Low Body Temperature! – Dr. J Live Podcast # 156

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

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

In this episode, we cover: low body temperature

03:27   Thyroid issues

07:05   Beneficial Nutrients

14:14   Toxins and Medications

22:51   Food and Supplements

33:46   Calorie Intake






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

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

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

Evan Brand: It’s insane.

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

Evan Brand: I know.

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

Evan Brand: Yes.

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

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

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

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

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

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

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

Evan Brand: Right.

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

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

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

Evan Brand: Exactly.

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Yup.

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Yup.

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

Evan Brand: Yup.

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

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

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

Evan Brand: Right.

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

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

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

Evan Brand: Perfect.

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

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

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

Evan Brand: Right.

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

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

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

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

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

Evan Brand: Yup.

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

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

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

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

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

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

Evan Brand: Right.

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

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

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

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

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

Evan Brand: Yeah.

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

Evan Brand: Right.

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

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

Dr. Justin Marchegiani: Exactly.

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

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

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

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

Evan Brand: Yup.

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

Evan Brand: Yup.

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

Evan Brand: Yeah.

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

Evan Brand: Perfect.

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

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care. Bye.

Evan Brand: Bye.









Bone Broth & Collagen for a Healthy Gut

Bone Broth & Collagen for a Healthy Gut

By Dr. Justin Marchegiani

Bone broth seems to be all the rage these days, but what exactly is it about this bone juice that has everyone obsessed? Today we’re going to go over the benefits of bone broth and how it can aid in healing many modern health issues.

The Power of Bone Broth

The Power of Bone Broth

What is Bone Broth?

Bone broth is made from animal bones, tendons, ligaments, marrow, skin, and other flexible connective tissues. In modern times these parts are usually discarded as they aren’t easily eaten on their own. However, when simmered in water for long periods of time, animal bones and tissues make a healing nutrient-dense elixir.

Bone Broth’s Secret Weapons: Collagen and Gelatin

Bone Broth’s Secret Weapons

The protein providing strength to animals’ (including humans!) bones, cartilage, and tendons is called collagen.

When cooked, collagen turns into gelatin, a jello-like substance.

As we will discuss in the following section, collagen and gelatin provide a host of immune-boosting properties, amino acids, and gut lining support to aid and heal many modern ailments.

Click here for help from a functional medicine doctor to determine if you have leaky gut and how to heal it!

Healing Benefits:

Bone Broth’s Healing Benefits

Bone broth is easily digested, unlike many other foods which can be hard to break down. But the real power of bone broth is that it is actually healing to the digestive system. It has been found to aid in cases of leaky gut, IBS, food allergies and sensitivities, and much more.

Collagen is a protein that forms the GI tract lining. Consuming the collagen and gelatin in bone broth helps heal the walls of the gut lining, preventing food and toxins from escaping and causing inflammation and other damage outside of the tract. This is major good news for those suffering from poor digestion and gut-related health issues (leaky gut, IBS, Crohn’s).

The collagen and gelatin from bone broth are also great for anti-aging effects. They keep the skin youthful by reducing wrinkles and improving elasticity, aid the growth of hair and nails, and strengthen your bones! Collagen also helps to reduce the appearance of cellulite over time.

Essential nutrients such as calcium, magnesium, potassium, sodium, phosphorus, and silica are all electrolytes in bone broth which keep you hydrated, help with bone health, and can reduce brain fog and fatigue.

The amino acids found in bone broth include glutamine, arginine, glycine, and cysteine, and proline. Together these amino acids offer a wide range of benefits, including:

-Skin elasticity

-Build up the walls of the intestines

-Aid in proper bile and stomach acid production

-Enhance the immune system

-Anti-inflammatory, reducing oxidative stress and autoimmunity

-Promote human growth hormone

-Liver detoxification support

-Generate glutathione

Amino Acid Benefits


Bone broth is incredibly simple to make, especially when looking at the benefits reaped from consuming this healthy elixir. The collagen, gelatin, amino acids and minerals in collagen make bone broth an incredibly simple and powerful solution to create healthier joints, skin, bones, and gut.

Click here to consult with a functional medicine doctor who can help you diagnose if you have gut issues that bone broth can help heal!









Keith Norris – Paleo FX, ARX Fit and Efficient Exercise – Podcast #137

Dr. Justin Marchegiani and Keith Norris dive into a discussion about Paleo movement that has evolved over the years and helped a lot of people improve their diet, fitness, finances and relationships. Be inspired by Keith Norris’ success as he shares about his daily routine that includes his diet, physical and mental activities. 

Learn about the  “ARX Fit” equipment and know about the exercises you can do with it, the benefits involved and the new cable version of it. 

Click on the podcast below to know more about ARX Fit and gym locations. 

In this episode, we will cover:

01:20   Paleo FX Event

03:13   Evolution of Paleo FX

06:25   Intent of creating Paleo Movement

09:35   How to Incorporate the Paleo template to overall health status

11:09   How ARX Fit is done

14:14   Pre and Post Workout Nutrition

17:40   ARX Fit and Efficient Exercises






Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio. We are on a live Youtube Podcast here we have Keith Norris here from Paleo FX, ARX Fit, and Efficient Exercises Key. Welcome to the show man!

Keith Norris: Hey Justin! Glad to be here brother!

Dr. Justin Marchegiani: Yeah I didn’t really recognize you with your fashionable tool. Normally you have the efficient flat top going, aerodynamic as always. But now you’re getting a little fashionable for me.

Keith Norris: Uh You know I just started to grow it out and then a little five, six years or since I have a flat-top and I was like- “You know it’s time for a change” So, uh- I am going through that very very painful process of coming back to some kind of a normal hairstyle from a flat-top, which uh- you can imagine this a little bit different called. So, shout out to my hairstylist at Berg’s Barbershop, Michelle for having such patience and uh- easing me through this very trying process.

Dr. Justin Marchegiani: Love it man! Well you’re looking great! And, we’ve got a big event this week Paleo FX the biggest more like, Paleo Primal Event kind in the world. So, I still don’t want to be a speak writer I know you and Michelle, your wife put this whole thing together it’s a total labor of love that seems that all the effort you guys put in all year round just to make it happen. Anything you want to, you talk about regarding the event?

Keith Norris: Well yeah, first of all, you know it’s uh- it’s a team effort and our Paleo FX family, the team Paleo FX has grown immensely and we could not do anything near this without them and all their dedicated efforts. And I can tell you that on the last couple of weeks, they work hard year round but in the last couple of weeks, they have really been pushing it.

Dr. Justin Marchegiani: Love it!

Keith Norris: And uh- especially in these last couple of days, men they are working hard. So if you are at the show, make sure you go out and give them a big hug because they deserve it. The show would, there is no way it could go wrong without them.

Dr. Justin Marchegiani Love it! so very still. We have Rob Will, we got Chris Kresser, Mark Stesin’s gonna be there. A lot of big names in the Paleo Community dropping lots of college bums. I’m very, very excited! Excellent!

Are you gonna… Oh! From Modern too?

Keith Norris From Modern will be up there…. Oh yeah! the the Active V will be up there as well. Uh- Presenting though, I have this kind uh- I have this kind of uh- an Ick factor about presenting up my own show. So, this is totally everybody else’s platform, not mine. They’re deserving in the provider of platform for everybody else.

Dr. Justin Marchegiani That’s great and anyone listening, there are some live stream auctions too. So (if there is) anyone that can’t make it down to Austin here for the week, -you know the weather’s beautiful- We’ll going to put some links below here so you can access the live stream and still be able to connect even if you’re abroad.

Keith Norris: Yeah yeah. I mean, you know nothing beats being at the live show of a networking options and just you know, rubbing up with people, hire in people, talking with people face to face but if he can’t be here and you can’t enjoy the beautiful weather here in Austin, the awesome vibe here in Austin, then next fast thing is pull up the live stream then check it out from there because it will wack here up in site and come following you for sure

Dr. Justin Marchegiani: Totally! Okay, talking about how this event that kind of evolve over the last 5 or 6 years.  It was a very kind of small event but now, it’s just blowing up! Can you just kind of walk through the evolution of how these started? How you and Michelle kind of birth this baby and how it grew into what it is now?

Keith Norris: Yeah well you know in that show; we uh- the whole light here was formed uh- sitting on the airplane it’s a LAX. Uh- we’re wagging for takeoff after the initial ancestral health symposium that took place out in a LA. It was the UCLA that year and that was the first year they’ve done it. Uhm- we have a fantastic time; it was the first time many of us said met in person.

That was the first really big gathering of all these Paleo people in this brand new movement it was forming up. And uh- we’re not there to have a fantastic time but uh- you know that as they should be ancestral health society, it’s a very academic society and it’s an academic conference. And we thought you know, if there needs to be a little bit more of the rubber meets the roach, we definitely need the academics, no doubt.

We need that for sure to keep the movement alive but there needs to be a middle option there for people who understand that all of this, this whole movement is packed with science absolutely. But, uh- you know whether they’re doing their day-to-day lives, they would pull this off. And, so that was the underpinning of the show.

We put together something very quick, how we’d pulled it off, I still don’t know. Again, (it was a) dedicated effort from a lot of different people, not just Michelle and I. But uh- a lot of people would butt into the idea and we got Rob Wolf to sign up right off the bat to be the first speaker. We told him, “You know, we don’t even know what it is but we need a speaker”. We need a big name to come in and kind of pull this off and he said “Hey any chance uh- hanging out with you guys for a week in Austin that I’m in? I don’t know what you guys are trying to pull off or you know even if it won’t come about but yeah I’m in.” Sign me up!

So from that, we’re off and running. We had about 800 people, the first uh- event in 12 Vendors. 10 of which we just begged to come in and set up a table just to have some money there.

 And now, you know we take over the entire Palmer Events Center. We are even moving outside of the Palmer of this year for the first time just because the movement has grown so fast and so furious. A 150 plus vendors, sponsors, thousands of attendees now, over the 800 we had the first year; uh- over a hundred speakers Justin, himself being one of them.

 Networking opportunities, it is the largest Paleo show in the world right now and we are very proud of pulling that off. But I will tell you that it is only a reflection of the Paleo movement, as a whole. And you know if the Paleo movement is a whole, once it’s there we will never be pulling this off because we’re just a reflection of that.

 Dr. Justin Marchegiani: Totally! And there’s a functional medicine clinician myself that kind of a foundation of which I work from this Paleo template and to me what that means essentially, is eating essential foods that we have enough time to evolve or adapt to, so to speak. And then trying to trigger our body from a lifestyle perspective and a movement perspective that make sense from an evolutionary and perspective and then in general, choosing foods that are anti-inflammatory, a nutrient-dense and low toxin. Well, I know that Paleo words kind of a big buzz word and it’s being co-opted commercially. What does it mean to you like when you and Michelle were creating this thing, what was the intent in this Paleo movement for you guys?

 Keith Norris: Yes, so you know- we come and the basic mindset that we bring to this is nothing makes sense except by seeing through the lens of biology, right? The middle lens of evolution. So everything we do, whether its diet, movement, uhm- relationships, finances even, uhm- spirituality even. All of these things have to be seen through the lens of biology and the lens of evolution for to make sense and for to function for us and to the extent that we’ve removed ourselves from that to the extent, that we have put ourselves, in an environment that uhh- there’s a mismatch to that process and we find ourselves in trouble.

 So the intent is not to go back to the cave in a sphere, that’s not what anybody wants to do but the intent is how can we leverage the beautiful gifts of technology that we do have and do it in such a way that actually helps our geno instead of hinder. That’s the whole idea and again you can extend that to diet, uhm ah- fitness, and any aspect of your life you look at and if you look at it through that lens, things begin to make sense.

Dr. Justin Marchegiani Right. We don’t want to throw the baby out of the backward. We have some things maybe today that are better or grab on some of the old knowledge in the past that we marry for God and we are applying it today. Totally make sense.

Keith Norris: Absolutely! And you’ll see many bio-hacking companies out at Paleo FX, because they realize that. And the only reason these bio-hacking companies exist is people within the community are asking for it, right? So there’s a give and take. The market asks for it, the market will provide. And so again going back to the first year we have Paleo FX, was 12 vendors, our brand 50. So we’re growing so very fast. This movement is growing so very fast. It’s heartwarming and what’s really heartwarming for me is to see the success stories there. And not just, and not just Obviously, I am not just talking about the health and wellness, the stories, professors, and so many of those diabetics who would essentially come up with all medications to hundred and fifty pound weight loss just what striking up the diet. All these success stories but then we have all of these entrepreneurs who are now able to pursue their dream of being an entrepreneur; number 1- making good living; number 2- give back to society, which is even more so important; number 3- are actually doing something that they can feel good about and make money while doing this. So, that’s thrilling to us.

Dr. Justin Marchegiani: I love it! So in this Paleo movement, we have people that are grabbing this information and they are taking it and they are applying it to themselves and getting better and getting healthy which is great. And then we have clinicians like myself and you because you also have many gyms in the Austin area efficient exercise for a year. Imagine you have some technology which we will talk about in a bit on the exercise side but walk me through when your patient comes into your gym and how are you incorporating the Paleo template to their overall health status?

Keith Norris: Yes, so I tell people when they come in that they’re human body primarily was meant to move we were obligated movers and opportunistic eaters. And the first thing that they hear or spoke up is, “Oh! Opportunistic eaters, so that means I get to eat everything in front of me?” And I say “Yes”. Now, imagine yourself 200,000 years ago. Now, eat everything that was in front of you, that did take or kill you first or be poison you out after you ate it. Yes, you’re right. It’s just your choice were very limited and so that generally perks people a lot “Oh I get it! My choices were very limited then, and so yeah! I didn’t have all these packaged foods and all the carbohydrates. We’re trying carbohydrates we have access to, now the good is you pick with this within our society and there’s a lot of reasons for going to – why those things were you picked within this society? You know the fact remains that they are.

So now we have to put a check on that. We have to be smarter about our food choices and we can’t just rely on our drives to eat everything in front of our face because let’s face it; if we didn’t have that drive, you and I wouldn’t be here talking right now. Initially, we have to be cognizant of that now and apply again, new technologies, new learning to be able to navigate this environment that we find ourselves in them.

 Dr. Justin Marchegiani: Got it! I am curious too, how are you applying it in your life? Kind of gives me a day in a life. What I mean of, what is your food look like throughout the day and exercise too?

 Keith Norris:  Well, I can tell you today; I didn’t eat anything up until about 30 minutes ago. So, I got up about at 8:00, fasted. Uhm- I normally, I will go through occurrence of fasting. Intermittent fasting is just what I’ve found that works for me. Uhm- I can pull it off. Otherwise, my diet is uhm uh- I would say it is Cyclic Ketogenic. I would classify this at of course I am not following any hard fast rules. I do train quite a bit and I have to fuel the type of training I do is by nature, repeat power output. So I have to fuel that with adequate carbohydrates. But I only eat enough carbohydrate to fill that process. You know I go by a feel because; I’ve done this for so very, very long. I know ate how much and be when to taking carbohydrates. And my carbohydrate sources are generally orchid tubers. But I ‘m not a mean to having the periodic shifts in case so or whatever. I allow myself that. And I find that if I allow myself that, I might have end up not eating very much of it. It’s just a psychological trick of known yet. I can have it if I walk but as soon as I try to put the brakes on it and say absolutely not. I’m just insusceptible like anybody else be tell me not to that just get lodged in my brain that “oh that must be something I really want”. So I applied in some just very basic psychological tricks on people because they work. I mean they are trying through and they worked.

 Dr. Justin Marchegiani: When you get people healthy too, it’s kind of like if you drink a lot of alcohol right when you built up a tar and then you need to more drinks to get buzzed. It’s the same kind of thing when you feel really good and you’re used to having a really good eating plan then you go off on a little bit, you can really feel the difference and then sometimes what happens is the feeling of being in the zone and in the flow state is just better than the small little bit of artificial taste you get from some of that you do. So you kind of played it out.

 Keith Norris: That is so true. You know I am a big believer in giving a person one win. You know, whatever that win is, whether it’s walked your first mile, whether it’s losing your first pound, whether it’s going your first couple of hours without eating sugar; very easy basic steps. But one win, begets the next win, begets the next win and overtime before you know it now yet; you have strung together in an entire day read of having the added sugar or now you’ve strung together five days in a row read at the gym and now you are on a roll. Because just like you said, once you feel great you don’t ever want to go back.

 Dr. Justin Marchegiani Yeah that’s great too because you’ve been in this community in the lifting in the body building community for a long time and you’re a clinician as well, yet you practiced what you preached. So it’s really refreshing seeing you walking your talk which is great. Love to see that. Well, I’m just curious how are you dialigning your pre and post workout nutrition?

 Keith Norris: That’s a good question.

 Dr. Justin Marchegiani: How do you do creatine, brushing aminos, carb timing or protein timing?

 Keith Norris: Yeah I don’t worry so much about the timing of my food just because of the nature of my lifestyle is all over the map. I don’t work out at any set time every day- I don’t even. You know- there are some weeks where I will work out 7 days in that week. That’s just because, it’s available to me. It doesn’t mean the intensity is super high every workout, it just means that I am doing something every day.

On the flex, there are weeks like the last two weeks where I’ve been just incredibly busy up and out of town a few days. I’ve worked out maybe three times in this last two weeks. And apparently, it will I know, I won’t work out again until after Paleo FX. So there’s like, but I don’t beat myself up about it. That’s just the way it is. So I can float in and out of those scenarios, so very very easily. So to answer your question there – If I were to put a nice tidy bow on all of this, I would say “Do I work out frequently?’ Yes, as frequently as I can. But the key to it is since I weigh intensities with every workout, so I don’t blow myself up every time in the gym. I blow myself up you know maybe once or twice a week. And then the rest of those workouts are more moderate in nature, call it going 80%. I think that’s the big key to it. People would ask -Can I workout every day? Yes, you absolutely can, you just have to weigh the intensities and be smart enough then.

 To your question about pre and post workout, I do take a pre and post workout drink that has Creatine, the pre-workout that has a little bit of caffeine in it as well. I’m pretty much a coffee hand to you even though I’ve gone through occurrence in my life where I completely cut coffee out. A- just to see if I can do it B- to see if there is any off benefits to it. Right now, I am back in a coffee kick. On the out swing of that, if that’s your question, you know basic things like zinc, creatine or you know those types of supplements that I would take in on pre and post workout. I’m not to go anyway a vitamin pitcher but I’m a founding member if ID life which is a Nutritional Supplement company so I use their products but again I don’t have to go in that pitch it just happen that I really like their pre and post products.

Dr. Justin Marchegiani: That’s good and what’s the name of those products? We’ll put the links down below

Keith Norris: Yeah it’s ID Life and you can just look for the pre and post workout products. I can send you a link. https://4healthresults.com/idlife/ 

Dr. Justin Marchegiani: Yes, please send some the link we’ll put it underneath people could take it.

Keith Norris: The great products the creatine that we use on these products is creapure which means…

Dr. Justin Marchegiani: Is that an alkaline buffered?

 Keith Norris: I’m not sure. That, I don’t know. I do know that you can get away with taking much less of it so it’s not like the old school creatine monohydrate which was the final product you just had to load up on it. You had to take quite a bit and that could cause some gastric distress to some people. With the creapure, it’s about half the dose of the monohydrate.

 Dr. Justin Marchegiani: Yeah that’s probably alkaline then that’s the buffered. Totally make sense. Good, so we got dose that’s for your doing pre and post. And then walk me through your workout because you’re incorporating a technology called ARX Fit, correct?And this is not like an ISO Kinetic really?

 Keith Norris: It’s ISO Kinetic. Yeah, the easiest way to explain it is the ISO Kinetic for people who know this conditioning. For people who don’t know string thing conditioning if you could imagine doing the bench press- you know this old school bench press. Then, imagine that you have some E or Elves on either side, able to load or deload the weight on the barbell that perfectly matches your maximum force output and each of the positions of the range of motion both concentrically and eccentrically. That’s essentially what we are doing with the ARX Fit equipment. What does that mean? That translates into 1, 2 or 3 repetitions that utmost going all out and you’re spent. I mean you just can’t do anymore because you’re physically thatched to your maximum peripheral range of motion if you choose the use of the equipment that way. That’s not the only way to use your equipment. You can moderate your force output and get more repetitions out of it and there are advantages for doing it that way for sure because then you can also use it as a rehab tool, as well. So I’ve rehab people from ACL Surgery using that same equipment that I could go on immediately following that client and go just bounce to the wall.

 Dr. Justin Marchegiani: And you guys also incorporated a new cable version on the last few years. How’s that going?

 Keith Norris: It’s been going fantastic. In fact, that particular union is selling A because it’s cheaper or B because you can do more exercises on it so the cause per exercise ratio is more in line with what people wanting to spin. But yeah, it’s a fantastic tool as well. So we have a hard fix version and we have a cable version of that machine and we have another version that we are currently working on that’ll be coming down the pikes soon. Both of those by the way you will be able to see it in Paleo Fx we’ll have them on the floor. And in addition to the ARX fit equipment, we also work with real fittest score. We put on a, what you could consider a combine for the regular guy. We’ll just put it that way.

 It’s a series of 10 exercises. Then these 10 exercises are easy to perform technically but they are very telling on an athletic output you know the words like a vertical jump. Very easy to perform, everybody can vertical jump. Great athletes vertical jump very high. Not so good athletes don’t vertical jump very high but everybody can do a vertical jump. Everybody can do a frog jump, everybody the exercises that we have picked everybody can do. It’s just that the better athlete you are, the better you’d be able to do. And so that’s a fun competition that’s been a big hit every year.

And we do incorporate the ARX fit equipment net for the high force production staff from the leg press, and its breast press is what we have think on top for this round of combat. So that’s fun as well. People really really enjoy that. And you get to check your scores against everybody else that’s at the show but you also get to check your score that gives everybody else in the room that database which is huge. And another interesting side note is some of the exercises like the 40-yard dash for example; you can also compare yourself to the best in the NFL and see how you’re 40 stacks up against those guys which can be very humbling if we put it that way.

 Dr. Justin Marchegiani: Absolutely, very cool. And that’s we call real fit and how does that plug-in to ARX, does it? Or there’s just something parallel to that?

 Keith Norris: It’s just a date post, wall pumps, real fittest score which is very good friends and there’s some business alignment there we’re looking at rolling out these combines across the nations that’s one of my projects coming up its each with a work with date of pulling that off. So we’ll take that particular part of the show on the road. That could be fine. We’ll see what’s available…

 Dr. Justin Marchegiani: Very cool. Now I’ve done the ARX Fit handful of times it’s one thing I can tell you what you’ve said before like 3 reps and you are set. So the idea like you don’t have a lot of time it’s just a few minutes to be able to kinda get that into your routine which I like. 2 questions out of that though.

1- If people are in Austin how do they find an ARX Fit to be able to use it

2 – How do you incorporate it into your workout and/or your clients’ workout?

Keith Norris: Sure. So I use particular equipment a little bit different than a lot of people do so to answer your first question you can go on the ARX Fit site. It’s ARXFit.com. There is a search function on that site and it will show you the nearest ARX Fit to your town essentially.

We’ve only been in four scales production mode in sales mode for about the last year and a half or so. So there’s not that many out there but we are manufacturing and shipping just as fast as we can. That’s the first question. So second question, I utilize the equipment along with more old school barbell dumbbell exercises and bodyweight exercises as well. So I don’t just use the ARX Fit as a standalone device although you could. I tend to like to mix and match because I think there’s a lot of values in a let me read backup.

Most of the blowback you give from people who are purists in this string thing conditioning game would be they would tell you that you know if you stay on the machine too long you’ll get kind of locked in that particular range of motion and it’s not functional because it is a machine which to some extent, I agree. I mean we are multi planer, we move in many directions and so to incorporate more functional movements I do more functional movements.

I just happen that I have access to the ARX Fit equipment too so now in those fixed positions I can load my body way above and faster than I would with a barbell exercise. Now for instance last night, I can do deadlifts very effectively on the ARX Fit equipment it just so happens last night I wanted to do freeway dead lifts and then I did freeway diets, both. Both exercises I could have done on ARX Fit but early in the week, I had done similar movements on the ARX Fit right so I’m like “Okay now it’s time for a little bit more of functional movement pattern”

So I weighed and weaved the ARX Fit into the workout as well. Same thing I would do with my clients. My clients’ workouts were about a half hour in length. I don’t sneak in it is because that’s our good to way to train in this setup at efficient exercise. And our clients like it that way, our clients are mostly doctors, lawyers, professionals- people who are on a fixed timeline. That whenever I workout I don’t have any time constraint whatsoever generally. For sure, I am not locked in into a half hour. So I can pretty much do whatever I want in there. There are some workouts that it’s only ARX Fit, and there are some workouts where I don’t use ARX Fit at all.  It just kind of depends. Mostly it’s a mix and match.

Dr. Justin Marchegiani: So when you’re doing ARX Fit, you said like the goal of doing the freeway functional movements is you’ll going to be developing stabilizers and there’s lot more functional movement pattern. Multiplanner like you said. But with the ARX Fit you’re putting more of a goal of just putting a whole bunch of load on that joint and those muscles.

Keith Norris: Yes so if you look at this ability force continuum right? The less stable you are, the less force you’ll going to be produced, and that’s fine in many instances. I mean most sports are played in an unstable environment. Maybe it just takes a look at soccer and how much time you spent at one foot for instance- Running and kicking and you know. So it’s totally unstable environment. And you need to train quite a bit and in an unstable environment for that particular sport or just for life. Like there’s value in maximizing instances of maximizing force output in a very stable position. And so it’s just a play it. I talked people and clients there’s kind of like difference between being flexible like a martial artist or a yogi and being very tight like a sprinter.

So many people now realize how in-flexed ball sprinters are. There’s a reason for that. I mean they are meant to be springs not slinkies, right? So you look at the yoga practitioners, they are slinky. They’re not meant to be a spring. That’s not what they do. Most people need to be in between that continuum, somewhere, to be very healthy. So it’s the same idea. One of the biggest problems in fitness I think is that we tend to paint these ideas in an absolute; some black and white. And that’s generally, in the less year in a leg sprinter or in a less year I don’t know what you would call that in a league yogi. You need to be somewhere in a middle continuum to be very healthy. That’s what I strife for, for also in a mix of being a stable and very strong in a fixed plane as well.

Dr. Justin Marchegiani: Totally make sense. And I’m just curious. How are you incorporating it into your workout for like a bullet pattern just like walk me through your last workout for instance? What movements did you do? What were the movement patterns that look squat push-pull and how did you weave it in there? Can you walk us through that?

Keith Norris: Yes so my workouts are a little odd in the fact that let me back up one more step and so here’s another way I incorporate fitness in my life. I have positioned myself such that I don’t have a car. I don’t own a car first and in fact that Michelle owns a car so it’s odd for me to be a carless. I have positioned myself on purpose not to own a car. I have a lot of meetings to go to. I’ve got a lot of traveling to do but I do it all on bike. That’s a combination of bike, bus, walk you know these kinds of thing. And I did that purposely to myself because I was you know what I’m getting a little soft. I go out and my car is always on the driveway and that’s always my first option is that I have to go somewhere grab the keys and go off the walls. You know what that’s ridiculous. I need to pull myself in an atmosphere where I’m a little uncomfortable. I like being uncomfortable, I don’t like being soft. That’s a whole philosophical thing to lie in bed. I need a little discomfort in my life to keep me on my toes. So get rid of the car which worked really good when we live in central Austin. I mean that was a couple of miles of everything- right in the middle of everything where we have since moved in the last couple of months way south Austin, which is cool. It’s a beautiful area and I love it. But, now I’m in a position the closest I am to anything that I really need to get to as five miles. So that means on a good day, on a very light day, I’m riding between 10 and 15 miles. In most days it’s about 25. And I’m doing it on a fixed speed bike because; I want to of the end of a little bit discomfort. So it’s all on a fixed speed bike. If anybody knows anything about fixed speed bikes, it’s exactly as it sounds. You can’t coast. There’s no coasting involved. If the wheels are turning your legs are pumping. You either applying force or you’re braking.

Dr. Justin Marchegiani: That’s going to be tough on the summertime though when it’s a hundred and plus degrees out of here.

Keith Norris: Yes, it’s a commitment. I’ll just hop on it that way. It’s a commitment to do it. But it’s like anything else you ease into it. You know the weather changes, you acclimate to it. Something practices where you can go 60-95 in a day and vice versa. You just get used to it. I’m lucky enough to be involved in events and health and wellness and see if I show up in a meeting sweating then people are like “Oh that’s what he does” So that’s just about every day that I’m on a bike. So I’m giving that constant movement every day. So I have to incorporate that I have done that in my lifting steam too. So, for instance, you are asking about a typical workout. The workout I did before the last night’s workout was a push pull and drive on the ARX Fit machine. We often to have pulling of the ARX Fit machines that are at the Paleo FX Office this is another perk of the multiple businesses. I can actually have workout equipment in my Paleo FX office.

Dr. Justin Marchegiani: That’s crazy

Keith Norris: So 8 miles from my house to the office road. And that 8-mile did a push-pull drive. And what I mean by push-pull drive is one of the devices that we have on the ARX Fit is a horizontal device where I can do a leg press, I can do a chest press which winds up looking like a declined press or I can do a horizontal rope on the same machine, utilizing the same machine just takes me about a minute to reconfigure between the different exercises. I did four sets of three of each exercise just rotating through. So, leg press, chest press, row, rest, leg press, chest press, row, rest- 3 reps of each. Went through four rounds of that, did some more work and then I rode back up to 8 miles, which is not an easy 8 miles having done all that leg pressing. So that’s a typical day for me and I understand that I am so untypical that most people are not going to be able to do that. They don’t have the equipment, number 1. They haven’t lost their marbles like I have and their willing to bike to work. Number 2, they don’t have to copy me per se but it’s the mindset, right? So again, going back to the nothing in biology make sense except through that lens of evolution I consider myself an obligate mover and I have positioned myself such right. I got rid of the car, you’re not driving anywhere you don’t have to move. Return to obligate mover part to it and then I just spice it up with some leg or feet. That’s a typical day for me.

Dr. Justin Marchegiani: That’s enough for a faint of heart though so I give you mad props for the biking. One thing I’ve done similar not nearly as extreme but I got to stand at, so I got to stand up a day and also bought a treadmill in front of my desk so I’m walking about 10-13 miles a day which are you know still really good you don’t even know what’s happening coz I’m you see I have patients, I’m on the phone, I’m doing emails and its like whoa I got treadmill on and then I walk 12 or 13 miles.

Keith Norris: Nice, I tell people – I was just able to get rid of my car and that just how I did it. i totally get that most people are not able to do that. And by the way, I still have a car in the driveway if it’s pouring down rain or whatever, I will always do Uber. I like that I live in the Austin where every bus has a bike rack. So I’m very familiar with the bus routes and our bus system here has an app so I mean it’s easy. I mean that part of it is very easy if you just commit to do it. And I realize not everybody is going to do that. Not everybody wants but for me it’s that was important for me to pull off. And I’m glad I did it or some days I’m like… Someday it’s like seriously? This is going to be a 40-mile day.

But at the end of the day, I’m like that was great I did it cool. And also to the movement helps in mind, we all know that the more you move the more mind is alive. But it really has helped my creativity to just. The movement he has but also the fact that I can rely on that car being in the driveway. In other words, I have to look at my schedule in the morning and go “Okay first meeting at nine, 8miles away, that’s going to take 30minutes by bike riding” So I have to do all these little mini calculations in my mind that keeps me on my toes and I think there’s a lot to be said there.

And not to mention just being aware while you’re actually on the street in riding your bike because I can tell you there’s a big difference riding in the birds where I live right now, and when I get to downtown Austin that’s a big transition. It’s far as traffic keeping your head while sweating. So it’s all good.

Dr. Justin Marchegiani: There’s an article in business insight or lash. There were interview of top CEOs about their exercise and morning routine and such and the big thing a lot of these CEO’s talked about was the main reason why they are exercising not just for health and to look good naked essentially was really for the mental performance boost that they got from the movement because being a CEO you got to be on top of things mentally, emotionally, and the big reason exercise was there because it helped their mindset and their performance.

Keith Norris: And I tell you I’m a big proponent of meditation as well although it is very difficult for me to meditate the traditional sense. It’s tough for me to spend any time on a cushion meditating but I can get into that meditating state when I’m riding like that or when I’m lifting or some. So I call it movement meditation for myself as well. I can just kind of get into that space at least when I’m in the suburbs, I can’t do that when I’m downtown but the appropriate times, I can get into that space. It works for me.

Dr. Justin Marchegiani: How are you doing is in more like base on draft and just not thinking and just kind of responding to movement.

Keith Norris: If you’re into different aspects of Buddhism so you have the emptied mindset which it would be more of a tradition of Buddhism? And then you have more of the Zen concentration. It’s kind of the other extreme of that so there’s extreme concentration on the lending hand. There’s the empty mind idea on the other and then the middle of that is concentration which is the middle path or midway path or you call it Buddhism.

That’s generally what I’m doing. I’m contemplating different ideas not necessarily concentrating with an unbroken mind but I’m you can imagine I have explained it like you have a ring like these old velvet ring boxes, and you’re just kind of tumbling around in your fingers contemplating it and you’re looking for the latch and you’re just kind of rolling it around on your fingers that would be the metaphor for contemplation so whatever the idea might be I’m just contemplating. That’s it and that should I know that does make a whole lot of sense. To set it to go low to centers plus but that’s essentially what I’m doing. That really calms my mind it helps me think through some concepts that I may be struggling with trying to figure out and it’s super calming.

Dr. Justin Marchegiani: So you’re not trying to force the mind to be quiet you’re just letting whatever thoughts about business or the workout or whatever just kind of float through you, you’re not forcing it to stop or start you’re just allowing to kind of move past you

Keith Norris: Yeah if a particular thought hangs, in my mind I will contemplate it I will force it to hang there once my mind lets it go I did not let it go nor do I try to force it out. Nor do I try to capture it and concentrate on it these are kind of the different schools of thought under Buddhism. You know under the Zen you would have coins so to speak and you were a mantra and you were just steady you know that mantra and you won’t let go of it you just continue with the mantra, continue with the mantra, and continue with the mantra you never let it go, which is fine. There’s different path for different people that works for some people that doesn’t work for me. Nor just completely emptied mind really work for me and some instances it can generally it doesn’t. But what works for me is at no path.

Dr. Justin Marchegiani: Love it very cool. Is there anything else you’d like to say that people that are kind of finding you guys over at Paleo FX or just incorporating the paleo kind of template into their diet or just maybe incorporating some of the things you do at efficient exercise? Is there anything else that maybe we should just touch upon but for maybe those people that are newbie just making their fingers wet?

Keith Norris: I think what I would tell people who are new to this are you know paleo FX is for you too. but there’s a misconception out there that paleo FX conferences for those well steep of this whole concept and yes most of the people there are very well steep in this whole paleo template and paleo concept but there is so much value there for even the person who’s wondering “you know is this template for me?” can i pull this off. I mean the very nearest of the new can come there and get a lot out of it. there’s just so much there for the uninitiated to just come in to try it on seeing if fits and you know like I’m kind of like rob wolf in that respect where I say you know give it 30 days to kind of like the greasy used cars else thing give it 3o days. I guarantee it’s been a work for you. Like you know if u give it 30 days and it doesn’t work for you, then what have you lose? You haven’t lost anything.

Dr. Justin Marchegiani: Plus you guys did a great job at Paleo FX because you kind of label everything like you has your intro if you’re a beginner, you’re intermediate, then you kind of have your advance sections. So people can kind of you know kind of jump over the advance if they feeling a little risk here, they go back to beginner stuff to get work on their foundations so really set that up well. So, people can self-navigate if they show off or…

Keith Norris: And the expo floor too, I mean you can learn a lot on the expo floor there’s a bunch of vendors who are there. I will tell you this if we’ve bet our vendors severely if they are on our vendor floor they are on the up an up and they you can feel rest assured that you can buy products from these people or get information from these people and they know what they’re talking about. It’s an extensive vetting process we have to get on the vendor floor because we want to keep the quality high.

Dr. Justin Marchegiani: the products there are amazing I meant I’ve could bought products are meat and some of the Paleo treats that are u know they be more treaty but they still maybe unlike a healthy safe starch in there which is better than the junk food that’s out there. So many great vendors that I was like you don’t even know. I remember I was there last year there was a person for whole foods that was they’re searching people out and pulling these vendors out and getting into whole foods  so it’s really cool pretty cutting edge for sure

Keith Norris: yeah we do have buyers out there for the vendors who are interested and we do have bio-mental foods to be out there again this year. And they are looking for the next best thing. And again this all comes back to our most immediate form of democracy is how we spend our money. Right, so it is totally market basis. So people who like whole foods any of these people if they see there’s a market demand for it, they are going to fill it I mean that’s just capitalism 101. And let’s fill it with good products. I mean it’s between 60 years of going the other direction now the shift is starting to turn and we are going in the right direction you just need to keep the momentum going we’ve done that

Dr. Justin Marchegiani: Excellent. Last question for you, if you’re stuck on a dessert island  and you can only bring 1 nutrient  1 supplement  1 of whatever it is what would that be for you

Keith Norris: wow am i say something that might shock you I would probably take some form of plant medicine with me I would mean the mushroom or ayahuasca. I have so much insight from that it is indispensable in my life now. But along with that, I would also take a heavily loaded barbell. I have to have both sides or the ARX Fit machine…

Dr. Justin Marchegiani: So we got paleofx.com, paleofx.com, efficientexercise.com

 Dr. Justin Marchegiani: Are you still accepting a client or patients here in Austin to train? I’m not personally but just like the vendors on the vendor floor on Paleo FX. I have some of the best trainers in the nation working for me at efficient exercise and yeah so am I personally taking clients? No, but my trainers are. The highest form of pre is when I recommend my parents or kids go too absolutely.

Is anything we missed? Anything else you want to touch upon or any other links or URLS we missed?

Keith Norris: Come to Paleo FX men I just want to send that out there to anybody especially those of you who are already in Austin you are really come up there and check it out. Change your life for the better.

Dr. Justin Marchegiani: If we can’t, we have the live stream access to the right.

Keith Norris: Yup! We have the live stream access.

Dr. Justin Marchegiani: Yeah we will put links below guys for everyone.

Keith Norris: Absolutely and I would say, “Whatever it is that you believed in, invoke that way, with your dollars” That’s how we’re going to affect change in this marketplace.

Dr. Justin Marchegiani: Keep that. I appreciate that man great chat today.

Keith Norris: Thanks, Justin! Thanks for having me

Dr. Justin Marchegiani: You too, take care.

Keith Norris: Yup!






IDLife Review

Jimmy Moore – The Complete Guide to Fasting – Podcast #132

Dr. Justin Marchegiani welcomes his special guest, Jimmy Moore, in today’s podcast about fasting and nutrition. Listen to them as they engage in a very energizing and interesting discussion on how to do intermittent fasting for a therapeutic reason.

Learn about how fasting benefits and affects our bodies in many ways and be able to apply the guidelines involved in a successful fast. Get valuable information on supplements supporting the Ketogenic diet and know more about cholesterol issues, including the testing involved and its possible root cause.

In this episode, we cover:

07:21   Fasting

11:40   Thyroid Function during fasting

18:43   MCT oil, Ketones, and other supplements

27:27   Ketones and Neurological Conditions

34:50   Lipid Panel: Cholesterol








Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. We have my good friend, Jimmy  Moore. And one of the biggest podcasts on the Internet here. He is a—he’s one of the guys that I look to for inspiration, kinda how I MC kinda my podcast coz Jimmy is— does it so right. Jimmy, how you doing today?

Jimmy Moore: Hey! What’s up, Justin? I love how enthusiastic you get. We all have our radio boys when we come on.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: We’re just talking to each other then, “Hey, hey, guys we’re back here on the Justin Marchegiani show.”

Dr. Justin Marchegiani: Hahaha. Well I always love how you exit your podcast. You say the person’s name, you’d say, “His name is Jimmy Moore” And I love that exit. It was just so great.

Jimmy Moore: I still do that.

Dr. Justin Marchegiani: I love it. I love it. It’s so great. I’m gonna do it today, too, as a little tribute for you.

Jimmy Moore: That’s cool.

Dr. Justin Marchegiani: But Jimmy, how have you been?

Jimmy Moore: I’ve been good, man. Just like us Tony before we came on the air. It’s just busy busy all the time and it’s the way I like it.

Dr. Justin Marchegiani: Excellent. I know you had a book that just came out recently on fasting. Let’s dig in. How’s that going? I know you did that book with Dr. Jason Fung.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: Talking about fasting and how to do it therapeutically. Just kind of any listener that’s trying to get some more information on fasting, why should they get that book?

Jimmy Moore: Well, we wrote the complete guide to fasting, Dr. Fung and I, uhm— because when I was looking for a resource on doing some longer facet done some intermittent fast pretty naturally, when you’re ketogenic, you know it’s extraordinarily easy to intermittent fast. I mean, if you go longer than or—or shorter than eight hours without eating between meals, you’re not doing it right. So intermittent fasting was very easy for me and I was even finding that pushing it to say 36-ish hours which is basically an alternate day fast also was pretty easy. So I want to try to push the envelope a little bit and do these longer fast. Well I met Dr. Fung of all places in Cape Town, South Africa he and I shared

Dr. Justin Marchegiani: Wow.

Jimmy Moore: — the stage together at a big low-carb conference that happen there a few years ago. And I went up to him after hearing his talk. I’d never heard of him before and he was talking about fasting as, “Oh, here’s somebody that does something about fasting.” And so, I said, “You know I’m looking for a good resource on doing some longer fast. What is out there?” And he said, “Nothing.”

Dr. Justin Marchegiani: Alright. So we’re back. So the last question we were talking about the fasting book and you mention you did it with Dr. Jason Fung, so tell me about kind of how that started?

Jimmy Moore: Yes. So he when he and I decided we wanted to collaborate on a book, I decided to start fasting myself. Again, I’ve been doing some— some intermittent fast but I wanted to push the envelope and see, “Okay, let’s see how I do with a little bit longer fast— no, context here.” I used to think fasting was the stupidest thing in the world. Why would you purposely starve yourself? It just made no sense to me. But that was under the thinking that I was starving myself. Once I realized it’s not really starving yourself. You’re doing this for therapeutic reason. That’s when fasting started to make a little more sense, especially when it was spontaneously happening on an intermittent level. Really, all you’re doing is just extending it a little further than that to give your body the benefits that you’re looking for. So I did a—a goal in September 2015, to go 21 days in a row of fasting. Now the longest I’ve ever made, it was like 6 1/2 days. And that one, I told this uh—story in the book, The Complete Guide to Fasting, that I— I took communion on the seventh day of a fast. And I was planning on going seven days on that one and to communion that day at church, got home from church and you know what happened, Justin. I crashed so hard.

Dr. Justin Marchegiani: So hard.

Jimmy Moore: And so my blood sugar got down to low 50s which in and of itself isn’t a horrible thing when you have higher ketone levels.

Dr. Justin Marchegiani: Right.

Jimmy Moore: But I wasn’t testing blood ketones at that time. And I was definitely in hypoglycemia because I was so hungry, and I was just curled up in the fetal position. And my wife’s like, “Please eat something.” And I was like, “I’m four hours away.”

Dr. Justin Marchegiani: Oh my gosh.

Jimmy Moore: I did in the beating uh—and—and breaking that fast, but that was kind of my horror story of fasting. So when I came to this one, I said, “Jason, will you kinda pay attention to me. I will not take communion this time. God will forgive me. Uh—and – and –

Dr. Justin Marchegiani: So you’re thinking with the communion, it created like a reactive hypoglycemic spike? Is that what you’re thinking?

Jimmy Moore: It really did.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Because I had gone, like I said, over six days without eating.

Dr. Justin Marchegiani: Wow.

Jimmy Moore: Suddenly I introduce this in—

Dr. Justin Marchegiani: Even a tiny bit. Anybody that has ever had communion, its’ just a tiny little wafer and a tiny little cup of juice. Uh—I mean very tiny and just that little bit, Justin push me over the edge in a hypoglycemia. Now that wouldn’t happen under normal hospices uh— if I just taken that in—in a fed state.

Dr. Justin Marchegiani: Exactly.

Jimmy Moore: But in a fully fasted state, uh— and my body just wasn’t ready for even that little bit of carbohydrate. So anyway, 21 days—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I attempted and September 2015, I made it 17 1/2 days in a row which was almost triple what I had done my longest before. So I was pretty happy about that. The only reason it ended was Christine and I were actually on vacation and I was having a good time. And that was stress and I found that stress for me as a very insulin resistant man, hits me harder probably the most people. And so, I couldn’t continue with the fast. Now some people said, “Well fasting itself is a stress and it can be early. But I think the longer you do it, the longer you stay on it, you actually find that it’s very sustainable beyond the first three days. The first three days can be pretty tough and we talk very openly about that. I definitely tell people day two is gonna really suck, worse than anything. But if you get through day two, it’s nirvana after that.

Dr. Justin Marchegiani: Awesome. Can you step uh—half a step to your right. Perfect. Now I got your whole beautiful face in there. Awesome. Love it.
Jimmy Moore: I’m trying to balance where I’m in. I ‘m in my bedroom so it’s like I –I’m like we’re doing st—

Dr. Justin Marchegiani: You look perfect right there.

Jimmy Moore: So the question I have for you is, what was the big difference between being able to go 30 days versus 7? I know the reactive hypoglycemia thing but it sounds like you’re at 7. Seven so, long way from 30. What was the different things that Dr. Fung was uh—coaching you on that was helping?

Jimmy Moore: I never actually made it 30 days. Uh—

Dr. Justin Marchegiani: Okay.

Jimmy Moore: The longest I’ve done is 28 days in January last year.

Dr. Justin Marchegiani Wow.

Jimmy Moore: 28 out of the 31 days uh—so wasn’t 28 in a row, but it was 28 of the 31. Again, travel rears it— reared it its ugly head and uh—kick me in the tail. Christine had to make uh— emergency trip to go see her family in Virginia. So I hop in the car and what does the stomach start doing? (growl sound) Great.

Dr. Justin Marchegiani: Oh, man.

Jimmy Moore: So I end the fast. But that—that—But that’s self-awareness.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You gotta know. You got fit fasting within your life. And so if life happens, and life happen that day, and of course we had to drive home from that. When life happens, you just have to deal with it and not fight back. Uh— listen to your body and I’m sure you preach this pretty often to your listeners, listen to your body and pay attention and respond accordingly. Don’t fight those signals that tell you something’s wrong.

Dr. Justin Marchegiani: Yeah. I totally agree. Now when you mentioned not fat—not eating for 28 days, so what does that look like? Is it just simple as you’re just not eating? Or are there certain things that you’re doing with hydration or minerals?

Jimmy Moore: Great question.

Dr. Justin Marchegiani: What else is there?

Jimmy Moore: Yes. So when I first started doing these longer fast, Justin, I thought, “Okay, I’m going to need something.” Because anybody that knows my history, you know, really eating literally all the time. Uh— it’s kind of funny to think, “Oh, not eating at all? What—what?” So, I decided I’m going to do it with bone broth, with some sea salt so that gives you a little bit of uh—nutrition there—minimal.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Coz I’m only having a cup or two a day and this may be like 80 calories for 2 cups of bone broth and really minimal nutrition. I also did a little bit of Kombucha but I’ve since cut that out. I found it was actually tearing my gut up pretty bad. Because I thought that I would need it to preserve gut health during the fast. What I’ve found is my gut health has actually done extraordinarily well without the Kombucha because of the fasting. And so we definitely into that coz I know that’s kinda your heart and soul, too.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You talk on gut health. So uhm— so I did that and of course, as you mentioned, hydration, hydration, hydration. I didn’t really count how much water I was drinking but I was drinking quite a bit of water. And— and the interesting thing is people sometimes they will just do water only. I would say do salt water in there as well.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: Because that helps to balance out the electrolytes and if you’re using something like pink Himalayan sea salt, you’re getting those trace minerals of the potassium and—and the other things that are gonna keep your electrolytes in balance. That’s a concern a lot of medical professionals have about these longer fast, is where do you get your electrolytes? That’s how you can balance that out. And I’m a big fan, so was Dr. Fung of, kinda adding in that salt from time to time as well.

Dr. Justin Marchegiani: Yeah. I think when you’re under stress and you’re in a stress response, one of the big things that happens is that hormone aldosterone can go loaded and that cause you to pee out a lot your minerals.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: So it that sounds like adding in the extra minerals, electrolytes, and also some—some little bit of amino acids in there, really made a difference for you.

Jimmy Moore: And speaking of elimination—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You wanna get down and dirty.

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

Jimmy Moore: So you actually do pee quite a bit, and—and that’s natural especially if you’re coming from a non-ketogenic state. You’re suddenly flooding your body with ketones by not eating anything. And so, when that happens, all the glycogen? Pheww— right outta you. And so what happens? You pee your brains out. And even if you’ve been ketogenic, you’re gonna have that as well. And those are kinda gross, but it’s real life, people. So here we go—

Dr. Justin Marchegiani: That’s cool. Keeping it real.

Jimmy Moore: But then the thing that come—comes out the other end, though, that’s the most interesting thing to me. Coz you think, okay, after a few days you’ve not eaten, all that’s gone. Uh-uh— I’ve gone really long times without eating and by day 12, day 15, you’re still seeing stuff come out the back side. And it—it freaked me out coz I’m going, “What else is in there?” It—it just it’s amazing we don’t realize just how much gunk is still in there. And you can definitely explain maybe why that stuff’s still in there that deep into a fast when you’re drinking plenty of water every day, you’re getting adequate salt which would ostensibly make things move along pretty—pretty good as well. Why would there be stuff still in there, 12, 15 days later?

Dr. Justin Marchegiani: Oh, I think some of that, too, is if you look at the composition of your stool, half of it is gonna be bacteria-based. So It just could be bacteria that’s replicating in the gut just kinda having this kind of passing its lifecycle. That could be one aspect.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: It’s definitely not the fibers in the food aspect.

Jimmy Moore: No.

Dr. Justin Marchegiani: That part is not there. But the other half of your stool is gonna be the bacteria so that make sense. So that’s good that you are having regularity there.

Jimmy Moore: Oh, yeah. Definitely regularity. I would say the the—the uhm—the normality of the stool was gone by day 5. In other words, it was all kinda soupy.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: After day five. And–and from what you just said that make sense.

Dr. Justin Marchegiani: Yeah. Totally. Now the big concern that I have with patients—coz I have a lot of patient with blood sugar issues and adrenal issues—is that when you–you cut calories, you know, one of the big things you’ll see in the research is— just type in, “hypocaloric diet” and “low thyroid” or “low T3”

Jimmy Moore: Yes.

Dr. Justin Marchegiani:– or “triiodothyronine” is we see the thyroid kinda down regulate. We see the body temp go down. We see the reverse T3 go up. We see the free and total T3 go down. What did you evaluate your thyroid function during the fast and all?

Jimmy Moore: Here’s the most exciting part I think about fasting. When you’re doing it deliberately as a therapeutic uh—resource, and let me give the caveat, I don’t think everybody needs to do really long fast.

Dr. Justin Marchegiani: Uh-hmm.

Jimmy Moore: I think most people probably could get most of the benefits of fasting just from doing uh— like a 16-8 or 18-6 type of—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —fast. If you did that, I think probably most of the population would do well. This is for those people that are the type II diabetic that are the very insulin resistant that do have a lot of obesity that they want to try to deal with. Uhm—this is uh— who it’s for. Now you mention hypocaloric diets. Here is the thing. Hypo caloric diets can be very detrimental to you. So let’s say, 5,6,700 calorie a day type of diets. That will actually slow your metabolism down. People worry about, “Oh, I’m gonna ruin my metabolism. It’s gonna slow —

Dr. Justin Marchegiani: Right.

Jimmy Moore: —my basal metabolic rate.” And all this, yada, yada, yada that you hear. And the research definitely bears it out. We’ve seen it with the biggest loser contestants.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: Here’s the thing. When you eat no calories at all, which I’m defining as that bone broth and the Kombucha, anything like less than maybe a couple hundred calories, that actually is a far different creature than a hypocaloric state of 5,6,700 calories. Fasting actually revs up your metabolism and gives you a lot of health benefits and impacts those hormones in a different way than even eating just a little bit which blows people’s minds. So thinking, “If I just eat a little bit, then that’s better than not eating at all.” No. Actually it’s a lot better to not eat anything at all again defined as 200 calories—

Dr. Justin Marchegiani: Interesting. Yeah.

Jimmy Moore: — than to have even a little bit calories. And your body thinks it starving and it’s gonna hold on to everything, whereas fasting releases it all and lets this cascade of really cool hormonal effects are to happen.

Dr. Justin Marchegiani: Interesting. Now what about people that have blood sugar issue, would they tend to go hypoglycemic? How do you address that on —when you’re going to do a fast?

Jimmy Moore: So if there’s concerns about that, obviously keep a very close eye on that and obviously this should go without saying, let uhm— medical professional follow you.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —while you’re going through this. Uhm— so don’t willy-nilly do a fast on your own especially if you have known issues like hypoglycemia. But what we’ve seen and what Dr. Fung has seen— he seen well over 1000 patients in his intensive dietary management plan uh— in Toronto, Ontario Canada and he actually has had some hypoglycemic patients come on and it actually regulates their hypoglycemia. So it doesn’t mean that their blood sugar doesn’t go down —it does. When you fast, it goes down. But the cool thing is, you have a corresponding rise in the blood ketones.

Dr. Justin Marchegiani: Ketones.

Jimmy Moore: — which then steps in the place of that. So that yes, you have lower levels of blood sugar, but it— but you’re completely asymptomatic of hypoglycemia.

Dr. Justin Marchegiani: Now what do you think about adding in synthetic ketones while doing the fast. Like the betahydroxy butyrate calcium salts. Are you concerned that if you do that while you fast, you may go up into that ketoacidosis rate? What’s your experience there?

Jimmy Moore: So I have used it uh— in the early days and I would say, use it for the first maybe two, maybe three days, but Justin, by the time you get today 3-4, you’re seeing betahydroxy butyrate levels of 4,5,6 very easily without exogenous ketones. So I would say, it’s probably a good idea in those first couple days especially day 2 where it’s hell—haha—

Dr. Justin Marchegiani: Tough to cravings.

Jimmy Moore: —to take it then for that purpose to kinda get through that period coz you’ll feel the effects that you’re in the fully fasted state because of the extra ketones. But then once your ketones naturally go up on their own, you can back off and completely eliminate those exogenous ketones. So I think as a beginning uh —part of the fast, absolutely. As you go higher, know and—I— I don’t think ketoacidosis would be a concern because you have to get extraordinarily high level—

Dr. Justin Marchegiani: 25, right? 20’ish—

Jimmy Moore: of blood ketones. Yeah. 20+ milli molar and I think the highest I’ve ever seen, and this was without exogenous ketones, was 7.6 Very naturally, again, it was early on when I started keto and I started kinda really doing this. Your body levels out over time, but blood sugar at the same time as 7.6 was like in the 50’s and so I wasn’t worried about it in the context of a lower blood glucose level. And if you’re fasting, your blood glucose level is gone drop like a rock.

Dr. Justin Marchegiani: Got it. Okay. And I’ve seen a lot of people do the therapeutic fasting with severe insulin resistance. It can be a game changer of turning that insulin resistance around right away.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And get them back on, you know, the right type of guy whether it’s a paleo, low-carbish, you know—

Jimmy Moore: Sure.

Dr. Justin Marchegiani: 60 carb, 20 protein, 10—10—or 20 protein uh—10 carb. Whatever that macro rain—

Jimmy Moore: Right.

Dr. Justin Marchegiani: You figure it out with your clinician and work on that. I think it’s a great starting point. My issue is with the low-calorie. I always see a lot of patients just automatically they tend to go lower calorie to begin with. And it’s hard to see if their fatigue is from a low-calorie issue.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: —or adrenal, thyroid issue. And the calories you can be driving all of the above.

Jimmy Moore: It could be both exactly where the one is feeding it to the other. And— and I do a Thursday podcast called, “Keto Talk” and my cohost on that one is a practitioner out of Arizona, Dr. Adam Nally and he sees 10, 15,000 patients a year. And so he’s seen literally everything come through the office and he says, “The biggest issue that he sees time and time and time again especially among women is they’re not eating enough calories when they go keto.” And so you gotta have adequate calories or it’s just a moot point.

Dr. Justin Marchegiani: Yeah. Definitely the fasting is therapeutic coz we— we need nutrition to run our body and we won’t be getting those nutrients in a fasting state. But when will be doing some severe uh —U-turns with our physiology when it comes to insulin resistance for sure.

Jimmy Moore: Absolutely. That’s why you do it.

Dr. Justin Marchegiani: Also, I had a little flashback when you’re talking about the constipation thing.

Jimmy Moore: Uh-oh.

Dr. Justin Marchegiani: I flashback to one of your podcast a few years back when I— you are interviewing— not Ornish, when uh — Mc Dougall.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: And he kept on referring you to Mr. Moore—

Jimmy Moore: Ho-ho—how’s your constipation, he told me.

Dr. Justin Marchegiani: Yeah. He kept on saying, “How’s your constipation, Mr. Moore?” “How is it?” So I kept on having those flashbacks there. That was an excellent interview that I think uh —everyone should partake in. It was just a uhm—amazing.

Jimmy Moore: It was fun. Hahaha—

Dr. Justin Marchegiani: —just you showing your patience on being able to stay calm. That was unbelievable. You’re a saint.

Jimmy Moore: What’s funny is behind the scenes, my wife could hear what was going on.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: She heard it very quickly took a turn for the worse. And she— I mean I had on mute and she was like, “Don’t let him run over you.” I’m like, “I got this—I got this.” Hahaha—

Dr. Justin Marchegiani: That was probably one of the podcast— one of the best podcast that I’ve ever seen. It was great. Love it.

Jimmy Moore: You gotta have fun in podcasting and sometimes talk to people that you don’t agree with and they can hang themselves.

Dr. Justin Marchegiani: Totally. Well, we’ll put that topic behind us. Uhm— literally and figuratively.

Dr. Justin Marchegiani: So you—

Jimmy Moore: See ya.

Dr. Justin Marchegiani: I know. Next— what’s your experience using MCT oil or other types of ketone precursors to help to kinda push yourself into a higher level of ketosis?

Jimmy Moore: Yeah. I think they’re great adjuncts. Like we said a moment ago—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —with the exogenous ketones in the beginning of a fast, I think anything that’s gonna give you even a psychological boost, I know that physiologically you should be getting a boost in your ketones because MCT is a precursor to that. But I think anything that’s gonna make you feel better about what you’re doing and how you’re fueling your body and—and the end goal of—of feeling better and getting healthier, is a good thing. So just be careful if you do add any of these products like MCT oil, specifically. I remember first time I was gonna—

Dr. Justin Marchegiani: Loose stools.

Jimmy Moore: —two big tablespoons full of this stuff—

Dr. Justin Marchegiani: Oh, yeah.

Jimmy Moore: And two hours later, I can’t get off the pot. So—

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: Hahaha—
Dr. Justin Marchegiani: Love it.

Jimmy Moore: So you gotta—It’s beware at that point and—and be prudent about it. Obviously, listen to podcasts like these. Uh— it’s gonna help you, you uhm—you know, and read up before you kinda jump full-fledged. I think sometimes a little bit of knowledge is dangerous, Justin. Because people think, “Oh well, I can do this on my own.” And you probably should not do it on your own.

Dr. Justin Marchegiani: Yeah. I hundred percent agree. Now you mentioned that certain people the fasting may not be the best thing for, especially when there’s a lot of active stress.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And is that because of the stress hormones affecting blood sugar and insulin levels?

Jimmy Moore: Blood sugar and just how you feel in general. I— I think all of those things uhm— it’s just not a good idea. I mean obviously, if you’re malnourished and underweight, you shouldn’t be fasting either coz you’re gonna lose weight. Uhm— if you’re pregnant, obviously you should not be uh— fasting because you’re basically trying to build a little one inside you.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: You’re going to needing to, you know, feed you and that baby. Uhm —I think if someone comes from an eating disorder, like uh—anorexia or bulimia, get that under control first. Uhm— and just— and children. If you’re under age, and you’re still developing and growing, probably not a good idea to fast unless the only caveat I’d give to the children is unless they’re very severely—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: — obese and diabetic and this is something that could be therapeutic for them. But again, in general, children probably should not be fasting.

Dr. Justin Marchegiani: Got it. Would you say if you also have like an active thyroid or adrenal issue, would you say get that under control before trying that?

Jimmy Moore: Yeah. You definitely want to get those things under control. Uh— it might help those things, it might— but I think getting those under control through nutrition first, and then as an adjunct in the process of your healing, adding in a few times a fasting just to see how you do, is definitely there is no downside to trying it uh —a time or two, just to see how it impacts you. And— and that’s the theme song, we say again and again with what I like to refer to as the other “F word”.

Dr. Justin Marchegiani: Nice.

Jimmy Moore: With fasting is you just gotta try it. And if it works for you, great; If doesn’t work for you, great. Move on back to your Paleo diet, your ketogenic diet and be happy with where you are.

Dr. Justin Marchegiani: Love it. And I spoke at 2015 low-carb cruise, and one of the things I talked about was thyroid function and insulin resistance. So, if you are insulin resistant, that can definitely affect thyroid function. And fasting may be a good short-term modality to help get that insulin resistance which would thus, help with thyroid T4 to T3 conversion, too.

Jimmy Moore: And see, it’s all related.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: People like to say, “Well, I have uh— heart disease, I have diabetes, I have cancer.” Guess what guys, they’re all metabolic diseases, they’re all cut from the same cloth. Uh— thyroid disease, the same thing. They are all cut from the exact same cloth and—and knowing that, keeps you so much more knowledge and power than probably most medical professionals.

Dr. Justin Marchegiani: Totally, 100% agree with that. So looking at some of the supplements that you’re using, I know you’ve up with your own line with Dr. Adam Nally there on your Keto podcast.

Jimmy Moore: Yup.

Dr. Justin Marchegiani: Let’s talk about some of the—the core or the big three so to speak. Uhm—what are those and then where do you—where do you stand on synthetic ketones, too?

Jimmy Moore: So uh— big three in terms of what the big uhm— supplements are?

Dr. Justin Marchegiani: Yeah. Exactly. What are those big three supplements that you’re doing?

Jimmy Moore: The big three—like—haha

Dr. Justin Marchegiani: Haha—

Jimmy Moore: We have two uh—two products in the line. Currently, one is multivitamin that’s very specifically uh —targeted to people on a ketogenic diet. We call it Keto Essentials. And we literally load that bad boy up with all kind of stuff uhm —and so in six pills, you get like all the vitamin D that most people would need. I believe we have 2000 IU of the vitamin D in there. We have biotin. We have uh—just a lot of things, K2, that you don’t usually see in a lot of multivitamins. You definitely can’t find this formulation in like uh— vitamin shop or anything like that. So uh— we worked hard and this is one that Dr. Nally actually uses specifically with his patients that he puts on a which is like 99% of the people that come through his door, he puts on a ketogenic diet. And then uh— uh—the other one is blood sugar tends to be an issue a lot of people deal with. And so Berberine Plus is the name of the product that we came out with there and it’s for Berberine, Banaba leaf and chromium all known to help lower and modulate your blood sugar levels. And the cool thing about that one is when you lower blood sugar, guess what also happens, you raise in the context of a low-carb, high-fat diet, you raise ketone levels. And so it helps you get into ketosis. Uhm— I would think that fish oil probably is a third one that’s really essential work we’re—we’re kinda looking into what we can do from an omega-3 standpoint. But I think getting that right balance of Omega 3’s is so essential. I personally just love cod liver oil.

Dr. Justin Marchegiani: Love it.

Jimmy Moore: And use it pretty often and definitely high quality pharmaceutical grade. Don’t buy the ones that are, you know, Walgreens or whatever.

Dr. Justin Marchegiani: Absolutely.

Jimmy Moore: No offense but just they’re just—they’re rancid, they’re nasty.

Dr. Justin Marchegiani: Yup.

Jimmy Moore: And—and when you fishy burp, that’s a really bad sign—

Dr. Justin Marchegiani: Yup.

Jimmy Moore: that you got a bad one.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: So— and then you asked about exogenous ketones, I’m still kind of— I’m still kind of filling that out because there’s a lot of companies out there really trying to get on this bandwagon with exogenous ketones. Uh— I think I was telling you before I came in the air, I don’t like to way some of them are being marketed.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Into ketosis within 45 minutes or less—No, you don’t.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You get ketones in your blood system.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: But you’re not in ketosis. You’re not keto adapted and then some of the other marketing is like, “Well, eat all the carbs you want, just take exogenous ketones and you’re in ketosis.” I’m like “No. No. There’s some dangerous implications there where you’re raising your blood sugar with these carbs you’re eating and then suddenly you’re raising blood keto levels. That would be a concern for ketoacidosis at some point if you go overboard.

Dr. Justin Marchegiani: Big time.

Jimmy Moore: So I’m very leery about this, Justin. And very open about it I do think exogenous ketones have a role in the Keto community where people that are struggling may be just starting off and they want to kinda feel some of the effects of having ketones in their blood system. This will do that for them and again, a psychological effect of, “Oh, well I already have ketones in my system, now it motivates me to go do it endogenously while I’m doing it exogenously. I think that can be—that can be a good use for them. But just these people that are pushing it and eat your carbs and have ketones at the same time, no— don’t do this. Don’t do that anymore.

Dr. Justin Marchegiani: I totally agree. I see a lot of these companies. They do that and they don’t really emphasize the dietary aspect of pus your physiology into nutritional ketosis by making the right diet and lifestyle changes. They’re just like “Hey, let’s forget that let’s just take this magic pill and get in the ketosis.” But we’re saying maybe do both. If you do some of that and then you make the diet changes than you can have a really beneficial effect.

Jimmy Moore: Yeah and unfortunately, I think a lot of these companies are just in it for the book.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: For the trend and, you know, Keto is very, very hot right now. I wrote Keto Clarity three years ago, and it’s still under a 1000 on Amazon. It just blows my mind how help long that book is just lasted. But it’s because so many people are truly interested and I’d— I don’t want anybody to get confused that Keto— exogenous ketones is anything close to being exactly the same as endogenous doing it through a low-carb, moderate protein, high-fat diet.

Dr. Justin Marchegiani: Got it. And what’s your take using endogenous ketones for like neurological disorders? Whether it’s epilepsy or whether it’s Parkinson’s or neurological conditions. What’s your experience with that did?

Jimmy Moore: Did you say endogenous or exogenous?

Dr. Justin Marchegiani: Uhm— I’m sorry I would be talking about exogenous.

Jimmy Moore: Okay.

Dr. Justin Marchegiani: So extra ketones. So let’s assume—

Jimmy Moore: Coz I heard you say endogenous—Wait a minute, uh—eat low carb and then—haha—

Dr. Justin Marchegiani: So endogenous is what’s happening inside. That’s the low-carb—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: —that moderate protein diet—

Jimmy Moore: Right. Right.

Dr. Justin Marchegiani: And then exogenous what we’re putting into our bodies. So what’s your take with that with some of those neurological conditions?

Jimmy Moore: Oh my goodness. I think these are the people that that was made for that. O-o—other than like the Navy Seals which I know Dominique D’ Agostino’s been kind of leading the way of creating these things for the Navy Seals to kind of help, you know, enhance their mental performance.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: While they’re out there. And plus they do a lot of fasting as well.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: So they do a lot of the endogenous ketones that way. So, yeah. Absolutely. These are the very people that I think they’re trying to reach this really cool ratio of glucose to— to ketone and if they’re doing it endogenously and—and working voraciously even more so than just someone just trying to heal insulin resistance, they’re going upwards 85-90% fat and then the rest is protein, carb. They’re doing really hardcore trying to get those ketone levels up for a therapeutic purpose. So don’t misunderstand me as, “Oh, I’m gonna go eat 90% fat. Jimmy Moore said it was okay.” No, I didn’t. For the purposes of Parkinson’s and—and some of the things that you mention, I think it, along with exogenous ketones, can be very uh —very therapeutic for those people because quite frankly, the brain— your fat head, by the way, Justin—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: And so am I. We all are. We’re all like we have— was at 70% fat—

Dr. Justin Marchegiani: Yup.

Jimmy Moore: —in our brains. And there are some glucose uh— functions in the brain but your body makes all the glucose you need endogenously. So you don’t have to eat, you know, uh— extra glucose in order to get it into the brain. So the brain’s gonna be fine. The brain’s actually going to be more than fine. It’s gonna be optimal when you start eating low-carb, moderate protein, high-fat. And then adding in these exogenous ketones, the brain just goes wild when you’re in a ketogenic state.

Dr. Justin Marchegiani: Totally. And you talked about brain here just one second ago. Now we are— we are 70% you know, fat in the brain. Uh— Tom —Tom Naughton uh— his video, “Fat Head” a few years back.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: It was just absolutely great. It was really emphasizing that. But in our brain, right? We look at some of the enzymes that are active in our brain. There’s one enzyme called insulin degrading enzyme. And that enzyme’s really unique because that enzyme’s also the enzyme that mops up insulin and also mops up plaque. So imagine someone spilled a whole bunch of insulin on your floor, right? And yet Mop comes in, and mops up that insulin but there’s some plaque on the other side of the floor because the mop’s so saturated it can’t mop up the plaques. In other words, that mop can only mop up so much gunk in the brain. The more insulin that’s there from the excess sugar and carbs, you have less of that mop’s utilization for the plaque. And that’s part of the mechanism of Alzheimer’s and some of these Dementia brain conditions.

Jimmy Moore: Alright. I wanna see an illustration of that on your website now. So—

Dr. Justin Marchegiani: Haha—

Jimmy Moore: The mop that’s dripping with insulin can’t get the plaque—Haha—

Dr. Justin Marchegiani: I’m gonna do it. I’m gonna do it. I’m gonna do a chalk talk later this week. You got it.

Jimmy Moore: Cool.

Dr. Justin Marchegiani: It will be uh —dedicated to you, Jimmy.

Jimmy Moore: Cool. There you go.

Dr. Justin Marchegiani: So we talked about the insulin piece, that’s important. What’s been your experience with fasting or using very— like you know, 200-500 calorie diets? And I know you said below 200. I had some experience using hCG. Some of the hCG protocols—

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: The Human Chorionic Gonadotropin. And using that to basically tap into your body secure fat sources and kinda having this appestat, you know, the appestacin or the brain kinda re-regulating that. What’s been your experience with that, if you have any?

Jimmy Moore: Can I be honest about hCG?

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I’m extraordinarily skeptical uhm— I know it’s helped a lot of people actually uh —know a lot of patients that have gone through that. I have not personally done that. Uhm— and I think the thing that scares me the most about it and maybe you can acquiesce my fear, is the— is the very, very low calorie. I think I find more benefit from being under the 200 than being at 500 with hCG. And it could just be my naïveté and not knowing enough about it, but I’m— I’m just extraordinarily concerned anybody that goes through that. Because once you go through the round of hCG and you go back to eating somewhat normally again, maybe a ketogenic diet, I haven’t really seen anybody continue to sustain the benefits from that. So that would be my only caveat concern about this.

Dr. Justin Marchegiani: Yeah. I’ve done it with a couple dozen patients. I’ve done it myself personally. My wife tried it a few times as well. And it has worked profoundly if you do it right.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: Couple of caveats, there’s a lot of homeopathic’s out there— homeopathic drops—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Don’t recommend that. If you do an hCG, you should do it the injection—

Jimmy Moore: You do the injection.Yeah.

Dr. Justin Marchegiani: You should do the injection.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And the easy way to do it as you should know because if you get a pregnancy test, you should test positive. It’s a great way to freak out your husband, by the way. Okay.

Jimmy Moore: Test positive— Will a guy test positive for pregnancy as well?

Dr. Justin Marchegiani: I —I think they will because that’s still gonna spill out—some of it will spill out in the urine.

Jimmy Moore: I so wanna do that to freak out Christine.

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: Hahaha—

Dr. Justin Marchegiani: But I tried it with a sublingual and I tried it with a homeopathic—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: You will not get a positive pregnancy test. And again, my wife has tried it, not me. I’ve done the injection but I haven’t tried it yet.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But I’ve seen it work phenomenal. It took her about one year to gain the weight back.

Jimmy Moore: Wow.

Dr. Justin Marchegiani: And she felt great. Going— that— In the first five days was tough, but you are able to keep it off. And again, you know ,the quick—the key is what do you go back to?

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: You go back to a really good diet.

Jimmy Moore: That’s right.

Dr. Justin Marchegiani: She’s kind of a Paleo, low-carb.

Jimmy Moore: Sure.

Dr. Justin Marchegiani: That’s where she—she lives. Uhm— but again, the key is don’t go back to a crappy diet. But the science behind that is the hCG is tricking the body. And this makes sense more with the female physiology.

Jimmy Moore: Right.

Dr. Justin Marchegiani: Not so much the male. You’re tricking the body that you are pregnant and your body is tapping into secure fat stores coz it’s trying to pull calories out so the baby can be nourished and fed. So the whole idea is you’re tapping into those secure fat stores. That’s the stores you normally wouldn’t tap into if that hormonal level wasn’t there. And there’s been a study at __was the British endocrinologist—

Jimmy Moore: Right.

Dr. Justin Marchegiani: —that came up with this in the 60’s.

Jimmy Moore: Right.

Dr. Justin Marchegiani: There’s a study in the Lancet where you have two group: one without the hCG, low-calorie diet; one with the hCG. And the group with the hCG loss more calories and also kept it off longer as well. So just kinda—that’s from my experience and pretty good.

Jimmy Moore: Yeah. I’ve interviewed a few people about hCG on the “Livin La Vida Low Carb Show” over the years. So I’m curious the 500 calories is key. You’ve gotta keep it down so basically you don’t overfeed your body because you’re tapping into the body fat stores to make up for the rest of calories that you need. Is that the theory?

Dr. Justin Marchegiani: Yes and no. I— I’ve modified it over the years where I still boost the calories up a little bit more upto —

Jimmy Moore: You do. Okay.

Dr. Justin Marchegiani: — thousand. I played around with that coz you still get—

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: —similar results. And also adding in— they recommend no fats but the only exception is been for me is MCT Oil.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And I find it boost up the ketones the more helps with the appetite.

Jimmy Moore: I would be willing to try a 1000 calorie one with the hCG injections that— that sounds a little more prudent. I think the 500 was what just freak me out. Every time I saw that it—

Dr. Justin Marchegiani: I’ve had so many good experiences with it with people that already have healthy diets, healthy everything.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And that’s like my go to with patients that are like at their wits end with their diet. Everything else is right— exercise, lifestyle, supplements, gut. That’s kind of my last go to. So I’d be curious to see your— your take on that.

Jimmy Moore: Yeah maybe will give it a go.

Dr. Justin Marchegiani: I love it. Very cool. So we talked about the ketone, we talked about some of the supplements which I think are really good. Now we talk about you— you talked about it before in Keto clarity kinda looking at your lipid panel Can we talk more about lipids when you’re— when someone’s reading their lipid panel, is there cut off for you? With your cholesterol so high that they should worry at all? What does that look like for you?

Jimmy Moore: Total cholesterol is that you’re referring to?

Dr. Justin Marchegiani: Total cholesterol. Correct.

Jimmy Moore: Yes. So I was just talking to this lady that was going in at the mail place I’d take books every day to the mail and this lady was there, and I don’t know how it came out, but her —her total cholesterol she just shared it with me. I guess she knew what I did for a living. And so, you have 620 total cholesterol and I’m like, “Okay, that’s high. I’m not really worried about total cholesterol in general, but that’s really, really high.” And so I said uhm— “So usually when your blood lipids are that high, do you have, you know, something else going on? Do you have like maybe infections in your teeth or something?” She’s like, “Oh, yeah.” and she pulls out the bottom of her teeth.

Dr. Justin Marchegiani: Ohh— Oh, man.

Jimmy Moore: She had six all pulled out that— that probably had infections in there from root canals that she’s had done. And this was the bad part. This was the part that just broke my heart, Justin. She just spent over $10,000 mercury amalgam galore all in her teeth. And I’m going, “I’m sorry to be the bearer of bad news, but that’s why your blood cholesterol has gone up so extraordinarily high.” So I think in the context of knowing why it’s high, it does matter. Uh—but it’s not the high number, I told her. I said, “You should be very thankful that you have that very high cholesterol because that’s the only thing that’s saving you from dying right now because of the inflammation.” And so it kinda startled her. “I just spend all this money” and like, “I know but total cholesterol can be an interesting marker if it starts to go up because it should clue you when something is going on somewhere in the body and it’s usually an inflammatory response somewhere. And teeth is a big one for a lot of people. I actually have four root canals done when I was in my early 20s, mercury amalgams.

Dr. Justin Marchegiani: Argh—

Jimmy Moore: And 2013, actually wrote a book, “Cholesterol Clarity” and an in preparation for that book, I thought well, I learned that infections in your teeth can be a big player in your total cholesterol. So I went and got them all cleaned up. I went to a holistic dentist down the road from here, he took all the mercury amalgam— amalgams and put good stuff in there and he cleaned up all of the root canals and the infections that had taken place. I can literally taste the infection that’s how bad it was.

Dr. Justin Marchegiani: Oh—

Jimmy Moore: So he cleaned all that up, and Justin, and in one year, my total cholesterol jumped a 100 points just from doing that. No other changes, just from doing that. And so it can be uh—uh —kinda your first telltale sign something serious might be going on. So that’s the only weight that I really give total cholesterol. I think looking at triglyceride – HDL ratio gives you a whole lot better indication.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: You know, any, maybe necessarily cardiovascular issues uh—and NHS CRP to kinda see you like the inflammatory response. There’s a lot of inflammatory uh —numbers I know that you run.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Uhm—in—in your office. And so I think cholesterol helps to a degree, but not to the degree that most mainstream medical professionals think it does.

Dr. Justin Marchegiani: I think you’re a hundred percent right. Anytime I see like, you know, over—over mid 300 cholesterol, the first thing I always go to rule out is make sure it’s not a hypercholesterolemia issue with it.

Jimmy Moore: Right.

Dr. Justin Marchegiani: It’s just a genetic issue with the—

Jimmy Moore: Right. And I had that tested, by the way. I have a 5% chance that I have familiar hypercholesterolemia which is, no, I don’t.

Dr. Justin Marchegiani: Right. Exactly.

Jimmy Moore: And that—And then it lead to—“Hey, maybe there’s something— oh yeah, had all these root canals, I had the mercury and that— that was the thing.” And now my— my blood sugars uh — or blood sugar — blood cholesterol is still pretty high. It’s in the 200’s but that’s not abnormal.

Dr. Justin Marchegiani: No, that’s not an issue at all.

Jimmy Moore: And we can talk about the context of uh— of a ketogenic diet, that’s not abnormal.

Dr. Justin Marchegiani: Yeah. I don’t worry until they’re into the mid 300’s.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But any than that

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: —to—where’s the HDL—where’s the HDL at?

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Just curious.

Jimmy Moore: Yeah. HDL 75.

Dr. Justin Marchegiani: That’s beautiful.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: So your ratio right there still under—It’s still under 4. That’s still beautiful. And at 3 ½, you have the risk factor.

Jimmy Moore: And—and 360, so yeah, exactly.

Dr. Justin Marchegiani: That’s less than 1. That’s beautiful.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: I don’t have an issue with that. But uh— you know, but if there is an issue, we’ll run the LDR receptor, the P—PCKS9 test, look at the genetic markers there and if those aren’t there, we’re doing all the things that you mentioned. Also looking at thyroid function.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Because low thyroid function cause— can cause—

Jimmy Moore: Will raise cholesterol—

Dr. Justin Marchegiani: to creep up.

Jimmy Moore: Yup. Do you run an NMR at all?

Dr. Justin Marchegiani: Uhm— Yeah. I do run an NMR. I was using the VAP before.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But then after they got shut down.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: So I’ve been doing more of the NMR to look at the LDL number.

Jimmy Moore: NMR is like the only game in town now. HDL Labs is gone now, and VAP is gone.

Dr. Justin Marchegiani: How about—how about the Cardiac IQ, is that still there?

Jimmy Moore: Yeah, it is. But I think NMR has a little more prominence.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: It’s got legs coz they’re like only game in the— in the subfraction game, so to speak. That I think more and more doctors are accepting that one. Although I will tell you my own medical doctor just down the road from here in South Carolina, he stopped running them. And I’m going, “Can I please have an NMR run coz I want to keep around small dense LDL particles” “Well, you’re gotta have pay for it out-of-pocket.” So insurance won’t even pay for it anymore.

They don’t have a code for it anymore at my local doctors office. So I run it on my own anyway I can— I can do it NMR for about— about 50 and done and done. And in that way, I know where I am.

Dr. Justin Marchegiani: Yeah. That’s so smart. And again, I’m imagining the main reason why they’re not running it is because there’s no modality that they can do to change it.

Jimmy Moore: Well, they don’t know what to do with it. That—mainstream medicine they even run the standard lipid panel. They don’t know what to do with it. So that— that’s we’re getting deep into an issue with the mainstream medical system. They run so many numbers that they just don’t know what to do with it. “Okay, you’re normal.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: And it’s like normal of what?

Dr. Justin Marchegiani: What?

Jimmy Moore: Sick people.

Dr. Justin Marchegiani: Yeah. Exactly. And also the fact that uhm— also when you’re looking at those test, typically the prescriptions gonna be a statin.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: The statin won’t touch particle size and won’t touch LDL number per se.

Jimmy Moore: Right. Well kudos to this uh— this postal lady coz she said, “They tried to put me on this medicine. I told them, I ain’t taking that ever.” It’s like, “You go girl.” Uh—so she was—she was really— do have a fasting story regarding uh—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —cholesterol when I did that September 2015 fast, 17 ½ days, I tested all of my blood markers uh —cholesterol before and then did it after. Do you know when that 17 ½ days my total cholesterol dropped a hundred points. And my LDL-P which was on the NMR like profile test, it dropped a thousand points.

Dr. Justin Marchegiani: Whoa.

Jimmy Moore: And small LDL was pretty low already but it even dropped another hundred or so points. Uhm— triglycerides obviously went down as well. HDL slightly went down which you’re not eating food, that make sense coz—since dietary fat tends to help your HDL go up. I wasn’t eating anything so uh— really interesting markers. And then the uh— really advanced lipid marker lipoprotein little-a actually was in the 400’s. I’ve always had really high lipoprotein little-a, like 423, and it dropped down to like 130 in 17 ½ days.

Dr. Justin Marchegiani: Wow.

Jimmy Moore: Nothing moves that. No drug moves your numbers that quickly. So uh— I was pretty impressed by the— just the therapeutic fasting. Just that little bit of fasting how profound it move those cholesterol numbers.

Dr. Justin Marchegiani: What If you’re someone that was going to their conventional position. Could just fasting for a day or two make— move the needle in the right direction so you’d be out of that danger zone?

Jimmy Moore: You know I didn’t test after a couple days. That— this will be a fun test to do.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Like uh— I like do daily NMR’s or whatever—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I just see when that— that dramatic shift takes place. I don’t think it would in that very short amount of time.

Dr. Justin Marchegiani: Right.

Jimmy Moore: Uh—I know some people they try to get like good health insurance or life insurance policies based on the cholesterol numbers.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I never get those preferred rates because I can’t get my numbers down that good. Uh— although, uh—you could do it with uh—you know, 10-day fast to try to get those numbers down. Get the good rate and go back to eating, it would go back up again. But, yeah, it’s uh— you know, I haven’t tried that but, that— would—If I could uh—make a little—If I can sell a few more books maybe I’ll do that daily NMR just to kind of keep an eye on what’s exactly happening.

Dr. Justin Marchegiani: That’s great work. Kinda doing the circle run here. We hit the fasting book, fasting clarity; hit the Keto clarity; we hit the cholesterol clarity; Are there any other key topics within those three books to give out now, that you wanna hit on? That you just feel is really important to address?

Jimmy Moore: Yeah. I mean, we’ve hit all the—the key points with that. Uhm— I’m obviously still writing books and still continuing to— to try to get information out there. The next book that I’m—I’m working on is kind of a sequel to Keto Clarity uh— coz all these people read that it was meant to be an entry-level book. I get some weird reviews on Amazon top uh—uh.com sometimes for Keto Clarity like, “It’s too simple.” Like, “Yeah. That was the point, dude.” Hahaha— I wanted it to be entry-level coz keto can be a little complex. You start talking about gluconeogenesis and ketoacidosis.

Dr. Justin Marchegiani: Gluconeogenesis. I love it.

Jimmy Moore: Yeah. Exactly. Oh, you remember that. Uh —And so I uh— wanted to go a little bit deeper and so Dr. Nally, uh—my keto talk co-host and I are actually working on a book called, “The Keto Cure” which will take all the major disease states uh—that a ketogenic diet helps with and show you the metabolic pathway of why it works, supplements you can take that would correspond with the ketogenic diet. And as a very last resort, any medications that might be an adjunct for that particular condition. So we’re really excited to get that book out in September uh—like a settl— kind of a long-awaited sequel to Keto Clarity. Uhm— and then another piece that’s not being talked about a lot, Justin, is the whole uh— mindset. The whole uh— getting your brain in the right— uh and loving yourself in the process.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I guess it’s a long time to say a lot of people give you the “Here’s the how to” “Here’s the practical” And some people say, “I just hate how I look.” “I just don’t know” They don’t love themselves. And so I’m teaming up with a registered holistic nutritionist named, Meg Doll. Uh— was Meg on the cruise the year you came?

Dr. Justin Marchegiani: She may have been. Sounds familiar.

Jimmy Moore: Yeah. So I— Anyway, she and I are collaborating on a book called, “Keto Freedom” coming out in December. And then I just signed the contract as of the recording of this, like today, uh —for my next book after that called, “Weight Loss White Lies” There are so many shysters in the weight loss industry and I’m so sick and tired of seeing them on television and in print magazines. And people believe the garbage that’s put out there about what they need to do lose weight. And so, “Weight loss White lies” is gonna come in 2018 and I’ve already asked my publisher, “Can I please just rail against everybody?” So they don’t let me do that and uh— really excited to get that out there. Constantly working on new projects trying to uh— help other people, keep doing my podcasts. I do five podcast a week now between the three shows. So stays busy.

Dr. Justin Marchegiani: That’s great. You are the major podcast guy over the last 10 years. Now you’re into the whole authorship field. You’re doing great. Any of those book hits uh—hit New York Times best seller?

Jimmy Moore: You know, Keto Clarity came so close.

Dr. Justin Marchegiani: Aww—

Jimmy Moore: It was 22 the week it would’ve hit. And—and some of the behind-the-scenes games people may not know about. There’s publishers that actually pay their way to get on the list.

Dr. Justin Marchegiani: It’s hard.

Jimmy Moore: And so—You know publishers pay their way to get on the list the week I would’ve it. Uhm— and so I missed it by two on that one. The Ketogenic Cookbook hit 21.

Dr. Justin Marchegiani: Aww— one away.

Jimmy Moore: But “Ketogenic Cookbook” did hit International Bestseller status as did the uh—the book after that one uh— was “The Complete Guide to Fasting” that came out on October uh—we originally called it “Fasting Clarity” but then we got into writing it and, “Oop, we need to change the title.” Coz he didn’t want to necessarily stick with the same form as the clarity books. And so “Complete Guide to Fasting” also it sold out in six hours on Amazon.

Dr. Justin Marchegiani: Wow. Unreal.

Jimmy Moore: The day it came out.

Dr. Justin Marchegiani: Everyone listening, let’s help Jimmy get to number one here on his next book.

Jimmy Moore: Hahaha—

Dr. Justin Marchegiani: Well, thank you. And yeah, we’re really excited about “The Keto Cure” and yeah, we’re gonna keep doing our thing, man. Getting the message out to think we’re all passionate. All of us in this community are passionate just about educating people and helping them change their lives.

Dr. Justin Marchegiani: We’ll put the links below to all the Amazon— all the Amazon links to the books of people can easily access that. Awesome. And if you want to get in touch with Jimmy, livinlavidalowcarb.com livinlavida pod —livinlavidalowcarb podcast, and as well as the Keto talks, right, with Adam McNally?

Jimmy Moore: Adam Nally.

Dr. Justin Marchegiani: Adam Nally.

Jimmy Moore: Yeah. He’s been called McNally. He’s been called worse, so—

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: that’s just from Jimmy Moore. Like Keto Talk with Jimmy Moore & the Doc on Thursdays. And then I have a brand new podcast that started with Dr. Fung in January called, “Fasting Talk” so that’s also out there, as well, fastingtalk.com

Dr. Justin Marchegiani: Love it, man. Excellent. And last question I asked all my guests here. If you’re stuck on a desert island and you can only bring one supplement with you, what would it be, Jimmy?

Jimmy Moore: Well, I wouldn’t need vitamin D if I’m on a dessert island so—

Dr. Justin Marchegiani: No. You wouldn’t need that.

Jimmy Moore: One supplement— I— I would bring MCT oil.

Dr. Justin Marchegiani: I knew you were gonna say that. That would myself ahead of time.

Jimmy Moore: Hahaha—Or coconut oil, either one—

Dr. Justin Marchegiani: Something to increase uh— ketones naturally. Love it, Jimmy.

Jimmy Moore: Or to be fuelled, you know, coz if you’re—because you’re probably gonna have to fast quite a bit. So if I’m fasting, I want some fat in my body.

Dr. Justin Marchegiani: Totally makes sense. And you’d be a pro at that. I mean 28 days, man. Coz me and you in a dessert island, I think you may have me beaten, man.

Jimmy Moore: Well, I’ve got a little more uh—uh— meat on my body as well. I would survive a little longer.

Dr. Justin Marchegiani: I hear you.

Jimmy Moore: Awesome, Jimmy. Hold on, I’m gonna do it. His name is Jimmy Moore. Thanks Jimmy. I appreciate everything.

Jimmy Moore: His name—is Jimmy Moore.

Dr. Justin Marchegiani: I love it.

Jimmy Moore: Thanks so much for joining us here today on the Justin Marchegiani Show.

Dr. Justin Marchegiani: I love it. And again, thank you for being an inspiration on the podcast. I listen to your shows for a lot inspiration and just kinda how do I captivate the crowd and just be a really good host and kinda like prod for those good questions and that good uh—interactive feedback. So I appreciate that, Jimmy. I think the spontaneity helps and—and when you’re good friends with the person you’re interviewing, that also helps a lot. Uhm— and yeah, behind-the-scenes, I try to mentor a lot of podcasters. People don’t realize that I’m talking to a lot of these people that are coming on new and I’m happy to do that. I’ve done this a very long time and I love every minute of it.

Dr. Justin Marchegiani: Love it, Jimmy. We’ll get you back on as soon as that book comes out.

Jimmy Moore: Thanks, bud.

Dr. Justin Marchegiani: Thanks so much, Jimmy. Take care.







The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting

Cholesterol Clarity: What The HDL Is Wrong With My Numbers? 

The Ketogenic Cookbook: Nutritious Low-Carb, HIgh-Fat Paleo Meals to Heal Your Body

Autoimmune Paleo Cookbook & Action Plan: A Practical Guide to Easing Your Autoimmune Disease Symptoms with Nourishing Food


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.




Natural solutions to combat stress – Podcast #122

Dr. Justin Marchegiani and Evan Brand talk all about stress, its effects on our health and variety of natural ways on how we can beat it. They discuss into detail the parts of the brain and hormones affected when we deal with stress and how these hormones are related to health issues like gut inflammation, ADHD, decreased libido, weight gain, depression and memory problems.Natural solutions to combat stress

Find out some of the sources of stress that we engage in consciously and unconsciously. Learn about the process and cycle of stress, develop awareness and apply some valuable tactics on how to combat stress in our life, which in turn improve our health.

In this episode, topics include:

1:46   Forest Bathing and its benefits

4:48   Cortisol levels and its effects on our body

9:19   Different sources of stress and  ways to deal with it

21:13   How the amygdala and hippocampi reacts to stress

26:09   Different approaches on how to beat stress







Dr. Justin Marchegiani: Hey there, it’s Dr. Dr. Justin Marchegiani here with Evan Brand. Really excited here, we got the video going today. So hopefully, we’ll have the face-to-face connection here for everyone at home. Evan Brand, how are you doing today, man?

Evan Brand: Pretty well. It’s sunny and cold but I’ll take it over cloudy and cold so I can’t complain.

Dr. Justin Marchegiani: Absolutely man, I love it. I know we talked about talking about stress. Speaking of stress, how you are you dealing with stress up there? I know you have winter and you got cold weather up there in Louisville. How is that going?

Evan Brand: I mean it’s not too bad to be honest. I love living here in Kentucky so much that I turned a blind eye. I think I put my rose colored glasses on despite the winter and it was like mid-20°F so cold. But I- actually, I put together a weight bench in the garage yesterday so I’m gonna be beginning some outdoor primal exercise. I joked with my wife I was like “Babe, there’s nowhere to put the weight bench. Let me put it down in our daughter’s room” and she was like, “ No” and she said, “our primal ancestors wouldn’t have needed to work out indoors” and I was like “Fine, I’ll put it outside”. So I’m gonna be getting some, some- I guess we’ll call it cold, cold exposure training and lifting weights at the same time.

Dr. Justin Marchegiani: I love it, I love it. That’s excellent. I can picture your wife using that excuse to send you to the store to run errands. Well normally, normally in the hunter gatherer society, the husband will be out for weeks trying to get food for his family. You should go to the store for at least the next hour or two for us.

Evan Brand: Exactly.

Dr. Justin Marchegiani: That’s smart. Very cool. Well yeah, here in Austin, it’s a great, great weather. It’s 56° on the colder side. I guess a little warmer up in the weekends but we talked about stress here pre-show. One of the big things I’ve been doing and I know you’ve done podcast of this in the past. I think you’re in bulletproof radio talking about this, is forest bathing.

Evan Brand: Yes, absolutely.

Dr. Justin Marchegiani: I found this awesome little nature trail behind my house there in Austin and I have taken my dog, Butter, and my wife and I now we go for a great walk down there and it is awesome. Really enjoying myself. We go for a couple of hours. I got my Fitbit on, I’m racking a couple of 10,000 steps days over there and then it’s great.

Evan Brand: I know, you feel so much better. For me, anytime that I’m stressed it’s usually due to a deficiency of nature. Obviously there are other causes at play which we can talk about some of those causes and effects-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -but you were designed as a human to be outdoors and if you separate yourself from the outdoor environment, you’re gonna have build up of stress. It’s just that simple.

Dr. Justin Marchegiani: Absolutely. And I know the research on forest bathing is pretty, it’s pretty- its quite compelling. Uhm the effects of lowering cortisol, lowering that stress hormone and the cortisol is this hormone that’s really interesting and today’s podcast is gonna be just on stress in general and natural things we can do. We’re gonna try to take a different nuance approach for it. But just getting outside and walking around not just on your street but if you can go on to a wooded trail, it’s actually great. The effects on lowering cortisol, if you just google forest bathing, a lot of really good effects with that. Can you go more into the detail? I know you’ve got more podcast on this topic.

Evan Brand: Yes, so basically a lot of the research is coming out of Japan who came up with the term “shinrin-yoku” and it makes perfect sense.

Dr. Justin Marchegiani: Totally.

Evan Brand: Of course we’re gonna have a reduction in stress compared to the control group in the research where they take salivary cortisol samples of people walking on the side walk walking on urban area. They actually see increase in stress hormone cortisol but adrenaline too and you see decreases in adrenaline not only DC reduction in cortisol but you also see increase in heart rate variability and the higher your HRV score is, the healthier your nervous system is. Meaning you’re more in parasympathetic, less in sympathetic. And for us in the modern world we’re constantly reacting to things that our ancient wiring system wants to put us in sympathetic like a bad email or a bad text message –

Dr. Justin Marchegiani: Yeah.

Evan Brand: – that can put us in fight or flight. We think our survival is at risk but it’s not.

Dr. Justin Marchegiani: Totally.

Evan Brand:  And forest bathing also there’s some cool research if you type in rumination in the forest, you can read that some of the bloodflow to the prefrontal cortex which is the newest part of the brain. The blood flow actually decreases and the more reptilian part of the brain in the back increases the blood flow back there meaning, you’re less likely to start overthinking and beating yourself up and being self-conscious and you know, people are hard on themselves. And I’ve been guilty being hard on myself too and a lot of times it’s just that front part of your brain is overactive and due to the modern world and technology, social media, I mean there’s a lot of bad influence that contribute.

Dr. Justin Marchegiani: And what’s that part of the brain that causes the rumination effect?

Evan Brand: Pre frontal cortex-

Dr. Justin Marchegiani: Okay. The prefrontal cortex, the neocortex, the high functioning part of the brain.

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Yup.

Dr. Justin Marchegiani: Excelllent. And also we know cortisol. Higher cortisol and lower cortisol are both detrimental, right? Higher cortisol is that tire but wire, you keep on going, you’re energized, but maybe you’re more anxious, maybe you have the heart palpitations, maybe you have excessive sweating and body odor. And these are the high cortisol. And again typically people that are higher cortisol, they least have the energy and the propulsion. It’s like the engine’s redlining but it still flying down the street versus, “hey, now the car’s going, it’s pot, pot and pot along”. But now your kinda in that low cortisol statement. Again, high cortisol, what it will do is rip up the gut lining, right. Coz it will rip up the IGA and it’ll tear up the gut lining. High cortisol also tear up muscle. So you start getting skinny fat. So maybe you look skinny but your muscles don’t really have much tone to it or contour. Or you start gaining weight because now you’re ripping up so much protein, you’re actually increasing blood sugar from the protein from the gluconeogenesis happening. So, now your blood sugars going up from the stress response as well. So you have- you can get insulin resistant, you can get sarcopenia, meaning the kind of the flabby muscle. And then you can also tear up the gut lining and tear up other tissues in the body, too. Hair, skin, nail, etc.

Evan Brand: I’m glad you brought up the IGA because I’ve been looking a lot. And I’m sure you have been too on the G.I. map at the bottom. Seeing how the link between people with adrenal issues their gonna have low IGA levels, but their also gonna have more infections, too.

Dr. Justin Marchegiani: 100%.

Evan Brand:  So not only are you tearing apart your tight junctions contributing to leaky gut, which can contribute to autoimmune disease. All stemmed from you being on social media too much, for example, you can also contribute to yeast overgrowth, bacterial overgrowth, SIBO infections because now your bulletproof vest, which is your IGA, your first line of defense, that’s now reduced. And I had a guy last week-

Dr. Justin Marchegiani: Yes.

Evan Brand: He’s in his mid-20s. His IGA level was, was one of the lowest I’ve seen. Like 2, maybe 200 and the scale is, you know, 500 to 2000 at least on the GI map that you and I use.

Dr. Justin Marchegiani: Yes.

Evan Brand: And yet, I’ll see a 75-year-old woman you would suspect would have lower IGA just to distress and aging. And her IGA could be perfect. It could be 700-800. So just because you’re young and overall you, you hit the gym, and you wear cool yoga pants, and all of that- that doesn’t mean you’re any healthier.

Dr. Justin Marchegiani: I totally get it, man. And here’s the thing, too, right- Is you can be making all these great changes to your diet to your lifestyle, and how you perceive stress- Let me just take a side out here, I’m gonna digress for a second. But Dr. Robert Sapolsky, the PhD stress researcher out of Standford, wrote a book I think in the mid-to-late 90s called, “Why zebras don’t get ulcers?” and his basic philosophy was that, a zebra, right- when chased by a lion, they have to run and they basically either live or they die. That’s pretty much it. And you’ll see a liberal, uh zebra that survives a tiger attack, or lion attack. I think it’s lion attack with a whole tank of flesh missing from its back and it’s out there- eating and drinking the water like nothing even happened. So this zebra that is basically close to death, is totally turning the stress response on and off like it’s a light switch. The problem with us is that our stress which keeps on flickering on and off all daylong is we cannot turn it off because that stress becomes a micro-stress. And it’s constantly being turned on we’re driving a conversation with our wife or partner, dealing with kids, poor sleep, you know, politics, this that, friendship drama, finance issues, that’s constantly flickering on and off. It’s like you have a- a light show going on in your house. That’s what kind of stress is happening. Even though you get this zebra, who basically almost died, totally relaxing and in drinking water and eating grass over there by the stream.

Evan Brand: Well, that’s the problem. We got too smart. Because if you look at- you and I- I know people heard the stories of car crash accidents where the adults may die in the crash but the children expect depending on what age they are the real young infant, you know, 2,3,4,5 years old. The kids will survive because they didn’t go into fight or flight. They had no anticipation. They didn’t tense up. They didn’t flex all the muscles and argh, before it- before the crash happens. And so they’re fine and the adults who anticipated it, they set off the fight or flight flexed all the neck muscles, got tight, tense. Boom, they broke their neck. They’re dead. So, I guess what we’re trying to convey in this podcast today is so many people are looking to the food and fitness gurus and they’re frustrated because they’re doing Paleo and it’s, “Oh, I’m doing AIP so well. I do paleo so well, but I’m still not getting results” and it’s like, “well, we could look at your circadian rhythm, I mean, are you using your iPad at night?” “Oh, I’m wearing blue blocking glasses” “Okay but your skin receptors still can pick up light, there’s light receptors on your skin”

Dr. Justin Marchegiani: Right.

Evan Brand: So you’re just bathing in an extremely bright bathroom plucking your eyebrows at 11 PM before you go to bed. This is the other factor.

Dr. Justin Marchegiani: I knew your eyebrows are looking good today.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ha ha

Evan Brand: Thanks.

Dr. Justin Marchegiani: I hundred percent agree with you, by the way. I think that’s a really important point, is that we’re just chronically under all the stress. My biggest thing is this, when dealing with patients is, try not to look at like- It’s so easy get stressed out over the diet and all the things that you have to do now. My goal is always a look at things from a perspective of, what can we exchange, what can we substitute or switch versus what do I have to remove and cut out, right. Because when you going to this cutout mode, “ I had to do this now”,  “Oh my gosh, I’m missing this”. The key is going to an exchange mode coz the exchange mode is kinda like a barter in your brain. It’s like, you want this result, that result is better mood, better energy, better libido, less brain fog. So for that, you’re gonna barter. What you gonna give up, what are you gonna exchange with, you know, uhm- let’s just call it your functional medicine doctor- us, right. What are you gonna exchange to Dr. J and Evan. What are you gonna do based on what they’re telling you to do, based on their experience and results to get to that goal that you want. So it’s kind of we’re having this barter. We’re  having an exchange of what, what habits can be put in your place, substitute in, for what your- what you were doing that’s not getting you the results you want. So, we can look at it as an exchange in a barter and negotiation versus like you have and give up all the stuff. I find patients have a much better mindset and they’re not getting stressed out by their mindset, making all these healthy changes.

Evan Brand: Agreed. The other thing too that’s really helpful if you’re stressing out about all the- minutiae. Coz that’s where the success really comes into me, is dialing in the minutiae. So getting the shower filter, getting the water filter, making sure that the butter is good. All of these minutiae things that tend to overwhelm people- you want to put those things on autopilot. So once that’s programmed on autopilot, for you it’s not a struggle to do AIP anymore. Maybe at first you’re like “Oh, I’m gonna miss this”, “I’m gonna miss that”.  But now it’s on autopilot, so it takes almost zero effort to maintain. And that’s the goal, is to get as much stuff and autopilot as you can that we don’t have to think about diet. You don’t have to think about exercise. And now all you’re focused on, is how my managing stress. So stressful situation comes at me, I know, okay- I’m to be more susceptible to go eat some sugar.  Because I’m stressed, I need a quick glucose to think better. That’s what your body’s gonna tell you to do coz that’s what you’re primed to do. Get a quick burst of glucose so you can think. And then the stress is gone.

Dr. Justin Marchegiani: Totally.

Evan Brand: But if you can catch yourself  and you’re on autopilot, then you could just- maybe you do EFT, may be due a round of EFT. I’m about to make a really bad decision.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m gonna tap this out.

Dr. Justin Marchegiani: All tapping points. Exactly. I think that’s great. I have my push up bar here. So between patients, I’ll be doing some push ups. Also, one of the best things I got- I haven’t told anyone, my patients probably hear it in the background- I’ve a walking treadmill now. So it’s lies underneath my desk and I stand about three quarters and half a day and I’m walking about 10 to 12 miles over 20 to 30,000 steps a day. Last week I walked 75 miles while seeing patients.

Evan Brand: Sheesh.

Dr. Justin Marchegiani: Isn’t that amazing?

Evan Brand: Are you wearing shoes? Or are you going barefoot?

Dr. Justin Marchegiani: I’m actually wearing sandals.

Evan Brand: Cool.

Dr. Justin Marchegiani: I wear sandals. I used to wear shoes, but they were just too loud.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they’re too loud when they hit and I went barefoot and after about 5000 steps I started getting blisters.

Evan Brand: I’m sure.

Dr. Justin Marchegiani:  I feel like this is kind of a good compromise but any of my patients that hear the uh-you know, little me walking in the background,I apologize but I’m giving you 100% of my attention. I can walk and chew gum at the same time. Uhm, but yeah, I’m really pumped because I’m getting 20,000 30,000 steps a day. And that’s actually helping to lower my cortisol.

Evan Brand: That is excellent.

Dr. Justin Marchegiani: It’s keeping the stressed down. And just to kind of reiterate one thing, is you talked about the habits. Like once you have your water filter dialed in, once you have like the sea salt by your water when you fill up, once you have like the stuff in your fridge to make meals, it’s all easy. Coz when I go to the- use the water, the filter’s already there. When I go to grab the cupboard on the fridge, the food’s already there. So I always say preparation is the biggest first step. Once you actually go through the inertia preparing and everything is there, it’s so easy to capitalize it, so easy to focus. It’s like, I’m a big Tom Brady fan, I know, haters are out there, but the Patriots are in Super Bowl this week. I’m really excited about that. And you know, you got to talk about the game time, right. When the game happens, so much of that game is one in the preparation leading up to that game, right. So, so much of the preparation in our health is one leading up to us making decisions every day. We can get ourselves prepared, if we can batch cook, if we can have the water and the minerals in the right place, we can have supplements in a really easy setup place, if we can have a good routine were our gym time is scheduled or we have a little set up at home to work out, like you do outside, that’s gonna let us be successful. But it’s gonna lower that stresses coz it’s gonna put these tasks in the random access memory the RAM versus havin’ a- havin’ a startin’up from the hard drive, so to speak.

Evan Brand: Right. Yeah, instead of having to retrieve and start fresh. I agree. I mean to retrieve and start fresh. I agree. You know I think what we’re saying in so many words is the lifestyle component to me is the most important aspect.

Dr. Justin Marchegiani: Huge.

Evan Brand: There’s so many sick people that have a great diet and they exercise 2,3,4,5 times a week. Maybe they’re doing hot yoga and Pilates and bar and all of these great things. And they eat at the hippest restaurants and they were the coolest leather boots. But at the end of the day, if you’re a stress case because you’re beating yourself up mentally, because there’s unmanaged emotional stress, or there’s a bad relationship that you’re not gonna cut out, I don’t care how organic your diet is. You’re not gonna be able to out supplement, you’re not gonna be  able to outkill it, you’re not gonna e able to out smoothie it. You’re toast unless you address the lifestyle. So you and I always talk about numbers, it’s tough to say because based on the context, our numbers might shift. But for this conversation, I could say 80% of the issue is lifestyle and 20% is combined diet and fitness. And lifestyle could include your circadian rhythm. So that can include getting bright light exposure-

Dr. Justin Marchegiani: Totally.

Evan Brand: – a bright environment. This could include grounding yourself, this could include swimming, this can include walking with your dog and your wife like you’re doing, this can include you drumming, listening to music, dancing.

Dr. Justin Marchegiani: Yup.

Evan Brand: I told you, I went to my grandparents house and played cards- huge stress relief. I mean that it’s so fun.

Dr. Justin Marchegiani: Yeah, absolutely.

Evan Brand: I mean it’s so basic but yet, the exchange that you’re making in a small lifestyle investment can be far more than a simple diet tweak or beating yourself up because you had an extra piece of chocolate. I think honestly, the biggest battle that people face is themselves.

Dr. Justin Marchegiani: Yup, I agree. It’s self-

Evan Brand: It’s self-inflicted wounds whether it’s physical because they’re under moving or over moving, or emotional. They’re beating themselves up for no good reason. They’re guilty about something because everywhere you go, there’s an article about how bad this is for you or how bad this is for you. There is no deficiency of information that anybody listening to this show has. Its not the deficiency of information. It’s preventing people from getting what they want. To me, it’s dialing in what, what does it take for you to be happy, what roadblocks are in your way there preventing you-

Dr. Justin Marchegiani: Yeah.

Evan Brand:- from making the action steps you need to make.

Dr. Justin Marchegiani: I agree.

Evan Brand: If you got a constant battle going on with a spouse but yet, you’re trying to kick the sugar habit at the same time, I can’t tell you that you’re going to succeed by just trying to go cold turkey on sugar. You’re gonna have to take care the emotional stuff, too. It’s not one or the other, right. It’s not like you can- a perfect diet’s can gonna fix all these other aspects. I guess that’s what I’m saying. But I’m just been very long-winded about it.

Dr. Justin Marchegiani: No. You’re right on point. I always tell people about the patients that we kinda get into care. There’s four phases which most people go through during any difficult skill after trying to undertake or learn. And I, I call being healthy a skill. And also one thing to add on, too. It takes no more effort to get what you want than what it does to get what you don’t want. Meaning you develop habits in your life that are running in the background subconsciously, that are constantly making you sick and unhealthy. Now, we can create new programs and new habits that are running that are getting you to be healthy. So no more effort to get what you want than it does to get what you don’t want- same thing. So the four phases that people go through, typically in their health at this. They’re unconsciously incompetent. They don’t know what they don’t know. They think their grains are healthy. They think saturated fats- bad. They’re drinking their soda. They’re using aspartame and Splenda. They are clueless and in fact, they are thinking that what they’re doing is actually helpful to them even though it’s not. That’s the first step. Now, the second step is they’re consciously incompetent. Now they’re starting to know that they don’t know. Because now they’re starting to get sick, they’re starting to not feel well they’ve gone to the conventional doctor, they’ve said “Hey, you know we can’t help you” or they give him a whole bunch of diagnoses that involve some drugs that don’t fix the underlying issue. The drugs cause more problems, more symptoms. Maybe they keep on going back. Now they’re given antidepressant and a psychiatric referral and they’re like something’s wrong. They’re consciously- they’re like, “ I know something’s wrong, but I don’t know what it is”. Now that’s the point phase 2 with a reach out to someone like us, right. Now phase 3 is kinda where we intervene. This is the hard part going from phase 2 to phase 3 is the hardest. That’s where they are consciously competent. Dr. Jay and Evan have educated the patient. they know the kind of water. They know the minerals. They know the food. But it’s hard and it’s tough. And when they mess up, they beat themselves up. And they don’t quite know what the best exchanges are. They don’t- they haven’t made it a habit yet. They are not batch cooking. They’re not doing things. They are not prepping the house in a way that makes it easy for them to succeed. So they’re consciously competent but it’s taking all of the RAM in their database.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Me and you, Evan. We operate in unconscious competence. We don’t even have to think to do the habits that we wanna do. We just, “hey, I got my walking treadmill. I walk 10-12 miles a day. I got a gym. I got kettle bells on the corner. I pop out push-ups. You do this. You go out in your gym. You go for walk with your wife. You walk your dog. You’ve all these habits. You are getting vitamin D. You’re hydrating and you’re not even thinking about it. And there’s zero bandwidth being taken up. And that’s where we’re trying to transition our patients to. And I think any patient that’s listening, they have to understand the really big binds in that first one to two months while we get you from consciously competent to unconsciously competent, it’s autopilot.

Evan Brand: Yup. That was well said. That was excellent. I had a thought, too. And then I lost it. It was about how the lifestyle component is brought up. People say manage stress but they don’t know how to manage stress. So let me out one piece assigned to this.

Dr. Justin Marchegiani: Yes.

Evan Brand: Because rational brains are like-okay, you guys are getting into airy fairy land. What is this actually doing to me?

Evan Brand: So you have this –

Dr. Justin Marchegiani: Yes.

Evan Brand: – part of the brain called the amygdala.

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

Evan Brand: And the amygdala is your- I call it your Rolodex, if you will. It kind of cycles through all of these thoughts, all of these things that come into the brain. And it determines whether it should trigger a fight or flight reaction, or is everything okay and we’re gonna press the green button instead. And with chronic stress- so if you are beating yourself up, You’re in this transition phase, you’re trying to remove bad habits, integrate new habits and your cell phone goes off. “Ding” that notification sound. Here you are trying to have a relaxing lunch, “Ding”, the cell phone goes off . Now you gotta go look at it. “Oh my God, it’s a text message from so-and-so”.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is the last thing you wanted to read. The amygdala, that part of the brain, is gonna go, “poof”, red button fight or flight. And the more that that red button gets hit, that becomes a hair- hair trigger. Just like a really sensitive firearm, that trigger is so sensitive you better be careful unless you’re ready to use it, don’t even get close. Because, “ding”, that notification goes off again, “poof”, red button gets hit. Fight or flight system goes, stomach acid becomes a luxury.

Dr. Justin Marchegiani: Yup.

Evan Brand: So there goes good digestion out the window. Blood flow’s now shunted away from the central part of the body and blood flow is basically going to design- be, be working to get you to run.

Dr. Justin Marchegiani: That’s it.

Evan Brand: And our goal is, you don’t want to press that red button. Leave that red button alone. Put a glass case over it. So it’s a lot more difficult to hit that red button. And this takes practice. You and I talk about this. There’s things that can still stress us out and still get to us but the goal is, with the combination of bringing in this functional medicine approach. So this is where the adapted genic herbs come in.

Dr. Justin Marchegiani: Yup.

Evan Brand: So like Rhodiola. You can look at a research study Rhodiola,  200 mg was used in about 1200 patients. And after just three days, it was- I believe it was above 90% of all of these patients experienced “a massive reduction in life stress”. So in this case, the adapted gene could be putting this glass case over this red button in the amygdala so no longer is as fight or flight system immediately, “ump” We’re not gonna hit the red button anymore. We’re building up the resilience so you can be a warrior. So next time that text message comes in, you can- maybe you shouldn’t have your phone by your table on the first place, but that’s fine. Let’s say you have it there, now you look at that bad text message and you can process it first. So instead of immediately, “ump”,  automatically hitting the red button. You can look at it, “okay not a big deal, I’ll take care of this . I’m gonna finish my meal first because I know Justin told me that if I skip meals, my blood sugars gonna crash coz I have adrenal stress right now. And if I skip a meal, have anxiety. And I’m trying to get off the Xanax that the doctor prescribed.

Dr. Justin Marchegiani: Yes.

Evan Brand:  Because I don’t want to be on it anymore and I want to get rid of this anxiety. So what I’m gonna do is I’m gonna put this phone aside. I’m not gonna hit the red button. I’m gonna put the phone aside, finished chewing my meal, take in my enzymes.

Dr. Justin Marchegiani: There you go.

Evan Brand: I’m gonna press the green button. Everything’s okay. There is not a situation I need to fight or flee from right now.

Dr. Justin Marchegiani: Yup.

Evan Brand: And let’s get back to life. And the more that you can hit the green button with the amygdala, and the less you can hit the red button, overall the better you’re gonna be. Because you are not designed to be in fight or flight 99% of the time like we are in the modern world.

Dr. Justin Marchegiani: 110%. I love it. So let’s just kinda recap. We talked about stress, how it affects our gut lining, how it affects and burns through neurotransmitters that’s why the more stress you are, you burn through dopamine you burn through serotonin and you start getting depressed. You start getting OCD, you start getting ADHD. So all these different things happen. It starts burning up the brain tissue and affects the area called the amygdala in the brain, which is right around the hypo, hypothalamic area. And that affects memory, the hippocampi, too.

Evan Brand: We didn’t even-

Dr. Justin Marchegiani: Yes.

Evan Brand: We didn’t even talk on the hippocampi. So you can- you can look at-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -with MRIs, the hippocampi you have one on each side. It gets marinated in cortisol and it begins to make these memory centers all look like Swiss cheese. So people as they get older, it’s happening younger and younger. But people joke about being forgetful that’s not funny. That’s a sign that something is going on. So, yeah. There’s tissue destruction, there’s the leaky gut aspect. Keep rollin’-

Dr. Justin Marchegiani: Yeah, a 100%. So you’re rippin’ up the hippocampus. With that affects memory and learning. So if you’ve any job like, let’s say me and you, Evan, we’re havin’ a problem solvin’, think all day long, you’re an attorney, you’re a doctor, you’re a nurse, you’re a teacher __, you-you’re a mom having to deal with your, kids you’re homeschooling you’re dealing with activities, you’re multitasking, people are calling. You need that higher brain function to perform at the higher end. Man, I’ve so many patients are reaching out to me, they’re like, I’m just- I’m a shadow of my former self.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right. They have that inner kind of feeling like that is not quite where they used to be. They’ve aged 20 years in the last year too, right. So we’re trying to develop all these tactics to help. So number one: the diet’s in place. Paleo template, autoimmune template, whatever works for you in that realm. Number two: gets some habits that you can do with your family that will help decrease stress. I like the forest bathing whether its just walking outside or doing a little nature hike. Love it. Number three:

Do push-ups or some air squats, or get a desk treadmill that you can walk at while you’re at work or in between whatever you’re doing. Just get a little bit of movement in. One of the biggest things that CEOs do is they exercise to not work with their body, but to help their brain coz they feel exercise helps with their brain and their ability to function and deal with work stress. So the exercise piece is not necessarily an aesthetic thing or physical thing, it’s actually more of a mental, emotional thing. Number four:  Make sure you have the lifestyle habits of clean water, a good sleep, good sleep habits, and hygienes. And your food- your fridge’s stock of really good food. And once you have all that piece left, then we can talk about supplements. Then we can have magnesium for stress. We can add Valerian or L Theanine. We can add our Adaptogens, our Rhodiola, our Ginseng, our Ashwaganda, our Lutarol, our Maca for female hormones, our chaste tree. We can add extra B vitamins, we can add even adrenal glandular and support. We wanted to find out that more based on adrenal test. And then next piece is we dig more into the functional medicine with the gut and the detox and other specific more nuanced nutritional deficiencies. Anything you want to add to that, Evan?

Evan Brand:  Well, I love how you’ve laid out 1,2,3,4,5 like that because the gut infections, although massively important, that’s so much later down the road. You put so many other foundations and placed first. A lot of people that come straight from what is called conventional and want to go straight to detox. Or, “hey, I took this detox tea” or “this detox Paleo  shake” or “I went straight into some gut protocol”. If all that other stuff is not addressed- Yes, it’s very important to remove Candida. This candida problem, definitely is impairing brain fog.

Dr. Justin Marchegiani: Huge.

Evan Brand: If you look back at- If you look back at my organic acid test from a few years ago, I had Candida problems and it perfectly explain why I was mixing up my words.

Dr. Justin Marchegiani: Totally.

Evan Brand: I was putting words in different order. When I had to address that to get the brain better; however, if I just slept better, I noticed 20,30, 40, 50% improvement in brain function there. So yes, it may be Candida, yes it may be the infection, yes it may be the mitochondrial function problems that we’re gonna have to fix, but also could be that you’re staying up until 2 AM and then you’re getting up at 6 or 7. And you say, “well I can just function better on 5 hours of sleep”. Well you probably just running on adrenaline which will give you that temporary heightened sense of cognitive function, but that’s because your body thinks that you’re running from a bear because why else would you be light sleeping tossing and turning all night. There must be a bear around. We’re gonna have to run from that in the morning. So you’re gonna get that burst, but in the long run, your brain function is going to be sacrificed and your memories can be sacrificed, your sex drive is a luxury. So why ovulate, women can lose their period.

Dr. Justin Marchegiani: Totally.

Evan Brand: Why have a sex drive for men if you’re running from a bear? That’s – Let’s do that tomorrow. We gotta-

Dr. Justin Marchegiani: Yeah.

Evan Brand: We gotta live.

Dr. Justin Marchegiani: Exactly. Yeah, 100%. And one of the things I’m gonna put it out there, so everyone can hold me accountable as well. But the biggest thing I find, too- for myself and a lot of people I talked to, is mobile devices, iPads, phones, Facebook stuff late at night.

Evan Brand: It’s not good.

Dr. Justin Marchegiani: Yeah, I mean, I think I like to go on Netflix or Amazon prime or Hulu and I like to wind down. Find a nice show that kinda entertain me, I can laugh, I can enjoy. But I’m finding, and my wife’s it too, is pullin’ out the iPad or the phone, checking this checking that, checking my email, checking a text, checking Facebook, all this thread. And it’s like, my brain just constantly go, go, go, go, go. The thing I’m trying to do now is, I’m putting my phone in airplane mode. I’m having a little moon on my iPhone so, no notifications come up and I’m putting my phone in my room, already plugged in and ready to go so I can go to sleep.

Evan Brand: You know many family members are mad at me because my phone is on airplane mode like 24-7. You’re like one of the only people that I text because I’m so  anti-phone.

Dr. Justin Marchegiani: I feel fortunate.

Evan Brand: Yeah, haha.

Dr. Justin Marchegiani: I’m taking you out of your Zen date now everytime I text you.

Evan Brand: No, you’re not. You’re fine, man. You’re fine. It’s always good to chat with you. But seriously, though. And apparently something happened to my voicemail, where now my voicemail doesn’t work. So you just get this voicemail has not been set up. I’m not even gonna fix it.

Dr. Justin Marchegiani: Oh, man.

Evan Brand:  I’m not even gonna fix it because that’s just one more thing, right. We’re always pulled away and I want to cut all the strings on things that are pulling me away. And checking voicemail is just one more thing. You how it goes, you get  2,3,4,6 voicemails piling up. I can’t do it.

Dr. Justin Marchegiani: I totally agree. And the big thing I’m challenging you and everyone else, else anyone else out there, have you cut off for your phone, right. Whether it’s 8 or 9 or 9:30. Have that cut off, it in airplane mode. Hit the moon or whatever that equivalent is on the android. What’s the equivalent on the android for zero notifications?

Evan Brand: I think it’s do not disturb mode, something like that.

Dr. Justin Marchegiani: Perfect. Do not disturb. Do not disturb mode, moon mode, sleep mode and then put your phone away. Put in your bedroom wherever that charging place it belongs for the rest of the night. And be present with your wife, or your partner, your child  or whatever that night on time is that you guys do special whatever that routine is. Be fully present with that. That’s the thing that I’m trying to do. Also, I’m gonna be on I think- I think a staycation next week. And I think I’m gonna uninstall Facebook for the week.

Evan Brand: Ooh, I’m proud of you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So one other thing that for me has been massive is completely getting rid of Wi-Fi in the house. I completely disabled it. And so now, I’m hardwired. And so for me to use my phone, you may think it’s funny, but I have an ethernet cord that plugs into a u, an ethernet to USBC, adapter.

Dr. Justin Marchegiani: Oh my God.

Evan Brand: And so-

Dr. Justin Marchegiani: Really?

Evan Brand: Yes. So listen- So this is how much work it takes me to get on my phone to use social media. I have to get- I have to disconnect the adapter for my computer, unplug the adapter, plug up the new adapter, ethernet to USBC, then run with the cable wherever I’m going to use the phone. Plug up to the phone in then use the internet access. So for me, putting that many barriers in place, my phone is completely hands-off. If  I’m not on calls, my phone does not exist to me. And that has been so massive for my productivity because you get in the social media loophole. You gotta check this, you gotta reply on this, you gotta upload new data to this, you gotta post an article here, you gotta put the podcast there. It’s too much. So now, actually a guy from the minimalist, I’m not sure that I chatted with him, was an email something, something with the conversation of the minimalist guy- it was Josh, he said that he completely got rid of Internet in his home. Now for us, we can’t do that. That’s not practical. But for him as a writer, he completely got rid of internet access from his home; therefore he was only able to write on like Word document applications and then when he would go to a coffee shop or something. Then he would have the ability to get online and do email and Facebook and blah, blah blah. So for as a writer, I think that totally valid. It wouldn’t work for us, but like I said, I’ve still for many- many, many reasons disabled the Wi-Fi completely. And it’s enabled me to- I have to be grounded in a set location before I’m gonna use the Internet as opposed to me just mindlessly walking around the house checking this, checking that on my phone.

Dr. Justin Marchegiani: Yeah, I agree. I think we’re hitting it two different ways. You know, I just try to put it in airplane mode and- and sleep mode. And then also the big thing is, you should’ve took this first, but either way, Christmas tree timer plugged into my router and modem. And the Christmas tree timer- that Wi-Fi and Wi-Fi is gone at 11 PM.

Evan Brand: I had that-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I had a power strip and a timer. I would- if we were not home, then I would I would use the timer. I would just let- because the fish tank was on the timer, too. But when we were home, I would just “poof” I would turn off the power strip. But for me, there’s a lot of cool, a lot of cool data coming out from Deborah Davis and some of these other-

Dr. Justin Marchegiani Oh, yeah. Yeah.

Evan Brand: EMF Wi-Fi experts that are showing like the different spectrums and babies. And in all of that- in showing that nature basically drops off around the 2000 MHz range. And that’s exactly where 2.4, 2.4 GHz

Dr. Justin Marchegiani: Gigahertz.

Evan Brand: – and router. That’s where they pick up. So basically, they have this natural, nonexistent field in the spectrums.

Dr. Justin Marchegiani: Yup.

Evan Brand: And that’s where Wi-Fi plugs in. So for me, I don’t want to touch that spectrum, especially with the baby around. I feel much better. To me, it’s- we don’t have to prove it’s dangerous. For me, we can’t prove that it’s safe.

Dr. Justin Marchegiani: Right.

Evan Brand: So for me, it’s not a huge deal to just do the hardwired Internet thing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And I chatted with Bing Greenfield, too. And apparently, he did that. He- in previous conversations he told me he was just turning Wi-Fi off at night. And last time I spoke with him,  he said, “nope, I’m doing completely hardwired. So I’m not the only one going- going so old-school. I don’t have dial-up.

Dr. Justin Marchegiani: Yeah, I think it’s good. I think it’s good but if you’re not ready to go that full length which I’m not because the TVs that I use, I have no cable- No cable TV. So my TV’s all Internet-based. And it’s- I don’t have router. I don’t have access to plug-in up there. So we keep it going just for the TVs at least. But if not, you can always put your router on a Christmas tree timer and just- There’s even one that will be like you can change the hours. So Saturday will go longer or Sunday longer, in case you’re up longer in the weekends. And you can adjust it. But I try to make it so that router is off for about eight hours a night. So that way, I can at least sleep without any Wi-Fi nearby.

Evan Brand: Agreed. Yeah, I think that’s- at the end of the day, the sleep time is most important. Some people goes as far as turning the breaker off in the room. I’ve not done that yet. Maybe when I get a new place-

Dr. Justin Marchegiani: Oh, that’s inconvenient.

Evan Brand: Yeah. You can put a kill switch on the wall but we’ll save that conversation for another day.

Dr. Justin Marchegiani: Oh that’s cool, I like that. Awesome. Part two coming up soon. Awesome, Evan. Hey man, great chat. I think we’re on video. This could be a really good one if we get this whole podcast issue fix, we get the video going, man.

Evan Brand: Go check out Justin’s YouTube channel. Type in justinhealth. You’ll see the videos. You’ve got what- twenty- 20,000+ subscribers there that are checking out your content.

Dr. Justin Marchegiani: Yeah. Over 25,000. Really fun, plus you get to see our ugly mugs here, too.

Evan Brand: Oh, yeah. Don’t say that.

Dr. Justin Marchegiani: Of course. All tongue-in-cheek, man. Alright, brother. Good chatting with you. You have an awesome day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.

Dr. Jack Wolfson – The paleo cardiologist – Podcast #121

Dr. Justin Marchegiani welcomes his special guest, Dr. Jack Wolfson, in this interview where they discuss topics related to cardiology practice in the Paleo World. Dr. Jack Wolfson shares his knowledge, views and expertise in successful testing and treatment of his patients following a Paleo approach.

Learn all about cholesterol, including its functions in our bodies as well as the important markers like triglyceride, HDL, APOa’s contributing to cardiovascular events. Gain a better understanding on the tests involved in assessing the above mentioned markers. Learn about statins and other alternative drugs involved in the treatment process as well as valuable information about diet, supplements and lifestyle to help improve heart-related issues.

In this episode, we cover:

5:40   Cholesterol & its function

10:12   HDL, LDL APOa: laboratory tests and ways to improve these levels

18:23   Statin drugs & how our body responds to it

24:30   Markers for inflammation

29:06   B vitamins & its relation to homocysteine & heart disease

30:57   Alternatives to statin drugs







Dr. Justin Marchegiani: Hey there! Here today, we have an awesome podcast with Dr. Jack Wolfson the Paleo cardiologist, Dr. Jack. Welcome to the show.

Dr. Jack Wolfson: It’s a pleasure to be out with you. We had much fun in Paleo effects in 2016 and we’d sure be sitting out there again. And once again it is wonderful to talk to you and I appreciate your message.

Dr. Justin Marchegiani: Awesome. Yes, well – well, also you were the Paleo cardiologist I know. You kind of got into cardiology to the back door. You came into to the conventional medical route. You’re doing a lot of the conventional cardiology procedures and then now you’re kind of in the functional medicine-paleo world. Can you just walk our listeners through how you – how you got there?

Dr. Jack Wolfson: Yeah, sure. I mean – uh, my father was a doctor of Osteopathic medicine. I followed right in his footsteps. He was the head of cardiology in Chicago and I – you know, went through four years of Osteopathic medical school, three years internal medicine, three years cardiology. And I was out here in Arizona for job a couple of doing all the angiograms, pacemakers, all the fun stuff.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: And uh – met my wife. My future wife and she is a doctor of Chiropractic and like she says, a doctor of causation and she taught me how to become a doctor of cause. And I started to change my practice, change my philosophy, get educated, open up my eyes to the reality and uh – it’s just been very successful ever since 2012 opened up my own practice at Paradise Valley. Our website is www.thedrswolfson.com and people schedule all over the world. Uh – with the us on that website and it’s really just been miraculous and reception results, you know, uh – I just can’t say enough. I, I can’t wait and say that I wish I did it earlier. In 2012, so the, the medical sickness paradigm.

Dr. Justin Marchegiani: That’s great. And so when you first met our wife, how was that like? So did you think she was kind of a little quaky at first? Like how long did it you or how long did it take her to kinda get through to you and educate you? What was that like?

Dr. Jack Wolfson: You know, I opened up my eyes pretty quickly to say so. My father who was getting sick in his mid 50’s. I saw –he dies eventually at 63 of a strange neurologic disease. And I talked about this in my book, the Paleo Cardiologist or teaching what kind of happened to my father. And then meeting Dr. Heather, she started telling me it was your father, you know eat the bad food, exposed to environmental toxins, is not getting sleep and the sunshine. All these different things that really just seem so basic. And I just –a light bulb went off in my brain and I said, this is really some interesting stuff and I started to read and I looked at the scientific literature and a lot of these stuff that you and I talked about. Doctor Justin is in the scientific literature. So, you know, it’s looking at it a fresh perspective, changing my practice. And uh – you know, listen, unfortunately most medical doctors don’t listen to this message because they are stuck in the fill on procedure model and they are holding on to the almighty dollar. So they’re not gonna make a change.

Dr. Justin Marchegiani: Totally get that. I’d patient who was seeing a cardiologist and we had the monk kinda like a paleo template type of approach. You know, high quality saturated fats, keeping the carbohydrates on the lower side because they were more insulin resistance so more vegetables may be a little bit lower sugar type of fruit here and there. But this patient went in to see their cardiologist and the cardiologist had recommended the standard American diet. You kinda know that is, lower fat and 10-12 servings of grains etc. etc. and the patient asked the doctor and said, “Hey, what do you think about this type of eating plan? I mean, you know, talk about kind of a lower carbohydrate, kinda paleo approach?” And the cardiologist looked at him and said, “Well you know, what that’s exactly how I eat.” But you know, I’m kinda hamstrung by the American cardiology board and what I can recommend nutritionally going outside of the recommendation. And so I’m just curious on your take. It seems like a lot of conventional medical physicians are really ham struck – hamstrung what their board will allow them to talk about nutritionally.

Dr. Jack Wolfson: Well you know, in reality it is that medical doctors get about zero training nutrition. And this is well-documented even at Harvard Medical School. They get very little nutrition in training. So unfortunately your medical doctors are just like the last place you’re gonna go for nutritional advice. And frankly, look at most of the medical doctors. They are overweight, they are unhealthy, they take drugs themselves. So uh – they’re not the right person to go to. And as far as I’m concerned, uh – you know, listen I’m getting people better I’m telling people, you know uh – uh you know there were nutrition plan and paleo is the way to go. Our ancestors did it for millions of years. And you know, frankly if there’s any doctors that are listening and in medical doctors, you know guidelines or guidelines. But you know, it’s not uh, it’s not the law. You know, a letter in a line that you got to follow.

Dr. Justin Marchegiani: Got it.

Dr. Jack Wolfson: Well, “the guidelines” We can step outside the guidelines a little bit when we’re doing what’s best for our patients.

Dr. Justin Marchegiani: Yeah, even conventional dieticians that are in the hospital. It seems like they really are restricted to that food pyramid type approach. I mean think of the last really good meal if you had at a local hospital, right. I mean, I can’t think of any.

Dr. Jack Wolfson: Well, hospital food is totally embarrassing and I talked about a certain way all the time is that can you imagine, Doctor Justin into a patient’s room. And the patient has diabetes. There are diabetic diets. And what do they have on their plate – they have the stack of pancakes and sugar-free syrup. You know, why made it – It just can’t get any worse with that microwaved artificial food, you know – that they’re serving. The hospital’s the sickest place in the world. I’d tell anyone who I know who’s going in the hospital. And fortunately, we uh – you know, keep a lot of people from going to the hospital. They do windup there, they do need some form of surgery. Uh – you know, bring your own food, have a local one bring in your food, get a nice, uh – you know, you know high quality protein powder. Bring your green strings and do everything you can not to eat the hospital food.

Dr. Justin Marchegiani: Absolutely. I 100% agree. So kinda switching gears a little bit to cholesterol coz you know, you’re a cardiologist. That’s the buzzword. Everyone’s gonna be looking for that type of a topic discussed here. How important is cholesterol to you when looking at someone’s health. Like – like, where’s the cut off where it matters and where doesn’t it matter?

Dr. Jack Wolfson: Well, you know at first I’d educate people and tell them the importance of cholesterol – that every cell in the body is cholesterol. The cell membrane which is that protective fence around the cell that lets things in the cell that belongs.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: And keep things out that don’t belong. It’s a large part of the cell membrane and how hormones and other vitamins and minerals interact with the inside cell. We teach people that Vitamin D comes from cholesterol. And digestion as far as bile acids and bile salts come from cholesterol. Cholesterol makes up all of our sex hormones and cortisol and aldosterone.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: We teach them the importance of cholesterol. But then we – uh, you know, you know, we start diving in deeper into the numbers. And I talk about this extensively of course in the book. And you know, total cholesterol things like that. I mean listen – you know, when your total cholesterol is super high, let’s say numbers of like – you know, 300, 400.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: That’s definitely their problem. There’s no there’s no doubt about it. But anything below 300, we certainly want to look at the breakdowns for the particle, particle numbers, particle sizes. Same thing with the HDL, that APL will APL ratio is uh – the number one risk that factor we know when it comes to lipids. So let’s go beyond the 1970s testing and get the uh – you know, state-of-the-art 2017 and beyond test. That’s what matters.

Dr. Justin Marchegiani: Okay, got it. So let’s kinda run through some hypothetical markers here. So my clinic – one of the big things we’ll look at is a big fan of the triglyceride to HDL ratio. If we see the trig’s go too high that could, could be a big sign of excess carbohydrate insulin resistance. Any feedback on HDL to trig’s ratio?

Dr. Jack Wolfson: You know – I uh, think you know if you are gonna use a 1970s panel in yeah –

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: I think the panel that you’re talking about is very important as well. I think that gives us a good surrogate as far as there’s cardiac risk. If you know, you’re producing too many triggers, like you said from – uh, too much carbs, too much sugar, insulin resistance. I mean that’s clearly in every study linked to cardiovascular events, cancer, on and on. Uh – and that low HDL, you know it’s important. When you look at HDL, it’s nice to break it down into APOa1. APOa1 is a protein that is on the surface of the LPL. And that really has to do with the HDL functionality because – uh, clearly we know from studies, where you raise HDL certainly with pharmaceuticals, estrogen for example, didn’t change outcomes. In fact it made outcomes worse. So raising HDL as far as a number is not necessarily a good thing. We wanna raise the APOa1s which is a sign that we are improving HDL functionality because HDL functionality is really the key because HDL is responsible for reverse cholesterol transport.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: Where you’re pulling – pulling basically going cholesterol from plaque and recycling of that to the liver. That’s what it’s really about.

Dr. Justin Marchegiani: Great. So when you’re talking about increasing the APOa1s that’s what you said. That’s primarily gonna be done with what healthy saturated fats like grass-fed meat, coconut oil and even fish oil. Is that the best way to improve those levels?

Dr. Jack Wolfson: Well, uh – yeah, I think that sunshine, physical activity –

Dr. Justin Marchegiani: I got it.

Dr. Jack Wolfson: Yeah I mean the whole white cell that we talk about.

Dr. Justin Marchegiani: Got it.

Dr. Jack Wolfson: Then, you know one thing that’s super big right now is getting a lot of people to use a lot of spices.

Dr. Justin Marchegiani: Uh-huh.

Dr. Jack Wolfson: Because even the best paleo eaters – you know, maybe they’re, they’re eating their grass-fed brown beef. And they’re eating their – you know, wild sea food. I mean they’re doing a lot of good things there that we – uh, you know as thousand paleo. But two things I think they’re missing – They’re missing number one, the organs. Uh –

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: Liver, kidney, thyroid, thymus, adrenal that our ancestors ate as their first choice. They weren’t reaching for filet. Uh – and number is two is spices. And if you look at spices medical literature map, I’m uh – putting together a blog post on this. Spices are little natural pharmaceuticals and in fact in a pharmaceutical industry no doubt came from the spice in the plant industry.

Dr. Justin Marchegiani: Totally.

Dr. Jack Wolfson: And a lot of these – a lot of these, uh – you know spices are proven to increase APOa1. They’re proven to, to increase reverse cholesterol transport. And uh – yeah, it’s really exciting and they of course do wonders some other cardiovascular factors including LDL’s and operating LDL receptors, on the liver. So, uh – yeah, add those early and often.

Dr. Justin Marchegiani: So we have the APOa1, you said. And the APOa2 is the, the kind of the negative marker. Is that correct?

Dr. Jack Wolfson: Yeah. I mean it’s uh – you know the APOa’s in certain most literatures right now is on the APOa1 and that’s clearly gonna – you know, demonstrate the best part functionality of that HDL particle.

Dr. Justin Marchegiani: Great. And the things that are gonna make the APOa2 or the negative APO’s uhmm go down the wrong direction are gonna be what – what trans fat, extra refined carbohydrates, insulin resistance, inflammatory foods, gluten. Those kind of things?

Dr. Jack Wolfson: Uh – you know, I think you’re right. All the bad stuff that we all talk about. Uh – clearly is associated with – you talked about it before, the – you know, omega-3. Uh – you know it kills me that so many people are following this vegan plan of – of you know, the China study.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: And the fire – firemen who wrote a book on- on nutrition and all.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: With all due respect, to firemen.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: In any case, uh – you know, I mean uh every study shows that fish eaters eat the longest the longest. And you’re – you’re, it’s so clear on the benefits of omega-3 when it comes to lipids, when it comes to inflammation, when comes to insulin resistance. You can’t get omega-3 from sucking down on walnut oil. You have to eat fish – plain and simple. You eat shellfish. Avoid the large fish coz unfortunately they are high in heavy metals. So, when we talk about fish, we talking about salmon, sardines.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: anchiove and those smaller fish. And I’ve got no problem with seafood. I test people’s heavy metals. Uh, when you’re getting high quality of shellfish, I think you’re in good shape. Maybe I wouldn’t overdo it. Uh, but I’ve got no problem with shellfish – one or two times a month. I mean oysters, how more –––– is an oyster? Why can’t a vegan eat an oyster? Why does an oyster have many more feelings than that a cabbage does?

Dr. Justin Marchegiani: Exactly. Yeah, totally. And I’ve seen a lot of patients who are vegan. This is really hard for a lot of people to get their head wrapped around. I’ve seen a lot of patients who are vegan and they actually have elevated cholesterol. And when I educate my patients I tell them, “diet has very little effect on your cholesterol”. If you look at the enzyme that the statin blocks that hemo method glutaric CoA reductase enzyme, the HMG enzyme – one of the biggest things that stimulates that enzyme is insulin. So you have many vegetarians and vegans that are on a  carbohydrate diet. And the extra carbohydrates feed that insulin and that causes more internal production of cholesterol. So I see dietary cholesterol actually is very little impact. I eat about 60 to 70% fat. My cholesterol’s still under 200 and my trig’s are at a one-to-one ratio with HDL probably at 1660. Any comment on that?

Dr. Jack Wolfson: Well, you know, listen – LDL, HDL these are part of the immune system. And when you eat uh – bad foods, or you eat gluten containing foods that are damaging intestinal lining and leading to the leaky gut – well, leaky gut leads to inflammation.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: And it needs system activation. When you activate the immune system, you’re stimulating the production of the repair crew, LDL and HDL. It’s not a surprise that they are elevated. But a lot of times vegan diet can dramatically lower lipids.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: And in most cases, it’s – it’s too low because you know, two things – number one, you’re not giving the body the tools it needs to make cholesterol. Uh, that’s number one. Number two when you’re avoiding fat and you do not need to make the uh – cholesterol to put into the bile, bile acid, bile salts to digest fat. So – you know, once again it’s kinda two-fold. You don’t need to make the cholesterol because you’re not using it in the gut. And you don’t get the tools your body needs and you suffer the long-term effects.

Dr. Justin Marchegiani: I agree and I think it’s the vegans that are more insulin sensitive. Meaning they don’t over produce insulin. Their cells are numbed insulin. Those are the ones whose cholesterol really drops and I – I agree and I see that frequently. Now in my practice, you know – we find that upping the cholesterol, increase in the saturated fats as many studies meta -, analysis many studies their conglomerate together to look for correlation they find that there’s no correlation between saturated fat cholesterol and heart disease. I think the Framingham heart study echo that. What do you think?

Dr. Jack Wolfson: Well you know, yeah – it was definitely thought on Framingham and uh, in 2010 American Journal of Clinical Nutrition –

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: – the biggest nutrition journal. They looked at 350,000 patients and concluded that sat fat has nothing to do with cardiovascular disease. Uh – uh, I believe it was four years later in 2014 there was another analysis over 5000 patients. So, yeah -the data is very clear set that is not linked cardiovascular disease. Sat fat is great for cooking. Uh, and most importantly, our ancestors have been eating sat fat for, you know, a million of years. And animals eat sat fat. Uh, breast milk – the healthiest food in the planet for a newborn baby up until the age of 3-4 years of age. Uh, this – this breast milk is loaded of sat fat. So I think that pretty much ends that debate.

Dr. Justin Marchegiani: Yeah, I totally agree. You kinda talked about the HDL and LDL. You mentioned it earlier. I just emphasize it for the listeners. People are out there always talking about good cholesterol, bad cholesterol. One of the things I echoed my patients is cholesterol, like LDL or HDL or good or bad, those are just the bosses. The LDL is basically the boss the takes cholesterol from the liver out to the – the peripheral tissues to help repair and fix whatever’s going on. Cholesterol is a powerful antioxidant and the HDL is the bus back home it’s the bus back home from the peripheral tissue back to the liver to recycle that cholesterol. Can you echo or comment a little bit more on that topic?

Dr. Jack Wolfson: Yeah. You know, I agree with everything you said a 100%. The LDL vilified by the pharmaceutical industry and therefore, in they push on the medical doctors and medical doctors told that same jargon. Why would the body make LDL if it didn’t have some role and some benefit? Uh – you know LDL’s the bad cholesterol in our body makes it. Does our body’s like uh, you know program to kill us and cause heart attacks? Why the animals make LDL particles? Why the animals make HDL particles? There’s a reason for all of it. Just as you said, we measure the good and the bad amongst the uh, the LDLs – there is good and bad LDL. There’s good and bad HDLs. And we measure those levels and uh, make recommendations based on that.

Dr. Justin Marchegiani: That’s great. And what kind of particle size test are you doing? I was doing the VAP by Azoteq but they close down recently. So I’ve been looking at the NMR as well as the cardio IQ. And for the listeners, the particle size has to do with basically how big or small the LDL or the HDL are. And I tell my patients big and fluffy particle size A – you want the A on the test. You want the larger, fluffy particle size A. And you wanna avoid the B for bad – the small atherosclerotic dense LDL particles. Can you comment on that a little bit more? And what lab tests are you using for your particle size testing?

Dr. Jack Wolfson: Well I think – Yeah, as you said it, there’s a lot of different companies that are out there. I personally use vibrant by America.

Dr. Justin Marchegiani: Okay.

Dr. Jack Wolfson: For my uh – for my lab testing and they’re doing amazing leaky gut panel. So really excited about that company. And uh – they uh, you know, started up a few years ago getting really, really high quality results from them. I’ve been using true health diagnostics like what you say, Cleveland, Heartland, Boston. There’s a lot of different companies uh, that are doing advanced lipid analysis. I think the important thing is to get the – the testing done and get that information.

Dr. Justin Marchegiani: Got it. So you’re looking for more of the – more of the A’s less of the B’s, generally speaking?

Dr. Jack Wolfson: Well, I mean like I said the, uh – the, in norm risk factor that we know is that APLB to APLA ratio. And you get the ration down below 0.6, uh – your urine are pretty darn good place regarding your lipids.

Dr. Justin Marchegiani: Can you go more into that ratio one more time? I just wanna make sure I get that.

Dr. Jack Wolfson: Yeah. Sure, thanks. So, APLB would obviously be a measure of LDL, VLDL, IDLs. All of the, lipid, you know – factors. Uh, so it gives you much more information than just LDL particles. And in ourselves, it’s kinda all those non-HDL’s. And then APLA would be a measure of HDL and really the HDL functionality, so uh – that’s what we’re using and uh – yeah, then I think obviously everything that where we work so many case studies where we’re making big differences.

Dr. Justin Marchegiani: Got it. APLA’s, the HDL’s, the APLB’s everything else essentially. 

Dr. Jack Wolfson: Yes

Dr. Justin Marchegiani: Okay. Great. So, looking at you being a cardiologist, maybe you get people with hypercholesterolemia coming in. When do you prescribe a statin? Is there a time where you – are you able to avoid prescribing it most of the time? How does that look?

Dr. Jack Wolfson: Uh, yeah. You know, the uhm – uh, you know to be candid about my practice, I mean unlike people that are on statins in my practice to the people that, that insist on it. So uh, you know, and some and those typically gonna be the people that have had a cardiovascular event already, that had a heart attack, that had bypass surgery, or somebody familial hyperlipidemia. And so many people of course come in and say, “Oh, I’ve got a family history.” Well, uh – you know, 50% of the population in the United States has cardiovascular disease. We all have bad family histories. Uh, so we can’t blame it in the family but there is a small, small subset of people that you have total cholesterols above 300 and LDL particles that are sky high that no matter what you do – once their APLB’s are high, their LDL particles are high, their LDL’s are high. Everything’s high in them. And those people requires significant intervention. I try everything – nutrition, I try supplements. Uh, I wouldn’t go through a whole litany of supplements that I think are beneficial. Sometimes at the end of the day, we reach for a low-dose statin. Uh, uhm – but once again I – uh, it’s not very frequent even in my practice.

Dr. Justin Marchegiani: Got it. And with statins is there one that you’re finding has less side effects? Are you doing like a Zocor or Zetia-Lipitor. What works the best? What’s like the typical low-dose you like?

Dr. Jack Wolfson: Yeah, typically I will reach for something like Rosuvastatin, which is a – the brand name is Crestor. I can get away with pretty low-dose on that. I think we can dose it to three times a week and getting success. But even amongst those genetic hyperlipidemia patients, the statins don’t have that much effect against them, either. So the new kid on the block is the PCS canine inhibitors that uh, uh – you know Repatha injectable. Uh, uh – things that help to increase the LDL receptors on the liver to clear LDL particles out of circulation. So I have not prescribed that yet. I have a few patients that are on that from another cardiologist. But I’ve not written that script yet. Uh, this is where I think – you know more on the spices actually help –

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: – increase LDL receptors on the liver and then my favorite supplement when it comes to – uh, lipids and blood sugar and so many other things is Faverin, PER, PCR, IME. The literature on that is – it’s extensive and prolific. And so many different things that’s really exciting product. That one on the way is it works. Uh increases MPK enzyme, therefore progrades degradation of the LDL receptors. In the liver, work similar to the PCS Canines, not as – as dramatic effect. But without the side effects with other benefits and uh, it’s natural.

Dr. Justin Marchegiani: Got it. So I think I’ve seen one of your cardiovascular supports, right. You put uh, the berberines in there as well?

Dr. Jack Wolfson: Yeah. Uh, right now we use a straight protocol BERBE – uh, B-E-R-B-E and you know – uh, anticancer. It lowers blood sugar, excellent for lipids, improves BPH symptoms. Uh, uh the polycystic ovarian –

Justin tin Marchagiani: Yeah.

Dr. Jack Wolfson: You know – syndrome. It’s like there’s a role in that for everything. So it’s a pretty exciting product.

Dr. Justin Marchegiani: It also helps with SIBO, too – small intestinal bacterial overgrowth.

Dr. Jack Wolfson: Uh, I mean – and that’s where all the literature kinda started off as far as what it did for us in antibacterial, uh and to improve bowel health. In fact I found a study recently that came out about how Berberine improves leaky gut. Uh how it’s uh – intestinal permeability is decreased when you put people in Berberine. So it’s uh – it’s really a, uh kinda a Swiss Army knife of supplements.

Dr. Justin Marchegiani: Totally agree. Now, I wanna pivot one second. I heard you mentioned leaky gut and know you mentioned a test that you run earlier – test for leaky gut. How are they assessing leaky gut? Is it based off of zonulin or occludin? What’s the, what are the markers?

Dr. Jack Wolfson: Yes. So in particular the uh, Vibrant America does the test called Wheat Zoomer. And the Wheat Zoomer looks for leaky gut. It looks at zonulin. It looks at antizonulin or antibodies again zonulin, antibodies against actin. Uh, and antibodies against lipopolysaccharides as active components of bacteria that you know, some of them get into the body but it shouldn’t be a lot. So they’re not looking at occludin. Uhm – uh I think Cyrex lab looks at occludin.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: Uh – and uh, it’s, it’s kinda like you know, Mercedes-Benz or you know, BMW. They’re both high end products. I happen to like the panel from Vibrant. The quality of the company that I know Vibrant is – I have nothing against Cyrex. I mean they’re both – both good options but you, you know, Dr. Justin, this is really kind what you consider kinda be the holy Grail of how things happen, right. And now – you know, we can really put it all together where you have the intestinal damage known as leaky gut. Bad things get in the immune system.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: Inflammation, oxidative stress and you know the immune system comes in and just consent with the machine-gun. And that machine-gun damage kills off bad bacteria and other particles but it also damages the rest the body. So, you know, the conventional cardiologist – this doesn’t get it. The conventional cardiologist thinks that coronary disease is, is a lack of statin drugs. Coronary disease is a cholesterol issue. Uh and they’re just totally missing the boat.

Dr. Justin Marchegiani: And we know so much of the cholesterol can be responding to inflammation. The cholesterol is kinda this natural band-aid. So if we have a lot of inflammation in the gut that could affect cholesterol level systemically.

Dr. Jack Wolfson: Oh, most uh – most certainly. Cholesterol’s part of speckle on the wall. You know, there’s damage on the wall and uh – you know, you thought a speckle. Cholesterol is part of that speckle. Speckle did not cause the damage.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: It’s coming, you know, the process.

Dr. Justin Marchegiani: Yes, love that. Typically in my clinic, one of the tests, a couple the test we’ll look at – we’ll do all the panels that you just mentioned on the cholesterol. One of the things I have to start working on, uh the APO, uh the APO1-2. I gotta start looking at that more. But we’ll also look at the inflammatory markers. We’ll look at uhm highly sensitive CRP, we’ll look at homocysteine, we’ll look at fibrinogen. What you think about those markers for inflammation or there any other markers that you also like to look at, too?

Dr. Jack Wolfson: Well I think you mentioned a – uh, yeah certainly HSCRP. The most data is on HSCRP.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: And there – there’s phospholipase 2.

Dr. Justin Marchegiani: Uh-huh.

Dr. Jack Wolfson: Which is PLA2. Uhm, real quick – If there’s, that’s thinking to get a CT, coronary in CT or coronary in calcification scan, I’m totally against it. I don’t know what your opinion is, Doctor Justin. But uh, I’m anti-radiation. You know causes heart disease, radiation causes cancer. Let’s just assume most people have coronary calcification because they do. So therefore let’s just use these lab tests. Let’s use maybe CIMT, endopath markers of vascular reactivity to – to define health. Uhm – but uh, and the other inflammatory marker is – is the oxidized LDL.

Dr. Justin Marchegiani: Yup.

Dr. Jack Wolfson: That’s the – the pinnacle of the testosteroid. There are, you know you’re measuring damage to LDL particles that are eventually targeted for uh – uptake by the immune system. And those oxidized LDL will go right into the vessel wall. They’re taken up by the system. The monocytes would become macrophages. And then –

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: Foam cells –

Dr. Justin Marchegiani: Foam cells, yeah.

Dr. Jack Wolfson: The foam cells rupture and people die. So that’s where that goes.

Dr. Justin Marchegiani: And what’s that test, the oxidized, you just call it oxides LDL test?

Dr. Jack Wolfson: That’s an OX LDL.

Dr. Justin Marchegiani: That’s it. Wonderful. Very good. I don’t really have an opinion on the, uhm calcification test. Glad that you brought that up. I know Dr. Davis – I think he’s a cardiologist. Well I think he’s – he has spoken highly of it in the past but you’re not liking it more just from the radiation exposure side of it?

Dr. Jack Wolfson: Right Yeah. Yeah, I feel Davis – uhm, uh you know up, up in Minnesota.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: He became the uh, famous cardiologist because of a test he did called, track your plaque.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: And that was his – he keep on doing CT scans. The more you keep doing CT scans, the more you’re gonna create coronary artery disease.

Dr. Justin Marchegiani: Totally.

Dr. Jack Wolfson: Radi – radiation causes cancer. Radiation cause heart disease. We know from young guys who had non-Hodgkin – uh, I’m sorry, the Hodgkin lymphoma. They had uh – uh, radiation to their chest. They all had severe coronary disease. They all have rate valvular damage from it. Uh – So it’s just a test we don’t, we don’t need it. Uh- frankly I think that’s a big reason why insurance doesn’t cover it either. Uh- because it’s just not useful beneficial test. If you know, you’re a 50 year old male, let’s just assume you’ve got coronary disease, now let’s do something about it. So, uh –you know once again, I’m totally anti-CT scan. Uh, you know radiation is factor that killed my father. Working as a cardiologist for all those years.

Dr. Justin Marchegiani: Right.

Dr. Jack Wolfson: So, uh- yeah. Let’s – let’s avoid it.

Dr. Justin Marchegiani: Totally. So I’m gonna go through a quick rapid fire questions. HSCRP – you like that below 1, below .5? What’s your range in that?

Dr. Jack Wolfson: I, uhm- I think the lower the better on an HSCRP, no doubt about it. I mean, HSCRP not only is it a marker, but it is a stimulator for- for dysfunction in the body. When you infuse lab rat –

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: – with uh, high sensitivity CRP, they all came down with hypertension and this filial dysfunction. And eventually coronary disease, so it’s not just a marker. It’s actually uh- a, a negative once it’s floating around. So you gotta get that lowered.

Dr. Justin Marchegiani: Absolutely. And how about homocysteine, do you like that below 8?

Dr. Jack Wolfson: Certainly. Uh, homocysteine – uh, I think 8 is uh, a nice position. Uh- you know, somewhere between uh, between 6 and 8.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: I think is good. We certainly don’t want it too low because homocysteine has a purpose. Uh, we gotta lower that number down and you know, –––– above the B vitamins.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: But another, uh- secret trick to lower that down for another part of the methylation pathways betaine. Uh and betaine, you get your digestive enzyme.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: If you take Betaine HCL product that tremendously works as well. Sometimes the B vitamins just, uh- you know just don’t get it done. Uh and of course you know, people have genetic snips and whatnot. But, you know, the betaine really helps to uh, lower that down. But you know, more importantly of course is uh- it’s for digestion. And everybody has not enough stomach gas as it is opposed to too much.

Dr. Justin Marchegiani: Totally. And the betaine is the trimethlyglycine, right? Same thing?

Dr. Jack Wolfson: Uh, well –what, uh when uh – trimethlyglycine, uh- is a fantastic methylator. Uh for this – from the betaine, you know-uh in a molecule, uh- in of itself but there in the betaine does contain, you know three methyl groups on there. So there is in similarity uh, but uh- it works, it works really well.

Dr. Justin Marchegiani: Loving the brain candy. Awesome. And I know the whole story behind – maybe our listeners don’t- but the whole, Kilmer McCully story of homocysteine. Basically he was laughed at Harvard. He’s trying to talk about the connection with homocysteine and heart disease. Basically figured out certain B vitamins, in particularly B6, P5P or folate or B12. Ideally, a methylated B-12 help lower that homocysteine. Do you find that taking those types of nutrients – those methylated B vitamins that I just mentioned, is that actually lower homocysteine? And does actually correlate or should I say, is that a direct causation because of that lower homocysteine to less heart disease?

Dr. Jack Wolfson: Why – the thing, uh- you know, the literature unfortunately has not been kind to the B vitamins to lower uh, uh- you know to make to a difference in cardiac endpoints.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: So heart attack, stroke, ––––– So it clearly lowers the number down on- on homocysteine. And uh- I can like postulate that- number one, they’re using inferior supplements. Number two, it’s not the whole program. You have to put it in context of- you know, eating the right foods, living the right lifestyle. Taking McDonald’s eater and trying to lower the homocysteine vitamins, you’re probably not gonna make a big difference. I think it’s all part of the big picture uh, in our holistic practices.

Dr. Justin Marchegiani: And they’re probably working from the inequated theory like, “let’s fortify some milk, orange juice, maybe some toast with some synthetic crappy B vitamins.” Obviously, that’s not gonna fix the underlying issue.

Dr. Jack Wolfson: Uh- I would agree.

Dr. Justin Marchegiani: Okay. So you think, looking at – if we just give the healthy B vitamins that we just talked about, at a higher level but we make the diet changes – you’re saying in your clinical practice, a reduced risk and a reduced outcome of heart disease?

Dr. Jack Wolfson: Uh- I mean, I think so. You know, I don’t have a big- uh, study to point to we’re doing. But I certainly think that you know, once again the edge here: improving the lipids, you’re improving the homocyesteine, you’re improving your omega 3’s, you’re improving the thyroid and blood sugar and all the things that we’re dealing. Uh- yeah, I think uh- it’s making a huge difference.

Dr. Justin Marchegiani: That’s great. And you mention the only people you’re really prescribing statins for. I wanna just make sure I heard you right. People that are already on a pre-existing statin that are coming to see you to manage that. Or you said number two, is people that were hypercholesterolemia. Is that correct?

Dr. Jack Wolfson: Uh, yes. Yeah. Uh, uh – that’s uh, uh correct. I’m not using it too often. Frankly, I use the Berberine, I use the Bergamot, I use Re–––

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: I use binders in the gut. So –

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: You know, uh – organic India. And you know, just really trying’ to- you know increase that fibrin in the diet. And uhm, uh- those are my therapies. But once again, once you address the basics. I mean, just get sunshine. Sunshine converts excess cholesterol back in the vitamin D.

Dr. Justin Marchegiani: Totally.

Dr. Jack Wolfson: And that’s- that’s free, you know. You know the big guys like you and I- a lot of money to do that. I mean, let’s just repair itself.

Dr. Justin Marchegiani: I know, that’s great. Coz I have a couple patients that have the hypercholesterolemia and are you typically diag-diagnosing that off of like PCS canine, the LDR receptor, the FH markers. Is that what you’re looking for that diagnosis?

Dr. Jack Wolfson: Well, I think there’s a lot of different uh- you know, genetics. You know, and I think you label the big ones there as far as why people have hyperlipidemia. Uh- but you know, once again if the uh- total cholesterol uh- that’s in the 35400 range, the LDL particles above 3500. I think that’s a pretty good sign the they’ve got- you know familial hyperlipidemia. You know, but sometimes you see people that are just- just this metabolic syndrome. They’re overweight, hypertensive, they have LDL particle number 2800. Those are not the familial people. Those are the people that- you know just have all the, you know-

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: -all the bad habits that lead to the lipids.

Dr. Justin Marchegiani: Yeah. And I gotta- these patients are actually expecting this interview so I told them I might ask some of these questions for them. But uhm, we talked about some of the natural things we could do. Would you be comfortable- would you want someone to be on the statin even if they’re trying not to be honest at with those conditions, if they’re doing the Berberine, if they’re doing the CoQ10, if they’re doing some, some of the red rice yeast and all the things you mentioned? Or would you still want them to be on a low-dose statin, as well as everything else?

Dr. Jack Wolfson: No. For the most part, I don’t want them on statins.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: I think about myself personally and I wouldn’t want to take a statin in any under circumstance. So I don’t push them on that at all. It’s really kinda patient-driven. Uh- you know, if they, if they say they wanna be on the biggest what they read or whatever then they can-they can stay on it. I’m not gonna totally dissuade them from it. And listen- you know, Dr. Justin, all we can do is give people the facts and say, “hey, listen-when you take a statin drug, your risk of having a cardiovascular event. is reduced from 7% ,for example, you know, down to 5.5%. And if you want that 1.5% benefit, go ahead. But I think in my plan and your plan, we’re gonna get down to close to 0%.” And when you explain that to people, they get it. It’s not just about moving numbers, it’s not about moving numbers at all. It’s about lowering risk of heart attack, stroke and dying. And in any statin study, under any circumstances, the benefit is small.

Dr. Justin Marchegiani: And what is the research say coz you talked about the 1.5% benefit.

What does the research say, though on increasing chance of Alzheimer’s, diabetes and uh, cancer- being on a statin?

Dr. Jack Wolfson: Uh- well, listen now they see increase in diabetes risk. There’s no doubt about that . Uh- you know, cancer risk is kind of equivocal. Uh- and listen, there’s lot of studies telling the benefits of statins and I think you have to look at a lot of those uh- you know with an inquisitive eye and saying who’s paying for the studies, who is doing the studies, what’s the motivation behind it? But you know, all these diseases, whether its heart disease, cancer, dementia, this is not from a-a you know, deficiency of statin drugs. There’s a reason for it. And the natural doctor finds that reason.

Dr. Justin Marchegiani: And I’ve also heard, too that the uh, the NT or the number needed to treat for a statin is what, 99. So that means 99 people have to take that drug for one person to be helped by it. Are you familiar with that?

Dr. Jack Wolfson: Well, you know- you know, most certainly so. And I love number needed to treat.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: And that’s what anybody should ask their doctor regarding heart disease or stroke prevention and certainly cancer prevention, chemotherapy. You know, if I get this chemotherapy, uh- what’s number needed to treat-You know, how many people need to take chemo for one person to benefit? And what is that, is that a three-month benefit? Is it a five-year benefit?

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: Give me-give me numbers. Give me numbers that’s what we encourage- you know, for that. But listen, your statins come in different category. For primary prevention, for example on women, the statin data- uh, you know, number needed to treat, uh as far as uh heart attack reductions- yeah, it’s around a 100-15. Uh- uh, you know for women primary prevention statins do not increase mortality at all. for man, it gets a little bit better. Studies are mixed. Uh- secondary prevention is where statins “shine”. And in that scenario you can uh- uh, make number needed to treat regarding heart attacks. Uh you know, is about 1 in 30 to 40 mortality data maybe 1 to 70 to 80. But then again- hey listen, the pharmaceutical companies are doing the studies. Uh, there is a better way. Uh- you know, in any of these scenarios, you know in 39 out of 40 people don’t get benefit after taking the drug every single day for five years.

Dr. Justin Marchegiani: That’s crazy.

Dr. Jack Wolfson: I think, uh- they can come up with uh- a, with a better plan. Uhm, uh- you know, by the way, real quick- you know, we’ve talked about like B10 to lower uh- uh, homocysteine. I just wanna correct myself uh- you know really quickly. I think about it uh- you know, TMG. TMG, you very astute and correct. It’s another way to do it. I just happen to like using betaine HCl because it’s kind of a 2-in1 thing.

Dr. Justin Marchegiani: Totally.

Dr. Jack Wolfson: So with the homocysteine, while we’re really cranking up digestion.

Dr. Justin Marchegiani: Yup. I totally agree. Most patients I find as you know, when they’re stressed, they uhm. have lower levels of stomach acid. And if we have stomach acid, it’s a two for one, you get better digestion and you get the reduction in some of the homocysteine. I agree.

Dr. Jack Wolfson: Love it.

Dr. Justin Marchegiani: And when you said secondary just a second ago, you meant secondary benefits like the persons already had a heart attack. Now they’re coming in to get treated by- with a statin that that has a little bit more benefit than preventative.

Dr. Jack Wolfson: Correct, correct. Some of the- uh, really- it’s gonna shine on people that had a heart attack. Uh- there will be some better data on- on you know, people that had bypass surgery or angioplasty. For it’s really in those post-heart attack people where there is the evidence of successful. Once again, it’s not about lowering the risk from 7 to 5 1/2 . It’s about lowering the from 7 to 0.

Dr. Justin Marchegiani: Exactly.

Dr. Jack Wolfson: And medical doctors cannot offer that. And Dr. Justin, you and I can.

Dr. Justin Marchegiani: Yes.

Dr. Jack Wolfson: -which is totally cool.

Dr. Justin Marchegiani: Yes. Exactly. And in your practice, are you putting those secondary people on statins or you still doing all the natural stuff that you already doing all the natural stuff that you reiterated earlier?

Dr. Jack Wolfson: Yeah. I mean, listen- if you wanna go on statins, go see somebody else.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: You don’t have to pay me as a private- you know, private physician. Go see your bill pushy doctor and they’ll be happy to give it to you along with their three-minute office visit

Dr. Justin Marchegiani: Yeah, right. And I know the statins, too, they block the HMG CoA reductase pathway and if we look at the metabolites from that, you have the metabolic acid that comes after it which is the precursor to CoQ10. So does that mean when you’re- when you’re managing patients that are already on statins, like you mentioned, are you making sure you give extra CoQ10 as well?

Dr. Jack Wolfson: Yes. For them and uh- you know, I measure CoQ10 levels and we see where people are at. And typically doesn’t take much to where we need to be. But you’re right. I mean, the downstream ramifications of, of uh the HMG CoA reductase inhibitors and blocking that enzyme are just catastrophic. What it does do a DNA and RNA replication. As you mentioned, CoQ10, uh- the squalene which has roles in our body.

Dr. Justin Marchegiani: Yup.

Dr. Jack Wolfson: And uh, uh dolichol.

Dr. Justin Marchegiani: Ughh.

Dr. Jack Wolfson: Dolichol is another cholesterol derivative. And dolichol, interestingly enough, is found in the substantia nigra in the uh

Dr. Justin Marchegiani: Midbrain.

Dr. Jack Wolfson: -midbrain and the neuromelanin cells.

Dr. Justin Marchegiani: Yup.

Dr. Jack Wolfson: And wouldn’t you know that’s uhm- that Parkinson’s, my father died of a Parkinson’s-like illness called progressive super nuclear policy. And my father is a cardiologist . He took Lipitor.

Dr. Justin Marchegiani: Ughh.

Dr. Jack Wolfson: So this is very, very important to me. And yeah, when you see that- you know, dolichol’s in that area, now you’re not gonna make dolichol because the drug- uh, we have a total linear connection on how it works. And it’s uh- it’s scary and sad and we need to stop it.

Dr. Justin Marchegiani: Dropping some truth bombs here. I love it. Very, very cool. Now, also one more question to you before we wrap up. Looking at CoQ10 we just talked about- Do you like the reduced or the oxidized form? The the ubiquinone or the ubiquinol? What does the research say?

Dr. Jack Wolfson: I personally use Ubiquinol. There’s good data, of course. I mean I use the Ubiquinol. But frankly, all the original data regarding CoQ10 was on ubiquinol.

Dr. Justin Marchegiani: Oh, yeah.

Dr. Jack Wolfson: So, so I think both serve a purpose. I think if you test levels, you can do that. But I think pretty much most people are going towards Ubiquinol version. Uhm, but you know, once- I think you do one that you’re taking. I think it’s fine,uh- and go from there.

Dr. Justin Marchegiani: And the Ubiquinol that’s the reduced version, right. That has the extra electron to it?

Dr. Jack Wolfson: Correct.

Dr. Justin Marchegiani: Okay.

Dr. Jack Wolfson: Correct and you know, it’s more of the deactivated form, but the body shifts pretty easily. You know, to and from, both of those and uh- uh, you know I think when you’re healthy, you’re gonna covert one to the other fairly easily.

Dr. Justin Marchegiani: Love it. Well, is there any other really important info that you wanted to talk about, but you haven’t get the chance to bring it to the surface?

Dr. Jack Wolfson: Uh, well I think you know- once again, our paleo ancestors ate- uh, you know ate- our pale ancestors ate paleo food, that’s number one. Number two, our paleo ancestors went to sleep with the sundown and woke with the sunrise.

Dr. Justin Marchegiani: Yeah.

Dr. Jack Wolfson: Let’s not forget about. Our pale ancestors were not in the artificial light, our paleo ancestors were in the sun all day long and they were naked. So, these things are free. Appropriate sleep is free, appropriate sunshine is free. Uhm-uh, you know the food is- is easily affordable. Get rid of the Starbucks and all the garbage. Uh, so – I think that’s about it, man.

Dr. Justin Marchegiani: I think that’s great. And last question for you. If you are on a desert island and you only could bring one supplement with you? One herb, one supplement, one nutrient, what would it be?

Dr. Jack Wolfson: Uhm- uh I would say, it’s gotta be probiotics.

Dr. Justin Marchegiani: Okay. Probiotics. I love it. Very good. And I just want to give you props, Dr. Wilson. You are a clinician as well as a researcher. You’re in the trenches. There are a lot of people that are out there that are postulating in and you know, coming up with their theories on what’s best based on the research but you’re in the trenches doing it yourself. So I really appreciate that.

Dr. Jack Wolfson: Uh, you got it, Dr. Justin. It’s an absolute pleasure to talk to you. I’ll be happy to do it again anytime.

Dr. Justin Marchegiani: Absolutely. And again, that’s doctors- thedoctorswilson with a D-R We’ll put the link below in case you guys miss it. So you can click to get access and also check out Dr. Wilson’s book the, The Paleo Cardiologist and he also has been getting a chance to do what you want for part two over at vaccinesreveal.com for Dr. Wolfson’s uh- awesome info on vaccinations.

Dr. Jack Wolfson: Sounds, uh- sounds fantastic. I appreciate it and uh- yeah, here’s to health.

Dr. Justin Marchegiani: Thanks a lot, Doc. I appreciate it. Bye.




Dr. Andrew Hill – Improving brain function, baldness and head trauma – Podcast #118

Dr. Justin Marchegiani has a special guest back again today, Dr. Andrew Hill. For this podcast episode, they talk about brain function, baldness and head trauma.

Discover the different medications or drugs that are used for ADHD, anxiety and sleep issues and how they will affect people in the short or long term. Find out how mindfulness and meditation can help with brain function and training. Get some information on insulin and the history of gluten as well as a brief history of genetics and evolution. Learn what should be done in cases of head trauma or brain injury when you listen to this episode.

In this episode, topics include:

01:40   Biofeedback/Neurofeedback

14:38   Medications and Smart drugs

40:16   Insulin

48:22   Gluten

56:48   Baldness

62:35   Brain injury/trauma







Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin Marchegiani. We got Dr. Andrew Hill on the show today. Dr. Andrew is a grad over the UMass Amherst School. I went to school as well so we’re fellow alums, also a PhD grad over at UCLA. Dr. Hill, it’s been a while, but glad to have you back on the show.

Dr. Andrew Hill: Yeah, thanks for having me, Justin. I’m guessing a lot has happened for Beyond Wellness, as well as on my end of things, the past couple of—few months.

Dr. Justin Marchegiani:  Very cool! I’m excited. What’s new on your neck of the woods?

Dr. Andrew Hill:  We are—and we, I mean, a new company I’ve been working on called Peak Brain, we’ve been opening up brain training centers, neurofeedback centers. We’re also doing a lot of free mindfulness instruction, you know, I’m sure we talked about this last time.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Just to review a lot of different aspects on you know, call it biohacking, call it therapy, call it exercise. There’s lots of different avenues into this space and for many people, different choices might make more sense towards you know, free things–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Like mindfulness and meditation where you’re always carry around the equipment. Once you know how to do it, you can always practice. So I have this focus, at this point of bringing tools to accessible, or bringing the accessibility to people. So the idea is to provide a lot of you know, open mindfulness instruction and these training centers as well as the higher tech tool that people can sort of you know, buy services and getting a lot of hands on training and qEEG and neurofeedback. So I’m taking it more to the—to the fitness and out of the clinical level as much as possible these days.

Dr. Justin Marchegiani:  And you’re doing more qEEG or neurofeedback work?

Dr. Andrew Hill:  Yeah, the—most of the neurofeedback we do is EEG-based–

Dr. Justin Marchegiani:  Okay, got it.

Dr. Andrew Hill:  Neurofeedback or biofeedback. We also do HEG, which is another form of neurofeedback. We do a little bit of HRV, which is biofeedback referral. Let me—let me break–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This down for one second. There—there’s some overlap in terms. All neurofeedback is a form of biofeedback but not all biofeedback is neurofeedback. The difference really—the central nervous system as—as you know is a pretty savvy guy, but the body is—some of the systems is everything encased in bone essentially. So—all the nerves are inside the spinal column, the brain and so–

Dr. Justin Marchegiani:  Exactly.

Dr. Andrew Hill:  And everything outside is—is peripheral nervous system, and so broadly you can define neurofeedback as central neurofeedback or sorry, central neurofeedback or peripheral biofeedback.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And that’s for the line that—that is getting drawn, but it’s a little blurry because you can do things centrally, like HEG where your training blood flow voluntarily and EEG is a form of central biofeedback where it’s involuntary thing—so the lines blue quickly because the body is not divided into, you know, discrete compartments that are purely isolated from each other in—in a system, so it’s a little bit of complicated but that’s probably more information than you need—on—on the differences. So–

Dr. Justin Marchegiani:  Very cool. So if someone is out here, maybe they have excessive sympathetic nervous system overdrive or an adrenal dysfunction–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Right? Neurofeedback and/or EEG tend to be a really good way to dampen that’s—over sympathetic, over fight or flight response that’s happening. So if someone’s having that, they’re making the diet and the lifestyle changes, maybe they’re on an adrenal program using some adaptogens and nutrients and they’re stabilizing their blood sugar, making themselves be a more—a fat burner, would the next step be, if they’re doing all these things correct, how would they incorporate–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  The EEG neurofeedback into their life?

Dr. Andrew Hill:  The next few steps in terms of you know, adding tools and technology to support, you know, health as well as transformation would be probably to add in either peripheral biofeedback tools like HRV, like all that skin response, like mindfulness, like meditation practice and then I would say the next level is adding in the sort of higher tech tools like the EEG neurofeedback. And—and to enter that stage, you sim—and if there’s a problem, I mean, for the average person who’s working on stress management or just trying to optimize the performance, you know, you will wanna build things to have a good foundation. If you’re trying to remediate a specific issue, you have seizures, you have ADHD, you got some, you know, problems that’s really getting in your way then you can go right to neurofeedback, I think as a, you know, first line intervention. And for something like that, you start with what is called a brain map, a quantitative EEG ideally and those are usually baseline assessments of brain activity that or then compared to a normative database, and out that you get maps that tell, you know, practitioner like myself how unusual you are compared to a population. And then we examine the most unusual aspects of your brain, how it’s functioning and some of those tend to cohere with certain functional limits or patterns or bottlenecks. You may notice I’m using a lot of very tentative language and that’s because the qEEG is not neuroimaging. It’s statistical analysis. You know, it’s you compared to some distribute—there’s some distribution of—of continuum of function, you know? So it’s really you compared to a bunch of different average people and—and your brain can be special and unique and wonderful, and—and really unusual and still be fine.

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

Dr. Andrew Hill:  So qEEG is—is much of an art as is a science. There are a few things in the EEG and the quantitative EEG that are well validated, some diagnostic markers, or other you know, some discriminants, pretty reliably if you have clean EEG, you can spot traumatic brain injuries in people if they are at all significant. You can often or almost always actually spot ADHD. The FDA has a pretty good at this point support of a few discriminants in the EEG that suggests ADHD, including you know, going so far as to support a hardware diagnostic headset a couple years ago as actually diagnosing ADHD passively without any clinical involvement and essentially it’s doing I—I believe it’s—it’s doing a ratios of frequencies in the brain. So you start with these assessment tools to get a peek under the covers, and so the quantified self implication as well as a, you know, remediation benefit and you get a sense of how your brain works and then the next step is to start exercising and training it using you know, biofeedback feedback essentially and we shape brain activity and figure out how that affects function and over time you make changes to the brain. I know we talked about this before, but it’s essentially offering conditioning, not if you could think Skinner not Pavlov–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  So we aren’t—we aren’t making you know, a voluntary response happen by providing a—a random thing like—like the bell and pairing it with the stimulants.

Dr. Justin Marchegiani:  Yes, exactly.

Dr. Andrew Hill:  What we’re doing is instead only rewarding certain stimuli you do. So Skinner, you know, Skinner’s left alone noted Pavlov but it—I think it bears expanding. Skinner trained essentially pigeons to peck along bars or do certain behaviors to get rewards, you know, to turn a light on or you know, hit a switch or something. And a Skinner box is a behavior-shaping device. You don’t just examine how pigeons behave. You examine how they learn so you’re shaping or changing their and the way you do that and operate conditioning is you reward behavior that is near what you want to accomplish, so–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  You find what the brain is doing moment to moment, and then you—you know, when—when a certain brain wave moves a little bit or trends in the right direction or stays in the direction that’s when you provide—provide the reward. So over time your—you’re shaping.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  You’re just rewarding—

Dr. Justin Marchegiani:  Shaping, right.

Dr. Andrew Hill:  A different trend, yeah.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And then you move the goalpost and you reward further, you know, development of the trend, the physiological trend and not direction. The—the weird thing about—about the analogy of Skinner vs Pavlov is this is operate conditioning. However, the pigeon knew what it was doing. It was—you know, it was trying different things. Pigeons actually can get very superstitious.

Dr. Justin Marchegiani:  Hmm.

Dr. Andrew Hill:  If you—you know, if they spin around once, and then get rewarded, they will then spin around once and they approach that food bowl and switch again because they’ve learned. Pigeons are like baseball players. They’re so superstitious–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  A little ridiculous.

Dr. Justin Marchegiani:  That is funny.

Dr. Andrew Hill:  But in the case of EEG—the—the analogy breaks down because what you’re rewarding, the—the behavior if you will of the brain, a fluctuating EEG that’s happening in a time course that is faster than you can perceive or control. So it’s really measuring sort of the real-time, you know, under 100 milliseconds or time window of what fluctuating in your brain. And you don’t really control things in that time course. You are only perceiving in the like 92 to a couple hundred milliseconds timeframe for most of us. We don’t proceed rapidly and we perceive most of what’s going on, you know, neurologically. And so as it’s fluctuating, reward it and shape it, and over time it changes which was kind of magical and lovely. But it—it’s not the magic of neurofeedback that’s doing that, it’s the magic of the brain.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  It’s the brain’s ability to interpret a signal, a shaping signal. It’s the brain’s ability to enhance its plasticity in response to a signal. There’s really good evidence now that neurofeedback rams up plasticity fairly profoundly, something called a—an evoked motor potential can be used to measure plasticity of cortex. Essentially, you—you trans—carry all magnetic stimulations and zap a little bit of the brain and see—like over the hand area of the motor cortex and see how much bulk it takes to make the hand jump.

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It—it sounds brutal but it’s actually a fairly innocuous little thing they do with TMS, just to see if they’re over the right area. The—there was an experiment a couple years ago that showed that before-and-after neurofeedback. After neurofeedback, the motor cortex respond to a much lower voltage, a much lower, you know, signal before it perturbs or it jumps in responds and changes. And—and so this is a sign of motor plasticity or learning–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You know, broadly, that seems to be upre—upregulated regulated fairly rapidly with neurofeedback.

Dr. Justin Marchegiani:  And when you’re saying–

Dr. Andrew Hill:  With the other evidence of this. Yeah.

Dr. Justin Marchegiani:  And when you’re saying neuroplasticity, basically your brain is almost starting to rewire itself essentially.

Dr. Andrew Hill:  Yeah, it’s rewiring itself. You know, I—I think of it sort of like it’s getting younger because–

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  For many of us we—we’ve have the experience of being, you know, over plastic. I mean, that’s being a teenager is to some extent. Things just change a little, you know, too rapidly, swing. But there’s this—there’s this proliferation of synapses, of connections between neurons in early seniors,  10 through 14 or 9 through 14, or around 9 or 10 or 11, the brain sort of finishes all this lateralization. It’s often that’s where a lot of final development happens. Post that age is when language acquisition without an accent becomes very difficult, but right after there’s this—there’s this proliferation for a few years or synapses. Massive like overbuilding in some ways. Think of like a forest that is becoming so thick and so overgrown that it just doesn’t have a lot of light getting through it. You know, it’s almost like too much in terms of synaptic density, and then there’s a big period of learning where those synapses change widlly in mid-teen years and many get pruned away, you know, this—this neuropile as it’s called.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It’s pruned away into more discrete circuits. And that’s the time of profound learning and skill development and self-regulation, and other things in those mid-teen years. And so I really do think about you know, the plasticity enhancement features of neurofeedback as sort of rolling back some of the—some of the kid, not the—the decline of synaptic flexibility that was so prevalent when most of us were in our mid-teen years when things were just changing and responding and changing and responding and—and learning was like trivial because it’s just learn, learn, learn, and change and grow and develop. And it all seems effortless, you know? Relative how things feel, you know, 20 years later or 30 or 40 or 50 years later. So—so that’s my goal from all this stuff. Be it nootropics or mediation or neurofeedback. And—and be it for whatever goal, peak performance, substance abuse, you know, remediation if you will, changing your relationships and your—and you’re in control over substance behavior which is hard when you think about it. Getting control of executive function, getting control of aging, getting control of mental illness. These are equivalent in my mind. They’re all about getting some control over this 3-lb blob that uses most of our, you know, glucose and oxygen resources on our body.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  And—and learning to take you know, a little more active role if you will in how it develops, how it changes, how—how it has a trajectory of improvement and aging, and learning and growth. So a lot of my focus is—has really swung far towards encouraging and supporting people’s access to these tools.

Dr. Justin Marchegiani:  Interesting and you mentioned a couple of things especially with ADHD, and it’s interesting when you–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Because when you compare and contrast, you know, the—the functional, more natural alternatives, EEG, nutrition, functional medicine for like, let’s say ADHD, you also have the conventional options which are pretty mainstream, but they typically involve stimulants–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Methamphetamines, Adderall, Prozac, you know, those type of medications where you’re trying to–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Overstimulate the brain into focus, into the ability to pay attention, how is that different? I mean, obviously, one I see is whipping a horse, whipping a tired horse. The other one is—is much more different and is trying to align the brain in a more functional, more sustainable way.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Can you compare that?

Dr. Andrew Hill:  Interesting analogy. An interesting analogy. Let me—let me just talk about medications for a second.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Now I’m not a psychiatrist. I’m a neuroscientist, but I—you know, I know a thing or two about pharmacokinetics–

Dr. Justin Marchegiani:  Of course, yeah.

Dr. Andrew Hill:  And dynamics and how—how they work. The—in theory, they should not be working. Psychostimulants should not be working by whipping the tired horse. In theory, the CEO of the company is asleep under the desk, and the psychostimulant is like a cup of coffee to get something productive again so they control all the random nonsense going on in all the different departments of the company.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  So it—it’s waking up some—an executive that is not controlling thing versus driving an already tired system. I just want—you know, I wanna shift the metaphor a little bit.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Because there’s a couple of other classes of drugs that are now used. You mentioned SSRI’s I think.

Dr. Justin Marchegiani:  Yeah, Prozac.

Dr. Andrew Hill:  Yeah, Prozac. Not as used sometimes—on no longer very much in kids and teens because the—the suicide fatality–

Dr. Justin Marchegiani:  Side effects, yeah.

Dr. Andrew Hill:  Increased risk is pretty high.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  They’ve discovered.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  That’s often not a great course, but the other two classes that are used, some of them promising with—with some promise are mood stabilizers and beta blockers, blood pressure meds that are being used really seem to work for some of the most acute behavioral symptoms.

Dr. Justin Marchegiani:  Are they beta-blockers? That they’re helping to decrease that action potential in the heart and the sympathetics. Is that how it’s working?

Dr. Andrew Hill:  Not sure how they’re working. Things like—like Intuniv which is a—what’s that? Atenolol or something. I forget–

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  What the—what the generic is.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Yeah, it’s basically beta blockers which work great for other things, too. And as well as comorbidity. So I wonder how much is it does ADHD cause anxiety being dealt with better, and you know, but all day long I look at brains that have been labeled ADHD or anxious or other things, and I often find there’s some agreement with labels on the physiology and how it functions, but not complete, you know. And they’re often very coarse and very poor agreement. So I—I will say that—that functional patterns that support the interpretation of ADHD, anxiety, and sleep issues tend to show up together more than they show up separately. So you almost always, if you see two of those three things, you almost always see all three—ADHD, sleep issues, and anxiety.

Dr. Justin Marchegiani:  And I know there are potential adverse–

Dr. Andrew Hill:  In terms of—Uh-hmm?

Dr. Justin Marchegiani:  I know there are potential adverse effects of the methamphetamines long-term on the brain, so I get in the short-term, hey, you got an exam–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  You’re gonna do it to kinda get really get those centers revved but long-term, what’s your take on that?

Dr. Andrew Hill:  Yeah, well, it depends on the class of psychostimulant. I mean, some things like Adderall–

Dr. Justin Marchegiani:  Adderall.

Dr. Andrew Hill:  Since you have a structure similar to—to methamphetamines–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Those things we—we don’t know too much about and—and it’s probably not great long-term. The drugs like methylphenidate, Ritalin–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  That seems to actually be a little neuroprotective but don’t necessarily work for everyone or you know, have—have all the benefits. You know, when I was just post college or in college, I—I need to add Ritalin and it made me really sedated. I was profoundly ADHD, classic ADHD, in you know, even in my 20s, not so much anymore but—but back then I was, and methylphenidate just made me feel numb, you know, Ritalin. And—and it just did not work to control my attention and at that time as a “young” man, I did take Adderall. It worked relatively well and I tried it again about a decade or two later and it my—I have my liver gotten too old. I couldn’t tolerate the side effects. And I—and I think I’m not so concerned about the—the short-term side effect.

Dr. Justin Marchegiani:  Right. It’s definitely the long-term.

Dr. Andrew Hill:  As you say–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  But—but even the short-term side effects can be fairly profound to a developing person. If you’re appetite suppressed, if your sleep’s disrupted, if you have underlying cardiac issues, I—I think that stimulants in general can really provoke a pretty, you know, negative set of consequences in the short-term. I don’t know that we know a huge amount about long-term, but I think that the sort of atypical stimulants like Ritalin, we know are fairly safe long-ish term because of how long people have been on them. And we know that the biggest risk for a lot of the other drugs is more about either sensitivities, like I said, cardiac or other issues or there’s—there’s risk of abuse in—in stimulants, right? There’s often very significant risk of abuse, and I think the problem—that the scope of the problem is actually, even I’m—I’m downplaying it a little bit is actually much more dramatic that I might—that we might suggest because I think ADHD and, therefore, stimulant prescription is so phenomenally rampant and fat outstretched the actual clinical sort of narrow scope focus of pathology that must be addressed. I mean, ADHD is a bucket that has become you know, huge, to swell and catch all kinds of things especially in school systems.

Dr. Justin Marchegiani:  Oh yeah.

Dr. Andrew Hill:  There are like something like half or three quarters of you know, in some school systems have kids that are on psychostimulants, and have these diagnoses. And I don’t think the diagnoses match. First of all, I think ADHD is only diagnostically relevant when it’s getting in the way and—and it’s so profoundly overdiagnosed that you know, it’s a fraction people who have some attention problems under some circumstances that I would call ADHD—you know, capital A, capital H, whatever.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  The—and prescribed for. Because the consequences are high and this is the medical doctor’s you know, job of course to know this that there are—are side effects you must balance against the desired effects–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And the side effects and stimulants are not significant, they’re better than other things. I’m not sure why the beta blockers work. I have a hunch we’re gonna discovered it’s more about reticular activating system issues.

Dr. Justin Marchegiani:  Uh-hmm. Yeah.

Dr. Andrew Hill:  And thalamic—and thalamic activation of downstate–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than it’s really gonna be about you know, cortical activation and—and relaxation if you will. But all those things regardless of how they’re working are doing short-term intervention. They’re not teaching their brain how to not be ADHD, but how to sustain your executive function, and sustaining sort of you know, sustain a—a perspective on attention that is resilient and not reactive. That takes some work and you can get there, but it’s not—you know, it’s not rocket surgery. You can get there through mindfulness or meditation, and you can absolutely work on ADHD and other another cluster type phenomena with a short simple mindfulness practice. In weeks, it will start changing your brain. The research is mounting. You can do a lot of mindfulness to—to reign back in executive function challenges that aren’t necessarily, you know, there.

Dr. Justin Marchegiani:  And I think you can learn a lot by the mechanism of how these drugs work. I mean, if you—if you know about the methamphetamines–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just the average listener here, they really are gonna stimulate serotonin and dopamine and a lot of your catecholamines, norepinephrine, epinephrine. So if that’s helping, while the question becomes how can we utilize construct of vehicles to increase those neurotransmitters? Also they block the reuptake to so they allow more of these nutrients or more of these brain chemicals to sit in between the pre-and postsynaptic neuron. The problem is long-term, we start to have more degrading or recycling enzymes that break them down faster. So if short-term, it works okay. But in the long-term, you start gearing up more enzymes to break them down.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  So the question I guess comes down to what can we do, I mean, on the neurofeedback side to improve these neurochemicals and maybe you want to take it to the diet side and maybe even supplements side, too.

Dr. Andrew Hill:  Yeah, you can do a fair amount. I mean another benefit of neurofeedback is it really makes your brain more sensitive and sort of reset some this—this acquired tolerance. And we see that in psychostimulants dramatically. You know, a couple weeks into neurofeedback you have to reduce your dose usually because you’re suddenly getting hit with a sledgehammer by—by your psychostimulants if you’re taking the.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  We also see it from things like cannabis oddly enough. You suddenly have to ramp your—your consumption down if you’re a cannabis user because your brain is super flexible.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  But some of the—some of the best of research is still coming in. I mean, we don’t really understand nutrition fully in terms of ADHD. And it’s also not a homogenous issue when it’s actually truly present. I mean, there are several variants, some more types of you know, dopamine receptor coding repeats that show up that gets classified as ADHD, and some of them make you more hyperactive but also more resistant to distraction and some of them make you, you know, more distractible but less able to focus—but also able to, you know, almost more able to focus rather when you get checked in. So it—it’s a little bit of confusing space and, therefore, what works for one person is not necessarily what works for other people. But those blog classes like mindfulness and neurofeedback works for pretty much every so that’s why I start there. There’s other things that may work for you. Things like L-tyrosine, which of course is the precursor to dopamine, does work for–

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  A certain percentage of people as a—as a support to attention pretty profoundly and I—I have a hunch that it’s working best for those people who’ve either been on stimulants, on who’ve got you know, one very sort of narrow subtype of ADHD where it’s really about a dopa—a dopamine receptor you know, proliferation. And for those people I think L-tyrosine is actually helping in need. There’s no real evidence that supplementing L-tyrosine increases levels of dopamine, but I have a sort of perspective on it where I’m gonna let the dopamine system regulate itself, because you know, anything goes directly to synapse or increases release of dopamine, things like stimulants. Those are always gonna be adapted to by the system because there are supraphysiological. They’re dangerous. They’re—they’re alarming to the brain and the brain has to adapt and, therefore, meaning tolerance, addiction especially in dopamine. So my perspective on this stuff is always to back up a level in the regulatory space if you will and feed the neurons, feed the dopamine neurons what they need to use their enzymatic chain to make dopamine. And there you’ll only get more dopamine if you actually need more dopamine in the moment. I mean I’m really somebody who—who believes that there’s no such thing as a chemical imbalance in the brain. It can’t really exist and there’s you know, massive sweeps of regulatory tuning in terms of receptor density and receptor sensitivity and all kinds of other things like that but my—my perspective on monkeying with the systems is they know how to regulate themselves and any ideas we have about what we’re are gonna be really imperfect at best, and you know, therefore, we’re gonna be trying things that don’t make sense. I think we got lucky with you know, SSRIs as mentioned earlier, Prozac. We now know that Prozac, yeah, if does work on serotonin, but not necessarily to increase it, you know, all sorts of neurons have autoreceptors that measure the amount of serotonin in the synapse that they are releasing into the synapse.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And if SSRIs decrease breakdown and, therefore, increase synaptic levels of serotonin, the autoreceptor shuts down release. So actually you have to adapt to it, you get sort of lower tonic release of serotonin in your—in your brain than you—than you did before you started taking whatever it was. You know, the SSRI. That’s—that sounds like that can’t possibly be true because serotonin’s the happy chemical and it—it’s antidepressive. It’s just not. I mean, if you—there’s something about the anxiety, it’s a little more closely linked to serotonin. But the antidepressive—antidepression effects of the SSRIs as well as anything else that lists depression, be it learning new things, be it exercise, be it whatever you’re dealing. The final common pathway if you will of depression release seems to be increase of BDNF. Brain derived–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Neurotropic factor.

Dr. Justin Marchegiani:  Neurotropic factor, right.

Dr. Andrew Hill:  In the hippocampus, which is all about learning and integrating information. That—that’s kinda what that job is and that’s really the key, yeah, I think. The key plasticity if you will, neuroregulatory factors. So it’s all about, I think the name of the game is BDNF. And depression is elicited by raising it through indirectly, you know, many steps back by—by tweaking serotonin and the brain responds to that loud signal by—wait, what’s going on? And getting a little more plastic if not integrate the slightly bizarre signal it’s getting from the SSRI is my—is my take on it. It cannot be, you know, perfect.

Dr. Justin Marchegiani:  How about B vitamins? How about B vi—I find B6 or P5P–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Pyridoxal-5-phosphate–

Dr. Andrew Hill:  Sure. Yeah.

Dr. Justin Marchegiani:  Is deemed really important to help convert some of these amino acids in the brain.

Dr. Andrew Hill:  Oh, yeah, all—all kinds of reasons. I mean, just look at the Krebs cycle,

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Just think back to our physical biology, there’s all kinds of amazing things that B vitamins do to the Krebs cycle, specifically some of the, you know, nicotinamide riboside, NA—NADH in terms of electronic streams. There was some related research—sorry—there’s related compounds in the Krebs cycle called alpha-ketoglutarate.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Which recently some research came out of UCLA, about a year ago, that showed that the anti-aging benefits in model organisms, C. elegans in this case. The anti-aging benefits of alpha-ketoglutarate are like 10 times higher than resveratrol in the same organisms and through a differnet mechanism—we know the resveratrol activates sort of the stress response gene, CERT, and that seems to be how they cause, you know, the sort of French paradox and other you know, animal model documented life-extension things. But the—the alpha-ketoglutarate is operating in a different place. It seems to be tweaking the Krebs somehow and, therefore, optimizing energy production. So all the other thing that tweak CERT, like caloric restriction, like cold stress–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  They do extend lifespan in model organisms but they do it at the cost of either mobility or reproduction, right? The animal become less metabolically active and that’s what happens if you restrict calories in humans, too, you know? Eventually we downregulate metabolism, not—not immediately.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  But eventually and—and so caloric restriction is the only biohacking modality that’s been proven to actually affect aging, but in model organisms, it does do it at the cost of metabolic output and it probably–

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Does the same thing in humans. So I’m excited about not only B vitamins, but things like alpha-ketoglutarate and this is the idea of going after the energy, you know, production machinery a little bit more directly. You know, lubricating ATP production. So B5, B12, and of course, we need versions that can cross-convert a methyl state, so ideally hydroxos and things. So yeah, I—I think a really good compliment B vitamin is kinda necessary. I think that you can also get really specific in a way that we don’t really understand yet, in terms of what you might need for B vitamins. I mean, there’s a lot of that genetic research done looking at methylation analyses–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And that’s essentially a study of how B vitamins are used in metabolism of energy and neurotransmitters. You know, that’s sort of how—how that—those analyses are used least. And–

Dr. Justin Marchegiani:  And when you’re talking about B vitamins and B12 though, you have like methyl B12–

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  And you mentioned the hydroxyl and the adenosyl, when would you recommend one over the other?

Dr. Andrew Hill:  I don’t know is the short answer.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And I—I don’t—I don’t think enough is known. I mean, the—the methylation stuff, you know, it’s not well-established. There’s—from my perspective and—and I come from sort of the optimism space being clinically many years ago, there’s a lot of focus on methylation in childhood diseases or development including these you know, things like autism and Fragile X and a lot—there was a lot of focus for many years on energy production and methylation. And some of it seems to do something in some of these people and some of it is just bad science, and we don’t know the line between it unfortunately because it’s grown out of a population of people who’ve been trying every—I mean, when you have an autistic kid, you try everything until you find something that works, and almost nothing works. This is how—this is why autistic spectrum population is a pretty good segment of the neurofeedback market because they discovered that it actually affect the brain, very little effects, you know, profoundly affects the brain people of autistic people. Neurofeedback can, doesn’t always, but it can. And that got a lot of attention in that community, so therefore, you know, word of mouth is very high, and—and that’s why there’s a big push there. And the same thing is true with methylation. Sometimes the right B vitamin cocktail, you know, dial it in in an authoritative manner.

Dr. Justin Marchegiani:  Are you familiar with—with pyroluria condition where you need excessive B6 and zinc levels?

Dr. Andrew Hill:  Yeah, I’ve heard of that. It seems to be related to phenylketonuria as well where there’s some aspartame sensitivities, right? It’s a similar genetic, but it’s more about elimination of—of some core vitamins.

Dr. Justin Marchegiani:  Yeah, so they—they need just accelerated levels of B6 and zinc and—and will see some of it–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  On the organic acids test, but we give them higher levels of B6 or zinc and helps their mood or helps their sleep or helps whatever else in their energy systems to function better.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Do you have any clinical experience with that?

Dr. Andrew Hill:  I—I don’t, but really this is outside my area of expertise. I—I sort of do a little bit of personal biohacking in this space but my understanding of supplements is not as broad probably as my understanding of nootropics, so you know, B vitamins when I think about them are all about, “Mmm, how can I t weak the brain?” So I think, you know, B vitamins, I think like saw beauty in the, you know, which is a thiamine, a B1 dimer essentially gets into the brain and then cleaves. Then you have a massive hit of thiamine to the brain and if somebody came in as an alcoholic, I would—I would think, “Ooh, thiamine.” Because they have impaired B1 metabolism from drinking alcohol for many years and they probably have memory issues and—and failing the basal brain like mammal antibodies because of thiamine deficiencies. So I have a very specific you know brain focus on this stuff and not a good understanding of either the—you know, the phlebotomy driven if you will understanding of—of the biochemistry. It’s just not—I work at a very high-level of brain waves, so for me it’s all about tweaking that—that dance versus reading out the—the low-level output if that makes any sense.

Dr. Justin Marchegiani:  Yeah, so let’s shift gears with some of the smart drugs that you’ve–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  You’ve done. I know we kinda have our pallet here, whether it’s modafinil or piracetam or aniracetam or oxiracetam. What’s—what are your favorites? I know in the past you’d mentioned you’re not–

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  A big fan of the modafinil, so I’ll let you have it.

Dr. Andrew Hill:  Yeah, you know, of course, I have designed TruBrain.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  And so I’m a big fan of mix of classic you know, a—a racetam plus a good choline, plus a few other things to support it and that’s sort of what went into the TruBrain formulations. Personally I—I’m still, you know, I still—piracetam and either CDP-choline or Alpha-GPC, still the best one to you know, combination I’ve ever found. And—and there hasn’t seem to be any downside or tolerance in these things when used for years and years and years, so that’s the, you know, the more serious biohacker’s you know, stack or the beginning biohacker stack potentially, but a little bit less racy, less risky, less you know, fully understood would be things like L-theanine. I—I mean I’m a big fan. I—I keep a couple things around my house, my office, and my campsite when I’m hanging out with my hippie buddies.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And those include L-theanine and ibuprofen.

Dr. Justin Marchegiani:  Ahh.

Dr. Andrew Hill:  Because L-theanine can pull back over caffeination pretty quicky.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And over arousal, anxiety, and a few other things.

Dr. Justin Marchegiani:  It’s doing that with GABA, right?

Dr. Andrew Hill:  For some people. Yeah, it’s very GABAergically–

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  It appears to be very GABAergic in alpha wave productions. If you really, you know, can break some—break some stage that aren’t comfortable, and then ibuprofen for—for those folks that have like, you know, smoked one too many joints or eaten one too many pot cookies and their, you know–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Freaking out because of that. Ibuprofen can knock back THC intoxication a little bit and—and help people who are in crisis. So from my perspective, there’s a 2-mile like emergency kit if you will, nootropics. Even though ibuprofen is not really nootropics. In fact, pain killers in general probably should not be considered nootropics because evidences is—is—and I’m sorry, analgesic pain killers, ibuprofen, acetaminophen, those are just things—the research is mounting that they actually turn off either learning or empathy a little bit in some cases. Now ibuprofen seems to be the better case these days because the cannabis research anyways, there’s evidence that it eliminates the memory formation problems that happen when you’re high as well as–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Reducing some of intoxic—the high level of intoxication that people gotten in trouble with it. So there’s a little bit of benefit there but a lot of things do actually tweak brain function fairly profoundly, and we don’t yet know, you know, what that necessarily is for many of these things. Even things like Tylenol and you know, ibuprofen, these—the brand names—I guess Advil is a brand name of that one, but whatever. Even those are not necessarily you know, that are without side effects and there are organ system issues with all those drugs as well–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, kidney for ibuprofen–

Dr. Justin Marchegiani:  Elevated liver enzymes. Yeah.

Dr. Andrew Hill:  And liver for Tylenol.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And every year–

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

Dr. Andrew Hill:  You know, people make sui–yeah, gut lining for apirin—or ibuprofen. Every year people make—make suicide attempts with Tylenol and end up in liver transplant wards waiting for a liver because Tylenol’s so profoundly toxic to the liver. So yeah, not those but I—I also think, and get back to the ADHD question, there needs to be a big emphasis on not only systemic inflammation but supporting lipid metabolism through things like fatty supplementation, you know, Omega 3s, medium-chain triglyceride, even get good ketone production. For me, the—the focus on nutrition is shifting more towards getting crap out, you know, bad sugar, bad starch, actually all sugar bad starch and leaving in or enhancing the quality fats which include Omega 3s, Omega 9s–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Medium-chain triglyceride–

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Usually food sources of those but I’ll toss them. I’m not a fan of refined oils. I—I don’t love them and most forms of refining I find either strip things out or leave things rancid, and so I try to get as much as possible from food, of course not always possible, and so I do supplement with DHA. That’s the only Omega that I—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Supplement and I get it form of—

Dr. Justin Marchegiani:  Algae or fish?

Dr. Andrew Hill:  In, yeah, exactly. Algae.

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  TruBrain—the—the capsule form of TruBrain, still has a DHA capsule in the afternoon packet, and so we—that’s my sort of baseline—gotta get some Omega 3’s in because I know my body can cross convert as necessary. It’s not efficient but if necessary to make EPA from DHA and DHA seems to have more brain affinity so it’s a better, you know, Omega to go after if you’re gonna supplement and then I of course, keep my diet super low and grain-fed in anything including, you know, I don’t eat grains. I try not to eat anything that’s eaten grains.

Dr. Justin Marchegiani:  yes.

Dr. Andrew Hill:  And that keeps my Omega 6’s pretty low, too, which is, you know, something Westerners, specifically Americans are quite bad at.

Dr. Justin Marchegiani:  Yeah, and it sounds like you like really established to—to really have good fats, kind of a Paleo template-esque as well.

Dr. Andrew Hill:  I did, I guess. I mean—I didn’t know it was called that, you know, I was—I was sort of looking at initially of course, I don’t know, 20-25 years ago I—I read this book, and it was all about cycling ultra-low and ultra-high carbs and you know, there’s some flaws in the theories in the book but it had really good explanation how insulin works and it really stuck with me and there’s all kinds of you know, before that I thought insulin was just the thing that your body secretes in response to blood sugar spikes so then your cell can suck the blood sugar up and store it, either as fuel or lipids, whatever. But you know, I sort of realize at that time that it actually is tied to all these other hormones and other regulatory, modulatory things that cause you know, catabolic or some anabolic changes and releases of growth hormone and—and cortisol and it started it started to get me thinking a lot about how probably somewhat a time bomb the—the typical way of eating, which was like repetitively spiking our blood sugar. I mean, let me—let me—the—the blood sugar question is fairly well understood but it’s also not, not magical. We dropped back to a sub—a less well understood but also very similar feature of regulatory systems in the body or brain which is cortisol in the brain, high levels of cortisol, a person responds to stress and it goes up so you can focus and be alert and a bunch of other things happen in the brain and the body, but in the brain, it watches the range of cortisol and as it goes up, it responds and when it goes down, it responds differently. If the cortisol level goes up and stays up, response fails. The brain stops responding and eventually those high levels of cortisol start killing brain tissue and you know what, that’s exactly what happened in things like diabetes. If insulin goes up and stays up with repetitively spiking your blood sugar until eventually your cells stop responding to the insulinogenic signal and that causes a cascade of failures at every level.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  In body metabolism and aging and repair and growth and learning and, I mean, the list goes on.  And so I figured that out about 20 years ago and, yes, I have a slight, you know, problem with ice cream occasionally I will admit it. But on the days that I’m being good, I’m perfect.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And I’m good about 80% or 85% or 90% of the time, and on those days I’m absolutely damn ironclad on keeping my total carbohydrates below 65g.

Dr. Justin Marchegiani:  Yup,

Dr. Andrew Hill:  Unless I worked out you know, hugely—

Dr. Justin Marchegiani:  Yup.

Dr. Andrew Hill:  Like a 90-minute ______ class when I can barely let myself off the ground, then I might have you know, like an extra 20g of carbohydrates right after that and coconut water or something to replenish my glycogen from my you know, quivering muscles.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  But that’s when I have profound physiologic signal of you know, glycogen depletion and good note for, you know, levels of carb intake, the human body is fully depleted can store about 50g of carbohydrates per hour.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Of glycogen.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So you know, you—it would never make sense to—to take more than you can store and spiking for me anyways, I sort of figured it out it used to be around 20g of raw carbohydrate seems to spike my blood sugar and I—so, so my—my general rule is never more than 20g at anyone sitting, never drink my carbohydrate—it seems to spike things faster if it’s you know, sugar in a drink or you know, even milk or something versus—

Dr. Justin Marchegiani:  How about the Glycemic Index though?

Dr. Andrew Hill:  Ah, Glycemic Index is a load of hooey. It’s—it’s about—it’s about as accurate as—as calories, you know? Which are also a load of hooey.

Dr. Justin Marchegiani:  How about—how about the—how about the glycemic load?

Dr. Andrew Hill:  Ahh, see that’s—that’s a valid concept.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  We just don’t know necessarily how foods produce it.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  The—the rating of food is, you know, arbitrary little bit but the—the effects of load on insulin and—and the carrying capacity if you will is occupying sensory—a sensing molecule is—is a real thing. I don’t know what that is but I do know if you keep your in—if you keep your signal of sugar low, very low in the body, the way regulatory systems work is s they listen harder. What that means for insulin is increased insulin sensitivity.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  So I don’t think it matters if you’re in ketogenesis or if you’re Paleo or Primal.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I think if you—if you stop spiking your damn insulin, and you get a sense of what that feels like when you occasionally go over it, I mean, if you spike it every day you don’t notice it. But if you spike it once a week, you—you know exactly what it feels like to have your insulin go up a little—a little bit above, you know, where you need because you have this drunk feeling and you get a little bit sleepy afterwards, and—but you know, after you adapt to lowish carbs and high fat, energy is rock solid stable. So at some point I figured this out and about the same time we started figuring out as a you know, culture if you will—Westerners how problematic you know, many grains mass produced farm grains at least are—

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  In—in their correct format, you know?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And I started two’s together, I went, “Oh yeah, that’s what my gut feels like, you know, pun intended, feels like crap all the time is because of all this, you know,  inflammation and sludge moving through my system all the time from eating pizza and whatever else I was eating in the 80s and 90’s.” So you know, yeah, it ends up being Paleo or Primal-esque and I—and I would say, I would say that you know, more—more primal blueprint if we have to tie it to an existing pran—plan in Paleo because I do think there’s a place for dairy in humans, or can be at least, not—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Not every human can handle it and we have to make space for inter-individual variability but dairy in a cultured or fermented form, I’m just not willing to give it up.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know? And there’s, you know, we can make a rationale but historically, ancestral health although I don’t generally make that connection because humans are ridiculously adaptable so we can point to any population in history and point out something that they’ve eaten that we couldn’t handle now. You know? People are variable. So whatever works for you is really what’s important. The insulin as a general rule, you know, carb loads are rules, the general—general guidelines are not you know, ironclad what’s gonna work for you, but—but I do think that you know, cheese and cultured butter and—and other fermented, you know, dairy can be fairly beneficial to the body I think it—it can develop in the gut biome can break it down to—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  To useful things. I think it can be a really great source of nutrition and I’m, you know, I’m also of Scotch-Irish ancestry. I’m gonna eat me some cheese.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You know, some really sharp, crumbly you know, grab me by the tongue and squeeze kinda cheese.

Dr. Justin Marchegiani:  Absolutely,

Dr. Andrew Hill:  I have to have that. It’s—it’s built into my—into my body.

Dr. Justin Marchegiani:  And if you can do raw cheese—

Dr. Andrew Hill:  So—

Dr. Justin Marchegiani:  You know, obviously if you get more of the enzymes intact so you can break down the casein and protein—

Dr. Andrew Hill:  Exactly.

Dr. Justin Marchegiani:  Which tends to be the more—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Problematic protein out of them all.

Dr. Andrew Hill:  Yeah and—more problematic and it’s also huge again, genetic variability in terms of—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Can you handle that or not? Right? And I am blessed to be able to handle dairy, no problem. I’m cursed so that at least current generation, you know, mass-produced chemical shit storm wheat—I can’t handle and I’m not like half the Americans who seem to have no problem with, you know, mass-produced wheat. I’m of the, you know, at least 40%, 50% that seem to have fairly significant issues with—with eating you know, bread so to speak from commercial grains. So, you know, I was a baker throughout high school and into college.

Dr. Justin Marchegiani:  Huh.

Dr. Andrew Hill:  And I’m a—I’m a nominal cook. I’m an amazing baker.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  I can bake you anything you want, name it. I’ll walk into a kitchen. If there’s ingredients, you’ll—you’ll, you know, be happy but—

Dr. Justin Marchegiani:  Awesome.

Dr. Andrew Hill:  I can’t—I can’t bake. You know, I can’t bake with wheat, with gluten as an adult essentially, as a—as a grown man because of the lack of, you know, ability to handle it and I—and I—this is—this not a new thing. I didn’t know why I had poor digestion as a teen and you know, early 20’s person but I did and it was eventually because of you know, of—of grains. I—I have a hard time wrapping my head around us as a society and human creature, culture, developing this big, fat, greedy, hungry brains that needed high starch to really be fueled with the fact that half the planet seems to be struggling to metabolize starches and grains. These two things are really incongruous to me and I don’t—I can’t quite wrap my head around it. I don’t quite believe the full you know, idea that we’ve distorted the plants you know, too profoundly because—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Humans are adaptable and—and they seem to be able to adjust long-term to re—and quickly to big changes in diet. I just don’t understand why we’re having such a hard time. I—this strikes me as a blind man and elephant situation.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  What I discovered there’s some third factor that’s really you know, causative in destabilizing our ability to handle brains, and you know, 50 years ago that doctor was not present.

Dr. Justin Marchegiani:  I think it is—

Dr. Andrew Hill:  Nowadays it is.

Dr. Justin Marchegiani:  Yeah, I know, if you’ve read Dr. Davis’ book, he talks about the—

Dr. Andrew Hill:  Uh-huh.

Dr. Justin Marchegiani:  Genetic modification of wheat, not like the genetic modification when we’re talking about with like Monsanto, but just we’ve started off—

Dr. Andrew Hill:  With breeding.

Dr. Justin Marchegiani:  With breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  Just kinda cross-breeding.

Dr. Andrew Hill:  Yeah.

Dr. Justin Marchegiani:  We have this einkorn wheat that was nine chromosomes and then we—we kinda cross, you know, cross-bred it so it can produce more gluten and you know, we’re res—basically be able to withstand various weathers and conditions. Now part of that from what I’ve seen with the genetic mod—genetic modificaion and the hybridization, the gluten content—

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Has gone up significantly. I think 50%, 75%. So part of it could be just the extra gluten that is present that maybe wasn’t there years back.

Dr. Andrew Hill:  Maybe. I think it’s really—it may be due to that or the gluten may have changed in some—in some form. And the reason I think of this is oats. You know, oats do not actually have true gluten. They have only gliadin, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  You have other forms of—

Dr. Justin Marchegiani:  Zeen—

Dr. Andrew Hill:  Gluten, gluten-like proteins.

Dr. Justin Marchegiani:  Or avenin, avenin.

Dr. Andrew Hill:  Yeah, but—but exactly. It’s different.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And theoretically, if there’s no cross-contamination, you have gluten-free oats, theoretically people shouldn’t have an issue with them, and you know, I’m about as—as pale as they come as sickly, you know, 23andMe points me at Scotland and Ireland and is not unsure about it at all. You know, I’m like I’m one of people. I’m short. I’m wide. I can climb mountains. I hang out in cold climates and love it. You know, I’m—my people ate oats and I as an adult cannot handle gluten-free oats all that. You know, a little bit but not all that well and there’s not a lot of those proteins in something like oats compared to true wheat, so I’m not sure what it is. I think there’s something else. I think we’ll discover that there’s something unrelated to wheat completely, unrelated to food completely that has changed how we—how we do this and I don’t know if it’s—you know, something in a processing step or—

Dr. Justin Marchegiani:  How about Roundup? How much is the—the glyphosate contributing?

Dr. Andrew Hill:  You know, and maybe—and maybe 20 years of ex—of exposure to that you know, in my traditional western diet has sensitized me forever to you know, those type of proteins found in starchy you know, grains. I held feeds just fine but not—but not grains. So and again—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  This is an N of 1 and I’m, you know, just an informed consumer here, but I—I think that those—those glyphosphate and other you know—

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  Chemically induced problems, we—we know those things cause problems. You know, when I was in grade school, you know, I wrote a paper on how DDT made you know, eggs fragile and it was—had to be removed for the environment in like 70s.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  And this is not—this is you know, there’s always things like this. Every year, we go, “Oh, yeah, oh yeah, BPA. Ooh, oh yeah, that, hmm. Okay, let’s get that out of the environment, let’s get that—that out of our diet,” and one of those things is gonna be—is gonna interact the gut environment, the micro via the—the genetic expression of the microbiome, something will—is gonna be manning—there are many, many times the genetic, you know, material load of chromosomes in our gut that are not human DNA—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Than—than there are. You know, the microbiome is incredibly more complex than our own genome, profoundly more, you know, many, many, many, many, many, many times bigger in terms of number of actual genes, and you know, I have a hunch that we’re—we’re gonna find something in there is—is you know, thrown off by something we’re doing—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  As a modern people.

Dr. Justin Marchegiani:  And I guess the next will be comes down to how long does it take for our DNA to adapt, because I know where human species have been around at some level at 1.8 million years, but perhaps and what grains have been here about 10,000. So I guess the question becomes are all of us adapting at that same rate to be able to handle grains?

Dr. Andrew Hill:  Yeah, I mean, it’s a bit of—what you mean by adaptation?

Dr. Justin Marchegiani:  Being able to digest. Yeah.

Dr. Andrew Hill:  We seem to very float—yeah, but that—that might happen quickly. It’s—I don’t think we fully understand what it—what is necessary in producing those, you know, old enzymes and ways to break down material. Like for instance, we can’t digest cellulose anymore, you know?

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  At one point in our development as—as creatures, we could eat wood pulp and survive off of it probably if we had to. That’s no longer the case. We no longer have those enzymes. You know, that swept through the population probably over many thousands or tens or hundreds of thousands of years, we weren’t quite yet human. But other things, you know, your—your grandparents had an experience that’s affecting your genes right now, Dr. Justin, you know?

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I mean, if your—if your grandparents were at World War II, I’m assuming you’re about my age—

Dr. Justin Marchegiani:  Yeah. Uh-hmm.

Dr. Andrew Hill:  And they experienced trauma or you know, stress—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or anything else, the way your brain and body secrete and respond to cortisol is different than it would be—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Otherwise.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  You know, two generations of epigenetic, sort of cascade—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Have affected you. So the question about you know, how quickly does it take to adapt is unfortunately you know, becoming blurrier and blurrier the more we—we discover about the—the genetic expression or the organism learns and changes and patterns on the environment. You know, the—the gene for sort of modern big brain size that is in humans, I think it swept through the primate population at the time in something like 20,000 years which is absolutely fast. I mean, there’s no way that—that could—that could have happened by breeding pressure. You know, it happened through a combination of a bunch of factors probably including things like natural disasters and isolated certain population.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  I mean, who knows what else, but you know, those are individual—actually two or three identified gene based on brain size, and those swept through the population in a—in a blink on an evolutionary timescale. But we talk about evolution as if it’s this massive glacier melting, no—no pun unintended.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Thing.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  And it can be, you know, this is why I’m—

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  The fact that I’m bald is—is gla—is a function of glacial evolution. It—it took a long time for that to show up, but the fact that I was hyperactive as a kid, the fact that I’m sensitive to gluten and other forms you know, grains. That might simply be a function of my genome going “Dude, that hurt,” or “I gotta respond to that,” or “That’s dangerous,” and I ‘m not sure what it responded to but it’s unfortunately left me unable to you know, enjoy baking or—

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Consuming, you know, really good pizza which is—which tragic.

Dr. Justin Marchegiani:  And what’s the evolutionary role for baldness? I know you were kind of touching on that briefly there.

Dr. Andrew Hill:  Ah, you know, I don’t know, I—

Dr. Justin Marchegiani:  A theory?

Dr. Andrew Hill:  I see a few theories including things like it allows radiation of heat a lot better.

Dr. Justin Marchegiani:  hmm.

Dr. Andrew Hill:  Because the brain is ridic—I mean, 90% of body heat is sort of escaping through the head. If you’re bald, you lose more heat through the top of your head. It allows your brain to cool itself more. There’s also some testosterone you know, relationships where it might not an adaptation so much as a you know, epiphenomenon of some other adaptation. Slightly higher testosterone expression or—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Or your levels in the—in the skin produce suppression of the follicle which is male pattern baldness, that set link characteristic of male pattern baldness, not all pair of patters in all baldness, but you know, the one that I have is—is probably a high level testosterone that reduced you know, the follicle. I’m not sure it—it produced, I mean who knows? The more I learn about the brain and the body, the more I’m surprised at how damn efficient every adaptation is. Nothing seems to happen by random and adapation is that you think serve one feature, serve multiple often. So I wouldn’t be surprised if at the same the organism was learning to become more efficient or a heat radiator. The same adaptation made it more you know, competitive sexually or something, and that meant the genes proliferating, you got both baldness and higher level of testosterone with some creatures, you know? But for me and I work in EEG which is a mysterious space. For me, understanding plausible is enough.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  If we can tweak a system and they can respond, then plausible is—is good enough as long as we are fighting is what is actual.

Dr. Justin Marchegiani:  Interesting.

Dr. Andrew Hill:  And we’re discovering what is actual in things like follicles. You know, there was a study out a few months ago that showed that—that they’ve figured out why hair goes gray and it looks like the same mechanism actually might be related to the—the key of the suppression of the follicle. There are some—some evidence that they tested but there’s some theory that was generated by this first finding. The first finding was, “Oh, look! Here’s what makes hair go gray.” And that actually explains why thigns like resveratrol may actually reverse—may actually plausibly reverse graying in some people who—who claim that it does, it’s not a wide—widespread phenomenon but it seems to happen. But the same mechanism seems to you know, suggest suppression of hair follicle and so we might be like right around the corner from you know, no more male pattern baldness through cosmetic you know, pharmacology if you will or genetic manipulation or who knows but it seems to be we’re right around the corner from—from solving that if you will. And then I’ll have a very firm opinion about how it works.

Dr. Justin Marchegiani:  Got it. So you’re thinking—

Dr. Andrew Hill:  But right now, you know—

Dr. Justin Marchegiani:  Yeah?

Dr. Andrew Hill:  It doesn’t matter.

Dr. Justin Marchegiani:  So you’re thinking the resveratrol could be helpful?

Dr. Andrew Hill:  I think it probably can be. You know, I don’t—I don’t mind being bald, you know? I—Ia m—I guess I’m blessed in that I have a sort of Patrick Stewart shaped head.

Dr. Justin Marchegiani:  Yes.

Dr. Andrew Hill:  And so I can cool it off—

Dr. Justin Marchegiani:  Love it, yeah.

Dr. Andrew Hill:  it’s fairly, it’s fairly round. There’s not a lot going on up there.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Beyond curve.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I—I can pull that off and I, you know, I wear glasses so doesn’t mean to break in that expanse of flesh but—

Dr. Justin Marchegiani:  Got it.

Dr. Andrew Hill:  It doesn’t really bother me and I don’t really care too much about it. But yeah, resveratrol will probably or some related molecule probably, you know, unsupress the follicle, I mean, right now resveratrol has other uses, right?

Dr. Justin Marchegiani:  Mitochondria, yeah.

Dr. Andrew Hill:  You’re taking resveratrol for mitochondrial support.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  It seems to suppress estrogenation or other Romanization—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Of some hormones, so take it to protect the heart valve. If you’re taking other compounds can be useful. You know, there’s a few other like—like serotonergic but you don’t wanna take 5HTP and—and other serotonin converting things and get peripheral nervous system serotonin, that will do damage. You know, you’ll get peripheral neuropathy and damage your heart valve. If you wanna take you know, resveratrol and things like to suppress Romanization of hormones, but I—I bet we’re gonna discover something else like that, and suddenly sprout big, thick full heads of hair. And—

Dr. Justin Marchegiani: Love it.

Dr. Andrew Hill:  And will I try it? Sure. You know, because I actually have a gorgeous—you wouldn’t know this—but I have a gorgeous you know, reddish blonde Scottish mane.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And you know, it’s been 25 years since I’ve seen it, and you know, I can grow a ground _____ Willy style moustache right now.

Dr. Justin Marchegiani:  Nice.

Dr. Andrew Hill:  And I might, but it’d be kinda fun to go all full like you know, lion again, just playing in my age, so I say, yeah. I—as much as I am sort of laughing about who cares if we cure baldness, I would probably partake if there was a you know, natural-ish substance that I could tweak my—my follicles with.

Dr. Justin Marchegiani:  Absolutely, I love that. Well, kinda finishing up here. I wanna just go through just a—a rapid question round for you. Just kinda hit these next couple things off.

Dr. Andrew Hill:  Uh-hmm.

Dr. Justin Marchegiani:  Just really quick, sound good?

Dr. Andrew Hill:  Sure.

Dr. Justin Marchegiani:  Alright. ADHD, what are the top 3 things you do for that?

Dr. Andrew Hill:  Meditate, neurofeedback and drop sugar out of your diet.

Dr. Justin Marchegiani:  Addiction.

Dr. Andrew Hill:  Understand why you’re using.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it impulsivity?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Is it boredom? Is it discomfort with your emotions? Is it brain injury that lead you to behave where you weren’t inspecting. Figure out which it is and solve it.

Dr. Justin Marchegiani:  Got it. You’re studying for an exam. What are the best things to get your brain revved up for that?

Dr. Andrew Hill:  The best thing is to space your practice versus mass your practice first of all.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Andrew Hill:  Short breaks ideally with rest and sleep in between them over many days to ensure consolidation. The other thing is to put yourself in the perspective of get to versus have to.

Dr. Justin Marchegiani:  Love it.

Dr. Andrew Hill:  So engaged with your—engage with your material because it’s fun and find a way to make it so. And the third thing is don’t binge on food when you’re studying. Snack very lightly make.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  To make sure you don’t end up in a—in a bonk, blood sugar-wise which will completely abolish the learning and studying interest you have for that session.

Dr. Justin Marchegiani:  Love it. Top three smart drugs.

Dr. Andrew Hill:  Clearly, piracetam, cito— citrocholine and let’s say DHA.

Dr. Justin Marchegiani:  DHA.

Dr. Andrew Hill:  These are the kinds of drug. Yeah.

Dr. Justin Marchegiani:  Yeah. Basically the 22 carbon fat and the fish oil. Awesome.

Dr. Andrew Hill:  Yeah, it seems to, you know, and maybe even Vitamin D might even fall in that category.

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  These things are so profound in—in so many tissues and supporting so much metabolism. I think they upregulate stock even when it’s not noticeable.

Dr. Justin Marchegiani:  Love it. Recovering from brain trauma or a TBI.

Dr. Andrew Hill:  First thing, don’t do anything immediately.

Dr. Justin Marchegiani:  Fast, right?

Dr. Andrew Hill:  Don’t jostle your brain physically or mentally.

Dr. Justin Marchegiani:  mmm.

Dr. Andrew Hill:  For a few weeks then drop inflammation, which means rest, low sugar, and then you can start doing things like neurofeedback and concentration-focused mindfulness to start waking up all that bruised and delta-rich cortex.

Dr. Justin Marchegiani:  I’ve seen a low of stuff on low-calorie diets especially for a couple days after the injury.

Dr. Andrew Hill:  Yeah, it’s just that fasting produces a drop in inflammation, so you know. Yeah, basically you gotta rest and you can’t even think hard ideally. You know, you definitely, you know, the—the damage comes in concussions from the second impact that you get in certainly within 3-5 days but maybe even 3-5 weeks after a first significant insult to the brain. There’s all these inflammatory cytokines that cause inflammation after the first insult that protect the brain in the—in the short term but make it fragile, make the tissue very shatterable for days and if you receive a second impact in that time, the damage—the damage is much more profound. You know, the damage carries through the brain , you know, through a solid almost, the way it would like a block of ice instead of just kinda pushing on a—on a corner like a piece of Jell-O or something, so—

Dr. Justin Marchegiani:  Mmm.

Dr. Andrew Hill:  You gotta let your brain rest for weeks, you know, 3 to 5 weeks if it’s a significant injury, and you can rebuild, you know, if you’re somebody who’s had a lot of wear and tear, brain fog, irritability, wearing out mid-day with cognitive fatigue, those are the—those are the 3 big signs. If you are somebody who’s post-concussive and you—you  realize that you still are, you know, months or years later, do something about it. Get some neurofeedback. You can completely—not completely maybe—but you can certainly affect it positively. And there are some long-term risk for many post-concussive. You know we know now that, you know, there’s a study out a few years ago, not even a few months ago I think or something last year, that showed that high school football players who never played a game but practiced with the team show early signs the chroma—of chronic, or sorry—CT, chronic, traumatic encephalopathy. From beginning brain scan, to the beginning to the end of the season, without ever playing a game—

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Simply doing practice. So the amount of damage the brain can actually shrug off is negligible. It’s not really supposed to be bounced.

Dr. Justin Marchegiani:  Right.

Dr. Andrew Hill:  Or st—or change direction suddenly at 60 miles an hour. It’s not designed to go 90 miles an hour highway and suddenly stop, you know, or anything else where—where you’re launched through the world and then suddenly stopped. The brain’s great at you know, not that extreme impact, but it fails very quickly over a certain amount of impact. Let’s say it’s not force and we hit that force all the time. A single—there’s a study out 2 weeks ago maybe—a single stocker heading drill, and in heading the ball 20-30 times in a few minutes, memory test before and after showed a three quarters drop in performance, severe hermit.

Dr. Justin Marchegiani:  Wow.

Dr. Andrew Hill:  Right afterwards. Now, the study didn’t—didn’t look at long-term, it looked at immediate and it found a—and it found massive GABA-ergic, well, they were hypothesizing GABA as an inflammatory response but they found inflammatory markers and they found massive impairments in memory right after drill, and those things we know are things the brain learns from and—and responds to. So there is no safe level of head impact, you know? If I ever have a kid in high school, they are not going to play football or soccer. You know, I—

Dr. Justin Marchegiani:  That was my next question.

Dr. Andrew Hill:  Yeah. Never.

Dr. Justin Marchegiani:  Would you like your kid to play football?

Dr. Andrew Hill:  No, I would not. No, I would not.

Dr. Justin Marchegiani:  And what do you think about what’s happening with the NFL? I mean, do you think this is just like smoking in the 1950s and it’s just, we’re just waiting for enough—

Dr. Andrew Hill:  Yes.

Dr. Justin Marchegiani:  Research to come to a head?

Dr. Andrew Hill:  Yes, absolutely. Yup, absolutely. The—the NFL will become and also ran a small network of people who were the bad boys who still continue to do this thing that leaves people damaged. The NFL will be seen as an organization like Monsanto that has secretly known for decades that they’ve been injuring and killing people and had been doing lots with millions of legal dollars to keep that suppressed.

Dr. Justin Marchegiani:  Absolutely.

Dr. Andrew Hill:  And we will discover that if there—it just isn’t. It was never safe. That will be considered a barbaric time in—in 50 years.

Dr. Justin Marchegiani:  I think you’re right. Well, here, last question with you Dr. Hill before we find out more about where everyone can go see you. If you’re on a desert island, what’s the one supplement or nutrient you bring with you?

Dr. Andrew Hill:  Alright, well, does this—does this desert island have coconut trees or not?

Dr. Justin Marchegiani:  It does, so you’re gonna have the medium chain triglycerides there.

Dr. Andrew Hill:  Nice. So if I have coconut meat and—and fat and everything else—

Dr. Justin Marchegiani:  You could probably fish, too, so you’re Omega 3’s and DHA will be recovered.

Dr. Andrew Hill:  I can fish, I got my DHA, you know, okay.

Dr. Justin Marchegiani:  Sunlight, vitamin D, that’s covered.

Dr. Andrew Hill:  I think that—I think that something, maybe beta-carotene.

Dr. Justin Marchegiani:  Okay, so vitamin A.

Dr. Andrew Hill:  Or, no, I don’t know, I may go get astaxanthin from like—

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  Shellfish.

Dr. Justin Marchegiani:  You probably would.

Dr. Andrew Hill:  So, hmm, what—what can I—what couldn’t I get from a natural, from an island I really needed? Yeah, I would probably have to say something like piracetam.

Dr. Justin Marchegiani:  Okay.

Dr. Andrew Hill:  You know? but not, you know, let me—let me give you a non-standard answer. I—I wouldn’t bring any racetams with me. I’m on a desert island. I’m gonna relax.

Dr. Justin Marchegiani:  Yeah.

Dr. Andrew Hill:  I’m gonna fish. I’m gonna you know, I’m gonna get plenty of vitamin D and—and good food and you know, maybe—maybe grow some vegetables. Huh! But if I’m actually on a desert island, high-performance is not my survival. I’m gonna survive and once I’m surviving, I think—I think the environmental press of—of having to live and pry on a desert island would be sufficient nootropic to keep me functioning at my highest level.

Dr. Justin Marchegiani:  Love it. very cool, Dr. Hill. Now people who are listening, they wanna find out more about you and about TruBrain and about some of the services that—that you provide. Where is the best place to find more info on you?

Dr. Andrew Hill:  Yeah, so fols can check me out at @AndrewHillPHD on Twitter. I think I’m also at Instagram, but that’s a pretty anemic page. Peak Brain LA, Peak Brain Institute has a Twitter, @peakbrainLA. We have a website, peakbraininstitute and of course, trubrain.com—T-R-U-Brain dot com is the supplement—it’s the supplement that the nootropic stack that you mentioned that I helped design a few years ago, and you know, I’d love if people reach out and ask me a specific brain questions. We have very unique brains. You put 10 people in a room, there’s at least 11 different brains in that room from my perspective. You really gotta share what’s special about you and celebrate it or take control of it and tweak it and address it. So I’d love if folks have, you know, quirky brains they wanna share to look me up and—and find out what we’re doing and you know, there’s lots of ways to—to take control and change your brain, so give me shoutout if you want one.

Dr. Justin Marchegiani:  Thanks a lot, Dr. Hill. It was a great talk and we look forward to chat with you again soon.

Dr. Andrew Hill:  My pleasure, Dr. Justin.

Dr. Justin Marchegiani:  You take care. Have a good one.

Dr. Andrew Hill:  You, too. See ya.

Dr. Justin Marchegiani:  Bye now.

Dr. Andrew Hill:  Bye.

Natural solutions for high blood pressure – Podcast #117

Dr. Justin Marchegiani and Evan Brand dive into a discussion about high blood pressure, something everyone is all too familiar with, and they explain what the root causes are and how you can manage it conventionally and with functional medicine.

Find out what nutrient deficiencies can be caused by blood pressure medications and what you can do about it. Discover how you can manage your blood pressure in the long-term with functional medicine. Also learn some tips on what to eat during the holidays and how to get that mouth feel while eating good food when you listen to this podcast.

In this episode, topics include:

01:45   High Blood Pressure Overview

05:39   Blood pressure myths

10:46   Mechanisms

12:04   Nutrition and stress

20:10   Lifestyle







Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin. Evan, how are you doing today, man? It’s almost Christmas.  December 23rd here, really excited for the holidays. How you doin’?

Evan Brand:  I’m as excited as you are.

Dr. Justin Marchegiani:  Great! So the question is have you been a good boy this year?

Evan Brand:  I’m on—I’m on the good list.

Dr. Justin Marchegiani:  Good, awesome!

Evan Brand:  What about you? Are you on—are you on the nice or the naughty list?

Dr. Justin Marchegiani:  Of course, I’m on the nice list. Now the question is, are you gonna leave some Paleo cookies out for—for Santa, or are you gonna leave some—some glutinous cookies out for him?

Evan Brand:  We actually did buy some organic Annie’s cookie for a Christmas party. I will probably not be partaking in them even though it’s organic which is great there’s the wheat, so I will be avoiding the wheat. I’ll probably buy Miracle Tart for myself for Christmas since I’m part Santa.

Dr. Justin Marchegiani:  Yes, exactly. That’s the—the Hail Mary tarts, right?

Evan Brand:  Yes, those are so good. There’s only one place in the whole city you can get them here and so that’s where I go to—to get them.

Dr. Justin Marchegiani:  Do you guys have a Whole Foods down there in Louisville?

Evan Brand:  Yeah, we got Whole Foods. They don’t stock them there though. They stock them at this little local place called Rainbow Blossom. They have random things like Epic. They have Epic products. They have their pork rinds and that’s the only place you can get him.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  And they’re really darn good.

Dr. Justin Marchegiani:  Wow. Very cool.

Evan Brand:  You know what I’m talking about? Epic?

Dr. Justin Marchegiani:  Yeah, the Epic bars you mean?

Evan Brand:  Have you seen them?

Dr. Justin Marchegiani:  The Epic bars?

Evan Brand:  No. Yeah, but they have pork rinds now. Have you seen them?

Dr. Justin Marchegiani:  Oh, I have seen them. I have patients that just got some recently/.

Evan Brand:  Yeah, the pastured pork rinds. They’re really good.

Dr. Justin Marchegiani:  Gonna have to get them for sure. I love pork rinds.

Dr. Justin Marchegiani:  Love it. Well, we talked pre-show that we were gonna chat a little bit about blood pressure. We really haven’t gone into that so much.

Evan Brand:  Yeah, I mean this is common. Just some statistics at a glance, you got 70 million Americans and 1 billion people worldwide with high blood pressure, and if it’s left untreated you run into many, many, many issues. The biggest one that people probably know of is a stroke, and one time probably 25-30 years ago my grandmother had high blood pressure so high that she felt a shooting pain in her brain. So she went to the emergency room. She had my grandfather take her in and her blood pressure was over 220 by maybe 150, 220/150 something like that, just insanely high that so high that the nurse freaked out and immediately, immediately took action to get the blood pressure down. So this is not always the way that people find out they have high blood pressure issues. This could be going on behind the scenes for decades, but there are some simple strategies that we can talk about that can help to reduce the risk of high blood pressure. It goes up naturally with age, right? But that still should not be over 200. That’s just mind blowing.

Dr. Justin Marchegiani:  Oh, absolutely. So when you look at blood pressure medications, you know, for the most part, that’s a chronic type of ailment. It tends to happen over a long time and it’s—for the most part, it’s something that’s chronic and that the blood pressure medications aren’t gonna get to the root underlying cause.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Now if your blood pressure, you know, you’re upwards of 160—that’s the systolic number. That’s the—the pressure that your heart creates in the blood vessels when the contracts and the bottom number, that’s called the diastolic number, like D for down, it’s the bottom number and that’s kind of where the pressure is in your arteries/heart when your heart’s kind of relaxing. So you pump—the lub dub—that’s the heart contracting and where it’s pressing down, that’s the top number, systolic, and then where it’s relaxing, that’s the bottom number, the diastolic. So when you get about 160 with the systolic, that can kind of be what I call the danger zone. So if you are at that level and let’s say, you haven’t quite made the diet and lifestyle changes, I do think being on a medication at higher levels until you get to the root cause is better because you wanna avoid a stroke or some type of a heart attack, right? So we want to make sure that if it’s high and you’re not doing anything about it, getting that blood pressure down is better, but in the long run we don’t want that to be the only answer.  We wanna look at getting to the root cause and we’ll kinda go over some of the root causes here in just a bit.

Evan Brand:  Great point. So just to be clear if someone’s listening and they have high blood pressure but they’re scared or they do not like conventional medicine you would still advise that person to go get on the drug even if it is short-term because you’re safer on a drug with side effects that lowers blood pressure than having high blood pressure and doing nothing.

Dr. Justin Marchegiani:  Exactly, and you were talking–

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Upwards of above 160 and let’s say you already have a lot of a healthy—or sorry, unhealthy habits going on, poor exercise, sugar, inflammation, all that and you don’t quite know where to go yet, again I just would hate to see someone, I’m—I’m a little more concerned and I hate to see someone go and have a cardiovascular incident that could’ve been prevented with some blood pressure medication in the short-term but in the end, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We wanna get on board with the functional medicine coach/doctor that can get to the root issues because the nice thing about blood pressure, it’s easy to monitor. You get one of these $30 Omron blood pressure cuffs, the self ones on Amazon you can monitor it multiple times a day, and then you can see the number go down and guess what? You just call up your doctor. “Hey, Doc, I’m doing some natural things to help lower blood pressure. My blood pressure’s dropping naturally. I like to taper off the medication.” And most medical doctors, if you’re being responsible and monitoring it and you’re telling them you’re doing things they typically have no problem with that if you show them that you’re responsible by keeping track of it.

Evan Brand:  Yup, well said.

Dr. Justin Marchegiani:  Yeah, so off the bat, anything you want to comment on that?

Evan Brand:  Well, so with blood pressure, you know, there’s tons of things that can cause it. I would say we should probably dispel the myth of the salt high blood pressure, I mean, kind of—part of it’s true if we’re talking about the garbage salt, right? The iodized salt, the sodium chloride plus iodide, but with like a good pink salt or a good Himalayan sea salt, there’s so many different options with black salts, there’s volcanic salts, the sodium is not gonna be the problem there, it’s the inflammation combined with a low-quality salt that could be the problem, right?

Dr. Justin Marchegiani:  Yeah, they’ve done studies I think it’s in the Journal of the American Medical Association where like salt even, they—I don’t think differentiated the quality of salt, probably your regular table salt that’s not so nice. I think it increased like maybe 2 mmHg, right? Two or three, that’s like the top number. That’s like going from 120 to 122, 123.

Evan Brand:  Why did that—why did that become such a popular widespread myth do you think?

Dr. Justin Marchegiani:  That’s a great questions. There’s a lot of things in conventional medicine that are that way. I mean, you can look at grains, you can look at sugar, you can look at trans fat. I mean, you can look at cigarette smoking. You can look at so many different things–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Of how they kinda got that way but for the most part the only reason, the only, you know, motivation to avoid salt is if you already have severe kidney damage, maybe the only reason why you’d want to decrease salt consumption is because you have active kidney issues right now. But if you didn’t have that, getting high quality minerals on board will be helpful and again, if your blood pressure is excessively low, salt will help bring your blood pressure up kind of in a modulatory way, but it won’t make it go excessively high. You won’t have high blood pressure because you have more sea salt intake. You will have higher blood pressure but higher and high are two different things. Higher meaning a couple millimeters of mercury bump, that’s where we’re looking at.

Evan Brand:  Makes sense.

Dr. Justin Marchegiani:  Except if it’s low—if it’s low, it’ll bring it up much higher because you know, let’s say your adrenals are really key at holding on to minerals and if you’re decreasing your mineral retention because the aldosterone that your adrenals make is low because of the adrenal dysfunction that’s happening, you will pee out more minerals and that—that’s important for regulating blood pressure and that’s also important for their sodium potassium pumps, so if we don’t have enough high quality sodium, those sodium potassium pumps kinda that creates the gradient and how things go in and out of the cell, now if don’t have adequate sodium on board, that can definitely be a stressor for the body.

Evan Brand:  Yeah, makes sense and you and I hear this all the time with people with adrenal problems, if you stand up quickly you may get lightheaded or woozy, you’re not regulating your blood pressure. You may not have high blood pressure, you could actually have low blood pressure in some of those cases, but either way your body’s ability to regulate blood pressure does decrease if there is adrenal stress which definitely there’s gonna be adrenal stress of there’s infections and inflammation, and all the things that you’ve already mentioned, maybe other things like insulin resistance. How do you know if you’re insulin resistant? Well, if you look into—well, there’s—there’s calculators and all of that to look at, what is it? Waist to hip ratio and all of that. But if you look into the mirror and you see that you’re overweight, it’s likely that you have some level of insulin or possibly leptin resistance problems which can then cause blood pressure to go high.

Dr. Justin Marchegiani:  Absolutely so when we look at blood pressure, one of the biggest things that will throw your minerals off and cause a higher than normal blood pressure is increased fructose consumption, i.e. sugar and just increased elevations of insulin. Insulin will cause a retention of sodium. That’s why one of the first things you notice, you cut out sugar for 2 or 3 days, you lose like 3 or 4 pounds weight, maybe even more. Now you’re not losing 3 or 4 pounds of fat. You’re losing 3 or 4 pounds of fluid because as the sugar goes down, right? One molecule of sugar holds on to—to I think 3 or 4 molecules of water, something like that. So as the sugar goes down, so does the sodium and so does the water. So what happens is you flush out a lot of fluid when you cut down the carbohydrates and cut down the sugar, and with fructose—fructose, high amounts of fructose inhibits this enzyme called en—endothelial synthase. Endothelial synthase is a nitric oxide-based enzyme that’s really important for vasodilating, and dilation means opening up those blood vessels. So if we decrease the enzyme that opens up those blood vessels, it’s like clamping down on that hole. It’s like going out in your garden taking the hose that’s putting out water and putting your thumb over the edge of it to make that stream go stronger and stronger.

Evan Brand:  That’s a trip. Now let me stack on another idea here. If there is adrenal stress, someone’s also gonna be dumping a lot of magnesium which you need that to help relax the blood vessels so you’re compounding the issue and if you are adding the fructose or the high fructose corn syrup or sodas in there, that’s gonna cause blood sugar issues which is gonna create a bigger crisis and the adrenals are gonna have to be more stressed if they’re not already. They’ll be more stressed because they’re having to kick in as the backup generators because then the pancreas and the liver not being able to keep up, so the whole cascade really kinda falls apart at sugar it sounds like.

Dr. Justin Marchegiani:  Exactly. So we have a couple of different mechanisms. Let’s break them down. So we have just the—the general sugar kind of mechanism with it’s table, you know, your sucrose, fructose, kinda glucose thing that’s increasing insulin and that’s gonna hold on to more fluid and more sodium, and that will increase blood pressure via that way. We have the fructose mechanism that will increase or decrease the endothelial synthase enzyme which will decrease the vasodilation, i.e. cause constriction of the blood vessels, and we also have plasminogen activator inhibitor mechanism. So the higher amounts of insulin we have, our plasminogen activator what that does is it—it decreases or I should say, it decreases clots, i.e. it increases fibrinolysis. So -lysis means to cut. Fiber means like a clot. So it’s breaking down blood clots. So imagine little occlusions from cells sticking together, fibron, it’s gonna decrease those clots and allow smoother flow in the plumbing in the cardiovascular system. So if we decrease the clots, that means the plumbing flows smoother and that means we’re gonna have less pressure to have to push through those clots. So we have the plasminogen activator inhibitor-2 mechanism that also gets drained with higher levels of insulin.

Evan Brand:  Make sense. Should we talk about nutrition now?

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  So Omega 3 deficiency is huge, I mean, if you look at hunter-gatherers or if you even just look Ennuit studies, you’ll see that the average Ennuit was consuming anywhere depending on what you look at, but on the low end 10 or 15g, sometimes 20g of Omega 3’s per day and we’re lucky if we get someone to take a 1g or maybe 2g supplement of Omega 3’s. So there’s a huge, huge deficiency and when you look at research linking Omega 3’s to blood pressure problems, what you’ll find is the people who have the lowest blood pressure readings have the highest blood levels or serum levels of Omega 3’s. This is a huge find and this is why I’m very, very passionate about getting people to supplement with some type of Omega 3. We’re gonna assume that most people are not eating enough wild caught fish and also then you run into the issue of the methylmercury in certain bigger fish like tuna. So for me I’m more pushing people towards a supplement because I know a lot of people don’t want to cook fish multiple times a week anyway, so you can look at like a fish oil or a krill oil, but at the end of the day, could you still get some fish into your diet? For sure, a cod or a wild caught salmon would be good, but your—what is it called? StarKist tuna that’s probably sitting in genetically modified soybean oil. You want to stay away from that.

Dr. Justin Marchegiani:  Absolutely, and fish oil also is a natural blood thinner. It keeps the cells of from sticking together. So it’s kind of a natural thinner, kinda like a Coumadin or a warfarin, but without the side effects. So it does thin out the blood a bit for sure.

Evan Brand:  Great point. Yeah, that’s why we gotta tell people if they’re going to get surgery you would think, “Oh, man, supplements are fine.” That is one case where we would say, “Hey, look, why don’t you stop taking your fish oil for now if you’re going to get surgery, because we don’t want your blood too thin.” So it is very, very effective for that.

Dr. Justin Marchegiani:  Absolutely. So we talked about vitamin D. There’s also other natural blood thinners like ginkgo which help increase oxygenation by increasing blood flow. Even things like systemic-based enzymes taken on an empty—empty stomach especially serratiopeptidase. So if you have various clotting or you have occlusions in the coronary arteries, taking some of these enzymes on an empty stomach they’re gonna be enterically coated so they’re not gonna be used for digestion. They won’t get exposed and degraded by stomach acid. Ideally they’ll make its way into the bloodstream where these guys can hit areas of plaque or occlusion and break up any fibrin or scar tissues that may be hanging out in there.

Evan Brand:  Here’s another—you—you brought up vitamin D. Here’s a good—a good hack and obviously it may take money if you’re somewhere closer to the polls and it’s wintertime, you’re not gonna have as much sunlight but there’s definitely some research that shows that if you exposed your skin to sunlight, that it’s gonna increase the level of nitric oxide which is isn’t gonna naturally help you to dilate your blood vessels and then, therefore, reduce your blood pressure. So you could be taking a fish oil supplement, you could be going to the beach and getting some sunshine, and then what about stress? We should probably mention stress, too, because a lot of this is we’ve already talked about stress, right? Nutritional stress, mineral stress, but emotional stress, too, if that goes unaddressed and people are harboring anger and negative emotions, that’s not good. That cannot—it’s definitely not helping your blood pressure. Put it that way.

Dr. Justin Marchegiani:  Well, all of that will basically increase cortisol and adrenaline which does have a vasoconstricting. It’ll—it’ll put that thumb over the water hose a little bit tighter, incre—increase that flow because of the stress hormone. So stress emotionally knocks over a domino cascade of adrenaline and cortisol, which does have a big impact on the vascular system.

Evan Brand:  Which would be good if you and I were running from a bear, right?

Dr. Justin Marchegiani:  Yeah, totally make sense, right? Because we gotta get blood flow to those extremities, the toes, the fingers, the arms, the legs, so we can run and fight and flee. But if we’re just sitting on their desk or like, you know, driving to work and we’re just boiling and we don’t—necessarily don’t need that type of blood flow. You can see the stress on the vascular system that is caused by that type of hormonal cascade.

Evan Brand:  Yeah, so I mean this is another example where the ancient wiring system really does try to benefit us but when it’s chronic acute stress which sounds like an oxymoron but you’re dealing with acute stressors like a cell phone notification—ding! And that goes off all day, that’s a chronic acute stressor. Your body doesn’t know the difference, so I encourage people if you have it, get rid of your notifications. I promise the world will not fall apart if you have your phone on silent or even airplane mode most of the time, and then you can get back to life on your terms. Because what I find with people dealing with emotional stress, and—and hypertension is that many people feel like there’s never enough time in the day. They’re always playing catch up and I found personally, if I get up a bit earlier I feel more in control of my schedule. You and I are very, very, very passionate about calendar software, so we love our calendars and couldn’t live without them.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So that—so that’s another helpful thing. But for me, it’s also focusing on the most important things in the morning. You gave me some really good advice when you talked about kind of the morning visualization and all of that. I’ve— I try to do some type of morning meditation, visualization exercise, that helps to increase the amount of control and at the end of the day, the goal is just to reduce your perceived stress. Justin and I can’t wave a wand and say, “Okay, look your stress is gone.” But if we can fix or improve the way that you respond to what you have on your plate, at the end of the day, you’re gonna be much healthier. You’re not gonna releasing cortisol all day. Hopefully, you’re gonna have less food cravings. You’re gonna be less dependent on glucose because you’re gonna be burning ketones and fat, and you’re gonna be in a much better place, mentally, physically, cognitively, blood sugar-wise, everything.

Dr. Justin Marchegiani:  A hundred percent and just piggybacking on what you said, just a little bit of sunlight makes a big difference. They’ve done some studies and again a lot of this is correlation not causation, but you know there are some potential mechanisms there, like with the nitric oxide and potentially with the kidney and how vitamin D can really help blood pressure, one study talked about a 10 ng/mL increase, so you know, if your vitamin D’s 30, that’s like taking it from 30 to 40, and someone who’s vitamin D levels are lower can have a 12% lowering of their blood pressure and also people who had the highest vitamin D levels had a 30% lower risk of developing hypertension. Again not causation but correlation but there are some hypothetical mechanisms that we just mentioned that could be at play so a good rule of thumb here especially in the winter months, get your 25-hydroxy vitamin D looked at and if you haven’t gotten it tested yet or you don’t have the ability to test it right now, a good rule of thumb is 25 for every 25 pounds of body weight, you have 1000 IUs of vitamin D is fine. So I’m a little over 200 pounds so I would do about 8000 IUs of vitamin D, maybe round up to 10. Someone who’s half that, obviously 4000 is a pretty good starting point if you’re just trying to figure out, hey, how can I take this vitamin D to lower my blood pressure?

Evan Brand:  Yeah, some people worry a lot about the vitamin K because we’ve talked before about the whole traffic cop analogy of vitamin K helping to direct and keep calcium where it belongs and not into your arteries and things like that. Do you worry much about vitamin K1, K2 supplementation or you just focus on getting plenty of good butter?

Dr. Justin Marchegiani:  If we’re going vitamin D on a high, if we’re using vitamin D and we’re going with it for a long period of time, we’ll make sure there’s a couple hundred micrograms of the MK2 in there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Right, MK—I think it’s MK4 and MK7.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Let’s see, I’ll have to look at my bottle over here, but the vitamin K 2, the X factor, the activator, that’s what we’ll use and that will significantly help keep the calcium where it needs to be in the bones, and also just getting high quality grass-fed and essential fatty acids, a little bit of liver, all that stuff’s gonna be phenomenal for vitamin K.

Evan Brand:  Excellent. Now I wanted to get back to more lifestyle things. We talked about vitamin D. We talked about Omega 3’s. Exercise is a good one for sure, I mean, the—the basic part of it is just that you’re becoming more insulin sensitive. I mean if you think about how hungry your appetite is when you get done with a good high intensity workout. Oh, my gosh, you can just feel amazing, and if I do a protein shake after an intense workout, I feel like it’s going straight my bicep. I love the feeling but now—

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  After super high blood pressure, would we want to tell people, “Look, start with just walking.” You probably don’t want to put somebody on a high intensity interval training if your blood pressure is already 150-160. You might not be able to handle it. You might get dizzy and—and more stressed out than—than we want you to be.

Dr. Justin Marchegiani:  Exactly so you have, you know, the mechanism you just mentioned by having the insulin receptors be more sensitive. That means your pancreas has to produce less insulin to get the sugar into your cell, so it can be burned up. Number one. You’re obviously you’re burning—you’re putting less sugar into your body so you’re using more ketones for fuel. So we’re being more fat or keto adapted at that time, and then also the heart just gets stronger. As the heart get stronger, it needs less force to pump. It has a higher stroke volume so it can push out more blood per pump and that obviously will have a—an effect of decreasing the blood pressure and then also growth hormone and/or just exercise will increase nitric oxide. And that will have an effect of—

Evan Brand:  That’s—that’s so cool.

Dr. Justin Marchegiani:  Vasodilating and opening things up, too.

Evan Brand:  Yup. That is so cool. How about—what about indoor—indoor air pollution. You know, the EPA talks about 10 or 100 times more toxic exposures inside your home than outside. So air purification could be a good idea because if you’re breathing in these different toxins, that’s also an invisible stressor that’s gonna be elevating that whole nervous system sympathetic, fight or flight response, which we really don’t need to press that button anymore.

Dr. Justin Marchegiani:  Exactly, so anytime you put a stressor on your body, whether it’s physical, chemical or emotional, and this kinda fits into the chemical realm, i.e. toxin realm, that can be a stressor on the body and your adrenals and your fight or flight system may respond. It may put you into a sympathetic type of stress response and again we already know what happens with that cortisol increase that’s gonna create constriction. Why? Because the stress response pushes blood flow to the extremities, right?

Evan Brand:  For survival—survival over I don’t know what the—the other side of the coin would be. But your body goes for survival any day.

Dr. Justin Marchegiani:  Yup, exactly. Surviving over thriving. The problem is thriving only happens after the survival mechanism is turned off, but most people are constantly living with that survival mechanism turned on and activated.

Evan Brand:  So now this can get a little bit complicated.  So I know this may be tough for us to cover this, but let’s say we have someone that is already on a blood pressure medication like a lisinopril and we’re wanting them to go the natural route or they have intentions to go the natural route. How does that work? Do we bring the doctor on board and we have to say, “Look, you know, I’m working with a functional medicine practitioner. We wanna start using some natural things like Hawthorne or other blood pressure modulating herbs. Can you help me to lower my medication?” You know, how—how should that relationship happen between the prescribing doc and then someone like us trying to help to switch them to something natural or just get them off any type of meds completely?

Dr. Justin Marchegiani:  So what I typically tell patients, I say, “Are you interested in getting off your blood pressure medication? Do you wanna get off them?” And almost anyone that’s seeing someone like us, they definitely wanna get off them.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Again, the biggest problem with a lot of the blood pressure medications is they actually perpetuate the need for more blood pressure medications. So what I mean is they actually create nutrient deficiencies. Things like potassium which are really important for blood pressure, magnesium which is a natural beta blocker—these little receptor sites in the heart that the nervous system activates and it creates, you know, more excitability in the heart and that can cause the—the heart to have to pump harder and that can increase the blood pressure in the arteries. So magnesium’s a natural beta blocker, really important for relaxation. People that take it, one of the first thing they notice is they start to relax and wind down. That’s why Epsom salt baths are so popular with people that are stressed. So magnesium, potassium, calcium, various B vitamins, so all these nutrients become more deficient in these types of medications. These medications are known to create these nutrient deficiencies. So like I mentioned before acutely if you’re not in good place, you wanna be on one of these medications until you can get your—your lifestyle and everything in order, and you find a good nutritionist and/or functional medicine doctor to work with, that’s when you can start to move forward and the nice thing is it you just monitor it. You can tell your doctor, “Hey, we’re gonna be doing some things to help lower it naturally. A lot of times they think there’s nothing you can do. I mean, they may be keen on the whole diet and lifestyle thing. They may think that you can’t get down to the point where you are off the medications, but a lot of times they’ll entertain the idea. “Hey, let’s monitor it. Let’s see where you’re at out and you can go from there.” The biggest though misconception you gotta be careful of if you’re only testing your blood pressure during the day when you’re at the doctor’s office, we called The White Coat Syndrome. Just being around the doctor in the office and all the, you know, “Hey, am I gonna get a shot today or a needle or give blood, whatever,” so it’s a lot of stress about getting poked and prodded when you go to the doctor’s office. That can increase your blood pressure as well. So I tell my patients, first thing you get up in the morning. You’re still horizontal. You’re lying down. Take your blood pressure there. Take it at random intervals throughout the day and just kinda make some notations of how your blood pressure ranges. It may be 20 or 30 mmHg higher when you’re more active, but when you’re more relaxed, it maybe 20 or 30 lower, and if you’re sleeping—

Evan Brand:  I had my grandfather—

Dr. Justin Marchegiani:  Yeah, go ahead.

Evan Brand:  Sorry, I didn’t—I didn’t mean to interrupt. I had my grandfather do that because he went to his doctor, which he doesn’t like his doctor anyway, and I tell him, “Look, you can—you can get a new doctor.” I don’t—he feels so tuck. I don’t know. It’s just that mindset. Anyhow, 40 difficulty—40-point difference from morning when he first got up, took his blood pressure—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Compared to at the doctor’s office. I mean, we’re talking a difference of 120 to 160. I mean, that’s insane, 40 points. So here you go and it’s not like the doctor is going to monitor you and say, “Hey, let me check your blood pressure again next week.” If they see that high once, they’re gonna put you on the drug.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  And write that prescription that quick.

Dr. Justin Marchegiani:  Exactly and the insurance base model for visits with your conventional MD, there’s just not time to talk about diet nor do they even—are they even educated about it? There’s virtually zero nutritional education and if there is any, it’s based on a pathological level, right? Vitamin C causes scurvy, B1 deficiency causes beriberi, or it’s the food pyramid—eat your 10 to 11 servings of grains a day.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Let’s not talk about the GMOs or the carcinogenic pesticides sprayed on the food daily.

Evan Brand:  Oh, my gosh. I know.

Dr. Justin Marchegiani:  So you don’t like get the best perspective.

Evan Brand:  I was watching a video by Eric Berg, you know, Dr. Berg?

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Watching a video of him talking about glyphosate which I already knew most of it, but it’s just mind blowing that now research is starting to look at how small of glyphosate exposure it really takes to disrupt this whole hormonal health cascade. I mean we’re talking points, parts per billion or are parts per trillion in some cases, I mean, here you are thinking, “Oh, the 80-20 rule, 80 organic, 20 not.” I wanna be as close to a hundred as I possibly can.

Dr. Justin Marchegiani:  Exactly, a hundred percent, and again glyphosate a.k.a. Roundup, right? That’s the major pesticide sprayed on a lot of these Roundup resistant crops, basically allows them to not have to do any weeding at all, because it kills everything except the plant, i.e. kills the weed and it’s the chelator. So it pulls away minerals, so guess what? It’s pulling away a lot of good minerals, some of the ones I mentioned that are really important for healthy vascular health and controlling blood pressure.

Evan Brand:  Yup. Wow. That’s a trip and you combine that with 24/7 technology, that Fight or Flight mode is going.

Dr. Justin Marchegiani:  Exactly. So obviously getting the adrenals under control, getting the diet under control, getting the—your glycemic load under control, meaning keeping the carbohydrates within range for you. If you’re overweight, getting them close to 50 and getting more to a ketogenic approach starting out is gonna be a great starting point and then getting some of the extra nutrients back in like magnesium, zinc, potassium, folate, B6. These are common nutrients that are deficient in people taking blood pressure medications, right? We’ve talked about the nutrient deficiencies caused by these medications and then also adding things like Hawthorne or a.k.a. foxglove. I think there’s a medication made after these herbs, too.

Evan Brand:  Yeah, I think—

Dr. Justin Marchegiani:  That are—that’s conventionally used.

Evan Brand:  I think they’re—they’re rooted from that. I think they come from the plant.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And of course, they patented and changed it to where it doesn’t resemble the plant anymore but—

Dr. Justin Marchegiani:  That’s it. So some medications are actually made from those types of extracts. So we kinda reviewed the diet and lifestyle things, and that these drugs work a couple different ways. You mentioned the lisinopril or the hydrochlorothiazide. These are like water pills. They just cause you to pee more and lose more of the fluid then you have ones that affect the angiotensin-converting enzyme that affects—it’s in the lung

area menu of ones that affect the receptor sites in around the heart whether it’s the beta blockers or the—these adrenergic receptor blockers that affect heart contractility, so there’s a couple different ones there and again in the end, we want to get to the root cause of why you have these blood pressure issues to begin with.

Evan Brand:  Yup, absolutely! I’m sure we can make this an hour—an hour-long show but it always is going to end. You got—you gotta dig deeper and figure out. We could talk all day about the lifestyle and all that, but in some cases, people are doing everything right or what they think is everything right and they still have high blood pressure so there could be some other type of infection or something deeper that is causing the sympathetic stress and we just have to uncover it and I don’t know if I mentioned it to you. I ran a 401H and a GI MAP side-by-side on a female, let’s see about two weeks ago, and the GI MAP showed up with seven infections including two parasites and the 401H showed up with nothing.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Is that not crazy?

Dr. Justin Marchegiani:  That is pretty crazy. The other one was–

Evan Brand:  So I sent over—

Dr. Justin Marchegiani:  Was the other one the GI Map?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Okay. So we got DNA technology on one versus the antigen-based under the microscope technology on the other.

Evan Brand:  Yeah and I have to go on symptoms because I mean those a lot of symptoms, so get tested but—

Dr. Justin Marchegiani:  Well, you know my—yeah.

Evan Brand:  What were you gonna say?

Dr. Justin Marchegiani:  You know my method on that. If anyone has got symptoms we always wanna cast a bigger net because we have the possibility for holes in one, so 2 tests as a minimum when we’re looking at gut infections for sure.

Evan Brand:  Yeah.  Yup.

Dr. Justin Marchegiani:  And again the nutrients that are so important for heart contractility where we’re always trying to—if we go off on a tangent everyone, we’ll pull it back in and try to relate it, but the nutrient deficiencies caused by some of these infections, these nutrients like the magnesium and the B6 and the folate and all of the other minerals, potassium, magnesium, etc., zinc are really important for heart contractility and blood pressure, so if we have holes in our intestinal tract metaphorically, where we have a decrease in the absorption of these nutrients, that can affect our vasculature and our blood pressure for sure.

Evan Brand:  Yeah, so we’re talking SIBO, other you know, any type of bacterial overgrowth problems, yeast problems, parasites, things that are stealing your nutrients basically you’re referring to where you’re not getting fed yourself because you’re starving from the inside out because you’re feeding something else and not feeding yourself or hydrochloric acid levels are low. I mean, could we go as far as to say—

Dr. Justin Marchegiani:  A hundred percent.

Evan Brand:  This cascade could start by having heartburn and then getting put on PPIs which then reduces hydrochloric acid, which then reduces absorption, so then the nutrient deficiencies cause the hypertension.

Dr. Justin Marchegiani:  A hundred percent and I’ve seen so many patients that are adrenally fatigued or have adrenal dysfunction per se, and they can’t really regulate their blood sugar. They have to eat every two hours and their blood pressure gets super wonky, right? It goes down below 90 sometimes and we have to flood their body with extra minerals, enzymes, and hydrochloric acid and eat every two hours just to be able to maintain everything because the glandular system is so out of whack, which again correlates back to blood pressure. Now in this side of the fence, we’re dealing with the lower side which can still create just as many issues, not as quite dramatic as the high blood pressure ones with stroke and heart attack, right? Heart attack is occlusions and blockages in the heart. Strokes obviously conclusions and blockages in the brain. So we wanna do our best to avoid the high stuff and make sure we adhere to as many of these natural strategies as possible.

Evan Brand:  Yup, absolutely. Well said. So if it’s high, implement the stuff that you can, take the free information, and then if you need to work further, work further. Reach out to Justin. Reach out to myself. Get help. Get this taken care of. This is something that is so common, but that doesn’t make it normal. So many people can relate to high blood pressure, maybe you’ve dealt with it or you have a family member that’s dealt with it. I could think of a dozen people off the top of my head and they just get put on the drugs, nothing ever changes with diet and lifestyle, they continue to suffer and will get more symptomatic as time goes on. So don’t be in that statistic. You can—you can get healed and you can reverse this without too much hassle and a relative amount of time.

Dr. Justin Marchegiani:  Exactly, so if someone’s tuning in now, maybe they fell asleep the last half hour, well, shame on you. No. But here’s the general gist, okay, here’s the gist. If you fell asleep and you’re waking up now, diet—get it in order, just what Evan said, get the carbohydrates dialed in. If you’re overweight, start with just vegetables and maybe add in a small amount of low fructose types of fruit. From there, optimize fat, become a fat burner, and then on top of that, look at the adrenals, look at your stress, make sure that’s dialed in because of the cortisol response. And then off top of that, look at the nutrients—magnesium, zinc, hydrochloric acid. Look at blood pressure medications, potential being—

Evan Brand:  Omega 3’s.

Dr. Justin Marchegiani:  Omega 3’s. You can look at herbs that can help, the foxglove/Hawthorne types of medications or herbs I should say, which are based off of medications as well.  Omega 3’s, blood thinning, gingko, systemic-based enzymes, Hawthorne. These are all really good things to help kind of support and address blood pressure and then get to the root cause, work with a functional medicine doctor that can help you put—put it all together because it could be a little overwhelming if you’re walking into this and you’re like, “Shoot! Where do I start?” And then also a little bit of exercise and then really look at the fructose, because how that has an effect on the endothelial synthase and the blood pressure via the contractility in the arteries.

Evan Brand:  Yup, well said. And I have heard people say that they like listening to us because it’s relaxing. So you did a great job! In case I did fall sleep for the last 35 minutes, you summed it up. So good job!

Dr. Justin Marchegiani:  Perfect! Excellent and again most people that come and see me at least and I think it may be for you, most people are coming because of a whole bunch of other symptoms, and then blood pressure is kinda like a—an artifact there sitting in the background.

Evan Brand:  Agreed, yeah, that’s exactly the case. They’ve been through 10, 20 people. They’ve been going for fatigue or joint pain, but “Oh, I happen to have high blood pressure, too”. And it’s something that gets thrown to the back burner and I don’t think it should be on the back burner.

Dr. Justin Marchegiani:  Exactly and most people there are just seeing their medical doctor, and medical doctors are more than happy to manage it which we mention is great in acute cases, right? But long-term, that’s not gonna be the best option because of the nutrient deficiency. So in the end, you know, don’t look at your medical doctor as the long-term person to give you the answers to fix it. They’re just there to help manage it and again, I mean, who wants to manage, I don’t know, diarrhea forever? You want the diarrhea fixed. Who wants to manage a headache forever? You want the headache fixed. So management’s okay in the short run, but in the long run, it gets pretty frustrating and you want to get to the root cause.

Evan Brand:  Amen. You can only put so much duct tape over that—that red light on your dashboard and you just gotta fix what the problem is. Why is that light on in the first place?

Dr. Justin Marchegiani:  Exactly, yeah. Well, this was a great holiday show. I mean, everyone is probably—well, I shouldn’t say everyone but a lot of people are gonna be getting their carbs and the refined sugar and gluten on on this holiday season. I will not be or if I do, it’s good to be in a—a way that is ideally grain-free and lower sugar, so I get the mouth feel effects, i.e, the food tastes good but I don’t get all the collateral damage later.

Evan Brand:  Agreed. So what if you wanted to do like some mashed potatoes and gravy, would you do something like that and try to get a wheat-free gravy taken care of like a slow-cooked turkey they would have some natural gravy coming off of it or what? How would you do it?

Dr. Justin Marchegiani:  Oh, yeah, some mashed potatoes, I mean, loaded up with some good butter, heavy cream, and then for your gravy, you just throw some of the drippings from the turkey in there with some celery and I use carrots, and I blend it up just like that and it’s just super thick. If you want to make a little thicker, you can add a little bit of coconut flour and that’ll give you a nice thick gravy there, and if you want you know, don’t go to the potatoes, go to the sweet potatoes that have a little bit of a lower glycemic index, i.e. they don’t—

Evan Brand:  Yup.

Dr. Justin Marchegiani:  They don’t go and then will convert to sugar in your blood as fast, so that could be a good move or you can do the white potato. You can do 25% white potato, 75% cauliflower mash, and you mix it in and it gives a—a pretty similar mouth feel mall feel you won’t really know that much if you’re not using it another glycemic load is decreased by 75%.

Evan Brand:  I know.

Dr. Justin Marchegiani:  That means less insulin.

Evan Brand:  That’s excellent. Excellent. Yeah, I got my wife converted over to sweet potatoes now. She’s like, “Wow, these are so much better than white potatoes..” I’m like, “I’ve been telling you that for three years.”

Dr. Justin Marchegiani:  Exactly. Anytime I’m dealing with patient’s—the key thing with dealing with patients when you’re making diet changes, the first thing that they go to in their head is like, “Oh, crap. I gotta remove these foods.”

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That creates a stress response. So I’m like, “No. We gotta be solution-oriented.” What’s the substitute? Because there’s tons of substitutes. So if we get them thinking about what’s the substitutes? How can I create the mouth feel? How can I get that taste in my mouth that I want that I’m missing by eating the bad food? How can we get with the good food? So like last night, I wanted a whole bunch of pasta. I’m like, “Oh, I really want pasta.” So I got some miracle noodles which are made from glucomannan, a fiber, basically has zero calories and zero sugar, and I did a whole bunch of butter noodles and I had it with some rotisserie chicken, and it was phenomenal, and I felt like I was eating pasta, but no sugar, no grains, virtually no calories which obviously calories don’t matter but it’s nice that you can eat a lot of it and it’s not gonna impact your insulin levels.

Evan Brand:  That is so cool, yeah, and I’ll speak for—for myself and possibly you, too—put it this way. I love eating if this way of eating was horrible, I wouldn’t do it. I mean, I am not missing out on taste or pleasure from my food at all. I’m more satiated than ever before. I feel so much better. My brain works so much better. The—there is light at the end of the tunnel for sure.

Dr. Justin Marchegiani:  Yeah, my favorite line is nothing tastes as good as good feels.

Evan Brand:  Say that again.

Dr. Justin Marchegiani:  Nothing tastes as good as good feels.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Meaning, it—for me it’s more rewarding to feel good later than to get that short taste in the moment of some crappy inflammatory foods. Because in the end it’s great but then I just feel crappy. I’m bloated. I’m gassy. I got brain fog. So you gotta weigh in that, you gotta weigh in the deleterious side effects with that short-term thing and a lot of times, there’s a risk for more analysis you can do where you can do where you can pull out some sugar, maybe use some Stevia or Xylitol or cut down the carbs or do a different source there that’s less inflammatory where you feel good and then honestly, if you’re like, “Screw it!” Well, throw in some charcoal. Take a whole bunch of charcoal to help decrease the toxins. That’s another good Plan B.

Evan Brand:  Yeah, I feel like we’re rambling at this point. I feel like this is the talk after the first cider has set in—

Dr. Justin Marchegiani:  Yes.

Evan Brand:  After the main conversation.

Dr. Justin Marchegiani:  Yes. I know. Nice little tidbit for anyone listening though. These are all gems I think though.

Evan Brand:  Yeah, I agree. I agree. Well, let’s wrap this thing up.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Go check out Justin’s site. Justinhealth.com and then check out NotJustPaleo.com. You could reach out to one of us, get help, get to the root cause. Justin’s got some free thyroid videos. I’ve got some videos on my site as well you could check out. So plenty of information. There’s no shortage of—of clinical pearls at this point I don’t think.

Dr. Justin Marchegiani:  Absolutely. Anyone that’s—well, everyone that’s getting ready to celebrate their holidays, I wish you a Merry Christmas and Happy Holidays, and if you’re kinda on the fence here trying to figure out when’s a good time to make changes in your health because you’re struggling, now’s always a great time. The New Year is coming up, so feel free and reach out to Evan or myself. Info is below and we wish you a super happy and healthy new year.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Thanks, Evan. You, too.

Evan Brand:  Bye.

Dr. Justin Marchegiani:  Bye.

Putting together the optimal functional medicine program – Podcast #116

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

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

In this episode, topics include:

01:26   Get help as early as possible

07:00   Body System One

10:19   Diet and lifestyle

17:16   Body System Two

38:22   Tests







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

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

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

Evan Brand:  Nice. Excellent.

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

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

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

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

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

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

Dr. Justin Marchegiani:  Absolutely.

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

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

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

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  A ton.

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

Dr. Justin Marchegiani:  Yup.

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

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

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

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

Evan Brand:  Right.

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

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

Dr. Justin Marchegiani:  Oh, yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

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

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

Dr. Justin Marchegiani:  Oh, yes.

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

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

Evan Brand:  Environmental.

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

Evan Brand:  Yup.

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

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  I know.

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

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

Dr. Justin Marchegiani:  Wow.

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

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

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

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

Evan Brand:  Right.

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

Evan Brand:  Right.

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

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

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

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

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

Evan Brand:  Yup.

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Cool.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup, amen.

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

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

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

Evan Brand:  Yes, sir.

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

Evan Brand:  You, too. Take care.

Dr. Justin Marchegiani:  Have an awesome day!

Evan Brand:  You, too. Bye.

Dr. Justin Marchegiani:  Bye.

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