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.

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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.

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  • 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.

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Low Body Temperature! – Dr. J Live 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 – Live 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

Hashimoto’s Triggers – Autoimmune Thyroid – Live Podcast #143

Hashimoto’s Disease - Autoimmune Thyroid

Dr. Justin Marchegiani and Evan Brand talk about the different causes and triggers of Hashimoto’s disease. Find out how it is connected to one’s immune system, diet and gut health and learn why women are more susceptible to having it.

The thyroid, adrenals and gut health are important factors to consider in addressing Hashimoto’s disease. Listen to this podcast and learn about the natural solutions and beneficial supplements to support them.

In this episode, we will cover:

01:29   Hashimoto’s Disease

09:24   Socialized Medicine

13:40   Use of Secretory IGA in Measuring the Immune System

15:39   Women and Stress-sensitivity

18:24   Ketogenic Diet, Insulin Resistance and Hashimoto’s







Dr. Justin Marchegiani: And we’re back! Evan, it’s Dr. J. How are we doing, man?

Evan Brand: Pretty good. How are you doing?

Dr. Justin Marchegiani: Good. I’m loving the ambience. My new plantation shutters in the background; just loving that there. Just nice. Ready for an excellent day. Got a little lunch break here. I’m seeing patients all morning. Ready to drop some knowledge bombs, and then get back to patients in the afternoon. How are you doing, on your afternoon?

Evan Brand: Yes. Likewise, same story. I had a female client this morning, who I was telling you over air. We had run her blood work before…

Dr. Justin Marchegiani: Uhhmm–

Evan Brand: …previously. And it was basically just a checkup. I said, “Hey, why don’t we check your thyroids?” She didn’t really have hyper or hypo symptoms, and she showed up with thyroglobulin antibodies, which is one of the type of antibodies you and I test our clients for on blood. And she showed up with a level of 50. And we should see that, as minimal as possible. I mean, hopefully less than 1, but she’s had a 50. And she said, “What’s triggering this?” And, we can go into that today, but I was hoping you and I could really outline a lot of different causes and triggers of Hashimoto’s because it’s so common in our females, we see it every single week. It’s like – well, there different triggers for different people. So, hopefully, we can try to go into a couple of different arenas here, and talk about the big puzzle pieces.

Dr. Justin Marchegiani: I like that. And then people on Facebook, we also got Evan’s audio on the background, too. So, if you’re listening on Facebook, go over, jump on YouTube, justinhealth.– or and vice versa with YouTube. Get on the Facebook page so you can get this live feed. We’d like to them and do our Q&A’s too. So this is great. So, a hundred percent. Hashimoto’s the big issue, vex about 30– or thyroid issues, about 30 million people in this country, uh – I’d say, at least, hmmn– I’d say a quarter of probably undiagnosed, or at least undertreated or undersupported because they’re given synthetic thyroid medication. That’s– is T4, right? T4 in origin. And then you have these various enzymes called D2 and D3, that help convert and activate thyroid hormone. And the problem is those enzymes, if you have Hashimoto’s, there’s a good chance that D2, D3 and even D1 enzymes are not working optimally, so then that conversion of T4 to T3 – that inactive thyroid hormone to active T3, about 400 percent increase in the metabolic activity of T3 versus T4, those enzymes aren’t there for the conversion. So that’s a big issue, right? [crosstalk] And not to mention, when you take a thyroid hormone, you’re getting a T4, right? But you’re also getting T3, right? Triiodothyronine, which is your active thyroid hormone, you’re getting T2, which isn’t even tested, right? T2, uh– Diiodothyronine, is a metabolically active hormone, only measure in the research settings, and not even really talked about in conventional medicine, T1, T0, Calciton, which is very helpful for Calcium metabolism. So, again, we’re not getting that in our conventional thyroid medication. The big thing is those D2, D3 enzymes that you’re missing, that T4 to T3 conversion with. So lots of people are being medicated with thyroid hormone, right? Synthroid, Levoxyl, Levothyroxine. Though TSH comes back in the normal range, so they look good on their conventional doctors uh– thyroid test, but they still have all these thyroid symptoms, right there. The thinning hair, the outer third of the eyebrows, swelling of the hands and feet, anxiety, mood issues, constipation, depression, and they’re not getting better.

Evan Brand: So, why? What’s up with these enzymes? What’s happening to them?

Dr. Justin Marchegiani: Well, I mean, there’s the underlying physiology, typically, inflammation, right? Inflammation is what drives people into that disease, or pathological state, right? And that pathological state means more symptoms, right. All the things I just mentioned, the moods, the digestive stuff, uhhmm– the hair loss stuff, the energy, the weight gain, all those things are gonna be affected. Now, a big component we talked about it, ‘cause a lot of these issues, right, thyroid-based things are gonna be autoimmune in nature, so autoimmune means your immune system is actually attacking your thyroid gland, so you have these antibodies, like TPO or Thyroperoxidase, you have antithyroglobulin antibodies, and these are primarily with Hashimoto’s, for instance, and they come and they attack your thyroid gland. And that’s about 90 percent– let’s say 50 to 90 percent are autoimmune in nature, so you and your conventional medical doctor or your endocrinologist says, “Oh, here’s – here’s the conventional thyroid pill.” They’re not actually getting to the underlying immune– immune imbalance, right? They’re not fixing the underlying things, like gluten, right. Grains and gluten, and that molecular mimicry that happens where your immune system can be exacerbated ‘cause of Gluten. That’s the one, one really big component. Couple of others will be gut – the gut issues. So, small intestinal bacterial overgrowth, gut bacterial imbalances, infections, H.pylori, Blastocystis hominis, uh– Lyme or Borrelia burgdorferi, uhm – Yersinia enterocolitica. So those are just a lot of gut infections that can significantly affect your GI. And again, that sulphatase enzyme in the gut made by healthy bacteria, really helps to activate, that thyroid hormone really helps to upregulate those D2, D3 enzymes to get your T4 to T3. So, all that technical jargon, what the heck does it mean? We’re trying to get your– your active thyroid hormone up higher; that’s the goal. Your T3 levels, get them up higher because, just doing it on the conventional side, and say, “Hey, let’s give you uh– a synthetic thyroid hormone.” That may not be enough to actually get the end stage thyroid hormones better. It may make the upstage TSH look better but not the downstream T4 and T3.

Evan Brand: Conventional, like the National Institute of Health, though, say that the Hashimoto’s affects one to two percent of people in the United States. Do you agree? One to two percent or do you think it’s much greater?

Dr. Justin Marchegiani: So you’re saying– repeat that question, one more time for me.

Evan Brand: National Institute of Health– is it – do you heard– are you hearing echoes? Is that messing you up?

Dr. Justin Marchegiani: No. No problem. I just got a comment here. Someone’s saying they’re not hearing the audio on the YouTube site. [crosstalk] You guys are hearing the audio, give me a thumbs-up here, but I think we’re looking good.

Evan Brand: Okay. So, National Institute of Health, they say, “Hashimoto’s affects one to two percent of people in the United States.” I think it’s much, much higher. Izabella Wentz, I think she gave a number that was much, much higher too. What’s your take on this percentage here?

Dr. Justin Marchegiani: Yeah, I think it could be much higher, for sure. I think it could be much higher, and the big issue is that most doctors they aren’t testing for thyroid antibodies. That’s the major issue. Uh– we talked about a patient this morning over in Canada, whose doctors aren’t uhm– they aren’t even testing for thyroid antibodies. And the big reason why is because, think about it, right? If the solution is a synthetic thyroid hormone, like Levoxyl, or Synthroid, or Levothyroid, right, if that’s the ultimate end game, and that doesn’t change whether there’s autoimmunity or gluten issues, or infections, then it stays the same. Why change that, right? Why change that variable up because they’re not gonna do anything different if something else comes back, right? Does that makes sense?

Evan Brand:  Yes, it does.

Dr. Justin Marchegiani:  Even though 90 percent are autoimmune in nature, right? Even though 90 percent of thyroid issue’s autoimmune, they’re not gonna do anything different anyway, so why even look for it? Because then, it just creates more questions the doctors have to answer, and they don’t like to answer questions they’re not prepared to uhm– to answer. Most people…

Evan Brand: And they’re not trained, because if antibodies do come back, they’ve got nothing. They’ve got no way to talk about Klebsiella and Citrobacter bacteria that need to be treated. Uh– yeah, and so uh – just to give a little bit more back story on the Canada, so– you know, Justin and I both have clients in Canada.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And they’ll say, “Hey, we’ve got health insurance over here. It’s free.” But there’s a catch to that. It’s not that good. All they’re gonna do is they’re gonna run, like, a one-marker, like maybe TSH, and then based on that they may give you a prescription drug. But if you don’t have your free T3, the reverse T3, the TPO, the TG antibodies we talked about, may not always using Algin, maybe you tell me there’s a better analogy, but mine is: if you just have TSH and you’re trying to treat thyroid, it’s like touching the sidewalk and estimating the forecast.

Dr. Justin Marchegiani: Yeah. That analogy sounds really, really familiar. I don’t know why.

Evan Brand: There’s no way you came up with that. I’m pretty sure…

Dr. Justin Marchegiani: I came up – I came up with that one. That’s been around for, like, six or seven years, ‘cause that’s how I teach my patients about TSH– TSH. The receptor sites in the pituitary are hypersensitive. The thyroid hormone, therefore, uhm – TSH will drop– will drop more precipitously because the brain is sensing thyroid hormone being a lot higher then what it is. So, peripherally, the thyroid hormones never get high enough and the periphery in the actual tissues but it’s– it’s high enough in the brain ‘cause the brain’s more sensitive to thyroid hormones. So, TSH will always drop faster than what the peripheral tissues need uh– in the periphery there for thyroid hormone. That’s why you don’t want to base your dosing or your support of the TSH 100 percent, ‘cause the TSH is so sensitive. Touch the sidewalk outside when it’s a hundred degrees out, it’s gonna be able to fry an egg on it, right. But again, the air temperature will always be a lot cooler. The peripheral tissues will always be less saturated with thyroid hormone uh– than the latter. Make sense?

Evan Brand: I’ll give it– I’ll give you a credit. It must have rubbed off of me then, if you had that one before. [laughs]

Dr. Justin Marchegiani: It did. I do– that’s mine. That’s uh– that’s a Dr. J-ism. But I’m– getting back on your thing, man, yeah. Socialized medicine for the most parts thinks– Okay, I’ve seen patients from all over the world. All over the world, Europe, Canada– Socialized Medicine’s great if you only need it for acute traumatic issues, right? You sprain your ankle, right? You have to go to the ER, ‘cause of some reason. But outside of that, if you getting stuck on that chronic conventional model, all you have for options are conventional drugs, right? And then number two the waits are like, three to six months to get in. Again, this is what happens. I have hundreds of patients where I’ve had this story, literally had this story they literally told me over and over again. And then because everything is socialized, the government says we’re not gonna reimburse. Reimburse then guess what happens. There’s not a market place for it, right? There’s less people going underground. Now, I do have people over in Canada that are functional medicine doctors and they’re doing– they’re thriving even in a socio uh– even in a uhm– sociological medicine society there, right? Even with a socialized medicine society because, people aren’t getting better even though the medicine’s free they’re still going in paying a lot of functional medicine doctors. And again, we start today. Why am I hampering on this is because, that doctor wasn’t running TPO or any of the thyroid antibodies. So, the socialized medicine said, “Nope. We are not gonna test your thyroid antibodies. We deemed that not appropriate, and this person needs to know they have Hashimoto’s so they can make changes with their immune system, with their gluten, with the gut, with a lot of the converting nutrients to help T$ and T3.

Evan Brand: So let’s– let’s go through a list. I know, we could kind of jump around but, maybe we could do like a top five [crosstalk] or maybe even like a top ten.

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

Evan Brand: So, number one– in no particular order, but number one, you already mentioned gluten. So, this would include any grains, right? ‘Cause even like our Amaranths, our Buckwheat, our Kiwa. That Kiwa could still be cross-reactive and trigger the antibodies, right?

Dr. Justin Marchegiani: Correct. I would still stay away from all grains. Grains probably being number one trigger becau– partly because of the amino acid sequence in the grains, I very similar to the surface proteins of the thyroid. That’s number one. So [inaudible]…

Evan Brand: What about now? Are you seeing issues with him?

Dr. Justin Marchegiani: Well, I mean, that’s a cross-reactive thing so, if gluten is like, you know – if gluten is like the brother and sister, you know, Hamp’s kind of like, maybe the cousin, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: The second cousin once removed, so to speak. S, again uhm– it may be something that needs to be pulled out with someone on an autoimmune kind of elimination provocation diet for at least a month or two. So, the grains component’s really important. Got to get that out. But not just the molecular mimicry thing. There’s uh– some research looking at Non-Celiac Gluten sensitivity, where they talked about gluten. Even in people that aren’t really Celiac or aren’t even a gluten, like, sensitive person, so to speak. Where just taking that gluten in, they still get gastrointestinal permeability. The guts gets a little bit leaky even with uhm – the fact that they aren’t really gluten-sensitive, so to speak. They aren’t gluten-sensitive but that’s the gut permeability that’s driven by the gluten. And prior, what’s happening is, we’re getting this protein called Zonulin increased. And Zonulin basically unzips, so it’s like an unbuttoning my shirt. That’s Zonulin, right? Unbuttoned zip, right? Opens that gut lining up, and then all these digestive proteins you get right through there.

Evan Brand: So, Zonulin goes up in the presence of grains. We had a question in the live chat about Brown rice. Absolutely, Brown rice would still be in a category of grains that you would want to remove.

Dr. Justin Marchegiani: Yeah.

Evan Brand: If you want to avoid Hashimoto’s. I tried to justify with you for a long time, “Oh, I love my white rice.” You know like, man, it’s just not worth it. And now uh– saw this stew– sweet potato now, and…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …my skin. My skin’s actually gotten better, too. You know, Even though I’ve pulled out – I’ve pulled out the rice.

Dr. Justin Marchegiani: Yeah, man. You go back to your old uh– YouTube videos, you had some– some stuff going on there, [crosstalk] and you like’s porcelain skin.

Evan Brand: I tried gut bugs, too.

Dr. Justin Marchegiani: Yeah. Use some gut bugs, man. You’re almost up to a runway model status, Evan.

Evan Brand: I don’t know about that but I appreciate it.

Dr. Justin Marchegiani: You’re getting there. Good.

Evan Brand: Oh, so gluten, [crosstalk] so gluten grain…

Dr. Justin Marchegiani: Gluten and the Zonulin – gluten, the Zonulin stuff and then also other grains still may have some gut irritating compounds, right? The Lectins, some of the Phytates, some of the Oxalates, some of those things, which can be irritating on the gut. So, really, it comes down to like, getting the immune system in the molecular mimicry going. But then it also has some impact on the Zonulin and the leaky gut.

Evan Brand: Okay, so you already said the immune system. Let’s hit on that piece. Let’s make that like our number two or number three. Uhm – we can measure the immune system with the secretory IGA on the Stool Test that we’re running on people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Uhm – can we go on that number and just use secretory IGA as our immune system, kind of our first line of defense?

Dr. Justin Marchegiani: Yeah.

Evan Brand: And if we see IGA’s low, can we say, “Okay, you’re more susceptible or…”

Dr. Justin Marchegiani: A hundred percent.

Evan Brand: …this will trigger?

Dr. Justin Marchegiani: Yeah. We’ll see low IGA levels. IGA is that mucosal membrane barrier. It’s that first line of defense that lines the gastrointestinal tract, all your mucus membranes, your mouth, you know, our anal cavities, flatulent tract, urinary canal, everything. Every little surface there, even your eyes have IGA in the surface there. Your first line of immune defense. So, when that gets weakened, typically, it will go up and there’s an acute infection. You’ll see it there. We run Stool Test while measuring the stool, and then we’ll actually see it drop down for Chronic Stress. So IGA’s really important, ‘cause that’s a good measurement that your immune system is under stress.

Evan Brand: Right. So, a lot of times, more often than not, you and I are gonna see chronically low IGA, indicating that someone’s been dealing with these issues for a long time. So, Chronic Stress, overwork, maybe they’re not sleeping as well as…

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maybe they have gut infections that are damaging that IGA because people may say, “Well, if I’ve got Hashimoto’s, how did I get a low immune system in the first place?” Well, chicken or egg, all of it– I mean, you could have had adrenal stress, which then weaken the gut. Then you picked up gut bugs, or vice versa.

Dr. Justin Marchegiani: Yeah, absolutely.

Evan Brand: Okay, what’s– what’s next?

Dr. Justin Marchegiani: Yeah, typically it’s a combination of emotional stress that tends to set people up. That tends to be it. So, there’s, you know, you choose with whatever’s happening with your life: work stress, financial stress, family stress, kid’s stress. Whatever’s happening there, that tends to set things up, and that will weaken the immune system.

Evan Brand: I had a female client did uh– that I talked with earlier. She’s a teacher, so she’s on summer break, right now. She’s feeling much, much better. But when she’s back in school, she’s done. She wants to get out of the field of teaching. Everything kind of gets worst, symptom-wise.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So that’s a good example of work stress…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …right there.

Dr. Justin Marchegiani: Yeah, absolutely. And then, women are a little bit more prone to it, because there’s actually a research on this, where their immune system can go out of balance. Like, one emotional, like, you have an emotional argument with the woman, their IO6, their Intergluten-6 can go out of balance for up to two days after a fight. For some of the men, they can go out of balance for like a few hours, but then it’s back in. So I always– this is part of the mechanism why women are more prone to autoimmune conditions. Their immune system probably just a little bit more, I should say, a little more sensitive. And there’s also the Estrogen issue, right, because, Estrogen can affect the CD4 to CD8 balance. And they can skew that balance. So, the more women are Estrogen dominant. That can throw off their immune system. Their CD8, CD4, their natural killer cell, to help her cell ratio. CDH’s your natural killer. Your CD4’s your helper cell. And they could skew that ratio uh – up.

Evan Brand: So, I’m guessing the– like the ancestral view of why woman’s immune system would be more sensitive. Would you say just because of uh– uh– having children, where the immune’s got to be able to modulate itself not to attack and kill the fetus, for example. So, their immune system’s a little bit more variable than a man. Or what do you think is the ancestral lenses?

Dr. Justin Marchegiani: Yeah. I think, it probably has to do with uhm– I think it probably has to do with just raising children in that extra level of empathy, being able to take on other people’s feelings, and kind of be able to uuuh– what’s your need, right? You got, like, you know, you’re raising a child. You have to be to really sense what’s going on. I think that may play into it. I’ve zero evidence outside. That’s just my opinion; just observation. But there’s research and studies on that. Also, blood sugar can throw people’s immune system off to. So like skipping meals, and not giving enough nutrition, and just going long periods of time. So, that’s a big thing, right. That’s a big thing, so, I just, you know, I tell people just make sure you get your communication and your relationships kind of dialed-in. If you’re having issues with the spouse, get the communication down. Try to get, like, try to create a really good environment, where you can communicate, and you’re not gonna get flooded and drive people’s immune systems off.

Evan Brand: Right.

Dr. Justin Marchegiani: You know, that’s kind of, that’s number one. Number two, so let’s get meals, right. Now, when you’re healthier, you can play around with intermittent fasting, okay. That’s a good tool, but you got to get it dialed-in with your hormones good first, and you feeling good first. I may get that dialed-in later on.

Evan Brand: Oh, how about Ketosis too. Like, I tried it with Dr. Mercola, and he’s like– he’s like concerned that a lot of people are going into a ketogenic diet but they’re doing it for too long. So, he’s kind of a proponent of, like, five days on and then two days off. Or hold his go and eat potatoes, and things like that. And really kind of carb-griefy. So, how much of this thyroid epidemic, Hashimoto’s even kid of in the Health Space where you and I are working. These women come into us. They have triggered Hashimoto’s, do you think Ketogenic diet could be a trigger, potentially?

Dr. Justin Marchegiani: Well, I think, Ketogenic diet has actually helped a lot of people with Hashimoto’s, especially ones that are insulin-resistant, because insulin-resistance can actually block thyroid conversion. So, that’s my issue– is if your insulin-resistant, you may do really well with the Ketogenic diet for a while, but then you may hit the wall.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, then the question. When you hit the wall, that’s where you may start gradually increasing your carbs up. Maybe 10 grams a week, and maybe do a couple of low carb days, like Keto days, and then come out for one or two days in the higher carb side. But, I think, if you’re coming into this, being overweight, with uh– hips circum– you know, waist circumference greater than 35 for a female, 40 for a male. There’s probably some level of insulin-resistance that a Ketogenic diet will help reverse. But then you may have to refine or retune your carbohydrate thresholds afterwards.

Evan Brand: Okay, and that will always be based on adrenal health, and that would be based on, maybe, Vitamin D status or gut infections, depressants, of those. There’s always more, more things, so when people find, “Oh! Ketogenic diet,” It’s like there’s so many different variables out there and these other pieces of the puzzle.

Dr. Justin Marchegiani: Yeah, yeah. I mean, Atkins was sniffing around the right area when he started talking about Ketogenic diets in the 70’s. the problem with Atkins is, he didn’t put enough qualifiers on it. I mean, okay, great. So I eat a whole bunch of meat now, is that gonna be hormone antibiotic, free, you know, laden meat, or is it gonna be organic grass-fed. Oh, Atkins says soy protein’s okay. Eeh! Aspartame’s splendid, okay. Eeh! Right, not good. So, protein quality’s really important. So, if you’re gonna do protein powders, you know, Collagen peptides, you know, P protein, like maybe– maybe some really good grass-fed wheat protein, right. Choose really good protein sources if it’s powder. Or choose really healthy meat souces, or really fat sources. Lots of toxins are stored in the fat, so if you’re eating diseased animals, you’re not gonna get high quality of uh– of a meat product passed down to you from a nutrient perspective.

Evan Brand: Yep, well said. Okay, so we hit the secretory IGA, we hit the Zonulin, we hit the gluten.

Dr. Justin Marchegiani: Also, we talked about thyroid nodules too, right. Someone on uhm– Facebook here, had commented here. So, thyroid nodules are just like these little abnormal tissue spots in the thyroid, but typically gonna be driven by autoimmunity, right. So, Hashimoto’s gonna be the major thing. Hashimoto’s, typically, is an autoimmunity that is involving TPO antibodies, and antithyroglobulin antibodies. Now, again, all autoimmunity, for the most part, will end in low thyroid. The difference is grave disease has a couple of antibodies that can jack up thyroid functioning. Keep it up to the point where you may stroke or you may have an issue if left untreated. So, we that with TSI or Thyroid Stimulating Immunoglobulin and also TSH Receptor antibodies, so, which you want to make sure under control. Why? It helped saved many thyroid uhm – from going into uh – graves or a thyroid storm state by using specific nutrients to help it. and also…

Evan Brand: What happened with uh– with thyroid nodules? Let’s say, someone…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …has antibodies at that point. Maybe we suggest they go get a thyroid ultrasound. They say– Okay, hey. Can you palpate? Like, would you suggest an ultrasound, or can you palpate and figure out whether you have nodules?

Dr. Justin Marchegiani: Oh, great. Let’s go into that. So, try to palpate the thyroid is – Find the Adam’s apple, so like, mine’s right here.

Evan Brand: Get a little closer to the mic, so people can hear good.

Dr. Justin Marchegiani: Yeah. This is your Adam’s apple right here. Right. So, I feel here. I go down, about one centimeter, and then out a centimeter. And, you know, I would do it by standing behind myself, who I can step out of my body. About be here. I touched each side and I press it into the other. And I would have myself swallow water. And I would feel, just for any irregularities in the surface. It will be almost impossible to do it to yourself just as I demonstrated with the angle. But you would stand from behind someone, and you have just nice flat palms, and you just go through the surface, and you touched, you pushed, and you want to feel it come out in the other side. And basically, you want to just feel a smooth surface, and you want to not feel it as an inflamed puffy. You have to feel a couple normal ones to know but, that will give you a pretty good idea.

Evan Brand: The ultrasound sounds easier though. I mean, let’s just say, that you come back with nodules, what happens? Do you just – do you just play the waiting game? You just watch him or how do you approach it?

Dr. Justin Marchegiani: Yeah, I mean, it depends where you’re at, right? There’s always that increase chance of potential thyroid cancer, right. So, it’s good to get that screened, ‘cause of the increased risk. But it’s not the first thing I worry about. Because if you just do all the things that we tell you, I can’t tell you how many patients whose nodules have just significantly reduced. Significantly reduced.

Evan Brand: Yep.

Dr. Justin Marchegiani: Though, I’ve seen that happen so many times, so, hey, you know, just run it by your endo. See what they say. And then just let them know that you’re gonna do some things on the functional medicine side. And, come back and monitor it. you just want to make sure it’s moving in the right direction. Now, some nodules can be caused by low Iodine, too. Again, w tend to get enough Iodine, a couple hundred MIC’s really odd. You need like 200 MIC’s is like they already– hey, you may need a little bit more, but you got to be careful with supplementing Iodine because the Iodination process that happens, so– Iodination is nothing more than the Iodine bonding to the Thyroxine molecules to make your thyroid hormone, right? Like T4 is your Thyroxine, your 4 molecules, your Thyroxine bound to four molecules of Iodine. That process of binding it and pulling out the sticking glue getting stuck there. That’s called Iodination. That process spits of a lot of Hydrogen peroxide which can be inflammatory. And that can drive a lot of B cell infiltration. Your immune cells into your thyroid and exacerbate that autoimmune attack. So you got to be careful off the bat when giving any Iodine. So I always like to get in the Selenium in there first, get the diet dialed-in, get the lifestyle stuffed-out then, and then really lower the information first before I go after it. And if we go after it, we’ll titrate that slowly. We won’t go at it hard. There’s a lot of docs out there that go really high in the Iodine I don’t recommend going high of the bat. I think it’s better off going slower, and work on the foundational stuff first.

Evan Brand: Yeah. Love it. Uh – I was gonna ask you a question about Iodine. I forgot what it was. Tsk. Darn. I lost my point. Alright. Let’s keep moving on. What else comes to mind for triggers.

Dr. Justin Marchegiani: Yeah. So we talked about the food stuff. We talked about blood sugar, we talked about emotional stress. That’s still a big one, okay. Because, emotional stress taps in to your sympathetic nervous system and your sympathetic nervous system wires right down to the adrenals. And that’s umping out Cortisol. Pumping out Adrenaline. And your body will always sacrifice sex hormones for stress hormones. It’s just the hardwired adaptation. Right? If you don’t survive today, you’re not gonna have to worry about reproducing tomorrow, right?

Evan Brand: Yep.

Dr. Justin Marchegiani: So, gut component– the gut component’s very important. We talked about gut bacteria, and how the healthy bacteria’s really helpful with the Sulphatase. Also, that’s where we absorb nutrients, right/ that’s where we absorb a lot of our B Vitamins, a lot of our minerals, a lot of our amino acids, right. Thyroxines and amino acids, that’s part of making thyroid hormone. Also, 70 to 80 percent of your immune system is located in your gut, right? So, you want to jack up your immune system, you know, just get your gut in bad shape by not digesting food, putting a lot of inflammatory things in there. [crosstalk] And uh – throwing off your gut bacteria and uh – whole bunch of steroids from the foods, antibiotics from the foods, anantibiotics in your uh – medicines for maybe, reasons that, maybe be unwanted, so to speak.

Evan Brand: Right. Yeah, the gut’s huge. I mean…

Dr. Justin Marchegiani: Yeah.

Evan Brand: I don’t really like the term SIBO because it’s so generic, but you and I, we see so many different species of bacteria. We can assume that most of them are going to be growing up from the colon to the small intestine.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So if you’ve never been diagnosed to SIBO, or any type of bacterial overgrowth, like specifically, Justin and I are gonna  be looking for, like, a Citrobacter or Klebsiella, or there’s two species of Proteus. Those are all autoimmune trigger bacteria. That’s in the literature too. So, if you’ve got bacterial overgrowth, bacterial infections, parasites, Yeast, or like we see many times a combination. So it could be a Citrobacter, plus Blastocystis hominis, a parasite, plus Candida. That’s uh – that a – that’s a triple whammy there.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That could definitely cause the antibodies to go up. The good thing is this is reversible, right. Now, would you say– I know for us, you know, we’re not medical doctors so we can’t use the term uh– cure. Uh– but is it possible for a cure for Hashimoto’s or when you get your antibodies down, let’s say, you were at a 50 on your TG antibodies, and we do all the good work with you. We get the antibodies back down, let’s say, below a five. Are you cured or can you always just rebound quicker than the average person back up to that bad state of Hashimoto’s again?

Dr. Justin Marchegiani: Yeah. I mean, you can always ramp back up, but it’s all about adaptation, right? The healthier you are, the greater ability you have  to adapt to stress. So, when you have the susceptibility for a certain disease. So, someone posted on Facebook, I have anti-NaN antibodies, that’s kind of a very broad sense, but your predisposed to certain conditions, certain diseases. Maybe Rheumatoid arthritis, maybe Lupus, maybe Scleroderma, maybe CREST, right. So a lot of autoimmune conditions you may now predispose for. But that just means you have the genetic triggers, those genetic switches, are kind of right in the middle, and if those stressors flick it down, right, that stress could flip that gene on and they could activate. So we managed all the things that we talked about, right? Blood sugar, nutrient density, stress, grains, gut health, uhm – being infection-free, ideally, healthy probiotics, healthy gut bacteria, and then making sure that if there’s thyroid damage already, we support that, making sure we support thyroid activation, right. Zinc, Magnesium, CoQ10, Selenium, maybe the right Iodine, use your functional doctors resource, making all those nutrients and things are dialed-in. That’s gonna significantly help improve your resiliency, so if you do have a disease, you may be able to– your body may be able to keep it in check enough, were the symptoms aren’t even visible. But some they say you’re cured, but legally we can’t say you’re cured.

Evan Brand: Right, exactly. What about the liver? What’s the role of the liver?

Dr. Justin Marchegiani: Yeah. Yeah. So the liver’s really important ‘cause a lot of those deionized enzymes. They come from the liver, right. So, the liver’s really stressed and taxed dealing with the whole bunch of fructose coming in there, ‘cause your Insulin-resistant or toxins, and round-up and pesticides, and a whole bunch of junk. It may not be able to do its job, activating and converting thyroid hormones, so we want to make sure, number one, that we are uhm – keeping the stress off it. ‘Cause a lot of liver stuff is more about to stop adding crap to the system, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: And then number two, I know, Izabella Wentz talks about it in her book, the Hashimoto Protocol. She starts a lot of her patients on a liver cleanse that first month, which can be helpful. So, Liver Support Phase 1, Phase 2, detox support. In my line, it’s uh– Phase 1 is either uhm– Antioxidant Supreme or Liver Supreme, and then Phase 2 is gonna be Detox Aminos. That supports all the Phase 1 and Phase 2 pathways that run your liver. The fat-soluble, the water-soluble, and the water-soluble to excretion in Phase 2. That’s really important.

Evan Brand: So, list of some ingredients. So this is like your Methionines, your Taurines, your milk fissles, [crosstalk] your Vitamins A, you Beet powder, your Artichoke extract.

Dr. Justin Marchegiani: Artichoke, yeah. And then your Phase 2 is gonna be  more of your amino acids. That’s like an acetylation, methylation, uh– glutathione conjugation. All that stuff. So cysteine, glutamine, glycine, uh – taurine’s in there, methionine, uh– We throw Calcium-D-Glucarate in there. Those are really good compounds.

Evan Brand: Cool, cool. Uhm–

Dr. Justin Marchegiani: So I think we hit some good triggers. We talked about some things to help about things to help with thyroid conversion too. We talked about the liver, we talked about the infections and the leaky gut, and then yeah. The whole thing about gluten– oh by the way.– uh– I’ll tell you off the air.

Evan Brand: Alright. Alright.

Dr. Justin Marchegiani: But I’m–

Evan Brand: Hey. Let me tell you something that– before you – I want to –  I want to mention two things. I believe we hit it already, but the adrenal piece, uh– with Cortisol stress, with adrenal problems. You can also pack the conversion of T4 to T3 hormone there. So you got to get your adrenals checklist.

Dr. Justin Marchegiani: Yes. Oh yeah. We got to hit that, man.

Evan Brand: Yeah. So…

Dr. Justin Marchegiani: Yeah.

Evan Brand: So, if you’re working on your thyroid, but you’re not working on your gut, and your adrenals, your results are likely going to not be very good, because adrenal stress is gonna reduce the conversion rate. And then, you can go back to it. But let me say one other thing. I had a client this morning. She was trying to justify uh– eating gluten, and grains, and crackers and stuf like that, because of her food-sensitivity test.

Dr. Justin Marchegiani: Exactly where I was going, man. You’ve read my mind.

Evan Brand: Alright. Her food-sensitivity test said, “I’m not sensitive to gluten.”

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so, she’s still doing gluten. I said, throw your food-sensitivity test away.

Dr. Justin Marchegiani: yeah. I mean the big issue, right. Some of the non-celiac gluten sensitivity research. People that weren’t even gluten-sensitive, they have increased gut permeability.

Evan Brand: Say that again. Just to make sure that it’s like super clear for people.

Dr. Justin Marchegiani: Yeah. People that weren’t gluten-sensitive, right, they weren’t like celiac, they weren’t like having any gluten issues, based on conventional standards, when they got exposed to gluten, they noticed some level of leaky gut, some level of permeability in the gut. Based on the study’s objective criteria diagnosis for it. So that means, more leaky gut, means more immunogenic compounds, undigested foods, LPS, Casein, right – all these things. Dysbiotic bacteria may get into that bloodstream, may start to cause some immune system kind of pissed off, right? Then it may go out looking for that thyroid tissue, or maybe even uhm– the pancreas, or other tissues, or other autoimmune tissues.

Evan Brand: Or even if it doesn’t go straight to that, the gluten could still cause a leaky gut situation, which then sets you up. So, when you go to Sushi Night, you could go pick up Blasto, or some other parasite, which then causes even more damage…

Dr. Justin Marchegiani: Yeah

Evan Brand: …which then leads to the antibodies. SO, one way or another, you’re setting yourself up. There’s really just no justification for gluten in the diet.

Dr. Justin Marchegiani: Yeah, exactly. I won’t give any press to the book. It’s out there right now. We’ve talked about it before.

Evan Brand: [inaudible]

Dr. Justin Marchegiani: Yeah. People say, “Oh. Gluten this and that, maybe okay.” Not necessarily okay. I don’t think it’s uhm– something that people should be consuming. Some people may be able to handle it. Again, if you’re gonna consume gluten, you better off doing it and uhm– sourdough form, if you’re gonna do it. Or, you know, if  you are healthier, right, and you’re on the right track. Every now and then you wanna do a little bit of white rice, as a treat. As long as you’re doing good, as long as you’re on point, right, then I think that’s okay.

Evan Brand: Yep. Yeah, for sure. Alright now, uhm– there was something else. I interrupted you. I hit the Adrenal piece, and I had to talk about the food-sensitivity testing and the lady trying to justify gluten.

Dr. Justin Marchegiani: Yeah, that was it. I think we hit it, and I think just the– the adrenal imbalance, whether high Cortisol or low. So, Chronic stress, low cortisol, with the reverse Cortisol rhythm, or acute stress, really high Cortisol, both can affect your thyroid conversion and activation.

Evan Brand: Yep, yep. Got it. So, I mean, yes. You can take adaptogenic herbs. We love, we promote those, but that’s still not addressing the root cause. So if you hate your job, we can give you all the Ashwagandha, Rhodiola, uh– Siberian Ginseng in the world, and we’re gonna help you adapt to the stress, but you still got to remove the stress. It’s like I know you see the analogy of the engine life, putting the tape over the uh – the check engine light in the car. I like the analogy of like a doorbell too. Like if you keep pushing the doorbell. Uh– your still gonna have issues. You can try to like disable a doorbell, but it’s still being pressed. Like, you hate your job, or you’ve got a turbo relationship. I had a woman, who she told me. She said straight up, “Evan, until I divorce my husband, I will not get better.” And I said, “Well, I fully support you in that decision.” And now, she’s going through the divorce. She’s already starting to lose weight, just based on the reduction of the emotional stress. So I think that’s just amazing, and unfortunately, that happens. But, if you wanna be healthy, you got to make some tough decisions, sometimes.

Dr. Justin Marchegiani: I agree. I appreciate you’d actually given me credit for that analogy. I thought you were gonna pawn that one off of yourself.

Evan Brand: [laughs] No, definitely not.

Dr. Justin Marchegiani: Good, ‘cause I wasn’t gonna give you, like, two Paleo demerits for that, but I’ll hold those back.

Evan Brand: Appreciate it. 

Dr. Justin Marchegiani: Good. You got a credit in a bank of Dr. J here. Excellent. So, I think we hit everything: the Cortisol stuff, we hit the gut stuff. Someone over here, I’ll try him in. So, someone talked about this is functional medicine on demand, can Candida hang around in the thyroid? Candida can create things known as acetaldehyde. Acetaldehyde can be inflammatory, right. Like, it’s one of the products of alcohol. So that can be inflammatory and really affect things. Candida can also get the immune system wrap up. Uhm –  Candida or acetaldehyde in the gut can convert in the Salsolinol. Salsolinol’s known to increase uhm– antibodies to uhm– receptors for dopamine in the substantia nigra midbrain. So, that can create other issues with autoimmunity, so yeah. Candida is not a good thing either. And that’s, you know, that’s according to conventional medicine, not really to exist at all. But we see it all the time.

Evan Brand: Oh, yeah. I mean, Honestly, and I think I may have mentioned this. I told you this or I told people on the air already, uh– sorry if I’ve repeated myself. I’m sure we do that all the time.

Dr. Justin Marchegiani: Yeah.

Evan Brand: But, when I first started learning about Candida and yeast, I thought, “Oh, candida, Yeast.” You know, I kind of put it on like the bottom of the totem pole, below bacteria and below parasites, in terms of the effect on the body. But I’ve seen all kinds of crazy stuff with Candida alone, where it’s like, whether it’s brain fog, depression, fatigue, cravings, I mean, something that sounds so benign. “Oh, Candida,” “I’m gonna do a Candida Cleanse.” It’s like, a lot of people promote it, kind of like– almost like it doesn’t exist, or almost like, it’s a trendy topic, and you can just do some type of, like, “Candida Cleanse smoothie”, “go buy my online candida program and you’re gonna get better”. It doesn’t work that way. But, candida can affect almost everybody’s system, whether it’s adrenals, whether it’s gut, whether it’s Lewd…

Dr. Justin Marchegiani: Totally.

Evan Brand: …depression, anxiety, etc., It can all stem just from a Yeast overgrowth. And I would say, you tell me if your stats are different on your side of clients, but for me, I’ve seen about, nine out of every ten people, shows up with Yeast.

Dr. Justin Marchegiani: Yeah, and the big issue with Candida and Yeast is that, some people have it but, it’s just the tip of the Iceberg. The other infections that may trumpet, so to speak in the hierarchy. So, Candida may be an issue in some people, it can be a main issue. Right? Like, we’ll run a Stool Test, and we’ll see it like, “Oh. We have some Candida there.” And then we’ll look at another test. Nothing else comes back. And then on uh– Organic Acids. We’ll see the Arabinose, or the Arabinitol, really high, so we’ll, “Okay. This really maybe a Candida issue.” And then we’d see some clinical symptoms, like uhm– Seborrheic dermatitis or Cradle cap, or just you know, dandruff. You may see some yellow-discolored fingernails, maybe some white coating in the mouth, maybe some tinea versicolor rash. Right? We may see some of those things that may say, “Hey. This may be a primary Candida issue and we hit it hard.”

Evan Brand: You said that a bit quick. The tinea– what’s that? Yeah. It’s like little blotches on the skin.

Dr. Justin Marchegiani: Okay. They just look like little blotches, and it’s uhm– it’s pretty smooth to the skin. It’s not really itchy. It doesn’t really spread but you want to kind of gross yourself out. Just put it in the Google images, and you’ll see the umpteenth degree of it. But it’s just gentle blotches on the skin. They tend to be a little [inaudible]and scarred.

Evan Brand: I know sometimes people may think it’s that but it could be like Keratosis pilaris instead.

Dr. Justin Marchegiani: Keratosis pilaris tends to be a little bit more flaky, and uhm– that tends to hit the back of the arms. [inaudible]…

Evan Brand: Yeah. Such like on your triceps he’s pointing to.

Dr. Justin Marchegiani: …like little back here. Right? That tends to be essential fatty acid stuff. So again, if you’re having issues digesting fats, someone in our live chat, so they don’t break down fat well. Hope you get the gut work done, ‘cause that’s a big, big component. ’Cause if you’re not breaking down fat well, you’re probably not breaking down protein well, either.

Evan Brand: So that would mean, if you’re spinning your heart and money on a good quality fish oil, then you could be potentially wasting your money even if it’s triglyceride form, if digestion’s compromised.

Dr. Justin Marchegiani: Yeah. I mean, most underrated supplements out there, if you were to start on two things: enzymes and HCl. That’s it. Enzymes and HCl get the diet. [clears throat] Excuse me; frog at me. Get the diet a hundred percent dialed-in so, you can actually break down that food. Put the money on the food quality. Get the food quality up.

Evan Brand: Yep. I had a lady tell me, she’s like, “I feel so much better by doing Apple cider vinegar. I don’t notice taking enzymes and HCl.” And I was like, “Okay. You can try it. But I– I’ve still think HCl and enzymes do better than just …

Dr. Justin Marchegiani: Oh.

Evan Brand: …apple cider vinegar but– so…

Dr. Justin Marchegiani: Yeah. Apple cider vinegar’s a great starting point if someone’s like, “Ooh. I don’t know. I’d had some bad reactions to HCl.” Okay. Great let’s just start with the teaspoon of apple cider, but, we’re gonna go with food in your belly first. And then they’ll do good, alright, let’s go to a tablespoon. [crosstalk] Okay, let’s go to–

Evan Brand: You know what I’d do? I make a little tonic. I’ll do like uh– apple cider vinegar. I recently got uh–

Dr. Justin Marchegiani: Yeah.

Evan Brand: …a lime, or like a citrus, squeezer. So, I’ll do like uh– a lime or lemon and uh– apple cider vinegar in there. And then, sometimes, I’ll add like some Vitamin C, or I’ll add that adrenal tincture I told you about. I’ll add that tincture to it. And it’s like a great little tonic.

Dr. Justin Marchegiani: Yeah. I think that’s great, and then, typically, then we do a little graduation ceremony when we go from that apple cider vinegar to the HCl. That’s the next step.

Evan Brand: Yep.

Dr. Justin Marchegiani: Any of the comments said? What do you think, man?

Evan Brand: I think we should wrap it up. I think we’d hit a lot of different triggers here. And if people want to learn more, you’ve done plenty of videos on Hashimoto’s. We’ve done more podcasts on this, so there’s hours of more content, I’m sure, that we’ve created on this. So, just go on You can search Hashimoto’s or search thyroid. You could check out my site too, Evan Brand, and make sure you’re subscribed. So, if you want to join in on the conversation, we can answer your questions on the fly. And, of course, if you want to work with Justin, visit his site too, You can schedule. If you want to schedule with me, same thing, And, we’re available. We deal with this stuff all the time, and don’t take no for an answer. Somebody says, “No, I’m not gonna run these antibodies, then you leave.” You fire them because, if you want to get on the root cause of your issue. You have to have the biomarkers. If you’re guessing and checking, you’re building up your supplement graveyard, you’re not gonna get better that way. You really got to get these number on a piece of paper first, because you got to be able to track them and we have to be able to see. “Okay, look. Once we did this, we fix your gut. We got the adrenal support.” And look at the antibodies, drop, drop, drop, drop. And then eventually, “Hey. Maybe you don’t have a thyroid problem anymore.” And it’s totally possible we do it all the time.

Dr. Justin Marchegiani: Awesome. So, here’s the sequence. Ready? Instead of buying crap food, you increase the food quality, and you choose the right kinds of food. That’s number one. That will start to get– that will start to lower inflammation, and give you more energy. As you start having more energy, you can start cutting the emotional stress out of your life. Get used to it with your spouse. Work on it with your spouse. Get a book on communication. Get it– things fixed with your kids. Do your best to fix things at work. Whatever other stressors, all dealing with emotional stress takes energy. So most people that have a lot of emotional stress, typically they don’t have the energy to deal with it. So, get the energy up by just getting the food right. Then you can start to deal with the emotional stress. And then, once that’s kind of dialed-in, you can start adding in some supplements to fast-track it. first set iss gonna be digestive support, and after that, you really want to work with the functional medicine doc to get everything else dialed-in. But work on the foundational stuff first, and then make sure while you’re doing all that, you’re not causing yourself to spin around in a rabbit wheel. While you’re doing excessive exercise, too much CrossFit, just so you’re getting drained with that. And then if you can combine in the good sleep and the good hydration, now you’re set. So, now, when you go see a functional medicine doc, it’s like, “Boom!” You hit the ground running.

Evan Brand: Oh, man. We could– we could have done a whole podcast just on CrossFit and thyroid issues, so maybe for a future day. But yeah, over exercise – I have a lady last week. She said, she exercises CrossFit six or seven times a week. She’s doing CrossFit, and like, “Gosh!” way too much.

Dr. Justin Marchegiani: Yeah. And a CrossFit may be great if you’re – if you’re already healthy, if you’re diet’s spot on, if  you’re resting hard, if you’re doing some good things, post-workouts and pre-workouts to recover. But if you’re not there, it’s not gonna be the best thing for you to start off. Unless, you’re a gym’s got a really good On-Ramp Program, and they get the Arm Wrap style in, where they’re not doing some, you know– they have some great timing with their Arm Wraps, then it’s probably okay. But you got to go somewhere where there’s a good Arm Wrap Program.

Evan Brand: But even then, even if you were optimally healthy like you were talking about, would you still tell somebody, “Go do seven days a week in CrossFit?”

Dr. Justin Marchegiani: No. No,– the only– I mean, professional athletes do that if they want, but they’re taking naps, and that’s their job during the day. But, the average person, typically, I would say, maxes four times a week.

Evan Brand: Working, living a life, being a parent or uh– spouse, I mean, it’s tough.

Dr. Justin Marchegiani: And, ideally, spread it out. Right? Monday, Tuesday– Monday, Wednesday, Friday gig, you know. During the week, trying to keep a day off in between.

Evan Brand: Yep, yep. Well said. You said something else in your, in your small rant. I forgot what it was. I was gonna– I was gonna ping off of it. But I guess we should wrap this thing up.

Dr. Justin Marchegiani: Yeah, I mean, it’s funny, like, you ping me at lunch time, “Let’s do a podcast, alright.” And then we’re like “Only fifteen minutes. Only. That’s it.” Then, it’s all like, an hour later, “Damn it!”

Evan Brand: I know. 

Dr. Justin Marchegiani: “What happened?”

Evan Brand: I know.

Dr. Justin Marchegiani: We tried to be disciplined. 

Evan Brand: I know.

Dr. Justin Marchegiani: Alright. Well, I think we hit all the good stuff on the foundatinal side. Is there anything you wanted to add to the foundational piece?

Evan Brand: That’s exactly what it was. Blood sugar balance, make sure that that’s keep.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That was exactly a blood sugar balance, hydration, you’re getting your good minerals, using your good salts, uh – using trace minerals if you have to, trace mineral supplements if needed.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Uh– we talked about the fatty acids with the fish oil. Optimizing HCl and enzymes, supporting the liver, gull bladder, supporting detox pathways, supporting methylation if you have to, uh– and looking for the root cause, getting the testing. Without the [crosstalk] testing, you’re guessing.

Dr. Justin Marchegiani: Love it. [crosstalk] Love it. Excellent. Alright. Evan, I’m gonna go hang up here on YouTube. I’ll go say goodbye on my Facebook peeps, and we’ll talk real soon, my man.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care.

Evan Brand: Bye.

Evan Brand: Bye.



“Hashimoto’s Protocol” by Izabella Wentz



10 Essential Nutrients To Heal Your Thyroid

10 Essential Nutrients To Heal Your Thyroid

By Dr. Justin Marchegiani


The thyroid is a bowtie type of gland that sits just below the Adam’s apple. It regulates your metabolism and weight, and thyroid hormones are required for almost every physiological process in your body.

The thyroid secretes a hormone called T4 that gets converted into an active thyroid hormone called T3 which is needed for all cells of the body to be metabolically active.

T4 is inactive, while T3 is active. 20% of this important conversion happens at the thyroid gland. The other 80% happens peripherally. Out of the 80% that happens peripherally, 60% is converted in the liver, 20% is in the healthy gut bacteria, and the other 20% is via healthy adrenal function and stress regulation


Signs and symptoms of a potential thyroid issue include:

Unexplained weight gain

Fatigue and tiredness/energy issues

Numb or tingling fingers/toes

Muscle soreness

Menstrual and fertility problems, PMS,

Thinning of outer third of eyebrows


Dry, flakey skin

Poor concentration and memory

Temperature intolerance


*Thyroid vs. Adrenals*

It’s important to note that adrenal fatigue is often found alongside thyroid disease, and many of the symptoms of the two overlap, so it is important to look at the thyroid and the adrenals side-by-side. Remember, 20% of the T3 conversion process relies on healthy adrenal function and stress response. One huge step you can take to support both the adrenals and the thyroid is by paying attention to your iron levels. Low iron is linked to low cortisol, a hormone produced by the adrenals which is necessary for proper thyroid function.





We want to look at the body as a whole in dealing with thyroid issues: hormones, diet, lifestyle and nutrition. To avoid supplement overload, the first thing we want to do is to clear out all the dietary and lifestyle sources of stress on the liver. This means cutting out aspartame, junk food loaded with additives, gluten, and anything else the liver has to work extra hard to detox. As we learned earlier, 60% of T4→T3 conversion happens in the liver. Because our liver is always giving detoxification support, we want to take off excess stress (and stop giving our liver stress to detox in the first place), then use supplements such as Liver Supreme.


Selenium: The thyroid is our organ with the highest selenium content and is necessary for production of T3. It can reduce autoimmune issues, as well as decreasing anti-thyroid antibody levels. Besides supplementation, whole foods sources of selenium include grass-fed beef, beef liver, eggs, chicken, spinach, brazil nuts, and yellowfin tuna.

B Vitamins: Thiamine and vitamin B12 help balance hormones, and aid in combatting chronic fatigue. Vegans and vegetarians need to pay special attention as they are much more likely to be deficient in these essential nutrients. Beef liver, sardines, grass-fed beef, eggs, lamb, raw milk and cheese, and salmon are great sources of these vitamins.

Probiotics: Healthy gut bacteria balance is vital for a healthy self. Thyroid conditions have been linked to leaky gut (when proteins such as gluten can leak through the gut and get into the bloodstream, which causes inflammation throughout the body, including the thyroid). 20% of T4→T3 conversion happens in the gut. Probiotic-rich foods include sauerkraut, kombucha, kvass, kefir, and natto.

Iodine: Iodine deficiency is often linked to hypothyroidism. Iodine can be found in whole foods such as fish, sea vegetables, eggs, raw dairy, and seaweed. For 10% of people, iodine can resolve thyroid disfunction, though those with Hashimoto’s should avoid higher dose iodine supplementation, as it can potentially aggravate the autoimmune condition especially in the environment of low iodine.


Tyrosine: In a process called iodination, iodine, tyrosine and thyroglobulin bind together in making your T4 molecule. Tyrosine is found in protein-rich foods such as chicken, turkey, almonds, avocados, beef, and eggs.

Zinc: Zinc is required for T4 to convert to T3, and is also required for T3 to function properly. Zinc impacts many areas of your health, including digestion, skin and eyes, the immune system, omega-3 fatty acid metabolism, and thyroid function. Zinc is found in red meat, pork, oysters, and chicken.

Fat-soluble vitamins: Many essential vitamins and nutrients required fat to be properly absorbed and used by the body. For example, high cortisol levels are associated with low vitamin D levels. But if you are on a low fat diet, you are not going to be absorbing as much vitamin D as you might expect. It is important to have quality sources of fat, such as grass-fed butter, in order to get the full benefits of your supplements.

Vitamin C: The adrenal gland contains the highest concentration of vitamin C in the body, and as we know, there is correlation between adrenal function and thyroid function.

Omega-3 Fatty Acids: Can help “decrease inflammation and help with immunity” for thyroid support. Research shows that omega-3 fatty acids can increase thyroid hormone uptake.

Iron: Research shows correlation between low iron and low cortisol, and cortisol is necessary to convert and activate T4 to T3.

Glandular supplements like Thyro Balance can be beneficial for individuals not getting adequate daily nutrients, particularly those that support the adrenal and thyroid glands. Another supplement that helps provide extra nutrients for thyroid hormones synthesis and T4 to T3 conversion is Thyro Replete.


Conventional medicine generally takes one of three routes in dealing with thyroid issues.

If a patient is labeled as having Hashimoto’s or hypothyroidism, they are prescribed Synthroid.  Most people that are given Synthroid, synthetic T4, don’t convert it to T3, leaving them with tons of thyroid symptoms.

If they’re diagnosed with Graves’, doctors typically just want to perform a thyroidectomy- meaning they pull the thyroid out!

Thirdly, they might want to use radioactive iodine, and shut the thyroid gland down.

The majority of people have hypothyroidism/Hashimoto’s, meaning there are underlying issues affecting thyroid T4-T3 conversion outside of their control, and the mainstream medicine routes aren’t going to tackle the real root of the problem.


While supplementation is valuable and always available for extra support, a balanced life and a healthy diet are the necessary foundation pieces for proper thyroid function.

If you are looking for supplementation to help your thyroid, we offer thyroid support in our store.

To listen to Dr. Justin’s podcast with Evan Brand on the thyroid, check out podcast #54.


Hypothyroidism, Low Iron and Anemia | Fatigue

Hypothyroidism, Low Iron, and Anemia

By Dr. Justin Marchegiani

Today’s video is going to be on hypothyroidism and low iron or iron-based anemia. Again, we’re going to talk about thyroid conversion; we’re going to talk about thyroid synthesis, as well as your thyroid activation.  We will also touch upon your adrenal function and how it plays into anemia.

So off the bat, iron – really important. Your animal-based heme iron source is going to be the best. There are going to be plant-based heme iron sources, but those aren’t going to have a real big effect on increasing your ferritin and raising your iron saturation

Big 3 things that may cause iron issues

  1. Vegetarian / Vegan diets
  2. Excessive menstruation
  3.  Malabsorption

Causes of Iron Issues

So when we look at why the iron is not getting into where it needs to go, these are going to be the big three why’s.

Again, iron is really important. These are the 3 mediums we got to deal with animal based-sources. In my line, we have a product called, Iron Supreme, that’s a Ferrous Bisglycinate. A lot of conventional iron, like the ferrous sulfate, can be constipating, cause your stools to go black, not the best. So we have an amino acid blend one that works good, called,  Iron Supreme.

Low iron and T4 production

There’s a process called iodination. And that’s basically binding iodine, tyrosine and thyroglobulin together in making your T4 molecule. T4 is tetraiodothyronine. So T4, really simple: it’s going to be your tyrosine, and it’s going to be 4 molecules of iodine around it – that’s going to be your T4.

Low Iron and T4-T3 Conversion

We need iron to actually make this process – the iodination process that binds these iodines to the tyrosine up there. That is going to be iron dependent. So we need enough iron for that process. Low iron and T4 to T3 conversion is also really important because iron is also part of the five deiodinase enzyme as well. And so we have selenium as part of the enzyme, but iron plays a role of coming in here. And it is actually converting this molecule T4 to T3.  How does it do that? It becomes in here like this and it’s actually going to play a role at knocking that off. Again, selenium also plays a role with that, too. So low iron and T4 to T3 conversion is very important.

Low iron and adrenal function

There’s some research showing there’s correlation with low iron (Fe) equals low cortisol.

low iron = low cortisol

Cortisol, an adrenal corticosteroid hormone produced by the adrenals. So we actually need cortisol to actually activate thyroid hormones. If you go look at the T4 to T3 conversion, one of the big things that’s needed in this conversion step is cortisol. So if we don’t have enough cortisol, that’s going to affect how we convert and activate T4 to T3. It’s also going to affect T3 pooling. We need enough cortisol to get T3 into the cell. So we can have T3 pooling and an increase in reverse T3, if we do not have enough iron – so really important.

Click here to have a functional medicine doctor help you with iron issues

What is low iron effect?

Low Iron Effect

Low iron affects T4 synthesis, iodination with tyrosine thyroglobulin and iodine. It affects T4 to T3 conversion with the iodination process and also affects cortisol in that conversion process. And also, iron is really important for thyroid hormone recycling as well –so very important.

What to look for in determining iron levels?

Determining Iron Levels1. Ferritin: A storage for iron. It will go low when iron is low. So below 30, there is an issue.

2. Iron Saturation (Iron Sat): This below 25, there is an issue.

3. Iron Serum:  It isn’t really that big of a deal. It’s typically around 40-80 on average. You can have normal iron serum, though, and have these other things out of whack, though. So it’s good to look at iron serum. Sometimes we’ll see that high and these can be low. And we’ll see increase in inflammation. So it’s good look at iron serum but it’s not going to be-all, end-all. Most people only focus on that.

4. TIBC & UIBC: Are binding proteins that go high when iron is low.

To access a highly absorbable iron supplement to boost your low iron levels, click here.

And again, these are your real good,  your more complete, advanced iron panel. Ferritin, iron stat, iron serum, TIBC, UIBC. Your typical medical doctor may look at RBC, hemoglobin, and hematocrit, and see if they’re all low. So RBC below 4.1; haemoglobin below 11.5;  hematocrit – I think, low 40’s. That will give you a pretty good idea of how to analyze your iron levels. And again, iron and anemia – iron-based anemia are deal busters. So if you don’t get your iron levels looked at and assessed, you’re not going to fix your hypothyroidism issue.

Click here and have your iron levels looked at and assessed by a functional medicine doctor

Again, this is Dr J here.  Click here and subscribe. Go below if you need help and you want to dig in, dig deeper your thyroid or other health issues, click below and schedule a consult. And again, subscribe for more videos coming your way. So, look for the live stream videos. We’re starting now on that, too.

Thyroid and Nutrient Deficiencies Live Q & A – Podcast #125

Dr. Justin Marchegiani and Evan Brand dive into an exciting discussion all about thyroid. Listen carefully as they engage in a dynamic conversation with the listeners and share some valuable information regarding their functional medicine approach on issues relating to thyroid; its connection to adrenal health, gut health, nutrition, and infections.

Learn about the hyper- and hypo- symptoms related to thyroid issues. Find out how other conditions like leaky gut and other infections are linked to thyroid health. Gain valuable information on different tests used to assess thyroid health and rule out other conditions contributing to thyroid issues. Increase your awareness about the different sources, like foods, supplements, and metals which all impacts thyroid function.

In this episode, we cover:

04:19   Thyroid and its connection to adrenals and leaky gut

12:50   Testing for Autoimmunity

16:42   Infections and Thyroid Health Connection

21:35   Cortisol Lab Test for Adrenal Issue

28:36   Thyroid Symptoms and Assessment

32:23   Iron

37:20   Gluten and its connection to leaky gut

54:23   Mercury

58:25   Iodine







Dr. Justin Marchegiani: YouTube as well. Any questions, feel free to type them in. Today’s podcast will be on thyroid. Evan, can you hear me okay?

Evan Brand: I sure can. You sound good.

Dr. Justin Marchegiani: Awesome, man. We are live. What’s going on, man?

Evan Brand: Oh, not too much. Like I told you, somebody in France has had a fun weekend with my business credit card. So uh – besides that, everything is good.

Dr. Justin Marchegiani: Very cool, man. Yeah. Well, at least you got a capital one card, so you’re pretty well protected, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s awesome. So we’re live on Facebook and YouTube. Again, better to be on YouTube, my opinion coz you get to see Evan and myself. If you’re watching me on Facebook right now, we’re a little compromised. We only got my feedback. You’re not gonna hear Evan’s side of it. So feel free and check out to be able to see Evan’s pretty face and be able to get some questions there. But we will answer questions on Facebook Live, too.

Evan Brand: Cool. So today we wanted to talk about thyroid. There is many lab test out there that you can get. Still, conventional doctors are not running the lab tests that are important, though, some of these antibody markers, some of the reverse T3 markers. Maybe you should briefly chat about that just since people maybe on Facebook. Talk people through why is this happening? Why are these conventional doctors not running these other important thyroid markers? Why is it just TSH and some of the other boring stuff?

Dr. Justin Marchegiani: Great question. And again, today we’re talking about thyroid and we talked about this topic a lot, done a lot of videos on it. I have a book coming out on this very shortly as well. So I’m just kinda do a brief overview. Feel free and check out Evan’s page not just and his podcast from more info as well as mine. We’ll give you more info here today. Hopefully we’ll be able to have a live interaction. But Evan’s question is for the Facebook live listeners. “Can we get podcast live on YouTube, too?” is the question about conventional thyroid issues versus functional thyroid issues. And this is a big difference, and most people they go and get help from their conventional physicians on matters of thyroid issues. They think that their conventional doctor is ruling them out for thyroid issues and they may, if it’s an extreme thyroid issue. You know, very, very high TSH, extreme thyroid swelling, uhm – maybe while hyper-symptoms if their grades are on the hyper side, or if they have a lot of thyroid destruction, or goiter things. They may get picked up by conventional testing, but many patients they aren’t getting picked up on conventional testing because they’re kinda in no man’s land. Conventional medicine looks at things like an on and off switch. You’re either healthy, right? The light’s on. Or you’re unhealthy, the light’s off. And we know in functional medicine world, that light switch is more of the dimmer switch, right? The light may be on halfway, right? You’re halfway healthy; or another way to look at it, you’re halfway to not being healthy. But it may not be all the way off. Maybe just flickering a little bit. And unless you’re all the way off, what’s gonna happen is they’re not gonna see anything wrong with your health issues regarding your thyroid. And they’re not gonna make any recommendations for interventions. And that’s the biggest problem. With thyroid issues, looking from the conventional to the functional medicine realm. And also, you have to look at the tools that they have right there. One tool – most part two, you’re gonna have some kinda surgical intervention or you gonna have some kind of uhm – pharmaceutical intervention. None of which typically fixes the root cause of what’s going on. Especially when we understand that thyroid issues are 90% autoimmune in nature. I’d say at least 50-90%. So we know if it’s autoimmune, and we don’t fix the underlying cause of why the autoimmunity is there, right? Then the underlying mechanism of the antibody is in the immune system attacking the thyroid tissue is still happening in the background.

Evan Brand: That’s terrible. I mean we’ve got thousands of people at this point who we work with, where they’re on thyroid drugs, and they still feel terrible. And I’ll go back and say, “Hey Doc, look, give up my Synthroid or other pharmaceutical, I still feel terrible.” And they’re just gonna up the drug more and more and more. So it’s like you’re jamming this gas pedal down, but you are not figuring out what’s the issue in the first place. And so for us, we’ll always gonna be looking at the gut; looking for infection; seeing what could be going on; why is there some type of attack going on. And then also looking at adrenals, too. And figure out what’s the adrenal thyroid connection. Maybe you could brief people on that a little bit? How someone with adrenal issues could have thyroid issues and vice versa.

Dr. Justin Marchegiani: Yeah. So Evan, your question was looking at adrenals thyroid issues, we also have a listener question as well, talking about thyroid and gluten sensitivity. I’ll try to intertwine with the two answers. But again, adrenals are really important because you have cortisol production coming from the adrenals, which is important for managing stress and inflammation. Also, generally energy via blood sugar. Also, cortisol – is they differ healthy thyroid conversion. So if we have two high cortisol, or if your stress response is too high, we’re kinda in a Stage I adrenal issue that can block thyroid conversion. So we have this T4 thyroid hormone that gets converted down to the T3. And T4 is relatively inactive compared to T3.  So we have to make this conversion. There’s a lot of things that are needed for that, whether it’s selenium, or zinc, or vitamin A, or other nutrients to help make that conversion. But cortisol, from a hormonal perspective, is also needed. So if we’re too low on our response, right? We have this HPA axis, this regulation, the brain, the agent P, the hypothalamus and pituitary are hypo functioning. They’re dysregulated like a broken thermostat in your house – doesn’t turn on the heat, or turn on the air conditioning. That same thing is needed to help make that conversion from T4 to T3. So we have depleted adrenals that can strongly, strongly be an inhibiting factor of thyroid conversion. And also, if we have too much stress, one of the mechanisms the body does to regulate the stress response, is to make more reverse T3, which is essentially like taking uhm – the clip by the – your gun and putting blanks in there. So they kinda – they fit into the – into the magazine. They fit into the cartridge, right? But they fire, but that then you don’t get the same metabolic effect. You don’t get the increase in energy; don’t get all of the hormonal benefits; you don’t have the warmness and the increased blood circulation; and you don’t have the degradation of cholesterol and other hormonal byproducts. So you can see that the adrenals are intimately connected. Now answering the person’s question here on gluten. Gluten is really important because that’s a big strong – That’s a big stimulator of leaky gut. So gluten exposure can drive leaky gut. What it does is it increases zonulin, which unzips the tight junctions in a lot of patients, even people that are necessarily having a response to gluten. It shows that there is still uh – intestinal permeability that’s happening. And the more food particles that get into the bloodstream, the more LPS is in the gut, the more that can unzip the gut, the more – allow more food particles in there, and create more immune stimulation. And it’s also inflammatory in the gut, too. And also can create this concept known as molecular mimicry, where the immune system sees the surface proteins, and it can mistakenly identified it is the thyroid, and it starts attacking the thyroid tissue, creating more inflammation. And that can cause these thyroid follicles. So still, that hormone is creating unbalanced levels.

Evan Brand: And this could all come from gluten exposure, you’re saying?

Dr. Justin Marchegiani: It can all come from gluten exposure. Gluten is one strongest stimulators of leaky gut, along with distress, along with LPS, which is a compound produced from bacterial overgrowth, right? So the worse stomach acid, the more stress we have, the more essentially we’re not breaking down our food, the more we’re gonna have bad bacterial overgrowth that’s gonna increase LPS, that’s gonna unzip those tight junctions even faster, which is gonna create more immune issues, more food allergy issues. Because think about it, right? The immune system shouldn’t be getting revved up to deal with food; shouldn’t be getting revved up to deal with the digestion. So the more that’s happening- well what that means is that your immune system is going in overdrive. One of the major reason why people are when they’re sick – think about it. Because their immune system sucks up so much energy. So the more you’re revving up your immune system by just consuming food, you’re gonna be constantly tired. And that’s just gonna drain your adrenals, and drain your thyroid, and increase that thyroid autoimmune attack.

Evan Brand: Yup. Well said. So I mean, we got the zonulin. What’s the link there between the zonulin and LPS? So are these connected at all? Or are these going up and down in relationship to each other?

Dr. Justin Marchegiani:  Yes. So the more zonulin you have, typically the more leaky gut you’re gonna have, right? So vitamin D is actually a zonulin inhibitor. So the more zonulin you have, the more leaky gut. So LPS will increase zonulin. Infections will increase zonulin. Gluten will increase zonulin. And that basically, if this is like Parker jacket, you’re wearing that’s kinda like unzipping those tight junctions and then basically food particles can get in there.LPS particles can get in there. When LPS flows to the brain and makes it way up to the brain, leaky gut, leaky brain that LPS can create inflammation in the brain which feels like brain fog, which feels like mood issues, which feels like depression, which feels like anxiety. And this is really hard for a lot of people. Getting back to Evan’s question on gluten and the brain, is people may have a gluten issue. Think that well gluten has to cause digestive problems diarrhea, bloating, gas, reflux constipation, diarrhea. But it may not – It may be causing depression, anxiety brain fog, poor memory, poor uh – just word recall. And you may have a gluten issue, but it may not be even because by – you know, you may not see it because it’s not those conventional symptoms. And again, that same thing is gonna create thyroid issues, too. Coz that same mechanism that opens up the lining of the blood-brain barrier and the brain, also affect the gut, which then creates that more autoimmune thyroid attack.

Evan Brand: Well said. And there’s a lot of people that justify eating gluten to us. Whether it’s like organic wheat, or they’re doing some type of like sprouted wheat, or something like that. But gluten is gluten, and even if you’re not celiac – now there is research that shows that celiacs are gonna have30 times higher zonulin levels than a non-celiac. So massive, massive leaky gut in the celiac person in comparison.

Dr. Justin Marchegiani: Right.

Evan Brand: But still, we could even talk about the study. It’s Scandinavian Journal of Gastroenterology. It showed that gliadin, which is a gluten protein can affect zonulin even in people without the gene for celiac.

Dr. Justin Marchegiani: Yes.

Evan Brand: And so basically they said, “All gliadin, regardless of what – whether you are celiac or not, it’s still going to activate zonulin, therefore leaky gut, therefore this LPS, these endotoxins are gonna get in there.”

Dr. Justin Marchegiani: Totally.

Evan Brand: Which is crazy. And – and I love that. I love that the science because then you and I aren’t the bad guys when we’re telling people to get rid of gluten. It’s like, “Look, here is the research.” Yeah, maybe you don’t get a – acne from gluten, but you still causing leaky gut, regardless. I love that we can actually prove that and it’s not just up for – it’s not just our opinion coz we’re the nutrition guys.
Dr. Justin Marchegiani: That’s the key thing that you mention there, Evan. The zonulin and the gluten can trigger the leaky gut and you may not necessarily have an autoimmunity, and the question is the more stressed you become, the more compromised you become, the more your toxic burden, your stress burden, the more  your – the physical, chemical, emotional stress buckets get full. That’s where your body’s ability to adapt to stress really becomes inhibited. And again, the biggest mechanism really is, leaky gut. Even if you’re not necessarily gluten sensitive, you may be getting a leaky gut, which is adding stress to that stress bucket, right? It’s decreasing stomach acid; it’s decreasing enzymes; it’s increasing the ability to have food allergens; it’s increasing transfer infections and SIBO.Because the more your immune system is weakening the gut, the more that force field, that IgA gets lower, and the more critters can come in. So, yeah, 100%. And again a lot of people – I’m not a big fan of gluten because its, one: it’s hard to break down, it’s heavily pesticide, it’s low in nutrient density. A lot of the anthropological data shows that it’s been consumed only about 10,000 years ago, and the people that are consuming it typically have lower bodies – body stature, smaller in uhm – skeletal structure and increased risk for osteoporosis. Again, hunter gatherers tend to be more forgers uhm – starchy tubers, berries. Those kind of things, and obviously, meat and bone marrow. You study how the brain evolved. Really, it was the hand axe that allowed us to carve into bones and access bone marrow, and then creates spears to kill animals, and access that nutrients to grow our brains massively. Omega-3 is fat from the fish. So all of those things were huge in evolving our brain. Now, getting back to thyroid-We got a couple questions over here from the listener’s here on YouTube. So I’m gonna list a couple of. Couple is “how do you test autoimmunity?”Number one: kinda tying it back thyroid. We would look at TPO, or Thyroid Peroxidase antibodies or anti thyroid globulin antibodies; we’ll look for immune attack on the thyroid tissue. Also, we can look at TSI, immunoglubin, which is a marker for Graves’ disease, which is also a thyroid condition; or TSH receptor antibodies for the hyper- TSH receptor antibodies for the hyper; TSI for the hyper; and then TPO and thyroglobulin antibodies for the hypo. Now again, you can have the hypo antibodies, though, and have hyper symptoms initially. So you can kinda be on both stages at one point. So just kinda keep that in mind.

Evan Brand: And then more time, just so people are clear to that. Seems a bit confusing.

Dr. Justin Marchegiani: A lot of people that start out with hyperthyroid – or sorry – hypothyroid antibodies, low thyroid function antibodies, the TPO and thyroglobulin bodies, even though those are markers for a hypo-, Hashimoto’s, they can progress into hyper- symptoms initially because your thyroid follicle have about four months of thyroid hormone stored in it. So what that means is, you can spill out that thyroid hormone many, many months before, even up to a year or so, before you actually get depleted and go low. And that’s where the TSH gets really high. TSH will go high as the thyroid gets depleted, but in the initial attacks, in the first year or so, you may feel more hyper- symptoms even though it is a hypo– Hashimoto thyroid mechanism that’s happening.

Evan Brand: Uh, got it.  Well said. Okay. So, people may self-diagnose themselves with hyperthyroidism, your saying that it could actually be a hypo-caused by Hashimoto situation that’s going on. They just don’t feel the full effects yet coz it’s a new – it’s a new attack. Is that correct?

Dr. Justin Marchegiani: Totally. So the symptoms they may have is irritability, anxiety, mood issues, difficulty sleeping, heart palpitations, uhm – they may have like tired but wired kinda feeling. Those are the big things that they’re gonna have. I would say, yeah, the anxiety is gonna be a big one. Difficulty sleeping is gonna be a big one. Where the hypo- symptoms star to come in, again you may still have anxiety; you may still depression. The big differences is you’re gonna start to see the hair thinning because thyroid hormones are needed for hair follicle growth. So the outer thirds of the eyebrows go; the hair starts to thin on top; cold hands and cold feet it starts to happen. You may start to see constipation issue, too. You may start to see your triglycerides and your cholesterol go up. Again, infections can cause constipation, too. Uh – increase insulin can also cause increase cholesterol and triglyceride, too. So there’s other things. But that’s a general indication, is the cold hands, cold feet, the fatigue, the hair loss, the constipation and the increase in lipids you’re gonna see. That’s why you wanna test full thyroid panel, which is gonna consist of TSH, brain hormone, T4,inactive thyroid hormone (free and total), T3, which is converted peripherally 20%, and 80% throughout the body (free and total) and obviously you T3 uptake. You can look at thyroid binding globulin, which can go up or down if you have PCOS or on birth control. And then also reverse T3 and all the antibodies I mentioned.

Evan Brand: Yes. So I’ve also16:19read about another one that I’ve not seen used very much called TRAB, thyroid stimulating hormone receptor antibody, but it says that the antibodies are only ordered when someone is hyper- . And a positive result for that usually means great. So I’m not seeing that one that often, though.

Dr. Justin Marchegiani: It’s just a different name for I think the TSH receptor antibodies. Like TPO also has a like a name called,microsomal antibodies. So again, typically it’s the same names. So TSH receptor antibodies that’s probably another name for that, just like the microsomal is the same name for TPO.

Evan Brand: Uhh. Okay, got it. Now should we talk about – Is this is the time we should talk about the link between infections and thyroid health? Because people that were looking at, we’re not just gonna look at thyroid, we’re gonna look at the gut, too. And the average between us is about 1 in 3 of having infections. You know, every third person is gonna show up with infection. Sometimes even – you know those weak. Sometimes it’s 9 out of every 10 people has a parasite or other infection.

Dr. Justin Marchegiani: Totally. So we have a few questions coming on the uhm – YouTube Live board here that we’ll kinda tie in. But yes, so the big infections that can affect thyroid and can increase that thyroid autoimmunity: H. Pylori, okay, Yersinia, Enterocolitica, blasto, E. histo. Those are gonna be the big ones that are really gonna affect the thyroid. Even Lyme has a specific amino acid pattern that can create autoimmunity to the thyroid. So for sure, those are the big ones. You know, there’s been study showing that when you eradicate H. Pylori – It’s Italian study out there, that thyroid antibodies significantly drop. I have a video on blasto, right? Blasto infections are resolved, antibodies drop. Same with Yersinia, infections drop. As you attack Lyme, antibodies drop. So that can be a big stimulator and drive more leaky gut, more zonulin, more immune stress, which then creates more stomach acid and enzyme environments, which creates more adrenal stress, more thyroid stressed, and more nutrient deficiencies which perpetuate everything. So you can see, if don’t get to the root cause in this, that’s fine. You can go see your conventional medical doctor to make sure your TSH isn’t elevated, right? But in the end, you’re still gonna be suffering. And that’s why I have so many patients then I know you do as well that have all these symptoms. And I’ve seen a doctor for over a decade and are just tired of it. Alright, you know, this can’t just be my thyroid and all that we done is on 50 mics or 100 mics of Synthroid and that’s it. We can’t do anything else. They know there’s something more and that’s why they are reaching for people like you and myself, Evan.

Evan Brand: Yeah. Well in toolbox, it’s just not there, right. I mean, it’s not their fault. They’re just doing all that they’ve got. That’s the only tool in the – in the shed. The surgery or wait till you have some type of disease, or some big nodule, or a goiter or something crazy. And now, okay, now we have to do surgery.

Dr. Justin Marchegiani: Yeah. And a lot of people are talking about, “Well, what if you don’t have antibodies coming back on your thyroid?” My personal take on that is, above 40% comeback false negative. So it’s negative, but it could be positive. So what does that mean? Well, typically I’ll run the antibodies on someone at least three or four times before I say that they probably don’t have – they probably don’t have an autoimmune issue – at least 3 or 4 times. Now, the gold standard is a biopsy. Still going with a needle aspiration, and they poke it into the thyroid, they’ll if the tissues have any lymphocyte infiltration. So there’s an immune response going into the thyroid. So you can also have – you know your conventional physician palpate it. They’ll typically reach around your neck. So here’s my Adam’s apple, so it’s down just maybe a centimeter, and then out 1 or 2 cm. So it’s right here. And then you can typically run your finger right across it, then you can touch and push from one side to the other, and just feel the surface. See if it’s smooth, and then you can swallow, and feel that structure. And you can feel like a little nodule or a little bump and that’s possible. A nodule can typically mean autoimmunity or can mean an iodine deficiency. You can go to your conventional physician for that. I talked about the needle aspir –aspiration, but I don’t recommend unless you have – must you really want to know a hundred percent. The next more conservative approach would be a thyroid ultrasound to see if there is any swelling at all. Yeah. And that will be – those will be – My first line of defense would be, “Alright, let’s do your antibodies.” Second line would be ultrasound. I typically wouldn’t recommend the needle biopsy unless you are more worried about the cancer side of it, right? If I’m more worried about cancer then we may do that, or we may do a thyroid scan. But again, those are more invasive. I really only want to see those if we’re trying to rule out cancer. Coz typically the ultrasound and the antibodies will be the best. And we know, uncontrolled Hashimoto’s can lead to cancer, right? It increases your risk of cancer. So everything we’re doing is actually decreasing someone’s thyroid from progressing to a mandibular, papillary, follicular cancer. That’s – that’s the goal. So regarding that piece, everything we’re doing is gonna work either way because we’re mitigating the gluten in the food; or reducing the infection load; or upping the nutrients to help lower antibodies and help the thyroid convert; or making all diet and lifestyle changes and getting rid of the infection, which are gonna help improve the thyroid conversion, activation, and  the upstream signaling downstream.

Evan Brand: Early on in the chat, someone asked, “How should one read the cortisol lab test for adrenal fatigue?” “What numbers indicate the issue?” That’s gonna depend on the lab. Justin and I really like Biohealth, especially because they’ve got a brand-new test that were using now, which is six-point cortisol test. So any practitioners that are using a four-point cortisol test on you-

Dr. Justin Marchegiani: Uh-hmm. Yup.

Evan Brand: They’re outdated. They need to get with the –the times. With the 2017, six point is the new one. And how can you read the numbers? Well, typically there’s gonna be like a high patient line, a low patient line and then you would wannabe right in between those sandwich. And it’s gonna depend. So other labs are gonna have different – you know, different markers, different reference ranges. So for us to read a reference ranges to you, will be really boring. Uh – but basically long story short, you wanna be perfectly sandwiched in between those two lines. And it’s very rare that we see somebody in that. Most of the time we’re gonna see a low cortisol picture. And this is a low-free cortisol.

Dr. Justin Marchegiani: Yeah. Exactly.

Evan Brand: They’re gonna be low pretty much all day. And this is for most people. And so, then we have to keep digging deeper.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand: We don’t just throw them a bunch of adrenal support and say, “goodluck” We gotta figure out what – why is this happening?  Is there a lot of emotional stresses, or chemical stresses, or thyroid issues, or parasites? And these are the other pieces of the puzzle.

Dr. Justin Marchegiani: Exactly. So you made some really good points there. So with the adrenal, the car test, the adrenal, the uhm – the cortisol-adrenal response, especially in the morning. Cortisol starts off low in that first initial bit of waking up, and really pops up in the first half-hour to one hour after waking. So Evan and I are looking more at those types of test to see how that cortisol awakening response is happening in the morning. Coz cortisol is so important for thyroid activation to prevent T3 pooling, which is T3 not getting into the cells, as well as to prevent reverse T3 up-regulation, right? Reverse T3 is the uh – the blanks. The blank bullets that fit into the magazine that prevent the real bullets from getting fired. The real thyroid hormone being the real bullets, upregulating your metabolism. So those are the things that we’re looking at. And I agree, cortisol, and low cortisol, and low thyroid can intimately feel the same, right? We have patients sometimes that will feel like, “hmm, do they have a thyroid issue or adrenal issue?” We’ll run both test and we’ll see their TSH is, let’s say: 1, 1.5; T3 is at 3, 3.2; and their conversion is okay. But we’ll see, “Oh, yeah” their cortisol awakening response is terrible. Their cortisol is low; their DHEA is depleted. If they’re female patient, their hormones are off, right? So we’ll see. We’ll be able to  differentiate the two. And if you’re just going based of a symptoms, and trying to self-treat yourself, it’s gonna be really hard. You start going in one direction over the other. You may not get better. And a lot of patients, they instantaneously wanna go get their thyroid supported and treated first. The problem with that is, you increase thyroid hormone levels, and you already have lower cortisol. You can actually lower your cortisol even more, right? Just go google uhm – Addison’s disease, which is cortisol failure, right? – Addison’s disease, contraindications – And one of the contraindications you’ll see on their thyroid hormone because thyroid hormone can actually lower cortisol more. Coz think about it, right? Thyroid increases metabolism. The more your metabolism is increased, the more you metabolize through your hormones as well. So if we lower our hormones, and you are already at super low cortisol to begin with, you can actually feel worse as well. A lot of people feel worse when they just go after their thyroid and it can really create more problems.

Evan Brand: Wow. Now that you say that, I’m picturing a woman last week who, she was on Levothyroxine for a very long time. Her cortisol levels were like the lowest I’ve ever seen. So I wonder if it’s that drug that’s contributed to her cortisol being even lower than it would have been without the drug. What do you think?

Dr. Justin Marchegiani: Yeah. Absolutely. Absolutely. You can see patients that they go on their thyroid support, and they start feeling worse. And it’s just – it’s really difficult because if they’re seeing a functional medicine practitioner, they may lose faith in that person, right? And – and just say, “Hey, I’m just gonna keep on doing what I’m doing. I’m just gonna go back on the Synthroid.” So you have that aspect there, right? And then uhm – also have the fact that you know, what’s primary? A lot of people have in – the adrenal issue is the more primary issue. And if we start treating that first, then we may get the patient feeling better, which then creates more compliance. The more compliance, the more – the more the patient’s gonna follow through on diet, on lifestyle, on addressing infections. And that gives us a better chance to leverage the patients to do the right thing to heal.

Evan Brand: Well said. And plus, if the adrenals get back online, then we know that that conversion from T4 to T3 active is gonna be better. So they may not even need to go to the “thyroid support” if all these other root causes were the biggest thing. I mean it’s a parasite and an adrenal problem. If you fix those two things, is it possible you can get away with never going into, “Hey this is your thyroid program now. We just have to fix the other pieces.”

Dr. Justin Marchegiani: Yeah. Absolutely. So uhm – looking at that piece, you’re hundred percent right. I see so many patients, we’ll measure their thyroid temperature like their basal temperature. And again, for basal temps: 97.8 to 98.2 °F is gonna be where you wanna be for your armpit axillary temperature; and then98.2 to 98.6 °F is oral temperature. And typically do that in the morning before you get out of bed. And also do it sometime in the afternoon before you have lunch, and kinda do a general average. And again, a lot of people will be relatively low, and they’ll start to see their temperatures start going up uhm – as we treat the adrenals. One of the big things we see with the adrenals is we see an erratic temperature. The temperature is kinda bouncing around. Anything greater than .3°F can be – can lead to be a sign of a potential adrenal issue via a temp.

Evan Brand: Let me ask this. Let me ask this with you. So you’re saying, .3 difference. So that would mean if you woke up one day and you tested your armpit temperature, let’s say you were 98° flat in your armpit before you got out of bed, then the next day, you’re at 98.3. To you, that’s gonna signify thyroid and adrenal issues. Is that right?

Dr. Justin Marchegiani: So we went from 98 to 98.3?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. So it’d be greater than .3 So if you’re 98-98.4 and we’re consistently seeing this back-and-forth oscillation, so we’re seeing 98, 98.4 or 97.9 and it’s constantly bouncing back and forth greater than .3 that could potentially mean an adrenal issue, right? And because it’s erratic, but at a good level of temperature 97.8 or higher. So we typically mean of an adrenal issue. If we see it low and erratic, let’s say, 97, 97.4, 96.9 to 97.5, then that would potentially be an adrenal and a thyroid issue. And again, temperatures aren’t perfect, right? Like when we assess thyroid, there’s three indicators we use. We use subjective, which in my opinion is the most important. How do you feel? Do you have a lot more hyper- or hypo- symptoms, right? Hyper- symptoms being anxiety, palpitations, mood issues, tired but wired.

Evan Brand: What about sweating? Increased sweating?

Dr. Justin Marchegiani: – sweating, irritability, difficult sleeping. Where the hypo- symptoms, again, you can still have the mood stuff; you can still have the anxiety and mood stuff; you can still have some tired and wired – some tired and wired

feeling but typically more tired, though. And then the big thing is the cold hands, the cold feet, the thinning hair, the thinning eyebrows, the constipation. Those are gonna be the big differences. And obviously what trumps any of it, is an increase in TSH or thyroid antibodies are gonna be the biggest distinguishing factor, if it’s TPO or TSH receptor antibodies.

Evan Brand: And I just wanna mention one thing, too. In a lot of cases, the people we’re working with are gonna have both hypo- and hyperthyroid symptoms which can be equally confusing.

Dr. Justin Marchegiani: Totally. Yup. Equally confusing. I mean we look at like the test that we give our patients to assess that uhm – right? The other big one’s losing weight. Losing weight uhm – even though you’re – or unintentionally gaining weight if you’re on the hypo- side or unintentionally losing weight if you’re hyper- side, right? That’s gonna be another, another big one. Elevated cholesterol – another, another big one. So those are a couple of the other ones that I mention there where the anxiety, the excessively sweating, uhm – again, hands shaking, difficulty sleeping, uhm – feeling more warm on the hyper- side. Those are gonna be the other big ones. And obviously having a family history. If your mom, or your aunt, or uncle, or your sibling has a thyroid issue, right? That’s gonna be a big – just, you know, big factor. One of the big questions I do in all my intakes is, are there celiac disease or any autoimmunity that runs in your family? Whether it’s thyroid, or Parkinson’s or MS, or ulcerative colitis, or Chron’s or anything autoimmune related, type I diabetes. And if there is, that really gets me to hone in there. But testing for autoimmunity, conventional medicine typically does it like ANA, or HLA-B27, or an RA Latex like – these are like the conventional, like broad markers for like scleroderma, or like – or celiac, right? Or see, rheumatoid arthritis, or lupus. They’re very non-specific a lot of times. And again uhm – and they typically are late stage markers. It takes a while for them to pop-up.  And again, a lot of people they may be asymptomatic and still have them. So it’s not a real motivating factor for a lot of people. Where some of the things we look at it with the thyroid antibodies, well even just a little bit above like the normal range. So like LabCorp, it’s 33 or 36 for the TPO. Where I think the thyro – the thyroglobulin antibody is anything greater than 1 is positive. So if we’re like at 1.5 or 2, you know – we will look at that and we’re gonna really push for autoimmune changes and autoimmune protocols. We see TPO going above 20, we’ll start to say, “Hey, you know, you wanna be careful with this.” And we’ll keep an eye on that. And then we have the – you know, people are on the thousands on the antibody levels. And we’ve made this change and I’ve seen 70, 80% drops. We take a patient from 2300 down to like 3 to 400, which is a massive drop.

Evan Brand: And so that’s diet, that’s lifestyle, removing infections, supporting adrenals. All those pieces, right?

Dr. Justin Marchegiani: Yeah. Absolutely. And I got a question here on FacebookLive. I’ll try to connect it in here. And again, I apologize for Facebook Live listeners here. If you’re watching us there, check out the YouTube so you can actually see Evan. I’m gonna try to reiterate the questions so that you can hear it. Uhm – but that will be the best way to get the full conversation. Regarding uhm – question on Facebook Live, he’s talking about iron. Now, iron is really important coz it’s a really important building block for thyroid hormone. And we also need triiron for thyroid activation from T4 and T3, and we need it for just generally carrying oxygen to ourselves, which is really important for cellular metabolism. So if we have low iron levels that could be an issue. Now I did a full video this for people to get back to the iron video to get like the specifics on that. But again, typically we’ll recommend, like in my line, we use an Iron Supreme. It’s a Ferrous Bisglycinate. And we’ll do about 25 milligrams of iron, anywhere between 2 to 4 times a day to help support that. But also, we’ll figure out the root cause. Coz a lot of females, it’s excessive menstruation or hemorrhage. It could be vegetarian and vegan diets, or it could be the x factor of malabsorption from gut inflammation, to low stomach acid and enzymes and not being able to ionize minerals to an infection that’s stealing your minerals.

Evan Brand: Yeah. I’m so glad you brought that up because here I am thinking about myself, and the whole time, I had two parasite infections.

Dr. Justin Marchegiani: Totally.

Evan Brand: I guarantee I have low stomach acid. I guarantee I had issues with iron absorption. And people, let’s say, even if you’re eating the best organic grass-fed beef, if you got an infection that is causing stress on the gut, therefore reducing stomach acid; therefore reducing the ability for you to cleave off those amino acids and iron from them – from the meat, you can still have trouble. And what about – what about ferritin, too? Because the iron storage protein, that’s what we’re gonna test. For many times, you’re gonna see, especially women have very, very low ferritin levels where – and you’ve got a woman with ferritin levels you know – in between say 20 and 40. You may be experiencing something like breathlessness, for example. You could definitely have hair loss falling out. Sometimes I’ll hear women say when their ferritin is about 20, let’s say their hair is falling out in clumps. So you wanna get ferritin, which is the iron storage protein. You gotta get that levels tested, too. And we like people to get up, you know, 60, 70, 80 with ferritin just to ensure that – that iron storage protein is actually working. Now – and this is something that I haven’t looked at very often, but I’m curious if you know Justin, if you’ve got low ferritin, are you always going to have low iron as well? Or is it possible that with low ferritin, your iron could still check out okay?

Dr. Justin Marchegiani: So with lower ferritin, iron serum can pop up, and it can pop up because – imagine like ferritin is like the gasoline that’s in the gas tank, right? And then think of like iron serum is like the iron is actually in the carbonator and then the piston’s ready to be – ready to be combusted, right? So one’s like – iron is like, what’s ready to go that’s in the actual engine and carbonator; and ferritin is like, what’s in the gas tank, right? So obviously the more important one is gonna be what’s in the gas tank coz that gives you the bigger picture, right? You don’t care, you know how much – how much engines – how much fuel’s in the carbonator. It will only take you maybe a couple of hundred meters, maybe a mile. I don’t know, I’m not a big car guy, so – But keep that in the back of your mind. Now the difference is your body has a little bit more of an interplay with other systems. So inflammation can increase iron serum. So that’s why we look at ferritin, but then we’ll also look at it with iron saturation, too. We see iron saturation low, below 25, when we see TIBC or UIBC on the higher side, that means your binding proteins are growing more and more fingers –  to have more iron. And if we see iron serum up, then we’ll be like, “hmm, maybe there’s some inflammation” We may wanna look at C-reactive protein, right? We may want to look at some of those inflammatory markers. Uhm – if we’re running a gut test, you may look at lactoferrin or calprotectin and see it – inflammation is occurring in the gut. So it really depends on what else is happening in the body. Does that make sense?

Evan Brand: Yeah. It does – it does. So, if you had to pick one or the other. Let’s say, somebody only gave you the option to run some of the specific iron markers or ferritin, what would you pick? For me, I think – I feel like I’ pick ferritin, if I could only pick one.

Dr. Justin Marchegiani: Yeah. I mean, ferritin for sure. But an iron panel is like 30 bucks. There’s no reason –there’s no reason why anyone should nickel-and-dime on that because you don’t wanna compromise $30 getting a complete picture. So I think we run it. We keep doing it for 30 bucks and that’s everything.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And that gives you the ferritin, the iron serum, and that gives you the UIBC, the TIBC, the iron stat. So then you have a real complete picture of what’s happening. And then you know, even just looking at someone’s CBC can be helpful coz you can look at red blood cells, hemoglobin, hematocrit and if that’s starting to go low, then we can look at MCH, MCB, MCHC, which is basically markers to see how big your red blood cells are, right? Smaller red blood cells typically mean iron issues; bigger red blood cells typically mean B12, folate and B6 issues.

Evan Brand: Wow. There’s another question. Actually there’s a comment up here by Tonya. She was talking about how she was able to eat gluten and dairy now after she had infections. And I guess she treated those, and now she’s able to eat gluten and dairy. I feel like that depends on the person. Me, personally even if I could get away with it, I still wouldn’t do it because you’re still gonna increase zonulin and leaky gut. Potentially set yourself up for future infections.

Dr. Justin Marchegiani:  Yeah. That’s the problem, right? Disaster doesn’t occur in –a day or a week, right? And we know that leaky gut can still happen even without the symptoms, right? We – there’s just been studies where they’ve given people pieces of gluten and they measured symptoms, they didn’t see necessarily an increase in symptoms or negative side-effects. But they saw this increase in zonulin and leaky gut because of it. Now we know that when that happens, you increase your risk of having other issues. So I know there are people right now, we get the same conversation. We’ll be talking to people that have been able to smoke cigarettes and not get lung cancer. Okay, great. Now, does that mean that you’re gonna go out and recommend smoking cigarettes to anyone? No. It’s still not gonna be beneficial. It’s still gonna be inflammatory. It still increases your risk. You don’t know who the people are that are gonna have the negative effects to begin with, right? It’s all like you have that looking glass that you can see in know. And also uh – you don’t know down the road when stress comes on and other things happen. Coz usually it’s not just one thing. It’s like, “great, now this person who’s talking – their stress bucket, they’re already filling it halfway.” So they’re going into with a half-full of stress bucket thinking that they’re okay, right? Alright. So, I got a half full of stress bucket. So now when other things come into their life, they’re gonna overflow faster.

Evan Brand: Agreed.

Dr. Justin Marchegiani: And then also – and also other people, that may overfill their stress bucket right away. And so that’s why you have to make sure that you know that some people may be the exception to the rule. They aren’t the rule. And this is where it’s –We have the advantage, Evan, because we see so many thousands of people that we can make correlations and can actually even see causation because we make changes and we see direct changes in the person’s physiology and their symptoms are getting better. So we can’t make – we can’t create all these protocols for the exception to the rule coz there are so many exceptions. There are people that smoke and don’t get cancer, alright? We know that. People that may consume gluten and may be okay, but the majority may have issues. Or they may set themselves up in increased stress bucket, right? Meaning increase their ability to handle less stress, so that when more stress comes on, boom, now they’re laid up.

Evan Brand: Exactly. Yeah. Tonya we had to put you on the chopping block there because for you commenting about saying gluten and dairy and you can get away with it now. You’re speaking for thousands of people that listen and do the same thing. And Justin and I will look at the symptoms of someone, and if there are still health complaints that haven’t been resolved, then let’s say we get the retest on GI-MAP stool test, and we look at antigliadin and antibodies, and I caught the lie detector test. I don’t know if you do, Justin. But it’s uh – when you get the antigliadin antibodies, it’s like, okay, one of three things happen. Either you’ve got gluten, you ate gluten, or you’ve got cross reactivity going on. And so, even if your symptoms are not supposedly there, your body is still fighting internally. There is still this internal battle going on, which is not what we want because then those antibodies can get confused and start attacking other tissues, which we don’t want.

Dr. Justin Marchegiani: Yeah. And it’s tough because there are people that we see eat a diet that is you know – highly processed with a lot of carbs. And their blood sugar is relatively okay. And that maybe because they’re naturally more insulin sensitive, or they exercise more. And we see some people that eat the same diet, and they’re diabetic. So what do you do? Like I can’t sit there, and say, “well this person who eats this way isn’t diabetic” that means that diets is fine. No, it’s not. You have to look at the greater picture. You also have to look at what – does that diet now, is it nutrient dense? Is it anti-inflammatory? Is it low in toxins? And no, it’s not. But again, don’t get me wrong. Like dairies are open-ended topic, right? Ghee may be perfectly great. Butter maybe perfectly great.  Raw milk may be perfectly great for some people. But then we go to the pasteurized dairy, we go into more of the yogurts, which could be great, but it may not be. So do – we have to kind of uhm – can have a criteria for all those different compounds, right? Because some dairy may be okay, some may not be okay. And sometimes bread, too. Some people may do okay with bread over in Europe. Or they’ll do fine with sourdough bread coz it’s fermented and has less gluten in it versus, let’s say, wheat bread here that’s conventional. So you got to look at it, too. Some of those things may be okay and may have to be more specifically talked about.

Evan Brand: Yup. She commented back. She says, we’re missing the point. If parasite is the cause, you can go back to the way you were, prior to eating – oh the way you were prior, like eating gluten. We as people, ate gluten for a millennia and now it is the cause of all ills. I’ll comment on it first, and then I’ll let you say something about it. In the modern world, we have a lot more toxins. We have a lot more things that we’re up against, and so gluten, where maybe only would have change someone’s health 2 or 3% 5000 years ago, now,  has the ability to modify someone, tell 50 or 75, or even80% in some cases. We’ll see 80% of symptoms get better without it. So for me, comparing millennia to the modern world, we’ve never had a world like today. So it’s just not really a valid argument.

Dr. Justin Marchegiani: Yeah. And the grains aren’t even like– If you look at the biblical grains, they talked about in the diet, and Dr. William Davies totally debunks this. If you look at the grains 2,000 years ago, reference in the bible, these are 12 chromosome uh – grain products versus the ones that they have right now, they’re hybridized and genetically modified, they’re up to 50 chromosomes. The gluten content is much higher and is also the extra stress of potential GMO nutrients, poor soils, as well as pesticide exposure. So it’s not quite the same way. Plus, people have to look at it from this perspective, if you drive around on your car, and you get a flat tire on your car, right? And you change the tire and you put the little – let’s forget that. Let’s just say you’re driving around on that flat tire for like a year, okay? So the flat tire is the cause of what’s happening here. But you drive around the flat tire for a year. That’s like ignoring the stressors of your health. It could be gluten. It could be parasite. But the longer you drive around on the flat tire, the more you front angles out of alignment; the more your suspension goes out of whack; the more your whole shock system in the car becomes stressed. And even if you decide, let’s say a year later, I’m gonna change that tire and put on a nice, fresh tire, which is like cutting out the gluten, managing stress, managing sleep, your car has been compromised where just changing the tire won’t fix it. You’re gonna have to go in for a full frontal alignment. You may have to get your tires rotated; you may need new shocks; your brake pads may have worn unevenly. There’s so many other issues that may happen with the car that where collateral damage from that flat tire being ignored. So just because you, let’s say, it was a parasite issue, and the parasites are now gone; or it’s a gluten issue, and the gluten’s now gone, doesn’t mean you now have nutritional deficiencies; doesn’t mean your enzymes and HCL are now effective; doesn’t mean your thyroid and your adrenals hormone system are now stressed; doesn’t mean your detoxification systems are now stressed, right? So this is what is happening. And other analogy is you’re in debt for 5 years. Great. You stop – you curtail your spending habits but you don’t get out of the hut – but you don’t get 100 grand out of debt by just changing your spending habits today. You need a bailout, or you need a lot more time just to start saving and get that money back up. Does that make sense, Evan?

Evan Brand: Yeah. Or the analogy of the spider web.

Dr. Justin Marchegiani: Yes.

Evan Brand: Where there’s other pit of the web that’s affected, too. So for example, we can use me as an example. You look at me when uh – first time I came to your house. You’re like, “Evan, man, you look like you get a parasite.” You just- you just saw it. And I was like, “okay” It’s been a year plus since I’ve eradicated those infections, but I still am using enzymes and HCL because I was in such hypochloridic state that I still need to use supplemental HCL and supplemental enzymes. And I don’t really have an end date in mind where I’m not going to use enzymes because if I’m busy, or If I feel like I’m just not chewing my food as much as I should, to me, I like that nutritional insurance policy in place.

Uhm – there’s another question too that Chris asked earlier. He said, “not to be the dead horse, but isn’t there another marker to show autoimmunity of failsafe?” I guess since he’s asking because a lot of times –

Dr. Justin Marchegiani: I already answered that one with the ANA and the conventional ones.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: And then the TPO. And also the gliadin antibodies be the stool testing we do. And then there’s uh – a test by Cyrex Lab that looks at leaky gut, which could give you a predisposing marker, where it looks at zonulin and occludin toxins which can open up the tight junctions. So that one will be another one when I look at.

Evan Brand: It’s pricey. Have you run that one often? The Cyrex, I mean, it’s like 600 bucks.

Dr. Justin Marchegiani: Yeah. I’m not a big fan of that because it doesn’t tell me any of the cause. So if people have infections and their diet is not good, and they have – we’re seeing a low stomach acid and low enzyme environments, it’s not worth it. We just kinda work on treating the cause and then a lot of times, the clinical picture changes. Peoples bloating in gas and all these symptoms improved, which we know that means their digestion is getting better, their absorbing more nutrients. That means there has to be a leaky gut mechanism happening. I’m a bigger fan of looking at causal test versus the effect test. The effect tests are only good if you’re trying to convince someone or that people are skeptical. But once – people that are coming to see us are very intelligent because they’ve already educated themselves. They listen a lot to podcast. They read lots of blogs. They watch a lot of videos. They already get it. They don’t need to be convinced. They just wanna be fixed. So it’s a different mindset with those people.

Evan Brand: Agreed. Well said. And we don’t have people that need to be convinced they have leaky gut. Most of the time, they’ve already self-diagnosed themselves. In many cases, you don’t need to spend – I’d say99.9% of the cases, you don’t need to spend the money on a blood test that’s gonna say you have leaky gut. We could just list off symptoms – boom boom boom. Yeah, you probably got leaky gut. Cyrex, for their food sensitivity test, that is – that is cool one, but even then I feel like it’s a unnecessary in most cases because if you and I are gonna put somebody on like a AIP approach, let’s say thyroid disease did show up, some Hashimoto’s. We’ll have to go AIP and maybe we could try to reintroduce things. But they’re gonna be able to be a better barometer of Austin than the test in most cases. Like, “Oh when I added dark chocolate back in” or “when I added dairy back in” and this is what happen. I feel like that’s more valuable than a blood test.

Dr. Justin Marchegiani: Totally.

Evan Brand: Totally.

Dr. Justin Marchegiani: We’ll do a full autoimmune elimination protocols and it’s gonna be very valuable for 90% of people. We’ll go an autoimmune diet, cutting out nuts, seeds, nightshade, eggs, obviously grains, legumes, dairy. And again, for people that are like the gluten fans that are on the message board here, they still aren’t nutrient dense food. If you look at the nutrients, if you look at the other compounds that aren’t gluten-related, right? Let’s look at the fact that some people are intolerant. They just can’t break it down because they’re missing the enzymes to do that. And that any time the food is not broken down, it can create stress in the body just like people that can’t break down lactose. They’re lactose intolerant and then they have diarrhea and bloating. So, some people just may be intolerant to breaking down the protein. Some people may be increasing inflammation because of the lectins and the phytic acid and then the oxalates that are just shutting mineral absorption. Other people may be having the autoimmune issue. So it’s still not a nutrient dense anti-inflammatory low toxin food. It’s not like there’s this missing nutrient that you can get out of gluten or out of these grains that you can’t get in some really awesome nutrient rich vegetables or healthy fruits with –or healthy starchy tubers. Does that make sense?

Evan Brand: Yeah. It does. Now – this is off-topic. But –

Dr. Justin Marchegiani: It’s not a missing link. That’s my thing. If people had to say that – we – could show me a nutrient density chart and say, “But Dr. J, you get these nutrients, or the zinc and this is amazing or this, B vitamins”. I’d say, “Okay, but there’s not that evidence that it’s there.

Evan Brand: Right.

Dr. Justin Marchegiani: Now a great – a great talk on this uhm – what’s his name, out of Harvard there – Matt Lalonde did a great talk at the Ancestral Health Symposium at 2012 on nutrient density. I highly recommend anyone watching that. But when you look at the nutrient density that you’re gonna get in meats, especially organ meats, it’s insane. It just destroys grains. And grains are the lowest out of all those foods.

Evan Brand:  Yeah. Now, we’re – we’re off-topic from the thyroid, but that’s fine because I love that’s it’s a dynamic conversation.

Dr. Justin Marchegiani: It connects in, right? Because-

Evan Brand: It does.

Dr. Justin Marchegiani: -nutrients help in thyroid conversion, they help with thyroid activation, they help with the adrenal, which helps the thyroid cells. Even though we’re off-topic, we’re gonna do our best to kind of meander our way back to the thyroid.

Evan Brand: Yeah. Now, what I was gonna say was a bit off- topic, which is – well all you’re saying is totally on topic but what I’m gonna say is it’s funny how even some of these professional healthcare companies are now designing supplements, which I’m not gonna even give them the credit of naming these products. But there are gluten supplements out there, where it’s like, “here, go eat gluten, but then here is this enzyme or here’s this XYZ supplement to where you can still try to eat gluten, but you just take these pills with them instead.” It’s like, that’s ridiculous. That’s like covering up the engine light in your car. The light’s still there, but here’s this magic tape that’s gonna hide it. I just don’t think supplements that enable you to eat gluten is a good idea.

Dr. Justin Marchegiani: Now, here’s the deal, right? If you have thyroid antibodies, if you know – if you have objective measures of autoimmune issues, or your heightenly celiac sensitive, another word is – almost like – almost like if you have gluten, like you’re laid up, like you’re just – you’re junk for days on it, I don’t ever recommend cheating with gluten. If you can manage, if you’re really healthy, and you don’t have severe thyroid or antibody markers popping up, then you could try going gluten-free you know, right? It maybe rice, or corn may be okay. If you do that, I typically recommend the enzymes, like the DPP-4 enzymes and we’ll take it with charcoal. But it’s a cheat, and we’re just trying to mitigate it. And we wouldn’t wanna ever do that as a staple to allow ourselves to eat gluten. Now, like myself, like maybe once year, like if I’m in Boston and I’m in the north end, I may have like a cannoli, but I found an alternative uh –modern bakery and get some gluten-free ones that are white flour-based. But if I go, I mean I’ll up the DPP-4 enzymes, increase the charcoal, and the vitamin C in the knack. And that will help me deal with it. Uhm – but again, that’s like – if you look at it, the 2000 meals I have a year, you know – maybe one or two have that in there, right? Not a lot. We’re talking .001% But people who are really, really sensitive or having gut over their health issues, initially you really wanna be puritanical. And then – I’ll kinda dovetail this with Johnny’s question here. Some of the testing that I will do to fine tune, if like patients are on the autoimmune, they kinda reintroduce things back in and they’re still having issues, and not quite sure what works, there will be some testing we’ll do like an MRT is a pretty good test. I’m liking the ELISA / ACT test as well coz it’s not just antibodies, it’s looking at various lymphocytes, too. And I do a combination of the ELISA and I’m – I’m kinda testing the MRT as well. And I’ll actually be doing some blind testing and sending some uh – different vials in with different people with actually my blood on with different names. I’m doing some blind testing on that. So hopefully I’ll do a video on that.

Evan Brand: You ought to try the, if you have it already, I believe it’s the Array 2. And there’s a couple of other Arrays form Cyrex, too. I’m a bigger fan of that than the MRT.

Dr. Justin Marchegiani: Well the problem with Cyrex, though, it’s only looking at Ig or IgA – that’s the issue. So with the ELISA, it’s also looking at T-cell lymphocyte response and you’re not gonna get that picked up on Cyrex. That’s the big issue. And if you’re not exposed to gluten, let’s say we’re doing this test, and “yeah, I haven’t eaten gluten in a month or a couple of months” Well, if the immune system isn’t responding to it coz it’s not being exposed to it, it won’t come up in the test.

Evan Brand: Uhhh.

Dr. Justin Marchegiani: And people will be like, “Oh, look, I’m fine.” But may not be the case. So you have to look at it in a complete spectrum.

Evan Brand: That makes sense. So the ELISA / ACT.

Dr. Justin Marchegiani: Uh- hmm.

Evan Brand: And that’s blood.

Dr. Justin Marchegiani: That’s blood. Exactly.

Evan Brand: Cool. That sounds great. Well, I feel like we should probably wrap this up. I know this has been a lot of information uhm – if people are interested in your book, then they need to sign up for your email list. I mean – you’re so passionate about thyroid health, it’s definitely infectious. And do we have a date on that? Of this thyroid book? What’s up with that?

Dr. Justin Marchegiani: It’s done, man. I’m shooting it up to the editor. So we can buff it out and – and you know, I read all – every thyroid book on the market, I pretty much read. And my biggest issue is, you can summarize every thyroid book in like 5 pages.

Evan Brand: I know.

Dr. Justin Marchegiani: So I want a book that’s shorter. It’s more condensed. I want every page to be neat. I want every page to be __I want every page to have like action items. People can walk away and really improve their health and then throughout – in a standstill, they can reach out to people like myself and you, to kinda like get to the next level. So that’s where I’m at right now – to fine tune and boil it down. I want to touch just one question. Dale mentioned it earlier, he talked about mercury. And mercury is an important aspect coz mercury can pinch it and affect the thyroid. There’s this study showing that lowering mercury can decrease thyroid antibodies. I have one patient that had thyroglobulin antibodies over 2000 and we saw the antibodies drop below 100. So we saw a 99% drop in antibodies by removing mercury. So we’ll test that. We’ll do challenge test via urine and we’ll use various provocation agents like DMPS, which is 2, 3 dimer propanoic acid, or we’ll do uh – 2, 3 dimer succinic acid, which is DMSA. Or we can even do EDT as well. But I typically do the DMPS challenge and we’ll be able to provoke that and see what’s coming out from the mercury. That can be a big, big uh – kind of underlying revealer of another aspect of what could be driving an autoimmunity, which is the mercury. And again, I know you’ve done the shade testing which looks at urine unprovoked, hair, and blood. Not a big fan of hair and because they don’t tell you an active or chronic uhm – a chronic level. Doesn’t give you a tissue burden. And also, there’s study showing that people that push more mercury out on the hair actually have better detox pathways, and they measure people who push less mercury on the hair, and they actually found that they had more provoked mercury in the urine even though they push less out in the hair, partly because their detox pathway is impaired.

Evan Brand: Wow. I’m gonna try yours coz it sounds like it sounds like I could be getting some numbers that are not what they actually are. I wonder what other heavy metals are impacting this, too? I wonder if cadmium, for example, or aluminum is also gonna impact thyroid. It seems like all heavy metals potentially could. Or do you think it’s specific to mercury. Mercury’s gonna be the biggest?

Dr. Justin Marchegiani: Well mercury is definitely gonna be the biggest coz it’s one of the second or third most toxic compounds in the world. It’s really bad. So that one. Obviously lead is gonna be really bad, too. Because lead and mercury interplay, right? If you look at the lethal dose of one – if you take uhm – the dose, you get hundred rats lined up, and you figure out, you keep on titrating the mercury dose up. So the first rat dies out of a hundred. So you titrate the mercury up, the first rat dies, right? That’s called the – the lethal dose of one, right? The 1, the 1% that kills – the dose of 1% of that kills. And you do that for mercury and lead, so you have the hundred rats, right? One dies of mercury, right? You increase the lead up here or one dies of lead. And you now combine the mercury and lead those together to all 100 rats, they all die. Did you get that?

Evan Brand: Yeah, I sure did.

Dr. Justin Marchegiani: So what they’re saying is even though it only kills one of here over a hundred and the lead over here kills one out of a hundred, but when you combine it together, and gives it all to 100, all of them die. Meaning that, these metals are synergistically connected and can have exponential effects when added. So if you see mercury and lead together, typically the compounds that we’re using, are gonna be specific to mercury and lead for sure. So you don’t have give a special one for mercury and a special one for lead, right? So you give it and it would globally affect mercury and lead and typically cadmium, as well. And we’d also wanna give extra binders. Crochet talks about this like MC but MCT like modified citrus pectin, MCP actually. Uh – we’d also give maybe charcoal or bentine clays. We’d also use things like chlorella, especially for mercury. And we’d also use things to support detoxification. So in my line, we use heavy metal clear and then we also use DMPS and we use a lot of sulfur amino acid support to run phase 2 detoxification, as well.

Evan Brand: And still eat your broccoli, folks.

Dr. Justin Marchegiani: Oh, yeah. Your cruciferous are gonna be really important for your DIM and Indole-3-Carbinol which all help run phase 2 detoxification.

Evan Brand: Awesome.

Dr. Justin Marchegiani:  Well, anything else here? Any other questions we wanted to run to? Uh – on the YouTube live here, anything else we can answer?

Evan Brand: I think that was everything.

Dr. Justin Marchegiani: I think we hit it all up pretty well. Oh, I didn’t touch upon this. Let me just hit it real quick. Iodine. Iodine is a really important nutrient for the Iodination process to make thyroid hormone, right? If you look at the T, the T typically stands for- some people say thyroid or tyrosine. And then the 4 number is the Iodine. So you have the Iodination process and then you have the 5 prime, the iodinase that comes in there and it grabs and pulls off an iodine, and activates it and makes it T3. Well, that enzyme that activates thyroid hormone is selenium dependent and comes from the liver. So healthy liver function is really important. But having adequate iron uhm – adequate iron level as well is important, but having adequate iodine is also important. RDA is about 150 to 200 µg a day to at least prevent goiter. Now some people may need more than that. Now you have people like Brown Steen and other doctors that are going super, super high, 2550 mg a day. I’m very, very cautious of doing any high-dose iodine. I have seen too many patients uhm – like literally just lose their hair. Like just like gaps, like handfuls come out and their thyroid has gotten worst. Number one, like if we give iodine and they have autoimmunity, it’s typically months later after we’ve stabilized the gluten, stabilized the adrenals, supporting thyroid, supporting nutrients, supporting the gut, get their diet in shape, get their digestion better and then we’ll start very low and we’ll gradually work them up. But we’ll be checking in, we’ll be monitoring it and we’ll be doing very low doses and then gradually tapering it up or also making sure there’s enough selenium there, enough B vitamins, enough minerals, enough vitamin C. So we’ll make sure there’s a lot of other cofactors coz when you give iodine, it can spit out hydrogen peroxide, which can increase D cell lymphocyte infiltration into the thyroid. So it can exacerbate autoimmunity. So if we do it, we’re doing it responsible. We’re doing a lower RDA doses as a starting point and then gradually working our way up from there.

Evan Brand: So what about working with foods at the same time? So I’ve heard some people, anti-kelp people out there. And I don’t know why there’s some anti-kelp people.

Dr. Justin Marchegiani: Well, I think you just gotta be careful with kelp just because just coz where it’s coming from, the whole Fukushima disaster two years back.

Evan Brand: Yeah.

Dr. Justin Marchegiani: -radiation. So just gotta be careful. There are some really good sources out there. You gotta make sure it’s not coming from one of those places and number two, there’s a whole list of foods that you can give. Typically, like in my multi- there’s gonna be at least the RDA there, which is great.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Egg yolks are gonna have some iodine as well. Uhm- obviously seaweeds have some good iodine sources. You just have to make sure that it’s not gonna be the Fukushima kind. I’ll get a list right here. I’ll read out a couple of foods that are really high in iodine in just one second.

Evan Brand: I’ve heard strawberries, too, which is interesting. And then I also wonder – it’s hard to get a composition sheet for a Himalayan pink salt. I wonder if you’re gonna get any iodine from pink salt or not?

Dr. Justin Marchegiani: Yeah. I mean there’s some maybe some trace amounts there. I know iodized salt; 1 gram will have about 77 µg. There are some research showing that increased iodize salt consumption did increase autoimmunity. And it could just be that these are the general public. They’re just taking it, they already have a poor diet, and they don’t have the selenium, and the B’s, and the minerals, and the vitamin C in the background. And maybe that’s why that happened. So it’s hard to say. So there are studies on that showing there could be an issue. But things like cod, right? Things like shrimp, uh – things like turkey. Even some navy beans, even some tuna, even some eggs are gonna have some good iodine. I mean one egg is gonna have 12 to 15 µg iodine. So if you do 4 eggs a day, that’s about 60. You got a good multi- that will be 150. Uhm – you have some fish, you got some other food, now you’re like at 3, 400µg. Now you may need to go higher, but you had to work with physician or functional medicine practitioner to be monitoring the antibodies and make sure you have all ducks in a row first, before you go there.

Evan Brand: Yeah. I mean there’s people that will just start covering themselves in iodine. And so that could be a bad idea, you’re saying, coz you could actually increase antibodies, right?

Dr. Justin Marchegiani: Totally can increase antibodies. Uhm- you gotta be careful with that.

Evan Brand: I’m not – for some reason iodine, one of those things and kind of the eggs will call the natural health community that is – it’s been portrayed as very benign. And I remember even in some of the – the classes I was taking down in Austin, I remember a girl in class, she like paints everyday, she was painting her arm with iodine. And she was like, “it’s the greatest nutrient ever.” I was like, “Oh, my Lord. This is out of control.”

Dr. Justin Marchegiani: Well painting on your skin for the most part, 80% of it evaporates.

Evan Brand: Uh-huh.

Dr. Justin Marchegiani: The only time I recommend painting it on your skin is if you have fibrocystic breast disease uh – you have a lot of cyst and painful breast tissue. Painting it on the breast tissue can be great coz you’re driving the iodine right into the localized spot, where there’s the cyst, which could help. But outside of that, I mean, if you have –if you need iodine systemically for your body and for your thyroid function, you wanna take it in – in your body. And typically do a liquid potassium iodide.

Evan Brand: So she wasn’t – She probably wasn’t making herself toxic then. She was just turning herself uh – brown.

Dr. Justin Marchegiani: Yeah. 80% of it – you know, the iodine pass test, like the faster it evaporates, meaning the more your body absorb it; the slower it evaporates the more iodine you have. It’s very crude measurement, right? The better test is gonna be like Hakala or I think doctor stated, there’s an iodine loading test. I think it’s 25 to 50 mg of iodine then you test uhm – your urine and see how much GPL. So the goal is, if you pee 90% or more, it means your iodine levels are saturated; if you pee less than 90%, right? You pee less than 90% that means your body grab more of that iodine. So it’s – you’re essentially low. That’s the theory on that. 90% and more, you’re okay; less than 90, you’re low.

Evan Brand: Uhh. That’s interesting.

Dr. Justin Marchegiani: But again, regarding iodine, you gotta do it responsible – responsibly. If you’re – think of iodine gasoline on the fire.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Gasoline is not bad when you put it in your car. But if your car is on fire, and you start putting gasoline in your car, you can create problems, obviously, right? That’s what’s kinda happening in your thyroid. You wanna look at everything holistically. And you want the body system approach that Evan and I use, the key three, looking at the hormones, ATF( adrenals, thyroid, female hormones); ATM (adrenals, thyroid, male hormones), gut and infections, putting nutrients, digestion, better food, allergies, and then looking at detox and nutrients, as well.

Evan Brand: Yup. Well said. Go to to schedule consultation with Justin. Check out the thyroid videos series. He’s got hormone videos series, too. You’ve got the supplement line there. And then, you could check out my stuff, too, or you could just google either of us. Justin, or Dr. Dr. Justin Marchegiani. Evan Brand. You’ll find us both. And stay tune because this is really fun. And I don’t know about you, but I’m loving this. I think maybe 3 to 5 times more than just doing an off-air podcast coz people are asking questions. And it’s like shaping and structuring this.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This little organic podcast ball.

Dr. Justin Marchegiani: Yeah. I love it. We love the questions. We like just having this little kinda dialogue back and forth and “ooh, someone responds over here, let’s see what they said” and we kinda see if we can interject it into the conversation. That’s great. Totally m__we’re on the fly.

Evan Brand: Love it.

Dr. Justin Marchegiani: Like impromptu, right? It’s like we’re on the stage, doing a little impromptu podcast.

Evan Brand: There’s no cuts; there’s no edits; there’s no –

Dr. Justin Marchegiani: Overall man, this is it.

Evan Brand: This is – this is the real deal. This isn’t – there’s not a makeup person coming in and touching you up here. I mean this is the real deal.

Dr. Justin Marchegiani: I know. If you guys are liking this, we’re gonna do it a lot more. We just need thumbs up; we need likes; we need shares; show us the love. Go like Evan’s channel. Share the podcast. And then we’re gonna do more of this, and get everyone’s questions answered, and just provide more value. Like how could we provide more value to our listeners and improve your health.

Evan Brand: Yeah. And I think I mentioned it already. But if you wanna schedule a consult with Justin, just go to the website, you could schedule the consults there.  And same thing for me, and we’ll chat with you all next week. And let’s do something next week, maybe – maybe on like clinical success stories we’re having in the practice.

Evan Brand: Well that means they’re coming in –

Dr. Justin Marchegiani: And just like, maybe go over our top 3 stories of the week. Coz we see – you know, so many patients. We can pick out 3 easily.

Evan Brand: Well, yeah. I thought of something, too. Uh- actually, a woman who was struggling with fertility is now pregnant. And I figured, getting her on and talking about her story with parasites and how her fertility was compromised due to the infections. Getting her on the air, maybe asking them– we have to make it fun for them, too. 

Dr. Justin Marchegiani: Yeah.

Evan Brand: For them to take time out of it, get them to share their story and just kinda talk them through what we did. I think that’s- that’s the most remarkable part of all this, is getting to hear the feedback, which a lot of people, they’re not getting to hear the stories. And this is what keeps us motivated and keeps us going.

Dr. Justin Marchegiani:  I love it, Evan. That sounds awesome, man. Well, let’s connect real soon, brother.

Evan Brand: Take care.

Dr. Justin Marchegiani: You take care. Bye now.

Evan Brand: Bye.


Putting together the optimal functional medicine program – Podcast #116

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

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

In this episode, topics include:

01:26   Get help as early as possible

07:00   Body System One

10:19   Diet and lifestyle

17:16   Body System Two

38:22   Tests







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

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

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

Evan Brand:  Nice. Excellent.

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

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

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

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

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

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

Dr. Justin Marchegiani:  Absolutely.

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

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

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

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  A ton.

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

Dr. Justin Marchegiani:  Yup.

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

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

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

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

Evan Brand:  Right.

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

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

Dr. Justin Marchegiani:  Oh, yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

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

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

Dr. Justin Marchegiani:  Oh, yes.

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

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

Evan Brand:  Environmental.

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

Evan Brand:  Yup.

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

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  I know.

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

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

Dr. Justin Marchegiani:  Wow.

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

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

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

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

Evan Brand:  Right.

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

Evan Brand:  Right.

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

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

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

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

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

Evan Brand:  Yup.

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Cool.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup, amen.

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

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

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

Evan Brand:  Yes, sir.

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

Evan Brand:  You, too. Take care.

Dr. Justin Marchegiani:  Have an awesome day!

Evan Brand:  You, too. Bye.

Dr. Justin Marchegiani:  Bye.

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

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

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

In this episode, topics include:

13:55   Infections

16:35   Stress

24:42   Biofilms

30:58   Supplements and Herbs

36:26   Toxins







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

Torea Rodriguez:  Yeah, Santa Cruz is it.

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

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

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

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

Dr. Justin Marchegiani:  Yeah, uh-hmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

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

Dr. Justin Marchegiani: Uh-hmm.

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

Dr. Justin Marchegiani:  Right.

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

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

Torea Rodriguez:  Yup.

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

Torea Rodriguez:  Yes.

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

Torea Rodriguez:  Yes.

Dr. Justin Marchegiani:  It—totally different mindset.

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

Dr. Justin Marchegiani:  Right.

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

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

Torea Rodriguez:  Oh, yeah.

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Oh, great.

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

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

Torea Rodriguez: Yeah. I mean–

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Uh-hmm.

Torea Rodriguez:  Iodine.

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  So–

Torea Rodriguez: I just did not.

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

Torea Rodriguez:  No.

Dr. Justin Marchegiani:  Or was it something else?

Torea Rodriguez:  Hashimoto’s.

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

Torea Rodriguez:  This was Hashimoto’s.  Yeah.

Dr. Justin Marchegiani:  Okay.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Correct.

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

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

Dr. Justin Marchegiani:  Mmm, yup.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Right.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

Torea Rodriguez:  I was not.

Dr. Justin Marchegiani:  Wow.

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

Dr. Justin Marchegiani:  Wow.

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

Dr. Justin Marchegiani:  Got it.

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

Dr. Justin Marchegiani:  Mmm.

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

Dr. Justin Marchegiani:  Right, right.

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

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

Torea Rodriguez:  Oh, yeah. They were–

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Correct.

Dr. Justin Marchegiani:  Okay, cool.

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  That was my first panel.

Dr. Justin Marchegiani:  Cortisol was?

Torea Rodriguez:  I think it was like 12.

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

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  How about your DHEA?

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

Dr. Justin Marchegiani:  Wow.

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

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

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

Dr. Justin Marchegiani:  Yes.

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

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

Torea Rodriguez: Yeah.

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

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

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

Torea Rodriguez:  Probably.

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Yes.

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

Torea Rodriguez:  Oh, yeah.

Dr. Justin Marchegiani:  Wow.

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

Dr. Justin Marchegiani:  Oh, wow.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Wow.

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

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  No, I flew charter and–

Dr. Justin Marchegiani: Charter.

Torea Rodriguez:  Corporate aviation. Yup.

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

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

Dr. Justin Marchegiani:  Right.

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

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez: Aspartame was fine.

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

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

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

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

Dr. Justin Marchegiani:  Ahh.

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

Dr. Justin Marchegiani:  Yeah. Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Totally.

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

Dr. Justin Marchegiani: Right.

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

Dr. Justin Marchegiani:  Wow!

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

Dr. Justin Marchegiani:  Yup.

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

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

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

Dr. Justin Marchegiani:  Crypto. Okay.

Torea Rodriguez:  Yup, yeah. Yeah.

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

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

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

Torea Rodriguez:  I didn’t. Actually–

Dr. Justin Marchegiani:  Okay.

Torea Rodriguez:  I was pretty lucky with the anti–

Dr. Justin Marchegiani: Uh-hmm.

Torea Rodriguez: Pathogens that we used.

Dr. Justin Marchegiani:  Okay.

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

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

Torea Rodriguez:  Oh, yeah.

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Yeah and–

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

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

Dr. Justin Marchegiani:  Mmm.

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

Dr. Justin Marchegiani:  Wow.

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

Dr. Justin Marchegiani: Wow.

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

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

Torea Rodriguez:  Oh, yeah.

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

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Mmm.

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

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

Torea Rodriguez: That’s my guess.

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

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

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

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

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

Torea Rodriguez:  Excellent.

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

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Very cool.

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

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

Torea Rodriguez:  Yeah, so lots of GI pathogens.

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Right.

Torea Rodriguez:  Vaccines, right?

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Vaccinations.

Dr. Justin Marchegiani:  Yup.

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

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

Torea Rodriguez:  Yup, absolutely.

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Deeper in, right?

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani: Uh-hmm.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Exactly.

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

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani: Yup.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani: -Biotic, yeah.

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

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

Torea Rodriguez:  Oh, shoot.

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Oh, Biocidin.

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

Dr. Justin Marchegiani:  Yup.

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

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

Torea Rodriguez:  Excellent.

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

Torea Rodriguez:  Fantastic.

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Okay.

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Yup. Absolutely.

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

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

Dr. Justin Marchegiani:  Mmm.

Torea Rodriguez:  I just see autoimmune diseases.

Dr. Justin Marchegiani:  In general.

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

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

Torea Rodriguez:  Rheumatoid arthritis.

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  Hashimoto’s is definitely in there.

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Yup, scleroderma or–

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

Dr. Justin Marchegiani:  Psoriasis.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Almost everybody–

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Yup.

Torea Rodriguez:  That’s fun. Yup.

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

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

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Uh-hmm.

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

Torea Rodriguez:  Uh-hmm.

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yup.

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

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

Torea Rodriguez:  Yes.

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

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Yeah, is that–

Torea Rodriguez:  Like it’s the same stuff.

Dr. Justin Marchegiani:  Got it.

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

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

Torea Rodriguez:  That’s right. Totally.

Dr. Justin Marchegiani: Yes, I noticed.

Torea Rodriguez:  Capt N Crunch, in fact.

Dr. Justin Marchegiani:  Yes.

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

Dr. Justin Marchegiani:  Right.

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

Dr. Justin Marchegiani:  I will.

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

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

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

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

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani:  Yeah, okay.

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

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

Torea Rodriguez:  Yes, those. Yup.

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

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

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

Torea Rodriguez:  Yes.

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

Torea Rodriguez:  Yup, yup, really nice guy.

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

Torea Rodriguez:  Great.

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

Torea Rodriguez:  I use both.

Dr. Justin Marchegiani:  Mmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

Torea Rodriguez:  Umm.

Dr. Justin Marchegiani:  Less than 20?

Torea Rodriguez:  Pretty much, yeah.

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Oh, yeah, yeah, definitely.

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Right.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Absolutely.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Mitochondria.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Huge.

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

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

Torea Rodriguez:  Oh, gosh.

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Yeah.

Torea Rodriguez:  Oxalate and yeast issues.

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

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

Dr. Justin Marchegiani:  Got it.

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

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

Dr. Justin Marchegiani:  Unreal.

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

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

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

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

Dr. Justin Marchegiani:  Exactly.

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

Dr. Justin Marchegiani:  Tons.

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

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

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

Dr. Justin Marchegiani:  Scary.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yes. You got it.

Torea Rodriguez:  Thank you.

Dr. Justin Marchegiani:  You got it.

Torea Rodriguez:  Yeah.

Dr. Justin Marchegiani: Try to be–

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

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Oh, cool.

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

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

Dr. Justin Marchegiani:  Huge.

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

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

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

Dr. Justin Marchegiani:  Uh-hmm.

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

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

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

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

Torea Rodriguez:  Correct.

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

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

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

Torea Rodriguez:  Yup.

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

Torea Rodriguez:  Excellent.

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

Torea Rodriguez:  Supplement.

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

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

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

Torea Rodriguez:  Yeah.

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

Torea Rodriguez:  Yeah.

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

Torea Rodriguez:  Avocados, awesome.

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

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

Dr. Justin Marchegiani:  Thanks.  Take care.

Detox course:
December’s Webinar on the course (06 Dec):
BHT Book:

Testing and tracking your thyroid health – Podcast #111

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

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

In this episode, topics include:

02:29   The role of the thyroid and hormones

05:26   Components of a full thyroid panel

09:48   Supplementing the thyroid

21:22   Thyroid antibodies

26:10   How or where to get full thyroid panel









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

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

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

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

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

Dave Korsunsky:  That’s right.

Dr. Justin Marchegiani:  On eBay.

Dave Korsunsky:  Actually, it was Australia.

Dr. Justin Marchegiani: Australia.

Dave Korsunsky:  Yeah, it was Australia.

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

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

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

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

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

Dave Korsunsky:  Yeah.

Dr. Justin Marchegiani:  Now–

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

Dr. Justin Marchegiani:  Absolutely.

Dave Korsunsky:  Another time.

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

Dave Korsunsky:  Yup.

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

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

Dr. Justin Marchegiani:  Uh-hmm, yeah.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:   Yeah.

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

Dr. Justin Marchegiani:  Mmm.

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

Dr. Justin Marchegiani:  Right, right.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Right.

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Right.

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

Dr. Justin Marchegiani:  Yes.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

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

Dr. Justin Marchegiani:  Yeah, sleep.

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

Dr. Justin Marchegiani:  Uh-hmm.

Dave Korsunsky:  Also the things–

Dr. Justin Marchegiani:  Yeah.

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

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

Dave Korsunsky: Yup.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Uh-hmm.

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

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

Dr. Justin Marchegiani:  Uh-hmm.

Dave Korsunsky:  is that right?

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

Dave Korsunsky:  Yup.

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

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky: Uh-hmm.

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

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

Dr. Justin Marchegiani:  Yes. Yes.

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

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

Dave Korsunsky:  Yup.

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

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  I did, too.

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

Dave Korsunsky:  Sure.

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

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

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

Dave Korsunsky:  Got it. Yup.

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

Dave Korsunsky:  Yup, good.

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

Dave Korsunsky:  Uh-hmm.

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

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

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

Dave Korsunsky: Yup.

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

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  The Total represents the balance.

Dave Korsunsky:  Yup.

Dr. Justin Marchegiani:  T3 Free and Total.

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Right.

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

Dave Korsunsky:  Exactly.

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

Dave Korsunsky:  Exactly. Yup.

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

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

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

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  It was really, really effective.

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

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

Dr. Justin Marchegiani:  Yeah.

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

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

Dave Korsunsky:  Uh-hmm.

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

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

Dr. Justin Marchegiani:  Yeah, go ahead.

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

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  That you always look at as well.

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  You were always looking for autoimmunity.

Dr. Justin Marchegiani:  Uh-hmm. Yes.

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

Dr. Justin Marchegiani:  One step ahead of me.

Dave Korsunsky:  Okay.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup. That–

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Yup.

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

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

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  And have helped them–

Dr. Justin Marchegiani:  Yup.

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Uh-hmm.

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

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

Dr. Justin Marchegiani:  Big time.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Dave Korsunsky:  Uh-hmm.

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

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

Dr. Justin Marchegiani:  Yes.

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

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Cool.

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

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

Dr. Justin Marchegiani:  Oh yeah.

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

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  On your thyroid.

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

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

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Yup.

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

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

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

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

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

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

Dr. Justin Marchegiani:  Yeah.

Dave Korsunsky:  What we’d be looking for?

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  Uh-hmm. Makes sense.

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Yup, makes sense.

Dr. Justin Marchegiani:  But–

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

Dr. Justin Marchegiani:  Yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

Dave Korsunsky:  Uh-hmm.

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

Dave Korsunsky:  Yup.

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

Dave Korsunsky:  For sure.

Dr. Justin Marchegiani:  You know, we’re not getting the insulin low enough because these receptors are so numb to get sugar into the cell.

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Right?

Dave Korsunsky:  Uh-hmm.

Dr. Justin Marchegiani:  Insulin’s the—insulin’s the key. The receptor is the lock and basically the receptor site’s not accepting the key so we have to put—put—essentially push more keys into the hole to get that key out, to get that essentially door open to let the sugar in. So we get this insulin resistance where more keys getting into the cell. So that’s not a good thing because insulin when it’s too high can cause lots and lots of hormonal issues. One of them being thyroid conversion or T4 to T3 thyroid hormone activation. So getting on a Ketogenic Diet is gonna be essential because it’s gonna really get that insulin level down. The only thing is I find sometimes when people are long-term Keto, sometimes we may be get a little bit—we may go a little too low on the insulin and if we add just a small amount of carbs even just 10-20g, it can be enough to get your insulin levels a little bit higher and we see an aid in thyroid conversion. We’ll see T3 go up on the lab work. We’ll see hair—hair improved or maybe even temperature improved but that tends to be when people are Keto chronically or long-term. Everyone’s gonna–

Dave Korsunsky: Yup.

Dr. Justin Marchegiani:  Benefit on off the bat and get a really big benefit. It’s long-term afterwards. We wanna fine tune it and I’m totally non-dogmatic about it. If you can keep at a Keto level or—that’s great. If not, we just up it 10-20g to see how we do. I had a patient just yesterday we upped it about—we add about a quarter of sweet potato at night and a lot of her low thyroid symptoms went away.

Dave Korsunsky:  Makes sense. Yeah, well, I mean this is all good stuff, Doc. I think there’s so many people that need the—the full thyroid panel. Maybe have never had it before or maybe they‘re stuck just where they are in terms of their health transformation. I know it was a huge step for me, just seeing these numbers, figuring out how we address them. I know you make the panel available to people who can’t get it from their doctor which is awesome. Heads Up Health has got the software to help people track all of this stuff especially if they’re getting data from different labs and they wanna manage it all in one place. So hopefully there’s some people who can use the information here, get their own panel run and it may be an important diagnostic piece for them as they work on their own health goals.

Dr. Justin Marchegiani:  Absolutely. I’m gonna put the complete thyroid panel in the link below so if you’re interested in it, feel free and click on it. That’ll be a great way to access that panel.

Dave Korsunsky:  Yup, and I can include some information for people who want to start getting all of their health records organized using Heads Up Health. There’s a couple videos we put out there that just showed how to integrate all the medical records, basal temperature, macro nutrients so I can send that along as well.

Dr. Justin Marchegiani:  Great. Any other questions, comments or concerns, Dave?

Dave Korsunsky:  No, this was great. I see this topic come up all the time. So I’m glad we were able to address it and—and provide some information on what the full thyroid panel is and—and what the markers are and some of the things you can start doing to—to fix it.

Dr. Justin Marchegiani:  So anyone listening to this and kinda, you know, has all these labs in front of them and not quite sure you know what to do with it, get over to Heads Up Health. Get it integrated in there so you can start seeing patterns and then it’ll be really fun as you go forward tracking your labs. You’ll be able to see trends that you may have not seen otherwise.

Dave Korsunsky:  Yup, sounds great.

Dr. Justin Marchegiani:  Alright, Dave. Great talk! You have an awesome day.

Dave Korsunsky:  Yup, likewise. Thanks, Doc. Take it easy.

Dr. Justin Marchegiani:  Thanks, bye!


Thyroid Test:
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