Dr. Kelly Brogan – A Mind of Your Own – Podcast #165

In today’s video, Dr. Kelly Brogan, an accomplished doctor and author of the New York Times bestselling book “A Mind of Your Own”, joins Dr. Justin Marchegiani as they both discuss the link between gut issues and mental health. Get some useful tips on how to keep your mind clear and active without gut issues hindering it. Get your own mind back with the help of functional medicine. Let’s watch and listen!

Discover some natural ways to be more productive and learn about the different ways to address brain and gut inflammation. Also, stay tuned for some more information about Dr. Kelly’s bestselling book, “A Mind of Your Own” and viral articles.

In this episode, we cover:Dr. Kelly Brogan - A Mind of Your Own - Podcast #165

02:41   Depression: Illness of Modern Civilization,

Not a Chemical Imbalance 

04:53   Animal Model of Depression

08:20   Multiple Different Lifestyle Pillars

12:00   Meditation and Productivity

16:42   Supplemental Ways to Address Brain Inflammation




Dr. Justin Marchegiani: Hey there. It’s Dr. Justin Marchegiani. Today’s podcast, we have a great guest.  Dr. Kelly Brogan in the house. Kelly is wicked smart. I’ll bring up my Boston ex. You went to MIT Undergrad in Cornell from Medical School. So, it’s a privilege to have her here. She has a New York Times bestselling book, “A Mind of Your Own.” Did I say it correctly?

Dr. Kelly Brogan: That’s right? [crosstalk] You got it.

Dr. Justin Marchegiani: A Mind of Your Own, really looking at natural solutions to get your brain back on track and move back on track. And one of the things about Dr. Kelly that I love so much is she looks at how mood is connected with the gut. Because most people, they just want to throw a medication to fix the brain. They fix the symptoms but not actually get to the root cause, which can be in the gut. So, Dr. Kelly, welcome to the show.

Dr. Kelly Brogan: Thank you. Total pleasure to be here.

Dr. Justin Marchegiani: Excellent. Well, tell us a little bit more about your self, ‘cause you went down this conventional medical rabbit hole, right? MIT, Cornell– You’re diving in deep– you do your residency, uhm– and you’re kind of learning all these conventional treatments for Mood disorders, etc. How did you come out of that alive? And how did you get your training to get to the real root cause and the functional medicine side here.

Dr. Kelly Brogan: Yeah. So, you know, I come from a very conventional mindset, and I was raised by uhm– an immigrant mom. And anyone who has immigrant parents knows that, basically, you follow the rules; you become a doctor, a lawyer and you’re supposed to be making a lot of money.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: And that was essentially, you know– My effort uhm– was to become a doctor. I thought, you know– I figured out through my work on a suicide hotline, actually, at MIT, that we’ve cracked the code of human behaviour. We know that these are genetic illnesses that are reflected as chemical imbalances that require pills for lifelong management. Cool! You know, I’m gonna participate in that model. And so, it really wasn’t into my own, sort of uhm– health journey, which is what you’ll all hear from any turncoat doctor. We had a personal experience where we bumped up against the ceiling of what conventional medicine has to offer. And we learned a broader version of the truth. And uh– you know, I’ve always been a Science Nut. I’m very comfortable on pubmed.com, and I went and researched for myself, you know– the truth about everything I learned in medical school and residency and fellowship. Uh– and what I learned was pretty jaw-dropping. I was ready to hear it though because I had already had my own uh– experience of putting an autoimmune disorder into remission through nutrition. And so, you know– what I learned is that depression, for example– Let’s just talk about depression because it’s a– It’s a emblematic of these more systemic issues in our medical system. But, uhm– it’s not a thing. It’s not a disease in a way we were told it was. And, you know, what I– what I learned through my review of the medical literature is that in six decades, you know– we’ve been trying to validate this idea that depression is a chemical imbalance. The science just isn’t there. I was shocked because I can’t tell you how many hundreds of patients I’ve sat with and I said, “You know, you have a chemical imbalance. It has something to do with Serotonin or Dopamine or Epinephrine, and you know– you need to manage it. And the sooner you accept that, you know– the easier your life is gonna be.” So patronizing. You know, I’ve said that to countless patients. And when I looked to the Science, it just wasn’t there. But, what is there, interestingly, is a science that frames depression as uhm– an illness of modern civilization, right? So, it’s a response on the part of the body, mind and spirit, uh– you know, to the kinds of stressors, exposures, triggers, toxicants that we are encountering today, that we just haven’t evolved to accommodate. And perhaps, we never will. Perhaps we’re not even meant to, right? Because…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …of– of wrong living today, and– and the way that the natural world will ultimately ask us to get back in line. And– and one of the ways that– that asking happens, that– that invitation’s delivered is through symptoms. So, uh– you know, I found  that there are actually a lot of reversible causes of what we are calling depression.

Dr. Justin Marchegiani: Interesting. Very good. And I see a lot of patients, clinically, right? ‘Cause I’m working with patients making diet changes or cutting out gluten, grains, refined sugar, a lot of the inflammatory foods, or cutting out a lot of the bacteria in the gut that has this compound called LPS or lipopolysaccharide. And, you’ve talked about that kind of getting into the bloodstream and making its way to the brain, and creating mood issues there. Can you elaborate more on that?

Dr. Kelly Brogan: Yeah. So, you know, I think it’s fairly intuitive for most people– you know, that the gut and the brain are connected, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: You felt nervous about giving a speech and maybe you lost your appetite or you have diarrhea, or something like that. And that makes intuitive sense. But, the other direction– you know, the gut to brain direction, is really something we’re just beginning to develop scientific comfort with. Although it’s been actually several decades since it’s emerged in the literature. When it comes to depression, it’s interesting because the animal model of depression– There is such a thing. In the animal model of depression, the way that they induce it is to inject– Systemically, right?– in these rodents, LPS, as you mentioned. So this– this compound in a grand– grand negative bacterial balls. And the deal is that it’s not meant to be sort of circulating around. So, once it’s breached that gut-brain uh– Sorry– that gut barrier..

Dr. Justin Marchegiani: Yes.

Dr. Kelly Brogan: …then it can alert the immune system to the need of greater inflammatory response at the gut level. It’s all by design. Everything that the body does makes sense if only we have the mindset and framework to, you know, receive that uh– information. So, you know, through this lens, uhm– the inflammatory response that ultimately results in the symptoms of depression, which are what? Sleep disturbance, social avoidance, changes in appetite, for example, changes in  motivation, fixation on very specific thoughts, uhm– you know, the– the– the driver of that perhaps could be reduced to a gut insult. So, where do gut insults come from? Most of the time, through what we put in our mouth…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …right? So that means that we are empowered to make changes to our brain behavior and cognition through diet, you know. And of course, now we have science that shows that within seventy-two hours of changing your diet, you change that ecology in your gut, your microbiome. Uh– and so, I totally agree, you know, that there are certain foods that really moved the needle quickly. They also happen to be foods that are very addictive in nature, right? You know, things like, wheat, dairy, sugar, alcohol. I actually stored coffee in that mix. I know that’s little controversial.

Dr. Justin Marchegiani: Hm– Mmhmn.

Dr. Kelly Brogan: Uh– but, you know, so– so, not only are you seeing what you look like without these addictive foods, but you’re also engaging in a pretty deep exercise of changing your gut ecology. And, you know, we could talk about the role perhaps of certain kind of starches in, you know, feeding gut bacteria, ‘cause that’s, you know, part of my approaches to restrict those for the first month.

Dr. Justin Marchegiani: Got it. Interesting. And what’s your experience treating patients ‘cause, clinically, I treat– well, fifty patients a week in my virtual clinic here in Austin. And I’m running Stool test–  sometimes, even multiple Stool tests on different patients, and I’m saying, you know, obviously, “Your SIBO type of overgrowth.” “You’re Methane and you’re Hydrogen overgrowth”. And then, I’m seeing infections like, Blasto, Giardia, and Cryptosporidium, E. histo and H. pylori. What are you seeing in your patients? Are you kind of seeing a similar imbalance of those creatures.

Dr. Kelly Brogan: It’s interesting because I– you know, when I departed conventional medicine, my first deep dive was into functional medicine.

Dr. Justin Marchegiani: Mmhmn.

Dr. Kelly Brogan: Uhm– and that’s, you know, uh– I was certified through ADIHM, and I was very interested ‘cause this is how my mind works…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in quantifying every aspect of my patients’ existence, right? So, I wanted blood and saliva. I wanted hormone testing. I wanted Urine analysis and I wanted Stool analysis. And I did that for several years– yeah, almost a decade, into this work. Uhm– until I came upon uhm– a deep desire to bring this opportunity to more and more people. Perhaps you couldn’t necessarily afford all that testing, or for whom it was just overwhelming, right? And so, somehow, I arrived at the point today, where my approach is actually quite simplified. Such that, I actually come to believe that if you recruit the synergy of multiple different lifestyle pillars. And they’re pretty basic, right? Pretty familiar, too, obviously. So, detoxification…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …looking at daily contemplative practice. Of course, I’m– have my specific opinion on what I believe is one of the more powerful types. I’m Kundalini Yoga uhm– Instructor.

Dr. Justin Marchegiani: Nice.

Dr. Kelly Brogan: And, also the role of a strict commitment to a therapeutic diet for the space of the month. So, in working with these pillars, even without testing at all– So, in my online program, we don’t do any labs. The outcomes that I have gotten actually more rapid and more robust than when I was mired in the weeds of testing. But when I was, I actually found that there are some common uh– reversible drivers of diagnosis of anxiety, of depression, even OCD, panic attacks, ADHD, Chronic Fatigue– In my practice, the one of the most common ones was blood sugar imbalance, so…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …big one, right? Uhm– so you could test for that. You can diagnose reactive hypoglycemia, or you know you can just do a dietary intervention for ten days and see if that was part of the deal for you, right? So, another big one is wheat and dairy indigenousity. So again, you can test for that or you can just take it out and see how you do. Another big, big, big– big one, probably upwards of 80 percent of my patients have a diagnosis of Hashimoto’s, often…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …perhaps driven by mimicry like you’re talking about e– Epstein-Barr, uhm– for example, uh– you know, infection. Uhm– Hashimoto’s, Graves, Postpartum Thyroiditis are big– what I call, psychiatric pretenders, right? If you do not know that you have this going on, you could land your self on Zoloft and Lithium, or more. And that’s why this kinds of testing– unless you’re really committed and you just know, you’re not gonna go the medication route– you know, this kind of testing can really– potentially even, you know, save your life. I’ll be that dramatic about it. Uhm– and, you know, and then, of course, I’d become very passionate about the untold side effects of other common medications, right? So, as drivers of psychiatric illness, so things like birth control pills and acid blockers, statins, antibiotics. Uhm– so, you know, sometimes it– it– it needs to be looked at through the eyes of an expert like yourself. Uhm– but sometimes it’s really simple. You know, and– and engaging in this kind of uhm– you know, pillar approach can– can be really all you need.

Dr. Justin Marchegiani: Very cool. Just curious. Can you give us like uh– a day in the life of Dr. Kelly. What does your diet look like, Breakfast, lunch, dinner?

Dr. Kelly Brogan: Yeah. So that’s the interesting uhm– part about this kind of like holistic medicine, if you want to call it that, is the power of your potential to influence and heal patients, I believe, is in direct proportion to your ability to walk the walk, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So, you know, you transmit something to the people you are looking to help, simply because you’re living that life. So, I– you know, I walk the walk completely, you know. I asked many of my patients to do coffee enemas, for example, which I learned from my mentor, Nick Gonzalez. And you know, if II didn’t do them, how would I ever convince someone else that it’s effective? And this is why meditation is a tough one for me because I follow the literature on meditation for many years and I never did it. I was too busy. Meditation was for other people. And everytime I sat down to do it, I hated it. I hated the experience of just being with myself and being with my crazy mind, right? So, until i broke through that barrier and actually committed to a daily practice– Now I have a pretty strong 45-minute daily practice…

Dr. Justin Marchegiani: It’s great.

Dr. Kelly Brogan: …predawn. But, you know, until I did that, I didn’t– I don’t think I convinced a single patient to meditate. You know, we both sort of thought it was a good idea. They weren’t doing it. I wasn’t doing it. So, you know, the real game changer for me, personally, ‘cause I heal my Hashimoto’s mostly just through dietary change uhm– in almost eight years ago now. Uhm– and my life really changed. I’ve really rewired my nervous system and my productivity performance and aligned it with my flow, changed dramatically when I started meditating every single day. And, specifically, when I started meditating before sunrise, uhm– everything changed. You know, I used to be up until 2 in the morning, working. I’m a total workaholic.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I wake up everyday dying into this work. I love this work. I– I would do it for free, forever. You know, this is what I’m here to do. But, I would work ‘til two in the morning regularly. And you know, in New York, that’s– it’s the culture here.

Dr. Justin Marchegiani: Totally. [crosstalk] Hustle and bustle.

Dr. Kelly Brogan: Totally. Exactly. Totally sanctioned. So, you know, I uhm– When I started meditating at 5:30 in the morning everyday, which I started after in the setting of grief uhm– you know, after my mentor died. It’s the hardest thing I’ve ever dealt with…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in my life.

Dr. Justin Marchegiani: Roger that.

Dr. Kelly Brogan: I was desperate.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. I was totally desperate, and I did it. The nest day, I woke up and I have never missed a day since. Uhm– but, if you’re waking at 5:30, you can’t go to bed at 2:00 AM, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Or you’re gonna be in trouble [inaudible]

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So now, I go to bed at nine. Do you know how revolutionary that is for a New Yorker…

Dr. Justin Marchegiani: It’s amazing.

Dr. Kelly Brogan: ….to go at bed at 9:00 PM? And–  and you would think, “Oh, I’m missing– you know, what is that?– five hours of productivity.”

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Like, how do I even keep my business afloat. Uhm– but my performance– and again, sort of alignment with– just things unfolding, everything happens exactly, you know, the moment I need to. I don’t need to drive this ship. You know, that’s one of the sort of secret pearls in self-care that you wouldn’t otherwise believe unless you’ve had the experience. So, i’m a big believer in foregrounding self-care as being really my only responsibility. All I have to do every single day is make sure that I have committed, again, to taking care of my self. And the rest is gonna. Is gonna be exactly how it needs to be.

Dr. Justin Marchegiani: Very cool. So, I think I missed it. What was breakfast again, typically, for you?

Dr. Kelly Brogan: So, I have this uhm– smoothie often. It’s so funny because sometimes I’ll write a blog that I, you know, spend weeks and weeks and weeks researching. It’s like, you know, ten, 15, 20, 30…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …represent it. And like four people will read it, right?  

Dr. Justin Marchegiani: Mhmmn.

Dr. Kelly Brogan: And then, one day, I just decided to write uh– the ingredients of the smoothie that I put uh– together. Okay, it’s like egg yolks, coconut oil, uh– plus/minus coconut oil. Uhm– nut butter, frozen organic cherries. It’s collagen powder, uhm– coconut water.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Just, yeah. Basic– basic stuff, but it’s not a green smoothie, right? Uhm– it’s not a ton of Kale and Spinach or anything like that. And it was– It’s like, to this day, the most viral thing I’ve ever written. [laughs] It’s just breakfast, [crosstalk] right?

Dr. Justin Marchegiani: Love it.

Dr. Kelly Brogan: Because if you struggle with blood sugar stuff, like I did, uhm– like many of the people I work with do, It’s like, within the day resolution. Like within one day, you can turn that around. You’ll feel what it is to put, you know– It’s two tablespoons of ghee. Put that much fat into your body for breakfast is an unusual thing uhm– for most people, and it tastes delicious and you actually feel full for some times, double-triple the amount you would have otherwise. So, that’s why I’m actually big– I’m glad you asked– big believer in just beginning with changing your breakfast. Like if you are not ready for the rest of it, just start with there. And see…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …how different you can feel.

Dr. Justin Marchegiani: I love it.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: ‘Cause stabilizing that blood sugar is so important. ‘Cause when your blood sugar goes on highs and lows, you get the Hyperinsulinism, which is gonna create all kinds of problems in your hormones. If you’re a woman, it will turn you into a man, uh– by getting the PCOS stuff going, and if you’re a man, it will turn you into a woman by upregulating aromatase. So, you have that side of the fence. And the blood sugar swings. When they go low, you’re gonna get a lot of Cortisol and Adrenaline, which can create mood issues and create that anxiety and that may be the reason why you’re on the Xanax. [crosstalk] So the other moods stabilizes, right?

Dr. Kelly Brogan: Exactly. [crosstalk] You said it so I don’t have to. That’s exactly it. It’s powerful. I mean, I have patients who’d have six panic attacks a day. They’ve had three medications heading to Electroconvulsive Therapy. And all that was going on was Dysglycemia.

Dr. Justin Marchegiani: Huge. [crosstalk] Huge. Now we have these cells in our brain, also called the glial cells, and a great portion of the cells in our brain are actually immune cells, which is interesting. And once these cells get activated from stress or inflammation– it’s like  positive feedback loop. It just gets more and more and more. Uhm– what do you do to help decrease brain inflammation? I think you’ll talk about the gut, but is there anything you do supplementally to help decrease that brain inflammation?

Dr. Kelly Brogan: Yeah. So that’s where I am a big believer in this multi-pronged approach, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: Because, if we’re– if we’re looking at an anti-inflammatory diet, the typical template of a diet I recommend is not gonna be any major surprise uhm– to anyone– but, the Vegans probably, because it’s uh– you know, a classical sort of ancestral diet. You know…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: It was animal food. You know, the nuts and seeds– all vegetables…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I restrict resistant starch for the first month. Uhm–

Dr. Justin Marchegiani: like a Paleo template, basically.

Dr. Kelly Brogan: It’s a Paleo template, basically. Includes, uhm– some starchy vegetables, but not uh– white potatoes. So, just to restricting…

Dr. Justin Marchegiani: Nitrates.

Dr. Kelly Brogan: …they always– Nitrates are included, so tomatoes are fine. Eggplants are fine. You know, mushrooms are…

Dr. Justin Marchegiani: Just the potatoes, okay.

Dr. Kelly Brogan: Just the white potatoes. And uhm– and you know, otherwise, my patients do always reintroduce things like white rice, gluten-free grains, uh– legumes. So, it’s not a long-term Paleo diet. It’s just restricted for that first month. Uhm– so that we can understand what resistant starch does to your microbiome, basically, because when you reintroduce potatoes– Do you have gas and bloating? You know, Are you super tired after you eat white rice? We just want to know that, right, for these potent starches. Otherwise it’s not that uhm– dramatic, but it is– just have this anti-inflammatory effect, ecologically rebouncing at the gut level. And then the meditation components, I just think, as one of the meditations I often recommend is called Kirtan Kriya Carer or _____[18:13]. It’s been studied in  randomized trials, actually, for changes in brain level profusion. Uhm– and the subjective outcomes in terms of resolution of cognitive impairment and Dementia patients, who we have nothing to offer, you know, on a pharmaceutical level. So, literally, all they did was 11 minutes of this meditation every single day.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: So, i’m a big believer in the potential of this ancient  technologies to send that signal of safety at the brain level. And then, of course, you know, when you’re engaging in detoxification– even if it’s as simple as taking the pesticides out of your diet.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Uh– You know, we’re fundamentally changing the way the immune system is being triggered. And as you said, you know, we have evidence that from a gut level, and also from a psychosocial stress level, we could mobilize the immune system in the– in the systemic circulation. That then tracks back to the brain. And like you said, kicks off that alarm. You know, when i was in med school, we don’t even know that the brain had an immune system. We thought that it was a privilege region.

Dr. Justin Marchegiani: It’s crazy.

Dr. Kelly Brogan: We didn’t know that what’s inside of the brain. You know, we’re just discovering basic anatomy, still, at this point. So, it’s important to work with the tools that do the least harm.

Dr. Justin Marchegiani: Very good. Now, I’ve seen you write this, and I may be off in a little bit. I’ll just throw it out there and you can correct me.

Dr. Kelly Brogan: [nods]

Dr. Justin Marchegiani: You know, you’ve talked about the brain-gut connection with mood. Now, being a functional medicine physician, I’m addressing everything: diet, lifestyle, blood sugar, [crosstalk] all the body system, hormone, detox. So, we’re never ever putting in on one magic pill.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: But as we fix things, I do see certain amino acid nutrients with certain nutrients, like B6, and certain B vitamins. I have seen that significantly helped a lot of people on the mood side, not every time. So, I know the SSRIs and some of these medications, we think they work by just blocking reuptake of some of these chemicals but that may not be the case. So, what’s your take on the amino acids? I do see benefits, but I know, you–you’ve talked differently about that.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: Things like 5-HTP, tyrosine, ___[20:09], L-dopa; those kind of things.

Dr. Kelly Brogan: Exactly.

Dr. Justin Marchegiani: Yeah [inaudible].

Dr. Kelly Brogan: Yeah. You know, listen. I am a passionate supporter of natural medicine. You know, and there are many, many, many, many different approaches. Uh– I mean I had patients who’d come– not patients. I know of people who come up of psychiatric medications using flower remedies. So…

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: …you know, i know that there is not one path here. And that’s the beautiful thing. Uh– but, in my approach, I use no supplements at all for the first month.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: Uhm– when– I don’t begin medications taper, for the first month either. So, in a context of medication taper, then I actually do use amino acids. Uhm–

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: I use things uh– you know, the ones you’ve mentioned in particular as a compliment to the purported mechanism of the given medication, and I aIways use a general mix of amino acids. And I find them to facilitate the process. Uhm– I don’t use any supplements as a replacement for medication because it’s not the contraces we’re going for, right? We’re going for uhm— you know, trusting the body, trusting it’s uhm– responses, curiosity about what the body is meaning to tell you. And then also working through a lot of uhm– sort of indoctrinated fear around emotions like, you know, deep sadness, rage, grief– You know, this kind of pain that we are uhm– not, in any way, making space for. You know, to– to investigate with any degree of curiosity because, you know– one of the greatest uh– most meaningful lessons I’ve learned is that on the other side of that process of personal encounter with your deepest, darkest uhm– experience of your mind and body, is a kind of expansive, you know, exposure to these exalted emotions: gratitude, joy…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …even bliss. You know, that becomes available to you when you have the courage to sort of walk through that dark night. So that is a big part of my uh– approach.

Dr. Justin Marchegiani: So, some free-form amino acids which is great. What do you do with adaptogenic herbs? I mean, I use Ashwagandha a lot. I find that really help modulate Cortisol, which can thus help along with anxiety and even sleep. What’s your take on adaptogens, and what are your top three favorites?

Dr. Kelly Brogan: Uhm– I would say, I have a top one favorite. [laughs]

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: Because I’m a big Rhodiola fan.

Dr. Justin Marchegiani: Uhh– love it.

Dr. Kelly Brogan: And had been for many years. And it’s one of my first introductions to the power of herbal– you know, herbal approaches and herbal medicine, personally. And, You know, I find that it’s a really powerful compliment, not only to support in cognition at the time when many of my patients have been injured by medications on the cognitive front, uhh– but also that inevitable, you know, exposure to stress. I think it’s a really magical plant to dance with. So, I’m a  big fan of it.

Dr. Justin Marchegiani: What about nutrients? And I say, BC– uh– B6, or P5P, Pyridoxal-5-Phospate, really essential for helping these neurotransmitters activate. What’s your take on the most important nutrients for you that you see makes the biggest bank for your back and also a B6, too.

Dr. Kelly Brogan: Mm– I– I would– In my experience, the most profound single nutrient– because, you know, most of us do offer that as uh– you know, sort of a compliment…

Dr. Justin Marchegiani: Uhmn–

Dr. Kelly Brogan: Uhm– in– in the entire birth.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: But the one that I had the most miraculous outcomes with is actually B12.

Dr. Justin Marchegiani: Yes. Huge.

Dr. Kelly Brogan: And, you know, through my work with Nick Gonzalez, I’ve had a better ability to contextualize why– that is, in the patients that I work with. They are what he would call parasympathetic dominance, and so they respond especially well to animal-based nutrients, particularly white B12. You know there are cases in the literature of one woman, in particular, who was diagnosed as uhm– having psychotic depression. She was given Electrocompulsive Therapy…

Dr. Justin Marchegiani:  Totally.

Dr. Kelly Brogan: …and uh– multiple medications, and all that she was going on was a B12 deficiency. So, I actually used– have my patients inject themselves uhm– with something like a Hydroxyvaline in a pretty generous dose. Sometimes like 5mg, sometimes several times a week uh– initially, which is obviously considered to be rather aggressive. But uh– it seems to be, you know, quite effective in a short period of time, particularly for uh– you know, cognitive and energy-related impairments.

Dr. Justin Marchegiani: You know, Dr. Brownstein’s also a big form of the hydroxyl form. Why do you like the hydroxyls so much– let’s say, over the methyl or the adenosyl?

Dr. Kelly Brogan: Uhm– I had– I started with a Methocarbamol form.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan:  I just had a couple patients who uh– felt overly activated by it. You know, like whose are wired by it. And– and again, I’m using large doses, so it could have just been that. Uhm– so I– the hydroxyl form is just a– a way to thread the needle, you know, for those patients who might be susceptible to the– the methyl as [inaudible].

Dr. Justin Marchegiani: And then, do you have any opinion on GABA as well? You know, some people say the molecule’s too big to cross the blood-brain barrier. Others are coming out with liposomal forms. What’s your take on GABA?

Dr. Kelly Brogan: Yeah. I have gone very comfortable using a form called PharmaGABA. [crosstalk] It’s a–

Dr. Justin Marchegiani: PharmaGABA, yeah.

Dr. Kelly Brogan: Yeah. Fermented…

Dr. Justin Marchegiani: The science got it.

Dr. Kelly Brogan: …form

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. And, you know, it’s uh– when it works, it works. And who knows if that’s, you know, Placebo. Otherwise, I don’t really care, because if it’s as benign as it is, I’ll apply that Placebo Effect all day long. But I, It’s a fan favorite– you know, of my patients, uh– particularly during the process of moving through a medication taper. It’s a very important uhm– tool.  

Dr. Justin Marchegiani: And then, when you’re dealing with people that are on these medications, whether they’re Benzos or SSRIs, or even Lithium and such. How are you dealing, like– Does every– Can everyone have the ability to get of those medications at some point, and who are the patients you don’t want to like take them off. Where it’s really you got to be super, super slow.

Dr. Kelly Brogan: Mm– Well, it’s my passionate belief that every single person should be offered the opportunity to come up with psychiatric medications.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I’ll even go farther to say all medications, period. What the most critical ingredient is uhm– is the mindset, right?

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: So, believe that it’s possible. It’s the readiness to commit uh– to lifestyle, medicine and to self-care. Uhm– which, of course confers the type of empowerment that’s very necessary to move you out of the dependent and helpless position that you are put in as a psychiatric patient. Uhm– but I had taken patients off of– you know I have videos of my website to prove this, so to speak. I’m publishing cases in the purity of literature. Uh– taking patients of up to medications they’ve been on for 25 years. Uhm– I have patients with histories of Schizophrenia, psychotic mania, suicidal depression. And over and over and over again, they’re shedding their diagnosis and they’re completely and totally off medication. I have yet to fail. Uhm– and I don’t expect to. But, I always screen my patients. I have a very skew population, because of these two criteria– the mindset and the belief.

Dr. Justin Marchegiani: Totally. And then, we’ll put a disclaimer. We don’t want anyone getting after uhm– psychiatric medication on their own. We want them to go back to the Prescribing Physician. But on average– just in general, are you typically tapering off about one to two-month timeframe? Is that generally, where you’re at?

Dr. Kelly Brogan: Oh, wow. No. It can be years.

Dr. Justin Marchegiani: So, years or so?

Dr. Kelly Brogan: I’m glad you asked, because…

Dr. Justin Marchegiani: Good.

Dr. Kelly Brogan: I think I forget sometimes that that’s not uhm– you know, uh– an assumption. So, I don’t touch uh– medication until my patients, in my online program– until they have gone through this month-long commitment.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Meditation, detox and diet. Literally, I won’t touch it. It’s a total requirement. Because I used to do it before I require that, and it was kind of a nice idea. We’ll start looking at your diet now. It’s non-negotiable. Okay? So, that happens first, and then the taper is around 10 to 20 percent of the total dose per month is a typical pace. So, it depends on…

Dr. Justin Marchegiani: Got it.

Dr. Kelly Brogan: …what you’re taking. It’s one medication at a time. The process can take years. And, you know what? If you want it to last, and you want it to be a permanently chaptered for you, you have a right with that. You know, because it’s an investment in this being, not just a revolving door where you’re back on meds in a couple of months. Uh– but I– I absolutely do not recommend that anyone consider coming off medications, particularly until they have uh– initiated this kind of self-care and physical healing regiment. And you know, in my program, I have an entire module dedicated to tapering, because it’s not a science, unfortunately. Uhm– and there are very few practitioners who know how to do it. And that’s why patients actually become more educated. Then their provided about how to do it. Uhm– it’s a bit of the wild west at this point.

Dr. Justin Marchegiani: And, is that course over at kellybroganmd.com?

Dr. Kelly Brogan: Yes! We– It’s called, Vital Mind Reset.

Dr. Justin Marchegiani: Vital Mind Reset. We’ll put all the links below. We’ll put the links to the Amazon Book as well, “A Mind of Your Own.” So, everyone that’s listening and finding value. Go support Dr. Kelly by getting that book. That’s great. Now, one last thing here before I let you go, Dr. Kelly. Uh– when I use certain amino acid with patients, even some of the free-forms, I’ll start to notice the patient is starting to have some of the– the side effects, as if the drug’s too much. Do you see that at all? And then, do you start to gradually taper if those higher side effects from the amino acids are making the drug work better? Do you notice that at all?

Dr. Kelly Brogan: That uhm– is possible. I don’t often encounter that for whatever reason, uh– but  that’s absolutely possible. And in fact there’s a proprietary formula called uhm– EMPowerplus by TrueHope. It may [inaudible]

Dr. Justin Marchegiani: Yes. TrueHope, yeah.

Dr. Kelly Brogan: Yeah. And, you know, they counsel about that– you know, that it’s very possible that in the setting of uh– nutrient repletion, that medication could become actually almost quasi-toxic uh– so that you would need to begin to ramp down on the dose of medication at that point. So, it’s– it’s highly possible and that’s an incredible reminder. You know, that nutrients are– are very powerful uhm– tools to be used with strategy.

Dr. Justin Marchegiani: Awesome, Dr. kelly. I think you’re changing the world. I appreciate you coming on the show. Last question for you, “If you’re on a desert island and you can only bring one nutrient, one supplement, one herb– whatever it is, what would that be for you?

Dr. Kelly Brogan: Oh, turmeric, of course. [laughs]

Dr. Justin Marchegiani: Turmeric. Okay. Got it. [crosstalk] Crucumin?

Dr. Kelly Brogan: Yeah, Crucumin.

Dr. Justin Marchegiani: Can [inaudible] can the anti-inflammatory on?

Dr. Kelly Brogan: It’s everything. You know, it’s like a miracle. It’s a miracle herb, and you know the research on it, of course had– had my skeptical mind convinced. You know, with the catalog research on Crucumin, which is one isolate of this…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …very complex herb, is astounding. You know, head to head against medications like Cox-2 Inhibitors, antidepressants. It’s extraordinary. So, I think of it as a, you know, the– the power performer, for sure.

Dr. Justin Marchegiani: I love it. Now, is there anything else you want to let the listeners to know? Any new books, products, online things coming out for you that people should be aware of?

Dr. Kelly Brogan: No. Just you know that we’re here to support your journey. If any of these is resident, it is one hundred percent possible for you. I see it every single day. And so, just to make sure that I plant that seed of potential. And oh, you know, we’re here to support. We have tons of free information on this site, and of course, greater uhm– complex products if needed.

Dr. Justin Marchegiani: And let’s hear those links one more time. kellybroganmd.com– the second one was?

Dr. Kelly Brogan: That’s it. You know…

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: …all the information’s there. So let’s just keep it simple.

Dr. Justin Marchegiani: And then the book– if you guys love it, go get that book on Amazon. Dr. Kelly, we really appreciate you coming on the show.

Dr. Kelly Brogan: Thank you so much.

Dr. Justin Marchegiani: Awesome. Take care.




“Vital Mind Reset Program,” by Dr. Kelly Brogan

New York Times bestselling book, “A Mind of Your Own” by Dr. Kelly Brogan


“Increase your Brain Health by Changing Your Breakfast: The KB Smoothie” by Dr. Kelly Brogan

https://www.truehope.com/effectiveness/ingredients EMPowerplus by TrueHope


Leaky Gut and Autoimmunity – Dr. J. Live Podcast #161

Dr. Justin Marchegiani and Evan Brand dive into a discussion about the link between gut infections and autoimmunity. Gain knowledge about leaky gut, how it occurs in the body and it’s connection to Hashimoto’s.

Explore the different stressors which affect gut health and contribute to a weakened immune system. Learn about Dr. Justin’s 6-hour template, which includes his expert recommendation regarding healing, nutrient and supplements.

In this episode, we cover:Leaky gut and autoimmunity

00:34   Leaky Gut and Autoimmunity Connection

04:05   GABA and the Blood Brain Barrier

06:48   Hashimoto’s and Gut Health

12:23   6-hour Template

22:40   Thyroid Health: T3, T4




Dr. Justin Marchegiani: Hello, ladies and germs! Dr. J in the house. Evan, how we doing, man? How was your Holidays? How’s your Thanksgiving?

Evan Brand: Holidays were great. Let’s dive in. I know we’ve got a short limited of time. But we’re doing this on the fly because this conversation of gut health and gut infections and autoimmunity is huge and hardly anyone is talking about this. Conventional doctors don’t have a clue about the link between gut infections and autoimmunity, so dude, let’s dive right in.

Dr. Justin Marchegiani: That sounds phenomenal. So we talked about in the show, kinda chatting about leaky gut and autoimmunity, which is really important because leaky gut is kind of like one of the primary mechanisms of autoimmunity kinda starting, which is kind of gastrointestinal permeability cells in the gut called the tight junctions. They start to unzip, kinda like you unzip your coat on a hot day and undigested food particles can get in there in this kind of creates this uhm— cascade of reactions call molecular mimicry, where certain food proteins— the surface proteins on these foods are similar to surface proteins of the thyroid or the brain or the pancreas, the beta—the beta cells of the pancreas, whatever. So you have this kind of immune system getting primed to similar proteins in foods which then prime the immune reaction for the immune system. It starts attacking these tissues in the body. So that’s kinda one of the first defenses is this autoimmunity leaky gut, molecular mimicry and that while they gut’s leaky, you have undigested bacterial compounds also getting in there, too. And then kinda just perpetuate and windup that immune system. And then also make it prime to—for other infections that kind of slip in there because the immune system now has weaken. Other infections can slip in. And typically, we’re gonna have a lower stomach acid environment so you’re gonna have less sterility in the stomach coz that low pH really prevents a lot of bacterial and critters from growing. But now that pH is like, you know, it’s like walking over to the dirty picnic tables and normally you spray it down with maybe some bleach. Or let’s say in a healthy version, maybe a really good antimicrobial essential oil. But now, we don’t have that because of the stress from the gut.

Evan Brand: Yup. Well said. Now, Hashimoto’s for example, is probably most common autoimmune condition that we’re going to see and deal with and that probably you guys listening are aware of. Leaky gut has to take place for Hashimoto’s to happen. That’s one of the dominoes that happens. So you’ve got the leaky gut situation. You possibly got the gluten in the diet. You got the immune stress, which could be internal or external. So bad boss, bad spouse, bad relationships, bad job— those are kind of the big dominoes we see. And when you all those up together, that’s how you get autoimmune disease. It’s really just that simple.

Dr. Justin Marchegiani: Totally. And then we have people on the live chat here. And again, this is a great reason why you should subscribe to our YouTube channel—justinhealth. Uhm because we have these podcast going live as well and we’ve also incorporated other technology in the background to get a higher quality audio versions. So if you want better audio, you can subscribe to Youtube, but also check out our podcast uhm—Evan Brand, notjustpaleo and then beyond wellness radio myself. So just keep that in the back of your head. And then your question was—I just missed it. We talked about—Oh, yeah! Leaky brain. Leaky brain is connected as well coz we have these live questions coming in. And so we are multitasking like it’s no tomorrow. So leaky brain’s important because we have these called astrocytes or the brain blood or the blood brain barrier which is kind of the interplay between systemic blood and then the passing over to the brain. And we have the cells called astrocytes. And again, same thing, when we have gut lining integrity, it tends to affect integrity of the lungs, integrity of the sinuses, integrity of you know, vaginal wall area, urinary tract. So you have people that have gut issues—gut integrity issues. It almost always can cause sinus issues, brain fog, brain issues, UTI issues, bladder issues, right? So you have all of that mucous membrane barrier, it’s gonna be compromised throughout the body not just the gut. But the guts kind of that first major domino that falls and then everything else tends to follow along with it.

Evan Brand: What you think about the GABA test for the blood brain barrier, where you take like a 500 mg GABA and if it works and you get relaxed, that says you have a leaky brain. Do you agree with that?

Dr. Justin Marchegiani: I’m not sure I buy that because I’ve seen people that do—that are really healthy and that do well with GABA.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And they, you know, symptomatically, they’re doing pretty good. They’re eating well. Again, certain supplement companies have kinda put that out where they have a GABA challenge. They say, “Hey, GABA is this really big amino acid compound and it shouldn’t go through that blood brain barrier; therefore if it does, that means your major blood brain barrier is permeable.” I’m not sure I buy that. I think it’s something to keep in mind, something to try. I have a lot of patient that have gut issues and they’re sick and that use GABA or will only give them GABA and they don’t notice much benefit either.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, you know, how do you sparse that? That’s hard.

Evan Brand: I know. Who knows, man. That’s a good question.

Dr. Justin Marchegiani: Everyone tries to be a little bit trendy and nuance in this functional medicine field.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they wanna make a name for themselves.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And I get that from a marketing perspective, but just looking at the clinical application, I’m not sure there’s ton.  But, heck, if you have GABA and you want to try it and you get uh—benefits, that’s great. I notice a little bit of improvement with GABA. Like when I take it, I feel little but relax. I also do that with Ashwagandha as well. I feel it with magnesium. Someone chimed in and asked if magnesium can be taken with Ashwagandha. Yeah, sure. I’ve no problem with that.

Evan Brand: Works great.

Dr. Justin Marchegiani: Hope everyone’s listening had a great Thanksgiving, too.

Evan Brand: Yeah. Tesa wants to know, “Have you reversed your Hashimoto’s, Dr. J, by healing the gut?”

Dr. Justin Marchegiani: Well, so we have to be careful when we say reversed, right? So have we decrease the inflammation? Have we address underlying issues that made people susceptible to having autoimmune attack? And we—can we lessen those and decrease them to the point where we are no longer symptomatic because we have the inflammation down or quench enough? Yes. I’m just very careful because you know, eyes in the skies and people listening in they’re— they’re looking for that the cure the cure-all word, right? We just got to be careful. We don’t cure anything. We support the body’s ability to—we support the underlying stressors that cause the issue to begin with. And we support the underlying systems that weren’t functioning well. And then the body can start to get these symptoms under control because the symptoms are just a manifestation of the symptoms— the systems not working. Symptoms occur because systems aren’t working. Systems breakdown because of underlying stressors. As functional medicine doctors, we come in, we fixed the underlying stressors, we support the systems that aren’t working and then the body starts to heal itself, right? The body’s on autopilot. We just got to get the stressors in the systems work. If the system’s working, then get the stressors out of the way.

Evan Brand: Yup. Well said. So you had some— you had some gut bugs and things going on, do you care to talk about your story for a minute with the – Hashimoto’s?

Dr. Justin Marchegiani: Yeah. I have—I have a low level of Hashimoto’s kinda in the background, I had elevation antibodies TPO and thyroglobulin antibodies and you know, I had some adrenal stress going on. And I just really worked on fixing the gut issues, which I had a handful parasites—Blasto, uhm— yeast, significant yeast overgrowth and H. pylori. Addressing those, fixing nutrient issues to help with the antibodies, fixing the digestion, fixing gut bacteria balance is of course working on stress reduction, sleep, all those important diet and lifestyle things. And again, the antibodies for me are just still slightly elevated, but there they’re in a range where you know, functionally my thyroid is not beaten up to the point where I need any thyroid hormone. My TSH is in a pretty good place and my T3 levels are pretty good. I actually have to go on for test real soon. So, yeah, I mean it’s possible to—to address the stressors and the system dysfunction to the point where you may not— you can call yourself cure. We just won’t call you cure for me, a functional medicine perspective.

Evan Brand: Yeah. Agreed. I need to get my thyroid panel run to. You’ve been pushing me to do it.

Dr. Justin Marchegiani: Yeah. You should.

Evan Brand: I need to do it. I mean you and I both have had these infections. I had H. pylori as well. I had a Crypto, Giardia and yeast and Pseudomonas Aeruginosa.  So, you know, that’s a fun thing about Justin and I. We both had all the things that we deal with in the clinic. So when you guys are looking to work with somebody, it’s— to me it’s a lot more honorable if you’ve had somebody that’s been in the trenches themselves, where we had to fix us to keep going to help other people. I think that’s always pretty cool. Uhm— what else I know we would have limited time, but what else should we mention here about kinda this autoimmunity piece, the gut piece. We mentioned the leaky gut, we mentioned some of the triggers just in a roundabout way. So Candida, bacterial infections, parasites, H. pylori, low stomach acid, gluten in the diet, dairy, possibly eggs, other food sensitivities. These could all contribute to that permeation of the gut barrier; therefore, causing the situation.

Dr. Justin Marchegiani: Hundred Percent. So, let me just kind of answer some of the things that you’re talking about while injecting some of the live questions we get. That’s the reason why the show is so unique compared to other shows coz we are off-the-cuff. This is the real deal here. So some patients are talking about having a lot of mucusy stools, right? And uhm— wanting to know where they should go for help, right? Of course, I recommend coming to see either myself or Evan, but typically one, we want to make sure food allergens aren’t driving this, right? Number two, we want to make sure we have enough digestive support on board to help those foods be broken down enough. So if there’s fat maldigestion issues, of course, adding in more bile salts or more lipolytic enzyme, right? Lipase— things like that. Uh— protease—proteolytic enzymes, right? These are all really important. And then, of course, once we can have the deck kinda dialed in, if foods are still a problem even with that, we may make them more palatable. We may go with more crockpot kinda GAP specific carbohydrate kind of eating template, where the foods are just easy—more processed via cooking, they aren’t raw, they are peeled or mashed. We’re decreasing salicylates and phenols and potential gut irritants so those foods can be consumed better. And then, of course, we’re gonna look deeper at the hormones because hormones have a major effect on inflammation and energy. And a lot of people that have gut issues, their guts are inflamed, we have to support the inflammation of the gut lining. And then, the big one is getting rid of the infections.

Evan Brand: Yup.

Dr. Justin Marchegiani: And that’s where you know, we’re probably go next.

Evan Brand: (laughs) Yes. You’re right. So uh—Cent50 here, who asked the question. Yeah, the loose, mushy stools, I mean that was me. I had Cryptosporidium, I had Giardia, I had H. Pylori, I had bacterial overgrowth. Until my gut issues were addressed, just FYI, I had IBS for 10 or 15 years of my life and conventional doctors had no solutions for my—my stools. And it wasn’t until actually cleared out the infections that my bowels and my stools became normal again. And so, yeah, you got to get yourself tested. Justin and I run several different companies. Uh—stool testing just depending on you know what—what we’re looking at. But, yeah, get a comprehensive stool test. Your conventional doctor may be able to order through your insurance, if you tell them you want diagnostic solutions Lab, it’s unlikely. You probably have a functional medicine guy like us to run it for you. But either way, once you get the diagnostic tool, you can fix this pretty quick.

Dr. Justin Marchegiani: There’s a lot of healing nutrients. So like, when we work with the patient, we kinda follow that 6-hour template— template that I’ve created over the last decade or so. There’s a lot of ones that are out there— three hours, four hours. In my opinion, a lot of them stink and they’re the wrong order. So the six that I’ve created and began to follow as well, in my opinion, is the exact clinical order which I follow things. So the first hour is removing the bad foods. And again, it’s not cookie-cutter because that maybe just getting someone from a standard American diet to a Paleo template. That may be taking someone from a Paleo template to an autoimmune template. Maybe someone on an autoimmune template and the Paleo template taking them to a GAPs or specific carbohydrate diet or low FODMAP template. I had patient last week who’s been Paleo for three or four years—chronic pain, chronic issues, chronic mood issues, chronic sleep issues. We took him from a Paleo template to an autoimmune-Paleo template and all of the symptoms went away in one week.

Evan Brand: That’s it.

Dr. Justin Marchegiani: This is someone that’s like already been on point for a long time and we just pulled out a few foods. So we have those— that kind of progression because you’d be surprised, the smallest things that we do have a huge effect. And it’s like, whoa! you would’ve thought I would have created the awesomeness protocol ever and found a you know, this hidden infection that everyone missed and got rid of it for that kind of improvement to happen. But sometimes it happens, we’re just removing some food. So, first, I remove the foods, second, I replace enzymes, acids, digestive support, bile salts, too. Third hour is gonna be repairing the gut lining. It could be also repairing the thyroid and adrenals and sex hormones, too. Fourth hour is removing infections. That’s where we go after— bacteria, parasites, uhm—fungal overgrowth. Those kinda things. We may even go after co-infections future podcast on that soon enough. Fifth hour, repopulating or reinoculating probotics. Some of these nice and beneficial bacteria. They’re transient. They only hang out for a month or so and pass on. So, getting some of that it in there periodically is helpful. Sixth hour is retest. We want to make sure infections are gone. And maybe even address family members too to make sure they are not being passed back and forth you know, playing hot potato.

Evan Brand: Yup. Well said. Riley asked a question about—he said, “Evan is your IBS completely healed now after addressing anything?” Uhmm—kind of a confusing question about addressing anything. Yeah, I don’t have IBS anymore. I’m infection free, no more H. pylori, no more parasites, no more bacterial overgrowth, no more yeast overgrowth and I feel good and feel completely normal, which was an amazing thing because after so long, you know, it took me to be so long to get here.

Dr. Justin Marchegiani: Totally. And with your situation, right? Like if you start eating bad foods again and your immune system got compromised, you may have another critter or two that pops back. You may have some inflammation from the food and such. And then those symptoms, they start coming back, right? So it’s not like a cure, like, “Hey, you have scurvy. Here’s vitamin C.” And then as long as the vitamin C is there, you’re good forever, right? It’s like, “Hey, there may be other stressors that may cause the systems to weaken again and those IBS symptoms start to occur, right?”

Evan Brand: Oh, Totally! Yeah. I mean I could go— I could go out to a restaurant and get some type of contaminated food and all the sudden creates a leaky gut situation. Maybe I pick up a gut bug, maybe I was eating while stressed during a week and I didn’t chew my food good. And then I picked up a parasite and have to start all over again. So, yeah, definitely, you know, you could always backtrack. You’re—you’re never permanently in a good place.

Dr. Justin Marchegiani: Totally. And again, one thing I see out there on Facebook, and I see it marketed, and it’s–  I have to call—I’m not  gonna call anyone out directly—

Evan Brand: No, come on. Do it.

Dr. Justin Marchegiani: I’ll call out the concept. But lots of people, they’re like, “You gotta heal leaky gut. Here’s a gut healing program.”

Evan Brand: Yeah.

Dr. Justin Marchegiani: And if you look at it, a lot of times, you know, it’s bone broth or just a lot of healing nutrients and a lot of probiotics, right? And maybe a little diet change. But if we go look at the six hours, what are they really doing? They’re doing the third hour, maybe a little bit of the first, maybe a little bit of the second, maybe a little bit of the fifth, right? They’re kinda skipping around. They don’t have a system and how it’s being integrated a lot of times. And I would say 99% of the time, it ignores going after and getting the infections fixed. Totally ignores it. Because you know, these people are recommending a general program to like thousand people at once in a huge kind of a webinar kind of style, right? Well, how do you get all the types of testing and customize everything in that format? You can’t. So it’s a very general kinda overview approach. And in my opinion, it’s going help some people, which I think is great. It’s admirable. But it’s also gonna  a miss a lot of people and those people that don’t get help may lose faith in functional medicine or say, “This is not for me.” So I’m just kinda calling that out because think about it, right? If the root cause of what’s going on is an infection component and you’re doing let’s say the first, second, third, fifth alright but you’re not getting rid of the infection. Well that’s like me giving you this healing aloe, right? You get a sunburn, you come back from the beach, I give you this aloe, right? The underlying cause of the sunburn is the— is the sun. And then you go back out the next day and you get sunburned again and I just give you more aloe. That’s the equivalent of what a lot of these people are doing. Well, just have some more bone broth, have some more of glutamine, have some more of this healing compound for your gut lining. So we got to get to the root cause. A lot of people are just being very general out there. And you know, the listeners of our show will get it and say, “Hey, I see that the missing piece there.” And that’s why we have those six hours that way coz then you can look at it and you can say, “Hey, this is a really specific way we go about addressing things here.”

Evan Brand: Yeah. Well said, man. And that’s the food is medicine, people. And we love the food as medicine people, but that’s why you know, we pursued functional medicine because the food is just the first step, right? It’s just one pillar of the house. It’s not gonna hold the house by itself as a single column. And also, I want to mention the order—the order of operations. If somebody just go straight to bone broth and probiotics and L-glutamine, that’s the wrong order. And sometimes people get worse. They’ll come to us and say, “Oh, Justin and Evan—“

Dr. Justin Marchegiani: Yup.

Evan Brand: “I took XYZ probiotics coz I heard it on a podcast or a blog and I felt terrible and I had a flare up of my condition. Can you explain what happened?” Yes, if things are just terrible in the gut,. sometimes you have to hit the reset button. You can’t immediately just add in all these probiotics and expect it to work. Sometimes we have to fix the balance first and eradicate the bad guys before the good guys can come back in.  So that’s why the order of operation is just a second when Justin said it’s so important. And this may explain why you’re spinning your wheels even though you’re all—you’re doing everything about the Paleo gurus are saying to do.

Dr. Justin Marchegiani: Yeah. We just want to make sure everyone’s educated. I mean, we have some people out here, they’re chiming about, “Hey, I really want a functional medicine doctor but I don’t have the—the money for it.” Well, guess what? The best thing that you can do right now is be listening to our podcast coz all this information is free.

Evan Brand: Yup.

Dr. Justin Marchegiani: We’re providing tens and thousands of dollars for free information off of people and I get messages all the time. “Hey, made a couple of these changes or recommendations and my autoimmune condition for 10 years is gone.” Right? I didn’t cure him.  I promise. I didn’t cure him, right? The body just heals itself, right? We got to say that as our disclaimer. But that’s you know, what’s that worth. When someone is you know, seeing a rheumatologist for 20 years on lots of expensive medication that’s tearing up their gut and their body and creating more symptoms than they’re actually helping. What’s that worth? So just utilize the pickup as much of the free intel as much as possible. And then you know, allocate some savings or HSA or flex spending. So if you want to dig in deeper, that’s an option. But utilize as much of the free stuff as possible because the diet is the foundation.

Evan Brand: Yup.

Dr. Justin Marchegiani: 50% is gonna be the diet so work on that first. Once you max that out, and you’re seeing some decent results, then you’d want to go in deeper. You can reach out, for sure.

Evan Brand: Yeah. And you can contact likely so. You can contact your conventional doc and try to get some stuff run through insurance. But it’s likely that they don’t have accounts with these functional labs and they likely just aren’t going to do it. Fut if you’re really lucky, you’ve got a really good M.D., you may be able to push push push push at least get the lab so you have the data. Now what you do with the data? Well then maybe that’s where you come to a functional medicine guy that can help in terms of creating a protocol. But getting the data should not be impossible.

Dr. Justin Marchegiani: Totally. And a lot of functional medicine docs that do a podcast or websites, I find that they take information, they wrap it up and they try to make people feel so confused where they walk away from the podcast or the video, being like, “What the hell just happened? What I do now ?” And they walk away feeling less certain. I want to make sure no one walks away from any podcast or video I do, gaining more certainty. And at least walking away with one action item that they can add into the repertoire of whether it’s a lifestyle or a supplement or just a different perspective on the6 hoir healing so they get better and they feel more confident.

Evan Brand: Yeah. I watch a couple of functional medicine videos like over the weekend and they were like hour-long videos I made it through 10 minutes. And I thought, “This is not gonna help me at all.” So I decided to turn it off. So let’s do it, let’s do our action steps and summary here.

Dr. Justin Marchegiani: So of course, we have our six hours, right? So everyone listening kind of our general feedback is gonna be a Paleo autoimmune template to start. And again, depending on where you’re at, that maybe really a lot of— really overwhelming for you, cutting out grains, legumes, dairy and primarily having healthy fats, proteins, uhm more veggies and fruit instead of starch. And having healthy fats like you know, if we’re doing a Paleo, maybe a little butter or ghee. If we’re going fully AIP, no nuts, no seeds, no dairy. Just coconut, Olive oil, may be avocado oil, some healthy animal fats. And that will be a good starting point for people. And then again, an AIP or an SCD or autoimmune diet, again, I’m just kinda laying out the Paleo template to start coz that’s probably the easiest buy in without pre qualifying anyone. I would say that after that, at least getting some digestive support going there. And again, you know, the ones that we formulated, we recommend the most coz we’ve put our stamp of approval. High-quality HCl or enzymes. In my line, it’s HCl supreme or enzyme synergy or I’ll add in the liver supreme for extra bile support for digest energy. And Evans line—Evan has a similar products as well. Uhm— so that’s a good starting point there. And then seeing where you’re at, I think is the next step coz there may be infections, there may be other testing that has to go in deeper. So I think if you can get that, that’s number one. And then I think if you can just make sure the hydration component and the sleep component is dialed in next, that’s a good second step. And that gives most people of really good you know, path to go down and if people are listening, they’ve already done that and they’re like, “what’s next?” well, that’s where I think you’d want to reach out and do a little bit more testing because that’s what I think the infection component and/or the hormone component and/or the nutriend malabsorption component from the infection could be the next vector we’d really have to put up in our sites, so to speak.

Evan Brand: I’m gonna address one comment here and then I’ll bring up a question then we could uh—we could wrap it up. Leslie mentioned the diet’s the foundation which kinda sucks no more pigging out in the middle of the night. The good thing is that could be related to infections. I mean for me, for example, when I had parasites, I would get these food cravings that just didn’t make sense and it wasn’t me. It’s these bugs. They are stealing your nutrients, they want food so they’re cannibalizing your muscle tissue and when you’re eating, they’re messing up your ability to digest especially coz I had H. pylori. My stomach acid levels were lower. I was basically hungry all the time and I was losing weight. Getting to like a scary point of weight loss. So really, the diet is not too hard once you just address your gut bugs, that— the whole like binging type thing on food, it really doesn’t happen once your gut is healed, once your adrenals and your thyroid are helped out and your blood sugar’s more stable. It’s not an issue. I mean you could fasted for a long time and feel stable. You shouldn’t have to get hungry or go on a crisis stage. Justin, a question for you. Uh—some doctors say T3 doesn’t matter; they don’t test it on Thyroid labs. The person’s taking T3 now slowly increasing. Would you be lowering T4 when adding this?

Dr. Justin Marchegiani: Well, I would typically be adding more than likely a T4, T3 put together so there’s gonna be a combination of both. Most doctors don’t care about uhm—T3 because the major pharmaceutical companies, Abbott’s the big one, that has a patent on Synthroid is a synthetic T4. It’s easier to monitor uhm— giving a T4 the half-life’s five days, so it’s really easy. It’s not like a T3, which could potentially have more side effects. Uhm—and it’s patentable, right? It’s the basically tetraiodothyronine with the sodium salt on it. So that’s how they get the patent to it. Uhm—again, they don’t m__ it because that’s just not what they do. They give you the T4, they get the TSH back in range. All your thyroid symptoms could still be present. Cold hands, cold feet, anxiety, mood issues, hair thinning, you know, gut here fitting things you know, gut stuff, constipation all could still be there, but if the TSH is in range, they’re happy. They checked off the list, you’re gone. So that’s where you got a dig in deeper. You got a look at the T4, T3 conversion. You got to look at the autoimmunity. You got a look at the nutrients. You gotta look at the adrenal conversion, the gut conversion connection and the liver detox conversion connection, too.

Evan Brand: Yup. Yup. Should you ignore TSH? No. It’s definitely worth factoring TSH in. You just don’t want to use that as the end-all be-all only marker. But you— but when you have the free T3 and the reverse T3, the TPO, the TG antibodies kinda all the stuff we run, the TSH makes a lot more sense when you got a full picture.

Dr. Justin Marchegiani: Yeah. We like to keep TSH in the equation and look at sometimes people come in with the TSH that’s perfect, but their T4 T3 conversion sucks. And then what do you do? You know when you’re treating the TSH or are you treating the actual patient? So we’ll try to increase thyroid hormones, see if symptoms change and we’ll try to support HPT access communication with specific herbs. And of course, stress modulation and getting infections— getting rid of infections coz that can really mess up the HPT access, the Hypothalamus Pituitary Thyroid connection.

Evan Brand: Yup. For sure. Uh—Leslie and a couple other comments about you know, where to go next? Well, I mean, you know, if people may say, “Oh, we’re biased.” But the answer is get tested. Our philosophy is “Test, don’t guess.” So if you’re confused, you’ve got symptoms that don’t make sense, get tested. That’s the first step. You can look at adrenals, thyroid, gut, get all the puzzle pieces laid on the table. That way you’re not just buying random supplements that you might not actually need. We’ve seen so many people with 20 and 30 supplements that they’re taking and they still feel terrible. And we cut that down to five supplements because it’s based on labs and all of a sudden people get better. So you know, save up your money for that. Maybe you don’t go buy the next newest supplement you hear about. Maybe you— you focus on investing into some testing first.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And you can check it out on Justin’s site. It’s Justinhealth.com You can look at the supplements, the labs on there. Same thing on my site, Evanbrand.com and we’re happy to help. So, feel free to reach out.

Dr. Justin Marchegiani: Totally. And also, couple of people asked about Dr. Gundry’s The Low Lectin Protocol. I think it’s the plant paradox. Again, my thing is if you’re just going to a Paleo template, you’re gonna cut a lot of those lectins out. If you actually cook some of the plants, some of the starches,  some of the vegetables and lower the lectins even more, if you still have a lot of gut issues, upgrading it to an autoimmune protocol, you decrease lectins more. If we still have issues and we can move to a specific carbohydrate or GAPS protocol and we decrease lectins even more. So it just depends on where you’re at cooking knocks a great chunk of that out and just going to a Paleo template, where we’re cutting out grains, legumes, dairy and focusing more on non-starchy veg, uhm— lower glycemic, low sugar fruits and safe starches that aren’t grain-based, you’re gonna have a huge effect and grains, where most of the lectins and irritants come from. So again, that— my opinion matches people making things a little bit more complicated than they have to be.

Evan Brand: Marketing.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: I mean, he’s done a good job that book is spread.

Dr. Justin Marchegiani: Yeah. It has gone viral. Everyone asked me about it all the time. I can’t get a go of a— one day without a patient asking me about it. So I have to follow it. I think I found it on fast reads on Amazon. So I got a—like uhm—abridged version of it that I’m siphoning through.

Evan Brand: Nice.

Dr. Justin Marchegiani: I’ve got a couple of services where they do these summaries. And it’a great.  I mean I get 90% of the information.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Suck it up in a half hour and I’m like, “Oop, got it!” That’s it. On to the next one. Well, any other questions you wanted to answer here, Evan?

Evan Brand: I think that’s everything. I think that’s all we can—we can chat on today and we’re gonna do a podcast soon on co-infections. We’re gonna talk about Lyme, Bartonella and Babesia Uh—Justin and I, I mean, we’ve literally got the books like right here that we’re—we’re diving into.  We wanna make sure we’re the most educated and current up-to-date with our information before we broadcast to you guys. So make sure you hit subscribe on Justin’s YouTube channel while you’re at, hit subscribe. And uh—we’ll be back again soon.

Dr. Justin Marchegiani: Totally. And one last thing. Patient asked here—person asked here on the chat list, uhm—“How do you—how do you choose your functional medicine doctor? How do you trust them?” He said, “I can’t trust them. How do I choose them?” Well, number one, I think they should have some kind of content out there whether its video, audio and/or blog post where you resonate with their information. Like their philosophy, their information, you should resonate. I find most patients are the biggest reason why they don’t get better is because, number one, compliance, and number two, they’ve been burnt and the past or they failed in the past and therefore they’re kind of priming their subconscious to fail again. So they don’t follow through and they’re off to the next one other, you know, they’re making a 180 move in can’t see someone else because some little thing happened. They’re not following through enough. So I think keeping—one, making sure you choose someone based on their philosophy and the information and making sure you resonate at an emotional level and just a logical level. Here’s the plan, generally speaking, right? And then number two, making sure you’ve given enough time and then follow through uh—for it to work.

Evan Brand: Yup. Well said. I’ll address— address this last question, then we’ll roll here. Uh—Is it common to have to go through a few rounds of infection killing protocols? Yes.

Dr. Justin Marchegiani: It can.

Evan Brand: You can. It took me a couple of rounds to go through, some herbs to knockout things coz I have multiple infections. When you’re trying to kill five or six or seven things at once, yeah. I can’t take multiple rounds. Why is that? Depends on the person’s immune system health or stress levels, how long they’ve had infections, the amount of damage that’s there, how much inflammation is there, are they sleeping well, do they have a good diet. You know, there’s million factors to answer why that— why that could be. Hope that helps.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Andrea is asking a question about his father’s prostate cancer. PSA levels are rising rapidly. Can we cast opinions or advice?

Evan Brand: I can’t. Justin?

Dr. Justin Marchegiani: That’s about thyroid, it’s about uhm— prostate issues?

Evan Brand: Yeah. Prostate. Prostate cancer this drug—Enzalutamide had been recommended for father’s prostate cancer PSA levels are rising rapidly. Can you cast opinions or advice?

Dr. Justin Marchegiani: Well, let me describe– I have one formula here that’s been helpful. Yeah. I have one compound here that I’ve been using here, just I had a couple of supplement companies reach out and I’m using it. It’s the pomegranate extract, and the flower pollen extract and its cranberry extract. So cranberry, pomegranate and flower pollen. This is an excellent support. Lot of research behind those extracts as well. Lycopene is phenomenal, getting adequate levels of selenium 200 mics a day is phenomenal, enough zinc as well is phenomenal saw palmetto’s great. These are excellent compounds that help. Lycopene is phenomenal as well. Again, the diet has to be in place. You want to get the lifestyle things going and again, these things don’t grow overnight. They probably taken decades to kind of move. So coffee and Coffee enemas may also be helpful to kind of early push detox in a faster more acute kind of way. But some  couple of compounds that I mentioned are phenomenal and wouldn’t hurt getting them on board in the meantime.

Evan Brand: Yeah. And look at my podcast I did with the lady named Dr. Nasha Winters.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: She did a book that’s called, “The Metabolic Approach to Cancer” She— she had cancer herself and she’s been holistically supporting people with cancer for about 20 years. So uh— look up Nasha Winters and uh look up her book and you could implement some strategies there hopefully.

Dr. Justin Marchegiani: Also, get the insulin levels under control. Make sure fasting insulin is five or below at least. That’s important because insulin is gonna cause a lot of cells to grow and then also making sure xenoestrogen exposure is mitigated, right? Don’t drink out of plastic bottles, avoid pesticides and GMO’s and glyphosate and Roundup. These are chemicals that you’re gonna get from conventional foods. Obviously, eat organic, right? Pasteur-fed meats. Again, these things— I shouldn’t have to repeat them, but I just can’t assume that everyone knows these stuff.

Evan Brand: They don’t. Not everyone does. So, yeah, keep repeating it and keep preaching. And I think that’s all the questions. So we did— we did really good. That was fun.

Dr. Justin Marchegiani: I heard a quote back. It’s a quote from the 1940s, where Joe DiMaggio was interviewed and they said that Joe said, “We noticed that you sprint on and off the field every single time at full speed no matter what.” And he said, “Well, there may be someone coming out to see me for the first time ever that seeing me play the way I’m playing and I wanna play at 100% every time.” And then maybe some people that are coming out for the first time seeing us play here, and we want to make sure that they get that information that we may assume that other people uh— may have, right? The equivalent will be like us jogging on the field, so to speak, if we just assume that.

Evan Brand: Yup.  Well said. Well, reach out if you need help. Justinhealth.com You can schedule with Justin. Evanbrand.com if you’d like to schedule consults with us. We should have some availability in the next 3 to 6 weeks or so. So just take a look and  we’re happy to help you soon as we can.

Dr. Justin Marchegiani: Oh, by the way, I’m adding in the Mimosa Pudica as well. So I’ll be reporting back on that in the next couple weeks. I think you as well Evan. So we’ll chat about that.  Again, I just got that in stock. That’s the Para-1 in my store. I think you have it in your store as well. So, we’ll put that in the show links, too. So that’s a cool new herb that we’re working on. We have a couple other herbal compounds in the mix that we’re using for different types of co-infections that we’re researching uhm—in the background, too.

Evan Brand: Awesome.

Dr. Justin Marchegiani: Hey, Evan, great chatting with you, man. You have an awesome day. We’ll chat soon.

Evan Brand: You too. Take care

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.








Lowering Histamine Naturally – Getting to the root cause of high histamine – Live Podcast #154

Dr. Justin Marchegiani and Evan Brand engage in a discussion about histamine. Listen as they talk about finding the root cause and driving factor of the issues related to histamine. Learn all about the symptoms associated with histamine issues and find out how problems with the adrenals, hormones, gut, diet and lifestyle contribute to these issues.

Know how some of the medications like anti-depressants, immune modulators and beta-blockers are related to nutrient deficiency. Gain information regarding higher histamine foods and natural supplements. Apply some of the natural solutions and recommendations regarding diet and lifestyle that would address histamine issues.


In this episode, we cover:

04:12   DAO& HNMT: role in our bodies

08:13   Medications and nutrient deficiencies

10:38   Higher Histamine Foods

18:39   Natural Supplements to lower histamine

21:57   Toxic mold

28:42   Diet and Healthy enzymes







Dr. Justin Marchegiani: And we are live on YouTube. Evan, to it’s Dr. J here. How are we doing today, man?

Evan Brand: Hey, man, Happy Wednesday! You and I have been pulling out the research books today. We’re like, “Hey, let’s make sure we know everything as— as much as possible about histamine.” A few have been asking you, asking myself, you’ve done interviews with histamine experts and what was it, the histamine chef is that who you chatted with?

Dr. Justin Marchegiani: Yeah. Yup. Yasmina Ykelenstam. She’s the histamine chef and we did a podcast last year on this topic. And uhm lot of good stuff, we’re kinda rehash some of the key take homes, we’ll talk about getting to the root cause and we’ll also talk about ways that we can supplement and just support histamine issues in general, more specifically.

Evan Brand: Yeah. So what you and I were talking about affairs. We— we don’t really market ourselves necessarily, it’s like, “Hey, histamine practitioner” There’s a lot of people the kind of attached the word “histamine” to their name or to their marketing efforts, but, you and I, as we start to dig deeper and find root causes of the histamine intolerance which we’ll talk about exactly what this means, we’re fixing histamine intolerance just as a side effect of doing all the other good work we’re doing to support the adrenals and support the immune system and ensuring that people are free of infections and fixing neurotransmitters like all the stuff, Oopp, it just happens to fix histamine intolerance.

Dr. Justin Marchegiani: Exactly. Like in the functional medicine world, you know, there is ways that you can market to so you can kinda row people in specifically coz you talk to their issues, but again, if you really are a good functional medicine practitioner, clinician, you’re hitting all of the body system. So in general, you’re not gonna really miss anything but there are ways that we can dive in deeper to issues such as histamine. And we’re gonna try to do that today. We’ll kinda zone out a bit. So we have like the big picture perspective, so people don’t forget what the root causal things that can’t be ignored are, and then we’ll also talk about you know, palliative things we can do on top of just the—the functional medicine principal stuff to get even better results.

Evan Brand: Sure. So should we start with some symptoms? What exactly people are noticing when they’re coming to us and they’re saying, “Hey, I think I have a histamine issue and I believe it could be coming from my diet.” We’ve got symptoms like headaches, could be anxiety, it could be your face flushing, it could be an itchy tongue or runny nose. What— what else am I missing symptom wise?

Dr. Justin Marchegiani: Yeah. Headaches. All those different things. It could be flushing, it could be even hives or the eukaryotes, those wheels that come up on the skin uhm— those can be all, you know, things that are happening. And again, what’s histamine doing? Histamine is a neurotransmitter. And there are various receptor sites for histamine in the body. There’s you know, H1 or histamine 1. Histamine 2, 3 and 4. And again, these things can control for instance, smooth muscle and endothelial tissue that affects blood vessels. This is what like Benadryl and like Claritin would—would utilize. So if you have like an allergic reaction and like your skin get super blown up, right? That’s why you do like Benadryl, right? Or histamine two controls acid secretion and abdominal pain. So histamine can also increase acid as well. It can also increase the heart rate. Histamine three has an effect on controlling the nerves, sleep behavior, appetite. Histamine four has an effect on the intestines, the spleen the colon, white blood cells and the inflammatory response. So it’s kind like this, right? You take your hammer; you whack your thumb, and all of these different reactions that happen, right? So you can look at all of the clotting factors and the cytokines and all of the inflammation and the white blood cell mobilization. And if you just kinda zone back, zone back, zone back, what caused it all? The hammer. So we’ll kinda zoom in, alright, what’s happening and the nitty-gritty, but then we’ll kinda zoom out and say, “Okay, what’s the hammer in this analogy?”  Coz if we can focus on the hammer, it’s way easy to wrap your head around, “Don’t whack your hand—don’t whack your thumb with a hammer than it is to look at all of the nitty-gritty. But we’ll kinda do both. So people that are looking to nerd out a little bit, kinda get satisfied and the people that just want the action items get satisfied, too.

Evan Brand: Sure. So let me just pronounce what we’re actually talking about. Diamine Oxidase also known as DAO, so basically, this is an enzyme that we’re making on our own in our body which is basically just like when we’re talking about proteases and lipases and lactases and just different digestive enzymes. DAO is an enzyme that’s basically going to find, it’s gonna seek out like the CIA, it’s gonna find the bad guy which is gonna be excess histamine in your foods and it’s can help break those down it could be foods or beverages so we’ll talk about the alcohol component in DAO when it works properly, it can break down up to 99% of the histamine. And then there’s 1% of histamine that actually enter circulation but we’ll talk about some of the root causes here. There could be going on with the gut. When you’re deficient in DAO, which is why you can supplement, which Justin told me off air, “Man, this stuff is sold out everywhere.” But when you’re supplementing with it or you’re fixing the root causes, and your getting your DAO in time to be back in adequate amounts, you’re able to break down the histamine and you no longer have histamine intolerance, which is why people can take DAO supplements and they can feel better but you’ve always got to work back to the root cause of other issues why is it not working in the first place.

Dr. Justin Marchegiani: Yeah. It’s also this DAO which is Diamine Oxidase and there is also another one called HNMT Histamine N-Methyl Transferase and these both have an effect of breaking down histamine. So if we take off our functional medicine root cause hat and we put on our palliative natural medicine hat, we wanted to just control symptoms, well, we can give enzymes like DAO which has been backordered for years. They are typically extracted from kidney or thymus tissue and big back order for a while, but we can give those to help lower histamine, alright? Coz that enzyme helps break histamine down so, you know, it’s like someone that has a lactose intolerance issue, they may take Lactaid which is milk enrich with lactase, the enzyme, right, to break down the milk, the milk sugar and they have less diarrhea. So kinda into that perspective where we’re adding in the enzyme to be able to break things down uh— which can be helpful from a palliative perspective. Uh— number two, we can avoid— we can make sure we have all the nutrients required to make a lot of these enzymes. So like the HNMT enzyme, we need SAMI, right? We need SAMI, S- Adenosyl Methionine which is really important for MTHFR. Uhm the Diene Oxidase we also need B6, we need copper, some of these other enzymes to for histamine processing, right? We need B2; we need iron; we need B5, right? And a lot of these nutrients we’re also gonna deplete with adrenal dysfunction, too. So you can see how adrenal issues and low histamine can be affected. Anytime you see B vitamins we know how important healthy gut bacteria is for producing B vitamins. So you can see, if we have a dysbiosis or SIBO, we have food allergens driving inflammation, driving leaky gut and/or gastrointestinal permeability, that can all affect our ability to make enzymes to lower and process histamine.

Evan Brand: Well said. So any gut infection, I mean, Justin and I that’s one of the things that we work on so much because it’s so common you probably heard our stories but, you know, I had H. pylori, I had parasites, I had bacterial overgrowth, I had yeast and all that’s driving leaky gut. So if you got something like H. pylori, for example, which we see every single week on lab results when we’re looking at people, the H. pylori is going to suppress the stomach acid and so if you’ve got undigested food, even that alone, could be causing leaky gut, therefore causing low DAO, therefore causing you to have “cortical histamine intolerance”. So if you work with a practitioner on histamine, we’ll talk about the diet piece in a second, but you’ve got to get the gut in healthy spot. You’ve got to fix the—the diet. Make sure that the gluten is out of the diet, or anything that could be causing a leak ego situation; otherwise, you’re just setting yourself up for failure. And then, surprisingly enough, which maybe you know more about this than I do, but it’s interesting that a lot of these medi—medications, I don’t know the mechanism but like antidepressants like Cymbalta, Prozac, Zoloft, you’ve got the immune modulators like Humira and Enbrel. You’ve got the Metaprololol, the beta-blockers; you’ve got Zyrtec and Benadryl. All of these things are causing the DAO enzyme to become deficient. I mean I guess the mechanism isn’t too important but it is interesting.

Dr. Justin Marchegiani: Well I think some of the mechanism pretty straightforward. Uhm— a lot of this is via nutrient deficiencies. A lot of these medications create nutrient deficiencies and a lot of these nutrition these nutrient deficiencies and a lot of these nutrition deficiencies revolve primarily around B vitamins and minerals. So it makes sense. If we create deficiency with B vitamins and minerals, of course, that’s gonna create more issues. I mean it’s like blood pressure. If you look at the acid block—the beta-blockers or the uhm—water pills like hydrochlorothiazide or the Lasix.

Evan Brand: Yup.

Dr. Justin Marchegiani: They are either diuretics but they create deficiencies with potassium and magnesium, which are really important for blood pressure. So you can see a lot of these drugs actually can make the problem worse. It’s an amazing business model if you’re only looking at you know the money factor, but if you’re looking at fixing the root cause, like we are, it’s definitely not good. You wanna really back up.

Evan Brand: Agree. Well said. You wanna talk about diet?

Dr. Justin Marchegiani: Just to kinda—just to kinda back out just a little bit. Uhm—we talk about the nutrient deficiencies, right? We talked about medications and antibiotics, antacids, antihistamines, right? Uhm—We talked about uhm—well, I’m gonna add it, nutrient stressors. So if we have more stress, more adrenal stress, more fatigue, poor sleep, inflammatory diet, that’s gonna drive more in a higher increase in histamine. If we have hormonal imbalances whether we’re estrogen dominant or that we have adrenal dysfunction, right? Imbalance in our stress hormones, cortisol, rhythm issues, a lot of that’s gonna be driven by a lot of these lifestyle stressors. That’s gonna really create more histamine issues. Now, I always backup. How do we know someone has a histamine issue? Well, do they have any of those histamine symptoms we mentioned in the beginning? Coz we know histamine does a few things. It helps increase heartbeat; it helps with gastric acid secretion; it opens the blood vessels, hence why when, you get allergies or allergic reaction, you swell. It helps increase bronchial dilation; it helps with gut permeability; it increases adrenaline. But if people get headaches or flushed or rashes or headaches with higher histamine foods, we definitely take notice. And those higher histamine foods, the big one, is going to be fermented foods. Do you get worse with fermented foods? Do things like teas create, you know, problems? If you have bone broth, does that create problems? Does citrus fruits create problems? Do meats over, you know, they’re too old, create problems? Uhm—does chocolate and coffee create problems? So if we start seeing issues with some of those symptoms, I really look a little bit closer to see what could be the driving factor.

Evan Brand: Yeah. I’ll list down a couple of more, too. Kombucha—that’s gonna be popular for our crowd, our community.

Dr. Justin Marchegiani: Yup.

Evan Brand: Yogurts, even if it’s like a grass-fed yogurt, your sauerkraut, if you’re having flare-ups, I’ve had some women that said have flare-ups on their skin after doing sauerkraut, that’s a sign right there and then alcohol, too. So wine, beers, champagnes even if it’s organic wine, it’s not gonna matter. Cured meats— so salami, could be pepperoni, the beloved bacon—bacon an issue, unfortunately for the time being. You mention the citrus fruit, aged cheese and then nuts— walnuts, cashews, peanuts, avocados. I believe— I don’t know if it was histamine, but I had something going on where I had to pull out avocados for like six weeks. I was having headaches from them. It was no other foods. It wasn’t any other nuts and seeds but I believe I had—I’m gonna guess a histamine issue because why else would avocados give me a headache?

Dr. Justin Marchegiani: Oh, exactly. Yeah, totally. So—

Evan Brand: I was doing like everyday they’re so good and so easy to add to a meal, so.

Dr. Justin Marchegiani: Totally. And then we also have things like mast cell activation disorder, right? Histamines produced by mast cells, so you got these like basophils, which are like in our white blood cells, right? They’re like one of the smallest amount of white blood cells are basophils. And these basophils go into our blood straight to our tissue. They become uhm—mast cells. And these mast cells will produce histamine, alright? So then you have this thing like called mast cell activation disorder. So like the more inflamed you become, right, the more your body tends to dysfunction. And—and you get more names for that kind of inflammation whether it’s IVD or IBS or mast cell activation disorder or some type of you know, allergic issue or some type of autoimmune issue. You can just go through all the different names. The more inflamed someone gets, the more symptoms. And basically diseases are nothing more than grouping a constellation of symptoms together. That’s why it’s funny when people tell me, “I just need a diagnosis.” Well, a diagnosis is nothing more than someone in the medical field taking a set of symptoms that have been, you know, trace for you know, many, many years into a disease name and someone studied and published. But it doesn’t do anything, it just basically groups these symptoms together and maybe there’s a drug for it, which is typically how a disease, you know, gets name because of the drug or treatment for the most part. But in the end, does it really help you fix the issue? A lot of times, “No”. But it gives people relief to know that it’s something, but again, if you’re depressed and you’re stuck on antidepressant your whole life, well, do you really feel good about that if you’re not fixing the issue? Maybe not.

Evan Brand: Right and I had a—I had a diagnosis of IBS, right?

Dr. Justin Marchegiani: Yes.

Evan Brand: We have no idea what’s going on but here’s some acid blockers I was never talked to about the root cause ever. So, for me, if you’re seeking a diagnosis, I would just let that attachment go because you really don’t need a term for the symptoms. We just need to figure out what’s going on. So, you mention the diet piece, we hit the gut piece, we hit the—

Dr. Justin Marchegiani: Adrenal and hormone deficiency, too, I think.

Evan Brand: Say that again.

Dr. Justin Marchegiani: We hit the adrenal and hormone piece, too.

Evan Brand: Yeah. Adrenals. That’s very important. So, how should we go about this? I mean, we’ve— we put all the pieces on the table, now how should we arrange this kinda step 1-2-3-4-5? Diet first?

Dr. Justin Marchegiani: So, off the bat, I would say, look at like kind of like your histamine bucket or your stress bucket. Everything goes in that bucket. Some people—it just sucks, they are brought into this world with the poor genetic constitution and their bucket’s smaller. What that means is they just can’t tolerate as much stuff. That means, hey, if they got a little bit of gluten and a little bit of stress, their bucket is full. Some people can have a lot more things. They could have some medications in there, some stress and sleep, some poor food, some nutrient deficiency, and then maybe their symptoms start to increase. Now, again, over time, we naturally have a smaller bucket overtime because our hormones become less restorative the older we get. So we just want to make sure that we know that theirs is bucket mindset and the more we take stressors out of the bucket, we can make a small bucket uhm— we can add more space to it. So someone that’s got a big bucket but is three quarters full, well, if we have a smaller bucket that’s a hundred percent empty, we may create more resiliency for us, even though our bucket, genetically, is smaller. So we have control. We’re not victims. We just got to be honest with ourselves. If we got a small bucket, we just gotta be on point more frequently. So, we do that by working on blood sugar stability, we do that with the baseline Paleo template, that you can work on customizing with your functional medicine doc regarding what that looks like macro wise and whether or not uhm—you have to add an extra digestive support to be able to breakdown the proteins and fats that’s important. Now we can look at the hormones, if there are significant hormone or adrenal issues, we gotta work on it because that helps improve our ability to regulate blood sugar inflammation and stress. And then, we also got to look at our hormones, too. We have significant hormonal imbalances, we have to work on supporting that so we can develop our healthier cycle or healthier anabolic hormones. We could put on muscle and recover. And then, of course, this goes without saying, gut issues. Coz if we have dysbiosis, leaky gut, we have chronic infections like H. pylori or Blasto or Crypto or Entamoeba histolytica or Giardia. Any of these parasites are gonna create leaky gut. They’re gonna create more nutrient deficiencies. And a lot of these nutrient deficiencies are needed to make healthy DAO or HNMT enzymes to break down histamine. And these enzymes, all these nutrients also help make healthy uh— nutrients for a detoxification system as well.

Evan Brand: Well said. So you got to get tested. That’s our philosophy—Test, don’t guess. I mean, you could probably fix maybe 50% of the issue just by working with a good nutritionist, their practitioners are gonna help you dial in the diet, right? Just getting that piece started even if you’re closer to an AIP approach, you are already gonna be eliminating a lot of the problematic foods including alcohol. So if you’re working with a nutritionist, you make it 50% there, but to get fully better, adrenals— test them, we’re gonna run the stool panel, we’re gonna look for infections that way. We’re gonna look for a lot of problems on the organic acids, too. Fungus, yeast Clostridium bacteria, uh— detox problems. I mean, all of that is a factor, so there’s never gonna be just one silver bullet. If somebody tries to sell you my online histamine course and there’s like one silver bullet they’re promoting, I would be skeptical because like any topic we discussed, there’s 20-30 maybe 50 factors that all need to be factored into that pie chart which is the pie chart being your problem. How is that problem broken down? Maybe it’s 50% adrenals for one person, but it could be 5% adrenals for another person. If they’ve got a super positive attitude about it, that could change things, too.

Dr. Justin Marchegiani: Exactly. So we fix the nervous system stimulation, the stress— that’s the diet and lifestyle,  that’s also the adrenals. We fix the gut bacterial imbalance, which could be infections, it could be just low beneficial bacteria. We cut out the high histamine foods. We cut out the histamine blocking, the DAO blocking foods: coffee tea etc. And we try to add lower histamine, paleo foods, in the meantime, which typically are gonna be uhm— low sugar fruits, the citrus-free, typically vegetables are gonna be okay, uh—typically fresh meats are gonna be okay. Healthy fats, maybe minus avocado, are gonna be okay. Uh— avoid the—you know, the aged meats and fermented foods for a period of time. But as we get the gut healed and we fix these issues, we should be able to get better and better and better. And then there also additional supplements we can add in as well. They can make a difference. So in my line, we use one called, Aller Clear, that I formulated that has things like, stinging nettles, it’s got promalin, potassium bicarb uh—these are things that have been used for a long time to help lower histamine naturally. Uhm— big big fan of that. Uhm—let’s see. What else can we do on top of that? I got my list here. Quercetin, like I mentioned, vitamin C, these are in Aller Clear as well to help lower histamine levels naturally. Well I also did a research on that. Grapefruit, seed extract and pycnogenol, which are in these kinda category of league Proantothocyanidin which are these kinda antioxidant bioflavonoid and some of these really good uhm—fruits that can be helpful. We have green tea. Again, it can be a natural antihistamine but can also be a DAO blocker so you got take that with a grain of salt. Uh—magnesium can also be very helpful, stinging nettle can helpful, omega-3 fatty acids uh—can be helpful, uh— some essential oils— peppermint, lavender, lemon can also be helpful. Again, but be careful because some of them are citrus there. You just got to test it out. And of course, a lot of the herbs to help knock down dysbiosis can help in the long run so like the berberines and the goldenseal can also be very helpful as well. So a lot of different alternatives there. Any other comments or concerns, Evan?

Evan Brand: Yeah. I’m guessing some of the medicinal mushrooms can help, too. I’m  not too familiar on the exact mechanism, but I’m assuming things like reishi, cordyceps mushrooms. I’m guessing those may help too depending on how they were grown, of course, uh—would probably make a difference modulating the immune system can be helpful.

Dr. Justin Marchegiani: Absolutely. Is there any other questions or comments you wanna add before we start hitting up some of our listeners questions. I don’t think so. Let’s hit the questions. I’m gonna pull them up, so I can see here, too.

Dr. Justin Marchegiani: Cool. And if you guys uhm—putting comments in the live chat  if you can kinda keep the questions kinda pertinent to the topic, it always helps and again, right now, for answering your question and you like it, give us a thumbs up right now, give us a share, give us a like. We appreciate it. We get really pumped and motivated coz of that.

Evan Brand: Should you—should you interview—uh, not interview—Should you introduce us, I mean I don’t know, maybe we’ve got new people that don’t even know who are these two guys talking about histamine all of a sudden. Should we briefly do that?

Dr. Justin Marchegiani: Yeah. Absolutely.

Evan Brand: Alright. Tell us who you are.

Dr. Justin Marchegiani: Well, I’m Dr. Justin Marchegiani, a functional medicine specialist, a functional medicine Doc and yeah, I see patients all over the world and we work on chronic health issues, from hormone to gut, to detox autoimmune issues and you know, we’re trying to always get to the root cause so that’s me.

Evan Brand: Absolutely.  I’m Evan Brand, functional medicine practitioner and Justin and I been doing this— doing this hustle on the podcast for— for several years. We’ve got hundreds of episodes together and I also work virtually with people via Skype and phone. And we do the live thing because we get comments like this, so let’ dive in.

Dr. Justin Marchegiani: And we’re the real deal. We don’t get a script here. We’re, we’re on-the-fly taking our clinical knowledge and plugging it into you guys, so you guys, the listeners can get healthier which—which is our purpose here.

Evan Brand: Yup.

Dr. Justin Marchegiani: So off the bat, couple things, uhm— I just saw here, Dale made a comment here about toxic mold. So yeah, I’ll connect Dale’s comment to toxic mold. But yeah, mold can definitely be a stressor that can fill up that histamine bucket.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So of course, things that we use to help with mold is number one: good quality or filtration. If the house is really bad with mold, we got to get that remediated maybe even move depending on how bad it is. I never have someone move unless they can—they leave the house for a week or two and they’re like, “Oh my God, all of my issues got so much better!” And again, we gotta be careful because if you’re leaving for a week or two, it may be a vacation where you’re not –

Evan Brand: Yeah.

Dr. Justin Marchegiani: We gotta kinda like control those variables. Maybe you get a hotel room or you go somewhere else and you work outside of the house for a week. But if you notice significant improvement, there could be a mold issue. So air filtration can be good uh—do that little one to two-week test that I mentioned and binders such as modified citrus pectin, zeolite activated charcoal, liposomal glutathione these are all great things to use. A lot of the nutrients to help improve phase I and phase II detoxification. So, in my line, we use Liver Supreme or  antioxidant uhm— Antioxidant Supreme or  we’ll do Detox Aminos. which have a lot of those phase I and phase 2 nutrients. That’s very helpful there.

Evan Brand: Good. I just wanna double comment on that with the recent hurricanes that have hit people in Florida, Georgia, Texas, all the other states affected this mold issue is probably gonna be a lot bigger. A lot of people will probably try to remediate their old mold. Uh—one of my wife’s friend down in Texas posted a picture of her car, they got flooded in Houston. Her entire car, I believe it was leather, may be a fake leather, her entire car was covered in mold that look like a lab experiment, so—

Dr. Justin Marchegiani: Oh my gosh! Sounds terrible.

Evan Brand: So if there’s mold there, please please please don’t try to mitigate that stuff unless you’ve got like proper mask and all that coz you can make yourself sick.

Dr. Justin Marchegiani:  Totally. Couple of questions here. “What are the best herbs for parasites?” Again, I would go look at some of our parasite podcast, we dive into it. Again, in my line, we have GI Clear 1-6 that we use for herbs uhm—to help knock down these infections. Evan has some similar ones in his line as well. So you can check out either Evan site, evanbrand.com or mine at justinhealth.com for more information on that by clicking on the store button.

Evan Brand: Yeah. I’ll hit the second part of the question there. “Are herbs usually enough to beat up parasites?” The answer is, “Yes” We do not prescribe drugs herbs is what we use for bugs and yes bacteria fungus, yeast, parasites. With the right protocol, the right approach, all the other factors, yes, you can successfully get rid of it. I’m a success story. Justin is a success story.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And you know, thousands of people in our belts that we’ve been able to successfully eradicate parasites with herbs.

Dr. Justin Marchegiani: And just to highlight one thing, I think you put in there, but just to make sure any new listeners don’t assume it, we’re also factoring in diet and lifestyle changes into that because that is a massive effect on changing and making the immune system more resilient which has a huge effect on decreasing the chance of reinfection, too.

Evan Brand: Yup, well said, well said. Yeah, you can just take one magic pills, you got to do the hard work, too, which is putting a fork to your plate with good food on it, is organic as much as possible.

Dr. Justin Marchegiani: Totally. 100%. And then, again, some people here talking about H. pylori and SIBO and eradicating H. pylori, uh—they still have stomach issues. So I’ll connect this persons question to the issue. But if you have SIBO and H. Pylori, does that go into your histamine bucket? Yes. So these type of critters and infections can increase that histamine bucket which can create more histamine reactions like Evan and I talked earlier and the breathing issues and the burping constantly, yep. Those are all symptoms of that and that can drive histamine problem. So we got to get to the cause of those infections and again, I refer you back to our H. pylori or SIBO podcast where we spent a full hour talking about that one topic.

Evan Brand: Yup. Well said. Get that test to get that treated. Rosalin, she has itchy skin, scalp. “Is that a symptom of too much histamine in the body always itchy?” What would you say? Sounds like probably.

Dr. Justin Marchegiani:  It could be a histamine issue, it could also be just a fungal issue, too. Seborrheic dermatitis is what affects scalp like that or a.k.a. dandruff and that can be fungal in nature. So I would just look at just the whole gut biome imbalance and/or histamine as a byproduct of that, right? Remember I gave you the a hammer and the thumb analogy, right? The— the histamine is just the collateral damage caused by the— the hammer, right? That’s kinda the whole idea. But, yes, it could definitely be— be part of it but more than likely, not the whole thing.

Evan Brand: Yeah. Kelly had a question, “Thoughts on the Biome test worth the money?” So Biome is a pretty new company who’s running stool testing. I met the guy who created the test. I’ve had a few clients who’ve had that run and they sent it to me. And the readout is— is terrible. I hope they improve on it, but currently, I’ve had a few clients send me their readouts, it’s crap. There’s a bunch of information but there’s no real action.

Dr. Justin Marchegiani:  Not  actionable, right?

Evan Brand: Yeah. It’s not actionable at all. It’s just too much data. So, Kelly, I do not use and Justin. Neither of us use the Biome test. We use more functional test that are available through practitioners. Which I like the idea Biome give people the power to get their own testing, but we still are gonna use other companies like the G.I. MAP on our clients.

Dr. Justin Marchegiani:  Exactly. But the biggest issue is like you get companies that are trying to give you like more information, they’re trying to like dazzle you with all this information, but then you sit back and you’re like, “What the hell can I actually do with it?”

Evan Brand: Yup.

Dr. Justin Marchegiani: What lifestyle change? What diet change? What supplement? What can I eradicate? What can I support or balance based on this information that will help the patient get better? That’s always the question. And the second question is, well does this test allow me to leverage my patient to make an action to allow them to get healthier? And if I don’t get one or two—if I don’t get an answer for one, primarily maybe two, then it just—it becomes not worth it. Kind of you know, glittery, you know, it’s very like, it’s kinda like glittery and flashy and like, “Ooh, look at this!” but it doesn’t really do much to me.

Evan: Yup. Should we get James’ question.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Yeah. So James put friends nine-year-old sons on a new drug, which I looked it up here, Spinraza for spinal muscular atrophy. And it’s a brand-new drug looks like December 2016, it was the first drug approved for this disorder. Now  he’s having swollen lips and hives. Any suggestions will DAO help enzymes? That’s a hard one. Coz who knows if that’s a side effect of the drug or is that some type histamine issue.

Dr. Justin Marchegiani: Yeah. Number one, the kids—Again I don’t know enough about this patient. So this is, take it with a grain of salt, this is a medical—medical uh—you know, uhm—advice. This is just me kinda talking here. So off the bat, kids notoriously have the worst, freaking diets in the world, okay? Especially if they go to school and they’re eating the school lunch and they trade in with their kids. They eat like crap. So number one, clean up the diet. And again, it’s hard because if you’re a parent who’s not eating healthy then it’s your house is full of crap. So first thing is the parent, get all the crap out of your house, create a really good environment, have really healthy snacks, get all of the crap out. So  get on the Paleo template to start. Do that for at least a few weeks to a month. That may fix so many of the issues, but in the meantime, yeah, can you had add  in enzymes like DAO can maybe hard to get them, but can you add in regular digestive enzymes and HCl, yes. Can you add in things like stinging nettle and bromolein and an acetylcysteine and all of the nutrients that I mentioned, yes, you can. So I would definitely add in all those histamine nutrients. Uhm— I would try maybe be going lower histamine, kind of a Paleo template and really get the diet a hundred percent and make sure they’re able to digest their food. HCl enzymes, all of those really good things and that’s a great starting point and then from there, if that still not helping, our only getting part of the way there, you want to really get a functional medicine doc to look deeper at what’s happening with the gut and things.

Evan Brand: Yeah. Well said. That was what—my next thing I was gonna say I’ve seen uh— little girls as young as three and little boys four, five years old with massive gut infections, parasites, and H. pylori and the rest of it. So it’s very possible that that’s going on in the gut depending on the history and use of antibiotics in the kid and things like that.

Dr. Justin Marchegiani: Exactly. Patient here— my w— My mom has been diagnosed with lichen sclerosis, that’s an autoimmune condition that affects the skin. I’ve seen a handful of patients after that cream after cream the probably referring to hydrocortisone, a corticosteroid cream. It gets worse, any tips regarding the root cause of this? Yes. Autoimmune. Get the autoimmune stuff dialed in. I’ll use some stem cell types of creams like J Bio Serum, it’s one of the nice sell that I sell it works great. It’s got some stem cells in it, but you gotta make the diet and lifestyle change. Autoimmune template to start with and then dig in with all the functional medicine principles, next. One of the symptoms of histamine tolerance all the things that we mentioned earlier, from swelling to flushing to headaches to rashes. Anything you wanna add there, Evan?

Evan Brand: Yeah. Fast pulse or a rapid heartbeat. I’ve had women say they eat the food and then their heart starts racing. So could be mood issues, could be physical changes as well.

Dr. Justin Marchegiani: Yeah. And the best way to test for histamine issues, in my opinion, is I just look at people symptoms and I connect them to higher histamine foods and we just pull those foods down a little bit and if their symptoms get better, then we know. I think for me the telltale sign for histamine issues, fermented foods and citrus fruits.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Those are the big telltale for me. Coz they’re relatively healthy foods. No one’s gonna say like, “Oh, eating a grapefruit is bad.” You know having some low sugar Kombucha or you know some sauerkraut is bad. It’s relatively good but if you’re –if we’re doing that history and we see symptoms of those food, then we’re like, “Ooh, there probably is a histamine issue.”

Evan Brand: Yeah. Well said. See, what else we got here. I’ll read a couple off here for you. “Does everyone have some degree of histamine tolerance, don’t think I have histamine problems but not sure.” Well, if you say everyone— the average person is very unhealthy. Autoimmune diseases ramp it, the standard American diet which is the same in Australia, the same in Europe, the same and most developed countries are following kind of a standard American diet— processed grains, sugars, conventional pasteurized dairy, meats that are not organic, they contain hormones and antibiotics. So, yes, most of people are taking Ibuprofen and over-the-counter drugs, they’re taking steroids and doing in antibiotics. They’re getting them in the diet. They’re doing acid blocking drugs, they’re not sleeping well, they’re addicted to their smart phones. So, yes, so many people have things in their bucket. Then, yes, I would say everyone has a degree. Now, kind of our tribe that Justin and I are building of you know, healthy people that are doing as many right things as possible, they’re probably gonna have a less risk of—of histamine intolerance.

Dr. Justin Marchegiani:  Totally. Hundred percent. Makes sense. And how about the bone broth stuff? I mean, I see, you know, I see uhm— lots of people with issue with bone broth and it kinda falls in and around the fermented food issue, right? If you’re having issues fermented foods or things that are slowly cooked, like bone broth, that can increase histamine and that can create a problems. So, again, we may hold off on the bone broth or cook it in a way where it’s cooked shorter. What kind of preparations for bone broth do you do to help lessen it? I know there are some out there.

Evan Brand: Well, I’m spoiled. I haven’t been making it because I’ve been using Kettle & Fire Bone broth that they sent me, so I literally does have to throw it in a in a pot and heat it up. I’ve been fine. I know they slow simmer or slow cook theirs for like 48 something hours like it’s an extremely long simmer time. So I don’t know how that would affect somebody that they were sensitive. But for me, I feel quite well with that. I don’t have any symptoms.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I don’t know. I haven’t had to modified it at all.

Dr. Justin Marchegiani: Yeah. So a couple, you can skim off the scum of the top of the bone broth. You can skim that out. Uh—it may be helpful, you can also do just the shorter brew maybe an 8-12 hour one. Uhm—that can be good. You can also just try buying some maybe your higher-quality or they may have a way of you know, producing it that produces low histamine like the Kettle & Fire. So that could be some good options. But again, if you have a food that we consider to be healthy like bone broth or Kombucha or fermented foods and you can’t respond to it, you can always put that food aside. That’s kind of like that’s like you’re free-histamine test, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So you can work on the gut. You can work on a lot of these hormone and diet things. And then you can add that thing as your free test add back in the future and that’s a good objective marker to see how you’re doing with your gut. And if it’s starting to heal, you may be able to handle more of that yet.

Evan Brand: Yup. Well said.

Dr. Justin Marchegiani: I believe my link should still be active Kettle & Fire sponsored my show for a while. They’re not anymore but they should still be giving people 20% discount so you can try it. If you do, evanbrand.com/chicken you should be able to get 20% off— so try it out. I think they pay me like a buck if you buy some, but that’s good bone broth and definitely—

Dr. Justin Marchegiani: We’ll support the cause. I know the products—only products that we ever mentioned on our shows are things you believe in. So again, you guys gotta know that we’re coming from a place of authenticity. So if you want to support us and we reference something, just know that it’s got to go to the filter of actually being a high-quality product and we actually have to use it on ourselves and our friends and family for us to recommend it.

Evan Brand: Yup.

Dr. Justin Marchegiani: We appreciate that support.

Evan Brand: Another question here. “What herbs do you suggest for fungal issues?” Once again, I’m gonna say it depends. And I know Justin would say the same thing because we’re gonna make our protocols based on what you’re up against. So if it’s bacteria plus fungus plus yeast plus parasite, that’s gonna be far far more heavy hitting protocol. If it’s just fungus by itself, which is not too common, because most people have a lot of issues together, you may be able to get away with some garlic or some oregano or like Justin mentioned earlier, Berberi or the barberry or the—

 Dr. Justin Marchegiani: Yup. Berberines.

Evan Brand: Berberines. That whole can be great and we’ve got several formulas if you just stalk our stores a bit look on justinhealth and look into his categories and you can check out mine, too. We’ve got many, many different combinations of herbs. Could you go and technically just buy a couple herbs and just you know, shoot a shotgun approach and maybe get success, yes. But I would of course, advise you to get tested because if you have fungal issues, you probably have other issues, too.

Dr. Justin Marchegiani: Yeah. And here’s one like clinical pearl that I’ve kinda find over the years. I’ll throw it out there for everyone listening. How I know fungal issues are more of an issue for— for some people than others, is number one, we’ll see the fungus on a stool test, which will be helpful. We can see either multiple kinds of yeast or fungus where it’s Geotrichum, Microsporidia, Candida, etc. We’ll see different kinds of species. But also on a organic acid test, we’ll see the uhm— D-arabinose, which is a metabolite of Candida but that also kinda means it’s gone systemic. It’s gone more more systemic coming up the urine. So if we see something like the D-arabinose is more of a systemic marker in the urine and we see in the gut, then we know that fungal issue is—is a lot deeper. Now a lot of fungal issues tend to be driven by other issues like H. pylori, other parasites are bigger but some people just gonna have a rip-roaring fungal infection. We’ll see it systemically via the organics as well as on the gut, too.

Evan Brand: Let me ask you this. I mean let’s say you see somebody with a really, really gross fungus fingernail like it look like their fingernails about to falloff because it’s so infected. Would you assume that person has got a massive amount of fungus in the gut and it’s manifesting on the nail on the—on the fingernail?

Dr. Justin Marchegiani: To a certain degree, I would say that’s a good, you know, you can’t hurt yourself faulting that, coming to that conclusion. But again, if you knock out some gut stuff, it can be hard for those herbs and for your immune system to get all the weight at that peripheral tip of that nail to knock out the infection. So sometimes we got topically hit things coz they just got to travel a long way so we’ll either topically hit our herbs there or we’ll uhm—have to do some kind of a soak to hit it as well. Even if we were to address the gut, it may not be enough to make its way down there.

Evan Brand: Coz I’ve seen that. I remember it was a cashier or somewhere, I saw a guy with his finger like his index finger, the nail was literally about the come off and it was completely—

Dr. Justin Marchegiani: There are different degrees, right? There’s like, “Oh, I had a slight fungal nail and I knocked it out with some oregano and a soak and just a few—in a few weeks.” There’s somewhere it’s like nail is incredibly like sclerotic and—

Evan Brand: It was extreme, yeah.

Dr. Justin Marchegiani: Almost falling off and then like totally dis_ that’s like the highest degree. I mean it’s just like, “Oh, it’s a little bit rough and then it’s got a slight yellowish hue.”

Evan Brand: No. I’m talking when it was like—it look like if you flicked it, it would fly off.

Dr. Justin Marchegiani: That’s one of the extreme.  And then the other extreme is maybe– is a light, it’s kinda like a little bit sclerotic like it’s rough.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And if you were to file it, it would get smooth but it would grow out of the bottom again rough. That’s how you know it’s fungal. And typically it’s slightly yellowed. And again, it can go really dark and brown, like dark yellow brown the longer it’s there.

Evan Brand: So what is that? When is that extreme? I mean how in the world would that happen? What sets the stage for that since we talked about—

Dr. Justin Marchegiani: Just chronicity. It’s just deeper and deeper and deeper and deeper into that nail bed.

Evan Brand: Yeah. Wow! Last question here: “What does it mean if a rash shows up only on the legs and not other parts of the body?”

Dr. Justin Marchegiani:  I have no idea. Uhm—again typically the body’s just gonna push stuff out. And again, if things are in the body systemically, where or why the body pushes it out there, beats me. Maybe that’s a stronger area for the body to push it out, hard to say. Again, as things get worse and worse, problems tend to be more systemic, so I wouldn’t worry about why it’s there. Uh the fact that it’s in a local spot is better. I would just want to make sure there’s nothing constant— contact dermatitis issue where things are in contact in that spot. And when nothing is contacting, I wouldn’t worry about it. We’re treating the body systemically as a whole. We’re really work on lymphatics and the detox so everything will get better.

Evan Brand: Yeah. Well said. And I mean—in a rash in the leg, that could be so generic. I mean, that could be something from your skincare products. That could literally be allergy to parabens or something. My wife—

Dr. Justin Marchegiani: A contact dermatitis issue where something is actually touching it.

Evan Brand: Right. Yeah. My wife she had a reaction on her legs and it had nothing to do with diet or histamine or anything. It was just uh—uh she had a sample of the skincare product and it must had some ingredient in it that we didn’t know about and she had a rash on her leg. So don’t—maybe don’t freak out, don’t think too deeply. It could be something that simple.

Dr. Justin Marchegiani: Yeah. And my baby just had some baby acne. My wife is freaking about it a little bit. But it’s just you know, he’s just metabolizing her hormones. So he’s getting over it pretty fast uh— which is good. But again, things happen and if it’s a contact issue like control all the vectors of what’s going on your skin. And then second is like, what’s in your body and just try to decrease inflammation.

Evan Brand: Yup. We got uh—you got time for one or two more?

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

Evan Brand: Alright. James he said, he’s not allergic to nuts and seeds but every time he eats peanut butter, he always gets a fungal rash around his glute region.

Dr. Justin Marchegiani: Don’t touch peanut butter, man. I mean it’s known to be higher in aflatoxin, it’s a legume as well. So that could be some gut-irritating stuff in it. Stay away from that. Switch over to high-quality almond butter instead and let us know how that works.

Evan Brand: Yeah. There’s a brand I use—what is it? Cadia. C-A-D-I-A. It’s like the only organic almond butter I found that’s less than 20 bucks a jar.

Dr. Justin Marchegiani: I actually created my own brand called Justin’s. You’ve seen that brand at Whole Foods?

Evan Brand: I did. Good job!

Dr. Justin Marchegiani: Nah, I’m just kidding. It’s convenient to say it, but, no. Not my brand.

 I won’t take credit for it. But I do like Justin’s. Uh—I will do that a little bit sometimes. And I do like just the whole food 365. I’ll get the organic. It’s also a cool one. Its’ really expensive! It’s called, NuttZo, in an upside down container so like the lid is on the  bottom and it’s upside down kinda thing. That’s kinda cool. Really expensive, but it’s really a nice treat.

Evan Brand: Here’s another question. Uh—little bit off-subject. How is holy basil an adaptogen for stress?” Uh—we’ve done—I could go so long on this.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That I’ll have to shut myself up right now. You just have to check out our other episodes on adaptogens  because I love them and Holy basil, __rhodiola, ashwagandha, all the ones you mentioned.

Dr. Justin Marchegiani: Good.

Evan Brand: We do use all those. They’re great.

Dr. Justin Marchegiani: Yup. I think it’s good. It’s good to kinda rotate through some or use a combination to use them individually and have a rotation to it. I think that’s great. Evan Brand: Yeah. “Is water sounding in ears related to histamine?”

Dr. Justin Marchegiani: The first thing I would look at are just food allergens in general. Uh– especially mucus-producing food, so like dairy and things coz anytime you get more mucus that could go in the ear and that can create issues. Just gluten and inflammatory foods to begin with. So, yeah. Definitely kinda hit that overall  Paleo template, you’ll hit a lot of those things out.

Evan Brand: I think that’s it. We should probably wrap it up. We’re gonna turn into a pumpkin here.

Dr. Justin Marchegiani: I know.

Evan Brand: If there’s any last questions please ask us.

Dr. Justin Marchegiani: How much salt did you ingest for every liter of water you drink replenish lost—I mean, I would just do half a teaspoon to a teaspoon twice a day of high quality mineral base salt. So like my favorites, Real Salt, or you can do Celtic, or Himalayan, just really good minerals that you’re gonna put back into your body. I like that.

Evan Brand: Yeah. I saw a new study about sea salt. I posted it up—I think I put it up on my twitter account where all the sea salt from US and Europe was contaminated with micro particles of plastic and so I’d support your idea of using the real salt which is gonna be an inland sea as opposed to the ocean sea salt that’s contaminated. Dr. J, do you think Tom Brady is on a low histamine diet?

Dr. Justin Marchegiani: Well, let’s breakdown Tom Brady’s diet. He’s eats 20% meat. There’s a lot of means out there. If Tom Brady goes vegan, no—you’re not vegan if 20% of what you eat is meat—not even close. But, as a qualifier there his meats are organic and grass-fed, so there’s really good quality meats. He avoids nightshades, tomatoes, potatoes, eggplants, peppers. He eats lots of vegetables. He eats very little starch. He eats a little bit of fruit. So I would say relatively speaking, yeah. I mean, his kinda thing is, “Oh, I’m eating acid alkaline kinda thing”, right? That may be the result of—that may be what he thinks he’s doing, but my thing is he’s really just doing an anti-inflammatory diet.

Evan Brand: Yup.

Dr. Justin Marchegiani: I’m not worried about acid alkaline. If he is worrying about so being alkaline a hundred percent, he’d avoid the meat, right? But we know that meat has a lot of important nutrients and it’s balance the meat with a lot of the veggies that are very alkaline. I don’t worry about that so much. Most of the acid your body’s gonna get is from inflammation. Inflammation is like 1000 times more acidic than actually eating an acid-base food. So I’m more worried about the food’s inflammatory qualities that I am about whether it’s acid or alkaline. But, again, grains are 10 times more acidic than meat. So if I can leverage that conversation or that idea with the patient, I’ll say, “Hey, if you really wanna be more alkaline, at least meat’s 10 times less acidic than grains.

Evan Brand: Well said.

Dr. Justin Marchegiani: I would think he would be indirectly not his goal but again, anyone that’s on anti-inflammatory diet indirectly, would be lower histamine outside it may be citrus and fermented foods and such.

Evan Brand: Yup. Well said. Well, we’ll wrap this thing up. We hope you enjoy it. If you have more questions, more ideas, more things that you want to hear us cover in terms of topics, reach out. We both got contact forms on our website. Send as an email.

Dr. Justin Marchegiani: Subscribe. We appreciate it. Give us a share, give us a thumbs up.

Evan Brand: Yeah. Justin— Justin’s over 30,000 on the YouTube, man. So great job! Keep it up. Hit the subscribe button so that we can keep pushing up this content in helping you guys achieve the most optimal health on the planet to help us get more people healthy we really appreciate health on the planet.

Dr. Justin Marchegiani: Help us get more people healthy. We really appreciate it. Healthy people make healthy decisions. They’re better parents, they’re better employees they’re better bosses, they’re better everything, so—

Evan Brand: Yeah. I saw Mark Hyman he was talking about autoimmunity and how it’s twice or even up to 10 times more expensive to take care of a sick patient with autoimmune disease and so we guys want you to be healthy because to save our population from collapsing. We’re kind of in the midst of healthcare collapse. Basically, the health of society falling apart. We’re trying to make a healthy dent in the universe by helping you guys. So thanks for the feedback. It means a lot to us.

Dr. Justin Marchegiani: Love it, Evan. Alright, man. Great chat today. I appreciate it.

Evan Brand: Take care. Bye.

Dr. Justin Marchegiani: You too, take care.


















Immune System, Tapping Technique and GI infections – Podcast Live with Dr. J and Evan | Podcast #131

Dr. Justin Marchegiani and Evan Brand engage in a lively and informative discussion about their recent clinical successes with their patients using the functional medicine approach. Listen to them as they dig into the root cause of their patients’ issues and turn chronic and seemingly complicated problems into success stories.

Know about the tapping technique which involves turning something negative into a better, positive thought. Learn more about GI infections, the bacteria or parasite that may be involved, as well as the tests and treatment options that are proven successful in the functional medicine world. 

 In this episode, we cover:

 03:50   Immune System, bacteria, and infection relationship

 15:50   Tapping Technique

 19:17   Treating Hypochloridia

 24:10   GI infections

 28:34   Enzyme Tests






Dr. Justin Marchegiani: We are live on YouTube here. Podcast live on demand. Also, live here on Facebook. Evan, how are you doing, man?

And again, Facebook people you gotta click on the link here uhm—I’ll put in the comments to see Evan’s pretty face and go back and forth on this. How we doing, man?

Evan Brand: What’s going on? I’m feeling really good today. We’ve got a blue skies, the trees are blooming which they probably—

Dr. Justin Marchegiani: Awesome.

Evan Brand: a year ago in Austin. So I’m enjoying myself.

Dr. Justin Marchegiani: Very good. So we got podcast on demand. So anyone wants to write in some suggestions as we chit chat here, we’ll figure out what exactly we want to talk about moving forward.

Evan Brand: Yeah. And I might as well post a link over here to my Twitter page and see if uh—people are paying attention over there. That way, if they’ve got questions, they can get them answered here.

Dr. Justin Marchegiani: Love it. Totally makes sense. Same thing, anyone on Facebook, too, every  chimes in first we can get this thing moving. But let’s uh—just talk about some clinical successes in the last week with patients. Any updates from you, man?

Evan Brand: Yes. So interesting update is uh—there’s a female client that comes to mind and she had seven, I believe, I have to go back at here stool test and count. But I believe it was seven infections and this is a combination of two parasites which—let me just pull it up, that way, I’m not just shooting into the dark here, but—Uhm— with these infections, we started a gut protocol and symptom improvement was seen. She was having a lot of irritable bowel symptoms uhm— running to the bathroom. So she showed up with H. pylori, Blastocystis Hominis, Entamoeba and Fragilis and Proteas  and Citrobacter. Somehow, cal protectin level was still low  which is intestinal inflammation where—

Dr. Justin Marchegiani: Yeah.

Evan Brand: –I look at but I was surprised. And so anyhow, we put her on this protocol. And this is like 8 weeks.  And the H. pylori while it’s still positive, instead of two viral factors, now she’s got one viral factor. The level of H.Pylori has dropped. The Citrobacter is completely gone. The Proteus completely gone. The Blasto is completely gone. But we still got Entamoeba. So there’s still the parasite and there is still the H. pylori there. So we’ve got work to do but yet, we’ve seen 3 or 4 things disappearing. So I think what the takeaway message is from me is that the bodies gonna heal in an interesting way. It may not heal everything at the same time. Some things may be easier to kill. Some things may disappear first, but you gotta heal yourself especially your gut, your microbiome. You gotta heal these things in layers. And that’s what we’re seeing here.

Dr. Justin Marchegiani: Yeah. So typically with a lot of patients that have chronic issues is there are some underlying stress, right? Emotional, physical, chemical stress but even deeper above and beyond that, there is some level – there’s some level of  infection that’s deeper that creating inflammation even though it didn’t show via calprotectin or it’s just creating leaky gut. And the whole leaky gut mechanism is getting the immune system fired up. The more the immune system is fired up, it’s just an energy suck for  your body. It’s like uhm—let’s say guests in you guest bathroom that you never go into your house. And they just leave the water on. Just a little bit—little drip, drip, drip. And then you get your water bill at the end of the month, and you’re like, “Where the heck did that bill come from?” And you’re like, “Oh, yeah. The faucet’s on.” But it’s like that with your energy resources. When got these bugs, it really—when the immune system is overactive. And even just a leaky gut, right? The more your immune system is overactive, the more it’s gonna suck your energy dry. That’s why when you get sick, the first symptom you get when you get sick is what? You get a lot of fatigue and malaise coz the immune system is sucking resources. Go ahead—

Evan Brand: I wanna hear uh—a recent case from you, but first I wanna ask you the question that I get asked all the time. And the answer really doesn’t matter because we need to fix the root cause no matter what. But people often ask well– chicken or egg? Was it that ma—my immune system got taxed first? And then I picked up these bacterial pathogens or these parasites? Or did I pick up the parasite and the bacterial pathogens and then that that set my immune system? What’s your take? Can it go either way?

Dr. Justin Marchegiani: Yeah. So typically it’s one of two scenarios, right? Typically someone gets exposed to a very high amount of infectious debris, right? Parasitic—parasites. So you drink some really bad water, you to go Mexico, you have really bad meal or at a foreign country, you get the Bali belly, so to speak. And then you’re overwhelmed with all of that infectious debris and then there’s so much of it that it compromises your immune system, you get diarrhea, you have a lot of gut inflammation that creates malabsorption. That malabsorption puts stress on all of your glandular systems and then you spiral downhill. That’s scenario number one. So just the infectious—the infection was so overwhelming, it just threw everything else downhill. Scenario number two is there some type of immune compromisation  that’s happening. Meaning adrenal stress, poor diet, poor sleep, or poor diet and lifestyle habits, low nutrient density. The immune system’s kinda a little bit weaker underneath the surface then you get exposed to some of these infectious debris at smaller micro levels that are in the food. And eventually makes its way to the system and creates inflammation.

Evan Brand: So yeah—so let me—let me clarify there. If we’ve—If we’ve got diet, lifestyle mostly dialed in, but let’s say people are cheating with gluten, for example. They still got intestinal permeability going on. You can still have good class, good sleep, blah, blah, blah. But if you’ve got just a simple thing like leaky gut, for example, you could potentially be more susceptible to pick up these infections regardless of whatever else is dialed in.

Dr. Justin Marchegiani: Yeah. I mean—here’s the deal with leaky gut, too. If you’re creating leaky gut, and then there’s some research, you know, on the non-celiac, gluten sensitivity side of the fence, that looks at these foods. Even if you’re not like reacting to a it, like symptomatically, and even if you’re not like having like IBS -like symptoms,  bloating, you know, gas constipation, diarrhea, that gluten can still create leaky gut. Where the undigested food particles in the gut can make their way into the bloodstream and create stress. And then the LPS that comes in there along with that, that’s the— the bacterial debris can get into bloodstream and create a lot of mood issues as well. So you can still have leaky gut and not risk from gluten— and still not respond to gluten in general.

Evan Brand: Yup. Yup. I just posted a post on uh—Facebook which I think might be a slightly controversial which was I wrote this little bit of a letter and I put kind of like these five things that have happened over the last year or so where people have said, “Evan, I’ve ditched psychiatrist or I’ve ditched my psychologist or my marriage counselor, or my conventional doctor because of functional medicine.” I kinda wrote the reasons why of how if you lower inflammation, you may need less adjustments at the chiropractor, for example. If you heal the gut, you start producing your neurotransmitters optimally, you might not you’re your antidepressants anymore, so you might not need your psychiatrist. Or if you heal your adrenals, you’re not gonna snap at your children anymore, so therefore you’re not gonna need the marriage counselor that is telling you need to stop yelling at your kids. And how basically how functional medicine can literally, not intentionally, but it’s just a side effect is that we can replace these other industries. I’m not saying these other industries are bad for mental health care or anything like that. But a lot of times, this is not root cause medicine. And my wife and I went out you with a friend of ours yesterday and she said she had a lot of stress, she had to put her dog down and she called up her psychiatrist and said, “Hey I need help, I’m freaking out.” What does he do? He prescribed her 60 Xanax and says, “Here’s your Xanax bars and take these.” And I told her, I said, “Listen, your anxiety and your stress from this issue is not a Xanax deficiency.

Dr. Justin Marchegiani: Totally.

Evan Brand: How about we do some emotional freedom technique. We start tapping. How about we cleanup the diet? And then before we left, out the parking lot, I had her do the quick coherence technique, the Heartmath, like the heart focus breathing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And focusing on someone that she loved and we got done with it, and she said, “That was weird.”  I said, “What happened?” And she said, “I got tingly and warm.” I said, “Oh, it worked.” And she said, “What happened?” I said, “Well, you just took yourself out of fight or flight that you’re probably stocked in which is causing you to be dependent on Xanax and now we’ve pushed you into that parasympathetic rest and digest mode.” And she feels better. And this is what this is all about. Uh—a little bit of uh—off-subject uh—, but I just wanted to mention to people, check on my Facebook post and you’ll read about what I’m saying. I’m not saying these other uh— practitioners out there are garbage. What I am saying is that if you’re not getting a practitioner to focus on root cause, even if they are psychiatrist, if they’re not a root cause psychiatrist, then what the hell are they doing?

Dr. Justin Marchegiani: It’s all about resources, right? And in functional medicine world, we’re trying to help enhance your resources. So just like someone with more money in their bank account can buy more things, well if we enhance our mental, emotional bank account via healthy and diet and lifestyle functional medicine principles, we have more resources to deal with stress in our life. Whether it’s family, friends, being a parent, being present for our partner, just being able to do the hobbies of a hobbit—hobbits—uh—

Evan Brand: Haha

Dr. Justin Marchegiani: The hobbies and the habits that we have going on in our life.  I got uh—I guess I’m missing my uh – Lord of the Rings movies there. Yeah. So—It ‘s all about resources, right? So we have to make sure that we have enough resources in our system so we can allocate them toward these stressors. And I always tell my patients, “Have you ever tried dealing with stress on 0 night sleep? or “Try doing your taxes the next day when you’re getting like three hours of sleep?”  You’re just  not gonna be able to handle it. You don’t have the resources. So everything we’re trying to do is let’s test the resources of our body systems, let’s look where the hormone’s at, let’s look at where the gut resources are at, let’s look at detox and nutrient resources are at, let’s support them and let’s work on fixing them.

Evan Brand: Well, the analogy I like to use is we’re just using a big spotlight. Because a lot of different industries and health care, what they do is they use like a little laser pointer or like one of those tiny little keychain flashlight. And they shine something real dimly into one corner. And you’re like, “Oh, Justin looks like we found something. We found some anxiety issues, here’s the Xanax.” But instead, we come in with a giant spotlight and we’re like, “Whoa, look at the left corner of this microbiome. We got parasitic and bacterial infections, which can steal your nutrients, can mess up your blood sugar and cause anxiety. Look over here,  we’ve got some adrenal issues. You got spiking of cortisol that’s gonna need to be addressed.” And then we shine the spotlight over here, “Oh, take a look at our detox pathways on the organic acids, you’ve got trouble over here.” And “Oopp, we shine the spotlight behind us, here’s mitochondrial issues. This is why you’re so fatigued.” And that’s the—I think that’s the greatest analogy. It’s a little laser pointer or a little small keychain flashlight, which is just pinpointing one industry of psychiatry or psychology or whatever versus exploring everything. Which is why for you and I, it’s tough for us to become the blank guy. You know people out there, “the thyroid guy” “ the detox chick” “ the bone broth chick” You know what I mean? It’s really gonna be tough for you and I to just say we’re the blank person because I don’t want to limit myself. I wanna let everyone know it is all encompassing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And if rest and niche yourself down, I think it’s a bad thing.

Dr. Justin Marchegiani: Yeah. Like from a marketing standpoint, right? Marketing is just telling the truth attractively. You know it’s good to have the niche because you wanna reach the people that have special conditions. Because if like, my specialty is thyroid. Number one, I have—I have or had a thyroid issue. It’s under control. Autoimmune thyroid issue. So I’m more passionate about that issue. But again, to treat  a thyroid issue, you have to be able to treat all of the systems. So it’s kind of a mythology, like you don’t just ever treat thyroid, you treat the whole thing. But you may mark and put information out there that’s gonna resonate and speak to someone with a thyroid issue more. But again, the underlying issue is from education and clinical standpoint. We’re addressing the key underlying surface issues and the deep root issues as well. So we’re never ignoring it. We may speak to someone uhm—more specifically and get into the more nuances of that condition, but it all comes back down to the foundational stuff that we always talk about.

Evan Brand: Right. I would say my specialties would be— it’s become parasites really. I mean, I’m seeing so many each week and it’s just so fun. I guess because I had parasites.

Dr. Justin Marchegiani: You had a parasite, you.

Evan Brand: Uh—Yeah. And also depression, I mean because depression is what got me into this whole thing. IBS and depression in college, I mean, like I told you before, I had to figure out when I went  into a college class, where’s the bathroom. Coz I have to get out in the middle of the class to run to the bathroom.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so for me, depression, IBS, parasites, you know, those are all linked together—the whole gut-brain connection. And I really am empathetic for people that have struggled with that because it’s so common and if you diagnosed with IBS, that’s a pretty generic diagnosis. And unless you’re with functional medicine practitioners, you’re gonna get an acid blocker, an antispasmodic—

 Dr. Justin Marchegiani: Yeah. Absolutely.  

Evan Brand: — or some other drug and—

Dr. Justin Marchegiani: Well actually, you were diagnosed with IBS, right?

Evan Brand: I was.

Dr. Justin Marchegiani: And you use the antispasmodic, you used the medications that helps with the gastroparesis. You know—

Evan Brand: Well, they never –

Dr. Justin Marchegiani: They even do that—

Evan Brand: Well they never got to use it. They try. They wrote me the prescription pad but I denied all three of the drugs.

Dr. Justin Marchegiani: And the thing is, too, we can also use natural medicines for a lot of those things. That may not fix the root cause, right? There’s root cause medicine and there is using natural medicine in a way that’s gonna help alleviate the symptoms that’s gonna up regulate physiology so things work better. But we have to still be investigating and digging to the root cause, right? So we’re dealing with someone with gastroparesis or low motility, we may add in things like ginger. We may add in things like carnitine. We may add, you know, higher amounts of mag citrate to keep that uhm—migrating motor complex moving. But we are still digging in deep. We’re still making the diet, the lifestyle. We’re still enhancing digestive nutrients, uh—hydrochloric acid enzymes. And then we’re digging deep for the infections. And we’re trying to lock in those diet and lifestyle habits, right? The supplements are great because they can give us that symptomatic relief while we continue to dig over here to the root cause. So as long as you have, you know, that  four pace envision that addresses some of the symptoms without the side effects, you know of some of the drugs, which may have more side effects than what you’re treating, and then working on the functional medicine plan, I think we’re in a really good place. 

Evan Brand: I agree. Yeah. I actually got a good—good success with that IB Synergy product from designs which get Bonigut in there. It’s got the 5-HTP. I had a guy with just super bad IBS and I said, “Man” I mean he was critically, critically stricken with both diarrhea and constipation just alternating every other day.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So I have him going with that 5-HTP Bonigut blend. And he got better. Now we start to wait for lab results but yeah—I mean  sometimes we will do some of the quick fix of band-aid situations to fix things, but we still got to work backwards. I guess to answer these questions uh—should we answer the question about the cancer question here or shall we just make a whole show on the future?

Dr. Justin Marchegiani: Yeah. We’ll do a whole show on that. I’ll get some experts on. I got Dr. David Jocker is coming next month as well. He was in the truth about cancer series. And we’ll go on ketogenic diets and we’ll talk more about therapeutic ways to address cancer outside of just the natural chemotherapy. So we’ll hold that one that—we need more time for that.

Evan Brand: Yeah. Agreed. Uh—Samuel asked, “What is the tapping technique? Can you show us? Well since most of our audiences are gonna be audio listeners we’re not gonna take up the air time to show you the technique, but the best resources—EFT (Evan-Frank-Tom) EFT.mercola.com and you can just view the different acupressure meridians that you’re gonna tap. But then also, you’re gonna learn about the affirmations that you can use for emotional freedom technique and that’s something Justin and I use all the time.

Dr. Justin Marchegiani: I think it’s helpful. I’m—I’m gonna just give it 15 seconds of airtime here, so—just—I do two hands coz it’s adding it’s more efficient. But you just tap the  inners part of the eyebrow, the outer parts of the eyebrow, under the eyes, I do under the nose, and the bottom part of the chin the same time. And then I do both collarbones. So I do this, and you can go top of the head and tap midline. So I do two hands coz I just feel like you get more stimulation. So I go here, and I’m just thinking about whatever is pissing me off, my wife, I just think about it.

Evan Brand: Haha

Dr. Justin Marchegiani: I kinda give it a number. So if I’m a t like 6/10 regarding irritation, I just think about it. Whatever that issue is, whether it’s like, you know, the person driving  in front of me is so slow  or whatever. And I try to knock that 6 out of 10 so that 10 is the worst.  6 is like 60% to being at the worst. I try to knock it down to a4 to a 3. And so every round—every 2 rounds or so, you kinda just check back in and see if you knock it down. And you go as you kinda knock everything down to a 3.

Evan Brand: Yeah. And we have—I—I start at the top of the crown which I usually like—many ways—

Dr. Justin Marchegiani: You can do that. You can start there, you can end there.

Evan Brand: Now do you do the sides? I know Mercola, he’s big on the side of rib cage under the armpit.

Dr. Justin Marchegiani: Yeah. I do that, too, sometimes. It’s just wasn’t good for a video.

Evan Brand: Yeah. So you criss cross?

Dr. Justin Marchegiani: Yeah. I do two at the same time just coz it’s stimulation.

Evan Brand: No. I mean you criss cross your arms so the underarm’s like this. I do like a monkey.

Dr. Justin Marchegiani: Haha

Evan Brand: And then—and then finish with the wrist. I typically finished by tapping the insides of the wrist together then doing the affirmations. So even though I’m angry, or even though I’m anxious, I deeply love and accept myself. But you gotta say the affirmation verbally. I tell people if you can, if you’re just embarrassed, then don’t do it. But why be embarrassed? Nobody—nobody is paying that much attention to you.

Dr. Justin Marchegiani: Yeah. That depends, too. Like you can do this stuff, and you can kinda say like if you’re at—let’s say, if you’re lying in bed and you’re just really stewing on something and your wife’s next to you and you don’t wanna wake her up, then you can just kinda think it in your head. And then you can just, you know, do the affirmations, tap like this.  And then you can tap here, and think about the issues.

I like them to end, though, with a positive thing. So you can end with something positive. So then I just go into like, “What is it that I want to manifest?” So I’m going into right there. I’m thinking about whatever I’m gonna try to create or produce in my life, I just tap it while I’m thinking about it. And the whole idea of tapping is you’re just stimulating various meridian systems that have been mapped out via acupuncture system for thousands of years. And really what it’s doing is it’s neutralizing the negative response that’s stored in the limbic system or in that subconscious of your—more in the psychological side of it. And you’re trying to kinda rewire it so you can get a good pattern there instead. So then, naturally that reflux is to go back to the better thing and not to the negative thing.

Evan Brand: So if you do affirmation about the bad part, would you do like an affirmation about the bad part and an affirmation for a positive?

Dr. Justin Marchegiani: Yes. So I start off with the negative and just try to lessen—lessen it first.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Coz if you’re—feeling negative, it’s really hard to be positive when you’re negative so I try to decrease the negative to about a three. And then I go into the positive because then, you are in a better place to deal with the positive, right? It’s kinda like when someone tells you to relax and you’re pissed off, like relax, calm down. You just wanna punch him, right? Like, “No, I’m too wound up, come on.”

So I wanna get that dialed in and then now I’m relaxed, now I can rewire it and create some positive things.

Evan Brand: I like it. I like it.

Dr. Justin Marchegiani: So calm down first, and then work on manifestation.

Evan Brand: Should we answer a couple of more questions here?

Dr. Justin Marchegiani: Yeah. Let’s hit it, man. Let’s hit it.

Evan Brand: Solam asked, “How long does it take to heal hypochloridia?”

Dr. Justin Marchegiani: It totally depends, right? If you have emotional stressors that are unresolved ore you’re eating foods that are incredibly inflammatory, maybe never. But if you’re making the root causal changes and your managing your stress, and you’re fixing the underlying gut stuff, I would say within 3 to 6 months, you have a really good chance of not needing hydrochloric acid to digest your food. But again, everyone is different. A longer—the longer the issues been going on, the more severe the infections, and the more infections that are layered in there, I’d say longer, up to a year, at least.

Evan Brand: Yeah. I’ll just have my two cents to that, too. If you had a previous history of a prescription, as a blocker’s proton pump inher—inhibitors are now it’s open to counter like the Xanax or the Toms, or anything like that, or—

Dr. Justin Marchegiani: Yup.

Evan Brand: Or if you’ve had H. pylori which we’ve chatted about many times, then I would say it may lengthen that time, too, to fix that stomach acid issue.

Dr. Justin Marchegiani: The longer that gut’s has been worn down, the more the immune system is revved up like you get patients are just supersensitive to every little thing. Like I can’t even put in an enzyme, I can’t even put in our apple cider vinegar or lemon juice or the smallest fermented food sets them off. It’s really hard and you’re looking at a couple of years to really dive into it because the immune system is so revved up and it’s so ready to attack the smallest invader that it’s so hard to put things into help and heal it because it’s looking at everything as a foe not a friend.

Evan Brand: Right. We really, really have the baby step in those cases so that’s why—

Dr. Justin Marchegiani: Totally. Yeah. I mean, just like you heal, with you know, food is medicine there, you go really slow and you do lots of things in broth form, in soup form so it’s – so it is so palatable. There is very little digestion that has to happen. And typically one supplement at a time and one nutrient at a time, titrate up from low to high. Even if it’s something that they can handle, if they go high dose, off the bat,   their immune system just freaks out.

Evan Brand: Well I wanna hit on something you just mentioned which is if we’re talking 1 to 2 years, it takes extreme patient—extreme patience for patients and clinicians because for us, that is a very intensive case for us to take on.

Dr. Justin Marchegiani: Totally.

Evan Brand: And you know, maybe this is to toot our own horns, maybe it’s just calling out the obvious that we do take the time, you know, with people we’re working  with. Sometimes it maybe 30-45 even an hour-long call for a follow-up just to take these baby steps. Whereas, let’s jus say some of the clinicians that we’ve seen out there, it’s too cookie-cutter approach and they don’t have the mental bandwidth or capacity for empathy to baby step this people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So it’s here’s your cookie-cutter protocol, good luck.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Where with us, we’ve really, really, really gonna get super details.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so this is why if you go and you buy like a leaky gut online program or some other type of program, and you get limited results and you get to us, we’re not gonna be surprised if you suffered through that, and you didn’t get a good result. Because at the end of the day, that’s why  Justin and I haven’t created  online courses at this point because it’s—it’s hard for us to sleep at night thinking that we’ve created a program that’s too cookie-cutter. We’ve really got to figure out a way that we’re gonna be able to work in all the minutiae and the small details and the variations—variation A, B and C, D for different people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So if someone uh—packages something up all beautiful and says, “Oh, it’s $297 and all your problems are gonna be healed.” Uh—please be a little bit skeptical  of that.

Dr. Justin Marchegiani: I agree. And I’ve talked to you about a patient that I had today that email in that was dropping out of care. And we try to always set realistic expectations. This person just had her labs reviewed a month or two ago, and had multiple parasitic infections, severe adrenal dysfunction, HPA axis dysfunction, and then a lot of issues on her organic tests. Uh— detoxification issues, mitochondrial issues, and we just started with simple adrenal support, made diet and lifestyle changes and she had some— some side-effects so we try to cut things down, go slower. And we’re gonna kinda reconvene and work on supporting detoxification, but person had dropped out. Now, the problem is, to have expectations that things will work off the bat when so many things are wrong like that, expectations are incorrect. So  a lot of people they have preconceived notions even if you spell it out to them and you let them know, “Here’s where we’re at now, here’s where we’re going.” They forget because they—they want it done now. And they think because things didn’t work in that initial uhm—in that initial experience, that there is no way to fix it. So continuing to harp on patients in managing their expectations, even though they have a lot of stuff they’re projecting from past failures, we kinda have to get through it. Make sure expectations are real and that make sure they know, “Hey, here’s where we’re going now. Here’s where we’re going next.” These things ahead that may have to be dealt with for us to really see great changes.

Evan Brand: Yup. Well said. We got another question here.

Dr. Justin Marchegiani: Let’s hit ‘em.

Evan Brand: Let’s hit Steve’s question. After all GI infections are eradicated, how long does it take the gut to fully heal? All my infections are gone, but I’m still dealing with IBS, leaky gut and issues after H. pylori.” I’m gonna hit on this first Dr. Justin Marchegiani, if you don’t mind.

Dr. Justin Marchegiani: Yup. I know you’re gonna say it, by the way.

Evan Brand: Okay. So – haha if—

Dr. Justin Marchegiani: If you say it—If you say it, I’ll—I’ll tell you that.

Evan Brand: Okay. Alright. Please. Alright. So here’s what I’m gonna say. You say all your infections are gone, but you’re still dealing with IBS, leaky gut, and issues, I would like to know what test was this that says all your infections are gone because I bet all of your infections are not gone.

Dr. Justin Marchegiani: Yes! Whoo! I knew it. Yeah. You’re totally right.

Evan Brand: Haha

Dr. Justin Marchegiani: Yeah. You’re totally right. And then also, just making sure that you have the digestive nutrients on board to help heal the gut lining and the digestive support to break down the food and then I would make the food more—more palatable right now. I’d be looking more at the GAPS or an SCD or more of a soup or broth approach that makes the food really easy to take in. No raw veggies, uhm—try to keep it really palatable so the body can access it without much stress.

Evan Brand: Alright. So the beauty of the Internet, Stevie says—Stevie replied and he says, “DRG” Well, uhm— Justin–

Dr. Justin Marchegiani: It’s missing a lot of them. It’s missing a lot. You gotta do the DRG with the GI map. I a—I never do the DRG by itself for the most part—always both. You gotta do both.

Evan Brand: Yup.

Dr. Justin Marchegiani: And if there’s still an issue with the DRG and the GI MAP, I want them go for the  41 side-by-side.

Evan Brand: Yup. Agreed. So, Stevie, not that—you know, we’re not diagnosing you. That’s not what these calls are for. But, hey, Justin and I have seen a lot of false negatives with DRG and some other test out there. So potentially some stuff going on. And I would like to add a couple of points about like the—the issues, the leaky gut type stuff. You know, make sure you are doing some of the easy supports, too. You know, chamomile is great. You can do chamomile in a supplemental form. You’ve got chamomile teas, uhm—you’ve got L- glutamine. So there are some leaky gut supplements that why your til—still trying to figure stuff out, you can still be taking support of nutrients in the meantime while waiting for retest.

Dr. Justin Marchegiani: Absolutely. Totally. Let’s hit  the uh—last question there by—E Center Riley. See here, just diagnosed with Hashimoto’s, TPO and TGB bodies, 465 is that high? Eliminated the foods, gluten, dairy, soy, balance in blood sugar, hard with 5 kids. What should I focus on next? So 465 is definitely high. The LabCorp reference range for TPO is 34. Anything 34 above is considered positive—I think it’s above 34. 34 below is considered positive. And anything about 20, for me, I considered to be subclinical. So that is high. Anything above or around 500 is definitely high. I’ve seen patients at 2000, though. I’ve seen patients that go from 2000 to below a 100. Now, my goal is to get people—If I were you, I’d like to see a 70 to 80% reduction in that. Again, maybe you were higher before you made those changes. So I’m not sure if it was  gluten, dairy, soy. That stuff was cut out and then you saw the drop. But either way, uhm—getting enough selenium in there, 400 micrograms of selenium, addressing the underlying infections, things like H. pylori, Blasto and Yersinia can be coming to increase the antibodies. And then making sure the adrenals are looked at. There’s a strong adrenal-thyroid connection and a lot of people who have thyroid issues also have adrenal issues. And remember, TPO is a microsomal or essentially it’s uh—intracellular microsomal antibody that helps bind the thyroid hormone together. So if you’re making antibodies to that, it’s gonna prevent that thyroid hormone that I—Iodination process from occurring. So making sure we have the adrenal support there because the adrenals help produce cortisol. Cortisol is an anti-inflammatory that’s gonna help with the inflammation. And with the TPO there uhm—you could potentially have increase in hydrogen peroxide, especially if there’s small amounts of iodine getting in there. So get them the selenium will help neutralize that hydrogen peroxide into H20. High quality H20 which is uh—not gonna be as inflammatory.

Evan Brand: Well said. Yeah. And so uhm—Isabella Wentz, I just did podcast with her a couple of weeks ago. Actually that was my last uploaded episode. And uhm—we’re talking about bacterial infections, too. So you mentioned some of the parasites and she’s seen the same thing the parasite but also the bacteria. The Klebsiella, the Citrobacter, and all these autoimmune triggers has been bad guys for uh—these Hashimoto’s situations and these antibodies, so—

Dr. Justin Marchegiani: Yeah.

Dr. Justin Marchegiani: So, look for the bacteria, too, and you can definitely fix this stuff and you can make significant progress.

Dr. Justin Marchegiani: Absolutely. I mean one person here, wildlab access, “How do you test for various enzymes?”Number one, if you have gut stress, you probably have low hydrochloric acid. And if you have low hydrochloric acid, you probably have low enzymes. Why? Because hydrochloric acid is important for acts of—for converting pepsinogen to pepsin which is the proteolytic enzyme. Hydrochloric acid lowers the acidity of the chyme, which is the mixed up food in the intestine. That inten—that food that chyme that goes into the small intestine which the acidity then triggers the pancreas to make bicarbonate, it also triggers CCK that then caused that the gallbladder to produce bile that also stimulates the pancreas to make light based trypsin and chymotrypsin and all the enzymes that come down. So if you have enzyme issues, you also have hydrochloric acid issues, but we can also assess it by looking at enzyme markers, like elastase, too, which will uhm—look at that in the DRG or the GI MAP test.

Evan Brand: You better get that frog out.

Dr. Justin Marchegiani: Frog out. It just attacked me, man. I’m like, Ugh—

Evan Brand: Alright.

Dr. Justin Marchegiani: My water—so uh—yeah. Elastase, I think it’s elastase 1 is the enzyme marker we typically look at for uhm— low enzymes. But typically, just assuming that we have digestive stress, let’s assume it for sure.

Evan Brand: Yeah. I mean that’s the same—the same answer that I would say for the leaky gut. I had people say, “Oh, can you test me for leaky gut?”  It’s like, “Yeah. We can go to Cyrex and spend 500 bucks if you want to, but based on your symptoms, I guarantee there’s intestinal permeability. You’ve got XYZ. And we can—we don’t need to spend the 500 bucks on that test. Save your money for the organic acids, your comprehensive stool panels, the GPL-TOX, maybe heavy metal testing. Save your money for that stuff that you can’t really guess on.

Dr. Justin Marchegiani: Yeah. Absolutely. I agree, man. Well, anything else you wanna hit off the bat here? I mean I think—I had some really good successes last week, too, with some patients that had chronic pain, chronic mood, chronic energy, hair loss. And I mean—just really simple things. We—we fix their hormones, this person has autoimmune thyroid, uhm—hypothyroid as well. T3 was super low, it was uh– T4 to T3 conversion issue, dysregulated cortisol. They had a lot of malabsorption and they had a couple of infections and we just—we just took them down the map. An then just everything first time around, uhm—just knocked in place. I mean it’s like you swing the bat once and it’s connected. It’s gone. Those were the patients where its like, “It’s just so rewarding coz it’s just—it’s easy” And then you have  some patients where it’s a lot more trial and error and digging in. So it’s nice to have those home runs every now and then.

Evan Brand: Oh, man. I—so I had a home run earlier with this guy that I got off the phone with name Dion. And he was on an inhaler. An asthma inhaler.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And also I believe he was taking uh—allergy medication, like a prescription allergy medication.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maybe it was one or the other. He alternated or he was on the inhaler something. But he was on prescriptions for allergies. And all we did is we cleaned up the diet, we’ve addressed some gut infections. He had candida and I believe a couple bacterial infections. I don’t believe he had parasites. I have to look back. But I remember a couple of infections, fix the gut, uh—supported adrenal’s basic adrenal support, some adaptogens. And I talked with him today and he said, “Evan, I’ve not used my medication in the last six weeks. And everything is blooming here right now. All the trees and plants and everything are blooming and normally, I’m debilitated. He said, “I’m completely fine.”

Dr. Justin Marchegiani: Isn’t that awesome?

Evan Brand: How in the world just by working on the gut and adrenals am I not allergic to the environment anymore? It’s just like, “Oh, it makes me feel so good.”

Dr. Justin Marchegiani: I see that all the time, too. And hydrochloric acid is one of those things that’s really great with allergies, too. You notice that?

Evan Brand: Ain’t that weird? I mean since digestive enzymes, I told him, I said, “Man, we’ve gotta keep up digestive enzymes.” And then actually I am gonna send him a bottle of some of the like natural herbal anti-histamines, just in case. Because he started sneezing on the phone. I’m like, “Whoa, maybe you’re not all the way out of the water yet. Have this on hand, in case you need it.” So the coresatin in, the rutin, some of those–

Dr. Justin Marchegiani: Hesperetin

Evan Brand: Yeah.

Dr. Justin Marchegiani: The things I love for allergies: number one, just really get a good air filter. I used one by Advanced Air. You can see that at justinhealth.com/shop Look at the approved products. I like it. It’s good. Uhm—and then your natural anti-histamine degranulating compounds. In my product, Aller Clear. Stinging Nettle, coresatin, and then you’re gonna have like some vitamin C in that, some potassium bicarb as well. So those are really good. And you can go up to eat. The nice thing about it, just not gonna be drowsy. So you can get that allergy support without getting the drowsiness and then really make sure the diet is anti-inflammatory. Up the hydrochloric acid because HDL is really important with low—with allergy. It’s gonna make a big difference.

Evan Brand: Yup, Yup.

Dr. Justin Marchegiani: Ginger. Ginger is phenomenal, too, for allergies. Really good.

Evan Brand: I love ginger. So it’s a great nutrient. I’d do teas, ginger kombucha, there’s so much you can do with ginger.

Dr. Justin Marchegiani: Oh, yeah. By the way, right after this, I’ve got a new grill. So I’m gonna go out, I’m gonna grill some grass-fed hotdogs, right? And then I’ve got some sauerkraut with mustard. And I’ve got a nice ginger kombucha, I’m gonna open up. So I’m really excited for my lunch break today.

Evan Brand: Nice. What kind of grill? Is that one of those  pellet jobs?

Dr. Justin Marchegiani: I actually—I got a new Webber just because it’s—it’s—my other one was 10 years old. And then the knobs are starting to go. So I got a nice, little Webber Spirit. So it’s great. It’s got three burners. Love it. And uhm—I got a smoker that I use sometimes for ribs on the weekend just like a 4-hour job. So it’s good to have a day or an afternoon to kinda be at home to enjoy that one but—Yeah. So love my grilling. Try not to get things charred. Try to keep the heterocyclic amines and the polyaromatic hydrocarbons to a minimum.

Evan Brand: Agreed. Agreed, man. Cool. Well I don’t have one on my end.

Dr. Justin Marchegiani: You wanna have a share?

Evan Brand: No.

Dr. Justin Marchegiani: Hope you guys are liking these calls here. We wanna do more. We wanna connect with the listeners. Our purpose really is to serve and help people get their health back. If people want more feedback, or want more kinda like rolling up the sleeves and specifically diving into your case, go to notjustpaleo.com or justinhealth.com, click on the schedule buttons. And we are here to help you out. Evan, anything else, man?

Evan Brand: That’s it. Have a great day people, drink clean water, get rest, reduce stress, be grateful. It’s gonna go a long way.

Dr. Justin Marchegiani: And people on Facebook, I’m hoping we can get Evan on here soon. We gotta just  figure that out. So hopefully, soon we’ll do that. So Evan, great chatting with you, man. We’ll talk soon.

Evan Brand: Take Care. Bye.

Dr. Justin Marchegiani: Bye.









Dr. Ben House – Enhancing testosterone and improving your health- Podcast #130

Dr. Justin Marchegiani welcomes his special guest Dr. Ben House, a functional medicine doctor based in Costa Rica who also works with a lot of athletes. Join them as they engage in a very stimulating discussion about boosting up performance athletically as they focus on the role of testosterone in the male body.

Gain valuable insight about the recent researches related to Dr. Ben’s area of expertise. Know about the different tests, markers and treatment approach that he uses to address his patients. Get to apply some valuable information related to effective movement patterns that might be related to your health and body goals.

In this episode, we cover:

2:35   Nutrition Recommendation

9:40   Overtraining and Cortisol: Testosterone Ratio

13:33   Functional Medicine Tests for Athletes

18:37   Steroid and Insulin Use

33:30   Movement Patterns

42:40   Blood Markers and Patterns in Athletes







Dr. Justin Marchegiani: Hey, there! It’s Dr. Justin Marchegiani. Today we have Dr. House in the house. Dr. Ben, how are we doing today, man?

Dr. Ben House: I’m doing great. How are you?

Dr. Justin Marchegiani: Excellent. We got you on Skype, too. So anyone listening to the MP3, feel free and click below and check out the YouTube channel as well. And Dr. House is over at functionalmedicinecostarica.com

Dr. Ben House: Yeah, that—that’s me. That’s where I’m at.

Dr. Justin Marchegiani: And you’re seeing patients virtually, as well, which is great. So if you feel like you jive at Dr. Ben, feel free head over there and reach out to him. Dr. Ben is also a PhD grad over at UT. Hook ‘em horns, baby. I’m in Austin now, too. So I’ve given up my Boston College UMass. I’m a modern now. And UT Longhorns, baby. So, congrats on that. Excited to chat.

Dr. Ben House: Yes. I miss Austin. It’s an amazing city for sure.

Dr. Justin Marchegiani: It is. And I know you used to work with a lot of athletes. Were you working with the UTF-8 as well? And the football players and such?

Dr. Ben House: Uh – I worked on a time, right, in basketball.

Dr. Justin Marchegiani: Basketball.

Dr. Ben House: Uhmm – Yeah, yeah. So now he’s in the Philadelphia 76ers. So I consult with couple of proteins but uhmm—it’s—yeah, I primarily work with males and athletes.

Dr. Justin Marchegiani: So tell me a little more about that. Like what are some of the low hanging fruits mean? Maybe we don’t have a lot of professional athletes listening here today. But what are some of the low hanging fruits are, you know, average people are listening can take and apply to themselves to make them better athletically?

Dr. Ben House: I think a lot of times we put professional athletes on the pedestal.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But most of the time, professional athletes are—uhm—they’re successful in spite of what they do.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Because of what they do.

Dr. Justin Marchegiani: Totally. So it’s probably not best to look at what they’re doing. Uh—uh there’s obviously exemptions to every rule. There are really some teams that are really pushing the envelope as far as nutrition. But you gotta think in the pro circumstance, there’s not a ton of motivation and drive to get guys healthy if it doesn’t get them performing.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Uhmm—so kinda sell there is—is Dr. Bob is really good about this—it’s you’re selling longevity.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Coz can you—after someone’s thirty, can you give him 10 years in the league, right? And that’s—that’s pretty important. And so, if we take this to the weekend warriors,  someone who’s—who just loves to train like me. I’m not a professional athlete.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I played college football, but after that, the dream was dead.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhmm—And so it’s—it’s we really gotta—I think the low hanging fruit is the fundamentals—the things that we always talk about. Coz most athletes—they—they don’t—they overtrain because they’re under recovered.

Dr. Justin Marchegiani: Totally. Totally. Now on the diet side, that’s probably a foundation. I think you’ll agree with this. On the diet side, are you kinda following the paleo template? What is the food quality? What does the macros look like with an athlete like that?

Dr. Ben House: So when I lecture on or talk about nutrition, I always talk about three things. So we have quality is the first thing for me. Quality is super important. Uh—we have quality in there, we have timing.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: Those are kind of—For me those are in the order of importance. Uhm—but we have to be really careful. Like Michael Phelps.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Who probably eats 68,000 calories a day.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You obviously can’t eat brussel sprouts and sweet potatoes and get it done. Uhm—so when you have—when you have some who’s just training 20 hours a week, your quality has to drop. And you have to make sure your adjustment’s on point as well.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: Coz otherwise you gotta just stop, put the car in the garage, and really kinda figure it out. And so it’s—we’re at a really cool point where I think we have some technology coming out where we can just individualize.

Dr. Ben House: So all these—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: –hypothetical, best way shit can just go away.

Dr. Justin Marchegiani: Totally. So we got the basically, high-quality proteins, high-quality fats. They’re probably—maybe these guys are gonna be higher on the macronutrients with the carbs and such, correct?

Dr. Ben House: That all depends – So carb work—

Dr. Justin Marchegiani: And in sport maybe.

Dr. Ben House: The carb world is really—there’s—I think of carbs as n__

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: And so if—if you want somebody to go fast, you need carbs and glycogen assistance. And so you can’t—you can’t feed high-intensity exercise on fat. It’s—it’s—

Dr. Justin Marchegiani: Right.

Dr. Ben House: We know that if your fat adapted, you’re actually—you’re actually metabolically inflexible so that you can’t burn carbohydrates at those—at those faster intensities. Uhmm—so for me, it’s all about what is athlete doing. What if they’re, you know, 40 year old, strength athlete and they’re 20 pounds overweight, uhmm—I’m gonna stay at the 5 rep range. Probably knock down carbs pretty well. If—are they a 20 year old athlete who’d never had any problem with weight, and I got their blood sugar, all looks fine, I’m gonna—how many carbs do you take, right?

Dr. Justin Marchegiani: Got it. Okay. Alright, got it. So we have kinda the macronutrients, we’re obviously cutting out—organics gonna be obviously dialled in, right? Food quality’s gonna be dialled in. We’re eating enough calories—that’s big. We’re mak—making sure the in the HCl and the enzymes are up to snuff so we can actually break down and digest those foods. We’re making sure we’re drinking, we’re sleeping maybe 8-10 hours. That could be big thing as well. Uh—more exercise, more muscle breakdown requires more recovery. I think with Steve Nash and Tom Brady, too. I mean they get like 10 hours sleep a night. I think that’s the biggest thing. Huge.

Dr. Ben House: Number one. Like if you wanna increase performance, like this is out of  Stanford, like sleep more. Spend more time in bed.

Dr. Justin Marchegiani: Yeah. You get to bed between 10 PM and 2 AM and you’re asleep during the cycle. You’re getting access to maybe $3,000 to $5000 of growth hormone a month just by getting in bed during those timeframes. Would you agree?

Dr. Ben House: Yeah. And I mean, testosterone is also secreted. GNRH works in that—inside that time block, too. So it’s—the circadian rhythm hormone. So you start jacking up your circadian rhythm. And a lot of the—one of the probably because athletes we see, they’re just hooked up on cell phones all the time like this is perpetual, you know, Twitter, Facebook, social media feed. Man, that’s—that’s a whole lot of bull S.

Dr. Justin Marchegiani: Yeah. Totally. So you get the nutrients, you get the digestion, you get the right amount of exercising. That’s a really key thing coz a lot of times it’s train, not drain. And you see a lot of overtraining with your athletes?

Dr. Ben House: Well, I think we have to be mis—I come from a strength coach background. So in the college setting, the strength coaches it—it’s unfortunate. And you even saw it at the  University of Oregon.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: When they got rid of radicals who was like, “who’s the man?” Uhm – and I bump into this other guy and he started smoking people and he put three guys in the hospital. Uhm—so the saying with this coach is pri—it’s sometimes they’re thought of as the punishers. So they have to dole out like someone doesn’t show at the practice. And so, if you’re in a team sport atmosphere, like—you don’t have that much control over the overall, though. There’s some people that are using like Zephyr or some really cool GPS program to over—to like measure overall look.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—but some of that is outside of your control.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: The cool thing—in the general population and if you have—while like private is because you can have total control over the athlete.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And—one of my favourite examples is Rutherford who like—he was like the 200 best in the world. Uhmm—and now, when he—he was training like typical like four days a week. And they brought him to like one-two hard training sessions every 10 days, and he won the gold medal. Alright. So—

Dr. Justin Marchegiani: Wow.

Dr. Ben House: So it’s kinda—it’s like everybody is individual and so if you can individualize that protocol and—and volume’s a hammer, right? And so that’s not the thing sometimes that we wanna use all the time.

Dr. Justin Marchegiani: Right. Right. That totally makes sense. So when you’re exercising these guys, are the movement patterns gonna be standard for each person like the functional ones like squats, deadlifts, lunges, step up, like core pushing and pulling movements. How do you adjust those and tweak those with the sports with the athletes?

Dr. Ben House: I—So that’s gonna be all dependent on the sport, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the position that they play. Uhm—so if you got a baseball player, like it’s all rotary power, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: It’s probably getting them—getting them at the right side of the right handed. Getting them kinda even and obviously not getting injured. from up your eyes standpoint.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Uh—so—it, it’s so rare but I think for that, it’s also gonna depend. Like is strength, is arm strength really doesn’t apply unless like you’re a full-back or a line man. Uh—sometimes the best guys in the weight room are the worst kind in the field. Uhm—

Dr. Justin Marchegiani: Right.

Dr. Ben House: It’s uh—we have crossfit now. I think that’s kinda—that—it’s really cool. And now the weight room is the sport.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And so weekend—it’s open right now—we can do crossfit as much as we want. But I think it just produced some people that can take insane amounts of volume. Uhm—and not everybody can. And they get—It’s very Spartan type society.

Dr. Justin Marchegiani: Oh, totally. Now when you’re working out with someone, is there a certain heart rate that you want people to get back down to? Maybe with your adrenal dysfunctional patient, is there a certain heart rate you want to get back down to before they go into the next set?

Dr. Ben House: Uh—I’m kinda __heart rate isn’t our best.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: It’s an okay marker.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: I—there’s a new technology that we’re using called mock C—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Which is essentially muscle oxygenation. So we wanna see that muscle is just resaturated with oxygen (O2).

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And it’s get—it’s probably not a horrible for just the average person right now.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But it will get more affordable, uhm—it will get more usable. Right now, it’s not that user-friendly. Uhm—I think you probably want to get back to a good resting heart rate. Also the—the research is pretty clear cut if you’re chasing hypertrophy. Uhmm—that 2-3 minute window for rest is probably where you wanna be.

Dr. Justin Marchegiani: 2-3 minutes. Got it. And are you looking at free cortisol to uhmm—I’m sorry, free testosterone to cortisol ratio to assess overtraining in any of your athletes?

Dr. Ben House: So I look at total testosterone. I don’t put a lot—this is my personal opinion—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’ve done a lot of research on salivary panels and I don’t like cortisol panels coz they’re just like—their—they’ve done 30 days of salivary test and they’re super variables especially in athletes. Uhh—so I don’t—If I could get a week of them, I would use them. But if I could only get one day, I don’t wanna just—I don’t wanna live and die by that one day. Uhmm—so, and I—you can ask questions. Like you know, probably the best indicator of overtraining is like hey, how you’re performing. Like how do you feel, how’s your mood like. So a lot of times, we can get a lot of information just by asking questions.

Dr. Justin Marchegiani: Got it. And what’s your total cortisol cut-off? Your total testosterone cut-off be like? Is it 100 above?

Dr. Ben House: Yeah. I mean the research is—I don’t really get, I don’t like the whole bench press number of testosterone.

Dr. Justin Marchegiani: Right.

Dr. Ben House: I think it’s only looking at production. We don’t know the sensitivity and the receptor. We—we can get such binding globulin and the albumin.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: We can get free testosterone but I mean the ment—the mental strain of that for guys like, “Hey you’re inadequate, you have a testosterone of 5.”

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I don’t like to do that.

Dr. Justin Marchegiani: Do you see correlations, though? Do you see like, “Hey, these are the althletes that are responding the best, that are recovering the best or getting the best results” Here is where his numbers at. Do you see any correlation there?

Dr. Ben House: Yeah. I think—we can’t really make that correlation—

Dr. Justin Marchegiani: Okay.

Dr. Ben House: inside of physiological ranges. Uh—we don’t have a lot of data on that as far as research. Anything I would say would be anecdotal there. Uhmm—do I think, do I have a hunch that it’s better to be at 800 than 380?

Dr. Justin Marchegiani: Yeah. Yeah. Totally.

Dr. Ben House: Do I know that 800 is better than 600 or 500? I don’t know. I haven’t seen that. I’ve seen—I’ve seen some beast that are in the 500 range like 10% body fat, like 210—like they’re front squatting 400 pounds. Like, so—

Dr. Justin Marchegiani: Testosterone can be really variable. I think it peaks more in the AM right? And they can drop down in the afternoon. It can be the variables. So you may just catch it at the wrong window.

Dr. Ben House: Yeah. And in some circadian rhythms are screwed up like you have no idea where you’re measuring. So, like it’s—it’s to me—it’s the lab value is not the person so I always wanna like, “Who is this person?”

Dr. Justin Marchegiani: Totally. Yeah. You gotta look at the clinical outcome along with the—the objective values. Totally makes sense. Are you doing any adrenal testing with your regular functional medicine patients?

Dr. Ben House: I don’t do a lot of adrenal testing. Uh—you interviewed Wakowski here, kinda one of my favourite sayings, like 99% of new-age primates are cortisol resisting or have cortisol dysregulation so—

Dr. Justin Marchegiani: Totally.

Dr. Ben House: To me it’s like why do I want to measure chaos? I’m a big fan of not measuring chaos. Uhmm—and that—that’s just my viewpoint. So I would be apt to use like—I would use it later.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So if you’re sleeping, if you’re doing all the things that you need to do, then I’ll run that—if we’re still not getting what we need to do. But the other way you can kinda frame it, too, is well, if I put this—I try to make it as least financially kind of—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—

Dr. Justin Marchegiani: Yeah. You’re trying to make it that the buying financially is low as possible so you can help more people, right?

Dr. Ben House: Yeah. Yeah. But for the testing standpoint, so—if—if someone—if I don’t—if they don’t care about money, I’m gonna get this test coz then if I show them, right? Then they’re gonna have it buying.

Dr. Justin Marchegiani: Yeah. Exactly.

Dr. Ben House: Yeah. And lever is gonna be higher. Okay, your free testos—you’re free cortisol’s jacked. You have no DHEA. You start to do the shit that you need to do, right?

Dr. Justin Marchegiani: Exactly.

Dr. Ben House: Uh but if I can get that from other means, If I can them dialled in the fundamentals, then—and doing all the things that they need to do—coz nobody in the general population’s doing that. I mean slow—today is low.

Dr. Justin Marchegiani: Exactly. So looking like at the palette of test, functional medicine test that you’re using with your patient, with your athletes, what are those top tests?

Dr. Ben House: Uh, so I – my top 2 are definitely a comprehensive blood panel

Dr. Justin Marchegiani: Got it.

Dr. Ben House: And then CSA. Like uhmm—

Dr. Justin Marchegiani: Stool analysis.

Dr. Ben House: Yeah. And if someone doesn’t—if that doesn’t pop, maybe I’ll go grab a SIBO breath test or something like that if they have—if they’re carbon tolerant—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But we gotta immediately fix the digestive component. And obviously you don’t fix that without fixing the cortisol component. But uhmm—that’s my—that’s what I do. And then I’ll run precision analytics sometimes.

Dr. Justin Marchegiani: Yup. Okay. So you will do one of the—the drug urine testing for the adrenal rhythm sometimes.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Okay. Good. I do those tests as well and their good.

Dr. Ben House: I want to see uh—so a lot of functional med—I think we can get in trouble coz I’m a PhD so I’m very research oriented.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So if a test doesn’t have a ton of research behind it, I—I’m not very apt to use it.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: And that can be good and bad. Uhm—but I think like 5 years down the road, like is that lab gonna run like duplicates for 30 days? Are they gonna—are they gonna just do everything in their power to validate that measurement? Or are they just gonna this is it. This works? Then that’s—that’s what I wanna see.

Dr. Justin Marchegiani: Yeah. That totally makes sense. And Biohouse got a new one out, called the CARS, the adaptive response. And they’re doing cortisol I think three times in the morning.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: And it’s interesting because you do cortisol right away, you do it an hour later, you do it two hours later, and you see a major change in that first two hours. So I think people are really getting more stringent on when you do cortisol especially in the AM which is helpful.

Dr. Ben House: Yeah. Our lab at UT actually did a bunch of stuff on the cortisol awakening response. Which is—which is—that’s kind of—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You knew that’s oughta things go as well.

Dr. Justin Marchegiani: Yeah. I totally agree. Now looking at growth hormone, how does growth hormone interplay? Kinda potentiates the effects on testosterone? How does growth hormone interplay? I know it’s connected to IGF-I goes to the liver. How does that affect testosterone and basically when you put on more muscle?

Dr. Ben House: So—

Dr. Justin Marchegiani: I know it’s a lot—

Dr. Ben House: Testos—testosterone’s gonna feed in IGF, right?

Dr. Justin Marchegiani: Okay.

Dr. Ben House: A lot of times and we can get the liver obviously want to work—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: growth hormones gonna be secreted at night and then the liver’s clogged is not gonna make IGF. To me, we can— from an IGF perspective—I’m not super well versed in IGF because I work with a lot of young athletes. And I don’t think we’re gonna have a lot of  IGF problem, like IGF-1.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’ve never—I used to measure IGF-1 all the time and like no one was out—like no one was—everybody was kinda in range. So I stopped running it. Uhm—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And that’s just my take. Now, could they benefit from growth hormone? Probably, right? Uhm—but we also have to be careful with that because IGF-1 is a growth factor.

Dr. Justin Marchegiani: Yeah. It causes cancer.

Dr. Ben House: Yeah. And well the research on that’s kinda another thing HGH is not related to increase cancer risk but I think—I think the evidence there—is there—just a little bit caution especially if you have a lot of cancer in your fate. Uh—

Dr. Justin Marchegiani: Yeah. Totally. So basically, the big things to increase testosterone: sleep, protein consumpt—ad—adequate protein, I imagine, right? The right amount of stimulus and then how about the timing of nutrition? Where does the timing come in to really potentiate testosterone and growth hormone?

Dr. Ben House: Well, I don’t know if we have a lot of research on that. Like acute—acute feeding of either fat or carbohydrate will actually lower testosterone uhm—especially in the fasted state. So to me, the bang for the buck there is probably from and under recovered mechanism. So if you just crash your glycogen stores, you probably wanna refuel. Uh—in—we know the biggest thing is gonna be total energy intake. You drop your total energy intake by 15%, you’re gonna lose D3, you’re gonna lose testosterone, so getting—if—if someone’s not—if someone’s training hard, they need the—in my mind, they have a body comp issue. And they’re training hard, they need to eat as many calories as they can to maintain their weight.

Dr. Justin Marchegiani: So when you see these guys in the NFL, for instance, let’s say a linebacker that needs to be big, strong, but relatively lean and fast, is it really just the quality of nutrients and getting enough of it? I mean these guys literally eating two-three thousand calories   more than what they would need just at that height and weight to keep that mass on?

Dr. Ben House: Yeah. In season, like you’re gonna see—you’re gonna see insane amount of calories going and going on their mouth. Like—they—they have to. They are that active. They’re—like you have a 230-250 pound man, they need a ton of food –three to five thousand calories easy. And so uhm—that’s—you gotta be careful coz that’s hard to get. And if—and that’s why we can get into trouble like intermittent fasting with that athletes.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And Paul Quinn is like very, very against intermittent fasting in athletes. And — I—I’m—I’m in the same camp. Uhm—if you—body composition is completely different, health is completely different, but I think—especially in season if you have an athlete that—you gotta get—you gotta make sure that you get him first.

Dr. Justin Marchegiani: Totally. What’s your take on steroids in general? Using steroid and/or using insulin as well. What’s your take on that?

Dr. Ben House: I—yeah. Yeah. This is awesome. Uhmm—

Dr. Justin Marchegiani: Let’s do it.

Dr. Ben House: From a TRT perspective, I think we’ve—and—a lot, just like a lot—like marijuana and I say marijuana’s bad or good. Nothing is bad or good, right? It is all context.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—I think we’ve had a veil dropped over our eyes as far as testosterone the same way.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—and everybody thinks their testosterone is very negative because of baseball, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But—the overall, the evidence for testosterone replacement therapy is overwhelmingly positive.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Overwhelming. So—uh—now, we don’t want the same thing. We don’t wanna just slap that on every guy. We wanna make sure—we wanna use all these lifestyle strategies first, but traumatic brain injury—I – you know that’s gonna affect testicul—the—testicularitis. And so—And also, blaunt trauma to testicles. My best friend played __cross. He got hit by a 110 mile cross bow in the nuts. He had three concussions, right? So is that guy—

Dr. Justin Marchegiani: Aww, man!!

Dr. Ben House: Is that guy gonna be able to produce his own testosterone, right? And that’s not that abnormal like you talk—

Dr. Justin Marchegiani: Right.

Dr. Ben House: You talk—you talk to a lot of professional athletes like how many testosterone do you have?  I don’t know—right? Especially—especially in contact sports. Ask any of the guy.

Dr. Justin Marchegiani: That’s crazy. And elbo—also the xenoestrogen exposure is gonna disrupt LH- luteinizing hormone feedback loops, too, right? So we have the—we’re bombarded with the xenoestrogens and if you’re a female, obviously just in birth control pills will scrap the females as well. But you have it in the water, you have it in the pesticides and yeah—the plastics as well.

Dr. Ben House: Yeah. This is something like—male health—this is why I feel so strongly about male health is coz we have no idea what’s gonna happen, right? Babies—they—their PON1’s are not very active. And PON1 is that enzyme that kids rid of persistent organic pollutants, right?

Dr. Justin Marchegiani: Totally. Yup.

Dr. Ben House: And so we got—30—the top 37 pesticides that are used in our foods are anti-androgen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So we have no idea what’s gonna happen, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And then so the—and they only run test on one of them. They don’t run it at all of them. Uh—it’s—it’s very scary. Uhm—and this is—from my protecting you have to do everything in your power to eliminate all of those potential pollutants, right? Skin care products, everything. So we gotta get kinda weird. Uhm—and you don’t know if that’s gonna have an effect but you have to—you have to make sure. You cannot—especially babies. Like we cannot put that on—Look at the male population it’s going up today like it’s pretty scary.

Dr. Justin Marchegiani: Oh, especially if you—you can’t breastfeed your child and you’re feeding them soy protein isolate. My god, the phytoestrogen content that you’re getting on that can rise up to potentially a birth-control pill in amount. Especially that’s all they’re relying on for the first six months to a year.

Dr. Ben House: Yeah. It—it’s wild, man. Like it—it’s—it’s gonna be—it’s gonna be really, really interesting as you see what happens in 30 years. Like when this generation gets so like their 20’s and 30’s and 40’s, it’s gonna be—it’s gonna be wild.

Dr. Justin Marchegiani: Absolutely. I have some people here in Austin, they’re uhm—doing some run care in melatonin and I’m researching helpful companies that’s more essential oils and more natural compounds and reusing like dying to meet—dying to make just earth to treat the fire ants or using boric acid for natural things. And peppermint oil for the Hornet’s and vinegar for different things. So we’re trying to limit our load naturally. But I see people everywhere else they’re putting a lot of chemicals out there. Are you familiar with the research on lung care products and like childhood lymphomas and leukemias and such?

Dr. Ben House: No. I haven’t—Well I haven’t looked at a lot of that research coz that’s not in my wheelhouse.

Dr. Justin Marchegiani: Got it.

Dr. Ben House: But if you look at people just eating organic vs. non-organic p—produce like if you eat organic produce, you’ll get higher sperm count—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Your sperm is clear. It’s hard—that’s the dopest study at Harvard Med.

Dr. Justin Marchegiani: Yeah. Yeah. I totally get that one, for sure. I’ll plug the documentary, too. The disappearing male.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Excellent PBS documentary that talks about basically these estrogenic compounds in the environment that are hurting men and our future babies. So, keep that mind, too. That’s really good.

Dr. Ben House: You can kinda educate me on this, but I think all of those are gonna be mitochondrial toxin-based, right? If you jack up the mitochondria, you’re gonna have trouble with cancer.

Dr. Justin Marchegiani: Oh, absolutely. You’re gonna have issues with cancer. There’s a great book it’s called, “Tripping Over the Truth”. That’s a really good book on cancer and the connection with the mitochondria. That’s a really, really, good one. And also, just the fact that it affecting the HPT access coz you screw up LH, uhm—you screw up the pineal gland, that affects melatonin that affects puberty. All these things that antagonizes itself. And then the more fats cells you have, the more estrogen you produces, then it’s a downward cycle, the more insulin-resistant you become. And it’s just this downward cascade—this metabolic accident, so to speak.

Dr. Ben House: Yeah. It’s just loops everywhere. And you gotta figure out how you’re gonna break those loops and—and that’s the thing, some guy, they have like 25 loops right in. And you just wanna give them to—that’s not gonna fix the problem. You have—That’s not—you’re not helping anyone.

Dr. Justin Marchegiani: Yeah. And what about things like anabolic steroids? The more synthetic ones? DBOL and such?

Dr. Ben House: Yeah. I don’t use those. Uh—I have clients who do. Uh—

Dr. Justin Marchegiani: Yeah. What’s your take on that?

Dr. Ben House: I don’t—I don’t manage any of that.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: What I do is I just wanna make sure that—that’s their choice, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So I—as a—as a—as—just a male in general and as a clinician, I don’t ever wanna change someone’s goals. I just wanna help them do what they do better. And so, if you wanna be a pro body builder—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re gonna have to play in that realm. Now I’m not the guy to run your anabolic regimen. But I can at least see like what’s going on? Are you—are you able to get rid of it? What’s your liver doing? How’s the hematocrit? Can manage all the things that could go wrong in that situation? 24:33 Uhm—the research on that is—is—is—is I think one thing that I would like to highlight—so they’ve done studies where they give a guy 600 mg a test.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the average builder like 1100, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And so they give these guys 600 mg a test in 12 weeks. They give 20 pounds a muscle without an exercise regimen.

Dr. Justin Marchegiani: Whoa!

Dr. Ben House: Yeah. So you’ll think about—

Dr. Justin Marchegiani: That’s insane!

Dr. Ben House: You’ll think about like instagram phenoms, like you got a lot of people out there—a lot of males that I think are chasing things that aren’t physiologically possible. Uhm—and that—

Dr. Justin Marchegiani: You mean—

Dr. Ben House: Yeah. Go ahead.

Dr. Justin Marchegiani: You mean like the people you’re seeing align, they’re doing those things that you mention. The 600 mg of tests and they’re just getting massive amounts of muscle that you may not be all to cheat naturally. Is that what you’re saying?

Dr. Ben House: Yeah. The ethotomy is uhm—so that’s a—that’s a calculation that you can do. And anything above 25 is—it’s kind of—then you start asking questions.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like my ethotomy is like 24, right? And I’m, you know, 1—190-185-190 and anywhere from 8-11% body fat. Maybe a little bit more if I’m off my game. Uh—and so there’s kind of a line in the sand that we can cross naturally. And obviously there’s gonna be people that are above that just from a statistical perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But if someone just looks on godly jacked, I mean maybe—well—who am I to say what they’re doing and I don’t wanna be the guy that’s the ultimate whistle blower.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But I think we just gotta—we just gotta—when you look at everyone else’s highlight here, you’re gonna start questioning your own self-worth and I don’t know that you wanna do that.

Dr. Justin Marchegiani: Totally. Totally. And what do you think about uhm—tendon growth when you’re on hormones like that? Let’s say, I know more of the artificial, but in general, do you get the compensatory growth in the tendons to support the increase in muscle mass?

Dr. Ben House: Yeah. So that’s one of the problems, right? It’s uh—you think about how the body responds like to__

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: The first thing that we’re gonna have is neural, right?

You can get that in minutes. And the second response is muscular. And so that’s gonna take, you know, 8 minutes, maybe last if you’re—you’ve never__

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But that—that collagen response that you know, that’s building up the fascia, building up all the tissue and the bones. That takes a longest time. So when you take shortcuts, if I put a 25 lb muscle on you, and I haven’t—I haven’t build up the structure, I’m gonna—that’s when you like—biceps tear don’t happen. Like you see a bicep tear on a deadlift, like, “Uhmm” I’m thinking, what’s going on?

Dr. Justin Marchegiani: Yeah. Totally. So do you uhm—

Dr. Ben House: Does that make sense?

Dr. Justin Marchegiani: Yeah. That totally make sense. So you—something you’re careful of and you increasing collagen supplementation to help provide extra tendons building blocks, too?

Dr. Ben House: Well, everybody had—everybody is pretty much using that I have is collagen protein.

Dr. Justin Marchegiani: Great. So you’re doing that.

Dr. Ben House: Yeah. Especially in the beginning, I take everybody off away for 30 days just coz it’s a common allergen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And if they can handle that, I want it back in. Uhm—but yeah—yeah I would say that’s kind of a non-issue for me.

Dr. Justin Marchegiani: So you sub out—will you sub out like the way for like a high-quality, hypoallergenic pea protein in the meantime?

Dr. Ben House: No. I’ll use—I’ll use uh—

Dr. Justin Marchegiani: Beef?

Dr. Ben House: I think if you take enough pure paleo, I think you’re gonna be fine on losing content.

Dr. Justin Marchegiani: Got it.

Dr. Ben House: That’s like a 3-gram threshold. So yeah, less than whey but if you take 30-40 grams of it, you’re gonna be fine.

Dr. Justin Marchegiani: Nice. Awesome.

Dr. Ben House: Well, I know you post a lot on Facebook. You got a home gym, you’re dad in Costa Rica now, you move from Austin down there. So you got a pretty awesome lifestyle going. Give me a quick walkthrough in the day of a life of Dr. Ben. What time do you get up? What do your meals look like? What does your work out looks like? What is post and pre work out nutrition look like? What does sleep look like?

Dr. Ben House: Yeah. That—that’s fun.

Dr. Justin Marchegiani: Ahaha.

Dr. Ben House: So my days, I wake up—one of the cool things of why I’d wanted to move here is getting closer to the equator.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—So I go to bed like 8:30. Can’t keep my eyes open.

Dr. Justin Marchegiani: Wow!

Dr. Ben House: And then I’m up naturally like you talk about cortisol awakening response, like I can’t sleep past 5:30. So—

Dr. Justin Marchegiani: That’s great.

Dr. Ben House: So I wake up—I wake up and I immediately sit, right? So I sat for—I meditate for 15 minutes. Done that for years. Uhm—

Dr. Justin Marchegiani: Great.

Dr. Ben House: Never—never will stop. That’s kinda—

Dr. Justin Marchegiani: Any kind of meditation? Just kinda like a blank slate in the head and you’re breathing or—

Dr. Ben House: I use mantra practice. Sometimes my dad is a—is Zen teacher.

blank slate and had new breeding or is much about is sometimes my dad as it is in Zen teacher is an ordained Zen priest.

Dr. Justin Marchegiani: Oh, awesome.

Dr. Ben House: Yeah. So in—I started—I took my whatever you wanna—I’m kinda involved when I was about 19. Uhm—probably the best gift that I was ever given uhm—was that to be able to go to that—come to that mindful practice early.

Dr. Justin Marchegiani: That’s great.

Dr. Ben House: So I’ll do—I’ll do some calming. Sometimes I do some Tibetan practice which is like—it’s one of my favourites where you wish someone well that—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the next breath, you wish someone well that you’re kinda apathetic about.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: someone that you don’t know very well. And the last, you wish someone well that you hate.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: That you don’t really like.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And it kinda—it really helps you and by the end, you’re kinda like, “Man, I don’t have that many people that I—that I don’t like and why I don’t like them.” It becomes mostly probably, you know, you start looking to word about that.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: That’s one of my favourites.

Dr. Justin Marchegiani: Love it. That’s great. So morning routine, you’re getting up 5:30, you do your meditation 15 minutes, what’s next?

Dr. Ben House: Uh—so if it’s a training day, I’m probably gonna have some type of easily digestible carbohydrates and Natchan in the morning coz it’s hot here. Uhm—also, I train in I’d—I like to smash myself with prob—I’m NEAT head, there’s no way around it like I’m gonna be that guy probably even if—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: ills me. Uhm—And so I’m—I’m working that glycolytic high intensity pathway uhm—3x a week. In my youth, I do it unbelievably too much, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But—so I’ll do that and I’d work for about 3 hours in the morning depending on what I got. I usually don’t take clients until the afternoon. Uhm—And then I’ll train or if it’s a non-training day, I’m just working. Uhm—and then right now, we’re building a retreat center so I have a lot of things that I—I’m the gen—I’m essentially the general contractor there so—

Dr. Justin Marchegiani: That’s awesome.

Dr. Ben House: And so half my day is in Spanish, the other half is in English. Uh—sometimes I have to run up there and do stuff but—

Dr. Justin Marchegiani: Nice.

Dr. Ben House: I spend—I spend 4 hours at least a day on Pub Med in researching and writing. That’s my—that’s my thing. I love it.

Dr. Justin Marchegiani: And you have awesome Facebook posts, too. I appreciate it. You really condense a lot of the research down.

Dr. Ben House: Yeah. I think that’s how we move people, right? We just consistently hit them. And you do it with a podcast.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like this is a—even if it’s—even if it’s repetitive affirmation like if it produces an action, that’s what I’m all about.

Dr. Justin Marchegiani: Totally. Got it. So Pub Med 4 hours a day, that’s awesome. And then patients and then what’s next after that?

Dr. Ben House: I try to stop working.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—I think a lot of us are super passionate about our craft. I’m better about that when like something isn’t coming like I have uhm—big—big presentation’s coming up in a month. So now, I’m kinda—I’m always prepping for that. Those are kind always in my mind. So I use a lot of hard mat to kinda like turn my self-doubt.

Dr. Justin Marchegiani: Yup. Yup.

Dr. Ben House: Uhm—And I try to shut it down. Shut it down in the evening, definitely by 5 or 6. And I’ll just do fun stuff with my life, right? Maybe we’ll read. Maybe I’ll read something like super unscienc-y. Maybe we’ll just watch a movie. We kinda watch— I tend to push for comedies. He tends to push for dramas but uh—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And I always make sure—one thing I’m really, really like big on is you have a treadmill test. It’s just baseline of movement. Like—

Dr. Justin Marchegiani: Huge.

Dr. Ben House: We put all these—we put all these pressure on exercise and it’s just a small bucket as far as like movement. It’s like NEAT is where it’s at, Non Exercise Activity Thermogenesis. And so if someone is not gaining 10,000 steps in a day, like all of the core can take can be just regulated. They’re not gonna be able to sleep. So so many good things happen if people just move.

Dr. Justin Marchegiani: Oh, I agree. I mean I just got seen patients yesterday. I’ve got 25,000 steps yesterday. I mean I walk about 10 miles a day. I’m on my leg uh—my fitness power here. And I’m like—you know, there’s a leader board section and I’m always like—I always like try to be number one. So there’s yesterday right there, 21, 500. So, super. I love it.

Dr. Ben House: You’re living it.

Dr. Justin Marchegiani: Oh, yeah. Absolutely. And then the key thing is to I kind have my kettle bells down over here and then some push-up bars so I try to rep some of the that stuff in between patients even if I can do 2-3 minutes in like 5 or 6x a day. It just keeps the metabolism up.

Dr. Ben House: Sounds good.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’m—I’m—I train so hard that you could I mean—

Dr. Justin Marchegiani: Yeah. I get it. I get it.

Dr. Ben House: I’m not doing pull ups—

Dr. Justin Marchegiani: You’re done. You’re done after that. You’re done, man. Absolutely. So right now, we have a lot of listeners that may not be at that professional level, right? You know, frankly, they wanna be healthy, they wanna be energised, they wanna have good relationships. And then probably I can say that they probably wanna good look naked, right?

Dr. Ben House: Yeah. Yeah. That’s the point also.

Dr. Justin Marchegiani: Yeah. So what are the top 5 movement patterns those people should be doing? And maybe you wanna differentiate man and woman so in case something is different there.

Dr. Ben House: Uh— So I would say first of all, like just how people are gonna come see us for a lot of like metabolic stuff and all the—everything that we do for functional med. See somebody who’s good at movement—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like—like you’ve been at a desk your whole life and you can’t take an exhalation. Like you probably shouldn’t be deadlifting.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Like if you’re stuck in this state of extension. I don’t know that that’s—are you really gonna even activate your hamstrings? I have no idea, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Especially __Uh—so I think we wanna be able to use—we have to be able to use the big guns. We gotta—you know—hamstrings, quads, back—

Dr. Justin Marchegiani: Yup.

Dr. Ben House: Chest, right? And so you’re gonna—you wanna squat, you wanna deadlift, you wanna benchpress, you wanna military press, but it’s always risk vs. reward. So the risk of anytime you strapping somebody, 2 hands in a bar is higher than if you put on single limb, one arm weighted, right? Or one leg weighted.

Dr. Justin Marchegiani: Yes.

Dr. Ben House: And so for me it’s all about how do we individualized this to the person? And if you don’t individualize this, what we’ve seen is—so one of my—one of my good friends in—we used to—we have a business together in Austin, his name is Erin Davis. He’s probably—he’s like the most unknown exercise scientist. And he’s like purposely so. He’s like a hermit. And he’s a—

Dr. Justin Marchegiani: Nice.

Dr. Ben House: He’s an insane, right? And so he straps up all these gadgets to this dude. And he’s like—and – he just messes bench pessing. He’s like, “What the hell? You’re chest doesn’t even turn on.” Right? And so he can’t even—out of a barbell  bench pressing, he can’t even get the guy’s chest to turn on because of his positioning. Gives him a dumbbell, boom, he can get—he can get pec activation. So I think it’s—

Dr. Justin Marchegiani: Oh, wow.

Dr. Ben House: So I think it’s really important that you see somebody who’s good at movement evaluation so you can look at your position, right? Coz muscles are slaves to position.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So the position—who the he—what are you gonna do? Uhm—and I think there’s DNS, PRI. There’s a lot of uh—FRC. There’s a lot of things that are looking at that now.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—and there’s a lot of people that are really good at it. And so see them, pay them for their time. Uh—in Austin, there’s a guy Steve Cuddy who’s amazing.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhmm—Erin Davis and Pad__ is obviously really good and Dave R__ has done the same as Marcus—who’s awesome as well.

Dr. Justin Marchegiani: That’s great. So what are the top 5 movements?

Dr. Ben House: You tell me. What’s gonna activate the biggest muscle groups?

Dr. Justin Marchegiani: So for me, off the bat, it’s gonna be deadlift coz that’s the only one that connects upper body and lower body but actually doing with correct form really activating the lats, locking them down. Number two would be squat. I wanna get your take on front squat or back squat, though. I would do uh—pote—I’m a big fan of unilateral single leg like deadlift movements. I like those with cables. Big Paul Chek fan with that. I would say step ups and/or lunges and then after that, I mean, If I’m doing a movement, I would wanna do something that has explosion. So I would wanna do either uhmm— snatches or uhmm- cleans or sprints.

Dr. Ben House: Yeah. I would—I would pick like maybe one of those. Haha—

Dr. Justin Marchegiani: Oh, let’s hear it.

Dr. Ben House: That’s good. That’s great.

Dr. Justin Marchegiani: I want—I want your take. Let me hear it.

Dr. Ben House: Yeah. Yeah. Uh—So you gotta—upper body pulling is like super—you gotta have—you gotta have one of those in there.

Dr. Justin Marchegiani: Yup.

Dr. Ben House: So whether—that’s probably a lot. Maybe a pull up if you can do it right.

Dr. Justin Marchegiani: Okay. So you’re talk—Alright. Got it.

Dr. Ben House: Uhm—if someone’s goal is just health, probably most people’s goal is hypertrophy.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So in my mind, they need to get really, really really good at the fundamentals.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: Variety may not be your bestfriend.

Dr. Ben House: You may need some of it just to keep you—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: –in the game. But you gotta be—I would probably use a trap bar. Uhm—safer for the general population. You can load it up.

Dr. Justin Marchegiani : Yeah.

Dr. Ben House: Uh—it’s gonna be more quad dom. Uh—

Dr. Justin Marchegiani: Yup.

Dr. Ben House: I’m—So the—From the—from the deadlift perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I think it’s great but if you’ve been a gymnast or if your hamstring length is really, really long, if someone can palm the floor, I’m gonna be very—I’m not gonna use—I’m not gonna throw a deadlift at somebody right there.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: I’m probably gonna use—I’m gonna use maybe couple of Bulgarian split squats, Which is probably my favourite exercise for the general population. Where you like get to activating the hamstring uhmm—from a front squat, back squat perspective, the muscle activation is fairly similar. Uhm—I would probably lean in the general population more towards the front squat because you’re gonna have more anterior core, you’re gonna have to stabilize, right? And also, like if you can’t do it, you—you drop it.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Whereas the back you can like—you can—you can—

Dr. Justin Marchegiani: Yeah. You’re gonna overpower it, for sure.

Dr. Ben House: Yeah. You might hurt yourself. Uh—so those are my view points. Again—and I use uhm—I think speed and doing things that people love is really important so—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You know how to Olympic lift, and you like to snatch, you like to clean obviously. I love those things. But if you don’t like doing Olympic lift, there’s a lot of—like sprinting is a great way. But in the jumping—there’s a lot of different little things that you can do to come and get that fast twitch movement coming. Uhm—

Dr. Justin Marchegiani: Are you doing any single leg stuff?

Dr. Ben House: Yeah. You can do single-leg hops, you can do, you know, whatever. You can—I do it ton. So I don’t—I do myself in all my single leg and kinda that prep toy stuff. That’s one of my cool down. So that never leaves, right? I’m doing a lot of like prehab, rehab stuff. But my meat and potatoes is my meat and potatoes. Uhm—it’s like you can’t lose sight of that. But if someone has never train in their life, their entire workout might be prehab, rehab.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Okay. That makes sense.

Dr. Ben House: Does that make sense?

Dr. Justin Marchegiani: Yeah. Totally. Now you’re reading a lot of studies. You’re spending 4 hours a day on Pub Med.  What are the key things that you look at in the studies so that you don’t get tripped up by you know—coz sometimes the conclusion might not match what the actual study has done. Just—I know we don’t have an example here, but what are the key things people should be highlighting or looking at when they’re reviewing the study?

Dr. Ben House: That’s a—that’s a problem to question. So like UT was kinda burning to us in the PhD department really, really early.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—the first thing he looks at is the chart.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So you go straight to the figures. Uh—you look at the figures and then—and then you kinda look at the stats section. You figure out— And this is from a research perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Then you look at the stats section, then you look at the subjects and then you start digging the—everything that’s going on the method section. Before you look, at the conclusion and maybe—sometimes I’ll just—I’ll buzz your abstract to see what I wanna read. I’ll definitely do that. Uh—but the problem is most people, even myself, being out of the grad school for, you know, a year and half-two years. We don’t—I don’t like looking at a ton of stat research. So like Microbiome data. It’s probably the best example here. Like our lab run a ton of microbiome data.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: We got stool samples on many people, we sent that out – yeah we send it out to another lab. Uhm—and that guy get all the analysis—all the genetic analysis on the poop.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And then that guy couldn’t even analyze the data. So had to send it to a statistician to analyze the data so that we can have—we can think about it. So think about all that. Like that is—

Dr. Justin Marchegiani: Lots of steps.

Dr. Ben House: Now you ask the general population. You’re asking the general population to look at some kind of general linearized cluster analysis. But I don’t even know what day it is, right? And so—that uh—that—like—you know—and so they have—they tend to digestible and take away. So there’s a lot of reliance on science. If you see a study, and this is kinda something that we could talk about. You see a study that’s running like 20 paired T-test, I’m immediately like, “What the hell are you doing?” Like you can’t run—it’s—you have this 95% like a .05 alpha.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So in order for something to be statistically significant it only has to happen 5% of the time, essentially.

Dr. Justin Marchegiani: Right.

Dr. Ben House: And so if you run 20 tests, one of those is gonna poll just from a statistical standpoint. So that’s—you gotta be careful with that. So in that situation, I’m looking for a manova instead of an inova.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—so if you see kinda like this fishing explanation which you’ll see a lot, you just see the smorgasbord of data. Uhm—be careful with that. And so—coz it can—that’s one of my favourite things to pick apart.

Dr. Justin Marchegiani: Anything else? So let’s summarize that. So you like the manova—you look at the—the uh T-score, right? The .05 you’re looking at that as well.

Dr. Ben House: Yeah. Yeah.

Dr. Justin Marchegiani: You’re looking at—

Dr. Ben House: You go ahead.

Dr. Justin Marchegiani: You looking at the graph—you go ahead.

Dr. Ben House: Yeah. You just—so we wanna make sure that something is—something can be  statistically significant but mean to us.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So if it is— if it’s like say, you have a .1 rise in testosterone, but it’s at the .001 level, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Okay. You have a statistically significant finding but it’s clinically meaningless. So we gotta make sure that—that their findings actually mean something.


Dr. Justin Marchegiani: Totally. Awesome. That’s helpful. Anything else you wanna add on that?

Dr. Ben House: Yeah. I think that Alan Aragon, the best way to learn about research is to read other people’s critiques of research. Uhm—and Alan Aragon has his research review. And it’s a steal. It’s 10 bucks and you get 8 years of monthly research review. So if you wanna get good at reviewing research, the best place is you just read it.

Dr. Justin Marchegiani: Yeah. Totally makes sense. Now you mention back earlier that you are looking at a lot of blood patterns. What are the big patterns that you’re seeing pop up? Are you looking at thyroid? Are you looking at protein digestion by some of these markers? What are you seeing in blood?

Dr. Ben House: Yeah. So the first thing—the first thing that I’m gonna look at is haemoglobin and glucose control.

Dr. Justin Marchegiani: Yup.

Dr. Ben House: Uhm—that’s not the best measure for athlete because they’re gonna dispose of red blood cells faster than general population.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So if you see a high HbA1C in athlete, you might actually be a little bit more worried. Like maybe like 5.6, you’re like, “Uh—what’s going on with you?” uhmm—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: And that all goes to context, too. Like are they gonna gain? Are they trying to gain weight? Then I’m not—they’re not probably not gonna get diabetic if they have a ton of muscle mass.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—And that’s all context dependent. And I actually like—I’m—I don’t put a lot of weight in my fasting glucose and fasting insulin.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uhm—you’re probably gonna see this, right? I don’t work with a lot of chronic patients. So that—that—C peptide and those measurement fasting can be really good for those kind of patients.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But when you—when you got a guy who’s 6’1, 8% body fat, that’s probably not gonna tell you much.

Dr. Justin Marchegiani: No.

Dr. Ben House: Uhm—and so I—what I really like to do is I like to use glucometer protocols.’’

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—and so I have people grab—

Dr. Justin Marchegiani: Come on right here.

Dr. Ben House: Just grab it 13x a day and see what happens.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And send me—send me a graph and send me when you eat and let’s have a—let’s have a discussion. Coz if you eat 3 rice cakes and you go to, you know, 200. That does not happen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re storing glucose in urine like we don’t want that to happen. So that’s the way we can kind of, you know, tweak carb load. The next thing uhm—obviously, you need thyroid support.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You need thyroid hormone. It runs in every cell of the human body. So I’m gonna drop—from there, I’m probably gonna drop down to thyroid and see what’s going on there. Uhm—I mean I’ve picked up so many like—Hashimoto’s in like 14-year-old kid like one of the best pictures in Texas.

Dr. Justin Marchegiani: Wow.

Dr. Ben House: And he couldn’t recover, right? He constantly has this stupid injuries. And we grab  his lab work, his TPL is like 300.

Dr. Justin Marchegiani: Whoa!

Dr. Ben House: And we’re like—Yeah, and we’re like, “okay”  And he feels better, right? All these—we can’t—I can’t—his dad is like, “Oh, he needs to eat like Brady.” All that stuff—

Dr. Justin Marchegiani: No.

Dr. Ben House: I’m like, “No, he doesn’t.” Like—and now the kid is taking ownership of it which is amazing. He’s like—he’s like, “No, I’m not gonna eat that.” And so now, he on—he pretty much eats only autoimmune paleo. He have some rice, he does okay with rice. Uhm—and he couldn’t—he was overweighing, still crushing it like meanest curve ball uhm—this side of Mississippi. And so—but now—he’s—he’s—he looks amazing, right?

And if you play at these schools, these Texas schools, you gotta look the part. Like even if you’re—even if you’re amazing, you have to—you have to look like an animal.

Dr. Justin Marchegiani: Absolutely.

Dr. Ben House: That’s kind of unfortunate.

Dr. Justin Marchegiani: Yeah. I mean have Hashimoto’s myself and I play baseball and sports and football growing up. And I had lots of injuries coz I was trying to eat 11 servings of grains in the food pyramid, so there’s a lot of misinformation out there. And again, a lot of people are seriously inflamed. And the more inflamed they are, the more catabolic. The more catabolic, the more they can’t recover and uh—put on muscle and heal, essentially.

Dr. Ben House: Yeah. To me it’s like—it’s all about breaking cycles, right? My dad has celiac disease.

Dr. Justin Marchegiani: Wow.

Dr. Ben House: We found out—we found out when he was like 40, like 10 inches of his colon moves—

Dr. Justin Marchegiani: Oh, man.

Dr. Ben House: His gallbladder is tightening up.

Dr. Justin Marchegiani: Yikes.

Dr. Ben House: Like that’s why I got into this. I was gonna go to medical school.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And my dad got super screwed up by the conventional medical system. He was having pain killer on demand. Uh—and then I was in Colorado and I—Breaking the Viscous Cycle, I’ve read the book—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And I was like, “Hey dad, let’s just change your diet. Three A’s set him free, he was struggling like 10 years.

Dr. Justin Marchegiani: I know. Isn’t that crazy? Dude, I know. I see it everyday. I mean—it’s—we have he most rewarding job in the world.

Dr. Ben House: Yeah, for sure.

Dr. Justin Marchegiani: Because you get someone banging his head against that conventional medical wall for 10 years plus, at some point, they started throwing it back on you. Saying it’s in your head, and they start making the Psychophol, right? And writing scripts for Zoloft and such. And then you’re just like, “ My god, this can’t be real.” You know—it’s gotta be real. So looking where you’re at, uhm—you mentioned uhm— blood markers. Anything else? You’ve talked about thyroid. Any specific cut off that you wanna talk about with TSH, T3 or antibody levels?

Dr. Ben House: Uh—Yes. So what I’m—I’m use uh—I use a software And so I’m always looking at total T3, total T4, free T3, free T4 and—so I’m always looking at what’s going on with that. Are they producing a ton of T4 but then they’re not converting any of it to T3?

Dr. Justin Marchegiani: Right.

Dr. Ben House: All the thyroid hormones are bound up. Like are they on—which is to me—like I see it constantly like if I take on a female client. I’m like, “Oh, your thyroid hormone is bind up, are you on birth control?” “Yeah.”

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: There it is, right? It upregulates thyroid body globulin.

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

Dr. Ben House: One of the ways that we know—we know that testosterone increases lean mass and metabolism is that it dominates your thyroid binding globulin. So—

Dr. Justin Marchegiani: Totally. Yeah. Makes sense. You see that in PCOS, right?

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Yeah. Exactly. So we got the thyroid. What are you looking at for protein digestion? Are you looking at globulin, creatinine, serum protein, albumin? What are you looking at?

Dr. Ben House: Uh—so yeah I think total protein and globulins are soft markers for—I always think of them as like check engine lights. They’re not like end-all be-all.

Dr. Justin Marchegiani: Yeah. Uh-hmm.

Dr. Ben House: But if I see them low, “Oh my god, let’s keep some work add on that situation.” Uhm—and then kidney markers—In athletes, like this is like—

Dr. Justin Marchegiani: Bone creatinine.

Dr. Ben House: Oh my god, this is like—I love talking about this because that—does can actually—kidney markers are essentially useless, right, in athlete. Because blood urine nitrogen is the breakdown of protein products.

Dr. Justin Marchegiani: Right.

Dr. Ben House: So if you’re in a Ketone, high protein diet, you’ve already—you’ve knocked that up. Now creatinine is indirect measure of muscle mass. So if I have a jacked gorilla who’s in a ton of protein, he’s automatically gonna have a GFR that’s probably pretty screwed up. But his kidney function maybe fine. Uh—so the best marker there is statin C. And so if someone is super worried about their kidney function, I’ll run that coz that’s not affected by protein intake or muscle mass.

Dr. Justin Marchegiani: Statin C for the kidney?

Dr. Ben House: Uh-hmm.

Dr. Justin Marchegiani: Okay. Yeah. Yeah. And I’m not seeing patients that are at the same level as you know, being an athlete but I do try to keep them 48 hours away from strenuous workout so you don’t get those false positives.

Dr. Ben House: Yeah. I do that as well.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—but the re—it’s all individual. So they’ve done studies, it can be 10 days that you’ll see like liver enzyme’s high, bilirubin high. So you can—you can see those things. It all depends, some people get back in 48 hours and obviously we can’t tell people not to train for 10 days. Uhm—that’s not gonna work.

Dr. Justin Marchegiani: Right. Right.

Dr. Ben House: We won’t do that. But I think 48 hours and making sure that their hydration is really, really solid.

Dr. Justin Marchegiani: Yeah. And do you think muscle soreness would also be a pretty—pretty good subjective indicator? Making sure that they’re not incredibly sore or like in pain or you know, hurting from the workout?

Dr. Ben House: Yeah. I think it’s probably good from an inflammatory standpoint.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re gonna—with CRP, you’re gonna see an acute rise with exercise and that is a positive in that overtime. Uhm—I—I hate muscle soreness like it’s— maybe—I don’t know if we have research to say that. It’s such a subjective indicator.

Dr. Justin Marchegiani: Yeah. Totally.

Dr. Ben House: And it’s so variable.

Dr. Justin Marchegiani: Got it. Is there anything else you wanna let the listeners know? Anything else on your health pocket that you’re kind of researching or on top of mind?

Dr. Ben House: Yeah. I think we can kinda get lost in kind of the little things, right And so—just make—I see a lot of people that are, you know, worried about something regarding their health.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: And that—that’s probably not good. If you are incessantly worrying about your health, that—that’s a problem.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: I saw, you know, a lot of type A people that come to functional med and so one of our jobs is like, “Hey, like, you’re not gonna die.” Like—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: This is okay. Like—

Dr. Justin Marchegiani: It’s alright.

Dr. Ben House: You have a homocysteine of 9, you’re not gonna get killed tomorrow. There’s things that we can do.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Let’s do all the things. So I’d say focus on the effort—not necessarily— always focus on effort. Uhm—and that’s my biggest thing.

Dr. Justin Marchegiani: Got it. And who is your ideal patient? Coz I know you made the switch from the athletic world to the functional medicine world now. You had your experience with your dad with the celiac thing. So you have some autoimmune experience. Who is your ideal patient? Someone who wanna come to see you?

Dr. Ben House: Yeah. My ideal patient is a male, any—any age range, uh—but probably a male that just wants to look good, feel good, look good naked, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: That’s my prototypical client. Uhm—and then, anyone is free to email me, obviously. And like I have—I get crazy emails like, “Hey, I have a—I have a tumor in my hypothalamus. Can you help me out? And no, I can’t but uhm—let me—let me refer you out to someone who might be able to reboot your entire endocrine system.

Dr. Justin Marchegiani: Totally. So functionalmedicinecostarica.com ,right?

Dr. Ben House: Yeah. That’s the website.

Dr. Justin Marchegiani: Love it, man. Very cool. Anything else?

Dr. Ben House: Thank you for all that you do. And just uh—just putting out there information that we all have—we all have our mediums. And you do a really good job in just finding awesome people and interviewing them. And—and letting them tell story. So thank you.

Dr. Justin Marchegiani: Right. I appreciate it, Dr. Ben. I appreciate it. And the last question for you, if you’re on a dessert island, you can only choose one supplement, one herb, one nutrient, what is it?

Dr. Ben House: Uhm—

Dr. Justin Marchegiani: Haha—

Dr. Ben House: I’m gonna pick magnesium.

Dr. Justin Marchegiani: Magnesium. Okay. Alright.

Dr. Ben House: I’m probably get—If I will get a multi, I’m gonna—I mean—If I’m training on this island, uhm—maybe a protein supplement if I can’t find enough meat.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But uh—yeah definitely—I mean most athletes are deficient in magnesium. It’s—if you give an athlete magnesium, and they’re deficient and like, they’re gonna feel a lot better. Uhm—

Dr. Justin Marchegiani: Awesome, my man. Well, thank you for that great feedback. Doctor House in the house. You can see him at functionalmedicinecostarica.com

Dr. Ben House, I appreciate you being on the show.

Dr. Ben House: Thank you, sir. Have a great day.

Dr. Justin Marchegiani: You too. Take care.



Documentary on The Disappearing Male

Tripping Over the Truth by Travis Christofferson

Breaking the Viscious Cycle by Elaine Gottschall


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 YouTube.com/justinhealth 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 Paleo.com 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 justinhealth.com 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, notjustpaleo.com 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, justinhealth.com you could schedule the consults there.  And same thing for me, notjustpaleo.com 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.




Common Causes of Weight Loss Resistance

Weight Loss Resistance

By Dr. Justin Marchegiani

Weight loss is one of the common issues faced by many of us. Sometimes we think we have tried everything, but weight loss just never really happens. Watch this video and learn about reasons why we can’t seem to lose weight effectively. Gain valuable insight about the factors affecting weight loss resistance and determine if any of these factors apply to us.

Today’s talk will be on weight loss. Essentially, weight loss resistance. I see many patients here at the clinic have issues with weight loss. Some of the common things that I find that really are kinda the main cause of weight loss is because you didn’t try, you’re kind of on that calorie roller coaster. And every few years, you notice your rate keeps up and going up. And it kind of feel like it just may never stop.

Factors causing weight loss resistance:

  1. Inflammation
  2. Gut issues
  3. Toxins
  4. Over exercising

Factors Causing Weight Loss Resistance


Inflammation is a really common factor to chronic weight gain. What is inflammation? Inflammation, there’s a couple of different kinds.

Acute inflammation will be something like cut or sports injury. So cut for instance, you’re body’s going to form clotting factors that is going to produce a scab, and eventually that scab will let go. That’s great.

What we find in today’s society is we have chronic, systemic inflammation. The body is systemically inflamed due to diet and lifestyle factors. Man is causing essentially stimulating a hormone called cortisol. Other hormones, still we have cholecystokinin, but just to keep it simple for this generalization.

Cortisol, essentially, is driving belly fat bad, driving fat that is actually breaking down protein and muscle. And it’s interesting to know that a lot of receptors for cortisol are actually right around our bellies and hips.

So our real first goal is addressing weight gain, knocking down that cortisol. That’s one.  Where does cortisol come from? We’ll just kinda go over couple of a few factors you may find in my patients coming here.  

What causes inflammation?

Causes of Inflammation

Foods being the first thing that we see that can attribute to inflammation. When you have to do it every single meal,
and when you’re either putting food in your body that’s creating the anti-inflammatory state or you’re putting food in your body that’s creating the pro-inflammatory state, that’s one. So eating the right fatty acids is very helpful. People on this called low fat kick today, they’re not getting the right nutrients and I suppose that’s one factor.


So if you’re eating lots of peanuts and different foods, like grains for instance, then you’re increasing your mycotoxin exposure, it is going to have a huge effect when you gain fat.

Want to know more about the causes of inflammation? CLICK HERE


So as we eat these foods that will cause this inflammation around the gut. And essentially, we can see inflammation on the skin. But in the inside, we can’t really tell what’s going on.  So we’re eating foods that, in the inside, will cause the inflammation. It will cause inflammation, then couple of things happen.

We have our different microvilli in the inside of our intestines that are our little vacuum cleaners. It suck up nutrients. So one may suck up vitamin C, some calcium, some iron, etc. So if we get clogged our vacuum cleaners from inflammation, we can’t really take in a lot of the nutrients that we need. It’s important that these nutrients are using their radar energy systems. So it makes sense that we can’t get the nutrients that we need. Our energy system maybe a little bit low.


Toxins are another huge factor that we see. Your body is very intelligent. It knows toxins are dangerous to the organs, dangerous to the brain. Well it does its best job to sequester them. Sequester meaning it stores it in the fat and keeps it away from going to systemic circulation. So if our body is constantly expose to toxins, isn’t it a hard time letting go of fat? Because you notice that fat needs to be there to help buffer that bad toxin exposure. So if we do our best to decrease toxin exposure, mycotoxins, food allergens, etc., we  put our body into a huge step of healing and feeling better. And where we see that fat that maybe there’s a safety net, so to speak.


Now the common thing you see, super common is over exercising. Patients are doing exercises that are actually increasing cortisol. You can check the medical databases, that long distance cardio, especially marathon running, anything that I consider over 45 minutes to an hour, long-term is going to increase cortisol secretions.

Then again, we talk about cortisol, the receptors are on your tummy, they’re on the hips. So at the same time, you’re adding on hip fat and belly fat and you’re also burning up muscle.

So, we like to get people’s  exercise dialed in precisely.  And a lot of times, it’s not about getting working harder, it’s about working smarter. So short bursts, shorter range and high amplitude burst is going to be a much better solution.

Summary and Recommendation

Summary and RecommendationsNow, so overall, we looked at some exercise components. We looked at some food components, and toxins, toxic exposure components to how weight loss tends to accumulate. And over time, what we find is patients with a sluggish metabolism, overtime, tend to accumulate weight.  So really the key is to address the metabolism, fix it. It’s important that we do not want to lose some weight to get healthy. You get healthy and then you lose weight. So it’s kind of a different way of thinking.

So I hope this video helps everyone here. And any questions, feel free and let me know. We can always set up a consultation.

Are you having trouble losing weight? CLICK HERE to ask an expert about it. 


The 5 Causes of Nutrient Deficiencies

Causes of Nutrient Deficiencies

By Dr. Justin Marchegiani

Good nutrition is what our body needs to prevent us from having issues that will compromise our health. Watch this video and increase your awareness when it comes to different causes of nutrient deficiencies.

5 Different Causes of Nutrient Deficiencies:

  1. Inflammation
  2. Conventional food
  3. Inadequate Supplements
  4. Infection
  5. Medication



There are couple of different kinds of inflammation. We have an acute inflammation, wherein you cut your finger, a scab forms or above your elbow, a bruise forms. It healed up in a few days and it’s not a big problem. 

What we’re talking about is systemic inflammation. Meaning, it’s systemic throughout the whole body based on diet, lifestyle, exercise. All of these factors.

One of the biggest things that affects inflammation is which kind of diet we eat. We’re eating a pro-inflammatory diet, high in sugar, high in inflammatory compounds like grains and sugar. Those are going to put our body in a more inflammatory state. The more inflamed we are, the more we decrease ability of our body to absorb nutrition. 

Now we have little finger-like projections called microvilli in our small intestine. Think of these finger-like projections like a vacuum cleaner. It’s job is to suck up nutrition. The more inflamed we are, systemically, think of that vacuum cleaner, each finger being a vacuum cleaner. Each one gets clogged and you see less vacuum cleaner until we have knocked – our vacuum cleaner is essentially fully clogged which does not absorb nutrition as effectively.

Conventional Foods

Conventional Foods

We’re just eating foods that are conventional. Conventional foods – meaning foods that aren’t organic. They’re not going to be as high in nutrition because the fact they are sprayed with pesticides and herbicides. Even GMO things like Roundup. These compounds with chemicals essentially devoid will make the nutrients in the soil very much devoid. Minerals are needed for the plant to essentially produce an optimal spectrum of nutrients. Studies have shown that certain soil that are devoid of manganese, certain vegetables and the fruit will actually have 50-60% less Vitamin C. If we have low mineral soils due to the chemical that our farmers are putting on it, that’s going to affect our ability to get much nutrition from that in the first place.


Supplements to Counter Nutrient Deficiencies

Having high quality supplement is going to be really important. Even if you are actually taking high-quality organic vegetables and eating high-quality organic meat, you’re still going to have some holes there. That is why supplement is there, essentially supplementing the gaps and the holes in the diet. You never want to supplement and eat bad, either. You really want to do your best to make some big change with your diet and also add those in helping building the gap to prevent nutritional deficiencies.

CLICK HERE to know more about the supplements which prevent nutrient deficiency



Infections are very common. These are these low-grade kind of inflammatory zombies, so to speak, in your intestinals. Just sitting there and its causing this drain on your immune system, this drain in your adrenals. If we can really cut down and figure out what kind of infection to go along with (H pylori infection, or a fungal infection, or a parasite infection) and if we can diagnose where the infection is, we can create a protocol that will help remove that.


MedicationsMedications are common and are known to cause nutritional deficiencies. There are actually textbooks on nutritional deficiencies caused by medications. So did you know the most common nutritional deficiency caused by a medication is a statin? This statin medication, which control cholesterol being produced by the liver, they actually decrease your production of your nutrient called coQ10.

CoQ10 is actually really important because the hearts need coQ10 to actually beat each time. We’re having our heart issues, congestive heart failure, atrial fibrillation, blood pressure. You should really want to make sure our heart has all the nutrients it needs. Two, coQ10 is really important for muscle production. One of the most common symptom you see when you’re on a statin is rhabdomyolysis or you see infected muscle pain or extra muscle soreness. These are very, very common things. Also, in diabetics taking Metformin or Glucophage. These medications cause mixing conditions B12 anemia.

If you’re on medication, give the office a call. At least make sure you’re being supported or the potential nutritional deficiencies that could be caused by the medication you’re up. If you really want to address the underlying cause of your condition, or what medication to prescribe, let us know and we’ll do our best to help.

CLICK HERE to know if your medication is causing nutrient deficiency

Leaky Gut Syndrome and the Autoimmune Disease Connection

By Dr. Justin Marchegiani

Leaky gut syndrome (gastrointestinal permeability) is a phenomenon that occurs within the intestinal tract where the epithelium tissue’s tight junctions open slightly, allowing undigested food particles and potential bacteria (endotoxin) to make its way into the bloodstream. These compounds are typically only found in the gut, so our immune system goes on high alert when it starts seeing new and unusual things. Our immune system reacts by creating various immune cells called antibodies to inspect what’s going on (and potentially attack)! These antibodies are equivalent to our navy, marine corps, air force, and army; their job is to tag these various particles for destruction. When our immune system attacks some of these foreign proteins (antigens), various organs can get caught up in the scuffle. This accidental tagging is a case of mistaken identity, or the scientific term molecular mimicry.
leaky gut and inflammation

How Does Molecular Mimicry Work? 

There are amino acid sequences on these antigens (foreign particles) that are similar to other tissues in the body. Our immune system reads these antigens by the sequence of its surface proteins. It’s kind of like getting pulled over by a policeman that is out looking for a similar make and model of the car you drive because a suspected criminal was seen driving the same car earlier that day. Foods like gluten can easily cause your immune system to start attacking the thyroid gland, brain, intestinal tract (celiac, Crohn’s, ulcerative colitis), or other nervous-system tissue based on similarity and genetic predisposition. There’s a good deal of research showing that autoimmune disease cannot occur without a leaky gut. This is why people with a chronic illness need to have their gut checked. Click here to get your gut checked!

Gluten and Cross-Reactivity

When these proteins have a similar shape to other proteins, cross-reactivity can occur. These proteins have the ability to bind into other receptor sites, just like with casein and gluten. As you can see by the picture below, the shape of the antigen can be enough to confuse the immune system.

cross reactivity

Foods containing things like casein from dairy products can cause the immune system to start attacking the pancreas. Casein can also cross-react with gluten too! Cross-reaction is where the immune system starts responding to other proteins as if they are gluten. This is the reason why some people who only remove some grains from their diet may not recover fully. The consumption of other cross-reactive foods outside of gluten can be enough to prevent your thyroid from healing.

It All Comes Down to Genetics

Wherever the weak link in your genetic chain is, may be the deciding factor regarding what autoimmune condition you express. The tighter you pull your genetic chain, the increased chance those weak links will be exposed and break. The tightness is equivalent to the stress in your life, while the weak link is symbolic of your genetic susceptibility.

genetic predisposition

Some people may get Hashimoto’s (autoimmune thyroid condition) while others may develop multiple sclerosis or Parkinson’s disease. There tends to be a genetic link regarding what condition you may express. If Parkinson’s or Hashimoto’s runs in your family, this may be a good indicator of what you are predisposed for.

Genetic predisposition is not a death sentence but merely a strong warning you need to heed. I personally have an autoimmune thyroid condition and also have many other autoimmune conditions that run in my family. Because of this, I pay close attention to my diet, emotional stress, physical stress, and chemical stress. The stressors, or allostatic load, in your life have a huge impact on your epigenetics. Your epigenetics control what genes your body expresses, kind of like turning a light switch on or off. So in other words, you have the ability to control what genes you express or don’t express.

So if you have a predisposition toward chronic degenerative autoimmune conditions, it’s really important that you develop other healthy habits that keep those genes from expressing themselves. The more our immune system is fired up, the more inflammation occurs in our body. The additional inflammation and undigested food proteins put additional stress on our detoxification system, causing our liver to have to work harder to filter out all those extra antigens and toxins in our blood stream.

What Causes Leaky Gut?

Inflammation is the underlying cause of leaky gut. Below I will talk more specifically about what the underlying drivers of inflammation are.


Food allergens

All grains, especially gluten-containing grains, such as wheat, barley, rye, oats, spelt, and Kamut, can be hyperallergenic. Other foods can also cross-react with gluten, such as dairy products (especially milk products that are higher in casein) and legumes (soy, beans, and peanuts). Butter, heavy whipping cream, and ghee tend to be OK. Some people who are autoimmune need to avoid everything but ghee. Many of these allergens tend to be a little controversial.

Most people think of allergies as the kinds that close up your throat, like when someone who has a peanut allergy eats peanuts. That type of allergy is known as an IgE-mediated immune response, or in the above peanut example, an anaphylactic response. We tend to know about these allergens in childhood because of some type of traumatic experience that may have included a blocked airway, itching, and/or hives. The allergenic response I am talking about comes from a different part of the immune system. Essentially, a low-grade inflammation that occurs because of a cross-reactivity or an IgA–, an IgG–, or a T-cell–mediated immune response. These types of immune responses can cause leaky gut and contribute to thyroid imbalances, adrenal fatigue, brain fog, weight gain, and other digestive symptoms.

Low stomach acid

We need HCl, or stomach acid, to help break down our proteins and ionize minerals. If we don’t have enough stomach acid, we can’t break down and absorb zinc. If we don’t have enough zinc, this can affect our immune system, sex hormones, and our ability to make stomach acid. As you can see, a downward spiral is occurring that causes our body to break down even faster with no end in sight!


With inadequate stomach acid, we are also prone to gut infections (bacterial, parasitic, fungal, and viral) and small intestinal bacterial overgrowth (SIBO). Many of these infections produce biotoxins/endotoxins that can affect hormone metabolism and nutrient absorption and can contribute to fatigue of the thyroid and adrenal glands. Chronic infections tend to play a role with autoimmune conditions as well as leaky gut.

How Do We Fix Leaky Gut?

When getting to the bottom of leaky gut, it’s essential to incorporate a 5R program (remove, replace, repair, remove, and reinoculate). Just like baking a cake, the order in which things are done is very important to making the recipe tasting great. Just like when addressing chronic leaky gut autoimmune conditions, the order and how we address the underlying cause is important to preventing relapse as well as to feeling as good as you possibly can during the process. Again, I want to stress that it’s very important to address underlying hormonal imbalances, including adrenal, thyroid, and female hormone issues, before getting to the chronic infection.

I personally find that patients will fall apart during the treatment if this isn’t done. This is dependent on how long the person is sick and how sick the person is, and there are exceptions to every rule. If the person’s hormonal system is not supported adequately when removing the infection, the chance of a die-off reaction is higher. Die-off reactions may feel something like fatigue, headache, nausea, and/or chills. Some people may notice nothing when the infection is being removed while others may have significant die-off reaction symptoms. There are various techniques and herbal medicines that can mitigate die-off or Herxheimer reactions.

The 5R program follows:


This part’s pretty simple. Remove the foods that are creating inflammation. Some people may need to be on a stricter autoimmune Paleo type of diet. Some may need to remove FODMAPs (a group of carbohydrates the small intestine has trouble absorbing). For others, a clean Paleo diet may be enough. An elimination provocation diet is the easiest way to be specific and avoid expensive and sometimes unnecessary allergy testing.


People with chronic stress can have low stomach acid. When there’s low stomach acid, there is typically low enzyme and bile salt production as well. It’s always good to work up to a patient’s stomach-acid tolerance so we can ensure the patient is breaking down proteins, fats, and minerals optimally. We need to make sure the building blocks are present, broken down, and absorbed so the person can heal.


Depending on how stressed or inflamed a patient is, adding additional healing and/or soothing nutrients can be helpful. Sometimes just making the above changes is enough to help facilitate healing. Others may need additional compounds, such as L-glutamine, slippery elm, zinc, aloe vera, and deglycerized licorice.


This is the place where we remove the infection. As you can see, the infection is one of the last things we address. This helps prevent die-off reactions from overwhelming the detoxification system, immune system, and lymphatic system. I find that removing the infection at the end tends to be the most effective.


This is where we add the probiotics back in. Many people have a dysbiosis (or SIBO) in the gastrointestinal tract. This is when there is an overwhelming amount of bad bacteria in relationship to good bacteria. Adding in probiotics when there is a high amount of bad bacteria can cause problems, such as gas, bloating, and gastrointestinal pain. Removing the infections and bad bacteria first, allows the good bacteria to flourish. The analogy is weeding the garden before you plant the seeds—you never put seeds into a garden full of weeds.

Hidden barriers

Chronic infections can encase themselves in the slime known as biofilms. These biofilms are resistant to antibiotics; therefore, the conventional approach to treating these infections tends to not be as successful. Working with a skilled functional-medicine doctor that can combine the right antimicrobial herbs for your infection with some well-known biofilm busters is an important ingredient to removing the infection in the long run.

What Should I Do Next?

If you’re suffering from an autoimmune condition, fatigue, digestive problems, and/or hormonal imbalances, there is a good chance that leaky gut is playing a part. If you want to take a closer look into what’s causing your health issues, feel free to click here for a complimentary consultation.

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