re seeing through your eyes. And then you’re really changing that screen. Like you’re the director directing that movie screen while you’re seeing it in the movie theater through your eyes. Does that make sense?

Evan Brand: It does. It does to me because I do it all the time. I’m always trying to visualize the outcome. This has already happened. The person I want to say yes, already said yes. What I needed? It’s already here. Even though I don’t have it yet, I’ve already got it. And that goes a long way.

Dr. Justin Marchegiani: And then also pretend like if you’re there in that movie theater inside your brain, remember you have control over that. If it’s in a bad space and you’re just all negative and you’re just looking at everything the wrong way, you can just put a new movie in, right? You’re not a victim, you’re not sitting there chained down like Clockwork Orange, right where they peeled the guys eyes open, right? It’s like you have control over what you’re watching, so put a different film in there.

Evan Brand: Yeah, the last thing I would say is just take a nap. Like if you’re just so overwhelmed the middle of the day hits, you’ve got fatigue that can also be overwhelming because you’re so tired. You have so many obligations you’re trying to do, but you’re so fatigued. Number one, get the labs run so we could figure out why you’re so damn tired on paper will,

Dr. Justin Marchegiani: Your adrenals looked at, yeah. See how stressed out there do you have that chronic low DHEA? Are your neurotransmitters VMA, HVA, 5-hydroxy, indoleacetic? Are they all depleted and down? Because this could take a while to get this thing repleted.

Evan Brand: Yeah. So if you’re feeling that, get the data then. If you gotta close your eyes for a minute, close your eyes, lay there and take a nap. If you can do it, if your lifestyle allows you to take a nap, escape from the kids, whatever you gotta do, do it. And hopefully you’ll come back a little more refreshed, a little more in control when you’re not so exhausted.

Dr. Justin Marchegiani: And when your neurochemistry is depleted, it’s really hard to willpower out, willpower that. And so sometimes, yeah, they get the food and the supplements on track and then it’s like then the willpower and then the energy and then the ability to now start doing the things you need to do is start to become easier, there’s less resistant to get this downhill kind of momentum, so that’s very important. And again, looking at the adrenals, looking at the neurotransmitters, looking at your DHEA sulfate, looking at your circadian rhythm, right, that circadian rhythm should should go up in the morning and down at night, and the more dysregulated that is if it’s reversed or flat, that tells me that stress feedback loop is disrupted and you’re probably using that amygdala in that brain stem. You’re operating more from that fight or flight state all the time.

Evan Brand: Yeah, that makes sense if you need help, reach out. You can reach Doctor J at justinhealth.com worldwide consult meaning labs can be sent to your door. Wherever you are. You get the results. Look at them, make a protocol, get yourself better. So justinhealth.com for Doctor J and myself Evan at evanbrand.com. We look forward to helping you guys, and hopefully this content was helpful. Share it with your friends, your family. If we can get somebody else out of the whole, that’s what we love. I mean, it just takes one person that could totally transform your life. This is your husband you’re trying to get out of, overwhelm your wife. Have them listen to this so we can help lift them up because it’s gonna make your life way better.

Dr. Justin Marchegiani: Yeah, just pick one thing. If you’re overwhelmed already and you’re like, crap, he just said 15 things, just pick one, like what’s the easiest thing that you can do? And then once you get some momentum, then we’re gonna go to two and then we’re gonna go to three. So just start kind of stacking and get that momentum and then you get that downward momentum going. Then it starts to be easier to add new modalities to the mix.

Evan Brand: Yep, Amen.

Dr. Justin Marchegiani: Excellent. Alright man, great chatting with you Evan and hope everyone listening enjoyed it. Feel free to share with friends or family. We’ll put a link down below where you can review us. We really appreciate a review on both our iTunes channels. Super helpful. It’s the word out there and you guys have a phenomenal day.Take care of y’all.

How to Deal With Stress and Feeling Overwhelmed? | Podcast #376

Connections between the brain and gut abound, which can be seen in the dysfunctions that often unite them. Many neurological and mood disorders often have enteric manifestations, GI disorders may present with neurological and psychiatric symptoms, and psychological stress may adversely impact microbiome balance and GI function.

Dr. J and Evan Brand discuss that consideration of the bidirectional relationship of the gut-brain axis will inform individual treatment strategies. Managing external stress-related factors while optimizing gut health may jointly address some chronic health conditions. Specifically, personalized therapeutic strategies that combine stress transformation approaches with gut health interventions, such as functional testing, nutrition, and natural supplements, may help to optimize gut function and bolster related body systems. Learn more about supporting the microbiome and its effect on overall health when you subscribe to this channel!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
0:46 – Stress
6:41 – Brain Chemistry
7:51 – Water Filtration and Organic Foods
13:56 – Cortisol Patterns
23:13 – Stress and Hormones
30:00 – Testing and Functional Strategies

Dr. Justin Marchegiani: And we are live. It’s doctor J here in the house with Evan Brand. Really excited. We are back doing our live podcast. Really excited to be back in the saddle. Evan, how we doing, man? What’s going on?

Evan Brand: Oh, doing really well. I’m excited to talk about stress. My wife, she woke up this morning.Which is like my jaws tight was like grinding my teeth last night and maybe you need to talk about that today. So I thought, OK, everyone is stressed, there’s a lot on everyone’s plate, but it’s really how you respond to it that really determines whether it makes you and you become someone and something and you get success out of your stress. Or do you just get frazzled and burned out and you resort to alcohol and tobacco and other addictions, chocolate and wine and whatever else to cope with that? And I think there’s a lot healthier coping mechanisms or stress for burnout, for feelings of overwhelm. And you and I have done this for years clinically. We’ve helped people through the toughest of cases. You and I have taken the huge load on our shoulders of, you know, trying to be the helper, be the healer with someone that’s struggling. And that’s a lot, that’s a heavy toll on us. So there’s things that you and I do personally. And then there’s things that you and I do clinically and then we’ve got some studies to kind of verify you know, what we’re seeing.

Dr. Justin Marchegiani: 100% So when I look at stress.You have the actual stress issue, like whatever that stress issue is, right? And so feeling anxious or feeling stressed about an issue is a good thing, right? Part of the reason that is there is to get you motivated to get off your butt to solve the problem. So I always look at the issue and I’m like. Right. Why do I feel stressed? Usually there’s you haven’t closed the loop yet. I call it closing the loops. Problem, right? You take action to resolve the problem, the problem goes away. That’s the closed loop, right? And so you have a lot of people with open loops. Meaning they have a problem out there and they just haven’t even figured out the solution. So when it comes to being healthy and having good neurotransmitters, good adrenal function, good healthy diet and lifestyle habits, good anti-inflammatory type of environment, nutrient dense foods coming in. Good nutrition, your ability to process one that stressor when it hits you, it’s not gonna hit you as hard. It’s not gonna knock you off your pedestal to you’re going to be able to adapt and you’re going to be able to think clearly and troubleshoot whatever the issue is. And so I always look at a problem. I said OK, got it, how do I close the loop on that, what’s the action item to execute? That so I always just kind of get clear, have a list. What are the things I can do and set in motion to resolve the issue. I think it’s really important if you just dust it away. The healthiest adrenal glands eventually is gonna eat away at you because you haven’t closed the loop. So always think about closing the loop on your issues #2 get healthier so these things don’t bug you as much, right? If you have good levels of B6, good levels of magnesium, you’re sleeping adequately, you have good blood sugar stability, Good amino acids. It’s gonna allow you to be able to process it. You’re not gonna activate that fight or flight part of your nervous system. That shuts down the frontal cortex and activates the reptilian brain stem part of the brain that’s all about fight or flee, fight or flee, fight or flee. And so the more you can keep this kind of reptilian brain from being activated, and then you can use that frontal cortex, you’ll be able to sit back, become troubleshoot the issue and close the loop.

Evan Brand: And this is hard if you’ve got toxins, if you’ve got lyme, different infections. I mean we’ve seen in the literature that certain infections and toxins. Basically, decrease the blood flow to that front part of the brain. So you become a monkey. You do become primitive as you mentioned. This reptile brain kicks in and you can’t make good decisions and you certainly can’t comprehend the future. You get stuck living in the day, the hour, the minute with that stress and when you say close the loop, I think that resonates for a lot of people, but many people are afraid to close the loop because this means that they have to end a friendship that’s toxic. They have to end a marriage that’s failing. They have to, you know, fire someone that they don’t like. They have to quit their job because they have a bad boss. So.You know, closing the loop sounds so simple, but this could be a huge roadblock. You know, for people, and I’ve seen it, where you’ve got a woman eating perfectly. She’s doing amazing with her supplements. But for example, here’s the case study. She’s in an open relationship and she’s miserable and she hates it. And she’s jealous and her husband’s with these other women and she doesn’t want him to be. And so there’s issues there. I don’t freaking care how much ashwagandha this lady pops. She’s not going to supplement out of this situation. That’s intense. And there is a place for closing the loop. And you can’t supplement your way out of a situation like that.

Dr. Justin Marchegiani: Yeah. In relationship, it’s always good to have healthy boundaries, right? It’s like good fences make good neighbors, right? Having good emotional boundaries and how were relationship operates, right? If your families asking 10 times of you, then, then you, then ten times of you, then they help you on the backside, right, this kind of Arctic give and take that. So you always have to have clear boundaries. I think that’s a really, really important one. There’s an awesome book out there. Um, by Henry Cloud called boundaries. That’s a really good woman. I see patients in relationships. They may not even be a relationship with their spouse. It could be a relationship with family or friends where they’re just kind of a parasitic element of people asking many multiples from that person. Then that person’s providing back and there should always be a give and take. Right. I always tell patients like when you play catch, I throw the ball, you throw the ball, right. Emotionally, there’s a give and a take and it’s back and forth and it’s equal. When I start throwing the ball, you don’t throw it back. I run back over, get the ball, come back, throw it again, that, that, that’s, that’s you know very depleting, right? You missed the give and take, and so you gotta make sure your good, healthy boundaries are there. Also, with relationships, it’s always better to try to restructure. Kind of reboundify the relationship, then just exit. I think exiting a lot of relationships is just, uh, it’s an easy way out. It’s, you know, you just go somewhere and end your and go on to your life. I think it’s always better to see if you can repair or give people an opportunity to repair and get on the same page and see what happens from there. But either way, right, you have all these emotional issues. Get healthy. If you’re afraid to deal with these issues right now, put them on the back burner. No, you have to deal with them. Adjust your expectations of healing and try to get healthier so then you have better energy, better focused, better calmness to address whatever the problem is.

Evan Brand: This is great advice and it’s uncomfortable and there are situations that are going to be intense, but I would encourage you just to go face first with those now if you have trouble making eye contact with these people. Some of that’s related to brain chemistry too. I see a lot of people that when they get in a stressful situation.They just shut down. They look down, they look away. They can’t face the person and therefore they can’t fully express themselves. That’s usually tied into low GABA, and so we can’t measure GABA on the organic acids. But we can measure serotonin, we can measure dopamine, we can measure endorphins. So before you and I go into a few of these studies and solutions, you know, let’s just give a little back story on some of this. And so, you know, when I had gut infections down in Texas, I had tons of anxiety. It wasn’t me, it was not my personality. It was the gut bugs. And when we looked in my brain chemistry, my serotonin was low. My dopamine was low. I had issues to fully get myself motivated. I still push through, but I didn’t wake up necessarily with that spark like I wanted, and so I know personally and you and I have seen it 1000 plus times clinically the low brain chemistry problem, it’s epidemic and it’s only gotten worse even in the last 10 years. You and I have been looking at these labs.

Dr. Justin Marchegiani: 100%. And so again, there are some people that have been on board here with us for years listening and they’re super advanced. And so just kind of out of the gate, we’re going to just give a brief overview of foundational things. OK. So first thing out of the gate is an appointment my phone because I just changed my whole house water filtration here, and Evan and I were talking about it earlier today. So check this out. I’m gonna hold up my phone. So you can see here.The clean one on the left, that’s a brand new filter. And that all the way up to the webcam.

Evan Brand: We can hardly see. Go closer. Yeah.

Dr. Justin Marchegiani: So the one on the left, right, the white one. That’s the new one.That’s the one that was in there for the last three months. I mean that is just nasty, dirty and gross that again that sense. That’s a post filter. So it went through a massive pre filter, went through the huge carbon based filter and then went through that afterwards. And it was dirty. It is nasty. I actually have it over on my on my bar countertop over there. So pretty pretty freaking gross. So, what does that mean? It means, prioritize good clean filtered water. If you don’t have a high water filter water filter system, we’ll put some links down below to the ones that we personally use, but in general, at least get a good quality glass water Topo Chico, Cheryl Steiner, a Perrier, a mountain valley one out of a good glass model was gonna be excellent during the day and then I definitely recommend getting a whole house water filter once you’re in a in a place where you can do it. Some people may be in an apartment, then maybe a temporary housing. You can always get an under the counter filter. There are even some temporary ones that actually go on top but still filter water out pretty well. But that’s pretty nasty. And so 70% of your body’s water in regards to all the liquids. So you need good clean filtered water without all the junky chemicals. Maybe drugs, maybe pesticide runoff? Bull run off, who knows. So the first thing is kind of get your water right. Comments there, Evan?

Evan Brand: Yeah, I mean, this is important because when you’re stressed, you’re gonna be dehydrated. You’re burning through everything. You’re burning through hydration, you’re burning through B vitamins. You and are looking at papers on B vitamins and magnesium for helping with stress. So we know that when you’re burning the candle, and most people in the modern world are.You need good water and the tap water. You can look up EWG and put in your zip code. It’s scary. I mean, almost every single city has insane high levels of trihalomethanes which are carcinogenic as you mentioned pesticide residue, pharmaceutical drugs like heart medications, beta blockers, anti anxiety, antidepressant medications. You know what’s scary? There are studies now being done on bays, some of these inland bodies of water. And there was one down, I think it was in Florida near Miami. Biscayne Bay is one of these most famous bays. They have an issue now where all of the fish. I’ll see if I can pull it up.They now have drugs in them. And it’s because of the runoff from people. So let me pull this up because this is.This is pretty crazy. This was, this actually came out over the summer this year. And I think it’s pretty shocking and most people don’t have a clue.

Dr. Justin Marchegiani: Yeah, there was that famous study on atrazine up at UC Berkeley showing the frogs were essentially having reproductive organ issues like a major. I think they were almost becoming like asexual and their sex organs were like switching some kind of weird dynamic what’s happening. Based on the hormone, like disrupting compounds in these pesticides. And that was atrazine.

Evan Brand: Did you, did this pull up my screen here? Oh yeah, the screen share, I’m going to share with you.

Dr. Justin Marchegiani: Go ahead.

Evan Brand: Alright, yeah. So here it is. Pharmaceutical drugs showing up in fish from South Florida waters. Yeah, so it’s Biscayne Bay and I know you’ve got 2.5 million Miami residents and a lot of those people are on pharmaceutical drugs and then they’re peeing that out and then some of that runoff is ending up in the water supply and then that runs off into the Bay and then the fish then accumulate those drugs. So they did a three-year study.They found the Valium. They found antibiotics. They found blood pressure medication in the blood and tissue of bone fish. One fish showed 17 different drugs. So here you are thinking you’re getting your fish clean. I’m gonna eat fresh fish. It’s like well. You know you’re looking at antidepressant treatment, medication, narcotics, pain relievers. That’s insane. Now they’re saying good news is that this is a catch and release species. But, what about the other fish that people are eating? So move. I don’t know. Just tuna fish.

Dr. Justin Marchegiani: Absolutely. So I mean, getting your water clean, getting your food quality clean, organic food. Here’s the atrazine study. And they were talking about it here at UC Berkeley Press release back in 2002. But it was April 16th in the National Academy of Sciences, UC Berkeley, essentially what happened here, the frogs were developing, they were becoming hermaphrodite. They were heading both sex organs. So you could see testes here, ovaries, ovaries, and you could see abnormal gonads and male exposure to this type of frog.The frogs have become hermaphrodites. Both male and female due to the hormonal exposure. So you can see because the atrazine environment basically an uncontrolled experiment this would be no atrazine free environment talking about because herbicides been used for 40 years of 80 countries. It’s effect on sexual development and male frogs could be one of many factors in the global decline of amphibians. So crazy, right? Now we’re talking about lowest levels of 0.1 part per billion. So this is real. So that’s why I’m saying out of the gate, easiest thing out of the gate. Clean water, good water filter, organic food, organic food. And then outside of that, right then we could talk about blood sugar, stability, at least a pound worth of protein at every meal. I think it’s a really good making sure you have good fats that aren’t all pufa-based fats. Seed, nut oil based fats, refined vegetable oils, you know keeping it good healthy saturated fats, coconut oil, avocado, olive, you know cold press. You know most of your good quality fats coming from more stable.Had accelerated fat sources. This is great. And then after that you just adjust the carbs for your activity level and kind of your metabolic type, meaning do you need to lose weight? Are you kind of a skinnier person? Are you really active right? The more active and the more at an optimal weight you are, the more carbohydrates you can handle. So you got to adjust it. It’s not a one-size-fits-all on that.

Evan Brand: Let’s transition. Talk about cortisol. Yeah. This is important for stress. When people think stress, most people think cortisol and you and I’ve run so many of these, probably more than anybody, I pulled up my screen. If you want to pull it up. This is a Dutch panel. That you and I run on almost everyone in regards to hormonal health and what you’re looking for is really the health of the cortisol pattern. So you can see here this particular female, she was absolutely exhausted. You could see for people on audio, you’re missing out, but you could go back to. Uh Justin Health YouTube channel and you can watch this video if you’re listening on the audio and you want to see the the the some of the screen shares. But you want to basically charge your smartphone battery first thing in the morning, get a full charge and that full charge last throughout the day, but in this case this woman, her cortisol pattern was completely shut. She was below range the entire day except for night time. She perked up just a little bit, and that could have been like maybe she was on her phone, she was watching a horror movie or a scary TV show or something an artificially boosted her cortisol. But this is the real issues. So no matter how clean your water is, if your cortisol pattern looks like this, you’re gonna be absolutely exhausted and you were gonna deal with stress terribly. You’re not going to deal with stress. How many people are you seeing like this now versus maybe 5 Years ago, do you feel like it’s becoming more common or no?

Dr. Justin Marchegiani: Yeah, I mean it’s, it’s always tough because we’re, I’m seeing a large percent of the population that are have chronic health issues, right. So I’m always gonna get that, that slice that’s going to be significant. But yeah this type of pattern is, is a big deal, right, because not only is this a sign of you being chronically stressed and depleted, but this is a reverse cortisol rhythm, so you’re gonna be tired during the day and it’s gonna be harder for you to relax at night and recharge. So it makes it really difficult to get that good regenerative sleep wake cycle going. And so these are the people that have.Hard time sleeping at night and getting and reestablishing those good healthy lifestyle patterns that should be in place. That’s what makes it really tough. One thing if you’re just tired, but you can work on getting sleep and and recharging if we can’t. And then also this person, I guarantee you there’s there’s stress handling capacities gonna be at Max, so they’re just gonna like flip out on their kids, flip out on their friends at the simplest thing, or they’ll just be an overwhelmed and they’ll just be in flight constantly ignoring and sweeping all their problems under the rug because they jerked their capacity so low.

Evan Brand: Yeah, and I know this particular female here was incredibly histamine intolerant. Someone in the comments said, let’s talk about histamine. So there is a component to that. And in her case, she was sensitive to everything, chemicals, fragrances, EMF food. So this was a, you know a pretty sick middle-aged woman, but I mean everything was completely crashed here and so you and I wanted to talk about some of the herbs. Now if we jump right into one of these papers on. What’s called Magnolia and Phellodendron? This is a blend, actually. And it’s usually under the patented name Relora. Some of the professional products you and I use contain Relora. Now. This is a good option for reducing stress and anxiety, but the problem is you really don’t just want to start taking supplements without the clinical data because if you look back at that woman and the cortisol pattern is completely crashed, if we were to go to something like Relora, I would say this is not an appropriate thing to use because if you look at the results of the study of supplementing Relora for four weeks, the salivary cortisol was18% lower in the Relora group. So what that means is they saw less stress, less tension, less depression, way less anger, less fatigue, less confusion, and a higher mood. But would you say in her case that’s not appropriate because she was so crashed already. We don’t want an 18% reduction in cortisol.

Dr. Justin Marchegiani: Now the question is what type of people were in that group, because a lot of these adaptogens, if someones low like ashwagandha for instance. There’s studies on Ashwagandha on helping to lower cortisol as well as increased cortisol. So I would say that the adaptogens are probably not like a drug where they’re gonna suppress. If someone’s already low, they’re probably gonna more help that HPA access kind of adapt. Now there are certain adaptogens like ginseng or licorice that may be more stimulatory even if someone’s high, it may still over stimulate. So you gotta be careful with over stimulating ones, but usually ones.like holy basil Holy basil, Magnolia, Ashwagandha tend to be more adaptogenic, so I’d be curious about that. What that sample size was? Were they kind of higher cortisol people? If they were higher cortisol people, then that would totally make sense that the herb was working to kind of bring things back into balance. Does it say it all in that study?

Evan Brand: We assess salivary cortisol and psychological mood in 56 subjects, 35 women, 25 or 35 men, 20 21 women. They were screened for moderate stress, so that would have been interesting if they would have came in and did a cortisol panel on all these people and showed the before and after, but that’s OK because you and I have seen this a lot clinically and as you described, we’d like to just give the nutrients to let the body do what it needs to do. Meaning we’re not coming in with Cortef necessarily and cranking her up. We’re giving HPA access support and the body can figure this out on its own in many many cases.

Dr. Justin Marchegiani: And the fact that a lot of these symptoms improved. It’s probably not a low cortisol person making their cortisol lower because that those symptoms would get worse, right? They would actually, you know, they wouldn’t be improving, right. So the fact that they’re coming down, there’s probably an improvement. So imagine these people had higher cortisol patterns.To begin with. And that would make sense. But that’s why we don’t even go all in on just any herb, right? Or making these diet changes. We’re getting the inflammation down. We’re increasing nutrient density. We’re also providing all the cofactors to help your adrenals function better, whether it’s vitamin C, whether it’s pantothenic acid B5, whether it’s B6, I have one study in here talking about B6 and Magnesium actually works better than magnesium alone. And part of that is unique cofactors for these nutrients to work better. And a lot of your brain chemicals actually have cofactors for a lot of these conversions of serotonin and Dopamine and norepinephrine to happen, you need a lot of cofactors. And then we can kind of go more into the category of like, well, if your diets crummy and you’re eating a lot of sugar or inflammatory foods, you can actually deplete those pull factors more. Or if you have mold exposure, you may deplete, you may be depleting your B vitamins in your in your in your folate and your B12 and your B6 for methylation purposes. Because that mold exposure is revving up those methylation pathways, you may be utilizing more of your acetylation and glucuronidation pathways for glutathione and acetyl cysteine right. You’re sulfur aminos may be depleted as well and also chronic stress does deplete sulfur because you need sulfur to actually activate dopamine to norepinephrine. And so when you look at those pathways, the more stressed you get, you will actually deplete sulfur and when you don’t have enough sulfur if you have mold exposure coming in.You see how you have a toxin on this side and then you have stress over here and you’re kind of burning that candle at both ends.

Evan Brand: Yeah.Let’s hit Ashwagandha. And then I like B vitamin magnesium when it’s pretty interesting. So ashwagandha, we hear a lot about it. I’d say it’s probably the most popular adaptogenic herb. I mean, you see it in grocery stores now at the checkout counter, I’ve seen Ashwagandha gummies and Ashwagandha pills, which I think in general is good, I have seen at the high dose and I have seen chronic usage in some people. It gives them a little bit of flatness where they just don’t have as much emotions. I’ve just seen, if you look on Reddit, there’s several threads if you type in like ashwagandha at Hedonia, this is basically just the loss of pleasure in life. So there’s some people that are reporting either high dose or long term use of ashwagandha. They just sort of become numb. So I think you need to watch out for that. But in general, you and I are cycling on and off of these things and we’re rotating. Now out of protocols and not necessarily, always in isolation. Just for a couple months, if they have excessive fatigue, maybe we’re adding in some rhodiola, so we’ll look at that in a minute too. But the Long story short is many, many papers on Ashwagandha. This is just one. But you’re always gonna see an anti anxiety activity and you’re always gonna see anti stress. It’s going to improve symptoms of depression and insomnia and it’s going to help primarily by modulating the HPA access and also the sympathetic adrenal medullary axis, as well as GABAnergic and serotonergic pathways, meaning that it may help boost GABA, which calms you down. It may help boost serotonin, which helps you become less irritable, less anxious, and you may sleep better.

Dr. Justin Marchegiani: 100%. I just swallow some Gabba and some glycine right now, some amino acids that also help with stress. Love, Mike.

Evan Brand: I took some right before. Yeah, right before we jumped on. I told you about those gummies and my wife. And so I had a couple. It was like Ashwagandha, Rhodiola I think it might have been some Maca too, but, so that was good. So here’s another paper on ashwagandha. This was a randomized double-blind placebo-controlled, which is the best, the best type that you want. And they said, compared to placebo, significant reduction in what they’re calling the Hamilton Anxiety rating scale. So significant reduction in that. In a near significant reduction and the depression, anxiety and stress scale. Also reductions in morning cortisol testosterone levels increased in males. So you and I didn’t mention that but. Stress.Those surprise stress is going to negatively affect your hormones too. Stress is going to reduce testosterone. That’s going to affect your sex drive. So when you see that Viagra is being passed out like candy, now you wonder what all’s going into the stress is a big component.

Dr. Justin Marchegiani: Yeah, we just saw a major study come out last month looking at the effectiveness of antidepressants. And they’re showed to be, you know, no long term benefit with a lot of these antidepressants. I think that was a Lancet study out of the UK and so we kind of look at a lot of the antidepressants, we look at the mechanism that’s happening there. You know, we know there’s data on things like tryptophan and five HTP and B6 helping. So there’s definitely like, there definitely is like a depletion theory where people are chronically stressed and then as they are stressed, they do deplete their serotonin, they deplete their dopamine. We see that in organic acid test. But the medications for that are blocking these reuptake ports, trying to accumulate more serotonin in between the synapses may not be the right school of thought. And there are a lot of doctors and people and pharmacologists looking in the direction of just brain inflammation. And so everything we do in functional medicine is about reducing inflammation. So when we give this nutrient with this herb we’re doing so many things in the background, diet and lifestyle wise to reduce inflammation. There’s so many variables we’re moving so it’s so hard in functional medicine world to do a double-blind placebo control trial because in those trials you have to typically control a variable or two at once. If you control 10 variables at once, 12 variables, there’s just too many things moving in one Direction to know which one was the deal breaker and like in this one, study over here. I’ll show you. Where they look at tyrosine supplementation. And or stress for cognitive demands. I’m going to pull this trial up here. So this is interesting right here. And this is kind of why we like to test and not guess, right, assessing over guessing. So they looked at dopamine, tyrosine which is a building block for dopamine, right. It goes, it goes phenylalanine and tyrosine and then it goes L DOPA dopamine and then under stressed dopamine can get converted to norepinephrine.Then you actually use a lot of sulfur. From dopamine to norepinephrine. But they talked over here that the potential of using TYR supplementation to treat clinical disorder seems limited and benefits. But then it talks about down here tyrosine does seem to effectively enhance cognitive performance particularly in short term stressful and/or cognitively demanding situations, we conclude tyrosine is an effective enhancer of cognitive function, but only when neurotransmitter function is intact and dopamine or norepinephrine is temporary or depleted. So if we have some functional deficiencies and we may see that based on a stress profile or you know functionally, we may see it on a cortisol rhythm test and we may see it with an organic acid panel, looking at vanilmandelate, looking at Homovanillate and we may see some of these markers either go overly high or overly low, which shows that there’s some significant depletion going on here. And so you can see that this the nutrient tyrosine tend to work better when people actually had a depletion.

Evan Brand: Well, you made me think of something and we’ve probably talked about this before, but how crazy is it to think about trying to do a proper, supposedly double-blind placebo-controlled study? Because, think of Sally who woke up and had a GMO Gluten bagel with vegetable oil. Instead of real butter for breakfast, she takes the antidepressant. Or she takes the herb and they’ve got Johnny over here who had a grass fed rib eye for breakfast and he took the same medication. They’re going to get totally freaking different results. So you and I were talking about this before we hit record, but it’s so hard to actually look at and appreciate a study that’s going to give you that outcome because like what time do they go to bed? Are they all going to bed at 10:00 PM or Sally staying up till 2:00 AM? No wonder she didn’t get relief from the antidepressant or the antidepressant herb or whatever. So it’s like, my God, when you really break apart using the functional medicine lens, you break apart the sleep, the stress, the diet, the family relationships, like how many of those people are going through a divorce during the study? Those are the seven people that didn’t get relief from depression, right? So it’s very difficult. And I think that’s why you and I can look at these studies and there’s other people that will talk about studies on podcast, but the reality is when you have the clinical experience that would, that’s what makes the difference because we’re coaching people through some of the lifestyle measures, the sleep, the nutrition, the water, we’re not just throwing the herb and saying good luck. It’s just not going to be that effective.

Dr. Justin Marchegiani: Yeah. And also like we just mentioned earlier. We got a test, right? We don’t wanna guess, we want to assess. And This is why someone may have, you know, no experience with this supplement and say it’s it’s joke it’s it’s snake oil and someone’s like no i had a really great experience because there’s one you may Had a really great experience because there’s one you may not need that nutrient as much if you need something more than someone else, right? Then you may have a better benefit, but also a lot of nutrients work synergistically, right? So this one study looks at magnesium with B6 and they found that this study that, right here, many civilizations regard subjects with severe extreme stress study provides clinical support for the greater benefit of magnesium combined with B6. So both groups did well. They had a magnesium group and a magnesium with B6 and they found the magnesium with B6 actually did better and so a lot of nutrients are synergistic. I mean, I think anyone, most people will benefit from magnesium just because a large percent of the population are depleted in it. Our food supply becomes less and less on it. It’s one of those core nutrients it’s hard to get enough of. So I think it can’t hurt to ever take some of these core nutrients, but a lot of these nutrients are synergistic and so magnesium is very important for stress and relaxation. But B6 also helps with, it’s an important cofactor for all of your brain chemicals to work. Very important cofactor and it helps a lot of your neurotransmitters like serotonin and GABA and dopamine and adrenaline all work and convert in the brain. So it’s important that you can’t just ever rely on one nutrient, you got to look at the whole thing and it’s always better to assess versus guests too.

Evan Brand: Yeah, and when you click on the podcast and it says helping with stress or feeling overwhelmed, you may think of us talking about meditation and float tanks and scheduling massages and getting manicures and pedicures.And take it a vacation and taking Fridays off and hugging your kids more and having more sex. All those things are great too. But we’re really trying to get geeky here with you guys, because most people that come to us, as you mentioned, they’ve already been to 5 10-15 20. They done the massage and they’ve been through the talk therapy and they’ve been to so many other practitioners. They need the nitty gritty granular stuff like this. It’s really going to get them better. So if you guys are listening for the lifestyle stuff, we try to integrate that and that is important, but ultimately most people are doing a lot of that, and they’ve tried and they’re still suffering. Let me pull something up on Rhodiola. This is pretty cool. I told you years ago how Rhodiola changed my life. And this is a paper that just concludes that Rhodiola is a very effective potent herb for treating mild to moderate depression. And we’re talking in six weeks. So this is not a long thing. Like people think it’s gonna take years and years and years.I’m not saying that if you’ve got mold, you won’t still be depressed. If you’ve got Lyme, you’re still going to be depressed like that. That can happen. But what if I can just give you a tool, which is gonna boost you. Let’s say it reduces your depression by 30%, enough for you to get back into the gym. And now you’re exercising. Now you get the natural endorphin boost, and then you feel more confidence. Now you go on a date with this woman you’ve been wanting to go on a date with, and now you have more fun and oxytocin cause your bonding. But at this this whole snowball effect happened all because I just gave you this herb to pull you out of a dark place. So that’s really what we’re trying to do.

Dr. Justin Marchegiani: Absolutely. So we talked about some of the Earth, some of the nutrients, some of our big favorite ones. Of course, movement is going to be helpful. Again, you got to figure out where your level is. If you’re chronically inflamed, movement maybe too much, too stressful and puts you in a more catabolic place because you’re breaking down tissue. Figure out where you’re at if you’re at a good place.You can lift some weights, do a little bit of interval sprinting, whether it’s a walks, walk, run, walk, Sprint, you can do a rower. We like rowers because of, you know, the extension and also there’s less impact on the joint. So if you’re already inflamed, you’re not going to create more inflammation. You can start with some bands or some gentle lifting of weights to kinda you know find that 8 to 12 you know rep 8 to 12 you know, Rep movement, that’s going to give you a good muscle breakdown, give you a little soreness. That’s good. You know, getting 10,000 steps today, these are all simple strategies. Strategies. We don’t have to overthink it. You don’t need to super crazy customized plan out of the gates. Just get some good movement. Make sure you’re, you have good form. If you’re not sure, you can always start with walking or yoga or something more gentle and you can always check out some YouTube videos and do some band work or some cable work or I like the new tonal that’s another good at home device for lifting is really good so you know just get get enough movement in there to get your muscles a little bit sore.

Evan Brand: Yeah, absolutely. I’ve got my roll machine right here. I just try to put it on this heavy of a setting as I feel confident with it’s not gonna injure me where I can still go. And I almost use it like a sprinting device. I don’t necessarily just go slow and steady, I try to just kind of sharp relatively fast. Kind of like a Sprint row movement and I tell you it, it can be depleting, but man, I’ve heard many people talk about this, like when you want to get out of your mind with your ruminating, if you’re worried, if you’re thinking negative, you’re going through all these bad things in your life and bad symptoms and all. I’m so, you do these pity parties for yourself when you’re exercising physically. It almost shuts that brain off completely to where you could just focus on like how hard this exercise, how hard this movement is.

Dr. Justin Marchegiani: 100% great 100% now outside of the gates here right? There could be some hidden issues that were not addressing and you have to see a good functional medicine provider over there could be you may need to look at your adrenals. Your adrenals could be more depleted like that patient Evan just show where they have significant kind of reverse cortisol pattern. It’s good to know your adrenal pattern because if you have chronic issues, you want to know, hey, this is where I’m at one it gives you a timeline of how long it may take to heal that person may look at look like a 6 to 12 month journey on that. Also it gives you the ability to have, you know, realistic expectations, good timeline, also something like that. We’d probably wanna do a retest on someone that’s that out of balance to make sure they’re back in balance, but also want to look at hidden stressors that could be behind that, whether it’s mold, whether it’s pests, whether it’s, you know, toxicity issues that aren’t being addressed. Whether it’s gut issues we talked about, a lot of these nutrients have to get eaten, so for our diets poor there’s a problem. But also what if it’s good now but we’re not breaking down and absorbing it? That’s where we’d have to do deeper testing on the functional medicine side to see how you’re doing digestive wise with HCL and enzymes. See if there’s any gut bug issues.And then we can also do other intracellular nutrient tasks for their organic acids or nutrients, look at other kind of intercellular nutrients. So there could be some other hidden stressors going on there. I always say just kind of start from the ground and work your way up, start with the low hanging fruit. Keep it simple because that provides a good foundation anyway, but you know if you have chronic issues, you definitely want to reach out to someone like Evan evanbrand.com or someone like myself,Doctor J justinhealth.com for the deeper issues and we’ll put links down below so y’all can reach out. Evan, anything else you want to add before we wrap things up?

Evan Brand: Yeah, I think for people that are, in a short term, acute stress, they have to travel for a wedding. They’re maybe going on a honeymoon. Sounds fun, could be stressful. Travel, new food, new water supply, their new parents. They’ve got small children, those are situations where you may come in, not small children cause those are long term stress, you and I can attest to that but you know, honeymoon, you know, new marriage, whatever. So, so those acute stressors, you could probably do some of these formulas whether it’s Tongkat or Magnolia or Ashwagandha,Rhodiola, holy Basil, there’s many, many options. Extra magnesium, B6, GABA, taurine and acetone. These things are great, but if you have been stressed and feeling overwhelmed for 1,2,3,5,10,20,25 years and beyond, you really don’t just want to go try to get rhodiola and get your way out of it. It’s not going to happen. I’ve tried. I took so many supplements when I was sick and it helped me to stay alive and it helped me to continue to work and be up on my feet but.I knew that ultimately I was missing something, and it wasn’t until I really cleared the parasite, cleared the H pylori, my energy started to come up like I was on Rhodiola while I had parasites.I was still tired. I was less tired, but I was still tired. And I think the problem is like naturopathic medicine. So naturopaths specifically, they may come in and instead of, you know, quartet for cortisol, they give you licorice and ashwagandha, which is great, but then it stops there. So you really have to ask the question why? Why did I get myself into this? How did I get into this? Was this the bad relationship? The moldy apartment? The college dorm? That got me sick? And I think people need to just ask why a few more times. So, like, I’m tired. OK, here’s rhodiola. But it could be. Hey, I’m tired. Well, why are you tired? Well, because I’m stressed. Why are you stressed? Because I’m in a bad relationship. OK? So we need to work on that. And if people keep asking why, usually you’re going to uncover some stuff. And I just encourage people, don’t be afraid, to look in those dark spots. Don’t, don’t be afraid to look in those corners where there’s some cobwebs of things that you’ve been emotionally shoving away, as you mentioned, dusting in a way or putting it under the carpet. Yeah, eventually those things are going to weigh you down.

Dr. Justin Marchegiani: Yeah, someone in the chat talked about a Epstein barr virus kind of plummeting their energy recently. Well, when it comes to Epstein Barr and some of these viruses like Epstein-barr said cytomegalovirus, it’s very rarely the virus just comes out of blue, comes out of the blue and just knocks you on your pot, right. Usually there’s some level of depletion going on and it’s the straw that breaks the camel’s back and so. There’s different supports we can do to address viral issues, whether it’s silver or Monolaurin or Rishi, right? Different herbs and nutrients cats claw. But you’ve got to look at how did your body, how did your immune system become so compromised and susceptible to it. And you tend to have to work backwards and fix all of those issues that led up to this point. It’s very rarely something just coming out of the blue and doing all of it. It’s usually a level of susceptibility that you incurred and then this virus came in. So you have to really address everything, never just one thing.

Evan Brand: Yeah, I’ve seen that too, and I’ve seen it with a lot of things that are probably still controversial on YouTube, but we’ve seen things that people put in their bodies that all of a sudden reactivate Epstein Barr and other problems. We’ve seen this in celebrities, we’ve seen this in clients. So yeah.

Dr. Justin Marchegiani: Absolutely. But guys, we want to give you actionable information. A lot of people out there, it’s just like sales, sales, sales, market, market leave you kind of hanging. I want everyone to kind of listen and be like, all right, here’s some foundational things. When we’re talking and doing a long podcast, it’s super easy to get overwhelmed. So just pick one or two things, execute, execute, execute action, action, action. And then if you’re feeling a little bit overwhelmed that you want to take next steps, you have Evan and I for resources. It’s all about educating. It’s all about empowerment. So we’ll put links down below where you guys can reach out and work on taking the next steps. But worst case, just continue to take action. We’re here to help.

Evan Brand: Absolutely. So go take a bath, do your lavender, your Epsom salt and all that. Get your mind right. But then ultimately you gotta figure out what’s under the hood.

Dr. Justin Marchegiani: Love it. Very good. Evan, wait. Great chatting with you man. Glad we’re back in the saddle.

Evan Brand: You too. Take it easy. Talk to you soon, brother. Take care everyone. Bye now.

Dr. Justin Marchegiani: Bye y’all.

References:

https://justinhealth.com/

https://drjabanmoore.com/

Audio Podcast:

https://justinhealth.libsyn.com/how-to-deal-with-stress-and-feeling-overwhelmed-podcast-376

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The Root Causes of Anxiety – A Functional Medicine Approach | Podcast #370

Conventional medicine labels anxiety as a neurotransmitter imbalance and relies on pharmaceutical drugs to dampen the symptoms. Although, prescription medications can be a helpful and even necessary tool in periods of overwhelming anxiety. But we have so many more tools at our disposal than just medications!

Dr. J and Evan explain that they recognize that anxiety is often the proverbial “tip of the iceberg” in functional medicine. It’s the clear and present warning that something is going on below the surface that needs our attention. Our current circumstances may have been the breaking point, but the anxiety manifests in underlying issues. That’s why rectifying these issues is necessary to make anxiety more manageable or even eliminate it!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
2:06 – Acute and Chronic Stress
4:06 – Amino Acids and Herbs
11:24 – Gut Issues
16:26 – Functional Medicine Approach

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the root causes of anxiety, a functional medicine approach, and how to get to the root cause. Really excited about this topic. We see many functional medicine patients with these exact issues and we always want to get to the root cause of why that is so. Evan, how are we doing man?

Evan Brand: I’m doing good. You know the anxiety story for you and I talking about anxiety goes back literally eight years. It would have been late 2014 when I was in my luxury apartment in Austin and I was calling you and I was saying, “dude, I can’t stop this”. My heart is pounding. I’m freaking out. What the heck is going on and you said, “man, if you go to the emergency room, all they’re gonna do is they’re gonna give you some sort of anxiety medication. So why don’t you go and take about a gram of magnesium and see what happens.” And so, that’s what I did. I think I might have had some pharma GABA or some other tools on hand, maybe some passion flower and luckily, I calmed it down but little did I know back then that I had some of the big root causes of anxiety that were unresolved which included mold toxicity, Lyme, Bartonella, some of these tick-borne infections that drive up the nervous system, unfortunately. Now, knock on wood, anxiety’s been a minimal to non-existent part of my life and It’s incredibly freeing because anxiety can be so debilitating that people become housebound or they become afraid to travel, they become afraid to go on planes. They become afraid to seek the raise at their job. They just want to live in this little cocoon because they’re so afraid and anxiety is also very debilitating for children too. It affects their confidence and their self-esteem and their motivation for school and how they get bullied and so, I mean, we could do an hour on this but think just to open this thing up with a bang, I would say that infections are a big driver of anxiety so whatever that is a tick-borne infection like a Bartonella, Babesia, Lyme situation or gut infections like we’ve talked about a thousand times in the last 10 years together which is parasites, bacterial overgrowth, worms, Candida, anything that’s gonna release a toxin or aggravate the immune system.

Dr. Justin Marchegiani: Yeah. 100%. So anytime you look at anxiety, you always have to get to the root cause, right? Obviously, if it’s unresolved emotional stress, your body is designed to create anxiety for a certain situation, like if you, I don’t know, if you have lived in a forest across the street and there are bears, there should be a healthy amount of anxiety so you know, don’t leave food out and you’re just a little bit more careful with your habits so you don’t get attacked by a bear, right? There’s a healthy bit of anxiety there which is good to kind of keep you on edge so you are alert and you make good decisions. We’re talking about things that are, you know, unhealthy amounts of anxiety where you don’t have those types of emotional stressors, right? Obviously, if those emotional stressors are there, kind of take inventory of them and figure out what that corrective action is you need to kind of close the anxiety loop. I always say close the anxiety loop. What is that action? You have to take that allows you to feel confident that you are not ignoring the reason why there is anxiety there. If you did that, great, awesome. Check that off your list. The next thing is like you mentioned, obviously, any type of chronic stress or acute stress can create anxiety, right? And so, chronic and acute stressors do different things to your body. They’re going to cause B vitamins to get recycled and used up at a higher rate. They’re gonna cause magnesium to get used up at a higher rate. They’re gonna put you in a fight or flight position, where your body goes into fight or flight and then that’s gonna cause increases of cortisol, increases of adrenaline and it’s gonna cause your brain to get hyperactive and obviously at the same time it’s gonna affect digestion too when you’re in fight or flight. It’s gonna decrease your body’s ability to make stomach acid and enzymes and it makes it harder for you to break down your food. And so, and then of course, the more stressed you are, now you’re gonna start craving more processed foods that increase dopamine and increase a lot of those, uh, feel-good brain chemicals to buffer that but so, I always look at like what’s the constructive vehicle to fix this, what’s the destructive vehicle. Destructive vehicle feels good at the moment but creates problems down the road. Constructive helps at the moment. May not, maybe not quite as fast but then actually gets to the root cause over time. And so, some of our constructive vehicles like you already mentioned, magnesium, right? Theanine, right? B6, B5, right? And I always look at nutrients first, like nutrients are in the hierarchy before herbs so nutrients first and then, in the hierarchy coming down would be herbs, Ashwagandha, passion flower, Valerian. Those things are nice herbs that kind of activate and stimulate GABA. So, GABA is an inhibitory neurotransmitter. So, it’s the brake pedal on the nervous system. So, think of the gas pedal as adrenaline, as cortisol. That’s the fight or flight nervous system response and the gas pedal is gonna be GABA and the things that are gonna help with GABA are gonna be Taurine, Theanine, GABA in and of itself. And then on the herbal side, things like Ashwagandha have multi-adaptogenic effects. They can increase cortisol and increase stimulation when things are too low but they can also tamp it down when it’s too high. I like my wife. She was really stressed the other day. We are getting our kids out for an easter party and she’s like, “you have something to give me? I am so stressed.” And I’m like, “here you go”. And I gave her a bunch of GABA, Taurine, and Theanine and magnesium, some B5 and vitamin C and some Ashwagandha and she looked at me like two hours later, she’s like, “what the heck did you give me. I’m on cloud 9.” I’m like, yeah, you know that, the better living through chemistry right there.

Evan Brand: That’s great. Yeah, and motherwort. I love motherwort too. It’s great for the anxiety when you’re having, like, heart palpitations, blood pressure type issues as well.

Dr. Justin Marchegiani: Hyperthyroid too. They use it on hyperthyroid, as well.

Evan Brand: Yeah. That makes sense.

Dr. Justin Marchegiani: Too high thyroid, it can also be. It can help dampen that down, as well, which is nice.

Evan Brand: It’s great for grief too so like the cool thing about certain herbs is they can be an emotionally calming tool but they can be a nervous system calming tool too. So, like, as you mentioned, there could be an emotional thing like a bad boss, a bad spouse, a bully. You know that type of emotional anxiety driver but it could be a chemical driver too, meaning like a toxin driving the nervous system to be ramped up. Also, we should talk about blood sugar. I know we’ve done podcasts on this before but you know there’s a big impact on issues with blood sugar. Thank the Lord, my blood sugar is so good now, I could eat dinner at five and not eat till 1pm the next day and I’m stable, like, I can fast for extended periods of time as needed and I don’t have any issue but however when my gut was a wreck which I want people to pay special attention to, if your digestive system is compromised, you’re not gonna be tolerating fasting that well because you’re already so likely nutrient deprived because of the malabsorption due to the infection. So, years ago when I tried doing this type of fast, I would have major anxiety and that’s low hanging fruit so do what you got to do but you got to get your gut tested and then fix the infection first.

Dr. Justin Marchegiani: 100%. So, just kind of looking at a bunch of different things. So, on the emotional side, right? If it’s unresolved emotional trauma that’s creating anxiety, you know, someone wrote about DNRS, that’s great. You know, this NLP, where you kind of visualize a stop sign or something to kind of do a pattern interrupt. That’s excellent. EFT, EMDR with eye movement or different tapping on meridian points to kind of dampen down that sympathetic nervous system response. And again, these are gonna be good, you know, uh, more chronic issues. Yeah. If it is an acute issue, you know, a lot of times, just get to the root underlying issue where that issue is acute.

Evan Brand: I was on a plane one time and the turbulence was so bad and I started tapping on the plane. That really helped. I’m like okay. Even though it feels like this plane is about to crash, I love and accept myself and I’m like okay that’s fine.

Dr. Justin Marchegiani: Yeah. Especially things like that. You don’t have control, right? There’s nothing you can do outside of just sitting there and getting through it. And so, it’s better when those things are kind of the case but you know, it’s kind of like, I’m just trying to think of you know an example, it’s kind of like, you go upstairs and don’t turn the alarm on for the house or like maybe did I leave the front door unlocked, right? And so, there’s a natural bit of anxiety. You start going down to bed and that little bit of anxiety kind of creeps in, you’re like, I’m not gonna be able to get to sleep fast if I don’t at least just check on the front door, right? So, let me make, oh good, it’s locked. Oh good, the alarm is on. Good. Now, that anxiety can go down because it’s there for a reason, right? So, if there’s a root cause, act on it, right? If there’s isn’t a root cause, right, but it’s more emotional, you can do some of the tapping and you can work with a practitioner to get to the root cause on that and then of course having better biochemistry will get will make every bit of anxiety better because you’ll be able to adapt to it and deal with it better. And so, of course, like we already talked about with cortisol, chronically high levels of cortisol and adrenaline are gonna be big so you have to get to the reason, the root cause why. And again, foods could be a reason why like gluten, too much processed sugar that can drive up that anxiety. Again, you already mentioned blood sugar fluctuations. If you’re on this reactive hypoglycemia roller coaster ride where blood sugar goes up because you ate too much processed carbohydrate, refined foods, junkie, vegetable oil, omega-6 fats. Blood sugars up and then it can crash right back down. The crashing is where you tend to get a lot of adrenaline cortisol stimulation and on the way up, you get lots of insulin so you get this insulin-cortisol-adrenaline kind of tug of war happening and that can be very stressful on the body. And then, of course, if your blood sugar is chronically high and you’re making tons of insulin that can also be a problem too. High levels of insulin can cause all kinds of problems with hormones, especially in women, it can cause issues with ovarian cysts and testosterone problems. And then, high levels of blood sugar deplete a lot of your B vitamins and magnesium. And so, if we have poor levels of B vitamin and B6 and B5 and B1 and B2 and B3 and folate and B12 and magnesium is depleted, that’s gonna cause more stress and more cortisol issues and it’ll be harder for you to deal with and adapt to that.

Evan Brand: And I would say, if you have anxiety longer than the week, I would almost consider that chronic. I mean, it’s crazy to me, how many people you have and I’ve talked to over the years who’ve had anxiety for a decade or longer and sometimes as one person commented that anxiety and OCD together is terrible. A lot of times OCD does come hand in hand with anxiety. We’ve done podcasts specifically about amino acid therapy and we use amino acid therapy in our clinics but if you have OCD, anxiety, low self-esteem, worry, negativity, depression, disturbed sleep, those are all symptoms of low serotonin. So, what you need to do is to get an organic acid test so we can measure this and look at the brain chemistry because if you’re not testing, you’re guessing. So, when you’re listening to this conversation about anxiety, I swear to you, you’re never gonna find a psychiatrist that’s gonna say, “hey, maybe we need to run an organic acids test, maybe you have low brain chemistry because you have bacterial overgrowth. So, we’re also gonna run a stool test. If they’re out there, send them our way, we’ll do a podcast with them but I doubt your psychiatrist is ever gonna consider running functional medicine testing on you to investigate this. I don’t care if you do lorazepam or the klonopin or whatever. It’s not the root cause and it’s gonna dig you.

Dr. Justin Marchegiani: Any benzo

Evan Brand: Yeah. Any benzo is gonna dig you further in the hole because now you’ve got this dependency issue and now you’ve got his issue of withdrawal and I don’t know if you’ve read some of the stories on this but my God if people try to acutely stop those benzodiazepines, there’s major major major side effects. So, it’s just not around

Dr. Justin Marchegiani: Especially, if you’re on doses, you know, above one milligram or so on a benzo, it can be harder to get off and sometimes the taper can be, you know, six months to a year coming off of it. If you’ve been on it for a while or been on a higher dose. Yeah, you need to kind of do a slower type of taper for sure.

Evan Brand: And there’s so much, I mean, just think of how many millions. I didn’t look at the numbers here but how many millions of people are on prescription anxiety medication and they never ever get to the root cause. It’s so sad to think about someone that’s been on like a Lorazepam or another benzo for 20 years and they’ve never once asked about the gut. The question came in, how does dysbiosis cause anxiety. What are the mechanisms? Well, I think, one, right out of the gates is gut inflammation. Number two would be nutrient malabsorption because as you mentioned, a lot of these B vitamins are necessary for many processes in the body including energy production so sometimes you have anxiety and chronic fatigue and that sucks too because now you’re too tired but you’re anxious so that’s not a fun recipe either. What else would you say about the gut anxiety connection?

Dr. Justin Marchegiani: Well, so anytime you have chronic gut inflammation whether it’s from food, whether it’s antibiotics. Antibiotics are creating rebound yeast or bacterial overgrowth. We could put H. pylori in that category, and other infections, as well. That’s a one you and I already mentioned, creates malabsorption just from indigestion, right? Not enough enzymes, not enough acids, not absorbing things well. Two, you’re gonna have exogenous production of lipopolysaccharides which in and of itself are a toxin, right? They’re produced, they’re part of the gram-negative bacteria in the gut and they’re stressful on the liver and there’s also can go to the blood-brain barrier. And when they’re in the brain, they can create mood and anxiety issues as well. So yeah, lipopolysaccharides, you could have acetaldehyde and mycotoxins from fungus. You could have issues with the parasites producing their own type of internal toxins for sure. Of course, your body also produces through healthy gut bacteria, a fermentation process to make its own B vitamins, vitamin K. Those kinds of things. So, if we have dysbiosis, we typically are gonna have low levels of beneficial bacteria so we don’t have that good endogenous production behind it. And then, of course, that’s gonna over activate our immune system. So now, we have all these toxins kind of slipping through our bloodstream. We have undigested food particles, getting through our bloodstream. Now, our immune system starts becoming hyperactive and that can suck up energy. That can suck up resources. So, there’s studies on for instance H. pylori creating mental health issues, mental, emotional issues, depression and anxiety partly because of the lipopolysaccharides and endotoxins are the same thing by the way. LPS or endotoxins and obviously nutrient absorption problems too.

Evan Brand: Man, when I had H. pylori, I was super anxious. I don’t know if I was depressed as much but I was definitely anxious and you remember how skinny I got, I mean, I lost so much weight too. So, a lot of people, you know, they look at anxiety on the surface right. And everyone looks anxiety is just like this mental thing and you just need to watch some hoorah motivational video and just get over your fears and that I was like no anxiety goes way deeper than that. You just eloquently illustrated this, the aldehydes from the yeast and the fungus toxins and the bacterial toxins and the parasitic toxins and the mycotoxins. You guys, this anxiety is not in your freaking head. It’s not. It may manifest in your head but the root cause is not in your head unless you’re describing like, this toxin getting across the blood-brain-barrier but beyond that, the gut I would say is the biggest driver of anxiety. I’d say, if I had to pick one place to look, it would be the gut.

Dr. Justin Marchegiani: Yeah. So, when we look at this, what’s kind of the hierarchy of addressing this? So, of course, you fix the foods, right? Because the foods are one. You’re gonna decrease inflammation from the foods. And the inflammation in the foods is gonna cause gut permeability so you cut out the gluten, the dairy, the processed refined sugars and flours, the junky omega-6. You focus on good high-quality animal-based fats, good healthy proteins, you know, more carbohydrate from fruit and starch, especially if there’s blood sugar issues and then from there, then you work on digesting it. So, make sure enzymes and acids and good digestion are there. Get your gut looked at especially if there’s any type of chronic bloating or motility issues or indigestion, unadjusted food in your stool, diarrhea, then you get your gut looked at and of course if this issue is more chronic, you want to look at your stress handling system so the interplay sympathetic and parasympathetic nervous system in your body and your nervous system is your adrenals and so you can get your adrenals looked at cortisol rhythm wise, you can do a cortisol panel. Look at your cortisol in the morning and throughout the day. Make sure it’s not too high or it’s reversed. On a good organic acid test, we can look at neurotransmitters like Vanilmandelate which looks at adrenaline. We can get Homovanillate which looks at dopamine, right? We can get the DOPA which looks at dopamine. We could also get 5-hydroxyindoleacytate to look at serotonin and then of course we can look at B6 like a kind of urenate or xanthurenate, right? We can look at brain inflammation markers like picolinate and quinolinate so there’s inflammation in the brain that gives us more indications. We can look at oxidative stress markers like 8-hydroxy-2-deoxyguanosine. There are good markers out there to look at these different things to give us a window of what’s happening so you know, we work on the food, work on the lifestyle, sleep. Make sure we’re digesting and breaking things down. Look at the nutrient deficiencies, look at the gut, look at the infection, look at the digestion and then of course, you know, we can always branch out and look at mold or mycotoxins or heavy metals or more toxic burdens down the road. That’s the foundation first and then I would say on top of that, if there’s any type of chronic pattern where there’s an emotional trauma involved that’s more unresolved definitely bring in a good practitioner, you know with some tools in their tool bag of NLP or EFT or EMDR or hypnosis. Anything that you want techniques to get into the subconscious but again the healthier you are the better the emotional stuff is to resolve so if you’re doing EMDR and EFT and NLP and you’re eating processed food and crap, it can still work, but it’s gonna be better when your brain chemistry is healthier.

Evan Brand: Oh, yeah. Amen. Well, think about all the people that are in talk therapy and then they go and they go eat a subway sandwich for lunch, thinking that they’re doing themselves a good favor by eating turkey on wheat bread with processed cheese and then they get mayonnaise or sweet and sour sauce on it or whatever the heck they’re doing and then they feel like crap, I mean.

Dr. Justin Marchegiani: Yeah. I’m not a big fan of talk therapy in the long term. I think, talk therapy is good did you kind of just consciously process something like how did this happen maybe you’re learning some tools to enter into your life from a habit standpoint to fix whatever that issue was but then most of that trauma sits in the subconscious area of the brain which is where 90% of all your thoughts are subconscious and so that’s where you want some of these techniques like we talked about but I think talk therapy is good to acutely process what you’ve observed whatever your experiences are and then talk about, hey what can you do, you know, as a person today as an adult today, um, you know, from a habit standpoint to address it but then after that then you gotta, you know, if you’re in talk therapy months and months later and you’re still just ruminating over the same thing then it’s a subconscious thing you got to work on next.

Evan Brand: Yeah, and look, don’t let me talk people out of doing it. I’m not trying to do that but what I’m saying is I’ve had people that said, “oh yeah, I’ve been with this therapist for 3 years and I meet with them every week or every other week”. And I’m like, “okay and what do you do with this therapist?” “We talked.”, “Okay and what else do you do?” That’s it. It’s talk therapy and I go, okay, you’ve been doing talk therapy every week or every two weeks for 3 years and you still have anxiety that’s this bad. We got to dig deeper. So, like I said, there’s a role for that but it’s not gonna get you out of the woods. The person who commented about the dysbiosis and anxiety question, they also commented in here said they did have a stool test that showed H. pylori. They have extremely high Morganella which is one of those bacteria we’ve talked about and calprotectin which is gut inflammation over a thousand. Fatigue and anxiety were the main symptoms. We see this everyday all day.

Dr. Justin Marchegiani: Yep. Exactly. I’m familiar with that case for sure. And inflammation in the gut can definitely create those types of issues and get to the root cause of it too. And then, someone writes in, about Accutane too, I mean, this is super common if you get into the dermatology world. I mean, dermatologists, they either cut something. They burn it off with a laser. They freeze it off or they use some type of antibiotic, topical or internal or they use some kind of like, synthetic vitamin A. That’s it. That’s the dermatology world you know in a nutshell and they tend to not get to the root, you know, we’re talking like more chronic acne, chronic skin stuff. They tend to not ever get to the root cause of how or why that’s even there. Diet, sugars, junky, omega-6, poor digestion, poor fats, poor proteins. They don’t really get to the root cause of what that is and so, they recommend synthetic vitamin A, which is Accutane, which again, will decrease the amount of oil produced by your sebaceous glands which can be helpful in the short run if they’re producing too much oil but they can create chronic skin and eye dryness in the long term and they’re not even getting to the reason why your skin’s producing too much oil to begin with. Usually, it’s too much insulin. Insulin is a huge driving factor of excess oil and then of course, you have different food allergens, gluten, dairy, too much sugar. That can also cause a lot of problems with the skin cells.

Evan Brand: And not to mention, the connection between people that have anxiety and acne. Guess what, they’re both linked to the gut. So, if you have acne and anxiety, you gotta investigate your gut. Please. Please. Please.

Dr. Justin Marchegiani: Yep. 100%. And again, you know, outside of that, you know, we look at different toxins down the road. If we look at heavy metals, there’s different tests. We can look at, to do a challenge test on your metals with a DMPS or some kind of a challenge agent. We can definitely look at mold if there’s mold in the environment that’s important to look at. And again, if you’re in an environment where you feel better leaving that environment then there could be some mold in there, especially, if a history of water damage that was unresolved, definitely want to get your mold looked at or just your home looked at too, especially if it’s something that the whole family is dealing with just get the home looked at to start. It’s usually cheaper and more effective out of the gates.

Evan Brand: Yeah. well said. And, heavy metals too. I’m glad you brought that up. You know, mercury and other heavy metals that can stimulate the nervous system and cause issues. So, if you have a bunch of silver fillings in your mouth, you’ve got to consider that. May not be your number one smoking gun, sometimes it is but heavy metals are a big problem and even detox too can make people feel too sick. I mean, you and I have seen this many times. Other practitioners that have handled people before they come to us or they’ve done something too aggressively with chelation or other detox methods and then they’ve ended up worse. So, there’s like a tight rope and that’s where the art of medicine comes in. Everything is not just like cookie cutters. So, too much is a problem. Too little is a problem and that depends on gut and detox and beta glucuronidase and liver and all of it. So, like if your friend got better and you tried what your friend did and you didn’t do well, that might not be your right protocol.

Dr. Justin Marchegiani: Yeah. Exactly. And then, just to kind of highlight the nutrients in, compared to talk therapy, Julia Ross is out there. She’s like a family therapist person but she’s done a lot of books on amino acids and diet and she had different clients that she used to use talk therapy for years and years and years and said, “hey, let me just try adding in some amino acid therapy to their protocol and let’s see how they do with their talk therapy when we add in the amino acids”. She started to do that and then these patients would come the next week and they’d be like, “Yeah, just, I’m just good. I just don’t even feel the need to talk about it. I’m over it”. And it’s like wow so it’s like it gives people the equipment to kind of, like, process these issues and again I think talk therapy acutely may be fine. It’s just when you’re talking about the same thing for years and years and years, you’re probably not getting to the root cause, right? This is probably just covering up something else, you know. Now, I think it’s better than being on a drug, right? So, if it’s helpful and you don’t need a drug that’s great but, in the end, you know, if you can do some of these nutritional things along with it, you may find that you can just deal with the issues better you know I, the analogy I get patients is, try dealing with difficult problems around the home and not having slept for a couple nights. You’re gonna lose your patience with your wife with your kids. You’re not gonna be able to think right, you’ll be foggy, get some good night sleep and then wake up and deal with the problem. It’s like you’re gonna be way more equipped to deal with it. I think that’s kind of how brain chemistry works when you’re dealing with these stressors.

Evan Brand: Yeah. Absolutely. Well, I remember in that book too, talking about how, like, amino acids were administered, right? At the beginning of a session and then the people would just immediately like, smile or loosen up or relax and so it’s amazing no matter how much you talk. Long story short, I know we’ve beat the drum on this for a minute but last thing, no matter how much you talk. It’s never gonna change your levels of serotonin just by talking it out. If you have a gut problem that’s affecting your nutrient absorption which is affecting the tryptophan and the conversion with the B6 over to 5HTP and then over to serotonin and then to melatonin so sleep issues too. So skin, sleep, anxiety, they’re all connected depression. We’ve already talked about that. This person here’s putting a bunch of question marks like they’re mad at us. What is the connection between Accutane and depression?

Dr. Justin Marchegiani: It’s just a side effect. It’s a side effect of the drug.

Evan Brand: It could be a side effect. Yeah.

Dr. Justin Marchegiani: Yeah. Just the side effects of the drug. That’s all it is. Yeah. So certain drugs, you know, are gonna have side effects. Ibuprofen can cause ulcers and liver issues, right? Just a drug side effect.

Evan Brand: Yeah. Well, we got to wrap this thing up. But if you need help clinically, you can feel free to reach out. We work with people around the world. We send these functional medicine labs to your door. We have an incredible logistical team on both sides where it’s incredible. We can help people in literally every part of the globe where people like us don’t exist or maybe they do but we’re better. So, if you need help, you can reach out directly to Dr. J, that’s Dr. Justin Marchegiani at justinhealth.com for consults or me, Evan Brand at evanbrand.com. We’re happy to help. You guys, don’t give up. We’ve been through it. We are warriors ourselves and we’ve worked on our health for years and we love what we do and we love helping people and there’s so much possibility when you can beat an issue like anxiety. So, like I said in the beginning, whether it’s seeking that raise, that new promotion, that new job, that new spouse, you know, that partner, that relationship that you want to grow but you can’t because you’re held back by anxiety. This is a huge huge problem and you can overcome this. So please don’t give up.

Dr. Justin Marchegiani: Yeah. If you guys enjoyed it too, look down below, you’ll see a little link where you can write us a review. We appreciate the review and if, also, it’s benefiting you, feel free to share with family and friends and there’ll be links where you can reach out to us directly to get that extra bit of help. All right guys, have a phenomenal day. Take care. Bye everyone.

Evan Brand: Bye-bye.

Dr. Justin Marchegiani: Bye.