Gut Irritation & GI Testing

What are the contributing factors to the gut inflammation we’re seeing and what are the contributing factors to the secretory IgA being low? Why does this happen?

So first things first is we have to do an adequate history.  How did we get here?  That’s like the first question that everyone needs to be asking themselves and their functional medicine doctor needs to be kind of reviewing with them.  So a lot of people there’s usually a history portion that reveals this.  So when I come in and I do a history, I do a timeline history.  I try to figure out how the person got here.

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So there’s 2 scenarios.  There’s either the person got this position where they’re sick and not feeling well acutely, i.e. I was in Mexico.  I ate some bad food and now I’m sick.  Or most of the time, there is a chronic insidious bit to it where there has been some stress—emotional stress, physical stress, chemical stress, bad foods, poor digestion, and then the kind of stress has been going in a downward pattern, health symptoms have been getting worse over time and then boom! They get sick acutely but it’s not really acutely.  There has been a downhill, kinda spiral the whole time. So number one, there is totally acute, feeling great, now they’re not.  Number two, it’s this chronic downward decline.  Boom! They get sick!  And I’d say number three is it’s just chronic and there’s no timeline.  There is no event at all.  It is just a gentle downward slope.  So 3 ways that kind of health symptoms unfold.  One, very acute.  Two, a downward decline, followed by an acute episode and it could be a couple of acute episodes by the way.  It may not be one and a lot of times there could be autoimmune flare involved in there and number three, it’s just a gentle downward decline with no acute episode.

So those are the big three scenarios.  So we have to really look at, “Hey, when was the last time you remember yourself feeling good?  Walk me to the timeline over the last 10, 15 years, when did things start to go sideways?  Was it when you were eating some bad foods, some gluten?  Was it when your diet was poor?  Was it when stress or sleep was poor?  Was it when you started going through menopause of having some hormonal issues?  Was it when you had a thyroid flare?  What was going on when all these stuff happened?  And those are the important questions because we have to connect the dots to the root cause so when we ask questions about symptoms that are downstream, we are actually looking upstream to the root cause that cause these symptoms to manifest.  So there’s a different mindset most clinicians and doctors are looking at.  “Hey, what medication can we do to cover up that symptom or even what supplement or nutrient or herb can we use to cover up that symptom?”  But we’re actually—we may be looking at that, too, but we’re also looking upstream as well.

A couple other triggering factors.  Divorce is huge.  So any issues with marriage, whether someone just had a bad marriage and needs the divorce but they haven’t yet.  They did get a divorce like I had a woman last week who developed Hashimoto’s.  She developed thyroid antibodies after her divorce.  She had bloodwork done before.  She had no antibodies.  She went through crazy stressful divorce, fighting over who gets the kids and all that and then boom! You look at the labs and then there are the antibodies that showed up.  It’s sort of a response to the major stress.  Ideally, when you deal with marital stress, ideally you are on top of it and you’re seeing a counselor to help because it’s always easier to mend it than to walk away.  In some situations you can, some you can’t but we always recommend getting some kinda counselor there to help on that side of the fence.  And then of course, you know, death of a loved one is gonna be a big one.  Even things like moving and a lot of times, moving may be tied to a promotion or a good thing but believe me, it’s very stressful.  We look at what’s called a social adjustment questionnaire.  Moving, death of a loved one, death of child is even more, you know, affairs, divorce, anything on the relationship side is really big.  So those are gonna be important things you wanna look at from an emotional stress standpoint because those can be a big thing and they put stress on the adrenal glands.

So, hey, we just wanna make sure that we’re addressing it.  We’re processing it.  We’re seeing a counselor or seeing therapist, someone to work on it.  Maybe there’s subconscious stress.  Maybe we’re working on EFT or NLP or EMDR techniques to deal with the PTSD from that trauma.  So we have things like that, right?  And then of course, like in your timeline history, we’re also gonna be looking at was there a leak in your house?  Was there any mold exposure?  Things like that because that’s a big environment pull.  Hey, do you feel better when you leave your house for a week, you know?  Barring the fact that you may be on vacation and stress is lower, if you just leave your house for a week, do you feel better?  So we like to have those kind of timelines because that can set you up for a whole bunch of gut issues.

So when we talk about gut testing, it’s never just the gut myopathy.  We’re trying to connect the gut to underlying stressors that have been accumulating for years if not decades that got you to this position to begin with.

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Low Potassium, Adrenal Dysfunction Your Immune System | Podcast #288

For today’s live podcast, Dr. Justin and Evan Brand talk about Potassium and our immune system. Among other minerals, Potassium also acts great especially in our body, energy, mood, blood pressure and a lot more. Let’s dive into why potassium is important for our immune health. Check this podcast’s transcript. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:18 All about Potassium

9:11 Oral Supplementation

18:32 Glucose

20:57 Foods with Potassium

27:11 Vertigo and Dizziness

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Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani, we are doing a live podcast here on potassium and your immune system. Potassium is an essential mineral. And it has major effects on the sodium potassium pump, how your cells function, energy, mood, blood pressure has a huge effect on the adrenal glands. I’m excited to dive in here with Evan Brand, Evan, how you doing today man? doing really well.

Evan Brand: So we were looking at some papers on this thing. And turns out a national survey found that approximately 98% not nine not 8, 98% of Americans are not meeting the recommended potassium intake. A Western diet is to blame as it favors processed foods over a whole plant foods such as fruits, vegetables, beans, and nuts. Everybody knows that the American diet is crap. And it’s not just the American diet. Right? This is the standard European diet. This is the standard Australian diet you know, kind of most developed first world Countries they’re doing too much. Too much potassium devoid food. And let’s tie that directly into what we were also looking at which is this paper this based on the names of these doctors. And yeah, actually it shows it right here. When Zhu Zi Yong ha, Province, China, so yeah, so this is a Chinese hospital and Chinese medical universities to study that came out of hyperkalemia and clinical implications and patients with Coronavirus and long story short people that had potassium deficiencies. They had severe hypokalemia, which is the technical term for potassium deficiency. And it said here that the patients responded well to potassium supplements. And they were inclined to recovery so they don’t say directly Hey, low potassium means you’re going to get the virus or low potassium means you’re going to be really sick, but they just talk about how, because of this whole Ace to enzyme thing that you and I’ve covered many times, and the whole relationship to the virus that one of the side effects of the issue can be low potassium, and if you’re already low potassium to begin with, then you can end up in potentially fatal shape, which is not good.

Dr. Justin Marchegiani: 100% in potassium is very important because our sodium potassium pump is requires potassium. So what happens is, you have your cell, and then you have sodium inside the cell and you have potassium outside of the cell. And they do a little switcheroo ski, right. This is called the sodium potassium pump. The enzyme that’s involved in making that happen is ATP. And then you know, it’s an enzyme because of the word Ace next to an ATP ace. So ATP is important because ATP is generated from your mitochondria, right? We have glycolysis outside of the cell in the cytoplasm, and then we have our Krebs cycle, right? And we have our electron transport chain within the cell we generate 36 to 38 or so ATP from that that eight TP part of that ATP runs their sodium potassium pumps that ATP takes that sodium that’s in the cell and that potassium outside of the cell, they do a dance, they switch. So it’s three coming out to come in, right? Boom, just like that. And the cell needs that healthy fluid fluidity to work and to communicate. And if we don’t have that healthy fluidity, we’re going to have side effects. So one of the big side effects is we’re going to have muscle or nerve issues because potassium and sodium are very important for the muscles slash nerves to work, right nerves help control muscles, so very, very important there. You’re also going to see it with you’re going to see it with potential mood issues as well because sodium and potassium play an intricate role with the adrenal glands and part of the reason why people’s potassium gets low outside of a poor diet is going to be because of adrenal function. Now, typically with adrenals. Your dosterone starts to go low, which is a mineral corticoid that exists in The cortex to the adrenals. And what happens is as your dosterone starts going low, your sodium can start to drop. And as your sodium drops, sometimes your potassium can look like it’s not too bad, it can look actually a little bit high, but you could still actually have potassium issues because of the fact that you are your adrenals are weak and you’re pulling out a lot of your minerals. So muscle and cramps are going to be a big deal, weakness and fatigue because your nerves need that. Also, if you don’t have good sodium potassium pump issues, you probably have energy issues because the mitochondria healthy mitochondrial function for ATP is needed for that sodium potassium pump to work so potassium works better when there’s the ATP so that whole sodium potassium pump works. We talked about cramping as well because of the the muscles needing the wiring the fluid wiring sodium and potassium and minerals. So cramping is gonna be a big deal. We’re also going to have potentially digestive issues right? your bowel movements and your motility starts to Coming slower when your potassium drops, so we need healthy levels of potassium. So we have good bowel movements. Also heart palpitations, we need potassium and magnesium. So our heart could pump right our hearts a muscle as well. So if your heart skipping beats or beating harder or faster, that’s a sign of palpitations, which could be from that. And also just achy muscles, muscle breakdown, feeling tired and stiff, right? the breakdown of muscle was known as rhabdo. My license or my analysis, right? And that breakdown is going to be very much helped with good potassium levels, right, you’re gonna have less muscle breakdown, with potassium levels being adequate, of course, tingling and numbness issues are going to be a big one difficulty, you know, using your lung muscles mood stuff because of the adrenals as well. I’ll pause and give you a chance to comment.

Evan Brand: I’m glad you mentioned magnesium too, because, uh huh. You and I were kind of looking with a microscope today, right? We’re kind of spot picking right? One thing to talk about, but all these people that are deficient in potassium, I’m sure they’re going to be deficient in magnesium as well. I mean, we know how hard it is to get it from the food, even if it’s organic, because the soil is so depleted. So it’s a really common problem. And then on that whole mood changes, I just wanted to talk about that real quick. There was one study, and this wasn’t a necessarily a causation, but just a correlation study that we were looking at here. 20% of patients with mental disorders that came into this psychiatric ward 20% of them had potassium deficiency. So it’s not saying directly, the potassium deficiency caused the mood issue, there could very well be other things going on you and I’ve covered hundreds of times about gut infections, which could lead to mineral and electrolyte imbalances you hit on the adrenals. So, of course, as we know, when we hear something like that, we say, Okay, well, if you just give these people potassium, are they not going to have mood issues anymore? And the answer is, they could still have mood issues, even if they supplement Potassium, but it’s interesting and it’s something that often gets skipped. This is really low hanging fruit. Somebody could go to something very nuanced as this particular herb for this retrovirus or this bug, but the person’s just simply dehydrated and they’re not getting enough electrolytes, it could be something very, very simple like that.

Dr. Justin Marchegiani: 100% and low potassium is so common, just like low magnesium is common. I think you said what 98% are going to have some kind of an issue.

Evan Brand: Yeah, and I think this idea that yeah, I think this study I was referencing was probably just a survey where they looked at diet and figured out whether people were even getting the the the recommended daily amount, and 98% of people are not getting the recommended daily amount are already on the recommended daily intake. So I guarantee magnesium is in the same boat, probably 90 plus percent.

Dr. Justin Marchegiani: Yeah, 100%. I agree. And then also there are medications that are going to affect potassium, right. We know a lot of the blood pressure medications as well as things that like water pills or diuretics. So if you’re on a BP medication, right, there’s a good chance some of that’s going to be actually driving further potassium deficiency. So low potassium levels are super common because of that. Also, we’re going to have problems with potassium if we consume too much alcohol, right, alcohols gonna cause us to pee a lot more potassium out because things like diuretics are going to cause you to lose more minerals, right? diuretics basically activate a hormone that causes you to kind of continue to pee. And the more you pee with a diuretic in your system, whether it’s, you know, excess coffee, or even access alcohol, you’re going to pee out a lot of those minerals. So that’s kind of like vitally important, right?

Evan Brand: And even Yeah, and even tea, I mean, even tea could be to blame. I think herbal teas can be great, but there is somewhat of a diuretic effect of certainties as well. So if you’re just like sipping on tea all day and not drinking enough just straight water or our preference water with a pinch of salt or water with some electrolytes, actually to it, you know, this can happen easily. And this is not just a problem in athletes, people hear the word electrolyte and they think you only need that if you’re in the NFL No, you need electrolytes just to function.

Dr. Justin Marchegiani: Exactly, the problem with a lot of people with their potassium is, it’s hard to get too much if you’re taking it orally, right? Obviously, you go back to like the lethal injection people are actually you know, in the lethal injection in the prison system, people are actually being killed by potassium IV right or injection. Now, it’s hard to get too much potassium orally because some of the vomiting and from some of the vomiting and diarrhea side effects and the nausea side effects that you get from have actually having too low potassium. Well guess what, you actually have similar side effects when you go too high. So usually you get so nauseous, and you’ll either throw off or you’ll get diarrhea. So it’s very difficult. The only way to really do it orally is going to be with an oral supplementation. And you’d have to do a lot of it and all those symptoms would come into place. It’d be really high. The only way you You can get your potassium levels to the point where you’re going to be too high is going to be on an IV. And what they do actually on an IV to reverse potassium overdose is they do a bicarbonate infusion, bicarbonate actually neutralizes that high level of potassium. But some of the major causes are going to be diarrhea, right? So if you have a parasite infection or a gut infection that’s causing chronic loose stools, guess what? You may be having low potassium because of your gut. I have some patients that need five or six or seven grams a day of potassium supplementation, whether it’s because of a stress or a malabsorption issue, but all of their low potassium symptoms go away when they hit that level, meaning like the cramping, the twitching, the heart, the mood stuff all go away when they hit that higher level. So I mean, the goal is let’s fix the stress. So you’re not dumping the minerals as much let’s fix the gut. So we’re absorbing but, you know, I don’t typically don’t recommend doing more than one to two grams of potassium supplementally and we’ll do a good high quality keylight whether it’s a discoloration A or A potassium bicarb or we’ll do a potassium citrate like a new salt, which is a cheap source, and then we’ll try to plug in the recipe of the diet but if we have to go above, you know, we’ll do it incrementally and we’ll start looking for those low potassium symptoms to go away but alcohol is gonna be a big one, chronic kidney issues. uncontrolled Type One Diabetes will do it diarrhea, like we mentioned. So gut issues, diuretics is a big one. So if you’re on a diuretic on a blood pressure meds side, that could be a problem. sweating a lot. So if you’re sweating a lot, yeah, you’re gonna need a lot more minerals. Again how Gatorade was figured out I think it was the 1968 late 60s I want to say was the Orange Bowl one of these big bowl games the Florida Gators were actually playing halftime I think one of the exercise physiologist or PT people, trainers said hey, let’s get these electrolytes in and they had a kick butt second half and they just they killed it and won the game. And part of it was the electrolytes they put it and now we have all these things. Gatorade substitutes, but the real they were called Gator lights, right? Gator lights, not Gatorade. They tasted like absolute crap. So what you have now are a whole bunch of minerals with a whole bunch of sugar and dyes. Back then they just had the minerals and it tasted awful. But from a performance standpoint, they did really well because the other team didn’t have it. So they their muscles were functioning better. So sweating, not having enough full later B vitamins, having high amounts of aldosterone, whether it’s a tumor, or just our adrenals being overstimulated. Some antibiotics can actually have problems as well. And then vomiting vomiting too much can create low potassium too. And then obviously, just that junk food diet, we’ll talk about what it takes to have enough potassium in a minute.

Evan Brand: Yeah, and one thing too, that people miss out on a lot of these new companies, they’re doing a good job because they’re getting away from the corn syrup and the fake sugar and all that stuff, but you still do need based on some of the stuff we’ve looked at. I believe you need a little bit of glucose to help get potassium And your other minerals and electrolytes into the cell. So you’ll see if you look at they call it o RS oral rehydrating solution. This is like the military grade electrolytes. There has to be a little bit of sugar there has to be a little bit of a blood sugar spike, I believe it somehow opens the channel to let the electrolytes in. I’m not sure the exact you know, molecular level stuff that’s going on. But I’ve read into formulas that are just stevia or just monk fruit, some of these natural sweeteners that if they don’t affect blood sugar, you don’t actually get the benefit. So when you look at legit like military grade, electrolytes, they have a little bit of glucose spike associated with it.

Dr. Justin Marchegiani: Yeah, and the glucose is better, right? The problem is a lot of these places they have fructose, the fructose doesn’t target the muscles the same way as glucose does. So if you’re looking for an electrolyte formula, you you really want you can get the electrolytes by itself but then if you want if you’re doing a lot of sweating or a lot of glycogen depleting activity, whether it’s football or some kind of a sport that requires a lot of sprinting or running, then you’d want a formula that’s going to have more glucose in it for the sugar source, not fructose. fructose is a problem because it hits the liver more than the muscles. Glucose hits the muscles more than the liver. And like you mentioned, that helps open up that cell with the insulin and helps deplete the glycogen levels and helps that sodium potassium pump work better if you’re using a lot of glucose or if you’re sweating a lot, but if you’re not, and you’re just the average everyday person, probably getting the minerals in without the extra glucose is probably okay.

Evan Brand: Yeah, we talked about mold and detox and sauna and all of that, but I’m really shocked at how many people are doing sauna 234 or five times a week and they’re just drinking water. I’m like, Are you nuts? You gotta be doing electrolytes that is a critical component of detox in my opinion, is you have to make sure you’re replenishing and rehydrating because you’re losing a lot of minerals. You’re not just magically sweating out heavy metals and mold toxin, you’re sweating out minerals and electrolytes. You have to replenish those and you You were drinking a green juice earlier, I think you said your green juice had like 1200 milligrams per bottle or something crazy. 

Dr. Justin Marchegiani: Yeah, this is a great brand right here. It’s called evolution. They sell them in Austin and Selma, even in target now, which is kind of cool. Like, I like the fact that a lot of these healthier things are coming into kind of more mainstream box stores. But organic greens, I’ll typically drink the celery juice, but I’ve been doing the essential greens, they have the celery is the first ingredient so it’s still great. I love celery because of the minerals in there the electrolytes and then potassium is really high in celery, but it’s got cucumber, spinach, romaine kale, lime and parsley. And then they have a green devotion instead of lime. It’s got lemon, so they go back and forth, but there’s no actual fruit outside of the lemon or lime which is pretty low sugar. And this has got just alone It’s got I’m almost about 1200 milligrams of potassium. So I got about 25 to 30% all my potassium right here. So that’s pretty cool. So I just kill that after I have my really nice good breakfast with collagen and then I’m already a you know, a quarter of the Through my potassium needs for the day, which is great.

Evan Brand: Don’t you feel more like your thirst is quenched to like when I drink regular water compared to something like that. It’s just not as quenching to me as the good stuff, the green juices, they’re more thirst quenching. I’ll do like a little bit of electrolyte through a pinch in, like with some beet powder and stuff like that. And I feel great if I’m just doing filtered water and I’m not using aro I’m using like a carbon system even then though I water just doesn’t cut it for me. I like a little extra bang.

Dr. Justin Marchegiani: Well, I think a lot of people what they’re really craving is they’re craving some water, but they’re also craving minerals, right? And so because they’re craving minerals, if there’s no minerals in there, yeah, you’re going to feel like you’re missing out on something, right? So that’s definitely a big part of what’s happening is your body’s craving the minerals, and if they’re not there, that’s a problem. Also, I’m pretty sure Cushing’s is going to be another potassium issue, right? Cushing’s and potassium is going to be a big problem as well. So now what does that mean? So the kidneys excrete large amounts of potassium when you make a lot of cortisol. So what does that mean? So If you have Cushing’s that’s kind of more tumor induced where the cortisol is so high probably because of some kind of a tumor. But what if you’re in between? Right? What if your your adrenals are just overstimulated, you’re not on the adrenal, you’re not on the Cushing’s disease side but you’re just making a lot of cortisol because of chronic stress. So it’s possible your chronic adrenal stress could be causing you to dump a whole bunch of potassium out. So that’s where when you’re getting stress, under stress, physical chemical emotional, maybe that gluten is causing the stress, right? You’re gonna probably need more potassium, more minerals. potassium and magnesium are the most common ones. It’s so hard to get them most people get enough sodium and chloride because of just it’s in their natural junk food. I don’t get they don’t get the good quality from like a good high quality sea salt or Redmond Real Salt, but they’re getting some it’s really the magnesium and potassium I’m seeing as the big big missing pieces and today we’re really focusing on potassium.

Evan Brand: Yeah, makes sense. I mean, think about what happens when you’re dealing with somebody that’s really stressed right? They may have issues with constipation, they may have issues with Sleep, they may have issues with their blood pressure, they may have issues with anxiety as you hit on earlier, potentially Heart, heart pumps. So all of that, to me sounds like stress induced mineral depletion, which then causes other symptoms and you’re stressed about your blood pressure being elevated. So then that cortisol dump and adrenaline dumps more minerals, and then it become more mineral deficient. So you see how this thing can get out of control. And it sounds really cliche and corny to say, well, stress did it but it really does. And it’s not just the emotional, it’s the gut stress. It’s all of it that we always hit on.

Dr. Justin Marchegiani: 100%. Also people are talking about in the messaging. Well, what about if I’m in ketosis and I don’t have glucose to open the cell? Well, I mean, we’re just talking about with x with extra exercise, right extra exercise, extra sweating. If you’re doing a lot of glycogen depleting kind of movement or exercise, you’re probably going to want to do some type of a glucose kind of refeed the night before the movement. And a lot of athletes who do keto still have a punctuated kind of glide And reefy the night before just other tapping their muscles out, because your muscles can hold anywhere between 250 to three to 400 milligrams or grams of glucose or glycogen, right? glucose in the muscles is glycogen, it’s stored, right? That’s the storage form of glucose in the muscles. So a lot of people, they’ll be in ketosis most of the time, they’ll do a refeed the night before, that way they have access to that glucose The next day, and again, depending on how depleting or how long you’re exercising, you probably want a nice little bit of a glucose, electrolyte drink. And again, that’s not most of the time, that’s going to be just more timed up according to exercise and kind of what your metabolic needs are. But for most people, you know, a good natural Gatorade source, guess what coconut water, got a little bit of glucose, a little bit of sugar in there, and it has a lot of potassium, so that can kind of be mother’s nature’s natural kind of Gatorade. It just depends on what you’re doing. If your kids playing football and sweating a ton, they may need a little bit more than that. You’re going to have to just feel it out. See what works. Test it on your own when your practice To sing and playing and see how you feel with that you may not need pure coconut water, maybe just diluted half and a half with a really good clean mineral water. And then you have a little bit of glucose, a little bit of extra potassium plus the other minerals working for you.

Evan Brand: Yep, you want to hit a little bit of the diet piece. Yes, you and I were kind of looking at some of this before you pointed out. Interestingly, and we’ve probably talked about this in previous but if you look at 100 grams of food as a measurement, the potassium per 100 gram of avocado is higher significantly than bananas. If you look at a full avocado, versus a full cup of banana, which maybe is a full banana, you’ve got almost double in the avocado. So you know as a kid, I remember thinking potassium banana, and that’s just kind of this thing you grow up with. But in reality, there’s things that are much much higher like beet greens takes the cake with number one here. 1300 milligram per cup of potassium that is insanity. 

Dr. Justin Marchegiani:  Exactly. So most people don’t get it. So if you’re sitting Get in there. And you’re on keto, right? Well, what are the biggest easiest things you can do? Well, beet greens is number one. Okay? What’s number two salmon, high quality fish that’s per hundred grams. So what’s 100 grams? 100 grams is about 3.3 ounces ish. Let me just double check that hundred grams and ounces. I’m pretty sure that’s what it

Evan Brand:  sounds about, right? Because it says here, potassium per six ounce filet of salmon.

Dr. Justin Marchegiani: So 3.5. So what does that mean? So Alright, so if you’re keto, right, and you want to really be on top of this, or you’re keeping your carbs down, what does that mean? That means Okay, if I eat seven ounces of meat, seven ounces of fish, I’m at 1300 milligrams of potassium, boom, you’re right there. And then you throw in some beet greens with it right? That’s three ounces worth right hundred grams. You’re at another one gram almost. And then guess what? You cut up an avocado with that. Right big avocados. Another 500 I’m sorry, another per avocado. You’re about one gram per full avocado you’re set. Right?

Evan Brand: I want to look up cassava because I love cassava. And what if you like did some guacamole with like cassava chips? I wonder if we’re getting any?

Dr. Justin Marchegiani:  Oh yeah, so we could do like Yuka in potassium because Yuka in protect you guys same thing as cassava. Yeah. So one cup of cassava is 558 milligrams, boom. 

Evan Brand:  So because our chips and I mean now, some would argue, well, you know, the, the baking process and whatever of the chips, okay, whatever, but it’s still better than zero.

Dr. Justin Marchegiani:  Yeah, but a lot of times if you don’t bake it or cook it, you’re not going to be able to get the nutrients anyway. Like, if you look at broccoli, raw versus broccoli steamed, you’re going to see the nutritional value in the content goes up once you cook it, because then the fiber is broken down so you can actually access some of those nutrients.

Evan Brand:  Yep.

Dr. Justin Marchegiani:  So cooking a lot of times can make certain nutrients more bioavailable, too. It’s not Oh, cooking bad all the time. 

Evan Brand:  No, I’m just thinking. I’m just thinking of the one devil’s advocate out there saying oh well you’re eating. you’re advocating Eating, you know, chips fried and avocado oil. It’s like Yeah, I am. I think it’d be great. 

Dr. Justin Marchegiani:  I think it’s okay. I think it’s fine. I mean, don’t make it a staple. But I mean, I think it’s if you’re gonna have something like that it’s all about not going to the place in your head about like, Hey, what do you have to cut out versus Hey, what can I substitute? When you have a substitution mindset versus the cutting out mindset? One, you feel a lot more free and you feel like you’re not missing out on stuff because there’s always a good healthy stuff the tuition option that works. So let’s let’s kind of just create a simple day like what does a day of potassium look like? So off the bat, you know, on the vegetable side, one cup of you know, your typical vegetable greens will be anywhere between 500 milligrams to about 800 milligrams depending on the vegetables, right? Like one avocados gonna be about a gram, right? One cup of Swiss chard is gonna be about a gram. So you’re really at the top with those. One cup of spinach is about 840 milligrams, and then you have on the lower side, which would be like broccoli and brussel sprouts are closest 500 milligrams. So just to kind of give you a sample day here, let’s say we start out with a full avocado, boom, you got one gram of potassium so that now you’re like you’re like really on the way there. If you do a serving of fish like a good six ounce serving of fish, now what? Well now another gram is added, right? No problem. All right, and then now you’re at about now you’re at about two grams. And then if you throw in a green juice like this, you’re over three. And then if you have a serving of squash, or even white potato, or sweet potato, well now you’re at another 500 to 800 milligrams. Okay, now you’re at 35 to 3800 milligrams. And then you just need about four more servings of vegetables. And most people when they have veggies, they’re probably going to have two servings at a time, right? They’ll probably have close to a gram anyway. So you need about, I would say about four to six servings of a good quality green vegetable, you’re probably going to need one full avocado, and then one full serving of a good quality fish. And then you’ll get right about there and then you can always add in an extra avocado, you could always add in a little bit more fish, you could always add in a little bit more beet greens or green vegetables to get you the rest of the way there which is about 4500 to 4700. And then if you’re doing a lot more sweating, you could always throw in some coconut water. So I would say about six servings of green vegetables one full avocado, a good serving of fish and then you can always plug and play coconut water or banana according to what your metabolic needs are. What do you think?

Evan Brand: Yeah, and yeah, very good. And you didn’t mention any nuts which is another easy low hanging fruit so if you can get away with doing like pumpkin seeds, you can get a ton there if you do almonds or almond butter or you put a scoop of almond butter in a smoothie, you can get some there pistachios are super high and then I was looking on this other foods like-

Dr. Justin Marchegiani:  potatoes potatoes are huge so it means depending white potatoes if you’re trying to keep low carb or autoimmune find Nick’s that go to a squash or a potato but potatoes are very, very high in potassium. He will forget that.

Evan Brand:  Yep, yep. I was looking on this nutrient density chart. Whey Protein is number four 100 grams away, you’re getting over two grams 2200 milligram potassium 400 grams away. So if you can tolerate a good high quality Grass Fed Whey protein, that’d be easy. Think about if you made a smoothie with some greens, some whey protein in there, he threw some pumpkin seeds and a scoop on the butter, man, you’re set.

Dr. Justin Marchegiani:  How many milligrams in the way?

Evan Brand: 2200 for 100 grams of, you know substance 2200 potassium.

Dr. Justin Marchegiani: okay, I put 400 grams in the whey protein. Okay, so your typical servings probably like 25. So how many again, per 120 200? Okay, so if you’re doing maybe 25 or 30 grams of protein, which is what most people do in a scoop, I mean, you’re probably about what 500 milligrams.

Evan Brand: I’m going to look up I’m going to see what the serving size is because you and I use a couple professional grass fed powders. Let me see what the what it looks like. Yeah, so so one scoop Typically is 30 grams. So exactly, exactly, yeah, so you could almost call it you could almost call it one third then so you know 2200 divided by 600

Dr. Justin Marchegiani: ish 656 50 ish. Okay, that’s cool. Someone else also asked about the vertigo and dizziness Yeah, low potassium can cause that vertigo and dizziness kind of feeling. So we kind of gave the general recommendation of 45 to 4700 milligrams of what you need per day on the potassium side. Most people aren’t hitting it, you’re getting six to eight servings of green vegetables, a high quality serving a good fish and some potassium and maybe I’m sorry, potassium from a full avocado or a green drink or some extra say starch, squash or sweet potato or white potato, you’re gonna be there at about 45 to 4700 milligrams. Most people may need more if they’re sweating, or if they’re under a lot of adrenal stress. So you may want to think about supplementing, if you’re still doing a great job on your food and you’re not there. You may want to fill in the gap, or you may want to just try it out. Add in a couple more of these nutrient dense foods that Evan and I just hit, and see if that fixes the issue. So, a lot of times people have these low potassium symptoms and they see it go away the BR and all I see is you’re going to see a lot of heart stuff, and a lot of muscle cramping stuff, those are going to be big things. So if you see the heart start to get better or the cramping get better. That’s an easy sign that you’re on the right track.

Evan Brand: What do you think, Kevin? Well, I think this is fun, and it’s something that can’t be ignored. So please address this, work on this, tweak it and see how you feel, I definitely feel better. I feel in a better mood. I feel more energetic when I’m staying regular with getting enough electrolytes as a whole. So I think he could be a game changer. And we can run some of these analyses on your body. You and I kind of talked before we hit record about how the blood really doesn’t change much. So looking at serum potassium may not be the best. So there are some other panels that we can look at, but as a whole, when we’re looking at organic acids testing and stool testing and we’re looking at gut infections a lot of times We can infer just based on observation symptoms, and what else is going on that you probably got a new issue. So the good news is, you can fix this, it’s relatively cheap to free to fix it outside of just tweaking the diet a bit at the grocery or farmers markets, but you can make it happen and make a big difference.

Dr. Justin Marchegiani: Exactly. Now, someone else chimed in about the evolution drinks and the plastic. I’m not too worried about the plastic with these, these are all cold pressed. Alright, so they’re cold pressed so that the juice that’s put in here is cold and these are refrigerated right away. So you’re gonna have leaching of plastics more when it hits UV light and or higher heat. So not now not that concerned about plastic plus, these things have a short shelf life. So it’s not like the the juice is sitting in there for like a year. It’s just sitting in there a very short amount of time it’s not being exposed to UV light or high temperatures going to being refrigerated, right. So you got to keep all that in mind. So I think if someone’s worried about the plastic, I think the extra extra nutrients that’s in there, it overlays any risk from the planet. Plus you’re not getting the heat you’re not getting warm substances and you’re not getting the UV light so I think the plastic is isn’t as big of a deal versus like a dishonor water that sits in there for a year or two and who knows if it’s going to be exposed to light when it sits out back the the the convenience store or the supermarket thought- 

Evan Brand: That’s what I’m thinking when you go to the gas station. You see the guy taking a smoke break you got the palette of dishonor water sitting there getting blasted by the sun on 100 degree day and then he goes and puts the water in the shelf at the gas station. So yeah, I think you got to choose your battles, right so I mean, the other argument would be well, if you were too busy this morning, you’re working with the kids you got to jump on here with me you got to go into clinic after this. You might not have got that green juice and you would have had zero minerals and zero potassium and zero greens because you didn’t know plastic because you would have tried to go for a blender instead. So you know.

Dr. Justin Marchegiani:  Exactly plus the higher quality grocery stores like Whole Foods for instance, they got a big dock the truck just goes right up to its full containment and some of the stores refrigerating it. If you’re going to a gas station and you’re kind of limited, some gas stations have the Pellegrino so you could always go by glass at the gas station. That’s probably a safer way but I’m not necessarily worried about the plastic with that but in general, a lot of sulfur in here anyway which will help you to toxify any lingering estrogen. So if you have the option I think it’s worth it.

Evan Brand: All right, well, let’s wrap this thing up. I think we covered a lot if you want to reach out clinically, Dr. Jay and I we work around the world with people we’re very grateful we’re very blessed for the opportunity to help you guys so thank you so much for not only commenting on these live videos, but of course just being there clinically because you help us learn we learned so much from working with people one on one way more than you learn in any book or any study is seeing how do people feel Hey, when you recommended this or that my energy went up 20% we love stuff like that it’s addicting for us. So we’re very very grateful and if you do want to reach out clinically, please check out Dr. Justin at Justin Health. and me, Evan brand at and we’ll be back next week to talk more. 

Dr. Justin Marchegiani: Excellent chatting with you guys. And if you enjoyed the content put your comments down below really want to know what you guys think. And if you have any future podcast recommendation topics we’d love to see it as well and sharing is caring. Get this to your families and friends and people that can use this information to help take control of their health. Alright guys, enjoy the fabulous holiday weekend. Take care y’all. See you later. Bye

Evan Brand: Bye.


Audio Podcast:

Coffee: Does it Affect the Adrenals?

By Dr. Justin Marchegiani

There’s no doubt coffee is an efficient way to get the day started strong–but does the temporary energy boost lead to an energy loss in the long run? Let’s dive into the pros and cons of this beloved caffeinated concoction to determine whether coffee is benefiting or draining you.

The Benefits of Coffee

Our brains have an inhibitory neurotransmitter called adenosine, which helps to calm and relax. Coffee decreases adenosine–the compound that decreases energy and alertness–thereby increasing energy!

This adenosine-dampening effect helps boost energy and focus, and can be particularly useful for burning fat. Taken before a workout, caffeinated coffee (averaging between 150-300 mg of caffeine per cup) helps increase lipolysis: fat burning. There are also many people who opt to swap coffee for breakfast to remain in ketosis: a cup of coffee with healthy fats (grass-fed butter, coconut oil, MCT oil, pastured egg yolk…) can be a fat-burning yet quite satiating meal replacement that helps you stay in ketosis while keeping you full and alert.

High quality coffee is actually quite nutrient-packed. B vitamins, a lot of alkaloids, and antioxidants are especially abundant in coffee. There are also several studies which indicate coffee may be neuro-protective, providing protection from neurological diseases like Alzheimer’s, Parkinson’s, and dementia.

Are you dealing with chronic fatigue? functional medicine doctor.

Coffee Downfalls

If you suffer from adrenal or thyroid issues such as adrenal fatigue or hypothyroidism, take note of how caffeine affects your condition and pay attention to how you feel in the hours and days after its consumption.

Coffees and the Adrenals

Coffee stimulates adrenaline and the adrenals–if you have healthy adrenal function, this is similar to getting a little cortisol or adrenaline push which may boost your energy and performance. If you have adrenal fatigue, however, you may want to exert a little caution when it comes to caffeinated coffee.

The science is somewhat contradictory: some studies show caffeine affects cortisol levels, some studies say it does not affect cortisol levels, and others have shown that habitual coffee drinkers have a reduced cortisol secretion response. Clearly, we need more research on this topic. Ultimately, research seems to indicate that there are a wide range of responses to caffeine intake. If you have adrenal fatigue or other adrenal/thyroid issues, it is wise to consult a professional who can help you test and track caffeine’s effect on your unique biology.

Coffee and Sleep

Cortisol rises and falls with your body’s internal clock– cortisol rhythm should be aligned with your circadian rhythm, rising in the morning and lowering in the evening. However, those with hormone imbalances may have cortisol issues. If you feel fatigued during the day but get a burst of energy at night (making it hard to fall asleep), you may have a hormonal imbalance, adrenal fatigue, or thyroid issues. This can be exacerbated by coffee, particularly if you are drinking it too late in the day. Coffee can keep you ramped up even 6 hours after drinking it, so it is recommended to have your last cup no later than 2pm.

How to Use Coffee to Your Benefit

Coffee is an incredibly useful substance which provides us with energy and alertness when used correctly. To avoid the downfalls of this caffeinated beverage, here are some tips to get the most out of every sip.

Hydration and Nutrients

Coffee can put your body in a sympathetic state, reducing appetite. If you are doing a keto coffee with added fat (like butter), you may feel like you can go for hours without eating. While this may work great for a healthy individual, if you have compromised adrenals or thyroid, it is important to eat regularly to prevent putting extra stress on your body. A combination of adrenal fatigue or hypothyroidism, caffeine, and fasting can cause undue stress. Be sure to eat meals at good intervals of every 3 hours or so, depending on your body: grass-fed meats, healthy fats, and organic veggies. It is also beneficial to add a high quality source of protein or a collagen powder to your coffee.

Coffee Quality and Decaffeinated Coffee

Decaffeinated coffee can be beneficial for those with adrenal fatigue or thyroid issues who want to avoid the burden of consuming caffeine. Be aware, caffeine is a natural pesticide, and decaffeinated coffee is sprayed more heavily to compensate. Organic coffee grown without pesticides will help you avoid this common downfall of decaf coffee. Just be sure the coffee is decaffeinated via a Swiss water process, not the toxic and carcinogenic benzene or methyl chloride process.

So, To Drink or Not To Drink?

Ultimately, every individual has unique biochemistry and whether coffee is helpful or harmful will depend on: the state of your health, the quality of the coffee you buy, and how you use it. Choose a high quality coffee grown without pesticides and checked for mold. If you have autoimmune issues, it might be best to cut caffeine for a little bit to see how it affects how you feel. Unless you’re in ketosis, a great way to prepare coffee is by adding healthy fats like grass-fed butter or coconut oil, along with a protein powder. This combination turns coffee into more of a ‘meal’ which supports your thyroid and adrenals.

Still wondering if coffee is helpful or harmful for YOU? Click here for a consult with a functional medicine doctor.


Strahler, J., Skoluda, N., Kappert, M. B., & Nater, U. M. (2017). Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neuroscience & Biobehavioral Reviews, 83, 657-677.

al’Absi M, Lovallo WR. (2004). Caffeine effects on the human stress axis. In: Nehlig A, editor. Coffee, tea, chocolate and the brain. Boca Raton, FL: CRC Press; p. 11331.

Lovallo, W. R., Al’absi, M., Blick, K., Whitsett, T. L., & Wilson, M. F. (1996). Stress-like adrenocorticotropin responses to caffeine in young healthy men. Pharmacology Biochemistry and Behavior, 55(3), 365-369.

Harris, A., Ursin, H., Murison, R., & Eriksen, H. R. (2007). Coffee, stress and cortisol in nursing staff Psychoneuroendocrinology, 32(4), 322-330.

Gavrieli, A., Yannakoulia, M., Fragopoulou, E., Margaritopoulos, D., Chamberland, J. P., Kaisari, P., Kavouras, S. A., & Mantzoros, C. S. (2011). Caffeinated Coffee Does Not Acutely Affect Energy Intake, Appetite, or Inflammation but Prevents Serum Cortisol Concentrations from Falling in Healthy Men. The Journal Of Nutrition, 141(4), 703-707.

Lovallo, W., Farag, N., Vincent, A., Thomas, T., & Wilson, M. (2006). Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacology, biochemistry and behavior, 83(3), 441-447.

The Thyroid, Adrenal and Microbiome Connection | Podcast #255

Together with Evan Brand, Dr. Justin talks about the adrenal, thyroid, gut, microbiome, brain connection and a lot more. Go through this podcast to discover more about functional medicine world. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

4:13 Potential probiotics to treat thyroid nodule

9:06 Microbiota modulate anxiety like behavior

15:02 Stress in gut

20:16 Chemicals in water

23:10 Eating organic



Dr. Justin Marchegiani: Getting ready to go live now go get it live this week. And we are live. It’s Dr. J here with Evan brand. Evan, how are you doing today? Man? I know in the pre show. We’re gonna we’re going deep, deep into the adrenal thyroid gut microbiome connection. How are we doing, man? 

Evan Brand: I’m doing really good. Yeah, this is trippy. You know, people talk about the gut brain connection. But when you actually look into the papers on this, you actually just found a paper that was from just a few months ago, that will have to dive into on gut brain, adrenal connection, thyroid cancer, all being tied into the gut. So where do you want to? Where do you want to start?

Dr. Justin Marchegiani: Yeah, so this one article, I just want to read the summary of his articles. I think this really shows you the connection of the microbiome with the thyroid and of course, we have some scientific articles looking at the microbiome with the HPA access and connecting to the adrenal, so this is really, really powerful. I just thought this one conclusion here, and I really wanted to highlight it because I just think medicine is just really going in a totally different direction. So the title of this article here, I’ll read it all for you all here is dis bios of the gut microbiome is associated with thyroid cancer and thyroid nodules. And there are correlated with thyroid function. And essentially, we know that autoimmunity which is the number one cause of thyroid issues with almost all people, right, that is a major association with cancer and with nodules, of course, the major cause of thyroid nodules are going to be autoimmunity. But the conclusion of this study was interesting they found our results indicate that both thyroid cancer and thyroid nodules are associated with the composition of the gut microbiome. These results may further support a clinical diagnosis to a great extent, and helping in developing potential probiotics to facilitate the tree Men have thyroid cancer and nodules. So conventional medicine in the Journal of endocrinology starting to come to the conclusion that, hey, we need to have probiotics to treat thyroid cancer and thyroid nodules. That’s pretty amazing.

Evan Brand: That’s a trip trip. Well, I’ve got another paper I was looking at here that was about babies. So let me read this one because this is pretty interesting and, and kind of up the same vein here that this was looking at 78 infants who were premature and were in the queue. And it was found that the infants that had despite AOSIS, which I just call an abnormal gut microbiome. They had more gut issues, even at age four of age, they followed these kids for four years. And if their gut was screwed from day one, even four years later, they still had gut issues. So not related to thyroid but just crazy how much the stress of the mom The diet of the mom the microbiome of the mom, if the mom doesn’t have enough good bacteria, not giving good bacteria to baby, this is crazy. I don’t want to get too off topic from from thyroid to babies, but there’s countless papers coming out on even there was another one I looked at two, which was about sun exposure, right. And the sun exposure paper was looking at people getting UVB as in Bob UVB light exposure. And they had significant changes with their gut microbiome but it only worked in the patients that were deficient in vitamin D. So there’s this you know, our mutual friend jack crews, he’s always talking about Sunlight, sunlight, sunlight, everybody gets sunrise get your skin exposed to the sun. It turns out Yes, that is totally true because in various studies, living in higher altitudes means there’s a higher risk of developing inflammatory bowel disease and Ms because at a higher latitude and higher altitude both you get less UV light. So now There’s this gut flora, sunlight link as well, but it only was in vitamin D insufficient patients. If the vitamin D levels were normal, the sunshine didn’t do as much to boost the gut bacteria.

Dr. Justin Marchegiani: Interesting, very good. So I want to just kind of connect the dots here with some of the more valuable Intel. So in the study that I just looked at, where they’re talking about potential probiotics to treat thyroid nodule, and of course thyroid function issues and thyroid cancer, the couple of things to highlight is what does that mean? So despite doses typically means a higher amount of bad bacteria in relationship to good bacteria. Now in this one study, just kind of giving people to take home is the bad bacteria they were looking at that they were looking at they were higher in these cancer patients was the streptococcus and the nice Syria bacteria, and the beneficial bacteria was the lactobacillus and they also looked at the beautiful record bonus and beautiful components. I think it’s just bacteria that helps make beautiful Beauty rate is the same fat that’s in butter. Okay, so eating healthy butter and things that help improve beauty rate bacteria could be very beneficial. Also, anything that’s going to be fermented is going to give you healthy levels of lactobacillus and support puter rate is great. So those are the big bacteria that we’re looking. So I mean, these studies are limited because you’re not looking at a whole suite of bacteria, right, or a whole suite of positive probiotics. So these studies are still a little bit myopic, and their focus, but I think it still gives us a little bit of insight that probiotics, beneficial bacteria important and some of the despotic bacteria can have negative implications even affecting your immune system and even cancer. So I think it’s good to keep that in the back of our head. So when we’re seeing patients, we’re recommending comprehensive gut testing, that’s DNA based, it’s looking at all kinds of normal Flora imbalances, despotic balances, we’re measuring it to, you know, the umpteenth degree because the DNA testing is about two to 3000 times more sensitive than your typical stool testing, and then we’re also looking at infections because the bigger thing here I think is we could have an H. pylori issue or a fungal overgrowth, or we could have a, a major parasitic infection that could be thrown off the bacteria too. So sometimes the bacterial issue isn’t necessarily the root cause. It’s an effect of something deeper in the gut. That’s kind of going wrong. And then also, we have to look at the fact that gut stressing gut inflammation can throw off digestion and when our digestion is poor, we’re not ionizing minerals. We’re not breaking down our Selenium and zinc and magnesium. We’re not breaking down protein as well. We’re not absorbing all the the hormonal building blocks like cholesterol and fatty acids and protein and fats to make our hormones and our neurotransmitters. So you can see this isn’t just an isolated issue, it spirals off into other systems not working well. That’s why you need some more the clinical picture clinical, I’m for this like me and you to dive in deep and kind of spiral off the intimate connection. And how and how and why this is a big deal.

Evan Brand: Well, I love that this paper exists because between you and I both we’ve put a combined 15 plus years of education and content about gut and how important it is and how it affects every other body system. But you still have people that go to their conventional doctor and they’ll say, hey, my guy and work with Dr. Justin told me that my gut is affecting the thyroid. And the endocrinologist says, No, it doesn’t know your hormone levels are just low. We’re going to bump up your your Synthroid, we’re going to give you extra t three and supplemental form and blah, blah, blah, and they never bring up the gut. Well, now here’s the proof in the pudding. Here’s the paper that proves what we’ve been saying the whole time. So it’s good. I like I didn’t need the validation, but I guess for maybe for our ego sake a little bit when you get good results with people. And we’ve seen countless time and time again that the thyroid antibodies and Hashimoto is go down when we fix the gut. I’ve always loved seeing that. But now we have the proof to be able to show why this is working.

Dr. Justin Marchegiani: 100% and I saw a patient just from a few years back, her antibodies were well over 2000 2000 regarding feral globulin and they were around 30. Now, so I mean, you’re looking at a 99% reduction with thyroid antibodies. And I’ve seen that quite frequently, and people listening and may not be practical to get your antibodies down, even below the reference range or even negative or to zero. That may not happen. But if we can have a 50 to 90% reduction regarding those antibodies, that’s going to be huge.

Evan Brand: Let’s Let’s move on. Let’s go into this other paper that you had sent me this was the one that was from frontiers and cellular and infection. microbiology. This was a 2017 paper. It was called microbiota modulate anxiety like behavior and endurance abnormalities and hypothalamic pituitary adrenal axis. Let’s go into this because this is another frickin awesome paper that proves what we’ve seen with regarding mood and the whole adrenal connection type into the gut. 

Dr. Justin Marchegiani: 100%. So if we go into the what’s that again? 

Evan Brand: This is the one I’ll I’ll put it back in the chat for you here. This is the pub man one, go check your chat I just put it in your chat on on zoom. This is the one that’s called microbiota modulate anxiety like behavior. And so I’m going to go into Yes, kind of the bottom section of this, where it’s showing all the pictures here about the connection between you’ve got your cortical, yes, hormone, your AC TH you’ve got the metabolic effect picture here. And what we’re finding is the microbiome, the gut, your microbes, your intestinal microbes, they are changing this whole brain gut access activity, and all of your gut microbes are responsible for your dopa mean, your Gabba, you’ve got histamine, you’ve got acetylcholine And regulating the function of the CNS, which is your central nervous system and the stability of the HPA axis. This is the crazy part to me, this last part of the sentence that the intestinal microbes regulate the stability of the HPA axis. Because when we talk about the kind of this brain adrenal connection, we just talked about, like adaptogenic herbs and you know, I meditate and and deep breathing and extra Asheville, ganda and all that and maybe you need some l theanine, which is all cool. But if you’re just doing that you’re missing the boat, you’re missing the fact that the gut is going to overpower any effort on your brain. It’s like, Oh, I’m going to go do yoga to calm my nervous system. You can’t if your gut microbes are screwed.

Dr. Justin Marchegiani: Exactly. I want to highlight one sentence in this study conclusion. I think it’s vitally important. They say here imbalances of the HPA access can’t cause by intestinal microbes. So now this study is kind of submitting to the fact that the microbes are calling HPA access imbalances could affect the neuro endocrine system in the brain. That’s the brain talking to the hormonal system primarily through the adrenal and the sympathetic nervous system and the parasympathetic result in anxiety like behavior. And the study suggests that intervention into intestinal micro Flora may provide a new approach for treating stress like diseases that is profound. They’re talking about altering the microbiome typically. And that’s going to be done in two ways. It’s going to be done by killing or knocking down this biotic bad bacteria or supporting beneficial good bacteria. Those are the two modulatory ways to do it. So that’s amazing. The fact that conventional research at no one even talks about this on the conventional medical side, partly because it’s about a 20 to 30 year lag between stuff and the literature making its way into conventional medicine and there needs to be a profit motive. So if a big pharma company cannot patent what’s happening here, and we probably won’t see this be applied, because there’s gotta be a reason to spend billions of dollars in research and get patents. And if we can’t patent it, what are you going to do?

Evan Brand: Yeah, so like the $30 bottle of probiotics that we sell after we do some type of a gut killing protocol, I mean, 30 bucks, is it your profit margins, not going to be like some of these cancer drugs, for example, they’re like 1000 to 10,000% markup, you know, you’ll have like, one vial of chemotherapy, that’s 10,000 bucks.

Dr. Justin Marchegiani: Yeah. And it’s not just a, it’s not just the the money you make on it, it’s the ability to guarantee that you’re the only one that can produce it. So if you get the patent, that you’re the only one that can produce it, then you can artificially make the price higher, right. So that’s kind of how it works. It’s not that there’s not a natural profit, you know, like a 50% markup or something like in a lot of stores that you see is going to be thousands of percent markup, and it’s going to be artificial, did a patent law.

Evan Brand: Oh, that makes sense. Yeah, you’re talking rather than 20 companies all making the same thing and charging 100 bucks if you’re the only soul guy, then you’re allowed to charge 10,000.

Dr. Justin Marchegiani: Yeah, you can charge a lot of money for it. Yeah, that’s how it works. That’s how you saw that with the, the epi pen when the patents went out. Only one company had it and they jacked it up. And that’s kind of that’s how it happens. So the more we can use things that are natural, that can’t be patented, you know, then you have a little bit more market force keeping the prices down. So that’s nice. So interesting. In this study, they also talked about however, the precise mechanism of action and how intestinal micro Flora means unclear. So it’s really interesting they have there’s some unknown pathogenic mechanisms I think with a lot of the the infections causing problems, my gas, all right, my into intuition really comes at it from the perspective of intestinal permeability. I think the intestinal permeability aspect is a big one. I also think a lot of the good bacteria has a modular Tory effect on your immune system, because we know your immune system is in the gut. So if your immune system is hyper regulate or hyper stimulated, that can do a lot of different things from increasing gut permeability, to just sucking up a lot of resources for energy. And I think it also has a negative impact on your mitochondrial function as well. And then I think the low hanging fruit is you may not be digesting, absorbing and assimilating a lot of the key nutrients in your diet, which go to make other systems work like your mitochondria, like your thyroid, like your adrenal, is we not getting enough selenium, we may have thyroid issues not getting enough. Magnesium, we may have issue with our mitochondria. So we need a lot of these nutrients. And if we have stress or interplay with the HPA axis and our gut, there could be some absorption issues for sure.

Evan Brand: We should almost just title this podcast which we already came up with a better title that you’re that you’re seeing or you already clicked on to download this, which was like the microbiome adrenal thyroid link, but really, we should call it yoga ain’t gonna fix you. gut. I mean, that’s basically the summary here.

Dr. Justin Marchegiani: Right. And again, there’s a lot of data on this where the stress in the gut and stress in the brain is bi directional. In other words, Stretton the stress in the gut can create brain stress, but stress in the brain can create gut stress. And we know this because high levels of cortisol stress in the brain that makes a CTH adrenal cortical tropic releasing hormone that stimulates the adrenal to make cortisol that can create gut permeability at high levels, it can break down the gut barrier, and we know stress in the gut through number one is gluten is a big one can easily create gut permeability, which can then also create gut stress. So these are important things. Quick Study I want to pull up here. I did not show it to you but this is called dietary gluten induced dysbiosis can create issues with the tight junctions. And that’s the summary of the title. The title is really convoluted, but

Evan Brand: I want to have that link from book market myself. 

Dr. Justin Marchegiani: Yeah, I’ll send this to you right now. So you have it. But this is fascinating. And basically they’re talking about gluten having a major impact on the gut bacteria and creating this bio system. And we know with this by osmosis, that can affect the whole neuro endocrine HPA axis cascade of things. And they talked about dietary gluten had effects on the streptococcus family, the lactobacillus family, the Koryo bacteria family, really, really, really interesting and how it affects different things. It Down regulated, the guts, absorption and a lot of different ways created inflammation. So there’s a lot of different potential cascades that happen when gluten comes into the equation. So the low hanging fruit that we talked about is kind of getting patients on a paleo template which is a grain free, grain free, dairy free legume free template. And then potentially even moving towards a paleo template where we’re going grain free, legume free dairy free, no nuts, seeds, nitrates and eggs.

Evan Brand: Yeah, you may have the autoimmune. So here’s the point that we’re trying to make is that the people who say, Oh, I eat gluten and I feel fine. It’s not about whether you feel fine. It’s about that internal biochemistry that’s changing. It’s about those microbes that are changing. Also, in that study that you just sent me here. It was talking about Prevotella being affected too. We know there’s a huge link between Prevotella and joint pain. We did a whole podcast on joint pain, you know, functional medicine. And so it’s not that like, Hey, you have to get a rash or you have to break out an acne after you eat gluten. That’s not it’s a lot more subtle, but the subtle changes over time, change the whole system.

Dr. Justin Marchegiani: As a lot of people out there that I hear I won’t mention their names but their podcasts out there and say, Hey, you know, you can have gluten if you haven’t, you don’t have any symptoms. You know, you’re fine. The problem is the inflammation that’s happening here. may not create a symptom, there may be a delay in the symptoms that occur. And that that’s kind of the myopic level of thinking. You can’t just you can’t go to that conclusion, well, if you don’t have symptoms, you’re fine. In this one study, they’re looking at inflammation associated with the micro RNA. So they’re looking at inflammation at the RNA level. I mean, that is a very myopic level, very, very microscopic level, I should say. And in this study, they had some people on a gluten free diet and some eating gluten. And they saw on the gluten diet, they saw this increase in inflammation at the micro RNA level, which is pretty profound. So it may take time to manifest into actual symptoms. And we know there’s data on the fact that there are people that even if they aren’t celiac, or even really gluten sensitive symptomatic Lee, they still saw permeability with their gut when exposed to gluten. So kind of my general recommendation is try to be grain free all the time, especially if you have an autoimmune condition. And if you’re going to cheat, try to choose gluten free cheat, if you can. Now, if you don’t have a known autoimmunity, then maybe you choose a little bit of gluten here or there but be very careful with it. Try to do things like extra enzymes, extra enzymes with DPP for maybe some extra activated charcoal include a bio and to kind of deal with the stress and the inflammation associated with that you can also add in some extra glutamine and things help with the gut lining. So these are some ways that we can mitigate it. So I kind of I tear things a known autoimmunity, no gluten ever, and if you’re going to cheat, try to make sure it’s gluten free. If you’re relatively healthy and no autoimmunity, then maybe you cheat a little bit with gluten but try to make it a special occasion holidays, birthday, etc. and then try to use things to blunt the negative consequences that may occur.

Evan Brand: Yeah, well said people aren’t even aware of that. We have some little cheats in our pocket, especially that will give to people around the holiday season, different enzyme formulations that can actually sort of break up or reduce the effect of some of those food allergens. Your dairy, your corn, your egg or soy, you know, you can use enzymes to help break those apart. But we don’t want people to get hooked on those or use that as a long term solution, because then you’re still cheating and it’s not going to be reducing the the impact 100% it’s just going to blunt it, as you said. 

Dr. Justin Marchegiani: Exactly. And one thing I wanted to highlight, I saw this article come across my desk too. It’s a compound called Tributyltin, is in the chemical paint that they paint on the underside of the hall of the boats, and this compounds getting in the water, and they’re finding that this compounds actually an obese engine, and it negatively impacts the gut microbiome and then you’re getting exposed to this in the waters. So I think this is really important, why we need to be filtering our water because it’s possible that these compounds may not be filtered out with conventional filtration processes. And this compounds Aaron obesogenic and they affect your microbiome. So another great reason why you should head over our sites get a good high quality Water Filter that we personally use or slash water. I’ll put the link in the description. Waters a big component is a lot of chemicals and toxins and tributyltin and it’s just one compound that could negatively impact your gut microbiome.

Evan Brand: Oh man, that’s amazing. Well, there’s countless like that I just got the Environmental Working Groups report on local Kentucky’s tap water. And you know, people say oh, we got voted the best tap water in the US because we’ve got a lot of limestone here naturally that kind of filters out our water. It was still garbage man. There was still tons of flame retardant chemicals that PFOA which is like the Teflon nonstick chemicals, foams, heavy metals, pesticides and herbicides. I mean, we had countless pollutants in our tap water here, even though it was voted best and it does taste good. But you might you’re not going to taste these part per million chemicals that like you said can be an obese adyen or disrupt hormones. So yes, drinking tap water can make you fat and sick. Absolutely.

Dr. Justin Marchegiani: Of course and then the number One thing you can do, this is a no brainer. Most of our audience and listeners know this is avoid glyphosate. So you really want to eat 100% organic because glyphosate, many, many studies are shown to affect the microbiome couple of rat studies, looked at different rats and microbiome and saw significant, you know, impact on the microbiome of these rats when exposed to glyphosate. So you really just got to be careful, make sure you eat organic as glyphosate, which is the major pesticide Roundup. And again, one of the studies I have up here now 13 weeks study, guess what bacteria were knocked down with Roundup. I mean, I’m going to guess all of them but probably lactobacillus. lactobacillus was the major one. It was reduced in the roundup study. And we know that the thyroid cancer study showed what that the cancer group had lower amounts of lactobacillus and then when we improved it, you know, we saw an improvement in the cancer. So we know lactobacillus is beneficial and glyphosate, roundup same name is going to negatively impact that.

Evan Brand: That’s a trip well, so people say, Oh, I haven’t done antibiotics doesn’t matter. You did an antibiotic and the glyphosate.

Dr. Justin Marchegiani: Yep, exactly. So you really want to be careful. This is another reason why you want to eat organic. There’s two reasons right? Number one, you’re avoiding toxicity, which is going to affect your microbiome and your immune system. Number two, increased nutrient density. Typically, organic farming will have higher level of nutrient density because the soil microbiome will be more healthy and the microbiome and the topsoil produce help the plants produce more nutrition. So we’re nutrition on one side, less toxic than the other side. And even if, let’s say you don’t buy what I’m saying about nutrition, just the fact that you’re getting less toxins, right? Because for it to be organic, USDA Organic, it has to have no pesticides in that soil for three years. You are definitely getting less toxins, for sure.

Evan Brand: Yep. Well, this has been fun. I mean, we could do Part 2 3 4 5 6 7 8 9 10 on this because this is like one of my favorite favorite things ever. So we’ll be back to talk more about I’ve got so so I’m just giving you I’ve been told you this, but this is what we’re going to cover. Next we need to cover the gut microbiome in the issue with pans, which is the pediatric acute onset neuro psychiatric syndrome and kids. I just sent you a paper on this one. Let’s Let’s hit this next time though, because it’s a whole nother can of worms, but it’s about all these children that are having behavioral issues and anxiety and different problems. And it’s related to certain species in the gut. And if you can shift the gut out of this pro inflammatory state, you can calm the brain down. I mean, we basically already hit on that but it’s a little different for kids and I’ve seen it personally and clinically, you have to So I do want to get into this and also, there’s talk about the specific bacteria this or ODR bacteria and the link to autism. And alzheimers. So Wow, this is I mean, it goes deep.

Dr. Justin Marchegiani: I love it totally, what I’ll do is I’ll put all the links of all the studies that we talked about today in the description so you guys can go take a look at it so you can see it for yourself. It’s amazing. Your conventional medical doctors aren’t going to know about this stuff. And it’s because of the 23rd 20 to 30 year gap between the literature and going into effect in the curriculum. And also there’s just has to have a profit incentive for the big pharma if if they can’t patent it, then you’re not really going to use it as a modality. And guess what, as functional medicine docs, we take that up and we put that in our metabolic toolbox. TV’s healing get better. So I love it. Is there anything else you want to highlight today? Evan? 

Evan Brand: We’re going to be looking into your gut if you’re working with us, so if you’re like, Okay, what do I do? How do I investigate this? How do I fix it? I mean, we live and breathe and look at labs all day every day. So we’d be happy to run some panels on you and take a look at your gut and see how is your thyroid function affected by your gut? I guarantee it is how much is it affected. I don’t don’t know yet, but we can run some labs and figure it out. So if you do want to reach out clinically, you can do so at Justin’s website, which is he works with people all around the world. So do I, my website is, and we don’t care who you work with as long as you get better. So please reach out if you need help. That’s what we’re here for. Don’t wait till you’re super miserable. We got tons of people that like buy supplements and listen to podcasts and listen to summits and they buy 50 to 100 supplements and they don’t know what the heck they’re doing. You’re spending a lot more money in wasting time and maybe getting sicker by doing that. So it’d be much better to have somebody that can help walk you through the process rather than you buying this probiotic and it didn’t work and then you bought that gut healing supplement and didn’t work and then you bought this detox supplement, you felt like crap, Okay, stop doing that. You know, let us help you through what we found to work clinically.

Dr. Justin Marchegiani: 100% also we can get a window into the HPA access as well using cortisol rhythm testing. So we’ll measure your cortisol which is your major stress hormone. That’s the hormone that Made by or that stimulated by ACTA, that’s that brain chemical. That’s the neuroendocrine connection, the brain, the ACTH, the cortisol, we can look at that rhythm. And that gives us a pretty good interplay into HPA access functioning, because the data says that, you know, as that cortisol starts to get this regulator rhythmically, that’s a big sign that the HPA access is out of balance. And so we can use specific herbs, we can use protocols, we can work on fixing the microbiome, we can look at getting rid of some of the chemicals like we talked about, we only mentioned to today, the cyberbullying and the glyphosate, mold, and others toxins and metals could be another factor as well. That’s another podcast of the day. So there’s a big is a big net that we’re kind of looking into and trying to connect everything here because everything’s intimately connected. And I hope you guys are enjoying the Intel. If you’re feeling overwhelmed, just feel free to reach out to us we can help break it down. The big connection here today is stress, brain stress, HPA access. That’s the communication all feedback loop brain to the adrenal brain to the thyroid. Think of that as the thermostat to the heater thermostat to the air condition, right? Imagine you having that thermostat not talking appropriately to the heater when you want it to get hot, or the air conditioner when you want it to get cool. And that’s a big big connection. So when we talk brain stress, or HPA access, pretend like your thermostat in your house is not working or probably that’s kind of the equivalent here.

Evan Brand: Makes sense. Makes sense. Well said.

Dr. Justin Marchegiani: All right. Well, if you guys enjoyed it, give us a thumbs up give us hit the bell as well. So you subscribe. We appreciate great reviews, for reviews. And let us know your comments down below things that have helped you things that have hurt you in regards to the HPA access and your gut microbiome. We appreciate it. Evan, it was great chatting today man you have a phenomenal day. 

Evan Brand: Yeah likewise you too see you. Take care. Bye bye.


Audio Podcast:

Hashimotos Root Cause Solutions With Inna Topiler | Podcast #237

Hashimotos is an autoimmune disorder in which antibodies directed against the thyroid lead to chronic inflammation. Also known as chronic lymphocytic thyroiditis, Hashimotos is the most common cause of Hypothyroidism in the United States.

Get a wider picture on Hashimotos’ root causes, symptoms, and solutions, and how can other issues with thyroid or gut affect your overall body health. Find out what Dr. Justin and Inna Toppiler talked about here.Inna Topiler

Inna Topiler – MS, CNS

In this episode, we cover: 

0:50 Eczema patient, oxalate issues

05:31 Moderate or high oxalate foods

10:19 Inflammation bucket

14:57 Hashimotos Symptoms

30:41 Solutions


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani, welcome back to beyond wellness radio. I have clinical nutritionist, Inna Topiler in the house, you know, as part of my thyroid reset summit, which was excellent. Make sure you get access to that, but you know, welcome to the podcast. How are you doing?

Inna Topiler: I’m good. Thank you so much for having me. I’m excited to be here.

Dr. Justin Marchegiani: Well thank you. It’s great. We’re doing it via video. So if you guys are listening to the podcast, make sure you subscribe to the Youtube Channel hit the bell, hit the subscribe button so you can get access to these awesome podcasts and video as well. So what’s going on with you, and I know you’re a clinical nutritionist, you’re kind of in the trenches every week with patients. Just is there a memorable patient or case that kind of comes to mind the last week or two we can kind of break down for the listeners?

Inna Topiler: Absolutely. So I am typically, I’m seeing, you know, probably about 1520 people a week. And then I do research and I do my podcasts. And working on the summit the other days. And so people usually come to me after it, probably similar to you after seeing two, three, four, sometimes even 10 different practitioners. So I’m kind of their health detective and I’m solving a lot of mysteries. So, um, lots of cases come to mind, but actually I’d like to tell you about one. Uh, she, um, is 30 years old and she was having a lot of Eczema and a lot of rashes and she’s been to numerous dermatologists and have taken, I can’t even tell you how many rounds of steroids and um, antibiotics, topical creams, you name it. And you know, it’s a very frustrating thing when your skin’s always itchy and red and uncomfortable. And a lot of it was on her face too, which I mean, that’s how you present to the world. So it’s, um, you know, it was great in a lot of issues for her and she’s tried everything and she, but essentially came to see me, she’s already gluten free. She was dairy free, you know, she was doing a Paleo type diet. So she was doing in her mind everything she was taking probiotics. She was paying, you know, $50 for this like very special probiotic yogurt. I mean she was doing it but yet unfortunately her symptoms were not any better. Um, and so we did some testing, we did an organic acid test, we looked at foods and what was very interesting for her, the issue actually wasn’t that she was sensitive to a food. She was actually sensitive to compounds in food. So as she was trying to be healthier, she was eating a lot of leafy greens. As you know, we all hear Kale, it’s good for us. And um, cauliflower and spinach. Um, and she was eating because she’s changed to more of a Paleo template. She was eating things made of almond flour and she was having a lot of sweet potatoes cause she wasn’t eating starches. And when we looked at it, we said, okay, well she actually had high sulfate on her organic acid tests and she was living a lot of sulfur, but she was also consuming a lot of foods that had, um, oxalates in them. Um, and oxalates are, they’re almost like these crystal x structures and they can really affect our body negatively. She also had elevated Billy Rubin. And what’s interesting is Billy Rubin has to go through this one specific pathway in the liver to get metabolized. And that same pathway is also what conjugates the oxalates and also a lot of carcinogens and estrogens, estrogens from the environment.

Inna Topiler: So not to make it too complex, but basically, if you guys can think of a, uh, you know, let’s say a drain, right? And we have the faucet that’s on. So if the drain is open, the water goes through where everything goes down. But if the drain is clogged, you have the faucet on, it backs up, and eventually the sink overflows. And that’s what was happening with her. So, even though she was doing all this sort of right things and you know, she did the Paleo, she was taking probiotics, she looked at all that and it really wasn’t her issue. So once we actually changed her diet and um, believe it or not, I had her removed green juices even though I know we hear that it is so beneficial for us, but it was too much Solfa for her. She was using tons of Kale and spinach is for sharing. It was too much sulfur. She was also eating spinach almost every day in a salad. And while spinach has a lot of benefits, it is very high in oxides. A Cup of spinach has 300 milligrams of oxalates, which is a really high amount. And so, and just so you guys know, if someone has issues with oxalates and if you have that sort of club drain and things aren’t going through, it’s recommended that you eat less than a hundred milligrams of oxalates per day.

Dr. Justin Marchegiani: Oh three times. That would just the spinach exposure alone. Right?

Inna Topiler: Exactly.

Dr. Justin Marchegiani: I’m just con– So, it’s a couple of questions here is off the bat it was the issue with the sulfur, was it more the oxide? It sounds like it was more of an oxalate issue.

Inna Topiler: It was more of an oxalate issue, but the sulfur kind of tends to go hand in hand. It seems like she was dumping sulfur in the urine and she didn’t actually have enough in her body. So we had to make sure that she wasn’t overdoing it. But sulfur is found in so many different foods and we can’t remove all sulfur. So, you know, they were kind of intertwined, so we had to make sure that she wasn’t overdoing it, but still getting some and then making sure that we’re working on the liver pathways to process that.

Dr. Justin Marchegiani: Totally now, a lot of the organic acid tests sometimes correlate a lot of the oxalates with yeast or fungal overgrowth. Did you see a yeast or fungal overgrowth with this patient’s [inaudible]?

Inna Topiler: Such a great question. Yes we did. It wasn’t that bad, but it was there. Um, and actually, um, to let you know, but that when we started to address her diet, we didn’t even get to the yeast yet. We just started changing the Diet. We took out almond, we replaced it with other nuts. We took out the spinach, her rashes disappeared.

Dr. Justin Marchegiani: So basically you kind of pulled out maybe like a list here of all your moderate and higher oxalate foods and you used, did you just focus on cutting the high ones or even the moderate ones?

Inna Topiler: I just focused on the high. Um, so many foods have oxalates and she was already so restricted. I didn’t want to overwhelm her too much. So we kind of spinach, we cut out almonds and we lowered potatoes —

Dr. Justin Marchegiani: and almonds and what are good replacements for those?

Inna Topiler: Um, so, um, you can do, um, I mean all of the — See, the problem is that with leafy Greens, uh, some of them are not gonna have as many oxides, but they’re going to have a lot of sulfur. So then we don’t overdo that. So I had her do more things like Romaine lettuce and then we ate other vegetables, asparagus, green beans, Zucchini. It’s okay not to always have leafy greens. I think that her body just needed a break from those. So we really focused on other vegetables.

Dr. Justin Marchegiani: What about Kale, does Kale works? Kale. I mean I think it’s obviously higher sulfur, but it’s a lower oxalate one, right?

Inna Topiler: It is.

Dr. Justin Marchegiani: Just cut the nuts out. And you were kind of not alternative–

Inna Topiler: We did coconut. Um, we also looked at other nuts like walnuts that are not as high in Oxalates. And then she wasn’t actually necessarily sensitive to the grains, at least not from what we figured out. So she was doing Paleo because she thought that it was healthier, but it wasn’t really helping. So we actually put in a little bit of a millet. Millet is really low in lectins. So a lot of people that don’t do well with grades can tolerate that. And then we put in a little bit of rice and she was okay with that. Of course, obviously everyone is different. So it doesn’t mean that everyone can do that. But in her case, it was better to have a little bit of the grain, um, and lower the amount of potatoes that she was doing because otherwise it was all potato or almond flour based stuff. Another thing we did was cassava flour. I’m a big fan of cassava and again, I mean you want to do it in moderation because if you have a lot of it that can be higher glycemic. But we did use it in some baking and she was doing cassava flour tortillas and that worked well too. And that’s grain-free.

Dr. Justin Marchegiani: Awesome. I know the oxalates can kind of get in the joints too and kind of crystallize and um, and create pain and inflammation. Was this patient presented with any of those symptoms at all?

Inna Topiler: No. So for her it was more the skin issue and I think that, yeah, I do have another person who was having that issue with their joints. Um, she was in her mid forties and she was feeling very arthritic and she said to me, I’m not that old. What’s happening here? And she went to see a rheumatologists and they tested for rheumatoid arthritis. He did all the testing that came out negative and she also was eating spinach, pretty much every day we cut that with for her. All we did was cut spinach and her [inaudible] went away. Another thing I want to mention is related to that is people sometimes don’t realize, and again I’m not trying to bang up on Kale or spinach. I mean obviously there’s benefits. I’m not saying it’s bad for everyone, but sometimes people also don’t realize that a lot of leafy greens, even though they do a fiber, they can back us up a little bit. So if you’re eating a lot of Greens and a lot of cruciferous vegetables and you’ve, if you have constipation, just be mindful of that. Especially if you have thyroid issues because you know there’s a correlation with that. Um, you may want to lower that and that can help.

Dr. Justin Marchegiani: Can cooking foods also help one, break down some of that fiber, but also help lower the oxalates a little bit. You look at strategies and trying to take some of those raw oxalates and maybe cook them down a little bit to help decrease the amount.

Inna Topiler: Yeah, that definitely helps. But I think initially it does help to try to cut more of it out. Um, plus you know, it helps with the rotation because people get into a rut, as you probably know. And you know, they have spinach and okay, this is good for you. I’m gonna eat it every day. Okay. They’re still, yeah, let’s get from an eat it everyday. So it’s nice to rotate. So I think, yeah, if you’re eating a lot of something, it’s good to give your body a break and then we’ll add back slowly. And the cooked versions are definitely going to be better.

Dr. Justin Marchegiani: Yeah. If you love it, rotate it. That’s a good edge. I like that. And what happened to her skin? So how did that progress? Did you have to go deeper and, and do, you know, work through the digestive system and you find the gut infections? How did her skin progress over the, you know, a bit of time here.

Inna Topiler: So what’s really great is that all of the rashes went away as soon as we changed the foods. And I mean, as you can imagine, she was just ecstatic because she’s been dealing with it for so long.

Dr. Justin Marchegiani: When you say rashes, you mean the Eczema, right?

Inna Topiler: Well, it was Eczema and rashes, so it was kind of a combination. So it was like rashy itchy bumps and then the dry scaly spots that —

Dr. Justin Marchegiani: Did you see any connection at all with histamine with her.

Inna Topiler: Yes. Um, and I think, I don’t know if you agree, but I feel that the histamine is just a temporary reaction because everything else is flared up. I don’t think that she would have that problem longterm, but a lot of the foods that have oxalates like the spinach is going to have histamine as well. Um, and we did lower some Kombucha and some yogurts that she was doing.

Dr. Justin Marchegiani: Yeah. I find the same thing. Like you have your stress bucket or your inflammation bucket. I did a podcast, they on allergies and we talked about, you know, here’s your bucket and we have all these different antigens in there. And when you’re already topped off and off, sometimes just those simple histamines could be an issue, but if your bucket was lowered, it wouldn’t be a problem. And a lot of those foods are still really nutrient dense and who doesn’t like Bacon and Kombucha. Right. So I totally get where you’re coming from on that.

Inna Topiler: Yeah, exactly. Exactly. Um, I think also, um, when you look at the histamine reaction, a lot of what goes on in the gut is going to affect that. So if you’re got some mass and if there’s dysbiosis and overgrowth and Sibo and everything else, you’re going to be more likely to react to them. So it’s kind of like same analogy as you’re get in with the bucket, but in addition to the food intolerances, there is all this infection that’s in there too.

Dr. Justin Marchegiani: 100%. And how much better is her skin now? She half is you almost a hundred percent gone.

Inna Topiler: It’s 100%.

Dr. Justin Marchegiani: Oh Wow. That’s awesome. Anything else you have to do with the skin stuff?

Inna Topiler: Um, well we are starting to address, um, there some SIBO, the yeast, we’re working on that, but the skin cleared up just from the food and it’s not always the case. I mean obviously everyone is different so sometimes you have to look at everything until you see improvement. But in her case, um, she was lucky and it was really nice that just the food alone clear it up. Now that doesn’t mean we’re done. There’s obviously still stuff going on and she was experiencing some bloating and some discomfort that’s still there, which made sense. She was a little bit upset about that at first cause she said, okay, my skin’s better, but why is this still there? So I had to tell her, well, we just started, we still have a lot more work to do. So one thing at a time.

Dr. Justin Marchegiani: Yeah. It’s always interesting when you work with patients because as a clinician, I mean, you know, there’s a bunch of levers you’re going to be pulling, right? Diet, stress, hydration, exercise, looking at the gut, looking at the hormones, right? And you may not know one of those levers make may get you 90% of the way there while the other couple don’t move the .. lot. And it’s hard to know which one it is because you have so many experiences where summits evenly spread out some, it’s just that one lever and everything is right. You notice that too.

Inna Topiler: Mhmm. Definitely, definitely.

Dr. Justin Marchegiani: And its always a surprise.

Inna Topiler: It is. And sometimes when I talk to someone I could Kinda tell like, all right, I don’t know if it’s my intuition or just looking at the test could be my logical brain, but I’m like, ah, I think it’s going to be over here. Sometimes I’m right, sometimes not. But yeah.

Dr. Justin Marchegiani: And what is your Mr average patient look like as she is? Is it female 35 40? What’s the Avatar right in there? What other, what other major issues are you seeing the patient’s coming in outside of just the skin issues? Is there another type of pattern that just, it’s constantly knocking on your office door.

Inna Topiler: A lot of fatigue. I see a ton of autoimmunity and you know what they say, you attract what you yourself have or had or I’ve dealt with. And so I’ve, uh, I have Hashimoto’s, which I’ve been able to successfully reverse. I still have some antibodies, but they’re a lot better than where they were —

Dr. Justin Marchegiani: Saying you’re a man. I’m in the same booth as you. What was your most recent thyroid test? You remember your personal results?

Inna Topiler: I do. I test mine every, you know, probably two months or so. Um, so just to give everyone a little bit of a history, my antibodies, when I first tested them, and this was back when I’d probably go in 20 years, when I was in my early twenties, they were in the seven hundreds, which is very high. And that’s when I was like, okay. And then over the years just with doing detox and working on my gut, working on metals, they’ve shut up to as high as 6,000. So that was my ultimate high. I’ve gotten them. Yeah. So I’ve gotten them, uh, to the 200 mark now. That’s the lowest they’ve ever been. Um, and interestingly enough, and I want to touch on this because I think this is an important piece. I’ve done everything. Literally like all the cleanses, um, took, took out all the metals that all the nutrients, um, worked on my gut and basically I was as perfectly as I could be and my antibodies were around 450 and they stayed there for awhile. They flared up postpartum after I had my son and then they went back to the 450 mark and I kinda thought, okay, this is just my baseline and you know, it’s better than 6,000. But then I started meditating and I got a lot more into the mind, body aspect and just seeing the importance of all of that. And without changing anything else, I was still doing the same diet, the same nutrients. My antibodies dropped under the 200 points. So that’s what got me to the 250 mark.

Dr. Justin Marchegiani: Wow. How about your thyroglobulin? Where are those coming back positive at all?

Inna Topiler: Mildly. So were added, vary anywhere between like 30 and 80. They never really got above a hundred.

Dr. Justin Marchegiani: Okay. Got It. I’ll go over mine with everyone. Just to be transparent. Are you, do you need thyroid hormone? You know?

Inna Topiler: I do. So I take a very small amount. And that’s another thing I wanted to mention really quick. As a nutritionist, I always try to do things naturally. And for the longest time I was very against taking thyroid medication. My TSH was always borderline. It was always in like the waterline normal lab, you know, optimal range. It was not borderline, it was out. I was in like the 4.5 um, range and by T4 was a little bit on the lower end. MIT three was always low, was in the 70s but I always said, you know what, this is my job. I need to do things naturally and I’m going to do that for myself. And finally, I mean years later I talked to someone and you know, cause every practitioner needs their own practitioner, right? We can’t take care of ourselves. We need someone to help us as well. And I decided to do a little bit of supplementation and it was so life changing. I can’t even tell you my hair started growing, my energy improved that I wasn’t feeling bad, but I just felt so much better. And I take, I do a compound it two 43 and I have 52 T4 and 13 micrograms of t three so really like not a very large dose, but what an amazing effect that has.

Dr. Justin Marchegiani: That’s great. That’s awesome. Yeah. I ran my blood tests here two weeks ago. My TSH, I don’t, I do not need thyroid support because of my labs. We’ll go over it. TSH was 1.81 so it was below two below two and a half. T 4 free was 1.4 which is good. A T4 total was 8.7 which is good. We want between six and 10 ish. If you, you know, Well if you don’t agree and let me know too, she had three total was 103 and T3 free was 3.5.

Inna Topiler: Those are great numbers!

Dr. Justin Marchegiani: Yeah, they’re pretty good. TPO antibodies. I’m, I’m keeping them below 16, 15 ish. So those were in the sixties or seventies. A couple of years back. Thyroglobulin has popped up to 74 though. So that’s a little bit on the higher side for me. When these labs were done, um, I ate a little bit of a gluten free dessert the night before, so my glucose was a little bit high in the morning, 105 and my insulin was a little bit high at 11. So right now I’m tightening up the gluten free dessert stuff and, or any dairy in my diet and I’m trying to go a little bit lower carb. I’m going to be testing my insulin and all my antibodies next month. So, you know, as clinicians we like to monitor our own stuff and kind of benchmark our own stuff too. So that’s just for transparency’s sake. That’s where I’m at.

Inna Topiler: Thanks for sharing.

Dr. Justin Marchegiani: Yeah. Cool. But it’s good though. I think it’s great as a clinician that you have your own challenges because it causes you to really look deep. It causes your patients, I think to know that you’re trying to practice what you preach as well. And I think it’s tough too because like I’m in a place where I’m like, I don’t want to take thyroid hormone, but I also understand, you know there’s probably a delineation of when you do, obviously you crossed that. Can you walk us through, what’s that threshold? Is it, are you looking at TSH? Are you looking at a T3 threshold? What are you looking at the say, hey, I need thyroid hormone.

Inna Topiler: So for me I looked at both of those. So while TSH of course is important, if you know with Hashimoto’s that can sometimes fluctuate and if my T4 and T3 was normal, I wouldn’t have done it. But I had the very textbook pattern. My TSH was elevated slightly, my T4 was slightly low a, my TSH was 4.5 so it was out of the optimal range. My total T4 was five point. I mean that, we’re going back years now, but it was under six, it was like 5.8 and my T3 was 70.

Dr. Justin Marchegiani: All is your T3 free.

Inna Topiler: Uh, like 2.7. I mean it wasn’t terrible but–

Dr. Justin Marchegiani: It was under this lower side for sure. Yeah.

Inna Topiler: Yeah. Um, you know, and because of the pattern that if it was just one of the numbers, then I would think, okay, maybe I’ll just wait and see. And I’ve tried a lot of natural stuff and I’ve tested it in the numbers were always showing up that way. So it wasn’t just, you know, cause the TSH will fluctuate. Things can happen from day to day. This was consistent month after month. And knowing that we need thyroid hormone for every cell in our body. And this is something that people may sometimes not realize because we think, okay, thyroid is important for our metabolism. It’s important for temperature control. But there’s just so much more than that. We need it for our brain, we need it for our feet. I mean we need it for our gut, for everything. And I actually realized, wait a minute, I’m being so hardheaded here, like I’m going to do things naturally. I’m not going to go on this. Meanwhile, I’m actually harming my body. If I don’t have enough thyroid hormone, then my guts not going to heal the way that it’s supposed to and other things are not going to work. And I’ve tried a lot of natural stuff. Now here’s the thing, I’m not saying anything against natural stuff. That’s always my first resort with everyone. Um, it’s just that because of fresh tomatoes for awhile and my thyroid was damaged due to it, I need it. Not everyone does, but you know, it’s just looking at everything and weighing it out. And I think it’s important because sometimes people can, you know, go too much one way and then kind of forget about everything else on the other side.

Dr. Justin Marchegiani: Yeah. A lot of people come into this thyroid game and they’ve kind of caught their thyroid or their immune system beating up their thyroid like 10 years into this relationship. And it’s like, okay, you’ve been beaten me up for like 10 years and there may be some functional tissue that’s not quite producing that hormone like it was, you know, a decade ago. So that’s where you kind of have to replace things. But a lot of times, you know, you may be able to replace some of that functional tissue by doing all the things that we’ve talked about. We’d be all in the thyroid summit that we talked about, but gluten and the leaky gut and supporting some of these nutrients, but sometimes there’s just kind of the gap, right? And that’s kind of where you have to really be real. Look at the TSH, the look, how much is the brain talking, and then look at the actual hormones and say, Hey, are we at least getting to mid range or so? And if we’re not, then we got to look at a bumping that up, especially if we have low thyroid symptoms, like your cold hands or cold feet, maybe thinning eyebrows, mood issues, motility. What kind of, what were your low thyroid stuff?

Inna Topiler: Uh, cold hands and feet. Yup. Um, hair loss but not so much loss where like, you know, it was falling out. It was just really thin and brittle. Yeah. And you know, it was interesting too, it never grew past my shoulders. It was just like the end when I was younger. It did and then it just stopped like it would get here and that’s it. And since then, you know, my hair swell, I’ve cut it recently but it’s way past my shoulders now. So that was kind of an interesting thing. I did have a little bit of the eyebrow thinning fatigue, irregular cycles, issues with motility. I mean, not terrible, but just, you know, things are just, we’re not 100% and when I optimize that, it all just completely aligned.

Dr. Justin Marchegiani: And was there like as you went through kind of like adding various things in and dressing various systems? Where’s there a couple of things that was like, oh, this really accelerated this or this really accelerated that?

Inna Topiler: Um, how many before doing thermos and I did a lot of stuff to really balance my body, still cleansing out the yeast. I had a lot of Candida, a lot of mercury in a lot of copper. Yeah. Clearing the Candida was huge. I mean I had a lot of IBS symptoms which got so much better than motility stuff was still a little bit off, which the thyroid helped with. But overall the dissension against the bloating in that, that way better with the candida. I had to tell a cop on a ton of mercury and that was not an easy road. I mean it was probably a year or two year and a half process, probably even more two years of detoxing that and I did a combination of some culation um, along with some other methods. Um, so that really helped a lot too.

Dr. Justin Marchegiani: That’s great. Excellent. And what made you want to go compounded with your thyroid versus like an armor or Nature-Throid or WP?

Inna Topiler: So that’s a really good question. And um, what happened to me was interesting. I actually went on West steroid. That was the first one I went on and I, uh, I still like kinesiologist back in the day and he muscle tested me and he’s like, oh, this is great cause I was back then I was like, okay, I’ll just do armor because that’s what everyone was doing. And he said, no, no, the WPS can be better for you. So I’m like, okay. I did that. And um, and I felt really good. That’s when my hair started to grow back and my energy was good, I felt great. But then I tested my antibodies and you know, before starting that there were in the four or five hundreds they went up to 3000.

Dr. Justin Marchegiani: Woah! Holy smokes.

Inna Topiler: And I thought, hmm, okay, that’s kind of weird. And I thought maybe it’s a fluke. I waited another six to eight weeks, retested 3,500. I’m like, okay. Did another couple of months where he tested above 5,000 the lab didn’t quantify when it was above 5,000 so I’m like, okay, well obviously something changed here. And I’ve talked to a bunch of different practitioners and colleagues and I knew that there was something in the WP that was affecting in, even though there’s not a ton of research and even though people say you can take it, it’s fine, you know, there are um, you know, studies that show and I think, you know, anecdotally like in my case as well, they, because it is a natural substance. If your body attacks your on fire and he can then attack the armor of the WP. And of course it doesn’t happen to every person. Not saying everyone Hashimoto’s can’t take it, but I was the one or 2% that it happened to.

Dr. Justin Marchegiani: Yeah, it’s rare. I have not seen the patient like that, that bumped that high because of it. I’ve heard from other colleagues though, I always retest because I’m always looking for it. You know, it’s like a, it’s like the, the, the, the metaphorical Unicorn you hear of it and I’m always looking, but it’s great that, you know, you actually went through that and you saw it and did you go right to compound or did you notice you had the same effect with armor and P or nature throid too.

Inna Topiler: Um, so what I did, and interestingly enough also I talked to a few colleagues and what they were saying is, well, if you feel good then don’t worry about it. And I just did not really agree with that and I guess I feel good, but there’s inflammation going on. So I wanted to, once I realized that it must be that I wanted to get off right away. I–

Dr. Justin Marchegiani: How did you feel though? I’m just curious. What happened to your thyroid symptoms?

Inna Topiler: Gone. I felt great. Hmm. Yeah, I felt great. No issues at all, but I just knew that these numbers don’t look right and if the inflammation is silent, but it’s there. So I, if I had more time, I was also trying to get pregnant at the time and I just didn’t want to kind of mess around with stuff. If I had more time I probably would have tried Armour just to see if it was different, you know, if there was something in the WP versus the armor. But I said, you know what, let me not waste time here. Let me just go to a synthetic. And I didn’t want to do Synthroid and Cytomel just because there’s some other additives in there. And my doctor that I was working with worked with a pharmacy that was nearby the [inaudible] Compound and it was very easy. I know sometimes it could be difficult if your doctor’s not open to it, but I had someone that already had a great pharmacy, um, that they worked with. And so I did the compounded synthetic T4 T3 and I have to tell you, and this is, I know it sounds weird because you’re like, how can this happen this fast? My antibodies dropped from above 5,000 to a thousand and then they went to 400 within two months.

Dr. Justin Marchegiani: Wow. Did you try the, the tyrosint for the synthetic T4 that’s clean?

Inna Topiler: I didn’t, I just went right to the compounds. Okay. Because with the tire scene I’d still need the T3 and —

Dr. Justin Marchegiani: Then you would really want to put it together.

Inna Topiler: Yeah, exactly. And it’s all in one pill so it’s easier.

Dr. Justin Marchegiani: Are you open or are you curious to try adding it back in and see what happens?

Inna Topiler: Not really. Only because you know, I mean, and I, I definitely play Guinea pig a lot and I try stuff, but I got my antibodies down. I really don’t want to take any chances, have them going back, ever–

Dr. Justin Marchegiani: Do it. That’d be an amazing blog post to, to do it. Cause this is really good because you mean as a clinician you hear about these patients but sometimes you don’t really see them or sometimes you know, a lot of doctors don’t retest. I always retest after someone’s given a thyroid hormone support and that’s amazing because that’s a huge jump. I’m blown away right now. It’s amazing learning experience for everyone though. Awesome. Yeah.

Inna Topiler: It really is. And again, I mean I, for everyone watching, I don’t want you guys to think that that’s going to happen to you. I mean there’s a small percentage of people. It’s not everyone who has Hashimoto’s, but it’s worth looking at because it is possible and it’s amazing how quickly that happens too.

Dr. Justin Marchegiani: What other strategies can the listeners kind of utilize or apply regarding reducing their antibodies outside of just changing thyroid support? Cause most people we’ve kind of recognized that may not be helpful. There’s a lot of data actually showing that things like WP or thyroid glandular can lower antibodies. In your case it was the opposite. But what other strategies have you done or you’ve seen work with patients?

Inna Topiler: Well, I think that when we look at antibodies, we want to look at the immune system, right? Because that’s the immune system being confused. Um, you know, it’s not your thyroid’s fault. It’s the immune system that’s producing those antibodies. So we really want to look at the triggers and everyone’s going to have different triggers. But we all want to look at different infections. So whether it’s Epstein borrows, recommend that people test that and see to make sure it’s not reactivated or that you don’t have a lot of past antibodies and you can test for that by doing VCA, igm, VCA, Igg, um, and the EBNA. And, um, so look at that cause that’s just such a common infection. Yeah.

Dr. Justin Marchegiani: You’re saying run the viral capsid antigen, the nuclear antigen. Would you also run the early Antigen for the EBV Epstein?

Inna Topiler: Well, the early one, I guess if you’re feeling sick, um, if you’re not yeah, to activate, if you’re not feeling sick, you could just run the other ones to see. And um, you know, there are things that you can do, um, specific antioxidant, zinc, selenium and Acetyl cystine lysine to help your body to fight that. Um, you know, also look at toxins and I’m sure you guys probably talk a lot about this on the podcast, but you know, things we’re putting into our body everyday. So, of course our food, but also what we’re putting on our skin, what we’re drinking, our water from, the type of water that we’re drinking. That’s all really important. Um, and um, you know, with food, obviously making sure that you’re not eating anything that you’re sensitive to and that can change. You might be sensitive to certain things at certain times of your life and others at others. So doing food sensitivity testing, looking at things like food compounds, like oxalates are so far. And then the other big thing is stress, um, and the adrenal glands. And I think that we all talk about stress and we all know, okay, we need to stress less, but a lot of us aren’t really doing anything about it. And we kind of just blame it and say, okay, well let’s just stress. But you know what? Yes, it’s just stress, but we still have to support it. And so I think there’s so many techniques. Meditation has been really, really life changing for me. And, um, I learned it from Emily Fletcher with this Eva. Um, really, really liked that technique because she talks about that you actually don’t have to quiet your mind. And that was so interesting for me because I’m a perfectionist, and so every time I try to meditate, I’ve tried not to think, and by trying not to think, I would think more. Yeah. Right. So then I felt like I was failing and I’m like, why can’t do this? Why would I do something that I fail at every day? I mean, any intelligent person is going to have that thought. Right. And so she teaches that the job of meditation isn’t to quiet your mind. Um, it’s kind of like she says, you know, you tell, you can’t tell your heart not to beat, so you can’t tell your brain not to think. Um, the, you know, so she kind of does it with a mantra and she has this technique of doing it that I found to be way easier than anything else I’ve tried, which is why it’s been so successful for me. And that’s changed so much for me in my health.

Dr. Justin Marchegiani: Can you walk me through what that looks like? So, okay. You sit down. Can you just kinda just walk me through your flow?

Inna Topiler: Sure. So, um, you know, and again, it’s not a meditation teacher, so there’s, there’s more to it than that–

Dr. Justin Marchegiani: But people I think value it coming from just an everyday person that’s done it but also gotten great results. I’m really intrigued with the antibody immune response you had by doing it. That’s amazing.

Inna Topiler: Yeah. And I think with that, and I’ll walk you through the technique in just a second. I just want to tell you what the antibodies, I think what was happening to me is whenever I would see my antibodies high or I don’t feel well, sometimes I feel achy or just off, I would call it my sort of quote unquote autoimmune symptoms. I would right away start to obviously get nervous and then think, okay, what do I do? Which supplement do I take? What food do I cut out? I need to do this, this, and this. So it was a lot of doing and while doing is good, I didn’t want to say anything negative about that. I was almost like getting in my own way, if you will. So I would be doing so much that I actually wouldn’t allow my body to rest. And I really needed to remember that the body does know how to heal. We just have to get out of our way and give it a chance. And because I was always doing and so active, I was actually elevating my cortisol by freaking out, so to speak about all of the stuff that was happening. So what meditation did, and what I do now is if I start to not feel well, and Emily actually talks about this in her course. So if you feel like you’re getting sick, the first thing you do is go get your buns in the chair. So then you could take that 15 minutes and actually get out of your own way, not thinking about every supplement to take. And again, you still have to do that, but allow your body that 15 minutes so that it could do what it needs to do and then go take the supplements and the other things that you need to do. So it’s a combination. And so with the technique, she walks people through a little bit of mindfulness for the first, um, minute or so where you just tune into your body so you listen to what you’re hearing. You can see what you’re seeing with your eyes closed. You can smell your surroundings, you can taste to see what the taste in your mouth is. That just brings you more into your body. Um, and then the way that she teaches is to do with a mantra and everyone actually gets a personal mantra, um, through her course. Um, but if we just take a word, let’s say, um, like we could use ohm for example. And so what people would do is it would close their eyes and then in their mind they would just say the word ohm and they would just repeat that with their eyes closed over and over again. Um, and it’s something that shouldn’t be super loud. It could just be like maybe slight whisper or just, you know, you can hear yourself saying it or, um, you can just kind of repeat it like very, very softly in your mind. And what’s nice about that is it gives you something to concentrate on. Um, and then if you go into some type of a daydream and you don’t realize, that’s okay. But if you realize that you’re not saying your mantra, then you want to go back to it. And that’s kind of the difference between if you don’t realize you’re still meditating, if you realize and you choose to stay off, then you’re off and you want to bring yourself back. I mean, obviously there’s more to it. Like I said, I’m not a meditation teacher. This is just her technique that I’m using. There’s more to which is a book and a course that people can learn from. And I don’t get paid for this. I just like her work. So I mentioned it again. Um, but it’s really, really helpful. Um, another thing that I also found very helpful in the mind body front is, um, uh, one mentor of mine, his name is Dr Mario Martinez. He has a book called the Mind Body Code, and he also has a workbook that’s an audio called the mind body code. I highly, highly recommend that. Um, what he talks about is that oftentimes a lot of our emotions can be stored physically in the body. And we all have different wounds that we can be wounded by, you know, our parents or society when we’re younger. And, um, some of the wounds that are really common are shame, abandonment and betrayal. And most of us are gonna have at least one, but probably all three at some point in our life. And you know, with portrayal doesn’t have to be something really, really major, but even minor betrayal can count. And then shame is something that, you know, we’re exposed to since childhood. I mean, even as toddlers, you know, if our parents says, don’t do that, um, you’ve been a bad girl or you’ve been a bad boy, that shaming. But of course it could happen to a higher degree as we get older. And shame can really affect the thyroid and autoimmunity because, um, you know, our thyroid is in our throat. That’s our fifth shocker. That’s our expression. And so when you feel shamed, um, that can really suppress that voice. And so there’s a big correlation there. So I did some of that work, um, with him. And you know, people can also, if they’re interested in that they can get the audio book and the workbook. Um, it’s very inexpensive and there’s a lot of great information with that.

Dr. Justin Marchegiani: I think we really touched upon some really excellent concepts. He really connected the dots here. Great clinical experience or feedback with the antibody increase with the glandular support. Is there anything else you know, that you want to highlight here for the listeners that you think is extra valuable you want to add?

Inna Topiler: You know, I think what I would want to add is, you know, for people that are watching, listening to this, that have health issues, you really want to make sure that you have the right mindset. Um, because when we look at people that get better, those that have a positive outlook and a mindset that they can figure out the answers and then they can heal, do better than people that are unsure. And of course for a lot of people it has been a long road and you guys may have dealt with a lot of stuff and may have gone to many doctors that perhaps were not helpful. And sometimes it is hard to keep the face if you’ve hit a lot of roadblocks and walls along the way. But if there is a way to just really believe that you can, um, because the answers are out there and there is hope, um, you know, we just have to have that notion that it is possible because it is, you know, usually if you’re experiencing a health issue, there is some type of a reason behind it. Like, things don’t just happen out of nowhere. Sometimes we don’t know what it is and we have to test and dig. Um, but if you can have that knowing that the answers are out there because they are, it’s gonna help you in healing.

Dr. Justin Marchegiani: I 100% agree when you’re in pain, right? Pay attention inside. Now that’s the acronym. So it’s always, instead of looking out, look in. So that’s really good feedback, you know, where can the listeners find more about you and what you do and the information that you produce and provide?

Inna Topiler: Absolutely. So I actually just recently launched a podcast. It’s Health Mystery Solves, and we had a great interview that went live a couple of weeks ago. So that’s a, you can subscribe on iTunes or it’s Um, I also have a virtual practice, complete nutritional I have lots of blogs, but I think probably the main thing is going to be the podcast because there’s new content every week.

Dr. Justin Marchegiani: That’s awesome. Yeah, I’m on the podcast, so everyone go over and listen to our interview was really great and thanks for this awesome information. Look forward to connecting with you again. So, you know, thanks so much.

Inna Topiler: Absolutely. You’re welcome. Bye Bye. Have a great day. Bye.


Audio Podcast:

Thyroid Reset Summit | Podcast #218

Thyroid Reset Summit is here! It is Dr. J’s compilation of expert interviews and advances talks on the topic of thyroid health. Don’t wait, don’t suffer, support your thyroid now!

In today’s podcast, Dr. Justin Marchegiani and Evan Brand engage in talk that covers the compelling topics around areas of thyroid health like autoimmune thyroid, gut infections, trauma and stress and how that affects thyroid and hormones. Listen as they discuss live interactive podcast with viewers and gain insights about the issues involved in thyroid and ways that go to the root cause to address them. Stay tuned for more!

Dr. Justin Marchegiani

In this episode, we cover:

03:00    Trauma

06:41    Reverse T-3

14:19    Maca and Hypothyroidism

19:55    Molecular Mimicry

26:28    Iodine and Iodide

28:03    Low Dose Naltrexone (LDN) and Hashimoto’s

30:38    Desiccated Thyroid

32:01    Natural Thyroid Glandular

37:37    Nascent Iodine

40:38    Oxalates and Hashimoto’s

44:09    Thyroid Replete or Balance

46:50    Candida Overgrowth and Kale Intolerance


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Guess what’s up, the Thyroid Reset Summit is live today. So, make sure you click below, there’ll be links where you can access the summit, make sure you register. I’m giving up my full, free 88-page eBook, it’s the first 3 chapters in my 12-chapter book, it’s gonna be amazing. I’m here with Evan Brand as well. Evan’s a- was a phenomenal interviews as well. So, make sure you subscribe to go access Evan’s interview. There’s gonna be links below where you guys can access it all, I appreciate it. Evan, welcome today’s chat, I’m excited that thyroid summit is here.

Evan Brand: Yeah, I’m excited too. Your talk is today. So, if people wanna hear me interviewing you, that’s a day 1 of the summit. So, your pretty face is on there, and you great- you gave a stellar interview, and there’s already tons of good comments, we were just reviewing that together, there’s tons of good comments and feedback coming in already on the summit and we’re still in like, you know, day 1. So, this is like the open house so to speak, of the summit. If people, you know, have been living under a rock, or they just don’t know how summits work. Basically, what it is, is Justin put together 30+ expert interviews. These are anywhere between 30 and 45 minutes in length, and they’re all on the topic of thyroid health. So we- he’s gonna get in to anything from autoimmune thyroid to gut infections and thyroid, to mitochondria and thyroid, to chemical toxins to trauma, and stress and how that affects thyroid and hormones. So, each different expert has their own unique view, and he make sure to extract as much information as he can, it’s all free. You just register free. So,, you go there, you register free, put your name, your email in, you can access it as long as you get on your computer or your phone, on the day of the talk, you can access about 5 talks for free every day for a week. And then after a week, depending on what your all’s feedback is, they’ll probably do an on-core, you get one last chance to view him for free, and then, what I recommend you do, is you buy the summit, it supports Justin, it supports the mission, it gets his information out to the masses because your average doctor is not having the type of conversations that Justin is having on this summit. These are conversations that are very advanced. And something that’s still broken down, simply free to understand, but in terms of timeline here, it could be another 10 years before mainstream doctors are even addressing the stuff that’s being discussed now. So, don’t wait, don’t suffer. Buy the talks, it ends up being like 50 bucks or something. That’s ridiculous how cheap it is, and you could own all 30 talks, you’ll get transcripts, etc. Is Justin paying me to promote this thing? No, he’s not, it’s just freaking awesome and I’ve already read the book. And, the book is amazing, and the summit is amazing. So, please buy it and support him so he can keep buying grass-fed stakes so- he’d to stay healthy so that he can do a podcast with me.

Dr. Justin Marchegiani: I appreciate that Evan, thanks so much. So, I just, you know, being a thyroid expert and also being a part of the summit yourself, what are some of the topics that you feel like were most compelling for you in and around the area of thyroid? I have a couple in my mind but, what reason they would give the most?

Evan Brand: Oh, man. Well, I would say the ones on trauma. Uh, you’ve got ___[03:03] on there, which is just incredible, because, I think trauma is something that, well, we already know this, uh- a- as Americans, we repress our emotions, we repress our traumas, we try to just move on, we ignore traumas, we throw ’em under the carpet and we just don’t wanna talk about this stuff, but what you and Nicky discussed was amazing which is the fact that, depending on how your childhood uh, was. You talked about the ACE score, the Adverse-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -Childhood Experiences score-

Dr. Justin Marchegiani: Yup.

Evan Brand: -and how- what you all are seeing. And I’m seeing the same thing too, is that, the higher the ACE score, the more likely it is that you’re gonna have a problem, and it could be a thyroid, and/or an autoimmune thyroid problem, all linked back to something 20 years ago. And so, you all had a great discussion about, well, how do you start working on these things that happen to you? It’s not to say, “Hey, we need to go back to counseling, and, you know, go take the guy into counseling with you, who beat you up 20 years ago, it’s not that, it’s no, there’s ways you can clear these traumas from your body, and a lot of it is free. So, I think that’s probably the most powerful starting place.

Dr. Justin Marchegiani: Yeah, and also a lot of these traumas too, they affect the HPA access. And, some people that they may have addressed the issue but, they’re kinda dealing with the collateral damage, whether it’s adrenal issues or gut issues, and- and/or compromising the immune system, maybe even infections just from all that stress, or maybe even they developed an ___[04:23] disorder which is created all kinds of adrenal and blood sugar and nutrient deficiencies. So, we gotta look at everything from the root cause. Okay, is the root cause addressed, okay good, and now, we gotta also do damage control as well. But, while fixing everything in a ___[04:37] root cause kind of, manner using nutrients and- and sport.

Evan Brand: Yeah, now, I will say, if you just focus on traumas and nothing else, and let’s say you start doing the EFT, the Emotional Freedom Technique which is the tapping that you and I both love. I love tapping. I’m gonna start tapping-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m [crosstalk]… uh, so, when you start tapping, this is basically like acupuncture without the needles, so you’re helping to basically recalibrate your nervous system, so you’re not stuck in fight or flight. And I’ll do this, like if  I going stage or if I’m gonna go on an airplane, I’ll just tap, tap, tap, tap it out, and I just feel really good from it. And, there’s practitioners, this is such a powerful tool. There are practitioners that’s all they do, is tapping. Now, you and I, we both agree that tapping by itself is probably gonna be pretty limited, it’s not gonna be fixing root causes, but can they help reset the nervous system, which could therefore improve your thyroid health and potentially lower your thyroid antibodies? I would say, absolutely.

Dr. Justin Marchegiani: Yeah, I mean, if you have significant unresolved traumas, especially in the area of sexual abuse, or just issues growing up. Uhm, even disorder stuff, control issues or any kind of abuse. I think it’s really important especially if- if I’m talking with a patient and, “Have you really fully adro- uh, you know, resolve that?”, “Can you go back and think about it, and talk about it, this is not really bring your emotion up let’s say, pass a 3 out of 10”. And if they can’t answer that, or you start to hear them sob on the phone, or on- on the video, and that tells me we gotta work on that. So, it really just depends on how much they’ve done to resolve and to move past that. Uhm, but, if- if they haven’t done- I have people that I refer out to, they had- they really dive in with that work for sure.

Evan Brand: Yup.

Dr. Justin Marchegiani: [Crosstalk]…that activates the sympathetic fight or flight kind of nervous system response and, if that keeps going, that can just be a drain on your adrenals. And we know how important a cortisol is to inflammation, and if we have thyroid issues and autoimmune thyroid, and we don’t have enough healthy levels of cortisol to- to deal with that stress, or if our cortisol levels had been depleted, uhm, the HPA access dysregulation that- that brain talking to the adrenals, that feedback loop is disrupted, that can definitely creates some major challenges for sure.

Evan Brand: Yeah. So, we should talk about reversed T-3. We actually had a question here from the Doc J.C., uh said, “Please go over the significance of reversed T-3. What range do you feel as optimal? It seems to be frequently ignored or not seems to be so significant. Thanks, looking forward to the summit”.

Dr. Justin Marchegiani: Yeah, I hundred percent agree. Now, think of reversed T-3 as like metabolic blades for our metabolic uh, magazine, or gun- gun cartridge so to speak, right? We put all the bullets in it, uhm, the metabolic blades, they take up space where an actual metabolic bullet would be, we fire the gun, we get the noise but we have no bullet coming out. Basically, these reversed T-3 compounds, they’re blocking the receptor sites; every single cell in the body has receptor sites for thyroid hormone. So, when we had excess, reversed T-3, it’s gonna clog up that receptor site for T-3, and it’s gonna decrease the ability for that T-3 to fill up the receptor sites. Also, you had T-4. Let’s say you have 80%- let’s say you have a higher percent of T-4 convert to reversed T-3 over T-3, it’s also robbing the ability for that T-3 to- to be fully expressed. So, imagine we have, let’s just say, let’s just say we have 10 units of T-4, alright? Just hypothetical numbers here. And let’s say we’ll typically converting 80% to T- to T-3, and 20% to reversed T-3, there’s naturally gonna be some reversed T-3 levels. Let’s say, anywhere between the low 10’s to the upper 10’s, right? Then you know that’s a good level, alright? That’s the actual lab reference range. In my analogy, let’s say we have 20% goin’ reversed T-3, 80% go into T-3, our actual metabolic active thyroid hormone. Well, typically, when stress starts to happen, low calorie diets, more stress, adrenal issues, inadequate levels of selenium, we may start to see a 70-30, a 60-40 split, where more of that building block is going to reversed T-3, less going to actual T-3. So, we’re having less T-3 but we’re also having the congestion of the receptor sites. So, that T-3 that’s now there, the lesser T-3 it’s there, it’s not able to dock in to that receptor site, the locking key methods not able to go in because someone put gum in the keyholes, so to speak.

Evan Brand: Yeah, great analogy. So, let’s take it a step further. So, what happens then? ‘Cause you and I , we’ve tracked my blood for several years, little that I know, I was living with mold, and that mold was messing up my thyroid, that was part of the problem, I had elevated reverse T-3, and you and I been looked at and we’ve been like, “Okay, let’s look at gut”, “Okay, stool test is clean, let’s look at adrenals, okay, adrenals look decent. Well, where the heck was this reversed T-3 be coming from?”. I’ve- in my opinion, I believe it was all the stress that my immune system was dealing with because I had elevated white blood cell count, at the same time as I had elevated reverse T-3. So, it’s not that it changed my game plan of my protocol at all, it was really just an indicator of “Okay, so here’s why I probably have cold hands, cold feet, my body temperature was running like a 97.7. Unless you tell me I’m wrong, I think that was all related to that reversed T-3 being so high. I was in the 30’s.

Dr. Justin Marchegiani: Yup. Yup, it could’ve been. And we also know, you know, if you have a- a liver stress, right? Livers’ really important because it make enzymes that are gonna help activate thyroid hormone, and it also helps to clear reverse T-3. So, make sense over stress, glutathione form toxins in the environment that can affect our ability to clear it as well.

Evan Brand: Yeah, I think I was like 35, uh, on my [crosstalk]

Dr. Justin Marchegiani: And again, how- you know, we can see low calorie diets, increased reverse T-3, that’s why- that’s why in the long run, cutting calories to lose weight doesn’t work ’cause it just slows down your thyroid. So, then when you come back to reality and you actually are eating a normal amount of food, now, your metabolism slower, so now you end up storing more fat on the buckets.

Evan Brand: You wanna know something crazy related to hormones and-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -gaining weight and all that? So, something that I learned the past few weeks, is that mycotoxins can actually bind to your leptin receptor. And this is why some people have gained weight on like 800 to a thousand calories is ’cause the mycotoxins are preventing leptin signaling from working properly.

Dr. Justin Marchegiani: Yeah, I know. I had a conversation with Dave Asprey a couple of years ago. There’s a compound called the Zearalenone. It’s- it’s a mold kind of herpes that actually put into the ears of these cows. And the Zearalenone literally causes the cows to convert more of their calories to fat.

Evan Brand: Oh my gosh.

Dr. Justin Marchegiani: That’s what it does. So, they would use some of these connection-

Evan Brand: And that’s a mycotoxin?

Dr. Justin Marchegiani: That’s a mycotoxin, they put it in their- in the cow’s ear, be the- like a little pellet-

Evan Brand: Oh.

Dr. Justin Marchegiani: -and they re-absorb it through the ear canal. And this is, you know, first hand from Dave Asprey. And it will cause more fat gain, so it would allow them to convert more calories to fat which, you know, bottom line, more weight on scale, so, more- uh, more cost per cow, so to speak, ’cause it’s all weight-driven. So, yeah, mold and mycotoxins are- are a big one, alright? And we’ll do another podcast on that-

Evan Brand: I did another interview- if I did another interview on your summit, my whole talk would be about thyroid and mold because I’ve had tons of hypothyroid symptoms. Now, I still have 6 pack abs, I’m still ripped, uh but I had like cold body temperature, cold hands, cold feet and all that related to mold. So, if I did an “Evan on Justin’s Summit Part 2” it would be all about mold and how I think so many people with thyroid problems probably have mold in their house that’s helping to destroy their immune system and cranking up reversed T-3, elevating liver enzymes, reducing detoxification, and the body’s got to try to focus on mold, and then they can’t focus on other stuffs-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -so then chemical toxins get built up, it seems like a huge like lynchpin.

Dr. Justin Marchegiani: Yeah, I- and the only thing I would add is do all the- the natural- do all the things first and leave that to the end-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -because, you did it that way too. And then we saw there was an issue and then we dealt with it on the back end, uhm, my biggest concern is mold and things like that can be- can be more in the expensive side, and it can be a rat hole for some people, meaning, if they do the foundational things first, they may get some significant relief upfront, and it won’t be as cost- it won’t be as costly as dealing with the- the mold in the back end. But, some people-

Evan Brand: It won’t be as overwhelming.

Dr. Justin Marchegiani: Yeah. And the only exception being, hey there’s active leak, you got water stains on your ceiling, uhm, you know, there’s- there’s an act- you can actually actively visualize mold or water leaking, then I would say that it has to be dealt with right away. [crosstalk].

Evan Brand: I’ve- I’ve probably stayed afloat a lot longer than I did before I developed a lot of major symptoms because I had all the foundations in order-

Dr. Justin Marchegiani: Yes.

Evan Brand: And so that’s- that’s why the summit is gonna be key- it’s not to- it’s not designed to replace a consultation with Justin if you have thyroid problems, you still need to consult with Justin, for sure, but this is more designed for you to get the information you need for you to get the questions answered that you have in your head. And once you have all those questions answered, you’re gonna learn more about types of thyroid lab testing that you need to run reversed T-3 being one of those markers. These are things you can bring up to your endocrinologist or your GP and tell them, “Hey, I heard on this summit, this guy Dr. Justin talked about “XYZ”, can you do that for me?”. And we’ve had clients report back to us and say, “Hey…”, you know, “…thanks to you, or thanks to your podcast, I was able to get this and this, and this run on my blood work, and my doctor only ran it because I asked them to”. So if you just go with the status quo, you’re probably not gonna get the result you’re looking for from the mainstream. Now, if you find a really good endocrinologist or a doc that’s gonna listen and run these extra important thyroid markers that are not generally run, you may be able to make them work, or you gotta go to the functional side. My opinion, I’m gonna say go to the functional side, ’cause your endocrinologist is never gonna look at the stuff Justin’s looking at and saying, “Hey, you know, these bacterial infections do this; this parasite does this”, it’s the last thing you’re gonna hear from them. They’re gonna say, “Oh, you can go to an infectious disease doctor, you think you have parasites?” And then they’ll just refer you out and you’ll go nowhere. That’s why we’re kinda generalist and specialist on the same token.

Dr. Justin Marchegiani: Exactly, that’s really good point. Let’s kinda dive in to the next question here, let me pull it up. Uhm… let’s talk about Maca. Maca and hypothyroidism. So, number 1, if we see- Maca’s gonna be really good especially for women. Uhm, there are some good Maca forms for men too but it’s gonna really help modulate estrogen levels that can even help with progesterone levels. So, why is this helpful? If we have estrogen dominance, that can definitely increase thyroid binding globulin and decrease the amount of free thyroid hormone. So, it can definitely lower our free thyroid hormones. So, if we modulate our female hormones and improve that balance in that estrogen and progesterone ratio that can definitely improve the amount of biologically active thyroid hormone. Also, for in a, estrogen dominant state, we need good levels of progesterone. And progesterone help stimulate thyroid peroxidase and make thyroid hormones. So, good enzyme activity from TPO is important, and that can help make thyroid hormone. So, good levels of progesterone help with that as well.

Evan Brand: Can you talk a little bit about age? I mean, this is something that you ask your average women, aged 15 above, they’re gonna say, “Oh, my thyroid”, or “Oh, my hormones”. Can you talk about kind of what happens when you’re transitioning from a normal cycling female to you go into perimenopause- menopause ___[15:33] when you go to those stages. And ___[15:36] to say, “Oh, oh it’s my hormones”.

Dr. Justin Marchegiani: Yeah. Yeah. So, in general, typically, women may start their perimenopausal phase in their early 40’s. This is where like a lot of these menopausal symptoms start to happen. Whether it’s skipping a cycle, mild hot flashes, mild hair loss, mood issues. And again, it’s- it’s- it can be- it’s hard to distinguish perimenopause and just PMS and cy- and cyclical hormone imbalances. Especially where I see a lot of these symptoms happening with women in their 20 and 30’s, it’s hard to distinguish, but you’re typically seeing some of these menopausal symptoms, they may happen throughout the month, where the premenstrual symptom that are just tend- tending to happen a week, maybe a couple days, sometimes 2 weeks before period. So, you- you gotta look at it and distinguish. Typically, what’s happening is you’re having a decreased ovarian reserve and then the estrogen and the progesterone are starting to drop. And sometimes you see estrogen drop a little bit slower than progesterone, so then you still have low hormones, yet still have estrogen dominance. And again, perimenopause is done once you’ve had cycle for one year. So you have that kind of in between phase and lower adrenal functions in a predisposed at because your adrenals are making a lot of precursor hormone that’s gonna provide building blocks for your sex hormones. So, lower adrenal function, cortisol stress, HPA access stress, that communication from the brain to the adrenals, when that’s dysregulated, you’re draining that backup ge- battery generator to help make more of the hormones. So, when that follicle starts to drop, then the adrenals gonna help pick up the slack.

Evan Brand: So, would you say all women post-menopausal should be on some type of adaptogenic herb hormone support, and can that replace or remove the need for like bioidenticals?

Dr. Justin Marchegiani: It depends how strong their hormones are, uh, it depends how strong their adrenal glands are already.

Evan Brand: Okay.

Dr. Justin Marchegiani: Number 1. And number 2, it depends on how severe their symptoms are.

Evan Brand: Okay.

Dr. Justin Marchegiani: So, we’ll use specific phenotypes of Maca for perimenopausal women or menopausal women, that can help, some do need adrenal support obviously than some may need some of the bioidentical progesterone, estrogen support, it just depends on their severity of symptoms, how long it’s been going on for, and how their hormones look, adrenal wise, female wise and thyroid. And this is where it stop because hair loss, it’s a thyroid symptom but also lower female hormones can cause it too. So, so can like cool their temperature when waking, that could be a thyroid issue, it could be a female hormone issue. This is why testing is so important. It really allows you to like, walk into the situation clinically, feeling like you’re on top of what’s going on.

Evan Brand: Yup, well said. And- and, I wonder, does that change much? If a woman’s had like a partial or a full hysterectomy, or maybe she’s got her ovaries gone, the uterus is gone, is that like, hey, there’s no way adaptogenic adrenal support’s gonna help you?

Dr. Justin Marchegiani: Well, soon as they go- as soon as they have a uhm- a full hysterectomy where the ovaries are gone, they’re menopausal right away, right? So, they’re automatically in menopause. If it’s a partial hysterectomy where the uterus is gone, typically that’s happening from maybe a fibroid, maybe some endometriosis. Uh, a lot of times it’s done in- in haste because there’s excessive bleeding or he- hemorrhagia, and the doctor’s like, let’s just pull it out which is crazy like, let’s fix the hormones, let’s fix the underlying issue, a lot of times you can keep your uterus. Now, there’s some literature, you know, if you look at some of the endocrinology techs, there’s some people saying that, “Hey…”, you know, “…your uterus maybe producing some level of hormone. So, it’s possible that you keep your ovaries, you get your uterus removed, but you- there’s still maybe some hormone stuff that happens, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s kinda like with guys and they get a vasectomy, there are some research showing it, you can still have a drop-in testosterone after vasectomy. What happened? You didn’t touch the testicles, right? But when you mess around with that anatomy there’s probably some feedback loops that are disrupted, there’s probably some hormonal secretion that’s happening from that tissue that were not quite, you know, fully aware of. So, that’s why when in doubt, always try to keep the tissue in place-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -if you can.

Evan Brand: It’s crazy. I mean, for to think, oh, it has no purpose when you’re aged 60 just ’cause you’re not menstruating, those organs have no purpose. That’s- that’s bizarre. Yeah, I mean, if you have no purpose anymore, it would come out just like a placenta comes out after a woman delivers a baby. That organ is there, and then that organ is not needed anymore, and the mom pushes the placenta out and then you’re done. You don’t push out the uterus. So, it- it needs to be there.

Dr. Justin Marchegiani: Exactly. It definitely needs to be there for sure. So, uhm, on that road, I think we answered that question.

Evan Brand: I’ve got another question for you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Okay. So, we got one here, “Can you discuss molecular mimicry?”.

Dr. Justin Marchegiani: Yeah, so, diff- i- in general, we have surface proteins on foods, especially gluten and casein, and these surface proteins, they get tagged by our immune system. And there are other surface proteins on tissue in the body like the thyroid that can look similar. So, imagine you have someone who just did a- a crime, and they’re driving a black Honda Civic. Well, Honda Civics are pretty popular car. Please come on the AP- you know, on the radio, APB, you know, be careful and just person, and the authorities driving a black Honda Civic. They’re driving the Honda Civic, you get pulled over. Why? Because you have a similar identification that was called on the APB there. So, what does that mean? Its surface proteins can be similar, and so of course, when that APB is called up by your immune system, A.K.A, the immune system makes antibodies to target these surface protein, and other tissues have a similar surface protein like the thyroid, then that can, uh, your immune system can attack it. And that’s why you’re see- that’s why gluten is such a big deal. Also, gluten also opens the gut lining. And when the gut lining’s more open and we have gut permeability or leaky gut kind of the slang, there’s more chance of your immune system to get in contact with undigested foods and create more antibodies for more stuff. So, leaky gut’s a big thing and, there’s a lot of data saying, “Hey, even if you’re not reacting to the gluten, gluten may still be opening up that gut lining, creating more gut permeability”.

Evan Brand: Well, here’s one other thing to take it even further on the anti-gluten train, which is the fact that people say, “Oh, I’m not sensitive to gluten, I don’t have any rashes, I don’t have any headaches, I don’t notice joint pain after gluten. It doesn’t matter, we’ve seen, and many, many, many pieces of literature, just google “Non celiac gluten sensitivity” and you could read about it for yourself. Even if a person that says, “I noticed…” quote, “nothing”, from eating gluten. We still notice that the secretory IgA gets lower, that gut barrier gets broken open, you get leaky gut. There’s no like, “I’m a tuff guy, I grew up in Wisconsin, grew in corn and I eat corn and gluten and I love it”, no, it doesn’t matter. You’re gonna have a leaky gut no matter if you noticed anything or not and, why is that important for thyroid health, wll, ’cause once a gut’s leaky, now, let’s say you get bacteria and parasites and toxins from the food supply, you breath in some guy’s diesel truck in front of you on the highway, those toxins have direct access to the bloodstream. And we know that when the gut is leaky, the blood brain barrier is also gonna be leaky, and then you’re getting toxins into the brain. So, you go and need some tuna fish on your night out and sushi, and that mercury can go into your brain now because your gut was leaky and they had access. So, you know, I kinda have like a zero tolerance, you know, policy. I like how, uh Rodney Ford, he was a gastro doc I had on a podcast-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -like, 7 years ago or some crazy, as if one of the first steps which I did. He said, I don’t like to term gluten-free, he said I like to term gluten-zero, because gluten-free sounds- you- you know, just like it’s toys or like, it’s- it’s a rec- it’s a recommendation. But he said, the idea of gluten-zero, is much more direct and blunt. It’s like, “no”, you don’t want any. Because even we’ve seen we- you and I, we test the antibodies, we look at anti gliadin IgA on the stool test, and what we see is that, even up to 3 months, 4 months after somebody’s had gluten, you know, here we are in early March, at the time of this recording, someone could had a bunch of cookies at Christmas and we could still see 3 months later, the antibodies elevated because of that.

Dr. Justin Marchegiani: Yeah, so, I mean, I’m pretty puritanical when it comes to gluten. I will- I met- I do have a cinnamon bun last night but it was gluten free, and I typically never cheat, I ended up getting within 30 minutes after the sore throat, and it’s lingering right now. I’m doing some-

Evan Brand: No way.

Dr. Justin Marchegiani: -essential oil lozenges to help- help [crosstalk].

Evan Brand: Rice flour, what was it that did that to you?

Dr. Justin Marchegiani: It was rice flo- it was rice flour, and it could have been just the carbs, it was pretty carb-heavy. But, you know, it just makes me think like, there’s one more sin in the fridge, am I gonna have it tonight? Hell no, you know?

Evan Brand: [Laughs]

Dr. Justin Marchegiani: I’ll- for my cheat, I’ll do my ___[23:49] chips and some fresh homemade guacamole instead for my little kraut treat. But yeah, e- even that, I still had the decision, you know, should I stop at dunkin doughnuts and get like the awesome cinnamon bun that I have memories of 20 years ago, when I used to eat lots good food but, now, I at least chose the healthier option, but still, I kind recalibrate and say it still not worth it. So, try to find the healthier option if you want a spurge. If you’re autoimmune condition’s under control and you don’t have an autoimmune condition, maybe you spurge every now and then on the holidays. My recommendation though is, you find a healthier option, and if you have thyroid antibodies, you definitely need to. I have thyroid antibodies, so you really gotta make sure that you’re on the right track. There’s a lot of healthy options these days. It’s crazy, I mean, I had some- some I think it was uh, Danielle Walkers got a new pizza that’s like, a yuca based pizza, and it’s freakin’ awesome. It’s really good, and the crust is great. It’s a little carb heavy, so I save it for my carb night, but uhm, it’s a great pizza.

Evan Brand: Wow, she makes it?

Dr. Justin Marchegiani: Yeah, it’s in the whole food section now, it’s frozen. But it’s a yuca based crust.

Evan Brand: And is it already, uh, it’s just a crust and you gotta put all your own toppings? Or-

Dr. Justin Marchegiani: No, it’s got everything on it already. But she’s got some I think where you can buy without the toppings. But I just love yuca for crust ’cause yucas just like- it’s a soft, it’s really uhm, moist too.

Evan Brand: I’ll have to look for it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I- I wanna point out what you said. I think it’s very important which is that, you may go off your diet for a bit and play with this food and play with that food is kind of a treat, but like you said, it’s not worth it. And, you know, people think when we come up with a diet protocol for ’em, then it’s like a diet of depravation. But overall, I would say you and I are not deprived at all. We’re eating good fats, good meats, good veggies, I mean, this is not a deprivation or starvation diet required.

Dr. Justin Marchegiani: No, I mean, last night for dinner, I had a dry aged Kansas City strip steak, step 4 from wholefoods. And, I had it last night with some green beans and grass-fed butter and some sea salt, and it was phenomenal. So, I should have eat really good like that, like, keep it simple, you know. The night before that, we threw some stuff in the instapot, 40 minutes later, some vegetable. I think we had some celeries, some uhm, carrot, and some chicken, it was great. I mean, keep it really simple, easy.

Evan Brand: I did some haddick last night-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: I had couple different fish, I had some haddick and some cod, and then we did some sweet potato fries that we baked, and then we did some broccoli. My wife is all into fresh broccoli now, because we were doing frozen broccoli, but it’s a game changer to do fresh. So, uh, hopefully when I get my garden, we’ve got snow on the ground, hopefully I can get my garden going and get some fresh broccoli. Last year, even despite my really good fencing operation around my- around my race guard bed, those darn rabbits, it ate on my broccoli, so I didn’t get any, I had to buy it all to store [chuckles], or the farmer’s market.

Dr. Justin Marchegiani: Uh, hundred percent man, that’s really cool. Uhm, very cool. Let’s talk about- someone asked about “Iodine and iodide”. So, basically, iodide is the ion form of Iodine. So, you have basically uh, the chemical structure of iodine is- is 2 molecules of iodine, and so essentially, iodine is one. So, typically, iodine’s bonded to a salt whether it’s a sodium salts or a potassium salts, and then in your body, your body converts it and- and puts it together and makes iodine out of it. So, you can have one molecule’s iodide, 2 is iodine, you take it and the it converts it in the body and it goes to through iodination and it- it can makes it iodine.

Evan Brand: How do you approach that with clients in terms of supplementing?

Dr. Justin Marchegiani: I typically use a potassium iodide.

Evan Brand: Yup. How often do you supplement it, is that something where it’s like, yup, a little amount is always gonna be okay ’cause there was a whole, you know fear mongering about “Oh, you know, supplementing iodine could- or iodine can uh… increase your thyroid antibodies”, but I’ve not found that to be true, let alone know.

Dr. Justin Marchegiani: Well, I mean, it’s potential, but, if someone has active thyroid autoimmune stuff, we just don’t go more than the RDA which is between 150 to 250 micrograms.

Evan Brand: Mm-hmm.

Dr. Justin Marchegiani: And if we see they’re stable, and/or they don’t have any that we may play around with going up to a gram or maybe a 1.3 gra- uh- sorry, 1.3 mg, 1.5 mg, alright? RDA’s a 150 to 250 micrograms. So, typically, within 5 or 10 x of the RDA.

Evan Brand: Okay.

Dr. Justin Marchegiani: It can. It- there’s a lot of data in the literature on that. So, uhm, I can just tell you, I see people go too high in iodine and lose their hair.

Evan Brand: Oooh.

Dr. Justin Marchegiani: So, you gotta be careful.

Evan Brand: Wow. I’ve got another question for you if you’re ready.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: Uh, a little one here rom Doc Jacey-

Dr. Justin Marchegiani: Yeah.

Evan Brand: “What is your take on using LDN for hashimoto patients? I do see the antibodies dropping and symptoms improved. Curious, if you’ve seen the same”.

Dr. Justin Marchegiani: Yeah. So, first off, it’s not the first place I go, the low-hanging fruit’s gonna be, uhm, obviously uh, autoimmune template to start getting good nutrients onboard, getting enough selenium onboard, CoQ10, magnesium, these are really important. Then after that, I would go to like curcumin, uhm, curcumin, things like that fur, you know, fur. So, it’d be the first things I would get in there first. You could even play around with resveratrol, uhm, I would do that first, and then maybe even CBD. I would try to do CBD over LDN, but I had seen some people do okay in LDN. I’ve seen some people do worse on LDN. So, I try to go to the more natural compounds first before I go to uh, an ___[28:54] blocking drug.

Evan Brand: Agreed. And I can’t prescribe it. So, even if I could, I wouldn’t because I’m, you know, my toolbox is limited to using natural professional grade products and nutrients and herbs, so I just don’t even have it on the table for me, so I just have to assume that I gotta fix the issue with other things. And you and I’ve seen hundreds of times that, when we just fix the gut, we’ve seen antibodies drop from it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: 2000, 3000 to sub-500-

Dr. Justin Marchegiani: Yeah.

Evan Brand: Just [crosstalk]… the gut and changing nothing else.

Dr. Justin Marchegiani: Yeah, I mean, the gut’s obviously the next big component. But supplement wise, curcumin, resveratrol, selenium, CoQ10, magnesium, a- autoimmune template, and then of course working on the digestion, working through all the 6 hours. Enzymes [crosstalk]… bad foods, replacing digestive support, hormones, moving infections, re-inoculating, repopulating probiotics and then retest it.

Evan Brand: We’ve got a couple other questions here. What’s your- what’s your schedule look like? How much time you got left?

Dr. Justin Marchegiani: I got enough time, I got 10 minutes here.

Evan Brand: Perfect. I’ll just uh, give people another plug. If you haven’t register to Justin’s summit, please do., it’s great. If you’re like geekin’ out on this, you’re about to geek out times 30 for the next week. Every day, you’re gonna get to hear Justin in your ear for like 6 hours. So, better put some headphones on, get your nice cup of camel milk tea and sit down and have a good listen. And uh, Justin did videos too, so that’s cool. If you wanna see the interviews, as opposed to just listening, you can do both, and if you end up buying his summit, you do get transcripts. So, I know, we’re getting a little, yo know, a little tricky, a little complicated sometimes in these interviews, you may want to have the transcript available so you can refer back to that.

Dr. Justin Marchegiani: Wonderful. Hundred percent. [crosstalk]

Evan Brand: Yeah, so that’s my plug. And uh, the next question from Colin is, “Any recommendations for…”, he said, “dedicated” but he meant desiccated, and we know what you meant. So, “Any recommendations for desiccated thyroid? Have you heard of the company thyrovanz?”. And I have not.

Dr. Justin Marchegiani: I have not. I have not in my life. We have a product called thyrobalance that is a natural glands. We’re support- I use with my patients, that I’d formulated, I’ve- I love that, it’s for credit, I use it on thousands of patients. And uh, on the prescription side, I do like WP thyroid, it’s a very clean formula. Uh, NP thyroid is another newer one out that’s very similar to iron, it- it does have a little bit of maltodextrin from corn in there, so you gotta be a little careful. The other good ones gonna be Nature Throid. Supposedly Nature Throid has a couple more ingredients than WP. Some people, if you check out my summit interview with Guillermo Ruiz, we talked all about that but, he said, there just not have extra ingredients and the same formula but, if you look on the back, there is lactose Nature Throid, there’s no lactose in WP. So, WP is the cleanest but, he seems to think they are both uh, equivalent. So, Nature Throid, and/or WP will be kinda number 1 and 2, WP first, Nature Throid second if you’re gonna go the prescription road.

Evan Brand: Supposedly Acella, A-C-E-L-L-A, it’s supposed to be- [crosstalk].

Dr. Justin Marchegiani: That too makes NP- That- that too makes NP.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: I’m pretty sure, that too makes NP thyroid.

Evan Brand: Okay. Excellent. Alright. Uh, here’s another one-

Dr. Justin Marchegiani: And then just to be- to be hundred percent clear on the question though, is with a natural thyroid glandular, you’re getting T-4, which is typically all you get in a centroid  levoxyl levothyroxine support, but you’re also getting T-3, T-2, T-1, T-0, calcitonin and proto morphogenic proteins which are in there that was your natural growth factors and- and taking thyroid glandular can also help lower your antibody levels too which is great. So, if you need a great, we don’t wanna give it unless we need it.

Evan Brand: Yeah, I was gonna say how do you rate when you need it versus let’s say someone was on a prescription, you know, is it possible that they are not doing well their prescription like centroid, but they may do and feel better and be able to use a glandular instead of that with the help of their doctor getting them off of the drug.

Dr. Justin Marchegiani: Well, you know you’re gonna need it if 1 of 2 factors or both are- are there. TSH is elevated, that could be the conventional range which is 5 and a half on the east coast, 4 and a half on the west coast, or, I use the- uh- uhm- the Association of Clinical Endocrinologists standings, once there’s a- above 2 and a half, I’m careful, okay? We’re about 2 and a half, 3’s kind of my cut off, but, then I look at the free T-3 levels. I’d look at T-4, T-3, how’s that conversion happening, and is there adequate levels of T-3, at least 3.0 on a free T-3. If we see a little bit than that, we could look at symptoms and we’ll see if it’s necessary to do anything for on the fence or a close, and then adrenals are shut, we may leave it alone and go after the adrenals come back on that. ‘Caue sometimes that’s enough to fix it. If the adrenals look okay, or the thyroid’s very low, we’ll come in there with support, get the TSH under control so the brain’s not screaming at the thyroid and getting it swollen, and then we’ll also get that functional T-3 level up to an optimum range. You know, 50% of the reference range. So, typically above 3 or so. Other country is different, but you wanna be at least 50% in the reference range.

Evan Brand: With that, you’re saying, take care of everything else like adrenals and all that? You’re saying circle back to the thyroid gland- glandular is kind of a last stage effort you would approach adrenals, maybe thyroid nutrients first, before thyroid glandular?

Dr. Justin Marchegiani: If we’re close- if we’re close. The only exceptional will be if the TSH is high, you know. Even if they didn’t have any symptoms but the TSH was high, let’s say above 3 to 4, then I would definitely look at putting that on a little bit sooner. If it was 3, I may hold off and just see maybe if we get the HPA access back on track, we’re good, if we’re on the 4 or up, I’m definitely gonna at least bring it down to 1 in the meantime.

Evan Brand: Okay, so, if we got a TSH of 5, we’ve got a free T-3 of 2, you’re saying, yeah, probably gonna need the glandular?

Dr. Justin Marchegiani: Definitely. Definitely need the glandular. Now, if we have a TSH of 3, and a T-3 of let’s say 3.2, that’s where it becomes very questionable. I’d wanna look at symptoms, and I wanna look at the thyroid, uh, the adrenals as well as the thyroid. And I probably- I’d probably say, let’s table doing anything directly with hormones on the thyroid for at least a month, and just focus on more nutrients and the adrenals and I come back and retest probably in 4 to 8 weeks and see where we’re at.

Evan Brand: Well said. We’ve seen massive swings in hormones in the right direction-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: -just by focusing on adrenals, it blows my mind-

Dr. Justin Marchegiani: Yup.

Evan Brand: -because I wasn’t someone that was comfortable with thyroid glandulars personally and recommending those to clients, I’d kind of stayed away from it, because I saw with doing rhodiola, and as you mentioned some of those special Maca extracts, and Ashwagandhas and Schisandra berries and helping the liver in detoxing, uh, and all of the sudden we looked and it’s like, whoa, TSH is normal. We didn’t even- we didn’t even try to focus on thyroid and it fixed itself, just with fixing the body, I love when that happens.

Dr. Justin Marchegiani: A hundred percent. I love it. And we’re getting to the root cause, we’re not just gonna throw everything on- throw everyone on the same thing. We really try to individualize the approach, just [crosstalk].

Evan Brand: Uh, I’ve got a question here from Paul, “How is Calcium D-Glucarate daily for detoxification?”. We use Calcium D-Glucarate all the time.

Dr. Justin Marchegiani: Yeah, it’s in my the detox aminos product. It binds to estrogens, so it really helps aid in estrogen detoxification. So, if a woman has extra detox, or if we see estrogen levels with the guys as well, I mean, it’s good to help bind it and pull it out, so I think it’s great. Just wanna make sure that we’re also getting to the root cause. If it’s just part of the general detoxification program, I think it’s great. It’s gonna help with thyroid binding globulin, and help with increasing free T-3 if there’s excess estrogen.

Evan Brand: Yeah, I- I- I don’t use it in isolation, same thing as you. I do have within a liver support product-

Dr. Justin Marchegiani: Yup.

Evan Brand: -our uh hormone support product, there’s kind of a couple things out there that we use will be blends of herbs plus Calcium D-Glucarate added in for PMS and, you know, breast tenderness and moodiness and irritability and all that stuff, we do see a Calcium D-Glucarate does move the needle.

Dr. Justin Marchegiani: Hundred percent. Hundred percent. Next question.

Evan Brand: Uh, Laura gave us some feedback, “Thank you so very much for explaining crucial information about gluten. I have tried for years to get people to realize that gluten hurts us all”. I agree Laura, thank you for the feedback and some people have to hit rock bottom before they listen to you. So, unfortunately that’s a reality.

Dr. Justin Marchegiani: Yeah, and again, some people, you know, they have the mindset of like, e- everything in moderation, it- it just depends. I don’t necessarily buy that, I mean, there’s probably never gonna be in the- in the- in a monitored amount of cocaine or methamphetamines that’ll ever do. But I get the fact that some people, you know, may not have that genetic predisposition. They may not have an autoimmune genetics that are active. But I just- I still think uhm- you gotta be careful if there’s an option to do something on the safer side on the gluten free, grain free side, it’s better. It’s- it’s better to do that. But I get why some people may feel like they- they get a little bit more freedom. You know, when you have a little bit more uhm, uh, health, so to speak, and a little bit less genetic predisposition, it makes sense why you do that.

Evan Brand: Yup. Got a question here, “My friend has hashimoto’s and only 20% of her thyroid. She tried nascent iodine and her face broke out with little lumps like pimples. Any idea why and what she can do to supplement iodine?”.

Dr. Justin Marchegiani: Well, if she has hashimoto’s, uhm I know that’s Dr. Group’s product, it’s a good iodine product, you just gotta be careful because you can go really high in it number 1, and that can elevate antibodies. Number 2, you could be pushing out other halides like bromine, right? And that could be causing the detoxification issue with the skin, is you’re pushing that out to the skin. [Crosstalk].

Evan Brand: Let me ask you this-

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is- this is mind-blowing. So, that you’re saying that nascent iodine can kind of clear out that receptor site?

Dr. Justin Marchegiani: Potentially, but it could also activate autoimmunity if that’s there too. It could-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -too high. So, I mean, if I were to do it, I would make sure that- if she’s my patient, we’re working for a few months, we’re stabilizing inflammation in the diet, all the other nutrients are present, ’cause with high amounts of iodine, the iodination process spits out hydrogen peroxide, H2O2, and with, inadequate selenium levels. Hydrogen peroxide’s inflammatory in the thyroid. So, with adequate selenium, we convert that H2O2, we pull off an oxygen to it and we make it H2O and make it water, something benign. So, we gotta be careful with the iodine and the lack of selenium, especially if antibodies are elevated.

Evan Brand: Yeah, well said. Selenium’s huge. That’s like, critical if you don’t address that, it’s very easy to fix that too. It’s like one of the cheapest supplements ever. Its funny people question the whole Brazil Nut thing, people say, “Oh, only a few Brazil Nuts per day is enough for selenium”. I’d look at some studies comparing that, like supplementation of actual selenium like chelated selenium versus a Brazil Nut, it actually surprisingly, the Brazil Nut actually held up, it actually did worked.

Dr. Justin Marchegiani: Yeah, I mean, the big difference for the Brazil Nut is there’s like a uh, a 10 to 1 ratio of how much selenium could be there. So, it’s just you don’t know if you’re at- if you’re doing 2 or 3 Brazil Nuts, hoping for 20 or 40 microgram, or 200 microgram the selenium, you may get 20, you may get 30, right. That’s the problem with it. So, I think it’s okay if you wanna do 1 or 2, but I think at least get your insurance policy of 200 micrograms of selenium via supplement formula, that’s your insurance policy.

Evan Brand: Yeah, I l- I love the idea of food as medicine but I agree with you. That’s not something you wanna dabble with, like, why try to get it from Brazil Nut if you can spend $8 and get the best selenium product on the market in capsule form, and you know exactly what therapeutic dose you’re getting in terms of milligrams right there on the bowl versus, “Oh yeah! This is a big Brazil Nut! This must be 20 milligrams”, it’s like “No!”.

Dr. Justin Marchegiani: E- exactly. And Brazil Nuts are commonly moldy too. So, if you have mold issues, there could be a problem there.

Evan Brand: [Crosstalk]

Dr. Justin Marchegiani: You know, if you wanna 1 or 2, fine, but just get your 200 from- from supplement.

Evan Brand: Yeah.

Dr. Justin Marchegiani: From selenium ___[40:20] primarily.

Evan Brand: Well, pesticides too, I’ve never seen organic Brazil Nuts on the market, I don’t want some sprayed.

Dr. Justin Marchegiani: I know, and then you also have the phytates and the other types of oxalate compounds in there too, for sure.

Evan Brand: I thought we had a question about oxalates. [Crosstalk]

Dr. Justin Marchegiani: Someone asked about “How do oxalates affect your thyroid?”, I think, right?

Evan Brand: Yeah, here it is. “What are you guys know about high oxalates and Hashimoto’s? Is there a connection?”. Let me just say something first.

Dr. Justin Marchegiani: Yeah.

Evan Brand: What I’ve seen, is that high oxalates are directly can’t- uh, related to uh, high candida. We’ve seen a lot of yeast, like, when I see candida high, I always see oxalates high.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: And then when you fix the candida, the oxalates magically go down. So, I would just throw- I would- I would kinda change that question and I would just say “What do you guys know about high oxalates, candida and Hashimoto’s?”, and I would say the answer is they’re all related.

Dr. Justin Marchegiani: Yeah, also, I would say that uhm, a lot of high oxalates foods are high goitrogens too. And these goitrogens can block iodine uptake. So, if you’re doing a lot of raw cruciferous vegetables, broccoli, cabbage, right? Uhm, those type of things that can easily block iodine uptake. If you’re doing a lot of it raw, that’s gonna really have some major impact. So, if you’re cooking it, you’re steaming it, you’re putting it in soups, you’re gonna have less in it for sure. But, you know, too much of that, if we have low thyroid, we gotta be careful with too much of that on the raw side ’cause that can definitely block our iodine uptake.

Evan Brand: I’m guessing you’ve seen raw vegans that have thyroid problems.

Dr. Justin Marchegiani: Oh, yeah, I mean, that’s a huge thing. Also, raw vegans tend to not have enough protein to make other hormones, so they can have other problems going on too.

Evan Brand: Did you see that article that was a uh- uh- an article the other day that went kinda viral. This medical wrote, that the- the vegan diet killed my mother early? Did you read that?

Dr. Justin Marchegiani: No. I think I heard of this though.

Evan Brand: Let me see if I can pull up-

Dr. Justin Marchegiani: Go ahead.

Evan Brand: -so I can say it, yeah. So, here it was, it was in the U.K., it was in London, this guy, Dr. Aseem, we may wanna get him on the podcast.

Dr. Justin Marchegiani: Yeah.

Evan Brand: He wrote a letter basically about this. And, yeah, he’s a cardiologist, his name’s Dr. Aseem, M-A-L-H-O-T-R-A. He said, my mother’s diet was full of ultra- aah, see here’s the thing I didn’t read before. Her diet was full of ultra-processed foods. So, talks about how uh, she was a vegan, her vegetarian rather, but, that she was consuming tons of, uh, biscuits, crisp and starchy carbohydrates. So, she probably had an unhealthy vegetarian diet. But the way-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -he wrote it, made it just seem like the vegetarian diet overall, killed her but, no, she’s eating that crap, that makes sense.

Dr. Justin Marchegiani: Yeah, she’s on a lot of carbohydrates but, yeah, one thing that you’ll see, you know, this is good for anyone listening is, with vegans’ vegetarians, go look at their hands. ‘Cause what they’re doing is they’re getting a lot of plant-based, uhm- beta carotene, and they’re hoping that converts to Vitamin-A. With low thyroid, you’ll see a lot of the orange deposits or their hands, or their feet, ’cause they can’t convert that beta-carotene, the Vitamin-A, the active uhm, retinyl palmitate. Uh, and- and- Vitamin-A is important for the thyroid receptor sites. So, you’ll see with some of these vegan vegetarians, they’re not getting active Vitamin-A form animal products or Cod-Liver Oil, so you’ll see beta carotene deposits in their skin, orangy skin.

Evan Brand: Whoa! Well, I- you know, I always trip people out about looking at the ridges on your fingernails-

Dr. Justin Marchegiani: Oh yeah.

Evan Brand: -for [crosstalk], but now I have something else to look at, “hey, let me see your hands, I’m gonna look at your nails, now, I’m gonna look at your palms”.

Dr. Justin Marchegiani: Yeah, I mean, it’s always good to look at it, just shouldn’t be excessively orange, but that’s a big thing. And Vitamin-A is really important for your thyroid, uhm, excellent sources of course are gonna be healthy, you know, egg yolks I think you’re gonna get it in, you’ll also see it in any type of high quality grass-fed meat, we’re gonna see it on Cod Liver Oil, and you’ll also gonna see it like liver glandular, for sure.

Evan Brand: There’s a question here which says a treatment-oriented questions so you’ll have to become a client of Justin if you wanna like dive in to supplements and protocols, but I’ll still read the question anyway incase Justin you wanna say something else.

Dr. Justin Marchegiani: Yeah.

Evan Brand: “With slightly low free T3, should…” uh, “…thyroid balance 1 capsule be taken every day?”, and “Dr. J., do you take your thyroid replete or balance?”.

Dr. Justin Marchegiani: I do not need my thyroid replete or balance. My T3 levels are above three and my TSH stays in the low-2’s or in the mid-1’s. So, I- I just don’t need it but, my Malte has enough selenium in there, and other nutrients uhm, for my thyroid to work. I- I just don’t need it based in my labs, so, I only recommend things that patients need that we can objectively quantify.

Evan Brand: Yup.

Dr. Justin Marchegiani: But in general, uhm, the levels are what again? Low [crosstalk]…

Evan Brand: …low free T3 , it was a 2.7.

Dr. Justin Marchegiani: Yeah, so, depending on the other symptoms that are going on there would depend on how the adrenals are doing. But that’s border line. What was the TSH?

Evan Brand: TSH, 1.3.

Dr. Justin Marchegiani: Uh, I probably would say no on that. I’d wanna look at the adrenals more thoroughly. I’d probably say no. Uh, I- I’m- I’m- for- if- if other- if TSH and T3 are- uh- TSH is good and T3 is close, I tend to say, “Let’s hold off and work more on nutrition and the adrenals”.

Evan Brand: See, here’s the problem though, we’re trying to get advice like that on YouTube or wherever else on internet, we know nothing about this guy, we don’t know how he sleeps, we don’t know he’s stressed, we don’t even know what his symptoms-

Dr. Justin Marchegiani: -Diet.

Evan Brand: -are, he may feel perfectly fine [crosstalk].

Dr. Justin Marchegiani: Yeah, exactly.

Evan Brand: You may feel amazing, and then you’re trying to fix something that doesn’t really need to be fixed. If you feel amazing, you- you might not need do anything. So kinda, you know, don’t fix it if it’s not broken. Obviously, if we knew, “Hey I had terrible anxiety and heart palpitations and I couldn’t sleep, and I had skin rashes, and we have a more complete picture”, then Justin maybe able to say, “Well, you know, maybe your free T3 is a little low because of ‘XYZ’ and we can fix that, and here’s the data to prove what you got in the gut”.

Dr. Justin Marchegiani: Yeah, exactly. So, there could be other things that are causing it that- on the gut that only improve it. So, hold off, but, you wanna dive in and become a patient we can also talk a little bit deeper on that.

Evan Brand: Yup. Uhm, Missy, “Thanks for your summits, I’ve learned so much and appreciate both your time and knowledge”. Missy, it’s our pleasure.

Dr. Justin Marchegiani: Appreciate it. Then someone write in about potato juice curing diabetes type 2, it’s a little off-question but because uhm, diabetes is intimately connected to thyroid issues. Diabetes commonly, uh, causes low levels of thyroid conversion because high levels of insulin can disrupt thyroid conversion. That’s why blood sugar is so important in keeping inflammation down. But uh, I’d be careful, anytime juice, I get concerned with, excess sugar and insulin resistance being a problem. Uh, that being said, there’s a high amount of… potassium in potatoes, so could just be some of these extra minerals that are there. But I would say, uhm, probably stay away from the excess sugar if there’s high levels of insulin in your type 3 diabetic.

Evan Brand: Uh, there’s other question here, “Are you saying candida overgrowth in the gut can be linked to kale intolerance?”. Uhm, maybe and around about way, yes, but no, not directly. What I was saying is that, when we see on the organic acids test that we have an elevation in oxalates, generally speaking, candida is a contributing factor to why oxalates are driven up. I had high oxalates one time on my organic acid test, I did not eat hardly any leafy green vegetables for significant period of time when my gut was a mess, and I still had high oxalates, I didn’t have many other foods with oxalates in ’em, so, I saw when I fixed the yeast in my gut, and then eventually found out I had candida in my home, and had to fix the candida in my home because especially if you have dogs, dogs have candida on ’em and then they jump in your bed and they spread the candida to your bed, and then you breathe it in, and it recolonizes your gut. So, if you’re working with a practitioner, and you keep beating yourself up because you feel good and then you feel bad, you feel good, you feel bad, you could have candida, driving that oxalate problem. And if that gets to extreme levels, you can end up with kidney stones and all sorts of problem. So, you know, fix your gut, but fix your home too, that’s gonna be like my new motto.

Dr. Justin Marchegiani: Yeah, I mean, the more people, let’s just say have inflammation, dysregulations in guts- and gut issues, that can create more oxalate sensitivity. Uhm, again, things like potassium and magnesium are really important for oxalate cleaner. It’s now- kale is actually kind of a lower oxalate food. It’s the spinach. Spinach is the big higher ones, so you gotta be careful with spinach. But again, you know, having enough good quality magnesium and potassium in your diet or supplementally can also help clear oxalates. [Crosstalk]. Oxalates high in organic acid test, that’s more of indirect candida marker. So you’d wanna look at like D-Arabinitol, or ___[48:31] if using the GPL test. Uhm, and, you know, uh, tartaric acid, other things like that.

Evan Brand: Yup. Well, that’s all the questions, I think we killed it in, we donated an extra 10 minutes of time here, so why don’t we wrap this thing up, I’ll tell people again about your summit website.

Dr. Justin Marchegiani: Excellent.

Evan Brand: It’s, it works. Expecting probably 50, 60, maybe 70, 80, who knows? Thousand registrants. So, if you’re not coming to the party, then you’re missing out. So, this is gonna be probably one of the biggest events of the year honestly because thyroid problems are epidemic in the U.S. I’m sure I can pull up some random statistic for you from the CDC if you wanted to, but I’ll just tell you what, Justin and I see which is that, there are countless men and women out there with hashimoto’s, and they don’t even know it, it’s undiagnosed, autoimmune thyroid conditions around the world, these men and women are having anywhere from one to a million symptoms, it could be heart palpitations and anxiety-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -one day, and they’re energetic, and then the next day they’re exhausted and they don’t know why. And then the next morning, they wake up in the middle of the night and they have heart racing in the middle of the night, they don’t know why. When that thyroid gets attacked by the immune system, it can squirt out little pieces of thyroid hormone and cause you to feel crazy. So, please make sure that you get your antibodies tested. Your TPO, your TG, maybe your TSI if you think you need to, because something you educated me on is that you can have hashimoto’s, and you can have graves at the same time, which sounds insane.

Dr. Justin Marchegiani: Yup, you can and, 1 out of 5 women have, uh, a- autoimmune issue, and, one of the most common thyroid issues, over 30 million people have it and don’t even know is, hashimoto’s. And the big issue with that is, it’s gonna create inflammation, it’s eventually gonna destroy your thyroid tissue, low thyroid hormones and it create all kinds of symptoms, and women tend to be more predisposed. I mean, on the guy, I’ve hashimoto’s too, so this isn’t you know, just me only reaching the females out there, men have it too, so you gotta look at it. Women are a little more predisposed, ’cause estrogen can- can affect the CD4 to CD8, uhm immune cell ratio and can make you more predisposed to autoimmune issues, but heck, we know guys are getting exposed to lots of estrogens too via the food, and the plastics and the pesticides. So, that’s another predisposing factor that can even make guys more susceptible even like myself, so, make sure you register. Thanks, so much Evan for the great podcast today, make sure you sign up and get that free 88-page eBook, my real book, the thyroid reset is coming out in the coming months is head. So, stay tuned, thanks so much, and have a phenomenal day. Take care.

Evan Brand: Take care. Bye-bye.

Dr. Justin Marchegiani: Bye.


Are You Anemic?

Are You Anemic?

By Dr. Justin Marchegiani

Someone with anemia has blood that is deficient in either red blood cells or hemoglobin. This means their blood does a poor job circulating oxygen, and as a result, the anemic person will oftentimes feel fatigue, brain fog, and weakness. If anemia is severe enough, possible complications include heart and brain damage.

So, what causes anemia and who is most at-risk? Anemia is most common among women of reproductive age, and is strongly linked to iron deficiency. As menstruation means monthly blood and iron loss, it’s easy to see why this demographic makes up a large portion of those with anemia. Other people at risk are those over 65 with a pre-existing health condition, those with a poor diet, and those who aren’t getting enough iron in their diet.

There are three general types of nutritional anemia

  1. Hypochromic microcytic anemia is linked to iron deficiency
  2. Normochromic macrocytic anemia (megaloblastic) is due B vitamin deficiency (B12, folate, and B6),
  3. Pernicious anemia is caused by an autoimmune disease in the stomach affecting intrinsic-factor production and the destruction of parietal cells, which produce intrinsic factor and hydrochloric acid (HCL)

Nutrition and Anemia

Iron is very important because it’s part of the hemoglobin that carries oxygen. One of the main jobs of the red blood cell is to carry oxygen to all of the cells so aerobic metabolism can occur.

If you remember back to middle school science class, when a glass jar was placed over a candle, the candle went out! This shows that the ability for oxygen to be transferred throughout the body is vital for health. A significant percentage of thyroid-hormone production involves iron as well.

Nutrition and Anemia

Red blood cells get excessively small when they are iron deficient, hence the term microcytic anemia (micro meaning “small”).

If you have a think you might be anemic, click here!

Erythroid Maturation Diagram

B vitamins are very important for the maturation of red blood cells. Red blood cells need certain B vitamins, like B12, folate, and B6, or they stay large, immature, and goofy, so to speak. Because of the red blood cells’ large size without B vitamins, the term macrocytic anemia (macro meaning “large”) is given.

Do you have symptoms of Anemia?

    • Fatigue
    • Weight gain
    • Depression
    • Leaky gut syndrome
    • Low thyroid symptoms
    • Digestion problems
    • Celiac disease
    • Female hormone issues

Anemia Symptoms

Leaky Gut, Celiac Disease, and Anemia

Leaky gut syndrome occurs when the normally tight junction of the gut unzip, which allows undigested food particles and bacteria into the bloodstream. The immune system overreacts to these unknown particles in the bloodstream.

With the immune system wound up from all of this, additional gastrointestinal stress can start attacking other tissues in the body, like the thyroid, pancreas, brain, skin, and even microvilli in the small intestine. This is how autoimmune disease starts.

Celiac Disease Anemia

Leaky Gut and Malabsorption

With leaky gut comes malabsorption due to the excessive inflammation in and around the areas of the microvilli, where nutrients, like vitamins, minerals, fatty acids, and amino acids, are absorbed.

The inflammation in the GI tract also creates excessive activation of the sympathetic nervous system (fight or flight), which makes it harder to produce hydrochloric acid, enzymes, and bile salts to effectively break down these nutrients as well.

Without the ability to break down, assimilate, absorb, and utilize, it’s as if the nutrients weren’t even eaten in the first place. Most people make the assumption that if they put the food in their mouth, chew, and swallow, then their body will utilize the nutrition for energy. This couldn’t be further from the truth when someone has excessive GI inflammation from celiac disease and/or leaky gut syndrome.

Anemia Treatment

When dealing with iron or B vitamin-based anemia, supporting with the deficient nutrients can be helpful but may not address the underlying issues. Below are some common patterns that need to be ruled out to ensure long-term success.


Without adequate stomach acid and enzyme production, it may be hard to break down, ionize, and absorb iron. Many people are stressed out, which shifts the nervous system away from the parasympathetic branch, which is needed for HCL secretion. Without enough HCL, bad bacteria tend to overgrow, and eventually even infections may take up residence in your gut. This chronic stream of inflammation continues to compound the issues and make the problem worse over time, even causing adrenal fatigue and low thyroid symptoms. Getting to the root cause of the gut issues, including the removal of stress and infection, can help improve HCL production. Taking supplemental HCL and enzymes in the meantime can be a great help.

Female Hormone Imbalances

Many females have estrogen dominance and/or inadequate production of progesterone. These hormone imbalances cause more PMS as well as excessive bleeding during menstruation time. This excessive bleeding can drive iron loss via the blood and potentially cause an anemia. This blood loss is a common cause of fatigue during menstruation, and I have seen it personally in dozens of my patients. Getting the patient on a female hormone-balancing program along with addressing diet and lifestyle stressors can help fix the underlying imbalances.

Everyone’s female hormone issues are a little different; to get yours assessed, click here!

Pernicious Anemia

This kind of anemia is autoimmune in nature and can be driven by gluten, infections, and stress (physical, chemical, and emotional). These types of patients need some type of autoimmune diet as well as sublingual B12 to ensure absorption, or perhaps even B12 injection. Most of the time, good methyl B12 along with activated L-folate in a sublingual form can be enough to maximize absorption.

FYI: If you have anemia, removing gluten from your diet is essential for healing!

Anemia and Diet

Dietary Deficiencies

Vegan and vegetarian diets are notorious for causing B12 deficiency and sometimes even iron deficiency. The iron found in vegetables is non-heme iron, is poorly absorbed, and does very little to improve ferritin (stored iron levels) on a blood test.  Iron from animal sources, especially liver, tends to be the best for raising iron levels. Most patients do better on a liver glandular as well as an amino acid iron chelate to help get their iron levels back to normal. Some may need an iron IV depending on how low their ferritin levels are.

If the deficiency is truly caused by dietary means, supplementing and changing your diet may be enough to fix the root of the problem.


If you have chronic fatigue, digestive distress, or low thyroid symptoms, there is a good chance there may be anemia issue holding back your health. If you want to dig a little deeper into what is driving your health challenges, click here!

Functional medicine does a great job figuring out the root cause behind your anemia. Stay tuned for the next article on how to diagnose anemia using lab tests!

Reversing Autoimmune Disease

Reversing Autoimmune Disease

By Dr. Justin Marchegiani

When your immune system response can’t distinguish between your body and any toxins you’ve ingested, the result is called ‘systemic inflammation:’ when your body attacks its own tissues. Your body might intend to fight off an infection or an allergen, but instead points the attack at your joints or your thyroid, or maybe even your whole body. This is how autoimmune conditions, such as arthritis, celiac disease, thyroid disorders, and lupus, begin to grow.

Causes of Autoimmune Disease

Causes of Autoimmune Disease

Autoimmune diseases typically stem from one of the following causes:

Genetic Predisposition: While your genes alone do not condone you to a fate of autoimmunity, having a family history is a good indicator that you should be proactive in preventing an autoimmune disease from developing.

The pathogenesis of autoimmune disease is multifactorial, meaning, just because you may have inherited the genes for an autoimmune disease, it does not necessarily mean you will develop one. Studies have shown that some combination of genetic and environmental factors are what ultimately cause or prevent autoimmunity from developing. In this article, we are going to break down some of the ways to prevent this from happening.

Leaky Gut: Food allergies, toxins in our food and environment, stress, gut dysbiosis and an inflammatory diet are causes of leaky gut. Leaky gut occurs when the gut lining is compromised, allowing large food particles and toxins to leak into the bloodstream, causing inflammation and autoimmunity.

Autoimmune conditions affect at least 50 million Americans, as well as millions more worldwide. However, autoimmune disease seems to exist almost exclusively in first-world countries. This is possibly linked to the diversity of the microbiome: in developed countries, we are regularly exposed to antibiotics and consume genetically modified foods laden with pesticides. These contribute to reducing the diversity of our microbiomes. Those in less developed countries have a wider range of gut flora, and don’t suffer from the same autoimmune diseases.

Click here if you are suffering from brain fog, digestive issues, or insomnia!

Trauma: Overwhelming stress or trauma, whether it be physical or emotional, such as a difficult break up, the death of a loved one, or a car accident, is enough to send your body into overdrive and trigger autoimmunity. The immune response due to physical stress (injury) causes profound inflammation, which is known to trigger autoimmune disease.

Up to 80% of people note that they experienced uncommon emotional stress before the onset of their autoimmune disease. Stress-related hormones are presumed to cause immune dysregulation, resulting in autoimmune disease. Stress can be responsible for more than just the onset of autoimmunity, it also feeds continues a vicious cycle of feeding the condition.

Prevention and Reversal of Autoimmunity

Prevention and Reversal of Autoimmunity

  • Eliminate any foods causing allergies or sensitivities. Here is a breakdown of what an elimination diet entails. Basically, by eliminating foods that are potential allergens, you’ll learn what your body feels like when you aren’t ingesting inflammatory foods. Then, you add back foods gradually and are able to pinpoint which foods are triggers for your autoimmunity or other issues you may have been experiencing.
  • Heal your gut to reduce inflammation. Your gut houses 70% of your immune system. If you don’t have a healthy gut balance, your immune system will be severely affected, contributing to autoimmune disease. An elimination diet can help you learn which foods are serving you and which are hurting your gut.
  • High quality probiotic supplements, eating and drinking probiotics in the forms of kombucha and sauerkraut, and drinking bone broth will all support a healthy gut!
  • Proper vitamin D levels. Research shows a strong correlation between vitamin D deficiency and autoimmune disease, cancer, and other serious diseases. This article studies the link between vitamin D and autoimmune disease in depth. Getting time in the sun, as well as supplementing with quality vitamin D, are ways to reverse and reduce risk of developing autoimmunity.

Click here for a personalized wellness plan!

  • Glutathione, the “master antioxidant,” helps your body detox any toxins you ingest. Glutathione is also a major player in immune system regulation, meaning it plays an important role in autoimmunity.
  • Zinc is essential for white blood cell production, and provides powerful immune system support (maybe you’ve heard zinc recommended to get over a cold quickly). In fact, studies have shown that those with a zinc deficiency are more susceptible to developing diseases.
  • Get good sleep will lower inflammation, heal your body, and reduce cravings for carbs, sugar, processed foods, and other junk that contributes to autoimmunity.
  • Magnesium A deficiency in magnesium increases production of proinflammatory cytokines, raising your body’s total level of inflammation, a trigger for autoimmunity. Magnesium deficiency is rampant in our society due to chronic stress, soil depletion, and high-sugar diets, so it is important to supplement with magnesium.
  • B vitamins support your immune system, hormones, sleep patterns, and much more. Vitamin B12 plays a role in your body’s production of white blood cells, which are essential components of your immune system. With lowered white blood cells, you are much more susceptible to illness, including autoimmunity.
  • Reduce stress Studies show stress can act as both a trigger and a modulator in autoimmunity, and stress-reducing techniques (yoga, meditation, massage) are viable treatment options.
  • Activated charcoal can be taken if you have consumed a food you are sensitive to, or any less than ideal foods. Activated charcoal binds to toxins to protect your body from inflammation.

If you are dealing an autoimmune disease, or have suspicions, please schedule a consultation with a qualified functional medicine doctor to assess your needs and help you heal.

Click here to talk to a functional medicine doctor about autoimmunity!


Low Body Temperature! – Dr. J Podcast # 156

Dr. Justin Marchegiani and Evan Brand engage in a very informative discussion about low body temperature. Learn how different potential stressors like thyroid issues, adrenal issues, gut health, autoimmune conditions, nutrition and low calories cause low body temperature. Find out about the role of micronutrients in thyroid hormone conversion and be aware of the medications that have a negative impact on mitochondrial function.

Gain information about the different foods, including modifications in macronutrients, and various supplements, which will improve your health and prevent different stressors that are possibly causing low body temperature.

In this episode, we cover: low body temperature

03:27   Thyroid issues

07:05   Beneficial Nutrients

14:14   Toxins and Medications

22:51   Food and Supplements

33:46   Calorie Intake






Dr. Justin Marchegiani: And we are live here on YouTube. It’s Dr. J in the house. Evan, my man, how are you doing brother?

Evan Brand: Hey man, happy Monday! We’re talking all fair about that shooting this morning so my mom, she worked right next door last night at the Hotel Luxor which was uh— right next door to that shooting event in Vegas. So I called her this morning and she’s safe and sound and she got released, so she’s home, hopefully sleeping. I’m sure she’s extremely adrenally stressed at this point, but hopefully she’s resting and settling down from all that.

Dr. Justin Marchegiani: Yeah. Lots of empathy for all the people out there going through that. It must be just incredibly stressful.

Evan Brand: It’s insane.

Dr. Justin Marchegiani: It’s just so difficult. So wishing everyone, you know, speedy recovery from that. That is just so difficult and man, everyone’s adrenals are revved up from that, right?

Evan Brand: I know.

Dr. Justin Marchegiani: So let’s go into some stuff here where people, we would get— put some information out there about improving everyone’s health.

Evan Brand: Yes.

Dr. Justin Marchegiani: Uh—and just continue to empower more people. So let’s dig in, brother.

Evan Brand: Yes. Yes, so you and I want to chat about low body temperature, which is something that so many people have. I’ve had it in the winter for a long time. I’m hoping that since I work so much, my gut and my adrenals that I don’t have it this winter but cold hands, cold feet you know that had been something that I mentioned going on with me for—for several years. I know there’s a lot of different causes that you and I wanted to go through. So how should we open this thing? Should we talk about hormones, thyroid, how do you want to lay the groundwork?

Dr. Justin Marchegiani: Oh, we look at body temperature. Temperature is probably one of the best indicators of your metabolism, right? Because the more energy you have, typically the— the better your temperature is. And so typically, you’re gonna have symptoms of cold temperature which are gonna be cold hands, cold feet those kind of things. Also, fatigue, but now there’s also objective ways that we can test your temperature. You know, with the thermometer, obviously. We can do axillary temperature, which is armpit. 97.8 to 98.2 is—is Fahrenheit is a pretty good range to be in. Or 98.2 to 98.6 orally. And so you can kind of assess your temperature. You can do it in the morning and then you can also do it in the afternoon as well. Kinda do it just for before eating. That gives you a pretty good indication but if your metabolism is low and your temperature is low, it could be caused by an interplay of different things. We’ll go into it. It could be thyroid issues. It could be adrenal issues. It could be gut issues. It could be nutrient issues. It could be mitochondrial issues. So all of these things are potential stressors that could be driving that problem.

Evan Brand: I’d say number one is probably thyroid issues. Wouldn’t you suspect because so many people we talk with they have adrenal issues with them on top of that there is a thyroid problem. Like maybe elevated reverse T3, whether you’ve got that blank bullet going on or they just got a low free T3 or like you and I’ve chatted about with adrenals, you’ve got the conversion process that happens where you take the inactive T4 hormone, you convert that to active T3.That conversion process gets messed up if you’ve got chronic stress. And chronic stress as you mentioned, could be gut infections, it could be emotional stress, could be chemical, heavy metals. It could be circadian rhythm stress if you’re working third shift, for example. That could be enough to change this whole cascade. Wouldn’t you say?

Dr. Justin Marchegiani: Oh, yeah. Hundred percent. I mean, again, all of those things can be intimately connected. The first we look at is thyroid because thyroid hormone has a major effect on our metabolism. And our metabolism is the sum of all chemical reactions in the body. And our metabolism is pH driven, right? So if our pH becomes too alkaline or too acidic, like you know blood pH, which exists in a very fine-tune range, right around 7.35+ or -1/10 of point there. And if that pH shifts up or down, that can affect how all of our enzymes in our bodywork. So that can affect temperature and there’s things like—uh like a diabetic coma, right? Where blood sugar can go to he— or too low typically. If someone’s type I dependent and they don’t have insulin, they don’t get sugar into their cell, which can create ketoacidosis. And that can really, really drop that pH and that put you into a coma. So our pH is very driven and has a major effect on our metabolism, so, totally.

Evan Brand: So let’s hit on—let’s hit on the thyroid peace. Now autoimmunity is something we talk about so much. Would you say a common symptom of someone with Hashimoto’s, for example, could be low body temperature or possibly even a fluctuating. Maybe their low body temperature if they’re a bit underperforming but then couldn’t they just bounce right back and get actually hot if they bump into hyperthyroid. If they’re in the Hashimoto’s state, and things are still fluctuating.

Dr. Justin Marchegiani:  Yeah. So, if you’re having Hashimoto’s and your immune systems constantly attacking your thyroid, your thyroid hormone can spill.

Evan Brand: Right.

Dr. Justin Marchegiani: Coz every time it’s attacked, hormone spills out. Eventually those follicles run dry and you’re not gonna quite have that hyper kind of symptoms. So in an acute attack, hyper symptoms may be increased temperature are common, right? You can have like PVC’s periventricular contractions. Uh—you can have, you know, kinda this—kinda heart palpitations. Your heart’s kinda beating erratic and hard, uh—anxiety, night sweats, irritability. These are all hyper thyroid symptoms. You feel warming, right? You feel excessive warmth or temperature. But then, in a chronic state, that will eventually lead to a hypothyroid kind of environment, where your body temperature just gets very low.

Evan Brand: So someone has had Hashimoto’s for quite some time, let’s say there’s been a pretty significant tissue destruction, you would say someone will not end up being hyper long-term with Hashimoto’s. It’d probably be hypo long-term.

Dr. Justin Marchegiani: Yeah. I mean you can—hyper feels very similar. Hyperthyroid Grave’s feels very similar to a hypothyroid autoimmune attack. The difference is with hyper, typically, there’s a specific antibodies or immunoglobulin compounds that come back. So with Grave’s, you’re seeing TSI immunoglobulins or you’re seeing thyroid TSH receptor site antibodies. So that’s what’s typically common in Grave’s. And when those things are high, it’s accelerating the thyroid hormone to produce excessive amounts of thyroid hormone. So there’s like a production stimulation where with the autoimmune attack, from like thyroglobulin antibodies or TPO antibodies is it’s more the spilling of a thyroid hormone out of the thyroid. It’s spilling out where the antibody attack from Grave’s, it’s stimulating the thyroid to produce more.

Evan Brand: Exactly.

Dr. Justin Marchegiani: With Hashimoto’s, you’re not getting the stimulation. You’re more or less getting that spilling effect, which eventually, you know, will run dry.

Evan Brand: Got it. Got it.  Okay. So we hit the autoimmune piece. What else would go on thyroid-wise that will be an issue with temperature regulation?

Dr. Justin Marchegiani:  Well, again, there’s also certain nutrients that have a major effect on thyroid uh—conversions. So we know things like selenium are super important for thyroid conversion. So someone may have decent thyroid levels from a T4 perspective, uh— but they may not have that activation, right? They may not have that conversion uhm— that’s so important.

Evan Brand: So could it just be the lack of trace nutrients, trace mineral selenium, zinc— things like that activators.

Dr. Justin Marchegiani:  So here, we are live on Facebook now, too with the low body temperature podcast. So getting back onto our common thread. Yeah, micronutrients like selenium are gonna be important for thyroid conversion. It’s a five—the enzyme that converts T4 to T3 inactive thyroid hormone to active thyroid hormone is a 5 deiodinase enzyme. It’s also important with glutathione and detoxification. So, yeah, that’s totally uh— important micronutrient that will affect thyroid activations. So when we look at thyroid function, we’re looking at are there blood sugar fluctuations? Are you eating grains or foods that are gonna cause that thyroid antibody attack that could cause the hormones to spill out and eventually deplete the hormones? Your thyroid follicles carry about four months of thyroid hormone. So again, if you have a chronic Hashimoto attack, where the thyroid hormone’s spilling out faster than you can synthesize and make more, then you’re going to definitely get to that depletion state where you’re gonna go hypo from a temperature standpoint. You’re gonna go almost hypothermic. That temperature will drop below that 97.8 – 98.2 armpit temperature wise or 98.2 to 98.6 and I’ll put a handout down below to my uh— metabolic temperature handout. So people can actually track their temperatures and it’s basically a graph of three different lines. And then the top brackets where you want your temperature to be through which ranges 97.8 – 98.6 We want to be checking off daily that your temps are in this bracket not the bottom or the very bottom.

Evan Brand: Got it. Okay. So what else? Should we talk about the nutrients next?

Dr. Justin Marchegiani: Should we talk about the nutrients, right? Vitamin A, we talked about uh— zinc, copper, selenium, magnesium very important nutrients for thyroid conversion. Now if you’re eating a whole food diet, you’re gonna be typically pretty good. If you’re having enough HCl and enzymes, you’re gonna be good as well because we need those type of compounds to be able to ionize the minerals. So it’s the diet component. It’s making sure we have the ability to break down the foods in our diet that are nutrient dense. Uhm— number three is making sure our stress response is okay because stress hormones will affect thyroid conversion. Cortisol being hyper— very high— will affect thyroid T4 to T3 conversion that inactive to active thyroid hormone. Also, if cortisol is too lo from chronic stress. So there’s this, kinda Goldilocks effect that we see here with thyroid hormone kinda need it to be not too high, but not too low to have optimal conversion. Does that makes sense?

Evan Brand: Yeah. It does. Well said. Let me mention about the gut, too, coz you just hit on the fact that you’ve got to have absorption. So even if the diet’s good, which many people listening to us, they probably already dialed in like a Paleo template but they could still have this symptom. You may want to check for infections. Coz like Justin and I talk about almost every week at some level, there could be an H. pylori, bacteria, yeast, fungus, something going on in the gut that’s stealing your nutrients or preventing you from optimally digesting. And then that issue is compounded, if you’ve been taking any type of anti-acid where acid blocking medication something simple as Tom’s or something more strong like a prior was it Prilosec or Zantac.

Dr. Justin Marchegiani: Yeah. So, yeah. Totally.

Evan Brand: Keep that in mind. If you’re looking at your medication list and that includes acid blockers and you have cold body temperatures, it’s probably cause you’re not digesting your foods therefore the thyroid is not getting fed the nutrients it needs.

Dr. Justin Marchegiani:  Totally. And also a lot of medications could affect your mitochondria. Just Google antibiotics and mitochondrial function, you’ll find that antibiotics can negatively impact mitochondrial function. And you’ll also find that other medications can impact the mitochondria. And the mitochondria is like the little powerhouse of your cell where it generates a lot of ATP, which is that currency of energy in which your body runs. So that’s really important and also an important nutrient call carnitine really helps that mitochondria utilize fat for energy, generate ATP out of that good fat, you know, it’s called uh—beta oxidation where you’re generating energy from fat. And carnitine is an important nutrient primarily made from methionine and lysine. Now, I did a video call why vegan and vegetarian diets can make you fat? Now—no—don’t make you fat. But you know, why they the can—meaning it’s not a hundred percent. But if you’re insulin resistant and you’re doing it the wrong way, where you’re emphasizing maybe too much carbohydrates, not enough protein and more gut irritating foods, yeah, it can definitely predispose people that have an inflamed guts and work more on the insulin resistance side to gain weight. And one of the big things is that when you eat certain animal rich amino acids, there are some plant ones as well, you activate the cells in the brain that are called—hold on, one __my notes—uh—tenocytes. And these tenocytes are receptor sites in the brain in the third ventricle area of the brain. And there’s a direct blood flow between them and the hypothalamus. These tenocytes, one, they sense satiety but the big thing that senses satiety for them is arginine and lysine which are really high in animal-based foods. So these amino acids really get that sense of satiation so that means you’re one, gonna have appetite regulation. Coz when you actually start feeling full, you tend to not eat all the crap, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So the more you can keep your cravings in check, the more you eat healthier foods because you got control over your biochemistry. You’re not reacting. You’re acting based on what you know you need to be healthy. But those amino acids are primarily gonna be higher in animal-based foods especially lysine as well.

Evan Brand: Yeah. Well said.  So in a roundabout way, if you are a vegetarian or a vegan and you’ve got low body temperature, it could just be something as simple as a carnitine deficiency. I mean you could probably get a little bit in beans maybe—

Dr. Justin Marchegiani:  A little bit in beans, a little bit in almonds, a little bit in plums and avocados, for sure.

Evan Brand: But even then, once we talked like—we talked all the time, digestion of those foods is probably not very good and the concentration of those is gonna be much less as opposed to a grass-fed beef.

Dr. Justin Marchegiani: Yeah. In my video, I talked about, you know, if you are a smart vegan where you’re not emphasizing a lot of the grains, you’re doing safer starches, you’re getting lots of fats from avocado, olive oil, coconut oil, you’re supplementing DHEA in the form of algae, right? And if you’re getting B12 uh—supplementation and you’re getting a good multi- in there and you’re getting lots of— you’re getting some protein supplementation in there, maybe from pea or hemp, right? You may be okay on a vegan-vegetarian diet, but it’s just— it’s still less than optimal just because of the fact that you gotta go through such extreme lengths to get high-quality protein sources without all the carbohydrate. Coz vegetarian-vegan diet’s typically are packed with 60 to 80% carbohydrates for that 20 to 25% of protein you get.

Evan Brand: Yup.  Well said. You hit on the mitochondria, too. We should take  that a bit further and talk about more toxins. You hit on antibiotics, some mitochondrial issues there. Makes perfect sense. We work with people all the time where they say, “Oh Justin or Evan, as soon as I took a round of antibiotics, all of a sudden things went bad.” And it could be temperature –temperature issues, it could be sleep problems, it could be gut issues, digestive problems. And so also with mitochondrial issues, we’ve got toxins. So if you’re not using 100% organic, that’s an issue because glyphosate and these other pesticides and herbicides, fungicides and insecticides— they all compound with each other. So it’s not that one chemical by itself will kill you, but if you get a little bit of glyphosate from your non-organic berries, you combine that with a little bit of conventional vegetables coz you did a salad at a restaurant, you combine that with in antibiotics that you’re getting from meat. If it’s not labeled “no antibiotics” you stock all those upon each other, you’ve got some bad mitochondrial problems here that you need to fix. And we can measure the—

Dr. Justin Marchegiani: Yeah. The enzymes that are needed to help move those gears that  kinda crank around that mitochondrial Krebs cycle and then flow in so the beta oxidation process. Uhm— you need certain nutrients. You need B vitamins, you need magnesium, you need zinc, the healthy levels of amino acids. You also don’t need all the toxins— the aluminum, the pesticides, the glyphosate. So those things can kinda gunk up the gears of that metabolic machinery. So it’s not only what those gears need to keep it lubricated, but what it is we don’t need to put in that will prevent those gears moving. So it’s a combination of avoiding certain things, right? And again, the medications are a double-edged sword. I’m not saying don’t use them. I’m saying just really make sure they’re— they are prescribed specifically for what you need. And it’s the last case kind of thing with antibiotics. We really want to go to herbs and botanical nutrients over antibiotics. They may have a time or place, but we want to use it only when we’ve exhausted other options.

Evan Brand: Yeah. Well said. And you and I were talking off air, we can quantify a lot of this stuff, too. So you’re talking about measuring your temperature. We can quantify what’s going on in the gut, right? We can test the gut, we can test the thyroid with—with blood using functional reference ranges and using functional numbers that conventional doctors don’t use. They’re only going to detect disease. We’re going to detect the issues before disease occurs. We’re gonna look into the gut so we could test you for infections. We could test the adrenals, look at your free cortisol rhythm so the uh— HPA axis, the hypothalamus, pituitary adrenal axis, you hear us talk about, you know, that is a factor in all of this. If your brain is not connecting the signal to the adrenals and adrenal to the thyroid, that whole system gets often chronic stress. And it’s up to us to figure out when we talk about stress what’s in that bucket. Is it just your job, your bad boss, your relationship, the divorce you’re going through? Is it that stuff only or is that stuff plus chemicals in the diet, plus nutrient deficiencies, plus infections, plus not having enough quality meat in the diet.  You see how these things can all add up.

Dr. Justin Marchegiani: Totally. And just to kinda look at the thyroid component again, there’s dysregulation up top where the TSH is either high extreme, higher extreme, low. Now it can be extremely low because you’re on thyroid hormone and the body needs more thyroid hormone. The body is sense— sensing more thyroid hormone in the brain, but there’s less than the actual tissues. So that you’re keeping the thyroid hormone higher, but that’s keeping the TSH low. That’s step one. The TSH may be low because of HPAT access dysregulation. That hypothalamus pituitary and that adrenal thyroid axis. There’s some kinda short-circuits happening in there because of the stress— the emotional stress, because of the physical stress, because of the chemical stressors. And we have to address those while we support the nutrients to get this hardwire back on track. We can also have low T4 levels. Coz if T4 is low, we’re gonna have low T3 over here. So we got to make sure the nutrients for T4 in there like I mentioned before the vitamin A, the zinc , the copper, magnesium, selenium, uhm— amino acids, tyrosine and potentially iodine. As long as we know that there’s not uh— autoimmune attack that’s the lease active going on. And then number three, after that, we let see how the T4 to T3 conversion is. If T4 is good, how does T3 conversion look? Is it this big drop off? Or also is there a very high amount of reverse T3 because of that stress? All those can make a big difference. And then one person ask here—James asks, “Well, is hypothyroid and hyperthyroid hypo and hyper kind of the same for treatment?” Yes and no. With hyperthyroid from a TSI thyroid stimulating immunoglobulin or TSH receptor antibody attack, we’re more concerned about coz it tends to be more chronically high which can increase the chance of a thyroid storm and then potentially a stroke. So we take that very seriously. We refer that patient out to their medical doctor uh—for monitoring. We don’t want—we wanna make sure there’s not a stroke going on. But typically, the treatment will be, you know, PTU. Uhm—basically  uh—propylthiouracil or methimazole. Things to basically block iodine uptake to make thyroid hormone. Or though— you know, typically, go to a thyroid radioactive thyroid kind of ablation or even a thyroidectomy. I’ve had patients where we’ve been able to avoid those because we give nutrients to help modulate the thyroid response and modulate the autoimmune response like carnitine, like blue flag, like lemon balm, melissa uhm—into certain adaptogens. They could also help kinda dampen that response. There are some protocols that even show higher amounts of iodine can block that sodium uhm— iodine’s import that transfers iodine into the thyroid. So there’s a couple of different protocols you can use to help. And of course, all of the diet and lifestyle things are the same. But we take the Grave’s autoimmune attack a little bit more seriously just because of the repercussions of it not being treated appropriately, what will happen, we really want to sidestep those.

Evan Brand: Yup. Well said. So get the TPO antibodies checked. Get your eTG antibodies checked, you talk about the TSI. Now, have you seen where TPO TG would be high at the same time as TSI? Where it’s gonna look like Hashimoto’s and Grave’s at the same time?

Dr. Justin Marchegiani: It could. I’ve seen it before.  Yeah. It definitely can. So get—we’re  gonna really get patients on an autoimmune protocol to help lower any autoimmune attack from the food, from the gluten, from the leaky gut. And we’ll also work on blood sugar stability coz high and low blood sugar fluctuations have a major effect on the immune system.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Now another person asked here, the reason why you know I’m such a huge fan of how we do our podcast is coz it’s literally on the go and we’re infusing questions from people on YouTube here right into the conversations. So it’s like—remember those books you read when you’re like a kid and you read it and it’s like, “Oh, if you want the character to do this, turn to this page. If you want the character to do this, turn to this page.”  You can totally change how the book goes.

Evan Brand: Yup.

Dr. Justin Marchegiani: Well, it’s kind how our podcast are. So interjecting here uhm—, Gerald asked, “What about T3? How does T3 work?”  Well number one, T3 can just help support low T3 levels. And if there’s some kind of conversion issue, that can kinda biased time to fix the conversion aspect, number one. Number two, giving that T3 in the Wilson protocol uhm— that can have some effect on clearing out the receptor sites. So that now the T3 works better and binds better uhm— in the future. You can do that by starting low and then tapering up, holding it and then tapering it back down. In the Wilson protocol, Dr. Dennis Wilson does that with time-released T3. But we do a glandular’s in it. That can still be helpful as well. We’re using that as a way of clearing out the receptor site but were also not, you know, thinking that that’s gonna be the only issue. We’re also banking that there’s other things that we’re gonna be fixing that will allow it to be a long-term solution, right?

Evan Brand: Got it. So you’re saying the thyroid glandular’s can be used for low—a low  T3 situation.  That’s the fix that’s going to get you better enough to keep moving the needle in other departments.

Dr. Justin Marchegiani: Correct. Like in my line, we have Thyro Balance which is a—a really glandular uhm—nutrient thyroid support from a glandular perspective. And then we have that we have Thyro Replete which is nutrients for the conversion. So there’s some herbs that help with conversion like coleus forskohlii and ginseng and then we have the nutrients for conversion that I mentioned—the vitamin A, magnesium, copper, zincs, selenium—all of those—and tyrosine’s. We wanna make sure all those are in there. Uhm so we hit it from all angles. I mean if we knew exactly what that missing like nutrient component was, we could hit it more practically. But it’s too difficult to do that.

Evan Brand: Right.

Dr. Justin Marchegiani: You’re better off using multiple methods to hit it. That way the patient can get better faster.

Evan Brand: Agreed. And you mention the adaptogens. I’m so glad you did. We use those all the time. I take them every day in some shape or form, whether it’s ashwaganda, holy basil, shoshandra. There are so many options and people ask, “Well, can I just take a bunch of adaptogens and fix myself?” Uhm— it doesn’t work like that. You just want to use them as one piece of your toolbox. You still want to be getting to the root cause. So adaptogens are life-changing but if there’s root causes, you can take all the adaptogens in the world and it won’t fix you.

Dr. Justin Marchegiani: I’m gonna take my ashwaganda right now—

Evan Brand: Perfect.

Dr. Justin Marchegiani: A little bit of immune support. But I mean, like yeah, if you’re doing okay and you’re like, “Hey, Dr. J and Evan talked about some ashwaganda and some of these nutrients. I want to try it out.” Fine, go ahead.  But if you’re actively having issues that are you know, the symptoms that we mention here whether it’s on the hyper or hypo side, you really want to get someone on board to help guide you because it’s never just one magic bullet. It is—it’s a whole bunch of things that we’re doing together. And the more chronic it is, the more you have a you know, that momentum working against you. You got overcome that inertia to stop that— that snowball effect and start pushing it back uphill. So, yeah, if you’re in pretty good shape, fine you know just try some of these things. But if you’re in not so good shape, you want to reach out, for sure.

Evan Brand: Yep. Cool. Oh, we got time for one more question. Uh James said, “It’s not a thyroid question.” He’s taking an antibiotic for root canal this week. “Will this affect the result of organic acids test and stool test if he collects the samples while antibiotics are still in the system?”

Dr. Justin Marchegiani: I mean if we’re doing some of the genetic base testing, it shouldn’t have an effect on it. If we’re doing a stool base to antigen-based testing, then it would.

Evan Brand: Right.

Dr. Justin Marchegiani: So you should be okay but we’re doing the G.I. map which is you know, what my go-to is. It should be okay according to the lab. I try to avoid it— doing it. So I would say in a perfect world, if it’s not gonna delay your treatment, I would say get to the antibiotics give it like a day or two to let it wash out and then do it. But if uhm— timing doesn’t work out, just do it, get done.

Evan Brand: I would also look at Mercola root canals and read about those. I mean maybe you’re too far down the rabbit hole and you can’t avoid the root canal. But you know there are some other options you may have available if you’ve got a good biological Dennis maybe will sit down with you and say, “Okay, root canal’s option A but maybe there’s a option B C you could look at too because we’ve had a lot of people to come to us with infected root canals and maybe Jessica can speak on this a bit. But I’ve seen it as a big needle mover for people.

Dr. Justin Marchegiani: Yeah. There’s a book by Ramiel Nagel that talks all about root canals. It is highly recommended. You take a look at it. Uh— fat-soluble nutrients, vitamin A, vitamin K are very helpful. Uh—oil pulling that kinda help extract any toxins that may be in there and you don’t want a root canal you want to get the tooth pulled out. Uhm— you want to get an implant put in using biologically appropriate material. You don’t want the gangrenous tissue still in the system without the blood flow. And the immune response to be able to get it is just a harboring place for a whole bunch of bacteria and viruses to hang out.

Evan Brand: Right. Yeah. Well said. So James, look into that. Maybe it’s not too late. Uh—hopefully, you’ve got some other options you can pursue it’d be much— much safer and much healthier in the long term. That way, you don’t have a hidden dental infection. There’s a guy named, Simon Yu that you and I should reach out and interview. He’s over in St. Louis he talks a lot about hidden dental infections. I think that’d be a good show.

Dr. Justin Marchegiani: Okay. Absolutely. Hundred percent. So couple of things we wanna talk about. Oh, also carbohydrate, I think is important. Again, my bias is towards a lower carbohydrate template—Paleo template. And again, I hate the word “diet” because it assumes something is temporary and it assumes that it is fixed; where a template gives us flexibility and modification and may change day to day. It may change uh—meal to meal. I tend to be very lower carbohydrate my first two meals of the day and then after that, I may increase in carbohydrate at nights uhm—you know a bit of the starchy based. So I’m very strict during the day. It’s high-quality. It’s— set—it’s 60 to 70% fats, the only carbohydrates are vegetables and then good proteins and then I go higher at night. On the carbohydrates side, maybe a little bit of sweet potatoes and some butter and cinnamon or maybe I have a—some dark chocolate or have couple more berries than I normally would. So there’s that component. So I always go lower carbohydrate to start because so many people are insulin resistant just because of the fact that we eat too much carbohydrate and were inflamed. So I always go lower carbohydrate to start and then typically, patient will do be better and will feel better because insulin resistance can affect T4 to T3 thyroid conversion, which can cause lower temperature. Now, in the double edge side of the fence, if people go too low insulin, they may also get poor thyroid conversion as well. So just like I mentioned cortisol has a major effect on thyroid conversion. Well, guess what? Insulin has a major effect on thyroid conversion. Type I diabetics— guess what? With low insulin levels coz of the autoimmune attack to the beta cells of the pancreas, they have low body temperature. So if you go too low carbohydrate, and this is for certain individuals not everyone, I know people are gonna be like, “But I’m low carbohydrate and I felt great and it reverse my low temperature.” I get it. Again, there are exceptions to every rule. There are tall Chinese people that play basketball even though they are more shorter in the population. There are exceptions to everything, okay? We got to get that in. So yes, there are some people that a low carbohydrate diet, the majority I would say would help partly because our consumption of refined carbohydrate and sugar is higher, but there are some people when they’re chronically load, they may increase that carbohydrate just a bit. And that ups the insulin a little bit which then helps that thyroid conversion. They’re like, “ Dude, my hair started to grow back better, my temperature’s better, my energy is better.” Boom! You at least now figure it out for you. So exceptions to every rule, figure it out. And uhm—if you feel great going low-carb, great, keep it there, hang out. But if you start getting some of those hypo temperature symptoms, then we’ll just ratcheted up a little bit.  And I primarily ratcheted up starting at night.

Evan Brand: Yup.

Dr. Justin Marchegiani: They’ll still get the benefit of keeping it lower carb during the day.

Evan Brand: Well said. I mean that’s me in a nutshell. I went very, very, very low-carb ketogenic, I guarantee. I was probably ketogenic most of the time and then I started to get cold and so I added in some starch with dinner and all of a sudden my body temperature’s perfect now. I feel good. So uh—if I go too low-carb again, it may come back or if there’s a huge piece of stress on my plate, the low body temperature may come back. But for now, I’ve been able to reverse this and been able to clear out all the infections with your help in terms of protocol a couple of years ago getting rid of all my gut bugs, plus supporting adrenals, getting the diet dialed in, getting my sleep improved, blacking out my room. All of those things are still important. So I hope this has been helpful. I gotta run. You’ve gotta run, too. Uhm—or are there any last questions that we could answer? I closed out the chat window. Uh there’s just one thing I want to say is it’s not about being higher carb or lower carb, have a –have a foundational template which you— which you go back to and then you can customize it. And then if you increase carbs, you can still get some of the benefits by having that first 20 hours of your meals relatively lower carb, higher fat, moderate protein and those last four hours you pop up a little bit and so you can still get some of those benefits. If you’re like, “Oh, I feel better with higher carbs.” You can still get the benefits of the first 20 hours of your day kinda in that ketogenic state and then pop up the carbohydrates later. So it’s not an either or thing. We can kinda straddle the fence but we want to customize it. I don’t give a crap if—if low-carb is your missing link and being low-carb all the time helps you, that’s what we’re gonna do. If being low-carb and a little more high carbohydrate helps you out, I don’t care. I’m all about the results and not about what tool I have to use to get the job done.

Evan Brand: Yup. Well said. For me that looks like the breakfast like a pastured sausage, maybe a handful of macadamias, maybe a handful of organic blueberries. Lunch—I  probably do some leftover steak and veggies like a big thing of broccoli with some butter. Dinner— that’s when I may do some type of pastured meat, a little bit of some veggies and then starch, so it could be a medium-size baked sweet potato, butter, cinnamon. That’s all it takes and I feel good. So just to kind of give people an idea what is that look like. That’s what it looks like.

Dr. Justin Marchegiani: Totally. That’s great. And a couple of questions here. Uh— Stephanie talks about menopausal women with lower estrogen and a low estradiol vaginal tablets. Well, this is interesting because typically low estrogen can cause hot flashes. And why does that cause hot flashes? Because typically the FSH and the LH starts to rise in the pituitary which is that signaling hormone trying to yell to the ovaries to make more progesterone and estrogen. So when LH and FSH primarily FSH goes high, that can create some vasodilation effects and create the hot flashes. So by giving a little bit of thyroid—giving a little bit of uhm— female hormone support, we can drop down that FSH then we can also modulate the receptor sites with some herbs as well to help with how flashes. Whether we use maca, or  we use dong quia, or black cohosh or raspberry root, or shepherds purse. There’s different nutrients or herbs we can do to help modulate that. So again, you could still have hypo, low thyroid issues, but have menopausal issues because of the low estrogens, which could drive the hot flashes up. So it’s kind of a conundrum. The hot flashes may—may overshadow this low thyroid thing over here. So as we get the female hormones fixed, you may notice the low thyroid comes back later on because it’s just not a secondary issue and the primary issue is the menopause. Once that’s ruled out, now this one comes to the surface.

Evan Brand: Got it. Well said.  We should probably do a whole show just on low estrogen if we haven’t.

Dr. Justin Marchegiani: I think that’d be great. I mean, I see estrogen dominance is a big problem.

Evan Brand: Right.

Dr. Justin Marchegiani: Where estrogen –the ratio of estrogen is higher than progesterone, right? So progesterone should be like this 25 to 125 times more than estrogen. But if that ratio starts to creep up where estrogen gets higher, that’s estrogen dominance. The problem is a lot of people, though, where that ratio—they’re estrogen dominant, progesterone’s slow but estrogen is also low. So they get this estrogen dominant, but also low estrogen sums at the same time. So it’s kinda like this conundrum. It’s like this little tug of war that’s happening there.

Evan Brand: Wow. Put it on this to do list. It sounds like it’s gonna be a fun one for us to dive into more. And I’ve probably got some stuff to learn from you on that topic as well.

Dr. Justin Marchegiani: I think it’s great. Well any last questions, comments, or concerns, Evan?

Evan Brand: No. I think this has been good. People, you got to get the testing run because if you don’t test, you’ve guessed. So if you’re trying to figure this out on your own, even if you’re not working with Justin or myself, then get the test run. Find a functional medicine practitioner they can take care of you. We are accepting new clients, so if you do need help, feel free to reach out justin We run these labs on all of our clients because it’s the foundation. We’ve got to have the data. We’ve gotta have the puzzle pieces on the table; otherwise, you can’t move the needle. We could throw a bunch of random stuff at you might help, can’t hurt, but we want to get you better. There’s a systemic process that we do step by step by step to take you through this. So happy to help. Reach out if you got questions and thanks for tuning.

Dr. Justin Marchegiani: Oh! One last thing, man. I forgot to add.  This is so important. Low calories.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just not eating enough calories will cause low body temperature. It’s shown to cause a low level T3. Now this is important because if your diet is 25% crap Ola and let’s say you’re eating 2000 calories a day and then we switch you over— we switch you over to a uh— autoimmune kinda Paleo template, but you’re only able to—to—to switch over 75% of your diet because you don’t—you don’t have enough you—you can’t replace all the crap that you’re eating with the good stuff, right?

Evan Brand: Right.

Dr. Justin Marchegiani: Because if you’re eating a whole bunch of crappy carbohydrates and stuff and then you replace it with a whole bunch of really good vegetables or lower sugar foods, well guess what? You’re probably didn’t replace the calorie amount either. So now you got this 25% calorie deficiency. So now instead of having 2000 calories, right? Now you’re having 1500 calories and maybe metabolically you need 2000 calories. Now you’re 500 calories in the hole which means your 500 calories deficient of various nutrients. So now your metabolism goes low coz there’s less fuel. That’s important. I see a lot. So you gotta  work with someone that really can make sure you’re exchanging the foods and you’re getting enough calories as well. Coz calories equal nutrition. if you’re eating real foods.

Evan Brand: I’m glad you mentioned that. That’s such a simple but common issue. If you’re going AIP, you are going Paleo, you’re eating real foods, you could have an entire plate full of broccoli and it may only be 50 calories.

Dr. Justin Marchegiani: Exactly.

Evan Brand: Yeah. Dude, great job. Way to kill it.

Dr. Justin Marchegiani: And of course, the infections like you mentioned can really suck down the energy. Of course, acute infection, you know, you’re causing a fever, right? Because the immune system’s trying to up regulate itself because a lot of the bacteria and crap there uhm—they’re like—they’re mesophilic. They—they thrive in a medium temperature. So when you go a little bit higher, you can actually kill them off with a higher temperature. But these chronic bugs can really deplete the energy the body and create this kinda lower temperatures as well. For sure.

Evan Brand: Yeah. And I went—I went to low-calorie for a period of time, not intentionally, not on purpose. It just happened. I was eating meats, I was eating veggies and  I track my calories for a few days and I was eating m—and my activity level  and all that. I was probably 4 to 600 calories deficient. So just added in an extra tablespoon of butter here and there, half of an avocado here and there, handful of nuts and seeds. And I was right back up to where I needed to be.

Dr. Justin Marchegiani: Like here’s a seesaw right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So if like carbohydrate is here, if carbs go lower— this is fat over here. The fats have to go up.

Evan Brand: Yup.

Dr. Justin Marchegiani: If you keep the fats here, you keep the fats on—on this side low, and drop the carbohydrates, that’s where the problem happens. The fats also have to go up. That’s the biggest issue. Proteins typically stay in the middle. Typically, proteins only go up if you’re doing a whole bunch of protein powders because proteins and fats are intimately connected. Uh so if you’re eating real whole foods, you know, it’s hard to get just proteins in whole foods, unless you’re doing maybe like venison or rabbit or like boneless chicken breast. But if you’re eating full fat foods, you’re gonna get fat. And then if you’re adding fats to your vegetables, you’re gonna get extra fat without the protein there as well.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So keep that at the back of your head.

Evan Brand: Perfect.

Dr. Justin Marchegiani: Anyone listening here, give us comments below. Give us some shares. Give us some likes. We want to hear thoughts in the comment section. If you’re listening to us on iTunes, that’s great. Click below and subscribe to our YouTube channel. You can see Evan and I’s mugs going back and forth in our little combos here. And then you can give us some comments below here on YouTube. We love the see the feedback. And Evan, hey man, you have a great day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care. Bye.

Evan Brand: Bye.




Chronic Fatigue Solutions – Podcast #147

Dr. Justin Marchegiani and Evan Brand talk about some of the natural solutions to chronic fatigue in today’s podcast. They also discuss some of the stressors which contribute to this challenging condition.

People who have chronic fatigue condition tend to have issues with their mitochondria, thyroid or adrenal glands. Many times, these issues can be driven by hidden gut stressors, like infection or food allergens. Listen to the podcast below to learn more about chronic fatigue.

In this episode, we will cover:

Chronic Fatigue Solutions

16:16   Sleep Pattern and Chronic Fatigue Relationship

26:45   Gut Component of Chronic Fatigue

19:40   Metabolic Side of Energy and Chronic Fatigue.

35:00   Correlation Between Fluoridation and Hypothyroidism

48:20   How Infections Aggravate Chronic Fatigue







Dr. Justin Marchegiani: And we are live! Evan, how are we doing, man? It’s a nice little magical Monday here.

Evan Brand: Magical Monday.

Dr. Justin Marchegiani: [crosstalk] How are you doing, man?

Evan Brand: I feel good. I feel really good. The heat index has been like over a hundred here. I don’t know if you watched the weather at all but it’s like the hottest part of the country. We’re like hotter than Texas almost. It’s nuts.

Dr. Justin Marchegiani: Yeah, I mean, right now dude, I got the apple kind of weather screenshot. My wife put it on her Facebook, and it was like– for the next week, it’s a low of a hundred to a hundred and six during the day. So, pretty darn crazy. Very hot, so we’re inside. Actually, I’d been jumping on the water today in like two hours.

Evan Brand: Good.

Dr. Justin Marchegiani: Do a little boat training things. I’m excited about that. This weekend was good. Didn’t go on the boat this weekend, but I look forward to go on it this week.

Evan Brand: Cool. Yeah, people have a misconception about Texas being like a desert, but Austin is– there is humidity plus that hundred degrees. That’s a scorcher.

Dr. Justin Marchegiani: Yeah. That is– it’s hot for sure, but uh– again, most of the year it’s great. That’s my kind of Texas secret.

Evan Brand: That’s true.

Dr. Justin Marchegiani: I got a little workout this morning. Got up. Did some PK, you know, sprinting. Sprint some of my rower, some kettle bells, some push-ups, some rows, some good twist ball, crunches and such. I’m feeling good. I’m ready to go. How about yourself, man?

Evan Brand: Yeah. I rode the mountain bike actually this morning. I’m trying to make it a morning ritual. Typically, I’m doing some good morning sunlight exposure as much skin as I can, and kind of gazing in the direction of the sun. But then I thought, “Why not just add exercise on top of it.” So, I’ve been hitting the mountain bike. Probably doing just a mile or two, enough into intense but my brain worked so much better with morning exercise, morning light. So, on the topic that we’re chatting about today of Chronic Fatigue, that’s one of the best strategies, I believe, as some type of morning exercise. If you’re not too fatigued, and you’re able to do even just a walking routine, or stretching, or morning Yoga, plus sunlight, that’s like a one-two punch combo.

Dr. Justin Marchegiani: Yeah, I mean, I have a little home gym at my house so I get up and I’m trying to do a little bit of 15 minutes– 15 to 30 minutes of exercise as soon as I get up. Close to the 30 is ideal. My wife tries to just get up. She’s eight months pregnant right now, so she just tries to get up and walk the dog for 30 minutes or so before it gets really hot. But yeah, exercise is really important. If you look at a lot of these higher-level CEOs, right. They talk about exercises really being a benefit on the cognitive side, right? Helps decompress stress. Helps them just feel better, less anxious, make better decisions throughout the day. So, exercise provides some awesome components, especially on the cognitive side. It’s very cool.

Evan Brand: Yeah. the problem is when we’re talking about the chronic fatigue, so many people they’re so tired that they can’t exercise. So, it’s really tough to give them that– that first little bump of energy. So, maybe we’ll chat about that today, you know. How do you actually get started with exercise when you’ve been sedentary for so long? It could be a struggle but there are options.

Dr. Justin Marchegiani: Yeah, I mean, first things first, is find your exercise tolerance. For the most part, many people can walk at least, right? Are they gonna at least do some walking, gentle walking, or they can at least, you know, let’s say that’s too much, they can probably at least do some gentle, like, Tai Chi moves, right? So that’s – there’s always a way that you can move a little bit, right? Whether it’s walking or even uhm – on the Tai Chi side, or even Yoga side, right? So, there’s always some level of movement you can do. Ideally, pushing people to get on to the resistance training side’s gonna be ideal. And even the burst training side. If you’re older and you’re not used to that kind of compression in your joints, utilizing some kind of elliptical or rower or bike, or something stationary, where you’re not getting the impact. But you can at least go out to all out intensity and then relax– all out intensity and then relax, that’s important for the mitochondria and for the muscles. And also, doing some resistance training is gonna be helpful because– again, like, things like walking, they aren’t really gonna build much muscle. I mean, you’ll burn fat, it’s good to move, but you’re not gonna be putting on a lot of muscle on walking. So, you get that the muscle building effects, and you get the higher growth hormone effects with the resistance training and with the burst. So, that’s really important.

Evan Brand: Now, did you cancel your gym membership? Do you still go over there now that you got the home gym setup or do you just use the home as a compliment?

Dr. Justin Marchegiani: I mean, I do both. I mean, the gym membership for me is like 19 bucks a month so it’s just nice to still have that because I can get out of the house maybe once to twice a week just to have a different change of scenery. As you know, when you work from home, it’s like– ah you don’t really get out much, right?

Evan Brand: Right.

Dr. Justin Marchegiani: Like you’re stuck, so just an excuse to get out. But I still have the home gym, which is great. I got to start shooting some more videos from there on some of the exercise stuff. I think that’s important. That’s kind of fun too. So, look for that coming soon. And then, what else is on your mind? I mean, let’s dive in if you’re ready.

Evan Brand: Yeah, yeah, so uhm – and you can use your wife, as your videographer for your exercise videos. People would love them on the channel, man. I don’t think you’ve done any exercise videos yet, have you?

Dr. Justin Marchegiani: No. No, I haven’t, but just simple stuff, right? Simple– you know, I kind of like the Pulse Check mind set. Break it down into foundational movement patterns, right. Push-pull– you know, push, pull, bend, lunge, squat, twist, walk, sprint, right? Those were like your seven kinds of primal movements in it. Any exercise you can think of, for the most part, you can fit into that type of seven primal movement pattern, and then from there you can, you know, you can have it. You can do it with weights. You can do it with cables. You can do it with TRX. You can do it with Swiss balls and body weight. And you can implement and shift according to what you need. And also– you know, if you’re on a budget– I mean, TRX, swiss balls, and push-up bars, maybe a couple of dumbbells, I mean, you got like pretty much a full body facility for yourself.

Evan Brand: Yeah, for probably less than 200 bucks.

Dr. Justin Marchegiani: Yeah. A couple hundred bucks, man, and you got a great gym.

Evan Brand: So, let’s chat about chronic fatigue. I mean…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …what’s your ancestral take on this? I mean, do you believe a chronic fatigue would have existed in ancient times?

Dr. Justin Marchegiani: Well, I think, ancient time-wise – I mean, look at the stress, right? Stress was punctuated. It was very short term, right? It was a tiger chase, whether you live or you die, right? It wasn’t this chronic thing where you got a mortgage, you got all these different things you have to do to uhm– you know, to survive so to speak. You have to get your food. You have to have your water. You know, a shelter over yourself, you kill an animal, and then, for the most part, you’re resting, you’re relaxing all day. Well today, we have bills, mortgage, we have ki– and then look at today, right? Kids are kind of a liability today. I mean, look how much they cost to feed, schooling, college, where in those days, like, kids were a massive asset. Like, you want to have as many kids as possible, so they can go hunt with you or help out around the house. I mean, it depends how far back you want to go, right? You want to go farming days, right. My family were farmers like a hundred years ago. So, they have…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …you know, seven, eight, nine, ten kids. And then, we’re all working on the farm every day. So, they were a massive asset to the family. Today, kids are kind of a, you know, a liability, right?

Evan Brand: Yeah. I mean, you make a great point. My great grandparents – there’s old picture – the average was like 16 kids.

Dr. Justin Marchegiani: Oh, yeah. I mean, they were a massive asset. They help the family out. Today, they’re a stressor. Right? You know there’s no reason why you can’t make your kid an asset. You know, give him some chores to do around the house and be a team player, right? But it’s– but uhm – you know, it takes energy and parenting to do that. So, you got to. We got to look at what we can do now to decrease stress. Because after food needs are met, you know, from an anthropological perspective. Food, shelter, hydration, I mean, typically have much to worry about after that. We have a lot more we worry about in our life: traffic, uhm – everything, right? So, looking at where we’re at now, we know the adrenal glands play a vital role because they kind of are the interplay with our sympathetic nervous system, so we get that spider tingling sense, right? Stress levels go high. That’s our sympathetic nervous system in there for always in fight-or-flight, then that’s gonna really play a game on our adrenal glands. Could look at Robert Sapolsky’s book. He’s the stress physiologist out of Stanford. It’s ‘Why Zebras Don’t Get Ulcers”? And he just talks about how animals – I mean, it’s like, this Zebra could literally be running from a lion, right? The lion jumps on its back, like, takes on huge chunk out of its back up but the Zebra gets away so to speak. And then you see the Zebra an hour ago– an hour later, just grazing on some grass, like nothing happened, right? Could is this punctuated, even though half of its– you know, back side’s gone. It’s like, “Okay. No big deal.” Like, it’s this fight-or-flight response. It’s either off or on, where we kind of sit into this micro off-on, micro off-on all day long from work stress, from relationship stress, and then also food stress, right? I think food stress is probably one of the biggest stressors that keeps our fight-or-flight on. Just eating a lot of refined crap and sugar makes this blood sugar go up and down, up and down, up and down, which then puts a toll on the adrenals. And then also, when you’re stressed, you’re actually burning up more nutrition, right? You’re going through more B Vitamins, you’re going through more amino acids, you’re going through more minerals, Magnesium – those kinds of things. But then, when you’re stressed, what also happens is you tend to crave more sugary sweet foods. So, you see this kind of vicious cycle that happens? Stress issues, more Cortisol, more B vitamins, more Magnesium, but also more cravings for the bad stuff, right? Alcohol, refined sugar, but then, all those foods, they don’t contain all of the nutrients that you’re burning up at higher levels. So, you see that kind of – that little kind of vicious cycle you get into?

Evan Brand: Oh yeah.

Dr. Justin Marchegiani: More stress, more nutrient issues, but then you crave the food that actually contain none of what you need. And actually, to take those foods in, you actually create more deficiencies. When you run those things through your glycolysis and through your Krebs cycle, it actually takes nutrients to metabolize those things. That’s why alcoholics are so notorious for having B Vitamin deficiencies because of the fact, it takes B vitamins to process the sugar and alcohol. So you can actually create more deficiencies by eating things that have zero nutrition. But you create even more than that because you don’t get it in. But also, you have to process that sugar with other nutrition that’s not there, right?

Evan Brand: Yeah. Your gas tank’s already gone empty and you’re trying to push the gas pedal even more. You made a great point about this because many people when they talk about stress, they say, “I’m not stressed. I don’t feel stressed.” That’s like, when you don’t necessarily have to feel the stress, and you might not feel the stress. This could be, all your nervous system. This is your gut. This is your pancreas you’re talking about with the Insulin surges. This is the liver stress, where you’ve got clogged up detox pathways. You’re not actually replenishing your Vitamin C, which every time we look at an organics, I know I see nine out of every ten people…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …in the organics. Their Vitamin C is completely bottomed out. And, for me, I think it’s just the afterburners. You know, in the jet fighter. You can’t use the afterburners forever. You can turn them on, but it’s not designed for permanent use, and that’s kind of us in the modern world. And then also, the workload too. It has increased, which, you know, some people, maybe they can’t change that, but I believe  a lot of people – they’ll tell me that they’re going on a vacation but they’ll still bring the iPad or the tablet or the computer with them to continue working. And so, even when we’re paying for a vacation, we’re still not letting that nervous system ever fully kind of hit the reset button. So, you get back home, and you still feel just as stressed, if not more stressed, because you left your home environment and you just worked the whole time. And then, obviously, there’s the deeper issues that will get into today as well. So, I’m gonna start off, since you already hit on the diet…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …piece. Let’s just start off with talking about a Vegan diet as a cause of fatigue, or specifically chronic fatigue. We’ve hit on Vegan diet so much, and I believe maybe, maybe, maybe you could do it right if you just tried extremely hard. You could survive. Could you ever thrive? I don’t know. I don’t know in a completely Vegan. Maybe vegetarian. We’ve hit on this. I won’t beat the drum too hard, but ideally, if you’re getting your good animal proteins that are pasteurized, you’ve got your digestion actually working, you’re gonna get a lot more minerals, trace nutrients. You’re gonna get your eye Iron, which are gonna help to prevent Anemias, which is also on our list of causes of Chronic Fatigue. You know, a lot of times, Vegans are gonna show up on their blood work with different type of Anemias. And then, when you and I run blood work for thyroid, a lot of times we’ll see thyroid issues too. Like elevated reverse T3, which is like the blank bullet, for people listening, “You’ve got your revolver but you’ve got some blank bullets in there.” Because you run a Vegan diet, the body thinks it’s starving to death. So, it says, “Well, Evan, I don’t know when you’re gonna eat, so I might as well hold on to as much body fat as I can. This is why, so many Vegans, you’ll see they’re actually overweight. And it’s like, “Wow. You’re living on vegetables but you’re still overweight. What’s going on?” A lot of times, this whole cascade: the adrenals, the thyroid, the fat storage, the malabsorption issues, all the beans and digestive problems that they’re experiencing. This is like another vicious cycle that could be kind of similar to the standard American diet cycle, you mentioned.

Dr. Justin Marchegiani: Totally, and now, when you look at Vegans, right? The people that do best on Vegan or vegetarian diet, are the ones that are going to be the least Insulin-resistant. So, let me say in another way. People that are the most Insulin-sensitive, right, their Insulin levels, their Insulin secretions are in a good place, right?

Evan Brand: They do best.

Dr. Justin Marchegiani: And then, they do the best because, typically, Vegans vegetarians, they’re gonna be consuming Carbohydrates at 300-400 grams a day, minimum. Minimum just because that’s what it takes if you’re gonna get the protein in, and you’re combining proteins with the legumes and rice and other things like that. You’re gonna be getting a whole bunch of starch in, so your carbohydrates will be at anywhere between 60-70 percent per day on average, if you are a Vegan. Now, also, if you try to do it the – if you’re trying to keep the carbs down as a Vegan, then you typically, are gonna be relying on a lot more protein powders. You’ll be doing rice protein, hemp protein, pea protein, and you’ll probably be having to add in a lot of good fats too, like, you know, nuts, seeds, avocado, MCT Oil, Coconut Oil, Olive Oil. So, you’ll have to really up the fats. And if you can handle the nuts and seeds, they’ll also be really good, but the you’ll also have to get a lot of the protein powders up. And you’ll probably still need, as an insurance policy, a sublingual B12 to ensure that you’re not getting Anemic in any way. So, that’s kind of the big thing, and if you don’t do it that way, if you don’t do the protein powders, it’s really hard. You got to get about 300 grams of carbohydrate as a minimum, if you’re gonna do it that way. And if you have Insulin resistance, or if you have any digestive issues, you’re gonna have to do a lot of legumes, and there’s gonna be a lot of lectins in there and a lot of potential mineral and protein disruptors there. That’s why, you know, Beano is such a popular supplement to break down beans because a lot of those foods require a lot of enzymes to break it down. It can be harder on your digestive system. Again, some people can do it. the question is, how do we differentiate why can some people do it, and it’s– a lot of it has to do with Insulin resistance, right? The more Insulin-resistant you are, the better you’re gonna with meat because you can get a whole bunch of proteins and fats without the whole bunch of carbohydrates too. [crosstalk] And it’s very nutrient-dense. I mean, there’s a lot of B Vitamins in meat. If you look at the top B Vitamin foods, they’re gonna be meats. And we just talked about B Vitamins: how important they are for Chronic Fatigue. Fish, meats, pork, they’re gonna be really high in B Vitamins. Also, nuts and seeds will be right behind there too. So, that’s kind of a good take home.

Evan Brand: Let’s chat about Labs for a minute. I mean, I mentioned like, some of the thyroid markers.

Dr. Justin Marchegiani: Yeah.

Evan Brand: What are you seeing on paper for people with chronic fatigue? How would we break this down? I hit like reverse T3 about– What else is gonna show up?

Dr. Justin Marchegiani: Yeah, so when we look at chronic fatigue, there’s three things on the hormone mitochondria side we want to look at: we want to look at the adrenals, we want to look at thyroid, both of those together. Right? So, making sure there’s adequate T4 to T3 conversion on the thyroids item. Making sure you’re reverse T3 levels aren’t going too high. Number 1, looking at the adrenal side of the fence, so making sure Cortisol’s not too high or too low. And typically, you know, the more chronic the adrenal dysfunction is, the lower the DHEA sulfate will be as well. So making sure the adrenal components could– also the rhythm, right? Cortisol should be having a downward slope throughout the day. And a lot of people, they almost get kind of reversed as the adrenal dysfunction gets worse. And the problem with that is, it tends to significantly – it tends to significantly mess up sleep patterns, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Sleep can do…

Evan Brand: Let me.

Dr. Justin Marchegiani: …bad health.

Evan Brand: Let me restate that just so people understand what you’re saying. So, when you’re try to med a reverse pattern, what we’re gonna see on your saliva test, will be low, depressed morning levels, but then we’ll see an elevated level of Cortisol in the evening. [crosstalk] So, you’re exhausted in the morning, but you’re also wired and tired at night. So, you can’t sleep yet you don’t feel rested in the morning. We see that a lot, and we’ve done videos and podcast on a specific topic, but a lot of times, it’s due to some type of stress, like an argument at dinner, or someone’s doing bluelight at night. You know, even just a tiny amount of blue light from your phones, your tablets, etc., can crank up Cortisol. And you can fix it, with the lifestyle strategy and there’s herbs you can use to lower evening Cortisol, like Relora. We’ve chatted about that before.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And like the Magnolia bar, can some of that…

Dr. Justin Marchegiani: Yeah, and I’m just doing so. My supplementation right now is doing some adaptogenic herbs.

Evan Brand: Yeah, what did you take?

Dr. Justin Marchegiani: I’ve just taken my Adrenal Revive, which has Rhodiola-Ginseng-Ashwagandha combo. And then I would just take in some amino acid and some mitochondrial support. Just to make sure I am revved up in that maximum potential. And, this morning, I had three hard-boiled eggs. I had two pieces of bacon, and then I had some coffee with butter and MCT and 15 grams of Collagen peptides. That’s kind of my day so far. And little workout actions, I’m feeling good. So, just kind of reader in what you said, we have the adrenals, we have the thyroid, we have the mitochondria component, and the mitochondria is the B Vitamins. That’s the CoQ10. That may be extra Ribose. That may be extra Carnitine. That may be some of your Krebs cycle, intermediary compounds, like Fumerate and Malate and Succinate. So these are all really important things that can help the adrenals that I mentioned, the thyroid and the mitochondria. So, all three of those needs to be looked at. So, my analogy is for energy, the adrenals are what shifts the gears. So, if you’re from first gear to second gear, second to third, third to fourth, that’s like a standard kind of transmission, right? You shift the gears. You go up, you go fourth to fifth gear. Now you’re at highway speed, right? As you shift the gears up, that’s you generating energy so you can deal with and meet the stress, right? That’s a faster speed. You downshift so you can relax and calm down and control your nervous system. Those are like adaptogenic herbs. That’s like GABA. Here’s some GABA right now. I’m doing a little downshift action if you will. So that’s upshift and downshift. That’s the adrenals. That is your body being able to meet the demands of stress and be able to calm down from the demands of stress. That’s adrenals. Two is thyroid. That’s your resting engine tone, right? You put that car in neutral. Let’s say it’s around 700 rpm on a normal day. Maybe on a cold day, it’s 1200 to 1400, right, because the engine’s really cold. It’s got to generate more heat. So that resting engine tone, that’s the thyroid. I think of the mitochondria as the gasoline and the lubricant that’s in the car, right. It’s the engine. It’s the oil in the engine. It’s the gasoline in the tank. It’s the fluid in the car, whether it’s wiper fluid revrols. It’s the internal fluids that help that car to run. So, thyroid is resting engine tone, right? And we know what happens if the engine tones too low, the car stalls out too, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: So, if it goes too low, you stall out. That’s like hypothyroid, right? You’re stalling out because you’re getting tired. You’re getting fatigue. You’re getting cold. So, let me go back. Number one is gonna be your adrenals that’s being able to upregulate or downregulate stress. Number two is your thyroid. That’s your resting metabolism, your resting engine tone, right. Too high, you burn up. Too low, you stall out. Number three is the fluids and the internal fuel in the car, right? The gasoline, the oil, all the fluids to help that car run. So, that’s kind of my analogy on the metabolic side of energy and chronic fatigue. We ca go a little bit deeper in, next.

Evan Brand: Yeah, yeah. Well– well said. I love your analogies. I think there’s been a few recent podcasts where I’ve not heard your analogies. So I’m glad that you’re ripping those out. Let’s chat about now, we hit on Anemias. We hit on kind of the three-body system approach to this whole thing. Let’s talk about the other factor. We hit on blood sugar already. Let’s talk about heavy metals, Lyme disease, Epstein-Barr. You know, some of these underlying…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …that could be driving the adrenal-thyroid detox problem issues. Mitochondria [crosstalk] issues. A lot of times they go unaddressed. Now, there’s some people out there that their whole business model’s wrapped around, like, one piece of the puzzle, like, methylation, which is a factor, but it’s not…

Dr. Justin Marchegiani: [inaudible] …your Lyme.

Evan Brand: But it’s just a factor, right? I mean, when Justin and I are working with people, we’re never just saying, “Look. This is your one thing. There’s never one thing that broke you and there’s not one thing that’s gonna fix you. It’s always a combination of these factors. So, if you had a diagnosis of like Epstein-Barr, or Lyme, or mycoplasma or cytomegalovirus, or these other infections, or heavy metals. Somebody says, “Oh. You’re toxic with Mercury or Lead.” You know, yes, those issues have to be addressed, but they’re not gonna be 95 percent of the problem. They’re gonna be a piece. Now, what percent of the pie? We don’t know, right? Because it depends on like Justin said, your diet. What kind of diet are you following? What’s your stress load? How many hours are you working per week? How well are you sleeping? What’s your EMF exposure? What’s your exercise exposure? What’s your light environment? Are you actually getting bright sunlight in the morning, and you’re kindling down and you’re not using artificial light in the evening, right? All these factors will pile on top of Lyme, heavy metals, Epstein-Barr, mono, etc., and that can make you or break you.

Dr. Justin Marchegiani: Hundred percent. And of course, the diet to be there because inflammation – one of the major factors of inflammation’s gonna be through your food, right? So, making sure the foods dialed in. again, that’s anti-inflammatory nutrient-dense low toxin. Our approach is gonna be kind of a Paleo Template. That’s macronutrient gnostic, so getting the protein fat and carbs right and dialed-in for you, for your metabolism, and for what you can actually digest. Because some people had a hard time with the whole food component because it has – it involves digestion. And if that’s not good, we have to make some modifications there. And that dub tails into the next component, which is digestion, because if we have problems digesting food, that’s where all the nutrients come into our body. So, if we can’t break that down, that’s an issue. And not breaking down foods actually creates a stress in the body. So, if we can’t break down the foods, then the foods ferment, putrefy and rancidify in the gut, and create more stress and more bloating. And then, if we get really stressed and we have a hard time evacuating our bowels or moving our bowels, right, it may get more in the constipated side and then we start getting this auto-intoxication phenomenon where we start reabsorbing a lot of the toxins that are in our stool. Right? That’s not good either, right? We’re literally drowning ourselves in our own toxins. So, that component’s there. And then, we need the enzymes and Hydrochloric acid and we know that’s important and stress affects that, right, because the more stressed we are, the more the sympathetic nervous system decreases enzymes and decreases acids. Also, infections, right? All of these things interplay because the more stressed we are, the more digestion’s poor. Infections can come in, and infections amplify all of the things that we’re talking about. And infections then create more leaky gut action, right, where the tight junctions in the Epithelium lining open up and then more of those compounds in our gut get into our blood. And then our immune system interacts with them more, which then creates more immune stress. And your immune system is 70-80 percent in your gut, so the immune system always being active, it will really suck up a lot of your energy. That’s why when you get sick and you have like a flu or a cold, you’re really tired. You’re not tired because of the virus, you’re tired because of the immune system allocating resources to kill the virus. So, if your immune system is always upregulated, it will suck a lot of energy from you.

Evan Brand: How about gluten, as a simple immune stress?

Dr. Justin Marchegiani: Yep. That’s why cutting gluten out can really improve people’s energy because number one, it’s gonna create gut inflammation if you’re gluten-sensitive, which a lot of people are. Number two, you know, unless you’re eating the best kinds of grains, there’s still gonna be a lot of Round-up and glyphosate and chemicals and lectins and gut irritants in there, even if the gluten component’s not a problem. So, that may drive more leaky gut, which then creates this more immune reactivation, upregulation, which then starts to suck energy out just like when you get sick from a coal.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, that’s why cutting those things out, really decrease your immune cell activation.

Evan Brand: Well said. I want to circle back to couple things you mentioned about malabsorption digestive problems. People may want to know how do we quantify that? Well, you know, our philosophy’s “Always test. Don’t guess,” So, like when we’re looking at a stool test for someone, we can look at secretory IGA, which is kind of that first line of defense against infections. Oftentimes, we’re gonna see that real low. In terms of stools, obviously, you can look at your stool, if it’s floating, you know you’re not digesting your fats. So, if you’re trying to implement a Paleo or a Ketogenic diet, and your stools are floating, we know you’re not digesting. But we can also measure it with Steatocrit, a fecal fat marker…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …which is important because we can track this stuff. So, people say, “What’s the value of testing? Can I just, you know, take all these supplements and do the diet?” You can, but eventually you’re gonna spin your wheels because you’ve got to have the diagnostic data to figure out what’s going on. I had a woman last week, who her gluten antibodies were above 400 and she told me she hadn’t eaten gluten in four years. And we know that the gluten antibodies can be elevated for six months, but not for four years. And so, I told her, “Look. There’s got to be some exposure if you promise me the diet’s clean. One lady I found had a chopstick she was using everyday with wheat germ oil on her chopstick. And that was causing her antibodies to go up, but for this lady, you know, I’m thinking it’s something with her skin care products. She said she loves wearing makeup. So, I’m guessing she’s got some gluten in her makeup somewhere. And that’s a stressor too. So, like even if you’re listening, like, “You know what. Justin, Evan, I’ve heard you guys a million times about the diet. I’ve already got a gluten-free diet. If you don’t test for your anti-gliadin antibodies, you’ll never know because these people that come to us and say they’ve been on the gluten-free diet for years, but they’ve still got issues like fatigue, boom! Now, we’ve got the Lab to prove it and we can see why.

Dr. Justin Marchegiani: Hundred percent. Hundred percent. So, again, the gut component’s really important, and we know there are certain infections that– You now, we’re not gonna go into the treatment because we can do a podcast in each one.

Evan Brand: Yeah.

Dr. Justin Marchegiani: We know things like H. pylori, Blasto, coarse Lyme, which is Borrelia burgdorferi. We know the co-infections of Lyme, like Babisia, Bartonella, Alexia, right? These are different things. Mycoplasma. Mycoplasma’s a big one with chronic fatigue. I think your wife had that at one point…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …after a tick bite too. Figure’s back.

Evan Brand: We never even saw a tick. Who knows?

Dr. Justin Marchegiani: Yes.

Evan Brand: I’m guessing it was a tick, but yeah.

Dr. Justin Marchegiani: [inaudible]…IGA levels for mycoplasma. They’re of the charts, so…

Evan Brand: Yeah.

Dr. Justin Marchegiani: I remember we treated that and your joint pain went down and your energy came back.

Evan Brand: That was scary. That was a scary time, I’ll tell you. So, infections, you know, I’ve got hands-on experience. You know, seeing my wife struggle like that with the infection piece, and she was definitely fatigued. A lot of times– maybe we should mention this. I’m sorry to interrupt you, but a lot of times with chronic fatigued there’s something else going on too, like depression, anxiety, insomnia, sleep issues.

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’s not just chronic fatigue by itself. Fibromyalgia– so, usually it’s not an isolated issue, I found. Which means that more people should be listening. Because even if fatigue doesn’t apply, there could be other symptoms that are kind of complementary to this.

Dr. Justin Marchegiani: Yeah. Fibromyalgia is intimately connected with chronic fatigue. Why? Because, your systems to regulate inflammation are also connected to energy. So, when your ability to generate energy goes down, your ability to resist inflammation or put the fire of inflammation out also goes down. So then, you get very easily sore. You kind of have central allodynia kind of thing where you’re– you know, if I were to just touch someone who has no chronic fatigue or Fibro like, like this, it’s not a problem right? But then, their nervous system is proceeding that as like I’m punching them at full strength, right? So, it’s just hyper upregulation of the nervous system, and also the inability to regulate inflammation. So, the smallest things create a fire, if they will.

Evan Brand: So, it sounds like it’s everything. It’s not just a nervous system  like you mentioned, but you’re saying it will be the immune system at play here too.

Dr. Justin Marchegiani: Yeah, yeah. And then you have the Myalgic Encephalomyelitis, which is the European term for chronic fatigue, right? So, the Myalgic Encephalomyelitis is the other one. So, we talked about the infections, right? H. pylori, Lyme, all the Lyme, co-infections…

Evan Brand: Parasites.

Dr. Justin Marchegiani: …parasites, Yersinia. These are gonna be big. And again, the reason why they could be so big, is because of the immune activation, number one. Number two, because of the leaky gut, which then exacerbates the immune activation. Number three, the impaired digestion, right? The impaired digestion which means Hydrochloric acid and enzymes drop. And then number four, it’s gonna effect the gut bacterial balance in the gut, right? More bad bacteria than good.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Right? Just like when there’s sharks in the water, the sharks got all these little kinds of things sticking to its underbelly. They try to get a free ride, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: But when there’s parasites there, you get those kinds of things. They try to get a free ride as well, i.e. dysbiotic bacteria, and then, these things are gonna eat up more of your B Vitamins and more of your nutrients. And we know that more beneficial flora actually produces nutrition. So then, when you have that lack of beneficial flora, then you have lack of that input of really beneficial nutrients produced by them. And then also, beneficial probiotics produce more healthy acids that keep the environment in the gut uhm– let’s say, inhospitable for the bad guys.

Evan Brand: Yep. Yep. I’m glad you hit on the piece of them stealing your nutrients, and also the point about the dysbiotic flora is awesome. It’s like your powerplants. If you have a bad diet, but you’ve also got dysbiosis, I mean, I can’t think of a better combination if you wanted to create chronic fatigue and to wipe out all the good guys. So also, you know, maybe this is worth mentioning. Antibiotics too. I mean, we’ve seen people with chronic fatigue that it happened after a round of antibiotics to the point where some people are almost wheelchair-bound or bed-ridden due to massive rounds of antibiotics, especially someone, let’s say, they got a Lyme diagnosis. They start doing a bunch of antibiotics, then their chronic fatigue due to everything going on. They’ve just destroyed themselves.

Dr. Justin Marchegiani: Exactly. Hundred percent. And again, there are studies about bacterial cidal antibiotics induce mitochondrial dysfunction, right? And I’ll pull up a study here and we’ll go through at least the conclusion part. And we’ll put the references on below. But I have a study here on mitochondria and antibiotics, and I have a study here on the mitochondrial dysfunction in heavy metals. Because we know heavy metals are a really important component. We get exposed to them in our environment. It takes nutrients to detoxify from heavy metals. So, if we have poor nutritional issues because we’re not eating good foods or we’re not digesting those foods, then all those amino acids and healthy sulfur-based minerals aren’t gonna be utilized for phase I and phase II detoxification as well.

Evan Brand: Yep. Well said. I’ll also add in occupational exposure of heavy metals too. I was working last week with a female in her 70’s, a retired dentist, and I said, “What’s your exposure to mercury over your lifetime?” And she laughed and she said, “Oh, Evan, you know, back in the 50’s,” She said, “I was putting Mercury in my hands to show the kids all the things you can do with it.” So, who knows how toxic she is. We’ve not tested her, you know, quite yet. But, I mean, dentist? What else would be toxic occupations you would say? I would say anybody who’s working on a ramp, like at an airport, people that are outside breathing in jet fuel all the time. We’ve got…

Dr. Justin Marchegiani: Chemiist. Potentially, Chemist, those people. I would say, the big one I think is a lot of people that are doing a lot of lone care work.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Their spraying a lot of pesticides or chemicals or glyphosate, right? So, a lot of potential things and they’re getting exposed to, and a lot of times, they aren’t going to the proper precautions regarding exposure. They’re just uneducated about it.

Evan Brand: Right. And I think we hit on this. Maybe not on this episode but as we know, glyphosate damages mitochondria too. So, you just brought up a study about antibiotics. We know glyphosate does the same. So, if you’re not eating an organic diet, I mean, it’s gonna be tough to get you out of this whole. What about– Let’s see. I mean it’s not too common anymore, but people who work in like a toll booth all day, where there’s cars, or a drive-through. People who work in, you know, say Starbucks. You are working at the drive-through. You’ve got these cars pumping out exhaust fumes. They’re breathing in that stuff in all day. I think all the guys at UPS that worked out on the ramp. You know, the meal of the night when you’ve got these big planes, just putting out tons and tons of jet fumes.

Dr. Justin Marchegiani: That’s really tough. Yeah. And I know we see a lot– I know you run a lot of the GPL-TOX Screens and you see a lot of benzene and a lot of, basically, by-products from gasoline metabolism, right?

Evan Brand: Yeah. Yep. That and also, thanks from groundwater contamination too. So, people that are drinking from well water but they say, “Oh, I had it tested 20 years ago.” It’s like, well, fracking and a lot of other industries have destroyed a lot of our groundwater, so you got to make sure that you’re filtering your water too. If you don’t have a good clean water source, that could be another source of your fatigue.

Dr. Justin Marchegiani: Yeah, yeah. I kind of on the fence about fracking. I’ve seen some of the documentaries on them, but I also have some family and friends that live in areas where they have to have water, you know, uhm– basically, trucked in, right? Because the water that they have is so bad. But I’ve also heard from other people that these people, you know, had lots of problems with their water even before fracking. So, I’m kind of the fence about that, but anytime we’re putting toxins into the water supply and we don’t have the ability to filter it out, that’s always really a concern, for sure.

Evan Brand: Yeah, so I guess, maybe we’re kind of all over the place, but we’re really not because we’re building a complete picture of all these different sources. I mean, even Fluoride, for example, if you’re drinking Fluoridated tap water, we know that that’s gonna block some of the thyroid functions. So, if you’ve got Hypothyroidism or you’ve got autoimmune Hashimoto’s…

Dr. Justin Marchegiani: Totally.

Evan Brand: …I mean, that could be a source too. So, I use a fluoride filter to remove all that from my water. Because here in Louisville, even though the water’s great tasting, it’s naturally filtered through our limestone, all of our caves here, but still they add Fluoride at the very last step before they send it out to the taps. Which hopefully, there will be a day where that is not the case.

Dr. Justin Marchegiani: Yeah, then they study over in the UK, where they looked at certain towns or sections of areas that have Fluoridation and certain areas that don’t. And they saw an increase in Hypothyroidism in the areas where there was more Fluoridation. So, there’s a correlation with more Fluoride equaling more Hypothyroidism. And that makes sense because Fluoride’s a halide, therefore it can pinch-hit into that Iodine receptor, which is really important for that iodination process of making thyroid hormones. What makes sense why Fluoride could affect that iodination process, for sure.

Evan Brand: Yeah. there was a Chines study too. I’m sure you saw this one, about IQ being lower.

Dr. Justin Marchegiani: Yeah. It’s like seven of ten points. I mean, this is why I’ve invested in two filters in my house. I have a whole house filtered. That’s a carbon-based filter. And then I have one that is a reverse osmosis filter just for the countertop. So I have one that’s whole house, which filters about 50-75 percent of the Fluoride, and then another one that’s countertop. So, that way, the water, like I’m drinking now, is gonna be a hundred percent clean. Now, the one of the Fluorides we have, it actually adds back some of the good minerals, one of those filters. And they also have a trace mineral supplement that I leave right next to the water filter. So, that could take a couple of drops of some minerals where I have some really good sea salt I just sprinkle in. That way, I get the minerals back in too. I always tell people, like, I just– you know, people are like, “Oh. It’s gonna take away all your minerals.” I was like, “Yeah. But what I rather have less minerals and just add them back in or more toxins than I’m exposing myself to.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Because I can always just add some good minerals back in with the Trace Mineral Support that costs like five or ten bucks…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …versus gets exposed to toxins over my whole life, which [inaudible], right?

Evan Brand: Exactly. Yep, and – or using your good Redmond salt or your real salt, your Celtic salts, I mean, you can replace minerals. I agree much more easily than just saying…

Dr. Justin Marchegiani: [inaudible] toxins.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Totally.

Evan Brand: Glyphosate. I mean, parts per billion is bioactive so–

Dr. Justin Marchegiani: Yeah. So that’s why double filter, just to be on the safe side.

Evan Brand: I like that approach. So, when you move it won’t be too difficult. Those are pretty easy systems to install in, who knows

Dr. Justin Marchegiani: Yeah. I mean, typically, I think I had a plumber come in for 200 bucks. He installed both of them. [crosstalk] Pretty simple.

Evan Brand: Nice.

Dr. Justin Marchegiani: Yup, exactly. Now I have a couple studies here I want to kind of dive in. There’s one right here. It’s by the Journal Scientific Translational Medicine 2013. It’s called “Bacterial Cidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells.” Studies on mice, just so you know. It may not correlate a hundred percent but it just gives you some good kind of ideas of why were, you know, trying to only use antibiotics, for like, last case scenarios, but it says that– It’s in the abstract. We demonstrated these bacterial cidal antibiotics induce effects that lead to oxidative damage to DNA, to proteins, and to the cell membranes. Mice treated with bacterial cidal antibiotics exhibited elevated oxidative stress. Markers in the blood, oxidative tissue damage, and upregulated expression of key genes involved in antioxidant defense mechanism, which point to the potential physiological relevance of these antibiotic effects. Now, here’s the interesting thing. What they’re saying is more oxidative damage. What’s oxidation? Oxidation’s when you lose an electron, okay? What does that mean in real life? Cut an apple in half. Watch it start turning brown in front of you. That’s oxidation. Leave a nail out in the rain. It comes back rusty. That’s oxidation. So, what happens in your body, is you have oxidation at the tissue and cellular level. Now that causes more antioxidants, right, which give off an electron to help prevent that tissue from oxidizing or essentially going bad. So, it takes a lot of nutrients out of that reserve to prevent this oxidation from happening.

Evan Brand: Wow. And now– [crosstalk] I also [inaudible] something about the gene…

Dr. Justin Marchegiani: Hold that thought, one second. I want to just dog tail this with the last sentence because it’s – there’s a lot of stuff here. I don’t want to lose track. Give me one last second. [breathes] Now it says, “The deleterious effects of bactericidal antibiotics were alleviated in cell culture and of mice when they administered antioxidants of N-acetyl-L-cysteine, which prevented the preferential bacteriostatic antibiotic deleterious effects so by giving that extra antioxidants and sulfur amino acids. It actually neutralizes the negative effects that happen. Sorry about that. All yours.

Evan Brand: You’re good. Well, you mentioned the word genetic too. You said in that– in that abstract there that some genes were either turned on or turned off that helped to bring on any oxidants. So that’s crazy too. You’re actually affecting things at a genetic level with antibiotics.

Dr. Justin Marchegiani: Exactly. Any other comments on that though?

Evan Brand: Well…

Dr. Justin Marchegiani: About the nutrients kind of help into alleviate some of that.

Evan Brand: Once I wonder is that gonna turn on or reverse whatever happened to the gene as well. You think it will?

Dr. Justin Marchegiani: Well, I mean, if we’re talking about epigenetics, so I imagine, “Yeah it’s gonna have an epigenetic effect for sure.

Evan Brand: Cool.

Dr. Justin Marchegiani: Everything we do has a genetic effect. I mean, just sitting down and meditating for a few minutes will have an effect on your epigenome. The question is, do you do it enough? So, that switch kind of stays on or it’s just a temporary, you know, flicker if you will.

Evan Brand: Yup, exactly.

Dr. Justin Marchegiani: Now, one more study I want to get your take on as well. Now, this is talking about heavy metals, in particularly, Mercury. When we look at heavy metals, we’re kind of talking about Mercury, Lead, Arsenic, Cadmium and Aluminum. Those are the big ones for the most part. But in this study, they talk about– they talk about Mercury, and how it can accumulate in the Central Nervous System. It can impair physiological functions by disrupting your endocrine glands. What do you think he’s talking about there? Probably thyroid, probably adrenal, probably the HPATG-Axis. They talk about the most important mechanism by which Mercury causes toxicity appears to be Mitochondrial damage via the depletion of Glutathione, coupled with binding to thiol groups, which generate free radicals. Mercury has a high affinity to thiol, so that means you’re increasing free radicals. It’s also binding up a as an– high affinity to Selenium as well. They’re present in the amino acids. Cysteine– N-Acetylcysteine, again, we just talked about those in the last study too, so keep that in mind. Lipoic acids, proteins, enzymes, NAC, which are all precursors to Glutathione, which is among the most powerful intercellular antioxidants, right? Those have bind up and prevent the loss of electron. When you think antioxidant, think anti-electron loss, okay? Keep on going down the list here, “which among are the most powerful anti-cellular antioxidants available to redact against oxidative stress and DNA peroxidation, right? That’s the– basically, the outer– in the DNA, basically kind of uhm – coming bad if you will, right? When you have peroxidation, it’s like fats coming bad. You heat the fats up too much, you get all the peroxides, it goes bad. The consense of these methylthionines, Glutathione, Selenium and fish and high omega-3 fatty acids appear strongly related to the degree of which organic Mercury, and the protective detoxifying mechanism in human. The inclusion depletion of Glutathione, mitochondria increase lipid peroxidation and increase oxidative damage of proteins and DNA in the brain. So, let’s break that down. What did that say? It says Mercury – increased Mercury, is gonna cause more peroxidation, oxidation, right? That all just means damage. Think about that as damage. It’s gonna deplete a lot of those nutrients that help make Glutathione your master antioxidant, which include your sulfur meal acids, cysteine, glutamine, glycine, alpha lipoic acid. But it talks also about more of those nutrients, fish oil, glutathione, cysteine, Selenium, can also help, too, though. Again, you’d probably have to do it in a supplement form to get enough of a therapeutic level there.

Evan Brand: Cool. That’s awesome. I’ve got one study too to add to this pile?

Dr. Justin Marchegiani: Great.

Evan Brand: It was from American Journal Clinical Nutrition, and I’ve seen this actually on a piece of paper on Organic acid. So, I can confirm that this is accurate because I see it time and time again. Vitamin C elevates red blood cell glutathione levels and healthy adults. All it took, uhm– they had a course, placebo, and then they had 500-milligram dose, daily dose, of Vitamin C, and then they had 2000 milligram daily dose Vitamin C for four to five weeks. And that was enough to elevate glutathione levels by– let’s see. What the brains and the subjects. Some humans, they had eight percent more glutathione. Some had 84 percent more glutathione. Justin four to five weeks of supplementing with Vitamin C. And I’ve had people taking liposomal, like glutathione or reduced glutathione, they’re still depleted. Other organic acids, and then I’ll give them Vitamin C, and then the glutathione goes up better. SO, I almost don’t even push people into glutathione supplements because time and time again I see that their levels are still depleted. Like – Look, you could just supplement with Vitamin C and replenish it just as good, if not better. And it’s gonna be significantly cheaper in the long run too because Vitamin C is pennies on the dollar compared to glutathione.

Dr. Justin Marchegiani: How much Vitamin C are you getting?

Evan Brand: I usually do about 2500 milligrams, personally. [crosstalk] I do about a teaspoon a day.

Dr. Justin Marchegiani: …of three grams a day or so?

Evan Brand: Yeah. Give or take.

Dr. Justin Marchegiani: I typically only do glutathione for people that are having more chronic G– more chronic detoxification issues. And I think doing Vitamin C, which is always a good thing, because that’s always gonna help the adrenals too.

Evan Brand: Right. And it’s so cheap too. Like, liposomal glutathione. You could spend what, probably a hundred bucks a month if you wanted to on it.

Dr. Justin Marchegiani: Yeah, I mean. It’s probably a little bit cheaper than that. I know Kroshay and his liposomal – you know, you do maybe two to four– maybe four to 8 pumps a day, so probably six years. So, yeah, it’s definitely more pricy but it just depends, right, on what’s going on and how sick the person is. The average person probably will be better with Vitamin C, but again more toxicity to glutathione may be something to add with the Vitamin C.

Evan Brand: Good. Good, well said.

Dr. Justin Marchegiani: What are the things you want to add, Evan? I think we hit a lot of stuff. We put some research out. Then again, that study by me that I just talked about was the Review of Environmental Contaminants and Toxicology 2014…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …called Mercury Toxicity and Neuro Degenerative Effects. We’ll put the references to these studies in the reference section on our videos, so we’ll put it in there. You’ll see it there.

Evan Brand: Good. Yeah, I just sent you the study I was talking about too in case people want to read through. I think we hit a lot. We should probably wrap it up. I mean, we could…

Dr. Justin Marchegiani: Wrap it up.

Evan Brand: …we could go for hours on this subject, and so we’ve hit on chronic fatigue but not maybe in these much details. So, uh– wrapping up, three-body system approach. It’s gonna recover so much. Adrenals, thyroid, gut, detox functions, mitochondrial. Get all those systems evaluated if you’ve not worked with a functional medicine practitioner before, you can guess and check, sure. You can take random supplements we mentioned, but your results will be limited. Get the testing done. Even if you just get the testing done, and then you want to go on your own journey to figure out what it says afterwards, go for it. But to me, the data has changed my life. I know it changed your life. It changed thousands and thousands of our clients and patients’ lives. So, for me, I like testing. I like to see the piece of paper. I like to see the needle move. Somebody says they feel better. We looked back at organics, “Oh my God! Look. Their Krebs cycle’s actually working now.” That’s cool.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So…

Dr. Justin Marchegiani: Again, up to a hundred percent. Is there any quick questions you wanted to answer by the listeners or do you feel like we hit a lot of them just on our rhythm here?

Evan Brand: I can pull it up. You want to read a couple off. I didn’t have…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …the question list in front of me.

Dr. Justin Marchegiani: Yeah. So, couple things here. From Sam, do you recommend a water softener with a reverse osmosis under the sink or a whole house filtration for home? Again, I would do both if you can, just because of the convenience of having, you know, like– at night, before I go to bed, I’ll grab a quick glass of water upstairs even though it’s not from my reverse osmosis. Well, it’s still really, really good. But 80-90 percent of my water’s coming from my countertop units, so I don’t feel that bad. Plus, it’s nice having– not having to buy shower filters for all the showers in the house. And, if you have gas they can just kind of drink water out of their faucet upstairs. So, I like the whole house, and I like the countertop. And, you know, really, when you factor it, it ends up being like maybe 150 a year, 100 a year. And if you factor what you pay on bottles of water, I mean, you’re paying that in probably every three to four months. Easy.

Evan Brand: Yup. I would use the softener– [crosstalk] So I used to live in Las Vegas. The water there is super hard. Even with the shower filter, you could see Calcium build up. And a lot of people, you know, even my Mom, had kidney stones from the water out there. So, for her, a water softener’s a game changer. I don’t know. I don’t know if it’s all the west coast, if it’s just Nevada, Utah, other states, but man, the water’s hard out there.

Dr. Justin Marchegiani: Yeah. It would totally depend, I think, on where your area is. So, I would uhm– more than like they’re just talk to the company that you’re gonna go with, because they probably have experienced dealing with the whole country as a whole. So, don’t know what areas that you probably need the water softener. And if you know, your water is very hard, then I would invest with the water softener component. I don’t have one but, if I needed one there’s an attachment that you can put on that would soften the water as well.

Evan Brand: Perfect. Perfect.

Dr. Justin Marchegiani: Yeah. And then, regarding infections, they can cause chronic fatigue in themselves because they can create a lot of toxins that can clog up that mitochondria. So, SIBO and infections can add to chronic fatigue just from the toxins, like yeast and the acetaldehyde that comes off the yeast. That can slow down the mitochondria too and create fatigue, as well.

Evan Brand: Yeah. I was fatigued when I had two parasites. I was definitely fatigued, and now my energy’s much, much better.

Dr. Justin Marchegiani: Yeah. And there’s a lot of mechanisms, right? Because – Is it because it’s affecting digestion? Is it because it’s affecting the immune system, which is sucking up energy? Is it because of the biotoxins that are affecting the mitochondria? So, like a lot of times, like, we don’t know exactly, like how much is causing what? But we just know, generally, that this tends to cause it, and here are the kind of mechanisms outline that we know which you can plug in and interplay and have a negative effect. But we’re not gonna know exactly what percentage. But, again, in the end it doesn’t matter if you get better.

Evan Brand: Right. No, it doesn’t. Jack, he asks, “Is AA good source for Vitamin C?” I don’t know what he’s talking about? Do you Justin?

Dr. Justin Marchegiani: Uh – AA, uh- [blows air]

Evan Brand: Ascorbic acid? I’m guessing.

Dr. Justin Marchegiani: Yeah, that’s got to be what he’s talking about. I mean, again, if you do Ascorbic acid, I like to have some of the Bioflavonoids, the Rutin, the Hesperidin, those kinds of things with it. Now, I like the buffered form of ascorbic acid, as well. With like, the Ester kind of in there, and like, some of the Potassium, Vitamin C, salts in there. So, yeah. I think it’s good but get some of the bioflavonoids in there with it.

Evan Brand: Yeah. And I– If you want the optimal, if you’re listening to us, you want to be the top 1 percent of health, I like to mix Ascorbates, where you can do like the Magnesium and Calcium Ascorbates mixed with Ascorbic acid. So, you’ve got kind of like, a Tri-effect of Ascorbates. That tends to work better. Ascorbic acid is the cheapest though. So, if you’re on a budget looking to get Vitamin C, yeah, that may cut it.

Dr. Justin Marchegiani: Yeah. Yeah, I like good buffered Vitamin C as well, but yeah, I think it’s still really good. Just try to use a really good quality, a brand as well, GMO-free, all that’s great. And I think we kind of hit a lot of the other questions, I mean, a lot of people have all the questions that may be off topic. I don’t want to go too far off topic. But of course, you know, if we didn’t highlight enough diet, lifestyle, and sleep are gonna be foundational things. And if you’re not sleeping, we probably have to fix a lot of the hormone stuff. Like the Cortisol Rhythm component that will then help the sleep too.

Evan Brand: Yep, yep. You’re welcome, Jack. Thanks for asking question. If you guys have more questions, you can always email us. Contact Justin through his site, Contact me through my site, We always love questions and we love topic ideas too. So, if you guys have something that we haven’t covered that we need to, you know, we’re happy to – we’re happy to dive in. So, definitely, you could reach out to us at any time for questions and then for consults, too. Justin’s available. And you go to his site, Book a call. We both work with people around the world, so wherever you’re listening, it doesn’t matter. We can get lab test across the entire ocean, to Europe, Australia, New Zealand. It doesn’t matter. And then, the good old United States, we work with thousands of people here. So, reach out,, and make sure to hit the thumbs up button on this video if you’re watching on YouTube.

Dr. Justin Marchegiani: Yeah, if you’re live, get it right now, guys. Give us some love. We’ll come back and we’ll do more of these videos, so give me some hearts or some thumbs up and a couple of shares and likes. We appreciate it. It energizes us, and it makes us want to come back, more frequently and drop more knowledge bombs.

Evan Brand: Take care.

Dr. Justin Marchegiani: Awesome, Evan. Have it a go, man.

Evan Brand: You too.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.


Mercury Toxicity and Neuro Degenerative Effects by Justin Marchegiani on Review of Environmental Contaminants and Toxicology 2014

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