What Causes PMS? Premenstrual Syndrome Holistic Approach

What Causes PMS

By Dr. Justin Marchegiani

Let’s go into a discussion about PMS or Premenstrual Syndrome – the symptoms and hormones involved and why it occurs in some women. Watch the video and see the overview of what’s really happening in a woman’s body to gain an understanding of this issue.


Symptoms of PMS

A lot of women are probably very familiar with it. Whether it be causing headaches, cramping, abnormal blood flow, breast tenderness. You name it, I’ve seen it.

Overview of the cycle

The average female cycle is 28 days. And 14 days is the halfway point. And what you see in the first half of the cycle, you’re going to see a lot of estrogen in that first half of the cycle, from there, it’s going to drop, and come back a little bit in the second half.

The first half, this is the estrogen-based part of it and your second half of the cycle, will be progesterone. What you’re going to see is nice, low-dose of progesterone in the beginning, and its’ going to come right up, and then nice crash at the bottom here. And you’re going to see the second half of your cycle, predominated with progesterone. Estrogen is going to really happen in the first half. Why is that? Well, what estrogen is doing is use your uterine lining like cells, thickening that uterine lining up nicely.

And then what happens in the second half of the cycle with that nice, thick uterine lining, you get the egg right there.

So important now is this middle area right here, this is where ovulation occurs. It’s kind of the intermediary between the estrogen and the progesterone and that’s where ovulation occurs.

So I think it’s really important to actually know what’s going on in your cycle.

Want to learn more about your ovulation cycle and PMS? CLICK HERE 


Causes of PMS

When the progesterone drops in that second half, this is where menstruation occurs. This is where you actually have your period. What we find is majority of women that have PMS symptoms- the breast tenderness, the cramping, the whole nine yards- their progesterone is actually much lower. So imagine this line, it’s much lower.

So we have low amounts of progesterone in the second half of the cyle. And that can trigger a lot of the symptoms we’re referring to.

So you’re probably thinking, what’s causing this low progesterone?  Well, the question is, where is the progesterone going? Well progesterone is actually getting converted into a hormone, called cortisol.

Cortisol is essentially a glucocorticosteroid. Alright. So, gluco – glucose. Alright. To watch sugar stability is one of the main role of cortisol. Steroid – inflammation, pain.

So one of the most common things that drive low progesterone in the second half of the cycle is blood sugar issues. You’re not getting enough high-quality fat and protein. It’s very important – Inflammation, Pain. This could be chronic back pain, knee pain, neck pain. This could be from too much or too little exercise. This could also be from food allergens. This could also be from infections. There’s really no magic pill for it. PMS, there’s no magic pill for it coz it can be a combination of these issues.



So what we do here is, we actually address the adrenal glands. The adrenals are really responsible for producing cortisol, as well as progesterone.

If we can address adrenal glands, we’re going to have a huge impact and balance in this last half of the cycle here. We’ll also have a huge impact for the rest of the lifestyle concern, which is blood sugar, exercise lifestyle, diet and things like that.

We also use some specific herbal blends and even adrenal support to actually help balance this last half of the cycle up.


If you have any more questions, please shoot me an email or schedule the consultation and we can go a little bit deeper with your concerns.

Schedule a consult and get more information regarding PMS by CLICKING HERE

Elise Carr – Getting in touch with your sexuality – podcast #114

Dr. Justin Marchegiani has a special guest today from Australia and she’s no other than Elise Carr where they discuss about holistic health and wellness. After having experienced a health challenge, Elise shares with us her journey on how she got to where she’s at now.

Elise CarrGet an overview of why there should be a need to connect with our sacred sexual and sacred spiritual selves and discover what Tantra really is about. Find out why breathing consciously is essential and how you can practice it properly. Learn about masculine and feminine energy balance when you listen to this podcast interview.

In this episode, topics include:

01:16   Past and present lifestyle

14:11   Tantra

19:24   Breathing

24:12   Masculine and feminine energy balance

32:15   Scheduling time







Dr. Justin Marchegiani:  Hey there, it’s Dr. J! Welcome back to Beyond Wellness Radio. Today we get a great guest, Elise Carr, from down under, right? Over in Australia.

Elise Carr:  That is right Dr. J! Is a pleasure to be here. Thank you very much for having me.

Dr. Justin Marchegiani:  I love it. I love how technology. We’re—we’re so close here. This is great.

Elise Carr:  It is, isn’t it? We gotta be grateful for that.

Dr. Justin Marchegiani:  Very cool, and I’ll just drop your site for anyone interested at kind of checking your info out, as your—as the interview goes—www.stellamuse.com. So really interesting stuff on there, really interesting information, and we’re gonna just kinda go over a couple of—the few key things that we talked about in our—our pre-interview. So I’m really excited to dig in.

Elise Carr:  Yeah, for sure, and yeah, absolutely. Stella Muse is a great website and plenty of free videos and—and info that we’re having a look at, you know, after we have a chat as well.

Dr. Justin Marchegiani:  Very cool. Well, tell me a little bit about yourself at least. How did you get into the health field. I know you do a lot of coaching with clients and patients so to speak. What are some the big issues that, you know, your patients that you see every day are—are dealing with? And how did you get into the field?

Elise Carr:  Yeah, great questions. I was definitely brought up in a very holistic way, so health and wellness and well-being and having a really strong connection to looking after yourself and the way you live your life, has been a part of my life since I can remember. So that’s probably a gift from—from my upbringing right there. But it was also in understanding that I had a choice as well. And when I didn’t make great choices like you know, not that I was ever, to be honest, everyone into the drugs, rock ‘n roll kind of partying phase, didn’t go there. But I had a really strong I guess view of that world because I came from the modeling industry.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  So I—I saw what it could be like when you made choices for yourself that really weren’t honoring your body temple, your life, anything to make you feel–

Dr. Justin Marchegiani:  Right.

Elise Carr:  Stronger, healthier, really actually connected to yourself and—and the earth and all of the above. So that was great in that sense. So when I say how I got into this, I came from a very different background. I actually originally studied journalism and Public Relations. I was working those fields whilst modeling internationally and doing freelance journalism. It was really being a part of this world whilst wanting to live a very holistic lifestyle that I found that these weren’t marrying up. It wasn’t really in sync. And—and I wasn’t able to be the person that I really want to be and—and serve the way I wanted to serve, so I eventually through different life circumstances merged into going back and starting my masters in Communications and Cultural Politics and Women’s Studies, and that was the catalyst for me to then pull back from the whole journalism pay on world and—and then instead go into studying coaching and get my Reiki masters and go and study more esoteric work and healing—healing work and from there, go and expand and learn and become certified as a Tantra practitioner and kind of gathered this interesting eclectic bag of tools to then create Stella Muse and offer this as an entire holistic yes, but also an empowering platform and—and space to be able to serve people in the way that I feel you I’m here to serve. So it’s kind of like a calling like–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Many of us are saving different ways.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  It’s not that I ever expected I’d be doing is. I thought I’d be a psychologist or a lawyer, you know? But those shoes didn’t fit. So–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  I’m very fortunate to be where I am now. I feel and having created Stella Muse and—and get to offer a service that I feel can—can enrich their lives and yes, connect them to a—a space of–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Absolutely wellness and—and holistic lifestyle, as much as empowering who they are and why they’re here.

Dr. Justin Marchegiani:  So it’s really interesting that you are a model first, and then you kinda transitioned over to the health field. Looking back, how difficult was it or—or maybe you didn’t even have that awareness back when you were modeling to–

Elise Carr:   Yeah.

Dr. Justin Marchegiani:  Practice a healthy lifestyle, meaning eating, you know, a nutrient-rich, nutrient dense diet.

Elise Carr:   Yeah.

Dr. Justin Marchegiani:  Not having to wor—worry about counting every calorie and also not having to worry about getting excessive movement to burn those calories up. What was that like for you? What was the pressures like?

Elise Carr:  Sure, well, I guess, I’m in my early 30s now and I started modeling at the age of seven.

Dr. Justin Marchegiani:  Wow.

Elise Carr:  And that was by choice. I was never pushed into.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  I had a very supportive mum that said, “What would you like to do?” You know like as—as an afterschool activity and she listed many things. Karate was one of those or Taekwondo and—and modeling was in the mix. So I chose–

Dr. Justin Marchegiani:  Right.

Elise Carr:  I—I always chose this, and to be honest I still am in the modeling world now. I just choose very different jobs to accept and—and weave it in with my work. So as I mentioned, holistic life, eating nourishing foods, knowing I need sleep, not choosing to take drugs, not choosing to drink alcohol, all those things were so they’re already ingrained in me. So when I was going into my thing in early 20s and started working internationally, I already had a very strong ethos and—and a pretty strong belief in self and this was tested time and time again, mind you, but what I found—what was one of my crossroads for me is that it wasn’t necessarily the wellness in the sense of exercise. I was very dedicated to exercise. I looked after my body temple in that regard.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Food-wise, I did the best with my capacity at the time. We can always improve.

Dr. Justin Marchegiani:  Right.

Elise Carr:  There’s always room for—for trying different things. Really when I can like narrow in, I think what I was missing was good fats to be honest.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Because the fat thing was like, “Oh, you can’t have fat.”

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  You know? But now I’m like, “Oh, my gosh. Give me the organic olive oil. Give me the avocados. Give me the nuts.”

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  So there was a misconception. So there was probably a lack of awareness there, but other than that, for me living in that world, what I was actually missing was probably vitamin L, which was love.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  When you’re living that lifestyle away from your family and friends and my beloved at the time, my—my partner, that was what was suffering. My soul was being undernourished. My—even my emotional intelligence and my intellect was hungry for something else, so that’s why I say, when we look at holistic health, it is the whole spectrum. And while I may have been eating to the best of my ability and looking after myself and—and not eating things that were gonna be the detriment of my health, and exercising very well and doing my best to plate—you know, how—how much you can fastest to playto when you’re working crazy hours and you know that being a doctor.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Crazy hours, too.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  But it was those other elements, the vitamin L as I mentioned and—and those are the connections that that made me actually quite unwell and I came back from one of my international stints with a cyst on my ovary that ruptured and my heart actually–

Dr. Justin Marchegiani:  Oh, wow.

Elise Carr:  Flatlined for a time so–

Dr. Justin Marchegiani:  Wow.

Elise Carr:  But interestingly enough, the cardiologist says you’re disgustingly healthy because every time my heart start again on it’s own. It was just the toxins from that cyst that went through my body that caused me to kinda have many kinda shutdowns, while it could do it’s best to help itself, and when I look back and—and apparently my—my insides, all my beautiful organs are textbook perfect. So the irony was like, if I’m actually “healthy”–

Dr. Justin Marchegiani:  Right.

Elise Carr:  What was my body shutting down for? And I—and I can’t say anything else. No other doctor and I spent years seeing many specialists, like the top specialist in all these different fields who could not give me any other answer. So I had to realize I had to take the power back myself and—and I realized that really the end of the day I was missing soul, spirit, love, heart–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  All those kind of things. We cannot function without it. We can’t. So I had to change my life in a big way and start nourishing those sides of me at the same time as yes, absolutely, still enriching my—my food choices and my exercise is still a massive part of my life, but you cannot discount the other factors.

Dr. Justin Marchegiani:  Uh-hmm.  So—so interesting you mentioned about the fat part because I think that’s something–

Elise Carr:  Mmm…

Dr. Justin Marchegiani:  A lot of people intuitively say well, you know, the fat you eat’s the fat you wear, but we kinda know it’s fat’s really important for our cells and lipid bilayers and our hormones and our brain health and our neurology, and just kinda–

Elise Carr:  Yes.

Dr. Justin Marchegiani:  Looking at what your friends were doing in that industry, knowing what you know now, what kind of pressure–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  Was there? What was everyone else doing from a lifestyle perspective? Were you living a healthier lifestyle the most? And others were kinda off? What was your perspective?

Elise Carr:  For me I guess it was that I was living a different—

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Different lifestyle. It was just different–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Choices and–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  We all have our own paths and some people–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Wanted to live in the now, in the moment, and it was just the next quick fix, however that looked.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  That might be buying, you know, the latest outfit and let’s—let’s be real here, maybe we’ll start with the consumerism, whether in the modeling industry or not. So it was that side of things, there was the, I wanna, you know, party so there was the drugs and there was the drinking. You know, there was the, I hadn’t had a meal today, so I’m just gonna grab fast food or I’m not going to eat.

Dr. Justin Marchegiani:  Right.

Elise Carr:  I’m gonna have coffee. There—there are all these different choices which, yes, we know are common in—in an industry like modeling or dancing or whatever it is. But this can happen in—in any walk of life. So yeah, I saw this. I also saw others–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Who were addicted to the gym.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  We see this in every walk of life as well.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  I never even considered counting calories. If someone said how many calories are in, you know, raw vegan chocolate, my favorite prize, or a stick of carrot, I would have no clue. It was never the same—that came into my mind. I did you know, weigh myself at that stage and I had an expectation of where I wanted to sit which felt healthy for me, but I never felt under extreme scrutiny or pressure–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  To have to in that moment lose 2 kilos or something absurd like that, and I would never capitulate to that. I had a very, very strong sense of self which as I said got tested all over and over again, but I still didn’t wanna be something I wasn’t, even though you’re pressured. I didn’t—I didn’t let that overtake me. I don’t feel.

Dr. Justin Marchegiani:  Uh-hmm. So after you developed the health challenge, the health scare with the ovarian cyst and you had the flatlining–

Elise Carr:  Yeah. Yeah.

Dr. Justin Marchegiani:  What happened next? How did you overcome that health challenge?

Elise Carr:  Well, I had to have a bit of time off.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  I wasn’t really—I wasn’t able to drive a car, let alone walk properly or wash my own hair like my body was in serious, just exhaustion. So I was back in Australia at this time, and I—I wasn’t able to do hardly anything. My relationship broke down. I wasn’t, you know, being a journalist. I wasn’t being a model. All the facets of me, what I thought were me, were taken away, and so I was really only left with what I really am. You know? Nothing that you can fix or do. You’re not your title. You’re not your job. You’re not what you have. We need to understand this and this was my big wake-up. It was a massive, massive AHA! moment for me and it was in that time that I then spoke to my auntie, who lives in the UK, and because this was before social media, the way I used to communicate with my family when I was away was writing epic emails, and that’s—I’d be sharing what’s going on with this show and this experience and where I’m at, and what it’s like living in Asia at the time. And she said, “Why don’t you take these emails and write a fat book?” As she termed it.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  And I was like, I never consider doing that. And that was me shifting my path from then instead of writing articles. I started writing a book and now 10 years later, you know, this book is in discussion with another agent to get it—to get it published. It’s been a bit of a rocky road to find the right fit. But it’s definitely–

Dr. Justin Marchegiani:  Is there a name for it yet?

Elise Carr:  Yes, it’s called Runway, and there’s a—there’s a page on my book–

Dr. Justin Marchegiani:  Oh, cool.

Elise Carr:  You can sign up to hear about the publishing when that gets finalized and—and now I’m writing my second book on women’s sexuality called Yoni Power, and it—it just shifted my life and it was from there that I then chose to go back and do my masters and—and follow on with all my other training and certification and studies and—and life experience. It just—it changed my life, and I—I didn’t choose then to—to want to model full-time ever again. Because as much as I loved being part of that world, I wasn’t of that world.

Dr. Justin Marchegiani:  Yeah, got it.

Elise Carr:  And I had to be real that that. I had to be real. I knew if I—you know, went—and I did. I moved to Paris. I went there but I didn’t—I didn’t push to try and get on the runways. I did work during Fashion Week over there but it wasn’t—it wasn’t enough and so I found an editor and got my book on the road, and I was painting and I was writing more, and I was just immersing in this place I always wanted to be but I didn’t—didn’t pound the pavement and—and you know, storm around forcing this—this career, I suppose, that did not resonate with my heart and soul unfortunately, as much as you know, there’s beautiful elements in the industry. On its own, it wasn’t enough for me.

Dr. Justin Marchegiani:  Got it. So you’ve taken all your experiences as a—a model and then kind of a transformation with your health challenges and then you have incorporated a lot with—with Tantra and—and various female sexuality and you’re incorporating that with the clients you’re working to—with today. Is that correct?

Elise Carr:  Absolutely.

Dr. Justin Marchegiani:  So how does that look?

Elise Carr:  Absolutely.

Dr. Justin Marchegiani:  If I’m—I’m someone coming in, who’s the average person or average patient or client you’re working with, and what are their issues?

Elise Carr:  No one’s average. I definitely have, you know, like I’m sure you do—there’s a massive mixed bag of tricks.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  We’re all very individual, although yes, you’re right. There are many similarities. I work mainly with women but I have more and more men, and I have more and more couples as well that I work with.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  And—and this is from the empowerment coaching, so looking at that whole holistic perspective and then weaving in elements of—of Tantra to get a strong connection with your sacred sexual and sacred spiritual selves essentially to raise your consciousness, have a deeper connection with who you are, deeper connection into the intimacy with your beloved, deeper connection with all that is. So there’s always kind of side, you know, elements and then also more of my healing work as—as a Reiki master doing more energetic and—and esoteric work. So there’s that kinda thing as well , but I can weave all of that into the coaching and mainly the people that come to me are at a crossroads and this crossroads is often that they are now at a point in life where they realize they don’t choose to live like this anymore, and whether that is changing their profession from being in, you know, a—a very demanding corporate job and leading that lifestyle where they are lacking substance, kind of like what I experienced, but the other way around. But that disconnection from soul, that disconnection from spirit, that disconnection from their purpose and wanting to transition into a—a service role that they really deeply connect with. There’s that side of things. There’s all these where it’s the relationship side of things where they are feeling a disconnect from themselves. They disconnect from the sexual power. They disconnect from their body. They disconnect from their heart. And then whether they are in a relationship are not, they usually are feeling that disconnect with their partner if they are in a relationship.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  So they kind of–

Dr. Justin Marchegiani:  So looking at a lot—Uh-hmm, go ahead.

Elise Carr:  Just because they’re—in answer to your question, they’re kind of, you know, common streams I guess that connect many of the clients that I work with.

Dr. Justin Marchegiani:  So I’m just trying to get a good visualization because we do similar things with, you know, the—the coaching side, right? You’re getting people’s diet and lifestyle, and kinda core fundamental things kinda dialed in, what you’re eating, sleeping, movement, hydration, those kind of things, and then you’re building on top.

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  You’re putting a lot of focus on the sexuality aspect which is something I don’t really touch upon too much outside of, you know, making sure relationships are—are relatively healthy or referring out for good support.

Elise Carr:  Yeah.

Dr. Justin Marchegiani:  But you do a lot with the Tantra—

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  Tantra part of it which a lot of people listening probably know that to be something about sexual positions and such. Can you go more into–

Elise Carr:  Yeah.

Dr. Justin Marchegiani:  What that is and then how do you—do you—how does that work? Are you giving people a prescription for certain things to do at night? How does that look?

Elise Carr:  Sure. Well, just—just to put out there–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  First and foremost, all the Tantra with the patients is fully clothed. There’s no genital touch.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  They can be misconstrued or misunderstanding if that–

Dr. Justin Marchegiani:  Got it, okay.

Elise Carr:  It’s—it’s in a very safe space.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  And I have a personal practice as well, so it’s really fundamentally about building a connection with yourself and then if you’re in a relationship or want to create that with a future partner, building that with your partner, a lot of this resides in getting rid of trauma.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  We carry an incredible amount of trauma within ourselves and—and like you’re probably aware. You know, everything is energy. We know this from a science space. We have memories in our minds, but we also have muscle memory, right?  Now let’s say we tear muscle, that muscle is—is going to remember that experience, right? Even though it heals. So we also have the memory. I work on energetic levels. So we are gonna get a little bit metaphysical here, but instead of just the physical, instead of even just the emotional, we are looking at the energetic side of things and realizing that you may have had a traumatic experience when you’re a young man or someone’s a young woman, and they have held onto them. And we hold onto that in different parts of our bodies and I work with different energy centers. Some people know the—the term chakra–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  They’re just energy centers in the body.

Dr. Justin Marchegiani:  Wheel.

Elise Carr:  We have seven of them.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Exactly. An energy wheel. We have seven of them internally and they connect to different elements of us. One of the biggest things I see is many people holding a lot of trauma in their second energy wheel.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  And this connects to the sex organs.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  So this trauma often connects to sex and sexuality. It also connects to money, power, and creativity. So if you’re not getting flow in those areas, they may likely be a trauma that you haven’t dealt with; release works through confronted, forgiven, and got your power back to get yourself in the present. We live so often in the past and so often in a future that we’re not really empowered in the present moment. So all this may seem like a very long path to get to your true potential, to empower you, for you to connect with your sexual energy, for you to able to express yourself and feel into your essential nature as an individual, let alone in a couple. We need clear that trauma. So I do a lot of work, you know, excavating these spaces and clearing them so that we can start rebalancing where we’re at in the here and now. And a lot of that to be honest works with forgiveness because–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  As humans it does not come naturally to forgive. We love to hold on to things like a bag of–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Hot coals and the reality is we’re when doing ourselves an injustice. We’re not helping ourselves because that person who, you know, abused you, neglected you, abandoned you, whatever it was and I am not saying that horrible things don’t happen and that’s, you know, these are being excused—not by any means—but I’m talking here on an energetic level. I’m talking here like it’s a mystical act to be able to forgive their soul, so that you can be released. You’re not necessarily going to have to forget that that happened and you don’t want to forget because it means then you will learn in the future not to make those same choices perhaps, and not to be in that same position perhaps. But we need to understand that we have the power, you have the power, I have the power to make those choices for our own lives to change where we’re at, and this is about the empowerment work that I do that weaved into the—to the Tantra. Because we give a lot of our power away. We give a lot of our sexual power away. You know, we say Yes–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  We wanna say No. We gotta strengthen our boundaries. So while Tantra is yes, sexuality and spirituality, there’s a lot of foundational work there that covers our entire life. And this is why to me Tantra is a lifestyle. We’re weaving together that sacral sexual and spirit to—to awaken our consciousness and by awakening our consciousness we—we’re making wiser choices.

Dr. Justin Marchegiani:  So when you look at–

Elise Carr:  We’re empowering ourselves.

Dr. Justin Marchegiani:  Right, so when you look at your—these clients, they’re coming in, whatever type of health issues you have, whether it’s on the health side, whether it’s their past trauma, you’re looking at that and from there, you’re kind of creating a prescription on the—the Tantra side of specific positions to help kinda reawaken these various chakras. Is that what I’m hearing?

Elise Carr:  I can do chakra rebalancing, absolutely, that’s part of it.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  It’s very much case-sensitive. Often I will say mainly for women, some men if they are open to it, to do a guided chakra regression.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  It’s kind of like a semi-version of hypnosis of sort, but you have to be really active in the mind or your body is calm.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  So if there are any yogis listening, it’s kinda of like Yoga nidra.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  It’s like you’re in a beautiful deep relaxation, but your mind is switched on and can do the work while your body is totally chilled out loving it. This kind of work is purely guided by my voice, so I will guide them back into their low-energy wheels to essentially bring up, confront whatever’s been housed there, and yeah, it’s in the form of memories. It’s not in the sense essential to relive it, to just purely bring up the past. That’s not the point. The point is that it’s there. You’re holding onto it. It is not serving you. We need to confront it. You need to get your power back and you need to forgive that person, that experience, whatever it is to di—like disconnect, detach from that, let it go and move on so we can clear that out and move up, and move you into the present. So that’s one element and that’s obviously my healing modality, but that is one simple practice that I can do with—and I do with clients all around the world via Skype to then have them in a clearer space, to be able to do, let’s say, the Tantric work, and you know–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  A prescription of such, you know, learning how to breathe is one of the found—like foundational techniques that I will teach someone on the Tantric path because we don’t breathe properly. We shallow breathe all the time and breath is one of the most important key parts to not only our survival, but then yes, our sexual empowerment. You can change your whole sexual experience when you start working with breath which sounds crazy, but once you learn it, it will change how you approach that and I’ve got free videos that I can share with you, Dr J, if you wanna–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Share them with your listeners as well to get them–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  On that track if they are curious.

Dr. Justin Marchegiani:  That’d be great. Yeah, I see a lot of people that are in that sympathetic Fight or Flight nervous system state.

Elise Carr:  Yes.

Dr. Justin Marchegiani:  Right? Kinda the adrenals–

Elise Carr:  Yes.

Dr. Justin Marchegiani:  Are being whipped so to speak. They’re really breathing from their chest which, you know, really actually further puts them into that sympathetic adrenal state because if they drif—if they breathe from their chest, right?

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  They’re activating a lot of these neck muscles which puts him into this forward head posture which then actually decreases the airflow, so then they have less oxygen going in and, you know, less airflow going to the nose and the na—the nasal sinuses is what actually activates the parasympathetics through breathing. So instead of this deep belly breath, where they are moving their—their belly as they breathe. They’re breathing from their neck.

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  They’re breathing from their chest and they’re activating that Fight or Flight nervous system. Are you finding something similar with your clients?

Elise Carr:  Yes. And—and obviously, I mean that may sound extreme for some people because they don’t realize how interconnected we are. The human body is just phenomenal. So I’m so pleased to you explained like that. It’s really important to have a good understanding of the effect of not breathing correctly, and—and to get an understanding of what breathing correctly looks like, watch a baby breathe or watch, you know, your pet like a cat or a dog and see that full belly expansion, and then the collapse of the belly as it draws—the belly button draws back towards the spine. This is what we are talking about here, and that’s the way, yeah, we slow down. You know, the Fight or Flight. We slow down the parasympathetic–

Dr. Justin Marchegiani:  Right.

Elise Carr:  Nervous system. That’s normally on edge and it’s that, you know, that heart kind of palpitation almost, that kind of flighty energy that is literally sucking our power away, right?

Dr. Justin Marchegiani:  Right.

Elise Carr:  So it’s—it’s the way we choose to breathe on si—one simple thing. If you don’t take anything else from this conversation we’re having for these lovely listeners, it’s looking at how you’re breathing right now. Right now in this very moment where you’re driving in the car. You can do it whether you’re walking with, you know, a podcast going rounds. The streets, anywhere, you can actually slow down and—and I encourage clients to do this first thing in their morning. You know, in the morning when they’re laying in bed, even put one hand on the belly and one hand on the heart, and have this connection. Have this connection with yourself and then to do it throughout the day whenever they feel a bit anxious or nervous or angry, overwhelmed, whatever it is, and then last thing at night. Bring yourself back to this point also helps with the reconnection to yourself, and that is so important because we are so disconnected, even though like we are talking across the world right now, we’re so connected technologically. But we’re so disconnected emotionally, spiritually, energetically, and–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  And this is what’s so important. This is what we’re missing in this day and age, and there is no—there’s no wonder drug. There’s no Band-Aid. There’s—there’s no, you know, remedy for that. We—we really need to—to just own it and understand that, you know, the power’s with me. I have to make some more conscious choices. So let’s start with my breath.

Dr. Justin Marchegiani:  I think that’s great and with patients you’ve kind of alluded to it, one hand on the heart, one hand on the belly–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  And what I tell my patients is very simple. The hand—the hand that’s in the belly is the one that should be moving and the one over the heart really shouldn’t be moving much. It should be primarily coming from that bottom hand on the belly which really tells me that your breathing from the diaphragm and you’re having those really good big diaphragmatic breaths, into the nose, out through the nose or into the nose, out to the mouth to really–

Elise Carr:   Yeah.

Dr. Justin Marchegiani:  Get the parasympathetics going, and I also recommend doing that to like one of the M waves. Familiar with the Heart Math Institute? They have like–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  The M wave that kinda helps get you into coherence which is looking at heart rate variability and its timing and synchronizing the breath in and out to get you into that state of coherence where the brain and the heart are neurologically kind of communicating at its peak.

Elise Carr:  Yeah, and the interesting thing, I’m not sure if you come from this school of thought, but I certainly believe that while we’ve obviously got our—our normal brain, you know, the heart and also like the digestive system, like you know that lower hand where it’s gonna be, they are also kind of like main brains as well. So we want those three kind of brain of sorts to be functioning and talking and in harmony together.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  To me that’s so important and—and while the hand on your heart may not be moving and we definitely don’t want this to be moving as much as that–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Belly hand, we want you to be at even connect with your heartbeat.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Start to feel that. Start to slow down enough, to be present enough to just relax into the moment and know that you are doing something wonderful by just being. This thing that I do a lot of work with is is the doing and the being. And I break this up–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Into like the masculine doing and the feminine being, because we do a lot of energy work. As I’ve already touched on my Tantra, and we talk about Shakthi and Shiva, like the god and the goddess.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  The two parts, like the Yin and the Yang.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  I’m sure we’ve all seen that, you know where it’s like–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  The black kind of little blob that’s actually a fish with the little white bit and—and the white with a little black.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  That is us. We are, like you are mainly masculine but you’ve got some feminine energy–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  And I mainly feminine but I have some masculine energy. We need these to harmonize ourselves in this day and age in such a driving, doing success, you know? Hungry environment, humanity, society we’ve create. We’re very disbalanced. We’re very masculine the way we do things. We think we must be doing things all the time. We have checklist. We have to rush here–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  And here. We don’t achieve enough at certain time. This is all masculine and don’t get me wrong, I have much reverence for that and I love it, and we need this side of us to get things done. But we also need to see the value in—in the being, in the feminine, in the creative, in the flow, in the slowing down and the enjoying, right?

Dr. Justin Marchegiani:  Right.

Elise Carr:  This is also what’s missing in our life and that saying that, you know, I feel was something that was missing in my life when I—when I had that health scare. And many clients that I see, they’re either too far in their masculine—some of them, not very often a too far of a feminine not getting things done, because they’re changing her mind and—and flighty and—and from here to there, here to there. We need to find balance and strike that balance every single day. That’s another thing you can ask yourself is, “Am I driving too much?” That the type A personality, the must achieve, the must do this, they’re working 12 hours, 14 hours a day. Pulling back and—and honoring some You time.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Sometimes we even need to have like, you know, a date for ourselves where I’m gonna go to the museum today. I’m gonna take myself to a movie. I’m gonna sleep in. I’m gonna read a book. And just, you know, whether it’s 20 minutes, maybe 5 minutes to slow down and have a cup of tea. We have to start valuing these as well because otherwise we reach burnout and I’m sure you’ve seen it with your clients.

Dr. Justin Marchegiani:  Right.

Elise Carr:  Like it can get to adrenal fatigue. It can get to absolute exhaustion. It can get to depression or so many different ways it can appear physically if we’re not–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Emotionally nourishing ourselves and—and looking at the energetics–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Things as well.

Dr. Justin Marchegiani:  And I—I see a lot of patients who are female, typically my average patients between 35 and 65 in female—I’d see majority female but I still have a good percent of—of males as well, but–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  There’s a typical pattern that I see in a lot of my female patients, right?

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  There—there’s this type A kind of, you know, go-go-go type of world that we all live in and–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  I kind of see that as women tapping into that masculine side, where they’re trying to go-go-go-go-go and–

Elise Carr:  Definitely.

Dr. Justin Marchegiani:  And there’s the inability to kinda bounce back and repair from that and it was interesting because you kind of can talk about in this abstract way of energy, but Dr. John Gray–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  Did a lecture and he was talking about the female hormones, progesterone primarily estrogen–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  When there’s lots and lots of stress in an estrogen-like environment, testosterone is the fuel that kinda helps us buffer the cortisol and I kinda–

Elise Carr:  Yeah.

Dr. Justin Marchegiani:  Testosterone’s like that male energy, right?

Elise Carr:  Uh-hmm, absolutely.

Dr. Justin Marchegiani:  And when testosterone is lower which is obviously the case in a female environment, right? 10 times lower than a male.

Elise Carr:  Yes.

Dr. Justin Marchegiani:  They don’t quite have that recovery from the cortisol aspect, and I—I see that what you’re saying about the—the male-male—male side of it and the female side is the women kind of depleting some of that female energy by tapping too much into the male. Can you elaborate more on that? Do you see that as well from this Type A world–

Elise Carr:  Yes.

Dr. Justin Marchegiani:  We live in?

Elise Carr:  Yes, and—and I love that you brought this up. And thank you for bringing the science into it. It’s so important as well and I totally hear you. In a simplistic way, I guess it well—what we’re saying here because we’re on the same page I feel is that females aren’t designed to function like that and yet we create a society where we have to fit into this box–

Dr. Justin Marchegiani:  Right.

Elise Carr:  That means this is how we are gonna supposed to act, so this is why now more than ever, there’s a massive calling for a shift. This is why you know we’ve got this new feminist kind of wave happening people are saying. Even men are saying I’m a feminist because I see the value in women. Now this isn’t about not loving men. Don’t get me wrong. I have deep reverence for men–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Absolutely. It’s about knowing where the strengths lie and saying that there is in quality in different strengths that we’re–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Equal but we had differences, right? And one thing that I find is deeply important that if we’re gonna, you know, speak about women in this regard, we obviously have a cycle, right? Let’s just say, you know, an average 28 day cycle. We are very much connected to the moon, the tides, all of the above.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  But to bring us back, you know, we know if we break it down like, you know, there’s seven days in—in each, kinda part of the cycle. If we look at this from an energetic perspective. We’ll see that you know, ovulation is an expressive time. A woman is mainly very expressive at this time. She then goes in, you know, to her creative phase for the next 7 days, and this right about she’s about to menstruate and then her menstruation time—we call it moon time, in my line of work—it’s a reflective time. She needs to pull back. This is not the time to be driving. I’m not saying you need to have, you know, five days off and that you—you can’t do things because you have your period. Not at all. But you need to know that you are in a very, you know, introspective phase of your cycle. You need to honor that, to slow down a little bit, to not book as many appointments–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  To not have as many meetings, to really honor where you’re at because women, we say the most psychic and intuitive at this phase as well. So that should be a gift. Back in ancient times, civilizations used to honor and revere women at this time. It was called the red tent. Women would gather in a space together and those who weren’t on the moon times, perhaps croons, the grandmothers who no longer are in this phase and—and the young children and the men would bring them food. They weren’t asked to do chores. They weren’t doing, doing, doing. They are being with each other, rubbing each other’s bellies, playing with each other’s hair, sharing stories, passing on wisdom from the eldest to the youngest. It was a very revered time. We have lost all of these because it’s like, “I don’t have time for that. I to do this, this, and this before 6 AM.” So we’ve—we’re really–

Dr. Justin Marchegiani:  Right.

Elise Carr:  Lost that balance plus the harmony. But the thing is once you come out of that reflective phase, after you’ve had your moon, after your period, you are in your most dynamic phase. But you will not be a most dynamic, really getting out, to do what you want to do if you do not honor that reflective time. We need harmony and balance. We need day and night. We need winter and summer. Like, you know, we can’t function all the time if everything was sunshine. We’d die. We could not function all the time if it was darkness; we’d die. And we’ve lost this connection and—and women especially because they feel they have to conform to something they’re not, but in saying that it’s also important for the men to know that they need to have downtime, too. They can’t always be the ones that are striving and—and having to do to provide in some ways. It’s okay for them to pull back a little bit and—and have a bit of time off and have some downtime and have some nurturing time, and to be held and seen as well. We need to install that into our young boys and young men and—and men of today and the world.

Dr. Justin Marchegiani:  Is it testosterone is a big buffer from a hormone perspective of cortisol–

Elise Carr:  Uh-hmm. Yes.

Dr. Justin Marchegiani:  Right? And that’s the biggest thing. Men with adequate levels of testosterone, they can buffer the stress from cortisol, that’s a big aspect. But the problem is we live in a very toxic world where there are lots of synthetic estrogens around us.

Elise Carr:  I’m pleased you said this.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  And that can affect a lot of the brain feedback loops that talk to the genitals to make the hormones.

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  It can do the same for females because they push them into estrogen dominance–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  Which we did a big podcast on 2 weeks ago which can cause–

Elise Carr:  Right.

Dr. Justin Marchegiani:  More PMS, fibroids, endometriosis, fibrocystic breast, so there’s kind of on both sides there’s this yin and the yang like we talked about–

Elise Carr:  Uh-hmm.

Dr. Justin Marchegiani:  Of different imbalances and yeah, you are totally right when it comes to the males as well. They have to make sure they’re doing the right things, keeping the insulin under control and doing all the good diet and lifestyle things regarding sleep and the breathing and the right movement. Is there anything else, let’s say a female listener here can be doing maybe different than a male, maybe we can break it up on what’s better for each to kinda their—more in touch with their sexuality outside of what we already mentioned so far?

Elise Carr:  Yeah, well I guess, besides what we just mentioned which is knowing your cycle and honoring those–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  You know, the express, creative, reflective dynamic.

Dr. Justin Marchegiani:  Breathing, too.

Elise Carr:  Honoring that in itself is so important. Yes, the breathing we’ve touched on that. Actually, setting some time aside and I call these sacred sessions–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Like scheduling lovemaking if you’re in a couple–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  But scheduling time for yourself as an individual as well. So if you have children or you have a busy schedule, this is perfect for you because you live a scheduled life and this is the way you’ve constructed your life and—and your, you know, you’re part of that system and that’s okay if this what, you know, you choose. And if that is the case, then you need to actively get your pen in your hand and carve out, put it in, write it in pen. This is what I’m gonna do for me, and made it something a week, or maybe it’s one hour a week—I like to obviously have a little bit every day which is much nicer than just having one bit a week. You gotta find what works for you. But I call this non-negotiable time. I wrote an article about your best threesome ever–

Dr. Justin Marchegiani:  Hmm.

Elise Carr:  And those three elements are with yourself–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  With—which is your soul I call that. With spirit, because it’s something greater than you have, however you connect with that, whether you believe that is God or the universal or source or whatever it is you call it. And then the third relationship is your tribe. It’s with your children. It’s with your beloved.

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

Elise Carr:  It’s with community beyond that. But those first 2 relationships are non-negotiable. Non-negotiable. The first relationship is with yourself. So you might be, you know what, every single day I start my morning ritual with a cup of tea and I—I watch the sunrise if you are getting up that early or–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:   Whatever it is, you know, on your phone, you are not multitasking. You are not with another. It is purely You time for you. You are nourishing yourself, your soul. And once that is done, you’re ready to have a connection with something greater than you. For some people, this is in meditation. It’s in prayer. It’s on the yoga mat. It might be you know, speaking to—to a spiritual director. It might be going to church, however it looks, it doesn’t need to look a certain way, it’s just what you feel is a way you can connect. It might be you know, reading an excerpt from—from a book that you feel gives you some wisdom. It’s having a connection thing that’s greater than you to open that that channel, so you feel you have a connection there like a lifeline, and once you’ve nourished those two, you are then a more full and a more fulfilled camp to be of greatest service with your partner, with your child or children, in your community, at the office, in your space of work, however that is. But what we don’t do is nourish those 2 relationships first. We always go to that 3rd relationship and then we wonder why we’re angry, frustrated, feeling not seen, not heard, not held. And this applies to men and women. So I’ve kinda answered that, I guess in one go.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  But in that regard, we don’t have to be different. We’re still having a human experience. We still have to learn to take care of these elements or their selves in whatever way looks good for us, there’s no right and wrong, but you have to show up and do the work. You have to show up and do the work. No one else that can do this for you. Like I said, there’s—there’s no pill that can do that for you.

Dr. Justin Marchegiani:  Right, right, and you mentioned something earlier, just a few minutes ago about scheduling lovemaking. Can you go more into that?

Elise Carr:  Yeah, absolutely. So I wrote a post called Sacred Sessions and I did this because I was seeing more and more people having a disconnect with their, I say beloved, with your partner, with your husband and wife, boyfriend-girlfriend, whatever it is. In this day and age, we may be really supportive of each other. You know, we may do little things for each other, one person buys the grocery, one you know, pays the bills, whatever it is, right? We—we support each other and we have a union. But we’re neglecting the sacred sexual and the sacred spiritual at coming together, the intimacy, the real sacred time, so I said, ”You have to schedule this in. If you want to invest in this, it means that not that it doesn’t have the romantic or it doesn’t have to be spontaneous.” It may not conventionally spontaneous because you’re gonna be like, “Okay, Thursday evening 6 til 9, or whatever it is, 6 til 8, it’s just you and me. We’ve got a babysitter or we’re gonna, you know, go somewhere or we’re just gonna create some time and space in our own bedroom, it’s actually honoring your relationship so much that you’re making it just as important, if not more important than other things. This is what we need to know here. Because your beloved needs to know that they are important to you and you need to demonstrate that with action. Some people like the words on top of it. They like a gift–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  On top of it. They like some service on top of it. We may have heard of the Love Languages. This exists, too.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  And whether this is time where you actually make love or however that looks to you or whether it’s just being together and snuggling and having a shower together. I’ve written a list which I’m gonna publish soon about different ideas of how you can use this time, and you can be really playful and you can experiment with different, you know, sexual practices that you may not have explored before and whether it’s role-playing or give each other massages. It can be anything that you both consensually agree to want to explore together, and holding that space for each other. There’s no judgment there. There’s none of that. This is a really beautiful space to get really intimate with your beloved and not let it be superseded by something else, unless I said it is, you know, a serious extreme—if someone’s really unwell something drastic has happened and we have to understand. Life happens. Other than that, this is non-negotiable. Non-negotiable and it needs to be scheduled at least, you know, once a week or once a fortnight depending on how your relationship is set up.

Dr. Justin Marchegiani:  That’s great. That’s awesome. Well, is there any way listeners here can get a hold of you outside of your website? Is there anything else you want to share, any books or any other opt-ins or video series coming your way?

Elise Carr:  There’s a free video series on my website.

Dr. Justin Marchegiani:  Oh, great.

Elise Carr:  It’s mainly targeted at ladies, but guys could definitely–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Get some value out of it. As soon as you click on StellaMuse.com, and that’s Stella with an A as you said, at the very top there’s an opt-in there for a 4-part video series and it touches on your sacred sexual space. We call it the Yoni, which means–

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Literally your entire female genital area. The Yoni, the heart–

Dr. Justin Marchegiani:  Ah.

Elise Carr:  The mind and how these need to be in sync for a woman to be fully in her most empowered space. So that video series is easily accessible and then at the bottom of our website, there’s a free e-book which is like a blueprint for your life purpose and it’s one that you can just print off and work through. It’s definitely for men, for women at any stage, great especially if you’re at a turning point and you want some guidance along the way. Other than that, you can head over to any of my social media links. There’s plenty of videos and—and lots of articles that are very practical and you can get some ideas that you can implement today, and if you feel I can be of service then Contact page, send me an email, and—and let me know specifically how you feel I can assist.

Dr. Justin Marchegiani:  Excellent, and before I go into my last question, is there anything else that’s on the tip of your, kinda tongue or your—on top of your head that you wanted to really put out there to the listeners?

Elise Carr:  The most important thing is—is to honor your integrity and truth.

Dr. Justin Marchegiani:  Uh-hmm.

Elise Carr:  Out if everything we’ve spoken about here, it really has to resonate with you. There’s no right and wrong but you have to carve out that time, a bit of space, a bit of stillness to start listening to what your body, your heart, your soul, your mind, your genitals is—is saying to you because our bodies talk to us all the time. We know when we’re tired. We know when we’re hungry. We know when we’re thirsty. It speaks to us in other ways as well and we don’t often slow down enough to listen so I—I urge all our listeners now to—to take that time to connect with themselves and find out what they need.  And one simple way, if you’re not sure how to do this, I love putting one hand on the heart, one hand on the belly–

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  Like we’ve already discussed–

Dr. Justin Marchegiani:  Yeah, yeah.

Elise Carr:  The exact same pose and just slow down, do some of that belly breathing and then ask, “What do you need me to know right now? What do you need me to know right now?” And without judgment, just let whatever answer comes to you come to you in whatever way, and if you get nothing that’s okay. Be open to an answer coming to you, that not in your dreams, seeing a sign, hearing a song on the radio, an answer will come to you because you’ve opened up that line of communication so be patient and come from a place of loving, kindness, and compassion for yourself.

Dr. Justin Marchegiani:  Well, you’ve inspired me to do a really good breathing session after this podcast, so thanks for that.

Elise Carr:  Right, you’re welcome Dr. J.

Dr. Justin Marchegiani:  Awesome. Well, last question for you. I typically end his podcast with every question for all the different guests here. But if you are on a desert island, what would be the one supplement or herb that you’d want to take with yourself.

Elise Carr:  Ooh, that is so tricky because I’m such an herb person.

Dr. Justin Marchegiani:  It could be anything.

Elise Carr:  Maybe—yeah, yeah. May—I say oregano. I know, you guys say oregano.

Dr. Justin Marchegiani:  Yeah.

Elise Carr:  I’ll probably take that because it’s so multipurpose, full of multi-useful being an antibacterial and anti-fungal.

Dr. Justin Marchegiani:  Absolutely.

Elise Carr:  And that you could probably take, you know, a little bit every day. I’m gathering a what, clean water on this island. Take a little bit every day to, you know, to keep my immune system strong as well and—and make me feel, you know, as healthy as—as I guess I can be with only one herb.

Dr. Justin Marchegiani:  I love it. Well, I’ve gone to Mexico a few times and gotten parasite infections and I brought it with myself and it’s totally knocked it out, so–

Elise Carr:  There you do.

Dr. Justin Marchegiani:  Very, very cool.

Elise Carr:   Thank you.

Dr. Justin Marchegiani:  Alright, well, Elise great chatting with you. StellaMuse.com and look forward to having you back soon.

Elise Carr:  Thank you so much, Dr. J. You have a wonderful rest of your day. It’s been a pleasure speaking with you.

Dr. Justin Marchegiani:  Thanks, you as well, Elise.


Estrogen dominance – Podcast #110

Dr. Justin Marchegiani and Evan Brand talk about hormones, their importance and their functions, as well as the symptoms of hormonal imbalance and what causes estrogen dominance. Understanding hormones doesn’t have to be complicated and if you listen to this podcast, you’ll get a clearer picture of what hormones really are and particularly for women. 

estrogen dominance - hormonal imbalanceFind out having balanced hormones is the key to feeling good and having energy. Learn how to avoid any imbalance and how to fix these issues to help you overcome stress. Discover what you can do and gain indispensable knowledge about dealing with hormones especially for females so you can perform at your best and be in optimal function.

In this episode, topics include:

00:42   Hormones

04:30   Symptoms of estrogen dominance

08:13   Causes of estrogen dominance

17:22   Phytoestrogens, stress allocation and avoidance

25:20   Nutrients










Evan Brand:  Dr. J! How’s it going?

Dr. Justin Marchegiani:  Evan, it’s doing great, man! How you doin’?

Evan Brand:  Pretty—pretty well. I’m glad we got this internet thing straightened out. Let’s hit this estrogen dominance topic. People have been asking via email, social media. Clients of ours have been asking about hormones and trying to understand them. There’s so many things in the environment that impact them. Your lifestyle, your diet can impact those and so you and I wanted to outline all this together and talk about what’s affecting your hormones, why is it so complicated in the modern world, what are the new variables that didn’t exist and then what do we do to fix it. So do you wanna start—start us off?

Dr. Justin Marchegiani:  Yeah, so hormones are interesting, right? Hormones are these messengers, right? They help with inflammation. They help with growth mediation, i.e., healing and recovering, putting on muscle. They help with reproduction. Not only reproduction like in reproducing ourselves so we heal but also having children and healthy hormone balance is essential to us feeling good, to us having energy, to us being resilient and vital as we—as we age and deal with stressful situation. So hormone balance is really, really important. Now as women—women have 2 different kinds of hormones that are constantly in fluctuation generally speaking, right? Men are kind of this foghorn of hormones throughout the month. Again there’s some fluctuations on a daily basis with cortisol, as are women, but on a monthly basis, you know, men kinda have this flat rhythm regarding testosterone. Women have this kind of symphony of hormonal fluctuations regarding estrogen and progesterone. And I tell my patients estrogen is the hormone that makes you grow. Progesterone is the hormone that makes you grow up. Meaning estrogen just causes cells to just grow bigger, while progesterone helps cells to differentiate and mature, okay? This is important so throughout your cycle, kinda breaking down a woman’s monthly cycle I think is really important for the first place of connecting the dots of where abnormalities happen. So first off, women’s cycle begins with bleeding, with menstruation. Typically about 3-4 days, maybe 5 days long in some extenuating circumstances. That happens because of a drop in progesterone and estrogen. So progesterone and estrogen drop, that signals bleeding. So the uterine lining is now shed over that 3 to 5-day period. The next thing is the follicle starts to grow and that follicle, FSH from the brain is starting to be produced and that causes the follicle to grow. So FSH talks to the follicle, the follicle starts to grow. As the follicle grows, estrogen is produced by the follicle. That’s step 3. As estrogen is being produced, it eventually hits a—a toppling, you know, where it hits its highest level around day 6-9 or 6-10. Then progesterone starts to increase as estrogen tops out, alright? Progesterone is increasing due to LH. LH is luteinizing hormone. That’s a brain hormone. The two brain hormones are FSH and LH. As progesterone topples out around day 20-23 or so, that’s where hormones are at its highest regarding progesterone and then day 27-28, progesterone and estrogen fall. So if we kinda recap it real quick, briefly what’s happening is we have brain hormones causing the follicle to grow. The follicle stimulating estrogen. Estrogen stimulating LH, LH stimulating progesterone. Progesterone and estrogen dropping. And that’s kinda the general dr—gist of the average female cycle, right around 28 days or so, and about day 13-15 is where ovulation happens. That’s right where estrogen tops out and progesterone starts to rise. That’s where that 2-3 window of pregnancy happens. I’ll just take a breath and give you a chance to break it down, Evan.

Evan Brand:  Sure, sure, makes perfect sense. And a lot of women that you and I are working with may be perimenopause or menopausal so we can talk about the ebb and flow and things that change there. So basically as you’ve kinda alluded throughout most of the reproductive years, the estrogen and progesterone are in a pretty good balance, but then if you look at all the information with progesterone and estrogen levels changing, then it looks like the gap becomes bigger where there’s a relatively high estrogen compared to progesterone and that’s what we would call menopause, and then that’s when these symptoms can start to occur. So I guess what I should do now is just go through some of these what consider estrogen dominant symptoms. So this could be allergies. This could be breast tenderness. You have copper–

Dr. Justin Marchegiani:  yeah.

Evan Brand:  Excess.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Which I did a video on copper toxicity and everybody’s like blown away by the idea of too much copper. How about cold hands and cold feet? Decreased sex drive, depression with possibly some anxiety or agitation added to it. Could be dry eyes, fat gains especially around the abdomen, the hips, the thighs, fatigue. Could be brain fog, which sometimes that could be yeast-related as well. Hair loss, headaches, blood sugar issues and fertility, irregular periods. You and I have talked about amenorrhea, just missing your period completely before. Irritability, insomnia, mood swings. I could go on and on. I think that’s a pretty good handful of symptoms though.

Dr. Justin Marchegiani:  Yeah, absolutely. So when estrogen’s out of whack, a whole bunch of symptoms happen. The real common ones like you mentioned—most females—these are the ones that I deal with on a daily basis with all my patients, you know, the big complaints. It’s gonna be moodiness. It’s gonna be breast tenderness. It’s gonna be cramping. It’s gonna be back pain. It’s gonna be migraines, moody, sweet cravings or sugar cravings, and I would say like water retention and even weight gain.

Evan Brand:  Yeah, I would say the sex drive one has been something big. I ask that question on my intake, you know. Do you think your libido adequate? And it’s very, very rare to find a women over age 40 who says that her libido is adequate. You know, some women said they haven’t had a libido in 20 years. So I mean, these things can change with hormones and they’re not just gonna magically fall into place by diet and exercise. So eventually you and I are gonna outline what exactly is going on in the external environment that is throwing off this whole hormonal cascade here.

Dr. Justin Marchegiani:  Exactly and typically, as a women ages, menopause is nothing more than the ovaries not functioning like they were when you were cycling and you have a drop in hormones from that. Typically over time, one the big things we see with hormonal—hormonal fluctuations over time is that estrogen drops at about 35% the rate from age 35 to 50, while progesterone can drop at 75% the rate. So this whole podcast is really surrounding the topic of estrogen dominance and part of estrogen dominance is just being exposed to a high amount estrogens in the environment—that we’ll go into in a second. The other half is is progesterone being essentially dropping so fast that estrogen—the ratio of estrogen goes above and beyond what would be normal essentially.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So if progesterone starts to drop faster than estrogen, even though you may have more progesterone as a basic flat line number, that’s still gonna be estrogen dominance. I mean, some people say over the course of a whole cycle you’ll have 300 times more progesterone than estrogen. At certain times of the cycle, like depending on where you’re at like let’s say, in the follicular phase you may have as many—as much as 25 times more progesterone to estrogen. So it’s different from the perspective of where you are in your cycle, but in general estrogen and progesterone—progesterone will be about 25 to 300 times more in relationship to estrogen, alright? So if that skew starts to get disrupted and we start to have less progesterone, let’s say below 20, you know, below 15 on average, that may be a big driving factor of estrogen dominance and a lot of the whole PMS symptoms and the symptoms that you just mentioned as well—the brain fog, the libido, dry hair, dry skin, dry nails, cold hand, cold feet, cramping, breast tenderness, all the things we already mentioned.

Evan Brand:  And let’s talk about some of the causes here. Birth control being a big one that can contribute because with birth control, you’re basically just keeping your estrogen levels sky high and so this is just a common prescription for many teenage girls, I’ve heard of even girls as young as 12 years old now getting put on birth control pills for their periods, you know, if they’re having really bad periods. So talk us through that. What’s going on with birth control pills? Why are these such an issue?

Dr. Justin Marchegiani:  Well, birth control pills are nothing more than like synthetic estrogens. You have like Yasmin and these synthetic estradiol compounds and they basically jack up your estrogen level as a female about 4 to 500%, 4 to 5 times. And that’s a problem because hormones, right? If you look at—go to any opera or any symphony, there’s a specific timing and a volume in which everything needs to operate in. If something goes too—too loud or too quiet or something, the timing’s off, you can easily have a beautiful symphony turn into noise pretty darn fast. Now taking that analogy to a hormone cycle, if those things start to go too high because of synthetic hormone overload or too low because of hormone stress driven by inflammation, that can start to create hormonal symptoms. So that’s the big thing right there off the bat. So estrogens are gonna be jacked up way high. Sometimes with the Merena IUD, that’s inter—interuterine compound that’s put up there to prevent the egg from implanting in the uterus lining, that is—that’s actually using synthetic progesterone. So that’s a little bit different. But most of the birth control pills are gonna be synthetic estrogen-based and basically what it’s doing is keeping the estrogen so high all the time so you don’t have that rise in progesterone happening. You don’t have that cycling of hormones. So basically it shuts the HPA axis and because your hormones are so high, the LH and FSH kinda go to sleep because–

Evan Brand:  So the body eats—the body thinks it’s pregnant.

Dr. Justin Marchegiani:  Well, not necessarily. The body—well, I guess you could say at a certain level. Typically progesterone’s gonna be really high with pregnancy and you’re gonna have HCG off the chart. So you’re not gonna see that because if you ran a pregnancy test while you were on a birth control pill, you wouldn’t come back with a pregnancy test being positive because you’re not making–

Evan Brand:  Right.

Dr. Justin Marchegiani:  The beta HCG. But what it’s doing, it’s shutting down the brain because the brain has this domino rally of FSH raising and then LH raising, so kinda shuts that down, because when the hormones are really high, FSH and LH don’t really have to work as much because the high amount of hormones is just shutting down the whole entire symphony. It’s like going into a symphony and with the foghorn. You just overpower all the instruments, you just can’t hear anything.

Evan Brand:  Makes perfect sense. Let’s talk about the metabolism of these two. That’s something that people do not talk about. There are side-effects that we could go into. We won’t bore you with those today, but there are nutrients—your vitamin C, your magnesium, zinc, and other minerals that are required for metabolizing these pills through your liver. So if you look at someone who has been on birth control for many, many years, mo—more than likely you and I are gonna look at their adrenals. We’ll probably see low function and if we look at like an organic acids test and if we’re looking for vitamin C or other nutritional markers, they’re probably gonna be deficient. Maybe not a—maybe not the only cause would be birth control but it’s definitely a factor. And then now I know we have to mention the environmental part of estrogen still. You know, we’ve talked about adding excess estrogen in via birth control but we have all the xenoestrogens in the environment, and now we’re seeing teenage boys with man boobs and you know, this is not—this is not good. This is not something that would have happened let’s say even 100, maybe 150 years ago with this breast enlargement. Can—can we go through some of those like the, you know, the—the meats, the plastics, the canned goods, all of that stuff?

Dr. Justin Marchegiani:  Yeah, exactly. So again, we already kinda mentioned some of the mild to moderate symptoms regarding estrogen dominance and again people that are listening that are familiar with some of the pathological situations like uterine fibroids, endometriosis, fibrocystic breast, polycystic ovarian syndrome, even breast tumors. Those are ultimate, you know, severe more pathological forms of estrogen dominance in action.

Evan Brand:  Right. It makes sense.

Dr. Justin Marchegiani:  And then—yeah, and regarding some of the underlying environmental causes, too much sugar is gonna drive a lot of this because too much sugar is gonna increase insulin. Insulin resistance drives more fat growth. Because if our cells are saturated and we can’t burn sugar in our muscles, well, guess what happens to that sugar? It goes right into fat and fat actually is its own exocrine gland. It produces a hormone that’s gonna cause fats—it’s gonna basically produce leptin which is another hormone that’s gonna decrease our body’s ability to signal satiation and signal that we’re full, which is another thing, and it’s also gonna produce more sex hormones like estrogen. So if we have more fat cells, fat cells will actually produce more hormones and throw us off even more. So driving insulin resistance, driving fat, fat will then drive more estrogen and then also it’s gonna screw up the whole combination here with leptin which is gonna make us feel hungrier and eat more of that same junk that got us there and to begin with. So a lot of these mechanisms that we overlay, you can see there’s almost like this vicious cycle to them where they kinda repeat itself on a loop over and over and over again.

Evan Brand:  Yeah, and then like you mentioned, they could all start with diet or sugar. So I mean, that’s a—that’s a huge one. It’s not something that we wanna skip over but you and I, we hit the diet piece so much that we’re assuming if you’re listening to this show, then you’re generally closer to like an AIP style diet where you’re not eating gluten. Maybe you’re doing a little bit of dairy in the form of like some ghee or some grass-fed butter.

Dr. Justin Marchegiani:  Right.

Evan Brand:  But beyond that, you—you gotta have that foundation in place, and then we could go on with the personal care products. You got your pesticides and herbicides.

Dr. Justin Marchegiani:  yes.

Evan Brand:  But you’re eating organic, you’re avoiding that. You got your makeup for women. So that—that is in the personal care category.

Dr. Justin Marchegiani:  Huge.

Evan Brand:  But think about women that are lathering themselves a lot of times with heavy metals and phthalates and all that, too, in their makeups.

Dr. Justin Marchegiani:  You also have your pesticides, I mean, a lot of those are estrogenic in origin. Pesticides, fungicides, herbicides. You have a lot of chemicals in the water as well. Remember when you get your water filtered back, the conventional water filtration in your community won’t filter out a lot of the hormones in the water. So you’re getting–

Evan Brand:  Yeah, we—oh yeah.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  The—the trace amounts of pharmaceuticals you’re talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That people flush down the toilet.

Dr. Justin Marchegiani:  Uh-hmm. Absolutely.

Evan Brand:  Fluoride would be another one that we could talk about.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  That’s another endocrine disruptor there.

Dr. Justin Marchegiani:  Yeah, fluoride. Also a lot of these polybrominated diphenyl ethers that are in flame-retardant products and various solvents, definitely not good. Milk if we’re drinking or consuming conventional dairy, a lot of the milks are treated with a Posilac, which is—or similar—no, Similac’s the formula. Yeah.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It’s Posilac. Posilac is the growth hormone given to cows to produce more milk essentially and then we have conventional dairy or conventional meat which could come from cows because cows are gonna be given hormones as well on the meat side, right? You have your Jersey cows which produce the milk. They’re given the Posilac to make more breast milk or make more you know, cow milk, and then we have the cows that are eaten for steaks and meat and those cows are gonna be given more growth hormone and estrogens to make more meat as well. They’re also given mycotoxins, too, to produce more fat to make their meat more marble then they’re given a lot of grains which are loaded with mycotoxins as well to make the meat more marbled. So a lot of different chemical toxins that are coming in on both sides of the fence.

Evan Brand:  Yeah, not even to mention the grain they’re getting fed is likely sprayed with glyphosate or it’s genetically modified grain that these conventional meat products have consumed.

Dr. Justin Marchegiani:  Bingo. Exactly.

Evan Brand:  Yeah. Last thing on—on the, I guess on the xenoestrogen route would be fragrances. So any woman or man wearing you know, perfumes, colognes, air fresheners, using those little trees that people put on their rearview mirror. It’s the worst smell on the world.

Dr. Justin Marchegiani:  Oh, absolute toxins.

Evan Brand:  Don’t use those.

Dr. Justin Marchegiani:  Absolute toxins. I remember in high school, I used to love having those in my car like the—the vanilla scent one. I thought it was so cool but then the more I studied it, it was just absolute toxins.

Evan Brand:  So were you the guy who when one of the trees ran out of scent, did you go to the car wash and buy another tree and stack it on or did you remove the first one?

Dr. Justin Marchegiani:  Well, I—I would remove the first one, but I always keep a tree in there to keep it going.

Evan Brand:  Oh, I—I’ve seen people who have 20 trees stacked on one another on their rearview mirror.

Dr. Justin Marchegiani:  I know.

Evan Brand:  They can’t even see out the windshield.

Dr. Justin Marchegiani:  Isn’t that nasty?

Evan Brand:  It’s horrible. Well, actually, Luke who and I were talking about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Before the show–

Dr. Justin Marchegiani:  Luke Storey.

Evan Brand:  Luke—he posted something online about he got in an Uber and he posted a picture of a guy who had like 20 of the black trees.

Dr. Justin Marchegiani:  Oh, God.

Evan Brand:  On his g—on his a—and so he had like a little portable ozone generator that he was breathing in in—in the backseat of the car.

Dr. Justin Marchegiani:  Oh, my God. Unreal.

Evan Brand:  Poor Luke.

Dr. Justin Marchegiani:  I know. What you gonna do?

Evan Brand:  Yeah. Let’s talk about phytoestrogens, too, in the food if—I guess we’ll hit the diet piece again. So these are your sources of soy. So mainly we’re talking about soy bean, your tofu, all of that. Something that’s frustrating for me is when you’re looking for a good protein bar, you may—you might find an organic protein bar at your health food store, but typically one of the first ingredients is gonna be soy protein crisp. It’s like come on, that’s not good.

Dr. Justin Marchegiani:  I know. Whatchamacallit, yeah, Clif Bars has got them. Even I think–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  A lot of the Zone bars, too. There’s only a few bars that actually have decent, clean protein in their bars, but that’s a big one. Soy’s a big phytoestrogen. Outside of miso, natto, or tempeh, soy is—for the most part is not gonna be good. Some menopausal females can get away with a small amount of it, if fermented-wise because it can help modulate their hormones when they’re lower in estrogens, right? Menopausal, but for the most part, people should not be doing soy. It’s not a good thing. It’s—and outside of that, too, we talked about the chemicals. We talked the industrial solvents, the hygiene products. You can always go to the website, skindeep.com or org to look up your products that you use on your face, on your hair, on your skin, your makeup, and see how much chemicals or toxins are in them. Oh, stress! Stress is huge because stress will cause your progesterone which is a major building block of your hormones to go downstream. Meaning it will progesterone and shunt it in the cortisol or stress hormones so you can deal with whatever that stressor is, because your body is hardwired to prioritize stress and inflammation first over recovery and healing and fertility second. And it kinda makes sense because if you’re stressed now, the body wants to deal with that stress, get over it and then because able to repair later, because if it doesn’t deal with the stressor, it may not get to that next point of being–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Able to heal and recover. So it’s just allocation.

Evan Brand:  Yeah, maybe you’re—maybe you’re dead and because you got eaten by the bear because your body was trying to repair and run at the same time. It can’t do both, so people who are listening, you know, always have the ancestral lens added as filter on to our conversations because this is very new. All this stuff that we’re dealing with, the environment is so new and we still have this ancient wiring systems that’s thinking–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Okay, there’s a bear coming down my driveway right now, I need to be in Fight or Flight, so recovery is—is not prioritized. And people listening, even just you having a notification sound—Justin and I have talked about this before, but even just having notifications on your smartphone or your computer “Ding!” every time you get an email, that’s triggering a biological response in the brain, that’s a hormonal response. Your body’s thinking, “Oh, what the hell is in that email? Is that a bill? Is that letter from somebody I don’t wanna hear from? What’s in that inbox?” That could be a huge source of stress so you really need to—you could either track your heart rate variability or just track how you feel. If you feel your heart racing or gut hurting after you’re expose to social media, something like that, these are the invisible stressors that can really trigger stuff for people and if you put—well, what does that actually do? You’re just saying this. But what does it do? Well, it inhibits the conversion of—of hormone, your T4 to your active T3, and so then you’re gonna have those hypothyroid symptoms and it could all be due to the stress.

Dr. Justin Marchegiani:  Yeah, and just think about it like this, right? If you’re barely getting—barely making enough ends to meet, you know, you’re barely getting enough money to make ends meet, so to speak, right? Do you have enough money to go and start investing in things in the stock market or real estate? Probably not because you’re just so focused on getting the bills paid. That’s all you can focus on. Once the bills are paid, i.e., once you’re able to manage stress and inflammation in your life, then you can think about investments after that, right? Same thing hormonally with how your body is prioritized to allocate bandwidth to essentially.

Evan Brand:  Right, that—yeah, that’s well said.

Dr. Justin Marchegiani:  You can–

Evan Brand:  Do you want talk about–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Do you wanna talk about solutions for this? I think avoidance is kind of the—the big one that we could say in one sentence and be done with that, you know? Getting these things out of your life, making sure that you’re eating organic, making sure that you are staying away from the chemicals as much as possible. You’re looking at your skin care products. You’re looking at the makeup, the mascaras, the foundation, all of that crazy stuff that women put on to, you know, they feel like they have to put that on to be beautiful. I promise most women I see, they’re more beautiful without makeup. You look so much better. I tell my wife, “You don’t need it.” Country singers they say—they sing that in their songs like, “Oh, don’t put on makeup.” But it’s a real thing, especially if you have, you know, freckles and—and whatever natural skin pigmentation, that’s pretty. You don’t have to cover that up. So maybe turning off the TV is the first step to get through that process.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Because women are brainwashed into thinking they have to—to have caked on xenoestrogens to look pretty and they don’t.

Dr. Justin Marchegiani:  Exactly and that’s part of the whole, you know, brainwashing that Hollywood does, is they try to make most people feel incredibly inadequate about themselves so they can go buy some product and you know, frankly, it works. As much as a lot of women don’t like it and they complain about it, but it works and that’s why they do it.

Evan Brand:  Well, because if—yeah, you’re saying because if one lady is gonna wear makeup, then you don’t wanna be the only one without it?

Dr. Justin Marchegiani:  Right. I mean, I—my wife asked me, “Should I wear makeup tonight?” You know, she’s telling—she’s asking me this. I’m like, “No, you shouldn’t.” I like you better without makeup. It’s just—it’s better. It’s healthier.  But–

Evan Brand:  It really is.

Dr. Justin Marchegiani:  But there are some natural things out there. I know there’s a-

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  There’s some—some mineral-based makeups that you can just kinda touch things up and it’s more mineral and more natural-based and it’s easy and you’re not adding a big toxic load. Those will be if you’re gonna use makeup because some people may not be ready to make that switch, but that’s the better next step to look at.

Evan Brand:  I’ve seen a couple organic mascaras. I don’t know how it could be organic. But Hannah’s purchased a few organic mascaras and then also a few foundations. I don’t know if they were considered organic or they were labeled without phthalates. I can’t think of the brand right now. I wanna say it had the name Doctor in it.

Dr. Justin Marchegiani:  Huh.

Evan Brand:  Doctor’s Best or something and it was a brand of makeup. If you look on Amazon, I know there’s a bunch of different companies out there.

Dr. Justin Marchegiani:  Yeah, absolutely. So diving in here, we talked about the stress allocation and how your bodies and your adrenals can be affected by this whole thing, right? Because of the prioritization of progesterone to cortisol. You also touched in on how that cortisol can affect your thyroid because if your hormones start going off, if progesterone starts going off, that can affect thyroid conversion because if cortisol’s out of balance, that can affect T4 to T3 conversion which is your inactive thyroid hormones, so you’re active thyroid hormone. And also progesterone’s a powerful stimulator of TPO, which is the enzyme that helps bind tyrosine and iodine together to make thyroid hormone. So progesterone is really important to building thyroid hormone. So you can see this is why you don’t just get one symptom when hormones go out of balance because it just has this constellation ripple that can happen and many symptoms can occur because of it.

Evan Brand:  Yup, well said. So avoidance. We talked about lifestyle changes, you know, doing what you can whether it’s a floating tank, whether it’s yoga, tai chi, qigong. There’s meditation. There’s gratitude exercises, journaling. You and I have done entire podcasts dedicated to that. I don’t wanna skim over it but I think there’s so much that said about stress that you—you just have to—you have to do it. And if you say that you don’t have 5 minutes to meditate, well, you probably need quadruple that amount of time.

Dr. Justin Marchegiani:  Exactly. Yup, setting a timer like that can be really helpful. Even just sitting and just breathing. Just—just staring literally out—out your window. Just staring and just thinking about the sky or whatever, just clouding your head or just whatever is going on and just think about whatever you’re looking at. That’s why you talk about forest bathing or walking in nature and just being 100% present where you’re at. Oh, look a tree! Oh, look a rock! And all you’re focused on is what your eyes are gazing at.

Evan Brand:  I love it. Yeah, I mean I’m looking outside right now. It’s a beautiful day here. It’s in the mid-60s so it’s getting chilly but the sky is so blue. I mean, I’m so grateful for that.

Dr. Justin Marchegiani:  Love it.

Evan Brand:  To not have a cloudy day.

Dr. Justin Marchegiani:  Love it. That’s awesome.

Evan Brand:  Should we talk about nutrients? You wanna go there in terms of like estrogen metabolism support–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Stuff like that?

Dr. Justin Marchegiani:  Yeah, so let’s just kinda dive in the gut because the gut’s really important to the nutrients getting to where they have to go. Would you agree?

Evan Brand:  I, oh—yeah, 100%!

Dr. Justin Marchegiani:  Yeah, so we’ve kinda talked about it when we did our dry run round 1 on this podcast on Friday that got—didn’t quite go through on our side, so we’re even more polished for this podcast round 2. We talked about estrogen hormone conjugation, and conjugation is nothing more than putting a straightjacket on the hormone. Okay, so, you know, because we’re talking about estrogen here, estrogen begins with E so we’ll use Evan as our form of estrogen in this analogy.

Evan Brand:  Here we go.

Dr. Justin Marchegiani:  Alright? So E for Evan, E for estrogen. I’m putting a straightjacket on Evan so I can escort him out of let’s say the—the rowdy club, right? He’s—he’s going crazy. He’s fist-pumping. We’re gonna put a straightjacket on him, escort him out of the club. That’s kinda like what our body does to estrogen. It’s done its thing. It’s going. It’s getting shot back out the gallbladder into the gut to get metabolized. We bind these proteins to it. It’s called conjugation or in this analogy, straightjackets on Evan so we can escort it out. The problem is back gut bacteria imbalances meaning more bad bacteria in relationship to good bacteria in your gut—this is called dysbiosis—this upregulates specific enzymes known as β-glucuronidase. You know it’s an enzyme because it ends on the word –ase. This enzyme basically comes over and takes the straightjacket off. So imagine Evan being escorted out of the bar, right? The club. He’s being rowdy. Someone clips open the straightjacket and now he’s loose and he’s—he’s running away from the bouncer or the police. That’s what happens. Estrogen gets unconjugated or deconjugated. Boom! It can go right back into circulation and cause tissue to grow, whether its endometriosis or cause fibroids to occur, or create hormonal imbalances and symptoms and mood swings, and affects your mood and—and cause you to gain weight. All these different things can happen when we have gut bacteria imbalances. So that’s kind of the—the estrogen-gut detox mechanism. And then we also have the fact that if we have malabsorption because we have too much gut bacteria imbalance, more bad than good. We have low stomach acid and low enzyme levels, well, we’re not gonna be able to break down a lot of the nutrients we need to be able to metabolize hormones, whether it’s B6 or zinc and magnesium or various B vitamins that, you know, help with phase 1 and phase 2 detoxification, sulfur-based amino acids. All these things have to be broken down into their constituents so they can be absorbed and get into circulation and also we need to ionize various minerals, like magnesium and zinc. These are really important minerals. We have ionize them. That basically allows these minerals to get soluble. It’s solubilized into the bloodstream so it can do its thing and be utilized.

Evan Brand:  Yeah, so I mean we could add another layer on top of that. Parasites, yeast, we know–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  With Doctor–

Dr. Justin Marchegiani:  All these things affect that.

Evan Brand:  Dr. Jonathan Wright’s book, Why Stomach Acid is Good For You. We know that any woman listening over age 30, you have lower levels of hydrochloric acid and enzymes than you did when you were 20. So it’s not to—you don’t have to guess and—and check and think, “Oh, do I low enzymes?” I guarantee it. I would suggest and you tell me if—if you suggest different, but I generally suggest anyone over age 30 especially people that busy or eating in a rush or scrolling–

Dr. Justin Marchegiani:  Big time.

Evan Brand:  Scrolling on their phone while they’re eating which is a big no-no, you gotta have enzymes.

Dr. Justin Marchegiani:  100%.

Evan Brand:  Supplemental enzymes that is.

Dr. Justin Marchegiani:  Yeah, I mean enzymes and/or hydrochloric acid because hydrochloric acid actually activates enzymes.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Hydrochloric acid activates pepsinogen to pepsin in the stomach and also provides the PA stimulation for the pancreas to produce trypsin, chymotrypsin, lipase, a whole bunch of other proteolytic enzymes that are really important. So without HCl and/or enzymes, you’re gonna be in a world of hurt when it comes to digestion. And most women don’t get this, men as well, but they don’t understand the fact that you can have digestive problems and may not actually have digestive symptoms. People think, “Well, hey I don’t have diarrhea or constipation or bloating, I’m not too gassy, I don’t burp too much, I don’t have any acid reflux, and I got to the bathroom every day. Hey, I don’t have a problem.” Right? But a lot of times, their moodiness, their PMS, they migraines, their other issues in their body–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Can be driven by the inflammation going in their gut because they’re not—they don’t or they’re not expressing with atypical—I’m sorry, they’re not expressing with typical gas symptoms, bloating, gas, constipation, diarrhea. They’re expressing with atypical, outside of the norm symptoms that just are really hard to be connected and their medical doctor they go to won’t ever recognize it because they are great, they’re depressed—could be a hormonal issue, could be a gut issue, but guess what? They’re gonna be put on Wellbutrin–

Evan Brand:  Lexapro.

Dr. Justin Marchegiani:  Lexapro, Paxil. Hey, you know they’re feeling, you know, a little bit anxious. Great, they’re gonna get thrown on Xanax.

Evan Brand:  Ugh.

Dr. Justin Marchegiani:  Hey, you know, they’re feeling like their cycle’s a little unstable, they’re getting thrown on a birth control pill. It could totally be from–

Evan Brand:  That’s horrible.

Dr. Justin Marchegiani:  All the other dysbiosis and the poor detox happening in their gut.

Evan Brand:  It’s horrible, man. It’s horrible. I had a female last week, she asked me—we found Giardia and Blasto—the double, double trouble there.

Dr. Justin Marchegiani:  Double trouble.

Evan Brand:  And she said, “Well, I don’t have any gut symptoms. Do we still have to treat it?” I said, “100%, you can—just because you’re, you know, not running to the bathroom with diarrhea, the typical manifestation of Giardia, it doesn’t mean we can just let it stay there.” Could you—maybe you would have a—a more, a better answer than me. I just said, “Absolutely.” But I know there could be more to that. You can be as long-winded as possible with this.

Dr. Justin Marchegiani:  Well, I tell people that everyone has the right to be infection-free, right? That’s my goal. To make sure everyone’s infection-free. Now the problem is everyone also has the right to have more than one issue going on at once. So a lot of patients, they have hormonal imbalances, but they also have other issues that are driving the hormonal imbalances that don’t necessarily from bird’s eye view connect, i.e., the Blasto and Giardia and this girl’s female hormone or mood symptoms. So–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah, so anytime there’s a stressor, that’s an issue. It’s like you walk into your house. Okay, let’s say you have a couple of guest bedrooms. Let’s say you don’t go in those guest bedrooms for a while. The guest that was in there last left the water running just a bit. You don’t know it. You don’t hear it. But you get this water bill every month and it’s just a little bit higher than you’re used to and you’re like, “Why the heck is my water bill 30% higher? I’m barely even using it. I’m gone half the month. What’s going on?” And then you look over and you’re like, “Oh, the water in my guest bedroom’s on. That’s what it is. I’m gonna turn it off.” Now what’s this equal? Having water in your guest bedroom on is like having a parasite or a bug stealing your nutrition, pooping inside of you, i.e., creating biotoxins, creating inflammation and maybe even creating leaky gut which is stressing your immune system which takes up energy. All of those stressors like that parasite or infections involved in, toxins, malabsorption, leaky gut, immune activation, that’s nothing more than draining your energy. So instead of your energy being allocated to performance and recovery and healing, right? It’s going towards something else. Just like your water bill’s being sucked towards these guest bedrooms that you don’t even—you’re not even aware of them because you’re not there on a day-to-day basis.

Evan Brand:  Now so from the nervous system perspective, couldn’t we say that you’re gonna be sympathetic dominant, more fight or flight?

Dr. Justin Marchegiani:  More, 100%. Yeah.

Evan Brand:  Because you’re fighting an internal battle.

Dr. Justin Marchegiani:  Bingo! And the problem, the sympathetic nervous system, the allocation because we’re hardwired this way and it totally makes sense is when the fight or flight, the sympathetic, that’s like the gas, go, go, go, go, go. That’s the gas, the sympathetic fight or flight nervous system shuns blood flow towards the muscles, towards the outer extremities because we have to fight and flee and we need oxygen and nutrition and glucose to get to those outer extremities so we can perform. If the blood glucose is inside the intestines and inside all the organs where they should be and they’re digesting, you will not be able to run as fast. That’s the main reason why activity after your meal is destructive for your digestion, you get an upset stomach. Remember the old analogy of like, “Hey, you shouldn’t go swim. You should wait, what, 2 hours or an hour after you eat to go swimming.” Why is that? It’s because at some point, someone did that and they got a cramp because there wasn’t enough blood flow or they got an upset stomach and got sick.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So–

Evan Brand:  Because you’re trying to rest and digest and be active at the same time. You can’t do it.

Dr. Justin Marchegiani:  Yeah, and the analogy is this, right? If the sympathetic fight or flight nervous system is your foot in the gas, and if the digestive system and relaxation and repair is the brake pedal, what happens when you hit the gas pedal and brake pedal at the same time?

Evan Brand:  Yeah, it’s not a good—not a good—not a good picture.

Dr. Justin Marchegiani:  No, no, exactly.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  You’re—you’re spending a lot of time going nowhere fast.

Evan Brand:  Yup, so to wrap this whole segment up of—of this part of the—the conversation. If you’re someone listening, especially female, or you and I are working together, you’re working with Justin already, and you tell us, “Yeah, but my life’s not that stressful. I’m not that stressed.” It doesn’t matter because all of this hormonal imbalance and these symptoms that you have could all be going on due to something in your gut. And Justin, you and I both are—we’ve seen false negatives on stool test results. So sometimes it may take one or two or three times to really find what’s going on. So if you’ve gone to your conventional doctor or even the gastroenterologist, the specialist you’re gonna get referred to that’s gonna throw you on prescription acid blockers, if they run tests on you and how up negative, don’t necessarily take their word for it. I hate to say this that these prestigious hospitals and et cetera are missing infections but you and I see it every single day in the clinic and we’re finding these infections. So if you actually get something on a piece of paper, you’re gonna have a lot more room to work with. So don’t just go buy hormone balancing or hormone this or hormone that supplement. You really need to get to the root of the root which in some cases could be the infection route.

Dr. Justin Marchegiani:  Oh, 100%. And again, really looking at everything holistically is really exactly how you have to do it because of the interplay with body systems that may not typically connect to the average person because you know, they’re not a trained functional medicine clinician and definitely will not connect with the average conventional medical doctor because they’re training is drug symptom, drug symptom, drug symptom, and they don’t look at upstream stressors and body systems that may be out of balance.

Evan Brand:  Sure, so I’ll put it even more—even more direct. If you’re going to your OB-GYN or your endocrinologist, they’re not gonna have a clue about you having a cryptosporidium infection in your gut and giving you an herbal protocol to remove that infection so that your hormones come back into balance.

Dr. Justin Marchegiani:  100%.

Evan Brand:  It’s never gonna happen. I mean, I will—I will bet you know every silver bar that exists on the planet that—that you’re not gonna get it. If you do, then that doctor, they—they’ve stepped up their game and they’ve done some functional, you know, they’ve taken some functional courses.

Dr. Justin Marchegiani:  And sometimes it’s good like get that workup done. You know, just you know, go with the low-hanging fruit. I find most of the time patients come to see me and that’s already been done–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And it’s already been missed but hey, always start with what’s the easiest and you know, what I consider to be the low-hanging fruits, that way you know you’ve crossed your T’s and dotted your I’s so to speak and then you can go up the chain regarding the—the functional medicine, you know, ladder so to speak.

Evan Brand:  Sure, and I guess we could briefly talk about, you know, the financial aspect of it, too. If someone does have health insurance or they’re able to go see a doctor through their work and it’s at no charge to them, then you might as well try to milk that for as much as you possibly can, but unfortunately in most cases the lab results that get sent over to you and I that we review, there’s not much evidence there. We can’t really work with that. We really have to do the more functional tests which are an investment but sometimes that’s what it takes.

Dr. Justin Marchegiani:  100%. So looking at this point here. If everyone listening or anyone listening is dealing with a—a hormonal imbalance, whether it’s men and just having low libido and—and poor muscle tone or women having PMS or menopausal symptoms or everything in between that we already mentioned, the whole litany of—of different items there, the next step is gonna be one, digging into the female hormones, right? Testing hormones at the right time of your cycle. We test female hormones typically around Day 20 or so if we’re looking at progesterone to estrogen. Some we even run a month-long cycle to see how the hormones fluctuate every other day. And some will even dig deeper into looking at thyroid as well as a full gut panel. So depending on where you’re at, if you’re having issues and you’ve already kind of ruled out the things we’ve already talked about on the diet and lifestyle, the next step would be to step it up regarding the functional medicine’s options that are available and kind of our—our palette if you will.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So the next step would be to reach out to either myself, to Evan, notjustpaleo, Dr. J myself, justinhealth.com or some other competent trained functional medicine doctor or practitioner to get everything kinda lined up in order based on what we talked about in the podcast today.

Evan Brand:  You hit on the—the last word that I wanted to say is the order.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  You know, something that is very important for anything, you know. If this is just adrenal problems or just hormone problems or just gut problems, whatever it is, it has to be done in the right order. Please, please, please don’t add to your supplement graveyard because you read about some product on Amazon or you saw it at the health food store and it was in the hormone section. Save your money because if you’re doing things in the wrong order, you’re really just wasting your money. Now I’m not gonna say that taking a zinc supplement is necessarily gonna make you worse because we know that–

Dr. Justin Marchegiani:  No.

Evan Brand:  70% of women or more are not getting enough zinc, so yeah it’s not going to hurt you. It might help you but why go and spend all this money if it’s not done in the right order because you’re gonna save so much more money in the long run if you do things in the right order by working with a practitioner.

Dr. Justin Marchegiani:  Well, it’s like baking a cake, right? Let’s just pretend it’s a gluten-free flourless cake for our—for our healthy analogy, right? You have the eggs. You have the—the coconut flour or you have maybe some Stevia in there, whatever else, maybe some grass-fed butter or coconut oil. Well, how we mix things in baking a cake is really important to the outcome of the product, of the outcome of the cake.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So let’s say you—you do start doing a heavy metal cleanse first, gut-killing second. You work on the diet 3 months into it and then you don’t touch the hormones and the thyroid til month 4. Well, you did a lot of things that were supposed to be done but they were just all done in the wrong order. Just like making a cake, you cook it before you mix the eggs and then you add the—the Stevia at the end or whatever. It doesn’t come out to be a nice-looking cake.

Evan Brand:  Yup, yup, Well-said.

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

Evan Brand:  I don’t think so. I think this is—this has been good coverage. Share this, if you have somebody who’s going through all this stuff. I mean, I could think of 20 people right off the top of my head who I know have problems with estrogen metabolism or estrogen dominance. So sharing is caring. This is the information that has to get out there. We’re gonna continue doing our work, we’ve got, you know, between Justin and I both, we’re over—likely over 6 million. I haven’t counted. I know for sure, 100% guaranteed over 5 million downloads of conversations that we’re having, probably up to 6 million by the 4-year anniversary of my show which is coming up really darn quick. I think it’s November 11th of 2012–

Dr. Justin Marchegiani:  Wow.

Evan Brand:  Would be the 4-year anniversary. So that’s—that’s a lot of people but that’s still not enough. That—I mean look at the suffering out there. Look at the people that are going and they’re spinning their wheels and they’re buying these diet programs and they’re buying these fitness books and they’re not getting the answers and they’re beating their heads against the walls, and they’re buying you know, diet root beers and look at Pepsi. I mean they had to bring back their aspartame version of their Diet Pepsi because so many people complained about the taste, you know? So don’t prioritize the taste. You know, prioritize the—the quality of your—of your liquids, the quality of your nutrition. Prioritize that better over taste and if you ask me, I think aspartame tastes horrible and it’s a neurotoxin, not to mention. So always look at something through the lens of the quality, not necessarily the taste or the cost or—or all of that, because you’re really gonna save yourself a lot of trouble if you start turning around the boat now as opposed to waiting til when you hit rock bottom and then you’re coming to Justin or myself and then you’re saying, “Look, I’ve had this stuff going on for 20 years.” Well, how long have you known something was wrong? “Well, I knew I should have gotten help you know, back in 2003, but I didn’t.”

Dr. Justin Marchegiani:  Right.

Evan Brand:  You know, don’t be—don’t be one of those people. Thousands of people have come to our clinics. It’s your turn. If you’re suffering, stop suffering. You don’t need to.

Dr. Justin Marchegiani:  Bingo. Love it, Evan. Well, feel free and reach out to Evan at notjustpaleo.com, Dr. J myself, justinhealth.com or beyondwellnessradio.com. Subscribe to the podcast and the YouTube channel and we look forward to providing more information very soon.

Evan Brand:  Check out Justin’s videos. He’s over 20,000 subscribers on YouTube. He’s gonna be—I’m telling him, he’s gonna be the King of Functional Medicine on YouTube.

Dr. Justin Marchegiani:  Just able to help more people. I love it.

Evan Brand:  Yes, sir. Take care!

Dr. Justin Marchegiani:  Have a good day, Evan.

Evan Brand:  Bye!

Dr. Justin Marchegiani:  Bye!


Functional medicine hair loss solutions – Podcast #94

Dr. Justin Marchegiani and Evan Brand talk about supplements, hormones and how the adrenals affect the thyroid in relation to hair loss. This interview is geared towards educating people all about hair loss and functional medicine solutions. Learn all about alopecia areata when you listen to this podcast.

hair loss solutionsAlso find out about the different things that you can do to help improve your hair quality and even grow it back. Get to know about ferritin and iron saturation and why you should pay attention to these. Discover the possible causes of hair loss and what hair supplementation to take which are proven to be very helpful. Learn how the functional medicine approach to hair loss can be very effective at addressing this issue.

In this episode, topics include:

00:23   All about hair loss and alopecia

02:32   Gut issues 

04:35   The thyroid connection

06:37   Blood tests and hormones

09:38   Supplementation










Dr. Justin Marchegiani:  Hey, Evan! It’s Dr. J. It’s a great Friday here over in Austin. How’s it up in Louisville?

Evan Brand:  Howdy! Blue skies and the grass is green. We’ve had about 3 feet of rain it feels like over the past weeks, so everything is super lush.

Dr. Justin Marchegiani:  That’s great. Another great Friday. Well, we talked pre-show we wanted to discuss a little bit more about hair loss and different things that we can do to help improve hair quality and potentially even grow back hair as well.

Evan Brand:  Yes, sir. Yeah, so I’ve had a quite a few—quite a few women, I mean, and it’s—it’s always there. Hair loss is always the symptom, but I’ve found this week especially that alopecia has been popping up, and it almost makes you think it’s more common when you’re hearing it multiple times a week. It’s like, “Whoa! Does everybody have alopecia?” And so we know one of our online friends, Yuri–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  He has alopecia and he talked about it. I believe he’s talked about it at least where he’s basically he’s lost his eyebrows, he’s lost everything, and obviously that’s an extreme case to lose everything, but there’s definitely some—I guess a spectrum of hair loss that can happen. So maybe it’s not a full state like the alopecia but there’s also like some thyroid dysfunction and some other stuff, I suppose we can chat about that it’s gonna be tied into mild hair loss.

Dr. Justin Marchegiani:  Got it. Yeah, I actually had a conversation with Yuri Elkaim about his hair loss and he mentioned a lot of it had to do with poor diet when he was younger as well as gut health issues. And if you look at alopecia or alopecia areata as it’s known in the conventional medical world. It’s kinda fun to say—areata, that’s autoimmune and we know with autoimmune stuff, there’s almost always a gut element connected, right? Because we know leaky gut is when those tight junctions, the epithelial tight junctions open up, undigested, whether it’s bacteria, lipopolysaccharide particles or undigested food antigens which are foreign food proteins get into places in the bloodstream where the immune system isn’t used to it and that can really drive immune attack or an autoimmune attack, and alopecia is nothing more than a disease that describes where the immune system is attacking especially the hair follicles.

Evan Brand:  Interesting. So we would have to assume that any person who has this hair loss issue has some sort of gut issue. Is that a safe statement to say?

Dr. Justin Marchegiani:  I would say anyone that has hair loss and I hate absolutes, but I would say there’s a very strong chance that if you have hair loss, outside of it just strictly being a genetic factor, there’s more than likely a gut issue. And when we look at gut issues, it could be a gut issue where there’s a full on infection, like a parasitic or fungal overgrowth or a bacterial infection. It could be just something like a small intestinal bacterial overgrowth or it could even be something like hydrochloric acid and amino acid or protein—prote—proteolytic enzyme deficiencies where you can’t break down those amino acids, where you can’t ionize those minerals. Now typically any type of deficiency in the gut where there’s lower enzyme levels and lower hydrochloric acid, after a period of time, they’ll typically be an infection present because we need the hydrochloric acid to sterilize the—the gut environment, especially the stomach. That sterile environment is akin to you going to a—a dirty picnic table and maybe spraying some bleach or some kind of sterilizer on the table. It keeps that area clean. Well, that’s what happens in your gut and hydrochloric acid is also important for cleaning the environment but also activating enzymes. So if we aren’t activating enzymes and we aren’t keeping that environment clean, overgrowths can happen and if food doesn’t get broken down, the food rots and ferments, and then typically bacteria will then feed on the remains if you will.

Evan Brand:  That makes sense. Yeah, and I actually had several—several people like I mentioned over the last week with alopecia and one woman, I think she ended up not proceeding with her lab test. I’m not sure what—what ended up happening but I really wanted to take a look at the gut, so at this point I don’t know what’s going on with her gut if we’re not gonna proceed with testing, but I think it sounds like that’s an important place to start. And then maybe you could shed some light on the thyroid issue, because any time we talk about hair loss, women think that it’s automatically the thyroid. Is that a place that you’re gonna look for issues as well?


Dr. Justin Marchegiani:  Yeah, so one of the common symptoms of thyroid or of hair issues can be low thyroid. A lot of women will see it with the outer third of their eyebrows, it’ll start to thin out. We need thyroid hormone for adequate hair growth. So on the things we see with lower thyroid hormone—thyroid hormone can be a really powerful growth factor for that hair follicle to produce hair. So if we have lower thyroid function, and it could easily be from an anemia because a big building block for thyroid hormone is iron—that’s part of the whole iodination process involves iron. So if you’re a female that’s vegetarian or has a gut issue, low stomach acid, which typically also means low enzymes, and malabsorption and/or you’re a vegan-vegetarian, you’re really set up for a world of hurt, of having a high risk factor for thyroid issues because we need that iron to make healthy thyroid hormone, and I did a blog over this a couple of  years ago over at FixYourThyroid.com—you can take a look at it—where we talked about thyroid function and hair loss. And that’s an age-old tell-tale symptom for low thyroid function. So we always wanna look at thyroid issues when we see hair loss and we always wanna look at anemia especially for women when they’re either vegetarian, they have gut issues and malabsorption problems, and/or they’re ec—they’re menstruating excessively. They have a lot of PMS and they’re bleeding—they’re going through more than, you know, 4 or so tampons, or they’re having just a prolonged bleeding period and they’re losing a lot of their iron that way.

Evan Brand:  Interesting. So there’s a few things here. So it could be some iron anemia going on. So we would wanna look at ferritin levels, and then you and I were also chatting off air earlier about iron saturation, correct? Would that be the two most important blood tests to look for?

Dr. Justin Marchegiani:  Yeah, so ferritin and iron saturation are gonna be important to look at. We like iron saturation 25 or above. We like ferritin, at least for a female, 30 or above. Now we can go above and beyond that, we can also look at your iron binding proteins like TIBC and UIBC. These are inverse proteins, so they go high—they go high when iron goes low. So think about it as like LittleFingers, right? The more you need the iron, the more fingers are gonna be up there to try to grab and pull that iron into where it needs to go. So binding proteins go up when iron goes low. So it’s kind of an inverse thing. It’s kinda like TSH, right? TSH screams louder to the thyroid when the thyroid goes lower, like you’re trying to get someone’s attention, right? You’re talking to them across the room, they’re not responding to your voice, so you raise the volume. Same thing, you’re raising the volume and trying to pull that iron and get it into your body so you can carry oxygen and make thyroid hormone.

Evan Brand:  Okay, so you’re talking about thyroid, so when TSH is high, that’s when we know the thyroid function’s gonna be low. So if we’re kind of mixing lab tests here, we’re kinda talking about a few different things that we’re gonna be looking for this whole hair loss picture, the thyroid’s a good place to look. The iron levels are another good place to look. And then what about the adrenals because typically we’re gonna see adrenal issues happening that could be tied into thyroid issues, correct?

Dr. Justin Marchegiani:  Yeah, it’s very possible. I mean, stress hormone will do a lot of different things to our body, right? So stress hormone will typically catabolize tissue and amino acids. So we’ll catabolize amino acids that could be used to make muscle or neurotransmitters, and amino acids can also go and make hair. So it’s very possible the more you are in a stressed out state, the more—the more the adrenals are hyperresponding or being whipped like a tired horse, you could potentially catabolize those building blocks that could go and make quality hair. That’s why many people have had experiences of extreme stress in their lives, like you know, really punctuated stress like someone dies or you know, something really catastrophic happens and they start losing hair. So it’s very possible that extreme stress and higher secretions of cortisol can really drive that hair loss and also we know we need cortisol healthy levels of it for thyroid conversion. So if we’re not activating our thyroid hormone because now our cortisol’s in the dump, we can also have it because of chronic cortisol imbalances that are driving low thyroid activation or low thyroid conversion.

Evan Brand:  Yeah, that makes perfect sense. So now the first place that people like to jump is supplementation. There’s who knows how many millions of products out there that are designed or marketed for women especially for hair, skin and nails. Is that something that we would wanna do right out of the gate, or obviously it sounds like the better alternative is we need to kinda look for these other deeper underlying causes first and then maybe the supplements are gonna be kinda phase 2 or phase 3 in terms of treatment.

Dr. Justin Marchegiani:  Yeah, absolutely, so obviously the diet stuff is really important. We kinda echo this stuff. Supplements are meant to supplement a good diet and lifestyle, so we’re making sure we have an anti-inflammatory diet because inflammation will drive cortisol because cortisol is our body’s natural inflam—anti-inflammatory. So cutting out the grains and a lot of the food allergens, plus we know that alopecia or alopuc—alopecia areata is going to be autoimmune and we know gluten, how important gluten is at being an autoimmune—part of the autoimmune mechanism, being an autoimmune stimulator, we know it can open up those tight junctions. We know it can drive inflammation, it also can be very high in sugar, right? A lot of the carbs, gluten, and a lot of refined sugar can drive your insulin levels up and high blood sugar can also feed fungus and a lot of people will have like cradle cap or aka dandruff or they’ll say—call it seborrheic dermatitis. A lot of times this is driven by fungus. I’ve had a handful of patients just this week that have come in with dandruff and with like psoriasis and things like that, and a lot of the seborrheic dermatitis and dandruff stuff is fungal in origin, like a lot of the—the Nizoral or these anti-fungal Head & Shoulder shampoos, they’re all trying to reduce fungus and we can do that by stopping to feed the fungus in our diet and the sugar and stop driving the leaky gut which could drive the autoimmune element with the alopecia areata.

Evan Brand:  Absolutely, so now are you gonna see—I guess if they’re new patients, then you’d probably don’t have the results yet, but are you expecting to see some elevations of some markers on an Organix to see maybe that there’s some fungus or maybe even some yeast and fungus together that’s causing these issues, too?

Dr. Justin Marchegiani:  Absolutely and if we see imbalance in gut bacteria, whether it’s SIBO, or whether it’s just a kind of run-of-the-mill dysbiosis, whether it’s a fungal overgrowth and H. pylori infection or a parasite infection, we wanna make sure all of those things are eradicated and then at the same time make sure we have enough good clean amino acids and protein in the diet and we’re actually able to digest it. So we wanna make sure we’re at least adding the secretions like the hydrochloric acid, enzymes, bile salts so we can break down these really good fats and proteins so we have the building blocks going right into our system.

Evan Brand:  Absolutely, and the thing that’s beautiful about this model that we use is it doesn’t really matter what the condition or what the symptom is, this net is—is both broad spectrum and specific in terms of the labs that we usually discuss and run to find things. So if it’s gut symptoms, if it’s hair loss in this case, you know, it may seem like just a general blanket approach, but really it’s general and specific at the same time to try to identify the underlying causes of what’s going on and really, there’s only so many ways it seems like that things can dysfunction or function properly.

Dr. Justin Marchegiani:  100%, yup, absolutely. So when you have a systems-based approach, we’re just going in and we’re assessing the body system. So we go and we look at the foundational system which is gonna be diet and lifestyle. Blood sugar? Check. Do we have our macronutrients dialed down? Check. Too much carbs, too much proteins. Are we breaking our food down? Check. Sleep, stress, all those things, and once we have those all checked off, then we can go into body system one where we look at the hormones in particular—adrenals, thyroid, fi—female or male hormones, ATM or ATF, and then we can go into the next system which is the gut and that’s where it gets interesting because we can go through the 5R’s there which are removing the bad foods or placing enzymes and acids, repairing the gut lining, removing infections, reinoculation with good bacteria. So we go through a lot of that there and then we can also look through other deeper infections, too, and then we can go down into detox and other nutrient deficiencies on body system three. So we really have this really great big net so we can catch as many potential intruders or imbalances before they become a major problem.

Evan Brand:  Definitely and that’s the goal about this whole functional medicine approach that we’re using which some people say like you said some people say they’re doing functional medicine but it’s different or it’s not quite this type of approach. This method is simple enough but it’s effective enough, too. So people, you know, when they’re looking on the Internet, say for hair loss supplements, you know, you could probably get locked in to some multilevel marketing scheme product or something similar where it’s really just a lot of hype and marketing but it doesn’t really have any solid foundation in science behind it and so people get frustrated and they go and they drop their money into these products and they don’t really move the needle. So maybe we can talk about some of the—the ethical or the intelligent ways that you could supplement if you really were trying to support, you know, optimal hair, skin, nails, hair growth, etc.

Dr. Justin Marchegiani:  Absolutely. So off the bat, I’ve—I skipped one thing—we also know that blood sugar swings and adrenal stress will encourage more reverse T3 which are like the metabolic blanks in our gun cartridge so to speak, in our magazine, because when you pull a gun—pull a trigger or the—on the gun, right? A bullet comes out, right? You actually have an effect. Well, metabolically, reverse T3 is supposed to bind to the receptor sites where T3 would go, but the problem, reverse T3 is like putting a blank in that gun. So you get the sound, but you don’t get the effect, right? You get the hormone in the receptor site, but you don’t get the increase in metabolic activity, that typical T3 thyroid hormone will produce. So that can cause less thyroid hormone via the reverse T3 mechanism, and we know that blood sugar issues will drive that, too. We know overall stress will drive that as well. So that’s one other mechanism I wanted to add.

Evan Brand:  That’s great. Now so you’re saying here that if we are looking at a blood panel that reverse T3 if that’s elevated, and maybe you can shout out some of the more appropriate ranges that that is gonna be an issue.

Dr. Justin Marchegiani:  Yeah, typically we like it below 24 or 23. Typically in the—in the mid-teens is okay. We actually would look at like a reverse T3 to free T3 ratio or a total T3 to T3 ratio. And pretty sure my free T3 to reverse T3—T3 ratio is around 10:14 is optimal. I’ll pull up my—my little reference range here right now and I’ll confirm that while we’re live, but that’s the general gist. Yeah, and total T3 to reverse T3—T3 ratio is 10:14. Free T3 to reverse T3 ratio is 20:30.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  So that’s the ideal range there. And you can just google those ranges online. There are a couple of good sites that will provide an actual kind of algorithm where you can plug in the T3, plug in the reverse T3, set the standard deviation, you know, whether it’s ng/dL or µg/dL and it’ll give you that number. So total T3 to reverse T3 is 10:14 and then free T3 to reverse T3 is 20:30, and we like to have that reverse T3 ideally in the very low 20s or mid-teens or so.

Evan Brand:  How high have you seen that number?

Dr. Justin Marchegiani:  I’ve seen it, you know, up into the—into the 30s very easily and that could easily happen with stress, emotional stress, blood sugar stress and/or just overall inflammation in the body because that creates internal stress as well. So the reverse T3 is important because it’s gonna take that T3 that would be active and make it go downstream, and then it not only makes less T3 but then it prevents the T3 that’s actually floating around in your bloodstream from binding into the receptor site and doing what it was designed to do in the first place.

Evan Brand:  Makes sense. That’s a big issue there and a lot of people are like I’m not stressed. It—it’s the invisible stressors, too, that we’re factoring in and we can see that. So you don’t have to actually identify as a person that is stressed, that could be invisible stress that we’re gonna see on these lab results here.

Dr. Justin Marchegiani:  Absolutely and also estrogen-dominance can provide problems, too, because that will increase thyroglobulin and thyroglobulin will decrease the amount of free T3 in your bloodstream. So it’s kinda like reverse T3. The difference is reverse T3 is more or less blocking the receptor sites, where thyroglobulin is decreasing the amount of free fraction. So 2% of your thyroid hormone is actually free, the other 98% is protein-bound, and what it’s doing is the thyroglobulin is decreasing the percent of free T3. So instead of having 2%, maybe now you have 1.9 or 1.8, or just having less free fraction available, so when we look at our total numbers, right? Maybe our total T3 is 110, 120 which isn’t bad, but now our free T3 instead of being at 3 or 3.1, now it’s at 2.9, 2.8, 2.7, and it’s dropping because of that estrogen dominance.

Evan Brand:  Yup, so estrogen dominance which we’ll probably have to do a whole show on that if we haven’t already, a lot of that’s gonna be exposure to synthetic estrogens?

Dr. Justin Marchegiani:  Yeah, it’s gonna be exposure to plastics, chemicals, pesticides, fluoride in the water, and also just being stressed, right? Because in women, progesterone predominates that second half of the cycle, and when women are stressed, they can use progesterone as a building block to make more cortisol. So more stress will actually steal from their progesterone. It’s kinda like a progesterone stealer or progesterone escape. We’re pulling progesterone in to make more stress hormones because our body’s epigenetically hard wired to deal with the stress of today versus the healing of tomorrow. The problem is most people live in a perpetual state of stress so tomorrow never comes.

Evan Brand:  Yeah, exactly. It’s crazy, isn’t it?

Dr. Justin Marchegiani:  So, I—I did the political side-step, I—you asked me a question and I gave you the answer that I wanted to give. It had nothing to do with that. So let me go back to your question. I’ll reiterate it for the listeners here. What supplements in particular? So number one, we can add good quality hair support from fatty acids, right? Omega 3s, whether it’s good quality fish oil or cod liver oil or sardines and things like that, salmon, mackerel, those are all really good quality Omega 3 fatty acids that can help with hair. Next you have conventional things that have been around a while like Biotin, which is kinda like, almost like a B vitamin so to speak, and that can very much help with the skin, help with hair as well. Next, I would say collagen is one of my favorite–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Things. Collagen’s amazing. It’s very high in glycine and proline and hydroxyproline, helps provide building blocks for skin, hair, and nails, and I was talking to Dave Asprey last year when he was growing his hair out longer, and I noticed it just being longer and more full. And I’m like, “Dave, what the hell are you doing with your hair? It looks great.” He goes, “I’m megadosing collagen, like 40g a day, 50g a day.” So since then, I’ve been really upping my collagen to really have good high quality hair and skin building blocks, and that’s I think one of the most important things you can do is good quality grass-fed collagen, and by the way we have a collagen product coming out very soon called True Collagen and I was able to source one of the biggest and best distributors for collagen that is grass-fed, hormone-free, pesticide-free. So stay tuned for my True Collagen which is something that we’ll be coming out very soon and I’m already using it now and I love it.

Evan Brand:  I want my sample pack in the mail.

Dr. Justin Marchegiani:  You got it, man.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Coming your way. So–

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  So we talked about Biotin, collagen, fish oils, anything you wanna add to that?

Evan Brand:  No, I think that was good, you know, the fatty acids for sure. Basically, things that are gonna help to reduce the inflammation in general, because if there is something going on in the gut, the gut has to be healthy so if you just or somebody listening and maybe you’re already taking collagen which a lot of women are, they’re frustrated, they’re almost like they’re mad at me. It’s like, “Evan, I’m already taking collagen and my hair is still falling out or my hair is still very thin.” It’s like, well, that’s—that’s the supplement, you know, let’s see what else is going on deeper and usually something pops back up on the stool test, and like, “Okay, well, you know, your digestion’s been impaired, here you are feeding these bacteria or feeding these parasites, not you,” so maybe it’s been good nutritional insurance to get the collagen, but if you have someone stealing your energy, you know, someone like kinda how they used to do in the—they used to steal cable, you know, they’d go up to the main line and–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Slice the cable wire down to your house, if that’s going on in the gut with your nutrients, then you could still have issues regardless of, you know, what you’re supplementing with.

Dr. Justin Marchegiani:  Yeah, I remember Dr. George Goodheart saying in various seminars, you know, years back, “The highest good is to get to the root cause.” The highest good and that’s always in my head. Like alright, “Are we getting to the root cause?” Right? And a lot of times, supplements may be getting to the root cause or they may be palliative and supportive with the fact that we are addressing the root cause but also adding these extra nutrients in so i.e., let’s say we have a gut issue and our diet stinks, but we’re adding in a whole bunch of collagen. Well, is that a bad thing? No. It’s not a drug. It’s not gonna have side effects and kill over a hundred thousand people a year like pharmaceutical drugs do in general taken the right way. So that’s a good thing. We don’t have that nasty side effects. Is it providing more building blocks than would be there anyway? Yes. But we wanna make sure the underlying cause is addressed. So I’m a big fan of if we’re gonna add something in that’s supportive and palliative, at least make sure the underlying cause is addressed or there’s a program set up in place to address it.

Evan Brand:  Right. So there’s nothing wrong with treating the symptoms and sometimes we have to treat the symptoms first to keep people motivated, move the needle enough with them to keep them on their program, but eventually we’re always kinda backtracking from this symptom back to the underlying cause.

Dr. Justin Marchegiani:  100% and like there’s another element here I didn’t talk about which was DHT, which is dihydrotestosterone. So if we look at kind of the breakdown or the formation of testosterone, it goes from DHEA to testosterone or I should say androstenedione then to testosterone and then to DHT. So in each downward cycle, the hormonal molecule gets more potent, more—more strong. So DHEA is weaker than andro. Andro is weaker than testosterone. Testosterone is weaker than DHT. So essentially said in the different way, DHT is the strongest and most powerful out of all of them, and DHT is shown to potentially starve out blood flow to some of the hair follicles. So that’s important. So if we run a profile, we can look at women with elevations like PCOS can drive elevations in androgens, and we can use things like GLA fatty acids like evening primrose oil or black currant seed oil to help with reducing that DHT. It’s a 5-alpha-reductase inhibitor. In men we can also use—I think women, too, this would work—but we can do zinc and selenium, which happen to be great for the thyroid, go figure. And then men we’ll do it a lot. We’ll use saw palmetto and/or pumpkin seed extract as a natural 5-alpha-reductase inhibitors, and you know, a lot of the medications, right? Like the—the names are fleeting me—I can think of all the commercials from the 90s, the—the Rogaine–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And a lot of those types—I forget the actual trade name of it—Propecia. That’s what it is. Those are typically 5-alpha-reductase inhibitors as well at a pharmaceutical level. But we can do it naturally, too. They won’t have all the side effects. So my big 5-alpha-reductase inhibitors for females are really easy one is gonna be the nutrients, selenium and zinc, and then one, I’ll add in the GLA fatty acids like the evening primrose or the black currant. Men can do that as well and they can also go the extra mile and add in some pumpkin seed or saw palmetto along with that.

Evan Brand:  Beautiful, awesome! I’m glad you got there because I—I’ve had that in my radar, you know, the 5—the—the DHT and I was thinking about, you know, men that have used steroids and they have the increased conversion of hormones there so they’re more likely to go bald and I’m glad that you were able to—to pull that out and digest it for us.

Dr. Justin Marchegiani:  Absolutely. So if we kinda break everything down. We talked about the supplements, those are great. Really, really important things. We talked about the hormones. We talked about how the adrenals affect it, right? Cortisol high or cortisol low will affect the thyroid. So if the thyroid’s affected by the adrenals, that’s gonna cause a problem. If the thyroid’s affected by autoimmunity, right? We’re attacking the thyroid gland because of gluten that can reduce thyroid hormone. That can cause a problem. Too much iodine with thyroid issue can drive hair loss. I’ve seen people do excessive iodine with an autoimmune mechanism in the background, massive hair loss.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  Massive. So we have the I—we have the thyroid piece. We have the nutrients that can exacerbate autoimmunity. Gluten potentially. Iodine if there’s already an autoimmune mechanism to process. The leaky gut. Poor nutrients in the diet regarding fats and proteins, not digesting these things, these compounds well. Infections can drive a lot of these things. I’ve heard Yuri talk about it with the gut and the infections causing his alopecia areata. So all of these different mechanisms—we have individual things that like the thyroid. We have individual things that affect the adrenals and thyroid together. We have nutrients that play a factor and then we have different hormonal things like the DHT and the progesterone as well.

Evan Brand:  Great! Great summary there.

Dr. Justin Marchegiani:  Anything else you wanna break down there?

Evan Brand:  Honestly, I think that was great. I think it would just be me doing a broken record pitch there. So I think you did great. You know, the—the takeaway from this is—this is kind of a complex situation so it may sound just easy on the surface. You know, you go to Walgreen’s, you see a hair supplement. “I’m gonna try it. My hair’s gonna grow back.” Maybe not. So if you do have this issue, you know, it would be important to reach out to Justin or myself, you know, let us look for you and see what’s there, at least rule things in and rule things out. And if, you know, run a test and Justin says, “Oh, look, you’re free and clear.” Well, that’s good. But we still need to try to figure out what’s going on. But you’d never know if you don’t test. If you haven’t test, you’ve guessed.  So keep that in mind anytime you’re gonna go invest your money into a supplement. You may need to invest into the clinical data that’s really gonna find out why this is causing it before you can actually work on fixing it.

Dr. Justin Marchegiani:  Absolutely. So let’s kinda back up here, alright. So I’m a male or female that’s dealing with hair loss, kinda what’s—what’s the action tree here? Alright if–

Evan Brand:  Yeah, so–

Dr. Justin Marchegiani:  Go ahead.

Evan Brand:  No, you go ahead. What you got?

Dr. Justin Marchegiani:  Okay, so you’re man, right? Figure out, this hair loss fall in your family. This is a male potter—male pattern baldness thing. Well, number one, we gotta first realize that a lot of how we deal with stress and how we, you know, eat, sleep and drink typically is passed down through our family. So is this purely a genetic thing or is this, “Hey I’m just following the footsteps that my parents did and, therefore, I’m gonna have the same genetic predispositions because I’m eating crap and taking care of myself in a very poor way.”? So figure out how much of this is in your control and how much isn’t. Either way, if it’s totally male pot—male pattern baldness and you don’t have any control, you still wanna be doing all the things we mentioned anyway. So don’t ever let that be your excuse, because you still get other benefits by doing all of these things there, like brain health and performance and muscle and libido and virility and energy. So keep that in mind.

Evan Brand:  Definitely.

Dr. Justin Marchegiani:  If you’re a woman, you g—you have a lot of control over this as well. So the first thing we do is diet. Cut out the crappy foods. Grains are gonna be the first thing. Get your sugars under control. Next, make sure you’re digesting foods and proteins and fats well. You’re having digestive symptoms and things like HCl and enzymes aren’t working, well, guess what? Get on those. Now next, if that’s not working, then we have to do some testing. We have to look at the adrenals. We have to look at the thyroid. We have to look at the gut. Alright, so that’s where you wanna reach out to Evan or I and figure out the next steps, but in the meantime, you can go pick up a high quality collagen. You can try some HCl and enzymes. You can try some of the nutrients we mentioned. But if that’s not working, you’ve already exhausted the low hanging fruit, so just make sure after that you reach out to a good functional medicine doc to get to the next step. But in the meantime though, don’t let the male pattern baldness genetic stuff if you’re a man stop you from taking action. You don’t know how much of it can be slowed or how much can go back. And if you’re a woman, this is a deeper sign that something underneath is happening. So I hope that helps and empowers everyone listening that’s dealing with this problem.

Evan Brand:  Absolutely. Well-said. Yeah, so it’s the gun. You know, you may have the gun there, and it could be loaded with your genetics and your family, just all of that, you’re—you’re susceptibility to stress, your environment, etc. but you have the ability to not pull that trigger, you know? So don’t just, “Oh, screw it! I’m just gonna binge eat on pizza.” That may not be the step that’s best for you. You know, sometimes we get frustrated with our health conditions and we just say, “Screw it! I’m going all in. I’m gonna go off the rails,” but oftentimes, you know, just pause, take a breath, and then think, “Okay, what can I actually do that’s gonna work me towards my goals? And not just self-sabotage myself,” and that is common for people to—to hit this point, and they do wanna just—it’s all over. They get this kind of a—what do you call that—like a black and white approach I guess.

Dr. Justin Marchegiani:  Yeah, absolutely. Absolutely, so we wanna make sure we have a multifaceted systems based approach, alright? And we wanna have objective testing to quantify it. And even things like temperature-testing can be a really good objective kind of test that doesn’t require any resources to do it outside a—a really good fertility thermometer. So kinda grab those low hanging fruits tests, right? We wanna assess, not guess. So get the assessments to figure out what’s going on and if you guys gotta reach out to someone like Evan and I to get more info, we are here at your disposal.

Evan Brand:  Well-said.

Dr. Justin Marchegiani:  Alright, Evan. Hey, it’s a great Friday, man! I’m looking forward to heading out in the water today in Lake Austin, probably tomorrow morning, do a little water skiing and get some good cardio in or I should say, it probably be more—more anaerobic with some of those movements that I’m doing. But anything else on your agenda for this weekend you wanna share with our crowd?

Evan Brand:  Oh, we’re just gonna get out and enjoy the sun. You know, we got 4 weeks left ‘til the baby comes, so we’re gonna be soaking up the blue sky and the sunshine while it’s here. And before you know, we’ll have a baby and who knows? I mean, maybe trapped inside and changing diapers all day. So–

Dr. Justin Marchegiani:  I know. I hear you. Well, make sure you say “Hi!” to Anna for me and you have a great weekend.

Evan Brand:  I sure will. Take care.

Dr. Justin Marchegiani:  Take care. Bye!

Evan Brand:  Bye!







Low DHEA Levels & Adrenal Fatigue – Podcast #85

Dr. Justin Marchegiani and Evan Brand share with us today some pertinent clinical information regarding low DHEA levels and symptoms of adrenal fatigue. Find out DHEA-effectsmore about the relationship between DHEA and cortisol and get more insights on cortisol rhythms when you listen to today’s podcast. 

Learn about the symptoms that people get if they have adrenal dysfunction or if they have adrenal imbalance. Dr. Justin also discusses how DHEA affects women who are experiencing menopause. Discover what strategies you can do to help with stress hormones. Also find out about what salivary tests you can take to measure your DHEA-sulfate levels and learn how you can supplement DHEA.

In this episode, topics include:

00:58   About cortisol

2:33   What is DHEA?

5:03   Symptoms of adrenal imbalance

12:10   Strategies to help with stress hormones

15:00   Supplementing with DHEA









Dr. Justin Marchegiani:  Evan, it’s Dr. J.  It’s a beautiful Monday down here in Austin, Texas.  What’s going on over in Louisville?

Evan Brand:  It’s pretty.  I had the window open but I had to shut it because there’s a bunch of big trucks that drive by and I wanted a super clean audio today.

Dr. Justin Marchegiani:   Nice, awesome.  Well, we got more pertinent clinical information coming out from our patients and from our practice, so more applicable information for everyone at home and we talked in our pre-show that we wanted to talk about DHEA, dehydroepiandrosterone.  Do not confuse that with DHA, the 22-carbon fatty acid in fish oil, known as docosahexaenoic acid.  We got all these multi-syllable words here that belong on Jeopardy.  So we’re gonna be talking about the DHEA, the sex hormone precursor, not the fish oil DHA.

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:   Alright.

Evan Brand:  So when we’re looking at adrenal cortisol or adrenal stress profile test, this is something that you and I run on every single patient, we’re gonna see that 24-hour rhythm where we want cortisol to be highest in the morning and we want it to gradually drop to the lowest point of the evening, where melatonin can come up and the person can actually go to sleep and feel good.  But something that we see every single day is people are gonna have a few different things wrong with their adrenal rhythm.  So one is gonna be that they have high cortisol that’s out of the charts which means that their body’s in a super catabolic state and they’re in one of the earlier stages of adrenal fatigue where they’re trying to start thriving and adapting to this stress.  The body is producing excess hormones to deal with bear that they’re running away from even if that bear is taxes that they haven’t paid that they need to pay.  And so secondly–

Dr. Justin Marchegiani:   Yup.

Evan Brand:   What we’ll see is that the cortisol is gonna be depressed all day and they’re gonna be in the later stage of adrenal fatigue where they’ve waited so long, they’ve burned the candle at both ends before they’ve come to work with one of us that now they have the depressed cortisol all day and that’s a whole another issue.  And then the third piece of the puzzle, what we’re gonna discuss today, is the DHEA which I kind of using analogy of a bodyguard that’s gonna be anabolic in nature, that’s going to protect you from the potentially catabolic effects of cortisol and a lot of people will have either really high DHEA and their boat is still floating and they can cope–

Dr. Justin Marchegiani:   Uh-hmm.

Evan Brand:  With this cortisol or the DHEA is super tanked out and the cortisol’s tanked out as well and those are some of the worse cases that we’ll see.

Dr. Justin Marchegiani:   Absolutely.  Now DHEA, if we kinda break hormones into a couple of different categories to keep it simple, hormones typically help your body grow and heal and recover, fight inflammation and/or improve energy.  We kinda put our all hormones in that category.  Alright, if we look at like progesterone and estrogen, they’re helping with growth, right?  So growth, tissue growth, ideally pregnancy at some point for women.  We have sex hormones like testosterone and DHEA which can be very helpful for men and healing and recovery and again, we have hormones that are more stress-based hormones, catecholamines, norepinephrine, epinephrine, adrenalin, again those are all the same hormones, 3 different names, right?  Medicine likes to be confusing like that and those are helping more with stress responses and to mobilize fuel during a stress response. So if we look at it in 3 categories, it’s inflammation, it’s cell growth and repair, and it is energy.  So when we look at DHEA, that’s helping more of the anabolic, the growth side and as we become more and more stressed, our body prioritizes resources to deal with the stress of right now and hold off the healing of tomorrow.  The problem is if you’re constantly stressed, well, tomorrow always keeps on getting put off by one day and we never quite reach that optimal repair window that we’re looking to be in for optimal health.  So when we’re stressed, we’re breaking down faster, right?  That’s catabolism or being in a cata—a catabolic state, right?  It’s catastrophic to be in a catabolic state.  That’s how I—I remember that.  It’s not a good thing, so you’re breaking down too much and we wanna shift it over and DHEA is really an important anabolic hormone and it’s a pre-cursor, right?  Because it can turn into 7 or 8 different things.  They can turn into all 3 estrogens, estrone, estradiol, estriol.  It can turn into your progesterone and it can even turn to—into andro or androstenedione and it can even turn into potentially DHT and testosterone.  So a lot of different hormones it can go into and the goal is to help rebuild your body.

Evan Brand:  Yeah and DHEA drops with age, too.  So–

Dr. Justin Marchegiani:   Big time.

Evan Brand:  You and I aren’t too old yet where the point we’re still probably making a lot of DHEA but I’m seeing people with 22, 23 years old that have depressed DHEA levels worse than some of the 60-year-olds that we’ll look at.  So just because you are young, it doesn’t mean that you are gonna have that maximum output if your adrenal stress is going to overwhelm that level.  Maybe we should talk about some of the symptoms that people may be feeling if they do have some type of adrenal imbalance which would include DHEA.

Dr. Justin Marchegiani:   Great.  So a lot of the adrenal symptoms are gonna be connected in and around energy, in and around pain or inflammation whether it’s in the joints or it could be inflammation in the brain like brain fog, mood, memory, because DHEA is primarily gonna be produced by the adrenal glands, a female is gonna significantly notice it as they transition to menopause because now they’re—they’re not getting a lot of their anabolic hormones from their ovaries anymore because they’re no longer cycling.  So as soon as they start going into this perimenopausal range where they start shifting or missing periods or they go 3 years without a period, that’s considered to be menopause.  Once they start transitioning between 48 and age 51, they’re gonna be relying more on their adrenal glands for that sex hormone output.  So my analogy is we get this backup generator, right?  Let’s see you live in the northeast.  I great up in the Boston area so this was common for me.  But you’d have a—you purchase generator because if you ever had the power go out because of a big snowstorm for 2 or 3 days, you wanna make sure you don’t freeze.  So you buy this big generator and typically the generators will run off of either electricity or gasoline.  Now the gas has to be in the tank for that generator to work.  So imagine if you got this big snowstorm, it hits and you don’t fill that generator up fully with gasoline, well, now when it comes time to need it and rely on that generator to power your house and to keep the heat going and electricity on, well, it’s not gonna be there for your needs, so you’re gonna start having symptoms have like maybe lower heat in the house.  You may have less electricity.  Maybe the TV will flicker.  Now that’s kind of akin to your adrenal glands because that’s the backup generator for women as they go into menopause for their sex hormones, so just like we had a—a generator that was not fully charged when the snowstorm hit, the snowstorm now is gonna be menopause so when menopause starts happening that generator, your adrenal glands, are more depleted with DHEA so now when we start to rely on more on those adrenals, they aren’t gonna be there to help us in this stressful transitionary period.  And then the symptoms of menopause come on harder which can be the mood, the hair loss, the—the skin issues.  Obviously the hot flashes, fatigue, depression, a whole milieu of symptoms.  It could be 20 or 30 going down a line, vaginal dryness, low libido, all of the—you know the top 10 or 20 things that we see, weight gain that all of our patients complain of.

Evan Brand:  Yeah, I would say the sex drive one’s huge, too.

Dr. Justin Marchegiani:   Yes.

Evan Brand:  Every woman is—I—I’ve heard several women say they haven’t had sex in 10 or 15 years with their spouse.  That is a long time and not to say that that’s what the whole relationship is built around, but a lot of people prioritize that as making love is a—is a good piece of their marriage and if that’s not in place due to hormones, it’s not you that will often get blamed or you’ll feel guilty or something or not.  It’s time to take a deeper look at the hormones, it’s not just your brains.

Dr. Justin Marchegiani:   Yeah, I totally agree.  And then a lot of times that’s a symptom of something deeper hormonally, right?  Because fertility is an important sign of health.  So if for some reason those fertility signals aren’t there, i.e., libido being an important fertility signal, right?  If we don’t have the libido, then you don’t have the—the strong motivation to—to have intercourse or to make love.  So that’s a really important sign that something is not there on the hormonal side and again, when we have adrenal issues, we kinda have our 3 stages of adrenal fatigue or a better terminology is adrenal dysfunction, which just means as we go from stage normal to 1, that’s a sign that cortisol’s increasing and as we have that hyper-stress response, cortisol and DHEA will typically increase together.  And as that response stays, right?  If we have like someone sneak up behind us—boom—we go into that stage 1.  It’s a quick—we call it the alarm phase by Hans Selye.  It’s the alarm phase.  So—boom—cortisol goes up, eventually we adapt and we go back into normal cortisol rhythm.  But if we continue to stay stressed, our cortisol will start to drop with the rhythm.  We’ll start to become more aberrant, meaning instead of having that nice high to low to lower to lowest rhythm, it starts going off.  Maybe a little bit lower in the morning or higher in the afternoon or lower at night, right?  And we start to feel that in our moods and our energy, and then we start to see DHEA drop in the stage 2 as well.  DHEA will drop.  And as we go into stage 3, we’ll start seeing cortisol and DHEA drop as well. And that’s like our ideal like scenario.  We can go into some other scenarios that happen outside of our conventional 1, 2, and 3 for adrenal dysfunction.  But as we go deeper from 2 into 3, what’s happening is HPA axis dysfunction.  That thermostat in our brain is not able to talk to the AC and the heater, i.e., our adrenals and maybe thyroid and other gonadal glands.  So we start having this type of dysfunctional pattern.

Evan Brand:  So the way that I’ve understood, too, and correct me if I’m wrong is it’s not that the adrenal glands run out.  They’re never gonna run out of hormones because they’re being told what to do by the brain and this whole HPA axis, so I’ve used this analogy for a while where the body is basically saying, “Hey, Justin, every time we give you stress hormones, you’re taking it and you’re running with it, and burning the candle at both ends or whatever, and so now I’m gonna downregulate and stop producing these hormones for you.”  So basically what we’re doing is we’re trying to turn on this process again and basically tell the nervous system in the brain, “Hey, everything’s okay, let’s turn the system back on.” Is that the best way to bring that across or do you have any other ways you could explain or visualize that?

Dr. Justin Marchegiani:   That’s exactly what we’re trying to do.  We’re trying to get that HPA axis rhythm back on track.  We’re trying to help support our body’s ability to regulate inflammation, generate energy, but also repair because the allocation is always hard wired to deal with the stress of now and the healing of tomorrow and we wanna make sure tomorrow actually happens. so our body can do what it has to do to repair.

Evan Brand:  I mean, we definitely are in the—I think there’s a key chess piece going about it.  It’s like a here today, gone tomorrow world, or something to that effect where people really are—they’re so stressed out and they’re so focused on today. 

Dr. Justin Marchegiani:   So Evan, we were just talking about strategies to help with stress hormones and to help push some of the anabolic hormones like DHEA back into balance. If you wanna go over a little more specifics on that?

Evan Brand:  Yeah, so the treatment is something that we’ll get to but the testing is the first step so people listening they may resonate with some of the symptoms but you really have to do get that—you need that 24-hour cortisol rhythm to be able to identify it and that’s something you and I rely on very heavily because without it, we’re just guessing and checking and that’s where—this is nothing against naturopaths or anything, other type of medicine practitioner—but if you go to someone and you complain of the symptom and you just get thrown a supplement and even if it is a natural herbal supplement or minerals for example, if you don’t have a lab that you’re basing that protocol on, you’re sort of short-changing your potential results because you might start spending money on various supplements and bottles and I know everyone has a supplement graveyard where they’ve tried things and they don’t work, you and I want to minimize how many supplements end up in the graveyard or completely eliminate the graveyard because we’re gonna be basing things on your results rather than, “Well, I think you might benefit from this.”

Dr. Justin Marchegiani:   Exactly. And again a lot of people is they get older that DHEA drops like we talk about and with some people, obviously, say with all people the diet and lifestyle strategies are gonna be really, really important, right?  The blood sugar stability, obviously making sure diet’s like a Paleo template to start and then making sure we’re getting sleep and doing some movement.  That’s kind of foundation.  So everything we talk about after that is gonna be that already assumed.  Just so we’re clear on that.

Evan Brand:  Right.

Dr. Justin Marchegiani:   But supplementing using DHEA, we like to do it sublingually because we bypass the liver and if we have patients, which we do quite frequently, that have digestive issues, we can bypass the gut, we can bypass the liver which can deactivate about 4 times—you have to get 4 times more orally via pill than you do with the sublingual drops.  So we can bypass that, we can get the same effect of an injection without the needle by absorbing it to our sublingual and buccal tissue in the mouth.

Evan Brand:  Uh-hmm.  That’s great.

Dr. Justin Marchegiani:   So again dosage-wise, we like to use smaller doses or lower doses, typically 5 to 10 mg is a pretty good starting dose and it’s kind of a little bit contradictory in thinking about we would actually use the more adrenally fatigued or the more adrenal dysfunction there is, we typically want to use less DHEA because of the fact that DHEA can also have an effect of lowering cortisol.  So you can th—you can think of DHEA and cortisol as like a seesaw and the more DHEA we put in the system, the more it can decrease our cortisol level, so if we’re already having issues with energy and adrenal insufficiency and low cortisol and inability to regular inflammation, going too high on the DHEA can definitely cause some problems.

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:  So regarding that, typically we do DHEA between 5 and 10 mg sublingually, and then as a couple—so that’s spread out over 2 or 3 times—3 times over the course of the day because we’re trying to mimic normal physiology and not just give one whack at once, right?  Your adrenals aren’t gonna just spit out a whole bunch of DHEA all at once.  It’s gonna do it naturally so mimicking natural rhythms is gonna be the best possible way to handle it.

Evan Brand:  Yeah, so if you’re at the health food store and you see 50 mg of DHEA, don’t buy and start taking that supplement just because you think you have low DHEA.

Dr. Justin Marchegiani:   Definitely not worth it.  And then also with DHEA, we—you alluded to like the DHEA cortisol ratio, typically we’re at this 6:1 type of ratio.  We should be able to make at least 6 times the amount of cortisol in relation to one unit of DHEA.  And as we start going above that, like you had a patient I think morning, Evan, that was at 30 you said, so there are—if we do the Math, they’re 5 times more catabolic than anabolic.  In other words, in layman terms that means they’re breaking down 5 times faster than their body should be rebuilding and healing.

Evan Brand:  Yeah, and this is actually a guy who’s doing CrossFit 3 to 4 times a week, and he’s wondering why he can’t build muscle.

Dr. Justin Marchegiani:   Right, exactly.  And again, there’s a lot of stuff out there on DHEA like not working, like not being good, or not being the best thing.  There’s a lot of factors that go into it, right?  Are we using DHEA in conjunction with the right amount of pregnenolone?  Are we fixing underlying issues, right?  If we just use DHEA like someone uses ibuprofen for a headache, right?  Well, that may not be the underlying issue.  If you’re banging your head every day and you’re taking ibuprofen for a headache, well, the underlying cause is banging your head.  Now that’s kind of a drastic analogy but people have underlying analogies like infections or low stomach acid or dysbiosis or SIBO, or toxicity issues or food allergens and that—even though the banging the head is pretty obvious—it’s more subtle with the underneath things but that may still be in motion and happening every day, so we gotta make sure if we’re using DHEA and potentially pregnenolone with it, we gotta make sure it’s being used in conjunction with the comprehensive functional medicine program.

Evan Brand:  Yeah, exactly, and based on labs.

Dr. Justin Marchegiani:   Based on labs, yeah.  And then typically for labs, we’re using that 2:10 I think—I think it’s the pg/mL ratio.  It’s the typically salivary ratio that most labs use like BioHealth uses it, Diagnos-Techs uses it, CRT uses it, that’s your—your broad spectrum lab ratio and we like it—I’d say 6:10 is a pretty good place for me.  What do you like?

Evan Brand:  What are you—what are you saying?

Dr. Justin Marchegiani:   For the lab rate—so like at the—the lab levels on the salivary lab, a DHEA-sulfate, what level do you like patients to be at regarding their DHEA?

Evan Brand:  Most people they feel the best somewhere on the mid to upper end there, closer towards 6, 7, sometimes 8, definitely not what I saw this morning which was I think a 0.8 DHEA.  That was just awfully low and he can feel it.

Dr. Justin Marchegiani:   Wow, you saw someone at a 0.8!  Yeah, that’s really low.

Evan Brand:  Yeah, and this is the same guy.  This is the guy whose cortisol sum was decent and he was like a 28, when we would consider something like 30 or more decent.  So he was—he was decent on cortisol but the DHEA was less than 1 unit.  So that’s the lowest I’ve seen, and most people say they feel best, it seems like 5, 6, 7, 8 somewhere in there.  And then I’ve seen some other crazy ones—I’m sure you have, too—where DHEA was 20 or 30, just out of the roof and sometimes I found that these people were just popping DHEA supplements like Skittles.

Dr. Justin Marchegiani:  Exactly and the—the range that I like for the lab of the DHEA-sulfate, that’s the salivary DHEA—DHEA-sulfate, it’s looking more at the storage form of DHEA, like 6:10 and that’s an ng/mL, nanograms per milliliter.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:   Okay, and then in the lab range like some of the blood labs, they’re a little bit different for the blood lab.  We typically like in the—in the 200s for the blood lab.  I’ll pull up my template that I typically use with most patients here in a sec.  Any other comments on the salivary labs that—the salivary lab ranges?

Evan Brand:   No.

Dr. Justin Marchegiani:   Got it.  Yeah, so looking at the blood labs are a little bit different.  When we look at the blood, so the reference range maybe a tiny bit different here.  Our blood labs, we’re typically gonna be looking at DHEA-sulfate.  I like upwards of 250 to 300, and that’s micrograms per deciliters.  So different reference range, different standard deviation, so upwards of 250 or so is a pretty good place to be and if you’re on DHEA drops, you gotta be mindful that you come off them for a day or at least 36 hours to 48 hours at least 2 days to get an accurate reading of what you’re DHEA levels are actually pumping out from the adrenals.  Anything else you wanna add, Evan?

Evan Brand:  No, that’s it.

Dr. Justin Marchegiani:   Alright, great.  Well, I know you got a patient here.  I do as well.  So wrapping it up, get your blood lab, a DHEA-sulfate done and/or get a comprehensive cortisol rhythm like Evan mentioned using the salivary DHEA.  Well, great talk today, Evan.  We will be in touch very soon.

Evan Brand:   Take care.

Dr. Justin Marchegiani:   Take care.

Evan Brand:  Bye.

Dr. Justin Marchegiani:   Bye.



Natural Solutions to Infertility

Natural Solutions To Infertility

By Dr. Justin Marchegiani

When the female body is stressed, one of the main things that occurs is the hormone progesterone gets converted into a stress hormone called cortisol. When this happens, it causes the progesterone to estrogen ratio to go out of balance. This is also referred to as estrogen dominance. The body naturally should have about 25 times more progesterone to estrogen which can be assessed via a salivary lab test.

The Female Cycle

Female Cycle

If you look at the female cycle, essentially it can be broken down into two phases. The first phase is referred to as the follicular phase, in this phase the hormone estrogen predominates and helps to thicken the endometrial lining so an egg can be implanted. Once estrogen levels drop between day 13 through 15, this signals ovulation where a corresponding rise in progesterone occurs. The rise of progesterone is a hallmark of the luteal phase and in plays a role as a pro-gestational hormone that helps the egg grow.

With many patients that have PMS, many are not getting enough progesterone in the second half of the cycle. This lack of progesterone causes symptoms just before bleeding such as breast tenderness cramping headaches etc. The solution is to not just give progesterone alone. It’s because if the underlying stressors are not addressed, the progesterone will just be used to fuel the stress response.


How we address the underlying cause of the problem is to reduce the prominent stressors the person is dealing with. Stress causes the body to convert progesterone into cortisol. Getting the predominant stressors under control prevents the body from burning itself up. So doing simple things such as addressing blood sugar and handling issues helps regulate cortisol. Addressing infections such as parasitic, bacterial and fungal infections can help address the underlying cause and put cortisol back in the balance.

The adrenal glands are primarily responsible for producing cortisol. At the same time, producing a good portion of the woman’s sex hormones. So to address PMS is vitally important that the adrenals are supported so they can function optimally to provide hormonal balance. The female hormones never spontaneously go out of balance by themselves. So to produce a lasting change, we need to address lifestyle, diet, and female hormone support all the same time. The solution comes from doing the right things, in the right combination, at the right time.

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