The Top 7 Root Causes of Inflammation with Dr. Jockers | Podcast #372
When your body activates your immune system, it sends out inflammatory cells. These cells attack bacteria or heal damaged tissue. If your body sends out inflammatory cells when you are not sick or injured, you may have chronic inflammation or other underlying issues.
Dr. J and Dr. Jockers suggest checking in with your healthcare provider if you experience a problematic injury or health issues. Also, talk with your functional doctor if you have ongoing pain, swelling, stiffness, or other symptoms. They can narrow down the cause and find ways to help you feel better.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
0:36 – Inflammation
4:41 – Acute Inflammation
5:21 – Root Causes
10:30 – Food Recommendations
18:22 – Herbs and Compounds
Dr. Justin Marchegiani: Hey guys! Dr. Justin Marchegiani here. Today, we have an awesome podcast in the queue, the top seven root causes of inflammation. I am here with Dr. David Jockers. Really excited to have him today to chat with David. How are we doing man?
Dr. David Jockers: I’m doing great, Justin. Always great to connect with you. You’re one of the leading minds in functional health, functional medicine and so always great to collaborate and discuss really important topics that are affecting so many people around the world.
Dr. Justin Marchegiani: Oh. Excellent man. I’m really excited to chat with you. I mean, you could just pull up one of your blog posts and just have the infographic run the whole entire podcast, right? So, uh, I’m really stoked to chat about it. So, first off out of the gate, I think we should just kind of define inflammation for listeners. How would you define it pretty simply?
Dr. David Jockers: Inflammation is an immune response that’s actually designed to help protect your body. See our body is hardwired to protect us from dying from an infection so you know our ancestors when you know they would go out hunting or let’s say they were in war or something like that, it would be attacked, they would have some sort of a flesh wound and then bacteria could get into that flesh mood into their bloodstream and then spread throughout their body and get into their lungs cause pneumonia, get into their nervous system cause meningitis and kill them. This is really the leading cause of death throughout the history of mankind. Even when people were in war, they really, they tended not to die like it was they were more commonly were dying from an infection they got from a wound than the actual wound itself and so the body is adapted to create this inflammatory response whenever you have an injury, right, and when we think about injuries we think about, okay, a sprained ankle. Let’s say what happens? You end up with a lot of inflammation in that joint and that inflammation is there to help protect against any pathogens getting in. It also helps break down damaged, uh, ligaments, tendons, different structures that are in there that are involved and it’s all part of the healing and remodeling process and so inflammation itself is actually very therapeutic, very healing and it’s designed to keep you alive. The problem is that most people in our society now are dealing with chronic inflammation because their main injury is actually in their gut. It’s in their digestive system. So, the gut when that becomes damaged, the body responds just like if we sprained an ankle or if we got a cut or a burn it creates this inflammatory response. You just don’t see it. So, you don’t actually see it and oftentimes, you don’t even feel it at least not in your gut like a lot of people are not feeling gut pain or even you know just like a stabbing pain even though the gut is damaged but when that happens when the gut becomes damaged, now proteins are seeping into the bloodstream and the body says okay these are abnormal proteins, abnormal bacteria in here. Let’s turn up inflammation throughout the body so that person may experience eczema or some sort of skin inflammation, acne, rashes. Another person may experience joint pain so when they have a leaky gut and their body’s ramping up inflammation, they notice it in their joints. Different joints are hurting. Another person may have a lot of brain fog and fatigue so it can impact us in different ways but in our society today, the inflammation is less so coming from like a physical injury and more so coming from injury in the gut.
Dr. Justin Marchegiani: 100%. So, kind of my simple kind of metaphor to understand inflammation is you have breakdown and build up catabolic anabolic. Anabolic builds you up. Catabolic breaks you down. Things that are responsible for the breakdown like cortisol, stress hormone, interleukin, cytokines, right? Inflammation, in general, is a good thing. When you go to the exit, when you go to the gym and you lift weights and you do push-ups, you’re creating an inflammatory response in the pec area but then you have this anabolic build up of remodeling proteins so your chest gets stronger and bigger but there’s a healthy balance, right? And so, what we’re talking about here is the inflammation causing a little bit more of a breakdown than you’re able to build up and so over time, whether it’s your brain, connective tissue, joints, cartilage, gut lining, all of this inflammation is causing the body to break down and depending on where that tissue breaks down is where the symptoms occur if it breaks down on the cartilage, arthritis. It breaks down on the blood brain barrier, brain fog, mood issues. If it breaks down the gut, you can have more autoimmune issues, you can have digestive issues, it breaks down, let’s just say in other tissues in the body it could be MS or type 1 diabetes. And so, yeah, so, depending on where the tissue is, is where conventional medicine puts that ICD-10 code but we’re looking deeper under the hood and we’re trying to get to the underlying mechanism. So, first off, we kind of define terms and then now we can go into, you know, other, um, other root causes and root palliatives to kind of support it. Any thoughts?
Dr. David Jockers: Yeah. For sure. And you have, you know, that acute inflammation which again is very therapeutic and healing and then you’ve got chronic inflammation. The big difference there is, the body when it’s in this breakdown, build up cycle. That is normal and healthy but when that never gets turned off and the body is continuously in this sort of healing cycle and it never gets turned off, that’s when we end up causing a lot of long-term problems that are happening in our society.
Dr. Justin Marchegiani: Yeah. Inflammation is a good thing because of the remodeling that takes place. It’s the out-of-control chronic-ness and especially when we look deeper at the hormones like cortisol, adrenalines if that’s kind of chronically high or even chronically depleted that’s where we’re gonna start to have big symptoms. What would you say are the next big root causes?
Dr. David Jockers: Yeah. So, you know, at the root a leaky gut is a huge factor with all of this, right? Because, again, if the gut is damaged now we’ve got proteins, we’ve got bacteria, yeast, different things like that seeping into that bloodstream and that tells the body, okay wow we need to signal the alarm because these things, we shouldn’t have abnormal proteins or bacteria going around in our bloodstream that puts at risk for pneumonia, for meningitis for something like that so we’ve gotta turn up and ramp up inflammation and the body kind of has this threshold level for how much abnormal protein and bacteria should be in the bloodstream and once we get over that threshold, it’s like a massive alarm throughout the whole body and then we’re releasing a lot of cortisol, right? We’re releasing a lot of hormones that are associated with fight-or-flight and that suppresses the hormones that have to do with healing and repairing, sexual reproduction, you know, our anabolic, our testosterone, our estrogen, our progesterone because we’re putting all of our energy into fight or flight cortisol and epinephrine and this is why leaky gut can cause issues with sleep for example. A lot of times people have insomnia. It’s really related to leaky gut and damage in their gut. So, that’s always the first thing that I look at and then kind of building off of that is just we have to look at their diet, right? Inflammatory foods are one of the main triggers for leaky gut.
Dr. Justin Marchegiani: Yep. 100%. So, of course, like the big, you talked about proteins, right? So, the big proteins I think, you agree, would be your glutinous proteins from grains and it could even be gluten free grains too. Sometimes rice can be a problem, corn can be a problem, especially if there’s GMO residue on that, right? Like, uh, the pesticides that are used, right? Round-up, etc. and then of course high fructose corn syrup can have a lot of different corn residue as well. Casein and a lot of dairies especially if it’s more conventional based dairy with a lot of the hormones and things in there. So, all those things can be a problem and then of course, the more our digestion is optimal. So, if you don’t have enough acid and enzyme and bile salts, we got to break these proteins down into smaller units called peptides and amino acids when these globules are just too big, that can create more food allergies because our bodies have these big proteins, they’re seeing in the bloodstream and that can create more stress so we got to break things down and if that fight-or-flight sympathetic nervous system is going, those enzymes and acids and bile salts may be really um, and at non-optimal levels and we have these bigger food globules in our intestines.
Dr. David Jockers: For sure we weren’t meant to eat on the go, right? So, we really need to be in a more relaxed state. Take a few deep breaths, you know, always pray before we eat, right? That puts us in a state of gratitude, activates that parasympathetic nervous system, the vagus nerve which travels from your brain down into the stomach into the gut and activates the production of those key digestive juices so you can really break down the foods effectively. So, yeah, we definitely need to eat with the you know we have to have mindful eating habits and eat foods that are nutrient dense and not foods that are higher on the inflammatory spectrum like you talked about. So, yeah. That’s huge. And then, we got numbers, you know, the third big thing is keeping our blood sugar stable, right? So, blood sugar stability is super important. So like, if you’re eating breakfast and your breakfast consists of let’s say, you know an apple or a banana or something like that and you’re only eating let’s say fruit even though it’s a healthier you know, more nutrient dense food basically all it is is sugar and so what happens then your blood sugar goes up, insulin comes out, brings that sugar down and now your blood sugar is down and now your body says okay blood sugar’s down and if you’re not metabolically flexible, your body’s not very good at burning fat for fuel that becomes, you know, again, the alarm gets signaled because it says okay wow we don’t have enough sugar to fuel the brain so we’re hypoglycemic now. So now, we need to pump out more cortisol, more epinephrine to get the blood sugar up because cortisol is a glucocorticoid meaning that it activates, uh, blood sugar released from the liver from the muscles into the bloodstream to get the sugar back up but with that we also kind of get this effect on our brain, this high cortisol, epinephrine, where it can cause us to have cravings, it can cause us to have mood swings, irritability, anxiety a lot of different issues like that and that just drives up inflammation in our body as well. For sure we weren’t meant to eat on the go, right? So, we really need to be in a more relaxed state. Take a few deep breaths, you know, always pray before we eat, right? That puts us in a state of gratitude, activates that parasympathetic nervous system, the vagus nerve which travels from your brain down into the stomach into the gut and activates the production of those key digestive juices so you can really break down the foods effectively. So, yeah, we definitely need to eat with the you know we have to have mindful eating habits and eat foods that are nutrient dense and not foods that are higher on the inflammatory spectrum like you talked about. So, yeah. That’s huge. And then, we got numbers, you know, the third big thing is keeping our blood sugar stable, right? So, blood sugar stability is super important. So like, if you’re eating breakfast and your breakfast consists of let’s say, you know an apple or a banana or something like that and you’re only eating let’s say fruit even though it’s a healthier you know, more nutrient dense food basically all it is is sugar and so what happens then your blood sugar goes up, insulin comes out, brings that sugar down and now your blood sugar is down and now your body says okay blood sugar’s down and if you’re not metabolically flexible, your body’s not very good at burning fat for fuel that becomes, you know, again, the alarm gets signaled because it says okay wow we don’t have enough sugar to fuel the brain so we’re hypoglycemic now. So now, we need to pump out more cortisol, more epinephrine to get the blood sugar up because cortisol is a glucocorticoid meaning that it activates, uh, blood sugar released from the liver from the muscles into the bloodstream to get the sugar back up but with that we also kind of get this effect on our brain, this high cortisol, epinephrine, where it can cause us to have cravings, it can cause us to have mood swings, irritability, anxiety a lot of different issues like that and that just drives up inflammation in our body as well.
Dr. Justin Marchegiani: Yep. 100%. And also, just having blood sugar go up and down, up and down, if you’re relying on lots of glucose to be your fuel source unless you’re doing lots of exercise and burning it up and you kind of have that ectomorph body type. These are the people that are kind of your basketball players, your marathon runners. These are the ones that when they eat a bunch of carbs, they just have to go right around the block because their glucose just triggers their bodies. They need to move. If you’re not, you know keto adapted, right? Glucose is a dirty fuel in your body, and tends to cause a lot of oxidative stress. This is why diabetics with high blood sugar that kind of oxidation is gonna create problems with the eyes the vasculature, peripheral nerves and so it’s good especially if you’re not super active to be doing a lot more to be more keto adapted and to kind of really switch your fuel source to be more kind of fat based which creates less oxidative stress.
Dr. David Jockers: Yeah. So, you really wanna build your diet around protein and healthy fats, right? I recommend typically when you eat, you want to eat roughly about 30 maybe 40 grams of protein if you’re trying to put on muscle mass, let’s say your weight lifting or something like that, you may even need more but when you sit down and eat a meal you should be looking at somewhere around 30 to 40 grams of protein in there. You know, roughly around 30 grams or so of fat in there, um, somewhere in that range is usually a good range depends you know can obviously range a little bit depending on the individuals body size or gender their activity level but somewhere in that range where you’re getting the fat, you’re getting the protein and then you know, you might have a little bit of carbs and some vegetables or maybe some berries, some low glycemic fruit but you know, you don’t want a tremendous amount, you don’t, you really want to minimize the amount of starch that you’re consuming throughout the day. Starch and sugars and just get them from real foods after you have your protein and your fat levels, your macros right on your protein and fat.
Dr. Justin Marchegiani: 100%. And kind of my philosophy is anywhere between a palm to a full hand of protein, that’s usually three to six ounces again if you’re bigger and may go higher to eight ounces, if you’re done doing a lot of lifting of weights, you know, you may be able to shift that and then usually carbohydrate-wise, I kind of say between two fish the two full hands and I would say mostly vegetables is pretty good. And if you’re gonna throw some starch in there, you know, there are some theories, I tend to go later in the day because of the carb backloading theory of just being more insulin sensitive later in the day and I try to stack in the fast at night with really lower carb throughout lunch to really tap into more being able to utilize ketones and fat for fuel. What’s your thoughts on that?
Dr. David Jockers: I completely agree about that. In fact, that’s what I talked about in my book keto metabolic breakthrough when I talked about carb cycling and even getting keto adapted in the beginning is really trying to push those carbs into the later in the day. Even a lot of people say well then you’re gonna store them as fat it’s not necessarily true because if you go low carb throughout the day, your body’s actually gonna burn up all your sugar stores in your liver and your muscles and so now you’re gonna have this wide open available storage for those carbs when you consume them to put it right back into the liver, right back into the muscle in the form of glycogen so you’re not just gonna turn it right into fat and I think that’s a much much better strategy and what I’ve noticed is that when people go lower carbs throughout the day. They have less cravings throughout the day. The earlier you eat more carbs earlier in the day, cravings go up and your overall, the amount of calories and the amount of carbs that you’re gonna consume throughout the day goes up.
Dr. Justin Marchegiani: So yeah. A part of the big reason why exercise, especially lifting or interval training is so beneficial is one it makes your muscles a little bit bigger and then muscles are like a sponge for glucose and so one you’re wringing out the sponge when you exercise so you’re burning the glucose but then you’re also hypertrophy in the muscle making it bigger so it’s like taking a big sponge and cleaning up that messy table I had a patient just do this as an experiment, he tested his blood sugar after meal, it was 140, 140, right, mg/dL and I tell patients, if you, you know, make a mistake with your carbohydrate or just too much junk after meal just do a five or ten minute walk. Well, he did an elliptical, a ten-minute kind of like interval on the elliptical that measured his blood sugar. 10 minutes later it went from 140 to 85.
Dr. David Jockers: He was activating that skeletal muscle. And another quick tip there too is you could even just do, if you know, you’re gonna have a higher carb meal, do 50 air squats right or 20 air squats or whatever you’re able to do, just do that. Get yourself kind of in a state where you’re breathing heavily. Give yourself a few minutes just kind of calm down, take some deep breaths and then eat your meal. Now, you’ve activated the Glut-4 receptor, right? So, the Glut-4 receptor, right? So, the Glut4 transporter protein that actually acts like insulin to pull the sugar into the cell and again you gotta get that sugar out of that cell because the sugar will create more oxidation and will create a process called glycation or browning inside of your body. If it’s stuck in the bloodstream at a high level like that 140 like your client there. So, we want to pull that out and we don’t wanna do it with a lot of insulin, right? So, we want to be able to get the sugar out of the bloodstream and into the cells with the least amount of insulin production and that’s what the exercise will help with.
Dr. Justin Marchegiani: Yeah, and that’s why I recommend like during the day I have a stand desk here so I have a treadmill over here that I can control with the remote so I’ll move my desk over there like yesterday on my fitbit here, I walked 18 to 19000 steps yesterday. So, I moved it over my treadmill. I’m working with patients and then I have my little Cubii stepper over here so I lower my desk and now I’m able to pedal so I’ll go from pedaling to just standing and then doing actual walking at three to four miles per hour. I can go one or two miles per hour if I want. If I’m really focused, I don’t want to put a lot of energy out and put more brain energy. So, it’s good if you’re in those work environments. Start with just the Cubii where you just get the little pedals, put them onto your desk and just try to get an extra 5000 steps a day with just that alone. That makes a huge difference.
Dr. David Jockers: Yeah. That’s great. And I can tell, you know, from the last time I talked to you, you actually look more muscular and trimmer as well.
Dr. Justin Marchegiani: Oh yeah. Thanks. Appreciate it.
Dr. David Jockers: It’s working.
Dr. Justin Marchegiani: You got it. You got it. Uh, What’s number four?
Dr. David Jockers: Yeah. So, number four is gonna be infections. So sometimes, you can eat a great diet, right? You can really try to put your body in the right mindset, right, and in parasympathetic mode so you’re able to produce the right amount of digestive juices but you’ve got infections particularly gut infections that are driving up inflammation in your gut, driving up inflammation, driving up cortisol levels and these bad gut microbes which could be Candida, right, or some sort of a yeast or fungal overgrowth. It could be bacteria like Klebsiella for example, it could be parasites, it could be worms, it could be, um, you know, Blastocystis hominis and different Amoeba and different things like that. These things are gonna eat the nutrients that you’re consuming. They’re going to poop out toxins, right? Toxins are gonna drive up inflammation in your system. So, sometimes, we need to use some herbs and different compounds to help remove these infections and follow specific protocols, uh, to get rid of these infections. That’s really the next thing that we got to focus on there.
Dr. Justin Marchegiani: Yep. 100%. So, first off, just being in a really healthy parasympathetic state with good acid and enzyme and bio levels. Those actually provide like almost like natural bleach for like the dirty picnic table so it makes it harder for microbes to grow when there’s good acids there, a good bile, these things have a natural antimicrobial effect, number one and then typically good beneficial bacteria in the gut it’s also gonna produce some level of acids whether it’s glucuronic acid or different acids that are very helpful for keeping bugs in check but then when you’ve eaten too much sugar or been exposed to antibiotics or your sympathetic fight-or-flight’s off, these microbes start to overgrow and then you’re in this then it starts to shift the whole milieu so then you kind of have to fix everything. You have to fix the digestion, fix the diet, use the herbs to knock down whatever microbes are going on. There can be different microbes and sometimes when those microbes are in there, you can’t just go back to doing lifestyle things changing your diet and digestion that may not be enough and sometimes the herbs are really necessary to kind of knock things down.
Dr. David Jockers: Yeah. Absolutely. So, just like you said, I mean, naturally if you’re producing enough stomach acid, bile, stomach acid really helps to sterilize the stomach and then bile is very alkaline, stomach acid is very acidic, bile goes in, really helps clean out the small intestine, you know, a lot of people are developing bacterial overgrowth in the small intestine. Sometimes, these are good bacteria but they’ve translocated from the large intestine into the small intestine and now they’re fermenting foods, you know, they’re eating foods before they should be creating a lot of extra gas causing poor nutrient absorption and this is oftentimes related to poor stomach acid, poor bile flow, not really creating the right environment and now these bacteria are translocating up there. So, yeah, these are all things that we need to get rid of. We need to really optimize stomach acid bile flow. So that’s key. And then sometimes, some different herbs, different compounds can be really helpful. Things like garlic, um, let’s see Berberine, can really, really be helpful here. Olive leaves can be a great one. Black walnut, right? What are some of your other favorite antimicrobials?
Dr. Justin Marchegiani: I’d say, the oil of Oregano’s wonderful. Ginger, um, silver, I like wormwood a lot too. These are all excellent compounds that are very helpful. And then, typically, when we do a lot of killing, we may even throw some biofilm boosters in there whether it’s ginger or silver or an acetylcysteine can work wonderfully to help the herbs work even better, kind of disarm the bug so to speak.
Dr. David Jockers: Yeah. Super important. And I know we’re running low on time so the next two I’m gonna put together. Chronic stress and poor sleep habits. So, these kind of go hand in hand, obviously, if you’re under a lot og stress, it’s gonna cause higher cortisol levels, higher epinephrine levels, which is gonna cause more laxity in that gut so when you have high cortisol, the tight junctions that keep the gut, uh, connected and with a lot of integrity become loose also high cortisol will cause a reduction in the mucous membrane which is kind of like the first line of defense in your gut before you get to the gut lining so you’ll have less mucus production, lower levels of secretory IgA which is your key immune component that helps protect your gut lining, it helps protect against pathogen buildup in your gut and then the gut junction will become more leaky or more loose and will tear more easily so it predisposes you to leaky gut and of course we know chronic stress will also impact your sleep quality and then if you’re not sleeping well that also is gonna cause more issues with stress with higher cortisol, higher adrenaline and you know, obviously, that’s gonna compound your gut health and your ability to just heal and repair and produce the right amount of anabolic sex hormones in order to repair and really thrive.
Dr. Justin Marchegiani: 100%. We talked about anabolic building up and catabolic breaking down. Well, cortisol, our stress hormone, the glucocorticosteroid, you mentioned, is on a circadian cycle so it’s higher in the morning and lower at night. Now, the problem is it goes down at night which allows melatonin, the sleep to come up but the problem is when we start to have overstimulation sympathetic nervous system stress, that rhythm can start to almost, it can actually pick up at night which then throws off our ability to make melatonin which throws off the parasympathetic restoration that happens when you sleep and growth hormone going up and all of your neurotransmitter turning over so like you kind of mentioned that sleep, it’s so important because when that throws off that prevents the healing and recovering and so it’s almost like a double whammy so to speak.
Dr. David Jockers: Yeah. You really can’t recover if you’re not sleeping well. That’s actually, it’s one of the most foundational things. I know I can help somebody if we can get them sleeping well. The faster we get them sleeping well, the faster their body is gonna heal.
Dr. Justin Marchegiani: Yeah. You can get like, um, like a fitbit where they have an HRV function or like the whoop or the aura ring and you can test kind of your HRV and your sleep depth and I’ll do different things, I’ll like take extra GABA or Athenian or Magnesium or avoiding alcohol like I’ll just have one like night alcoholic drink like two to three hours for bed and my HRV score will be way lower that next morning so get a device where you kind of test and see the different inputs and outputs in regards to healthy supplements and lifestyle strategy and see how that moves the needle. You may see it with blue blocking glasses or prayer or meditation or breathing or cold showers. These are all important inputs and then you can see how your body responds as a result.
Dr. David Jockers: Yeah. Totally. Totally. And the last thing is just environmental toxins. So, we’re being exposed to pesticides, herbicides, mold, you may have mold in your home that you’re being exposed to or in your office or something along those lines. Heavy metals, let’s say you’ve got Amalgam fillings in your mouth, um, you know, you can obviously get, get, get toxins from that, um, lead, let’s say you’re in an old home and there’s lead paint or something along those lines or you’re using conventional lipstick which actually has lead and you’re putting that on every single day. So, there’s a lot of different exposures to environmental toxins that you know may be causing you not to be able to heal effectively and drive up inflammation in your body. So, we gotta do the best we can so I always recommend trying to go as organic as possible with food at least trying to get non-GMO for sure and organic as possible with your food. That eliminates one of the major causes of you know toxicity and just a build up of toxins in your body. It’s like, we all have this bucket of toxins we can handle, we have a certain threshold that we can handle and our body will eliminate those things. And so, when we build it up though once that bucket gets to the point where it’s overflowing, that’s when we start to have the major symptoms. All our systems start to shut down so the more that we can reduce the amount that we are going into this bucket the better off we’re gonna be at eliminating them and so you know just trying to reduce exposure is key. Get natural household cleaning products. You know, try to get outside a lot, breathe fresh air as much as you can and uh and exercise, right? So, trying to exercise, you can obviously get in a sauna and try to sweat, try to open up all the drainage pathways and try to minimize your exposure to these toxins. That’s really the key.
Dr. Justin Marchegiani: Totally. And, each one of those seven could be a podcast in and of itself and of course we got lots of recommended supplements as well. We’ll put maybe a link below and you can put some of your favorite products and uh below. So listeners that are wanting to understand. Hey, what can I do to sleep? What can I do for inflammation? Like, I will put our favorite ones below and you guys can take a look at that, um, and then also feel free to reach to Dr. Jockers. J-o-c-k-e-r-s dot com. David’s got all kinds of supplements and tools and great information there and I’m Dr. J, justinhealth.com, you can reach out to podcast videos and functional medicine consult worldwide there. Dr. David, anything else you want to add?
Dr. David Jockers: You know, I just want to inspire you guys to know that you can heal if we can find the root causes and move those right and eliminate and reduce those. Your body has this natural built-in mechanism to heal, right? It’s the innate intelligence that runs you that God designed you with. And, you can heal and you can repair and can get inflammation under control. Inflammation is there to support you, you’ve got to just find out what’s causing it to be chronic, what’s causing it to be turned on all the time, start reducing that and now your body is going to be back into a mode where it can heal repair and you can really thrive in life even if you’ve tried these things we’ve talked about and you’re not getting results, reach out somebody like Dr. J here or my health coaching team. You’re gonna need a professional to help, walk you through the process, put you on protocol and get you the results that you want.
Dr. Justin Marchegiani: I love it and there’s a lot of foundational information out of the gates. People can kind of take and turn with and then kind of get that extra, you know, uh, that extra guide or that Sherpa helps that kind of get to the top of the mountain so to speak. So, Dr. Jockers, I really appreciate today’s podcast. Great intel, great information. Awesome man, you have a great day. Good chatting with you.
Dr. David Jockers: Awesome. You too Dr. J. You’re blessed.
Dr. Justin Marchegiani: Thanks Doc.
The Mold Gut Connection – How Your Digestive Issue Maybe Caused by Mold Toxins | Podcast #371
If you’ve encountered mold from a water-damaged building or contaminated foods, you’ve likely encountered mycotoxins—toxic byproducts of mold. They’re common environmental toxins, and they have adverse effects on many body systems, including the gastrointestinal tract.
While you’ve probably heard about other symptoms that can follow mold exposure, Dr. J and Evan discuss that mycotoxins can also cause severe problems for your gut. They also talk about how mycotoxins impact gut health and the microbiota and what you can do to help restore your gut health once you are exposed to mold.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:57 – Mycotoxins
10:16 – Functional Medicine Approach
13:54 – Dopamine Mechanis
15:20 – Mold Inhalation Effects
Dr. Justin Marchegiani: And we are live, It’s Dr. J here in the house with Evan Brand. Today’s topic is gonna be wonderful for the podcast. We’re gonna be talking about the mold-gut connection and how your digestive issues may be exacerbated by mold toxins, so great topic here Evan, personally been affected by himself and we see lots of patients all the time with these issues so let’s dive in. Evan, how are we doing today man?
Evan Brand: Yeah man, doing really well, and a lot of people have been to naturopaths, they’ve been the functional medicine people they’ve been a conventional doctor, they’ve been treated for SIBO and SIFO, whether it’s Rifaximin or natural SIBO protocols, maybe they’ve done SIBO diets or some of these rotational food diets and that sort of things, maybe they’ve tried berberine, oregano, garlic, and maybe they’ve made some progress, but then they’re still stick, they’re still suck, I’m gonna mix up my words, they’re stuck and sick so that’s a bad combination of essays and this is likely due to a mold toxin problem because I’ve seen it too many times and I suffered on my own and even the labs now tell us they give us a cookie-cutter report but that cookie-cutter report nonetheless is still valuable because even the lab has painted the connection between mycotoxins which are essentially mold farts that you breathe in, in a water damage building and the connection to certain bacterial overgrowth, specifically Clostridia but also Candida and the mechanism of why this is so damaging especially to young children is because we know that Clostridia bacteria screw up the organic acid levels called HPHPA and this affects levels of neurotransmitters, so when you get these children, they have behavioral issues, they may be diagnosed with something like PANS, which is a Pediatric Acute Neuropsychiatric Syndrome. These kids usually have sensory problems, food sensitivity, skin issues, histamine problems, allergies, maybe they’re biting children, maybe they’re angry or irritable, this can all be traced back due to this toxicity.
Dr. Justine Marchegiani: 100%. So that’s quite interesting, now you talked about mycotoxins essentially being mold fart, so essentially the mold off-gasses, right? And, your different kinds of mold, right? It could be Penicillium, it could be Aspergillus, right? It could be the black mold, Stachybotrys, these types of things and then they produce various mycotoxins and when we do different tests, like plate testing on homes, supposedly each mold or so can produce about 300 different mycotoxins, whether it’s Ochratoxins, or aluminum is that correct?
Evan Brand: Yeah, which is crazy because we can only test for a very, very small amount on the urine so really, we’re trying to just look for some evidence of this bonfire, we’re looking for the ashes, Oh my god, there must have been a fire here, this big mold exposure, we’re only looking at the tip of the iceberg so yeah, you’re right. Our testing is good but it’s still very primitive compared to the amounts of mycotoxins that are being produced.
Dr. Justine Marchegiani: Yeah. And the type of organic acid testing that we’re doing is on the great plains. We’ll look at some of the organic acid compounds that correlate with, like Aspergillus or different mold toxins. Is that correct? What are those big mycotox? What are the big organic acids again?
Evan Brand: So, it’s all on paper.
Dr. Justine Marchegiani: Membranes
Evan Brand: Yeah. So, you’ll see oxoglutaric. You’ll see citric acid can be high in a fungal overgrowth too so it’s all page 1. Oxaglutaric, you got hydroxybenzoic which is related to bacteria. I could pull up an O but in general it’s just page one. It’s typically numbers 1 through 18. If you see any big red flags on that either a combination of a bacterial overgrowth specifically a clustering problem and or Candida or fungal colonization and the lab indicates that so tartaric acid would also be on there, carboxy citric acid is also on there. So, in parenthesis, you’ll see under these organic acids now which is great because this has improved over the years that you and I’ve been running these labs. It now says Aspergillus so on number 6, which is tartaric acid under number six, it’ll now say Aspergillus. And you’ll know if that’s elevated, you’re colonized for Aspergillus which means that you’ve now been exposed to a couple situations could have happened either you had a large enough amount of mold, you were exposed to mold, long enough or your immune system was weak enough where now you become a mold factory. So, you can be a mold reservoir, more specifically a mycotoxin reservoir where you just have this exposure at the moldy hotel in Mexico and then you come back home and you’re sick or if you were weak enough, now you’re growing mold. Even if you move to the desert to avoid mold, you stay sick because you’ve got that colonization so with
Dr. Justine Marchegiani: Ionization, that’s happening.
Evan Brand: Yeah. So, you can prove that which is very important because now that would justify the use of herbal antifungals to try to remedy this situation.
Dr. Justine Marchegiani: That makes sense. Let me go pull up one of my old tests. Let me see if I can find it. Hold on.
Evan Brand: Now, the conventional treatment is typically antifungal medications that are gonna knock this out. But, as you and I with our functional practice, we don’t like to use that. So, number 4 would be classified as the fungal, the ferran-2,5-tricarboxylic, you’ve that Ferran carbonyl glycine. Yeah. So, number six. Yeah. So, this is old enough where they didn’t have the molds but on the new ones in parentheses
Dr. Justine Marchegiani: Let me say Aspergillus. It is primarily Aspergillus for all three of these.
Evan Brand: Yeah, and the number nine tricarboxylic is Fusarium.
Dr. Justine Marchegiani: Fusarium. Yep. And then Arabinose and Tartaric are also correlated with yeast overgrowth. This test here for instance, I did a great plane and a Genova test at the same time and this one actually came back much higher on the Arabino side than the great plains. then the Genova tested. So, it’s interesting you know different samples and such. But yeah, this one Arabinose is strongly correlated with Candida but then
Evan Brand: I just ran my own, I’ve got Candida right now too so I’m on a protocol, right? Now, I just run. Yeah. I showed up with Candida and I want people to know because you were a speaker on the event. It was called the Candida summit which I ran like five years ago and you know we had like 30 people talking about it and I could look back but I tell you I don’t think anybody had made the connection here which was the mold Candida connection back then and now what I’m finding is basically you’re just playing whack-a-mole with Candida until the mold’s gone meaning you may rotate through various rounds of antifungals but out the back door, you’ve got to be using the appropriate binders to pull out the mycotoxins so if you’re just beating Candida down and it keeps coming back. It’s probably the mold, not the Candida that you need to be after.
Dr. Justine Marchegiani: Yeah. And, that’s where it’s good to run a test like this. Also, maybe a urinary mycotoxin test or just make sure your environment’s good because I always tell patients if the environment’s not good and you’re having reoccurring issues then you’re just not getting to the root cause. So, the first thing is to isolate the environment. Make sure the environment, your home, your apartment wherever you’re living run a high-quality mold plate test on there. We’ll put links down below where you guys can access the plate testing. Isolate that, right? Make sure there’s no water damage or if there’s been leaks. Make sure it’s been addressed and dealt with. Make sure that’s dialed then the second thing is you can run a test like an organic acid test with your functional medicine provider. See if there’s any colonization. And, it that’s chronic, yo can get to the root on that and then you can always run urinary mold where you’re looking at mycotoxins coming out in the urine that can also be helpful but typically if this is good and there’s nothing at the home then you’re probably in pretty good shape and it’s probably more of an acute kind of dysbiosis thing probably from poor diet, poor digestion other bugs, other infections, etc.
Evan Brand: Yeah. And the cool thing is that you can kill two birds with one stone or even three birds with one stone and what I mean by that is let’s say you run that oh and you showed the elevated Arabinose, you know, there’s a Candida problem but if we see tartaric above that’s high and then down below, we see some of the bacterial overgrowth markers, the blends that you and I formulate and have, we might be able to kill bacterial overgrowth, fungal overgrowth and a Candida problem. All in one fell swoop and that’s incredible and you know your gastroenterologist or even your mold doctor is likely not gonna be able to do that. They may come in specifically with itraconazole or fluconazole or nystatin. But as you know, we’re facing this big problem of antifungal resistance just like we’re finding with antibiotic resistance and so now, you’ve got these very virulent strains which are difficult to kill with conventional medications. You and I have talked about this before but the long story short of it is all the different alkaloids and terpenes and beneficial nutrients in the plants, those don’t have this resistance problem. And if you’re mixing this herb and that herb, it’s not one plus one equals two, it’s one plus one equals ten. You get the synergistic effect.
Dr. Justine Marchegiani: Yeah. You see the same thing with addressing bacteria and other bigger bugs and berberines and Artemisia Wormwoods have synergistic effects. Also, the fact that you get a lot of antioxidants in a lot of these herbs. And so, especially if they’re high-quality, you get a lot of antioxidant support because when you start killing bugs, it’s a lot of oxidative stress that’s happening. And then, when you provide like an antifungal like Diflucan or an Amphotericin or a nystatin or a ketoconazole, obviously, there’s no antioxidants in those drugs and so you’re gonna have a lot of oxidative stress so it’s nice to have a blend different herb in there. One, to prevent the resistance. And then, also, people have yeast issues and a lot of times they have bacterial bugs as well and efflux pumps are a big thing that a lot of bacteria and bugs use to kind of protect themselves. So, I cannot say, like bacteria is like a sinking canoe, right? and essentially, you poke holes in that canoe with a lot of the herbals and think of the efflux pumps as the person in the canoe, baling water, right? So, they try to keep on bailing water, bailing water, so they don’t sink, right? And so, think of the herbals when you inhibit the efflux pumps whether it’s a ginger or different antimicrobials, it’s like taking the buckets away from the bacteria that’s bailing water and allows then to sink that allows them to effectively be destroyed that along with addressing biofilms too.
Evan Brand: Yeah. That’s awesome and the cool part too is you can minimize the die off if you’re doing this right. You know a lot of people when they hear these conversations, they get afraid. They go oh my God, Candida, mold, bacteria, parasites, worms like oh my God, this is a lot of stuff in me. I want it out of me but now I’m afraid. Am I going to feel worse before I feel better and the answer is if you do it properly that should be minimal to a nonexistent problem? I think you and I have refined our protocol so much over the years now that we have these tools and these other therapies in place that are standalone products but we often add those in or if we see that we hit a roadblock or a big bump in the road like a die off, we can change dosing. We can rotate. We can add in other support. We’re always talking about liver and gallbladder and binders and hydration and biofilms. These other pieces, these other variables, these are the make-or-break things for some people.
Dr. Justine Marchegiani: 100%. And when people kind of want to go after the gut, we live in an antibiotic like kill, kill, kill generation so people tend to, when they find out they have an issue, they want to go kill, kill, kill and that can be very stressful in the body so it’s always very important to calm down the inflammation, get the immune system stronger, get the hormones that help with anabolic metabolism which is healing, recovering, anti-inflammatory support that kind of sets the table because the more stressed and inflamed you are, your lymphatic system, your detoxification system, your immune system won’t work as good and plus people forget your detoxification system, right? The cytochrome p450 oxidized pathways, especially the phase two pathways, they’re gonna run off of a lot of sulfur-based amino acids and so if we don’t have great digestion and we’re not eating you know good healthy animal protein or good healthy plant cruciferous vegetables. If we can’t tolerate them, we can’t break them down. May not have a lot of those sulfur building blocks to run those phase two pathways and so that’s why kind of getting the deck set so to speak so we can really hit phase two better just not with support but just getting digestion working better and a good diet working better sets the table and allows us to effectively kill so much better.
Evan Brand: Yeah and I know we’ve talked about a lot in a short amount of time, we’ve gone fast so listen back as needed but I want people to understand the connection because of the title of this episode, I want people to understand the mold-gut connection. So, the connection is the following: the mycotoxins weaken the immune system and allow the opportunistic bacterial overgrowth to thrive along with the Candida. So, if you’re working upstream at the SIBO-SIFO situation but you’ve got an underlying mycotoxin problem, you’ve got to address that if you fully wanna get better. The other mechanism of the mycotoxins is a couple. Number one is they damage the microbiome so we know specifically that mycotoxins do the same thing as, like food allergens, they disrupt the gut barrier and create intestinal permeability. So, that’s another reason you want to pull those out of the circulation by using specific binders based on your labs. And then the other mechanism too is we know mycotoxins affect the brain chemistry and specifically lower dopamine so when you get into pain signaling, you get into motivation and mood and just your overall vitality. If your brain chemistry is affected, we can also measure that but it could be directly attributed to the toxin for example in like rat studies when they inject them with mycotoxins or expose them to mold toxin, the dopamine levels crash. So now, all of a sudden, you’ve got this brain chemistry piece to address too, now people have heightened pain sensitivity, they’re depressed. They may be just more flat with their life. Once again, they go to their psychiatrist. They’re not gonna bring up mold toxicity, they’re putting them on an antidepressant medication. They’re never gonna say, “hey, oh your basement is flooded, that’s why you’re depressed and anxious and you have diarrhea”. So, the connection of the gut symptoms too, the diarrhea, any type of bloating, burping, digestive pain especially in children. Children don’t use the same language as adults. So, if your child is complaining about stomach pain that could be one clue that there’s something related. That was my issue for my daughter, Summer. She was complaining of tummy aches so we did run stool on her. She did have H. pylori when she was two. We tested real high. Maybe I gave it to her by sharing water bottles or something but either way, we took care of that and then stomach pain was continuing that was when we had got exposed to mold. Luckily, I got her on binders. Now, she’s in a better place. So, I’ve seen it unfortunately with my own kids and it’s stressful to see your kids suffer but it’s a good lesson. It’s a good learning lesson that your children are not crazy and if your kids are complaining of a chronic issue like this with pain, you know, consider this as a possibility especially if you as the mother are toxic because the toxins go through the placenta and they also go through breastmilk. So, if you have your own digestive skin, whatever problems, mood problems in your kid, has similar issues as you, well, it could be the generational passing of toxins.
Dr. Justine Marchegiani: So, let’s go over that mechanism one more time with dopamine. So, obviously dopamine is a neurotransmitter and when we’re chronically stressed, physical, chemical or emotional, dopamine can go downstream and get converted into adrenaline which kind of helps manage the acute stress response. Is it just a fact that the mold is inflammatory and creating a stress response and activating the sympathetic nervous system that the dopamine is being taken and depleted downstream or is there something else? I want to make sure I get that mechanism hammered down.
Evan Brand: I don’t know. Type in rat dopamine, mold or rat dopamine, mycotoxin. See if you can find it. There were several papers on this. I don’t know if they discussed the mechanism in it or not. My assumption would be that it’s multifactorial. I think the big mechanism would be that the mycotoxins affecting the gut barrier then affecting nutrient absorption then there’s likely less amino acid conversion to dopamine. So, I’m thinking, it’s more of a malabsorption problem but also we know that ochratoxin for example damages
Dr. Justine Marchegiani: Like malabsorption, like it’s affecting the absorption of protein in the gut?
Evan Brand: Yeah. I think that’s one mechanism. I think the other mechanism would be direct brain damage. We know that okra toxin for example damages the cerebellum. We know that the Verrucarin and the Stachybotrys mycotoxins affect the brain and the prefrontal cortex which impairs, like your ability to think clearly. So, I think it’s both. I think it’s the gut damage and I think it’s the direct brain damage too. I am going to pull it up here. Can you see it on screen?
Dr. Justine Marchegiani: Yep.
Evan Brand: Let me make it bigger on my side here.
Dr. Justine Marchegiani: Yeah. So many mycotoxins, trichothecenes. We test that in some of the mycotoxin tests. Yeah. Induced neuronal cell apoptosis so some of that could be you’re just causing the cells in the brain and especially in the substantia nigra of the midbrain. That’s where dopamine cells are being produced. Some of it could be apoptosis that means programmed cell death and or inflammation in the olfactory epithelium.
Evan Brand: Interesting.
Dr. Justine Marchegiani: So, it seems to be a neurodegenerative and then look it says it caught ochratoxin A causes acute depletion of dopamine and its metabolites.
Evan Brand: Look at that.
Dr. Justine Marchegiani: So, I wonder if that’s a, it sounds like it’s possibly a stress response, right? Because dopamine can, tends to go downstream to adrenaline. It could be almost like an autoimmune response because you’re having apoptosis. This is neuronal cell death, program cell death. This is part of the reason why apoptosis is important, right? Because if you don’t have good immune function, this is how cancer forms, right? Your immune system helps program cells to die when they need to die. This is apoptosis but if you can’t do that then cells can overgrow hence you have a tumor, right? And so, this is actually happening to unhealthy or the very healthy tissue that you need to be functionally healthy that produces dopamine in the midbrain. So very interesting.
Evan Brand: Yeah. Talking about the hippocampus too, we know that hippocampus, I’ve got two of them. Remember, that’s why a lot of people have brain fog problems and also I would say that short-term to long-term conversion is impaired.
Dr. Justine Marchegiani: Can you see this one here? The mold inhalation one
Evan Brand: I’m just seeing that you’re highlighted on the hippocampus word for now.
Dr. Justine Marchegiani: Let me switch back to the other one here. This is mold inhalation. This is interesting. Let’s go pull this up. All tight. Mold inhalation causes innate immune activation, neural cognitive and emotional dysfunction.
Evan Brand: So, this is pretty new. July 2020 paper here so relative.
Dr. Justine Marchegiani: Yeah. Yeah. So, the ability of mold to cause such symptoms is controversial since no published research has examined the effects of controlled mold exposure on the brain. Patient symptoms following mold exposure are indistinguishable from those caused by innate immune activation by bacterial or viral exposure. Interesting. So, in this study here they added in. See here. Toxic and nontoxic mold stimuli would cause innate immune activation with concomitant neural effects and cognitive and emotional behaviors. We internationally administered intact stachybotrys. This is black mold extracted non-toxic stachybotrys spores and a saline vehicle to mice.
Evan Brand: You don’t want to be that mouse.
Dr. Justine Marchegiani: Wow. No. As predicted, intact spores increase interleukin 1 beta, immune reactivity in the hippocampus both spore types decrease neurogenesis. This is forming new neurons in the brain and causing striking contextual memory deficits in young mice while decreasing pain thresholds. So, this is another word saying, causing more pain in the body. So, if you have mold exposure, joint pain could happen, right? And enhancing auditory acute memory in older mice. Nontoxic anxiety. Yeah. Also increase anxiety like behavior. Levels of hippocampal immune function correlated with decreased neurogenesis that’s creating new neurons in the brain. Contextual memory deficits, right? Obviously, less memory and or enhance auditory cued feared memory. I wonder what that means. Maybe it’s just like, uh, you’re more sensitive to external stimuli.
Evan Brand: I read that. Yeah. I read that as sound sensitivity which is yeah part of the toxin and light sensitivity too so people will often have to wear sunglasses even when it’s not very bright. You and I talked about that in the context of adrenals years ago but that’s also a mold toxin thing.
Dr. Justine Marchegiani: Yep. And an immune activation may explain how both toxic mold and nontoxic mold, skeletal elements cause cognitive and emotional decline. So, it’s really important. We don’t wanna be in an area where there’s a bunch of mold toxins and we can do a whole other podcast on how to mitigate mold toxins as a whole. I mean, of course, get your home tested. That’s the first thing. If you have water damage, make sure it’s mitigated by a professional right away because mold starts to form when sitting water in as little as two days. Got to make sure that’s under control and then if you’re on the fence, get yourself tested, right? We’ll run an organic acid test. Maybe run a urinary mycotoxin test and see what your actual load is but again one of the big telltale cue signs is you know, get your home. If there’s mold there and you start feeling significantly better and you go back, you notice an increase and definitely get your internal mold tested as well via urine.
Evan Brand: Yeah. Well. I know we got to wrap this thing up. We got calls to get to but I hope this is helpful for people. We can always get geekier and dive deeper and go longer but I think you guys get the gesture, the connection of the brain toxicity, the gut damage. There’s a mitochondrial element with the chronic fatigue piece. So, if you are suffering from any chronic issue whether it’s mood like depression, anxiety, energy problems like chronic fatigue, low libido, poor erectile function, cold hands, cold feet, increased light sensitivity, blurry vision could be other things but this is a big smoking gun and all of us are inside way too much. We’re not outside like the Amish are all day. They might have moldy homes but they’re not breathing it in the majority of time. They’re outside in fresh air where the toxins are diluted. So, us with our indoor lifestyle as modern humans, we’re at more risk of this stuff and our buckets are already full due to pesticides and other toxicity in the environment so this is a really, it’s an epidemic problem, maybe the biggest one.
Dr. Justine Marchegiani: And not everyone is as genetically sensitive, right? Some people, they go into a moldy area. They get brain fog, right away. Some people do fine. Either way, it’s definitely a stressor in the stress bucket and if you know it’s there, you definitely wanna pull it out because it’s gonna help give you more resiliency and more adaptability. Great podcast today Evan. Everyone listening on the audio version, we pulled up some studies and some lab tests on the video version. We’ll put the link down below so you can see the video version. We’ll put some links to some of the labs and the products that we talked about today so you guys can take a look at those. Evan, great chatting with you. Head over to evandbrand.com to reach out to Evan via functional medicine nutritional support worldwide as well as justinhealth.com, Dr. J myself at justinhealth.com for me myself. We are here to help and support you guys wherever you are. Have a phenomenal day everyone.
Evan Brand: Take it easy. Bye-bye.
The Root Causes of Anxiety – A Functional Medicine Approach | Podcast #370
Conventional medicine labels anxiety as a neurotransmitter imbalance and relies on pharmaceutical drugs to dampen the symptoms. Although, prescription medications can be a helpful and even necessary tool in periods of overwhelming anxiety. But we have so many more tools at our disposal than just medications!
Dr. J and Evan explain that they recognize that anxiety is often the proverbial “tip of the iceberg” in functional medicine. It’s the clear and present warning that something is going on below the surface that needs our attention. Our current circumstances may have been the breaking point, but the anxiety manifests in underlying issues. That’s why rectifying these issues is necessary to make anxiety more manageable or even eliminate it!
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:06 – Acute and Chronic Stress
4:06 – Amino Acids and Herbs
11:24 – Gut Issues
16:26 – Functional Medicine Approach
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the root causes of anxiety, a functional medicine approach, and how to get to the root cause. Really excited about this topic. We see many functional medicine patients with these exact issues and we always want to get to the root cause of why that is so. Evan, how are we doing man?
Evan Brand: I’m doing good. You know the anxiety story for you and I talking about anxiety goes back literally eight years. It would have been late 2014 when I was in my luxury apartment in Austin and I was calling you and I was saying, “dude, I can’t stop this”. My heart is pounding. I’m freaking out. What the heck is going on and you said, “man, if you go to the emergency room, all they’re gonna do is they’re gonna give you some sort of anxiety medication. So why don’t you go and take about a gram of magnesium and see what happens.” And so, that’s what I did. I think I might have had some pharma GABA or some other tools on hand, maybe some passion flower and luckily, I calmed it down but little did I know back then that I had some of the big root causes of anxiety that were unresolved which included mold toxicity, Lyme, Bartonella, some of these tick-borne infections that drive up the nervous system, unfortunately. Now, knock on wood, anxiety’s been a minimal to non-existent part of my life and It’s incredibly freeing because anxiety can be so debilitating that people become housebound or they become afraid to travel, they become afraid to go on planes. They become afraid to seek the raise at their job. They just want to live in this little cocoon because they’re so afraid and anxiety is also very debilitating for children too. It affects their confidence and their self-esteem and their motivation for school and how they get bullied and so, I mean, we could do an hour on this but think just to open this thing up with a bang, I would say that infections are a big driver of anxiety so whatever that is a tick-borne infection like a Bartonella, Babesia, Lyme situation or gut infections like we’ve talked about a thousand times in the last 10 years together which is parasites, bacterial overgrowth, worms, Candida, anything that’s gonna release a toxin or aggravate the immune system.
Dr. Justin Marchegiani: Yeah. 100%. So anytime you look at anxiety, you always have to get to the root cause, right? Obviously, if it’s unresolved emotional stress, your body is designed to create anxiety for a certain situation, like if you, I don’t know, if you have lived in a forest across the street and there are bears, there should be a healthy amount of anxiety so you know, don’t leave food out and you’re just a little bit more careful with your habits so you don’t get attacked by a bear, right? There’s a healthy bit of anxiety there which is good to kind of keep you on edge so you are alert and you make good decisions. We’re talking about things that are, you know, unhealthy amounts of anxiety where you don’t have those types of emotional stressors, right? Obviously, if those emotional stressors are there, kind of take inventory of them and figure out what that corrective action is you need to kind of close the anxiety loop. I always say close the anxiety loop. What is that action? You have to take that allows you to feel confident that you are not ignoring the reason why there is anxiety there. If you did that, great, awesome. Check that off your list. The next thing is like you mentioned, obviously, any type of chronic stress or acute stress can create anxiety, right? And so, chronic and acute stressors do different things to your body. They’re going to cause B vitamins to get recycled and used up at a higher rate. They’re gonna cause magnesium to get used up at a higher rate. They’re gonna put you in a fight or flight position, where your body goes into fight or flight and then that’s gonna cause increases of cortisol, increases of adrenaline and it’s gonna cause your brain to get hyperactive and obviously at the same time it’s gonna affect digestion too when you’re in fight or flight. It’s gonna decrease your body’s ability to make stomach acid and enzymes and it makes it harder for you to break down your food. And so, and then of course, the more stressed you are, now you’re gonna start craving more processed foods that increase dopamine and increase a lot of those, uh, feel-good brain chemicals to buffer that but so, I always look at like what’s the constructive vehicle to fix this, what’s the destructive vehicle. Destructive vehicle feels good at the moment but creates problems down the road. Constructive helps at the moment. May not, maybe not quite as fast but then actually gets to the root cause over time. And so, some of our constructive vehicles like you already mentioned, magnesium, right? Theanine, right? B6, B5, right? And I always look at nutrients first, like nutrients are in the hierarchy before herbs so nutrients first and then, in the hierarchy coming down would be herbs, Ashwagandha, passion flower, Valerian. Those things are nice herbs that kind of activate and stimulate GABA. So, GABA is an inhibitory neurotransmitter. So, it’s the brake pedal on the nervous system. So, think of the gas pedal as adrenaline, as cortisol. That’s the fight or flight nervous system response and the gas pedal is gonna be GABA and the things that are gonna help with GABA are gonna be Taurine, Theanine, GABA in and of itself. And then on the herbal side, things like Ashwagandha have multi-adaptogenic effects. They can increase cortisol and increase stimulation when things are too low but they can also tamp it down when it’s too high. I like my wife. She was really stressed the other day. We are getting our kids out for an easter party and she’s like, “you have something to give me? I am so stressed.” And I’m like, “here you go”. And I gave her a bunch of GABA, Taurine, and Theanine and magnesium, some B5 and vitamin C and some Ashwagandha and she looked at me like two hours later, she’s like, “what the heck did you give me. I’m on cloud 9.” I’m like, yeah, you know that, the better living through chemistry right there.
Evan Brand: That’s great. Yeah, and motherwort. I love motherwort too. It’s great for the anxiety when you’re having, like, heart palpitations, blood pressure type issues as well.
Dr. Justin Marchegiani: Hyperthyroid too. They use it on hyperthyroid, as well.
Evan Brand: Yeah. That makes sense.
Dr. Justin Marchegiani: Too high thyroid, it can also be. It can help dampen that down, as well, which is nice.
Evan Brand: It’s great for grief too so like the cool thing about certain herbs is they can be an emotionally calming tool but they can be a nervous system calming tool too. So, like, as you mentioned, there could be an emotional thing like a bad boss, a bad spouse, a bully. You know that type of emotional anxiety driver but it could be a chemical driver too, meaning like a toxin driving the nervous system to be ramped up. Also, we should talk about blood sugar. I know we’ve done podcasts on this before but you know there’s a big impact on issues with blood sugar. Thank the Lord, my blood sugar is so good now, I could eat dinner at five and not eat till 1pm the next day and I’m stable, like, I can fast for extended periods of time as needed and I don’t have any issue but however when my gut was a wreck which I want people to pay special attention to, if your digestive system is compromised, you’re not gonna be tolerating fasting that well because you’re already so likely nutrient deprived because of the malabsorption due to the infection. So, years ago when I tried doing this type of fast, I would have major anxiety and that’s low hanging fruit so do what you got to do but you got to get your gut tested and then fix the infection first.
Dr. Justin Marchegiani: 100%. So, just kind of looking at a bunch of different things. So, on the emotional side, right? If it’s unresolved emotional trauma that’s creating anxiety, you know, someone wrote about DNRS, that’s great. You know, this NLP, where you kind of visualize a stop sign or something to kind of do a pattern interrupt. That’s excellent. EFT, EMDR with eye movement or different tapping on meridian points to kind of dampen down that sympathetic nervous system response. And again, these are gonna be good, you know, uh, more chronic issues. Yeah. If it is an acute issue, you know, a lot of times, just get to the root underlying issue where that issue is acute.
Evan Brand: I was on a plane one time and the turbulence was so bad and I started tapping on the plane. That really helped. I’m like okay. Even though it feels like this plane is about to crash, I love and accept myself and I’m like okay that’s fine.
Dr. Justin Marchegiani: Yeah. Especially things like that. You don’t have control, right? There’s nothing you can do outside of just sitting there and getting through it. And so, it’s better when those things are kind of the case but you know, it’s kind of like, I’m just trying to think of you know an example, it’s kind of like, you go upstairs and don’t turn the alarm on for the house or like maybe did I leave the front door unlocked, right? And so, there’s a natural bit of anxiety. You start going down to bed and that little bit of anxiety kind of creeps in, you’re like, I’m not gonna be able to get to sleep fast if I don’t at least just check on the front door, right? So, let me make, oh good, it’s locked. Oh good, the alarm is on. Good. Now, that anxiety can go down because it’s there for a reason, right? So, if there’s a root cause, act on it, right? If there’s isn’t a root cause, right, but it’s more emotional, you can do some of the tapping and you can work with a practitioner to get to the root cause on that and then of course having better biochemistry will get will make every bit of anxiety better because you’ll be able to adapt to it and deal with it better. And so, of course, like we already talked about with cortisol, chronically high levels of cortisol and adrenaline are gonna be big so you have to get to the reason, the root cause why. And again, foods could be a reason why like gluten, too much processed sugar that can drive up that anxiety. Again, you already mentioned blood sugar fluctuations. If you’re on this reactive hypoglycemia roller coaster ride where blood sugar goes up because you ate too much processed carbohydrate, refined foods, junkie, vegetable oil, omega-6 fats. Blood sugars up and then it can crash right back down. The crashing is where you tend to get a lot of adrenaline cortisol stimulation and on the way up, you get lots of insulin so you get this insulin-cortisol-adrenaline kind of tug of war happening and that can be very stressful on the body. And then, of course, if your blood sugar is chronically high and you’re making tons of insulin that can also be a problem too. High levels of insulin can cause all kinds of problems with hormones, especially in women, it can cause issues with ovarian cysts and testosterone problems. And then, high levels of blood sugar deplete a lot of your B vitamins and magnesium. And so, if we have poor levels of B vitamin and B6 and B5 and B1 and B2 and B3 and folate and B12 and magnesium is depleted, that’s gonna cause more stress and more cortisol issues and it’ll be harder for you to deal with and adapt to that.
Evan Brand: And I would say, if you have anxiety longer than the week, I would almost consider that chronic. I mean, it’s crazy to me, how many people you have and I’ve talked to over the years who’ve had anxiety for a decade or longer and sometimes as one person commented that anxiety and OCD together is terrible. A lot of times OCD does come hand in hand with anxiety. We’ve done podcasts specifically about amino acid therapy and we use amino acid therapy in our clinics but if you have OCD, anxiety, low self-esteem, worry, negativity, depression, disturbed sleep, those are all symptoms of low serotonin. So, what you need to do is to get an organic acid test so we can measure this and look at the brain chemistry because if you’re not testing, you’re guessing. So, when you’re listening to this conversation about anxiety, I swear to you, you’re never gonna find a psychiatrist that’s gonna say, “hey, maybe we need to run an organic acids test, maybe you have low brain chemistry because you have bacterial overgrowth. So, we’re also gonna run a stool test. If they’re out there, send them our way, we’ll do a podcast with them but I doubt your psychiatrist is ever gonna consider running functional medicine testing on you to investigate this. I don’t care if you do lorazepam or the klonopin or whatever. It’s not the root cause and it’s gonna dig you.
Dr. Justin Marchegiani: Any benzo
Evan Brand: Yeah. Any benzo is gonna dig you further in the hole because now you’ve got this dependency issue and now you’ve got his issue of withdrawal and I don’t know if you’ve read some of the stories on this but my God if people try to acutely stop those benzodiazepines, there’s major major major side effects. So, it’s just not around
Dr. Justin Marchegiani: Especially, if you’re on doses, you know, above one milligram or so on a benzo, it can be harder to get off and sometimes the taper can be, you know, six months to a year coming off of it. If you’ve been on it for a while or been on a higher dose. Yeah, you need to kind of do a slower type of taper for sure.
Evan Brand: And there’s so much, I mean, just think of how many millions. I didn’t look at the numbers here but how many millions of people are on prescription anxiety medication and they never ever get to the root cause. It’s so sad to think about someone that’s been on like a Lorazepam or another benzo for 20 years and they’ve never once asked about the gut. The question came in, how does dysbiosis cause anxiety. What are the mechanisms? Well, I think, one, right out of the gates is gut inflammation. Number two would be nutrient malabsorption because as you mentioned, a lot of these B vitamins are necessary for many processes in the body including energy production so sometimes you have anxiety and chronic fatigue and that sucks too because now you’re too tired but you’re anxious so that’s not a fun recipe either. What else would you say about the gut anxiety connection?
Dr. Justin Marchegiani: Well, so anytime you have chronic gut inflammation whether it’s from food, whether it’s antibiotics. Antibiotics are creating rebound yeast or bacterial overgrowth. We could put H. pylori in that category, and other infections, as well. That’s a one you and I already mentioned, creates malabsorption just from indigestion, right? Not enough enzymes, not enough acids, not absorbing things well. Two, you’re gonna have exogenous production of lipopolysaccharides which in and of itself are a toxin, right? They’re produced, they’re part of the gram-negative bacteria in the gut and they’re stressful on the liver and there’s also can go to the blood-brain barrier. And when they’re in the brain, they can create mood and anxiety issues as well. So yeah, lipopolysaccharides, you could have acetaldehyde and mycotoxins from fungus. You could have issues with the parasites producing their own type of internal toxins for sure. Of course, your body also produces through healthy gut bacteria, a fermentation process to make its own B vitamins, vitamin K. Those kinds of things. So, if we have dysbiosis, we typically are gonna have low levels of beneficial bacteria so we don’t have that good endogenous production behind it. And then, of course, that’s gonna over activate our immune system. So now, we have all these toxins kind of slipping through our bloodstream. We have undigested food particles, getting through our bloodstream. Now, our immune system starts becoming hyperactive and that can suck up energy. That can suck up resources. So, there’s studies on for instance H. pylori creating mental health issues, mental, emotional issues, depression and anxiety partly because of the lipopolysaccharides and endotoxins are the same thing by the way. LPS or endotoxins and obviously nutrient absorption problems too.
Evan Brand: Man, when I had H. pylori, I was super anxious. I don’t know if I was depressed as much but I was definitely anxious and you remember how skinny I got, I mean, I lost so much weight too. So, a lot of people, you know, they look at anxiety on the surface right. And everyone looks anxiety is just like this mental thing and you just need to watch some hoorah motivational video and just get over your fears and that I was like no anxiety goes way deeper than that. You just eloquently illustrated this, the aldehydes from the yeast and the fungus toxins and the bacterial toxins and the parasitic toxins and the mycotoxins. You guys, this anxiety is not in your freaking head. It’s not. It may manifest in your head but the root cause is not in your head unless you’re describing like, this toxin getting across the blood-brain-barrier but beyond that, the gut I would say is the biggest driver of anxiety. I’d say, if I had to pick one place to look, it would be the gut.
Dr. Justin Marchegiani: Yeah. So, when we look at this, what’s kind of the hierarchy of addressing this? So, of course, you fix the foods, right? Because the foods are one. You’re gonna decrease inflammation from the foods. And the inflammation in the foods is gonna cause gut permeability so you cut out the gluten, the dairy, the processed refined sugars and flours, the junky omega-6. You focus on good high-quality animal-based fats, good healthy proteins, you know, more carbohydrate from fruit and starch, especially if there’s blood sugar issues and then from there, then you work on digesting it. So, make sure enzymes and acids and good digestion are there. Get your gut looked at especially if there’s any type of chronic bloating or motility issues or indigestion, unadjusted food in your stool, diarrhea, then you get your gut looked at and of course if this issue is more chronic, you want to look at your stress handling system so the interplay sympathetic and parasympathetic nervous system in your body and your nervous system is your adrenals and so you can get your adrenals looked at cortisol rhythm wise, you can do a cortisol panel. Look at your cortisol in the morning and throughout the day. Make sure it’s not too high or it’s reversed. On a good organic acid test, we can look at neurotransmitters like Vanilmandelate which looks at adrenaline. We can get Homovanillate which looks at dopamine, right? We can get the DOPA which looks at dopamine. We could also get 5-hydroxyindoleacytate to look at serotonin and then of course we can look at B6 like a kind of urenate or xanthurenate, right? We can look at brain inflammation markers like picolinate and quinolinate so there’s inflammation in the brain that gives us more indications. We can look at oxidative stress markers like 8-hydroxy-2-deoxyguanosine. There are good markers out there to look at these different things to give us a window of what’s happening so you know, we work on the food, work on the lifestyle, sleep. Make sure we’re digesting and breaking things down. Look at the nutrient deficiencies, look at the gut, look at the infection, look at the digestion and then of course, you know, we can always branch out and look at mold or mycotoxins or heavy metals or more toxic burdens down the road. That’s the foundation first and then I would say on top of that, if there’s any type of chronic pattern where there’s an emotional trauma involved that’s more unresolved definitely bring in a good practitioner, you know with some tools in their tool bag of NLP or EFT or EMDR or hypnosis. Anything that you want techniques to get into the subconscious but again the healthier you are the better the emotional stuff is to resolve so if you’re doing EMDR and EFT and NLP and you’re eating processed food and crap, it can still work, but it’s gonna be better when your brain chemistry is healthier.
Evan Brand: Oh, yeah. Amen. Well, think about all the people that are in talk therapy and then they go and they go eat a subway sandwich for lunch, thinking that they’re doing themselves a good favor by eating turkey on wheat bread with processed cheese and then they get mayonnaise or sweet and sour sauce on it or whatever the heck they’re doing and then they feel like crap, I mean.
Dr. Justin Marchegiani: Yeah. I’m not a big fan of talk therapy in the long term. I think, talk therapy is good did you kind of just consciously process something like how did this happen maybe you’re learning some tools to enter into your life from a habit standpoint to fix whatever that issue was but then most of that trauma sits in the subconscious area of the brain which is where 90% of all your thoughts are subconscious and so that’s where you want some of these techniques like we talked about but I think talk therapy is good to acutely process what you’ve observed whatever your experiences are and then talk about, hey what can you do, you know, as a person today as an adult today, um, you know, from a habit standpoint to address it but then after that then you gotta, you know, if you’re in talk therapy months and months later and you’re still just ruminating over the same thing then it’s a subconscious thing you got to work on next.
Evan Brand: Yeah, and look, don’t let me talk people out of doing it. I’m not trying to do that but what I’m saying is I’ve had people that said, “oh yeah, I’ve been with this therapist for 3 years and I meet with them every week or every other week”. And I’m like, “okay and what do you do with this therapist?” “We talked.”, “Okay and what else do you do?” That’s it. It’s talk therapy and I go, okay, you’ve been doing talk therapy every week or every two weeks for 3 years and you still have anxiety that’s this bad. We got to dig deeper. So, like I said, there’s a role for that but it’s not gonna get you out of the woods. The person who commented about the dysbiosis and anxiety question, they also commented in here said they did have a stool test that showed H. pylori. They have extremely high Morganella which is one of those bacteria we’ve talked about and calprotectin which is gut inflammation over a thousand. Fatigue and anxiety were the main symptoms. We see this everyday all day.
Dr. Justin Marchegiani: Yep. Exactly. I’m familiar with that case for sure. And inflammation in the gut can definitely create those types of issues and get to the root cause of it too. And then, someone writes in, about Accutane too, I mean, this is super common if you get into the dermatology world. I mean, dermatologists, they either cut something. They burn it off with a laser. They freeze it off or they use some type of antibiotic, topical or internal or they use some kind of like, synthetic vitamin A. That’s it. That’s the dermatology world you know in a nutshell and they tend to not get to the root, you know, we’re talking like more chronic acne, chronic skin stuff. They tend to not ever get to the root cause of how or why that’s even there. Diet, sugars, junky, omega-6, poor digestion, poor fats, poor proteins. They don’t really get to the root cause of what that is and so, they recommend synthetic vitamin A, which is Accutane, which again, will decrease the amount of oil produced by your sebaceous glands which can be helpful in the short run if they’re producing too much oil but they can create chronic skin and eye dryness in the long term and they’re not even getting to the reason why your skin’s producing too much oil to begin with. Usually, it’s too much insulin. Insulin is a huge driving factor of excess oil and then of course, you have different food allergens, gluten, dairy, too much sugar. That can also cause a lot of problems with the skin cells.
Evan Brand: And not to mention, the connection between people that have anxiety and acne. Guess what, they’re both linked to the gut. So, if you have acne and anxiety, you gotta investigate your gut. Please. Please. Please.
Dr. Justin Marchegiani: Yep. 100%. And again, you know, outside of that, you know, we look at different toxins down the road. If we look at heavy metals, there’s different tests. We can look at, to do a challenge test on your metals with a DMPS or some kind of a challenge agent. We can definitely look at mold if there’s mold in the environment that’s important to look at. And again, if you’re in an environment where you feel better leaving that environment then there could be some mold in there, especially, if a history of water damage that was unresolved, definitely want to get your mold looked at or just your home looked at too, especially if it’s something that the whole family is dealing with just get the home looked at to start. It’s usually cheaper and more effective out of the gates.
Evan Brand: Yeah. well said. And, heavy metals too. I’m glad you brought that up. You know, mercury and other heavy metals that can stimulate the nervous system and cause issues. So, if you have a bunch of silver fillings in your mouth, you’ve got to consider that. May not be your number one smoking gun, sometimes it is but heavy metals are a big problem and even detox too can make people feel too sick. I mean, you and I have seen this many times. Other practitioners that have handled people before they come to us or they’ve done something too aggressively with chelation or other detox methods and then they’ve ended up worse. So, there’s like a tight rope and that’s where the art of medicine comes in. Everything is not just like cookie cutters. So, too much is a problem. Too little is a problem and that depends on gut and detox and beta glucuronidase and liver and all of it. So, like if your friend got better and you tried what your friend did and you didn’t do well, that might not be your right protocol.
Dr. Justin Marchegiani: Yeah. Exactly. And then, just to kind of highlight the nutrients in, compared to talk therapy, Julia Ross is out there. She’s like a family therapist person but she’s done a lot of books on amino acids and diet and she had different clients that she used to use talk therapy for years and years and years and said, “hey, let me just try adding in some amino acid therapy to their protocol and let’s see how they do with their talk therapy when we add in the amino acids”. She started to do that and then these patients would come the next week and they’d be like, “Yeah, just, I’m just good. I just don’t even feel the need to talk about it. I’m over it”. And it’s like wow so it’s like it gives people the equipment to kind of, like, process these issues and again I think talk therapy acutely may be fine. It’s just when you’re talking about the same thing for years and years and years, you’re probably not getting to the root cause, right? This is probably just covering up something else, you know. Now, I think it’s better than being on a drug, right? So, if it’s helpful and you don’t need a drug that’s great but, in the end, you know, if you can do some of these nutritional things along with it, you may find that you can just deal with the issues better you know I, the analogy I get patients is, try dealing with difficult problems around the home and not having slept for a couple nights. You’re gonna lose your patience with your wife with your kids. You’re not gonna be able to think right, you’ll be foggy, get some good night sleep and then wake up and deal with the problem. It’s like you’re gonna be way more equipped to deal with it. I think that’s kind of how brain chemistry works when you’re dealing with these stressors.
Evan Brand: Yeah. Absolutely. Well, I remember in that book too, talking about how, like, amino acids were administered, right? At the beginning of a session and then the people would just immediately like, smile or loosen up or relax and so it’s amazing no matter how much you talk. Long story short, I know we’ve beat the drum on this for a minute but last thing, no matter how much you talk. It’s never gonna change your levels of serotonin just by talking it out. If you have a gut problem that’s affecting your nutrient absorption which is affecting the tryptophan and the conversion with the B6 over to 5HTP and then over to serotonin and then to melatonin so sleep issues too. So skin, sleep, anxiety, they’re all connected depression. We’ve already talked about that. This person here’s putting a bunch of question marks like they’re mad at us. What is the connection between Accutane and depression?
Dr. Justin Marchegiani: It’s just a side effect. It’s a side effect of the drug.
Evan Brand: It could be a side effect. Yeah.
Dr. Justin Marchegiani: Yeah. Just the side effects of the drug. That’s all it is. Yeah. So certain drugs, you know, are gonna have side effects. Ibuprofen can cause ulcers and liver issues, right? Just a drug side effect.
Evan Brand: Yeah. Well, we got to wrap this thing up. But if you need help clinically, you can feel free to reach out. We work with people around the world. We send these functional medicine labs to your door. We have an incredible logistical team on both sides where it’s incredible. We can help people in literally every part of the globe where people like us don’t exist or maybe they do but we’re better. So, if you need help, you can reach out directly to Dr. J, that’s Dr. Justin Marchegiani at justinhealth.com for consults or me, Evan Brand at evanbrand.com. We’re happy to help. You guys, don’t give up. We’ve been through it. We are warriors ourselves and we’ve worked on our health for years and we love what we do and we love helping people and there’s so much possibility when you can beat an issue like anxiety. So, like I said in the beginning, whether it’s seeking that raise, that new promotion, that new job, that new spouse, you know, that partner, that relationship that you want to grow but you can’t because you’re held back by anxiety. This is a huge huge problem and you can overcome this. So please don’t give up.
Dr. Justin Marchegiani: Yeah. If you guys enjoyed it too, look down below, you’ll see a little link where you can write us a review. We appreciate the review and if, also, it’s benefiting you, feel free to share with family and friends and there’ll be links where you can reach out to us directly to get that extra bit of help. All right guys, have a phenomenal day. Take care. Bye everyone.
Evan Brand: Bye-bye.
Dr. Justin Marchegiani: Bye.
Top 5 Reasons You Are Losing Muscle Mass | Podcast #369
Muscles are essential to everyday movements, and if you noticeably lose muscle mass — especially without knowing why — it can be alarming. Losing some muscle mass is normal as you age. However, losing muscle mass quickly or atrophy, especially in the context of other symptoms, can indicate an underlying illness.
In this video, Dr. J and Evan discuss the top reasons you lose muscle mass aside from aging. Preventing a loss of muscle mass can also be achieved by exercising regularly (such as functional strength training) in conjunction with a balanced food template of lean meats and proteins, fruits and vegetables, healthy fats, and whole grains.
However, if the loss is due to an underlying illness, it must also be addressed and mindfully managed with a trusted healthcare professional or your functional medicine doctor.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:33 – Functional movements
3:37 – Infections
7:21 – Vegan-vegetarian
9:35 – Autoimmune digestive disorders
12:21 – Hormones
15:06 – Types of muscle building
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be chatting about the top five reasons you are losing muscle mass. This is really important. All right. If you’re losing muscle mass, it’s gonna be essentially an all-cause predictor of mortality, increased mortality. So, we gotta make sure that we’re keeping our muscle mass and or improving our muscle, especially as we get older, we need good muscle to support and stabilize our body so we don’t get hurt, we don’t slip, we don’t fall, we don’t get injured. We don’t slip a disc so to speak. So, we have to make sure that we are keeping our muscles strong and functional. Evan, how are we doing today man?
Evan Brand: Doing really good. I talked with a guy actually this morning where his mother, due to age and related muscle loss, fell, broke her hip, got in the hospital, had to get surgery, got an infection, died. So, I’m not saying everyone is gonna end up like that. But my God, look at how quickly something just like a fall due to lack of muscle strength and mobility could turn into something scary where you’re hospitalized, you’re getting surgeries, you end up with a hospital acquired infection then you’re on antibiotics then you go septic, I mean, this is crazy and so I hope we can help people prevent. This is such a common story. I mean, how many times have you heard, like, old granny falls, breaks her hip and that’s the end of her. She never recovers. It’s like, that’s not good. And so, fortunately, in the past, up until the past couple years, both of my grandparents right around 80 years old, they were playing tennis and they were still active in mobile so I just encourage you guys, just because you’re getting grow older that doesn’t mean that you need to become a couch potato. Even some of her friends that she’d played tennis with are in their mid-80s, still playing tennis, still moving well on the court. So, I just encourage you to find something that you love first and foremost. Use exercise as a side effect of having fun, meaning, if it’s pickleball, if it’s tennis, if it’s ping pong for all I care, I mean, basketball, volleyball, I mean, whatever you can do it. It doesn’t have to necessarily be intense. That’s all fun stuff, maybe competitive, fine. But exercise is a side effect of it. But if you’re just trying to depend on willpower to go run a mile, I think that’s a terrible long-term strategy and I don’t think you’re gonna like to continue with it, like my row machine, you and I both, we have the same row machine, we love it. You can go on there, and you can do little games, you could do just row, you could pick like, oh, I’m gonna, I wanna burn 10 calories or I wanna grow 500 meters and you have this like goal that motivates you to do something, but at the end of the day, all this physical performance is gonna pay dividends.
Dr. Justin Marchegiani: No. Exactly. 100 percent. So, when I kind of, when I lift weights, I’m always trying to do functional movements, I think as you get older, especially as you know, you move into adulthood, you want muscles, right, you want to look fit or lean or trim right? You wanna feel solid but you wanna have functional muscles. One that allows you to do housework or click pick-up your kids easier and feel more confident or do well at your sport or just be able to enjoy life and feel good like if you think about, like, getting into a car, right? You get into a car, it’s like a one-legged kind of squat, right? So, I’m a bigger fan. As you get older, trying to do more unilateral body movements, meaning like a one-legged squat, a one-legged lunge or a lunge obviously with that, you know, you can look at discrepancies in your body. If you’re doing a squat, you know, you have other sides that you can compensate for but when you’re doing one-legged movements either a dead lift or a squat or a lunge or a step-up, it magnifies imbalances in the body. I like that because most of the time, when you’re moving, you’re actually on one foot in a sense and so it’s good to do movements like that so you start to develop a lot of the stabilizer muscles that support you when you’re moving so you don’t get hurt.
Evan Brand: Let’s get into the functional stuff, like the functional medicine stuff, not functional movement but like functional reasons, I’m gonna go ahead and say, number one as a category of infections and you and I can break this down as much as you want. Yeah. I’m gonna say infections because you know my story, you saw me, I lost like, 25 pounds without trying and some of it was related to H. pylori. I think the parasite also wrecked me so I would just say infections as a whole.
Dr. Justin Marchegiani: Yeah so when you have inflammation in the gut, right, it can be cause by infections like a parasite like Cryptosporidium, Giardia, Blasto, H. pylori, bacteria in that category, SIBO, general dysbiosis, bacteria imbalances, right? It creates inflammation in the intestinal tract, right? Whether it’s small intestine, large intestine, if you look at where these nerves sit on the spinal column, they sit in the lower thoracic to lower lumbar spine, and you know, let’s say t10 to L5 or so. Maybe even, maybe even S1 and when you have inflammation in the intestines, it’s on a two-lane nerve root highway from your intestines to your spine back to the muscles, right, so we have what’s called a visceral somatic reflex. So this Visceral means organ, somatic means muscles. So inflammation in the organ can actually take that signal of inflammation put on that two-lane highway to the muscle and it can actually create that muscle to shut down or not be fully facilitated or active and so with inflammation in the intestines can cause that. Now, women know this just think about the average women that has PMS and has PMS symptoms of back pain. It’s their ovaries having inflammation or hormonal imbalance that’s then refluxing to the muscle, right, visceral organ, somatic muscle. So, women know that if they have PMS or if you ever had a gallbladder issue, you feel it in your shoulder, if you have appendicitis, you feel it in that lower right hip quadrant, right? If you have a heart attack, you feel in the jaw down the left side down the left arm so we know there’s this organ muscle connection so a lot of people can have muscle issues because their core and their back gets very weak due to inflammation in their intestinal tract and the more inflammation there is the less likely you’re wanna, you’re gonna, wanna lift and want to do one of them, you know put resistance on your body because you’re just more inflamed and you’re more likely to get hurt and injured.
Evan Brand: Yeah. So, if you, now, not all people lose weight and I’ve seen many women who gain weight magically 20, 30, 40, 50 pounds, sorry ladies, sometimes it happens that way. It’s where you gain weight due to infection but for me and I’ve seen other men the same, you lose weight, so I don’t know, I would just say this, any fluctuation whether it’s weight gain, including muscle loss so you could gain weight and still lose muscle right. You could gain body fat and lose muscle so whether it’s a significant, let’s say 10, 20 pounds or more weight loss or weight gain with no explanation, I would definitely look into the gut, start looking for infections and as you mentioned, the strength is important and people don’t want to get strong if they feel like crap and so for me, luckily, my gut’s much better and now I feel good with resistance training whereas before I was just so depleted. So, let’s go into reason number two, I’m gonna say nutrient deficiencies, now, this ties directly into infections right because in the case of H. pylori, if it’s reducing stomach acid. Now, if you’re eating this good grass-fed steak, you’re not really getting as much nutrition from that and so these nutrient deficiencies compound over time because if you don’t have the amino acids being cleaved off the meats to produce muscle mass that also creates a big problem so nutrient deficiency and we could go any direction you want with this even vegetarian vegans, we could talked about the deficiencies there and how they’re gonna have trouvle with muscle mass.
Dr. Justin Marchegiani: Yep. 100%. So, of course, if we have vegan vegetarian, we’re not gonna get enough carbohydrate, we’re not gonna get enough protein, typically or if we get enough protein, right, let’s look at the combination of rice and bean which is a pretty common one. Well, you end up getting 70 grams of protein to 15 grams or so of carbohydrates so you get a lot of carbohydrates. Now, if you’re not that active or you’re more insulin resistant, you know some, most people are gonna need probably a minimum of half their body weight and in ounces of protein so if you’re like 200 pounds that’s 100 grams of protein. Well, do the math if you’re getting 15 to 20 grams of protein per 70, 75 grams of carbs that’s you know, 75 times five, you’re looking at like 340 to 400 grams of carbohydrates. Obviously, you can fix some of that by doing, like, a protein shake, like protein or hemp protein, you know, you can fix some of that. But again, you’re still relying on artificial sources, not whole food sources. Now, the benefit of the animal product is you’re gonna get all the protein, none of the carbs and you’re typically, if they’re grass-fed and pasture-fed, you’re gonna be getting excellent good fatty acids along with it and you won’t be getting a lot of the excess omega-6 fatty acids like you’re not gonna get on the vegetarian vegan side. So, you have this nutritional density that you get on the animal side which is wonderful and as long as we’re choosing you know, avoiding the factory farm, you know, we’re doing grass-fed pasture-fed, you’re gonna be in great shape and the next thing after vegan vegetarian is low stomach acid so if we have achlorhydria, low stomach acid, and that typically connects with low enzymes too, we may have a hard time breaking down a lot of that proteins. So, I know when you had some of your gut infections years ago, I think you had what Cryptosporidium, Gardia, H. pylori, that’s it Three Amigos, right? And so, when you had this gut infection, you also had lower stomach acid, lower enzyme levels. So, supplementing the enzyme and the acid so we can break down those amino acids and then also adding in or cutting out the bugs is helpful and then sometimes adding in some amino acids in a free form can be helpful because 40% of the Energy that you get from the protein actually goes into digesting the protein. It’s like having a credit card with a 40% transaction fee, right? Very expensive. So, there is some benefit by doing amino acids, if it’s already broken down but we still wanna make sure the whole food is dialed in and that we’re getting enough, uh, we’re getting access to the whole food nutrients via hydrochloric acid and enzymes too.
Evan Brand: All right. Moving on to another cause here, and this is inspired by a comment here from Teresa, she said that she has muscle wasting from my colitis. So, we could just say, any gut issues and that one include autoimmune gut issues, right? So, colitis or what’s called pancolitis would be the whole colon, even celiac, Crohn’s, I mean, any of these autoimmune gut issues oftentimes that’s gonna create a lot of muscle wasting that ties directly into what we just said though which is nutrient deficiencies and infections. A lot of these people with major gut issues, like this, there’s usually a trigger. Now, in the case of like, celiac, obviously, that may or may not have a parasite infection involved but this is still part of the equation and we can use gut healing nutrients to work on this, you can put some of this stuff into remission but you know what, I don’t want people to do, you know, what I don’t want people to do is like eat clean all week and then they go eat garbage on the weekend.
Dr. Justin Marchegiani: Correct. Yep. 100%. And so, of course, if you have colitis, right? Whether it’s microscopic or ulcerative colitis, you know, it’s an extreme irritable bowel disease, you gotta look at the foods and then sometimes the foods could even be in vegetables it could be in the oxalates, the phenols, the salicylates, the FODMAP, so sometimes even healthy foods on paper could be problematic and then of course, you know, the grains and the dairy and he refined carbohydrate and the omega-6 fats of course those right. So, getting the inflammation via food is super important, we talked about dysbiosis, we talked about SIBO, H. pylori, of course is super common because H. pylori is notorious for lowering stomach acid and so of course, if we’re just taking stomach acid and enzymes and we’re not fixing the H. pylori, you know, that may not get to the root cause. So, if we’re taking supplements like hydrochloric acid or enzymes or bile support, we also got to make sure we’re getting to the root cause of any additional bugs that could be present and if we’re chronically stressed like the adrenals if we’re in sympathetic fight or flight the sympathetic fight or flight nervous system tends to be more catabolic than anabolic. So, anabolic is building back up, healing, recovering, getting stronger. Catabolic is breaking down. So, from this fight-or-flight state, our bodies always tend to be it. You know, running versus, building and growing and so if you’re catabolic from the adrenals being over active with cortisol, that’s gonna make it hard to build muscle, you’re gonna be breaking down the muscle instead, making glucose out of it and it’s also gonna be harder to digest because your body’s hard wired to take blood and bring it to the extremity so you can fight, flight or kind of run versus to the organs so you absorb and break down. So, that fight or flight is really important in fir digestion, for where the blood goes and also and how it allocates nutrients. It’s more likely to break down muscle than build muscle back when that fight or flight is really active.
Evan Brand: That’s a good call. That’s exactly where I was gonna go next is hormones, I was gonna talk about maybe low testosterone. We’re seeing that in men in their 20s, 30s, 40s, I mean just low hormone levels and women need some level of testosterone too. So, if you do hormone issues whether that is adrenal related cortisol, thyroid hormone, maybe you can riff on that for a minute because I think people are focusing on gut gut gut, which is great but there’s also this other connection of the hormone piece and I will tell you my cortisol was completely depleted when I did a salivary panel years ago. My cortisol was flat all day and it was really tough no matter how much I tried in the gym, I was weak. Like, just my God, I could not make progress, fortunately better now, but man I’ve been through it.
Dr. Justin Marchegiani: Yeah. Some people, they may be high with their cortisol and we have to use adaptogens to calm it down of course, like good diet and lifestyle things, some may be low and typically you don’t just go low all of a sudden. You ten to be on the higher over stimulated side for a while and then you ten to crash and that’s where that low cortisol kind of comes together and with that chronic cortisol, a lot of times we see low DHEA, and DHEA is important because that’s gonna be a precursor to a lot of men and women’s sex hormones and so women will go more down the estrogen side. Men, it will trickle more down testosterone. These are both anabolic hormones and so if we have lower DHEA, that tells us the adrenal issues that are going on are more chronic and DHEA will go downstream to more of these anabolic building up type of hormones so very important to take a look at your DHEA because that could tell you if you’re more catabolic inflamed place. And also too, if you do exercise, I get it if it’s like your first couple of movements, It’s like a new exercise kind of thing, you may be a little bit torqued. It’s new but you shouldn’t be overly sore after your workouts. If it’s a new thing, fine, or it was really you know, an acute hard workout but in general you shouldn’t be overly sore, you know, more than two days or so later. You really shouldn’t, you should still be able to function like maybe you feel it like it feels like you did something but it’s not overly sore if you are um and it was a reasonable amount of exercise, it wasn’t like you did too much you’re probably in a more catabolic state, and it’s also you could be over exercising too. So, you gotta make sure you’re not over exercising.
Evan Brand: Yeah or I’m thinking like what about lactic acid build-up too due to gut bacteria or a mitochondrial issue due to some sort of toxin where they’re just depleted, they’re not recovering well, they’re not performing well. So, maybe not directly related to muscle mass but I think mitochondrial issues could be something to look into. You and I measure this and look at this on an organic acid test and we often find a lot of issues, I mean we’re in a toxic world with a lot of chemicals, metals, pesticides and so these things damage the mitochondria which to me would directly impair your ability to perform. Is it directly reducing muscle mass? If your mitochondria are damaged, I’m not sure on that. I’m sure we could look into it but it makes sense.
Dr. Justin Marchegiani: Yep. Absolutely. So, a couple different types of um ways you can build muscle, right, we talked about resistance training is obviously gonna be my favorite, right? So, we can do resistance training that kind of acts like cardio so if we do let’s say three or four movements back-to-back to back-to-back that kind of acts like cardio like or instance if I do like bicep curls, right, this is resistance training, you’re probably not gonna see a big bump in your heart rate which is bicep curls, right? So, there’s resistance training where you’re not getting a cardio effect and it’s resistant training where you’re actually getting a cardio effect. So, just like, people think cardio, like, oh, I’m gonna try them all that’s cardio. It’s well no, you can do exercise that’s resistance and still have a cardio effect. So, if I just did like bicep curls or tried extensions probably not a big cardio effect. Now, if I did like bicep curls and then I paired that with the next exercise, let’s say kettlebell swings, right and then the next exercise being some type of full body row or a lunge, you can see how you start getting more muscle groups involved. Your heart rate starts to go up significantly. So, that’s nice because there’s some benefit if you look at some of the zone two exercise theories that are out. With zone two exercises, essentially, when you’re working at about 60 to 70 percent of your max heart rate so if you’re at typically like you know, typically around if you’re like max heart rate for most people in their 40s or so will be like maybe around usually, it’s 225 minus your age and so if you’re like 40 that’s like what 225 minus 40 would be like what 185 and so you do 185 times 60 or so that should give you then you’re around like typically around 120 or so for your heart rate so they want you to stay around 120 for about 30 minutes. Now, you may find that you kind of have that zone 2 type of benefit while you’re actually doing lifting, if you kind of do it in a circuit fashion, then you choose movements that are more compound, you may find your heart rate stays that high. Now, the benefit of zone two is you get this really nice drop in your resting heart rate. There’s a lot of people that are reporting a lot of their data from like their fitbits or their or rings where they just have a significant drop in the resting heart rate that they wouldn’t necessarily see for like interval training or I’m sorry like a type of a tabata training where you’re like high intensity low, right? So, this kind of steady state thing for 30 minutes, you know, could have some cardiovascular muscle benefits and you may also be able to get some of that like if you do circuit movement so you can, you know, get one of these fitbits and measure your heart rate while you’re doing it and see if you can stay around 120 for that 30 minute phase that kind of put you in that zone two category around 120 or so.
Evan Brand: Very cool. There was a comment in here from Selena, what about muscle wasting with chronic Lyme? Yeah. 100%. Unfortunately, I’ve dealt with Lyme with co-infections from many tick bites over the years and that’s a big big factor because Lyme loves collagen. It really likes to eat up your collagen reserves and then the inflammation it creates, that invites other things like the Bartonella to move in and create more inflammation in your joints. I’m sure that is a big big factor for you. I think you can get better from it. I’ve certainly gained muscle mass even with the infections, I would still throw it in the infection category though. I think the gut infections are a big one too so don’t go all in online and forget the gut bugs because if you’ve got H. pylori, I think that’s a bigger smoking gun for your digestion. Lyme could still wreck you and cause you to lose muscle, I know one of the girls that I used to work with, I saw her recently at a park and she was so skinny, skeleton skinny and she’s had Lyme for like a decade so I know it really affected her in that way but I do think some of that is reversible if you work on the bugs and get your gut better.
Dr. Justin Marchegiani: Yeah. And also, people that have Lyme, it’s very rarely it’s just Lyme. It’s like Lyme but then they have, like a ton of dysbiosis, really poor digestion, so it’s usually people are already in this kind of not so great state and then Lyme comes in there and it’s the straw that breaks camel’s back and because it was the thing. They pushed them over the finish line. They just look at Lyme as being the culprit for all of it and therefore, I think it’s all then all they do is focus on that one thing because they think, oh well this is the root cause because this is what happened when everything went sideways and they get myopically focused on just that and then they’re on these crazy herbal antibiotic protocols for years and they don’t fix the other thing so still get back to the basics with your digestion with your, you know addressing the guts, um, really addressing all the stressors, the adrenals, make sure all of that’s kind of dialed in. Also, how did you do with collagen, I mean I found collagen it’s just great for building up that connective tissue because even like in today’s day and age, we’re getting a lot of muscle meat from our protein source, we’re very, we’re not getting enough of our connective tissue or skin or hide or those type of things like the soups and bone broths probably our ancestors used to do. We’re not getting a lot of those amino acids which are really important for connective tissue.
Evan Brand: I do good with it. I do it every day. I do collagen protein every day so it helps man. I don’t have any elbow problems anymore, my knees are better so like my joints are like so much better, my skin is probably better, hopefully that’s helping with the muscle too. She commented that she did have Bartonella and Babesia. So, yeah, that’s a triple whammy, I mean, you gotta keep working on it, I’m not a fan of the antibiotics, this is a topic for another podcast but you had mentioned that you were doing antibiotics and you know that typically causes the Lyme to go into like a cyst form where it hides from the immune system and a lot of people rebound and relapse on that so I prefer herbs.
Dr. Justin Marchegiani: Yeah. And also, if you go look at all the antibiotic side effects, they all match Lyme as well and so it’s like joint pain, fever, malaise, and so there’s like you see a lot of these conventional or should I say more natural minded medical doctors like oh that’s just
Herxheimer, that’s like but it’s like you literally are giving something that has the same side effects of the disease you’re trying to treat and so that’s why we tend to like herbal treatments that are more gentle and we’re trying not to hurt and we’re trying to kind of choose a low dose of herbs that are gonna allow us to support the immune system, still have an antimicrobial benefit, we’re still providing a lot of antioxidants and nutrients in the herbs which is the benefit of the herbs and they don’t cause as much mitochondrial damage while we work on everything else. So, we’re still not gonna ignore everything else and we’re gonna find a treatment that makes sense and doesn’t make you feel sicker and have this self-fulfilling prophecy that the side effects actually match the disease that you’re taking.
Evan Brand: No joke. I mean, we do a whole podcast. Let’s do one sometime on this but she said that she was tired of antibiotics, it’s been three years. Yeah. I mean, that’s affecting your gut which is affecting digestion. We know antibiotics damage the mitochondria so if someone had muscle mass and they had done antibiotics, obviously, you got to look at the gut so I would recommend that you do a stool panel. Do organic acids, try to uncover it, somebody said I look like Arnold Schwarzenegger with the beard, I hope that’s a compliment. Thank you.
Dr. Justin Marchegiani: Yeah. There you go. I like it. Very good. So, I hope this helps everyone out of the gate here. I mean, just kind of like start from the basics like all right, so to keep your muscles strong you have to have one not be stressed, right? So, do not put yourself in a catabolic state. Think of like, your adrenals being an overdrive, think of like good sleep, good hydration, good food, allowing yourself to be in a parasympathetic nervous system state. Deep nasal breathing, right, appreciation, gratitude, right, make sure we have good digestive support enzymes, HCl, we’re eating a really healthy anti-inflammatory, nutrient dense, low-toxin template, again, I have some patients that have autoimmune conditions where they have to be even more carnivore because they’re really sensitive to the plant nutrients then after that, looking at all the bottlenecks that could be absorbing things or causing absorption problems in the gut, right, like Evan mentioned, Evan had three Amigos, right, Giardia, Crypto, and H. pylori. And then looking at any of the other bugs there and then of course what types of movements are you gonna do, right? You can start out with just walking if that’s kind of a foundational level then you could start off with some type of a you know circuit training, picking three or four movements and going back-to-back-to-back. You could do some kind of a zone two cardio thing where you do about 30 minutes or so at 120 beats per minute and you can do something non-impact. I like rowing because rowing devices you’re using upper and lower body and you’re putting your body into extension or most of the times on like cardio, you’re kind of like hunched over and like doing your elliptical or you’re running like this or you’re kind of in this flexion state where a rower you’re kind of opening up so that’s kind of cool so those are a couple of tools you know to stimulate the muscles and to um make your heart work as well as make your muscles work.
Evan Brand: I love the rower. Hiking too. I mean, hiking is so easy.
Dr. Justin Marchegiani: Yep. Hiking is great.
Evan Brand: I really love it because there’s a lot more variability in your movement as compared to walking on a flat surface so I’m having to like bring my leg up more to go over that rock to go over that tree root like it’s a lot of more leg involved than a flat surface so I love it as long as I’m not getting a tick bite, I’m happy in the woods.
Dr. Justin Marchegiani: Yeah. And my favorite functional movements would be like a one-legged squat, uh, it’s excellent and you could just have a chair underneath you where you sit, touch and come back up and you could put up like a phone book on it or something so you don’t have to go all the way down to parallel, uh, a single leg deadlift is excellent and step up. I know, right. I know you can just grab whatever book right. I’m thinking up like the thickest book I could think of right. You know something like that. And then, you could do that and then you could do a step up which is great like on a plyo box and step up. That’s what this is.
Evan Brand: How about, I mean the jumps? Obviously, that’s more intense but man those jump boxes, my God, that’ll, you talk about workout, that’s intense.
Dr. Justin Marchegiani: Yeah. Yeah. I mean those plyo boxes are wonderful, I mean, I like is that
Evan Brand: What it’s called the plyo like p yeah how you spell that?
Dr. Justin Marchegiani: Yeah. Like P-L-Y-O like a plyometric box
Evan Brand: That’s where you’re jumping up and down up and down?
Dr. Justin Marchegiani: Yeah. I actually like going on top of those and then just jumping off and then get into a squat because then you’re teaching your body like I’m generating all this force and I’m trying to absorb it so you’re teaching your body to be a shock absorber like just soak up energy which is great.
Evan Brand: To think about that, that hurts my knee. Thinking about jumping off, I used to, I screwed up my knee years ago though you know, I was jumping off loading docks like behind warehouses when I was a kid with a skateboard and when you bail off the skateboard I would land flat on the concrete, my God. That hurt. That was done.
Dr. Justin Marchegiani: No. Totally. But yeah, if you’re putting your joints in that kind of intensity, make sure your form is good. Some people say don’t go knees over toes, there’s a whole knees over toe guy on I think Instagram that talks about knees over toes but if you do that just make sure your form is good and you’re not causing any inflammation. Make sure you have enough protein and collagen, amino acids on board as well so you’re dialed in.
Evan Brand: Yeah. And if you need help please reach out, we work with these issues all the time. We’ll help you investigate what’s going on. You may have this root cause, you may have that root cause, you may have multiple root causes but we’re happy to help find the puzzle pieces because you can’t fix what you can’t find so that’s where we come in, we’re happy to help you with this issue. If you want to reach out clinically, we work around the world with people we’d love to help. You can reach out to Dr. J directly at justinhealth.com and there’s consults available everywhere, lab testing, we can get it to your door. It’s no problem. If you’d like to work out with me, not physically but work out with the labs, let’s do it at evanbrand.com. So, justinhealth.com, evanbrand.com, we’re happy to help.
Dr. Justin Marchegiani: Yeah. We’re here to help and we’ll put some of the products that we talked about like collagen and some of the nutrient support, we’ll put them in the description below so if you wanna access some of the things that we recommend for our family and patients and take ourselves, feel free and access that. All right guys, hope you have a phenomenal day. Take care of you all. Peace.
Evan Brand: See you. Bye-bye.
Dr. Justin Marchegiani: Bye.
Evan Brand: Bye.
How to Address Sinus Infections Naturally | Podcast #368
A sinus infection, also called sinusitis, is a common problem that causes your sinuses to swell up. The sinuses become inflamed and cause symptoms similar to the common cold. Many people can contract a sinus infection after having a cold or the flu. A bacterial infection usually causes sinus infections, but viruses or fungi can also cause them. These infections can either be acute or chronic.
Dr. J and Evan discuss nasal flushing, which can help clear the mucus out of your sinuses. It is one of the most effective home treatments for a sinus infection. They also emphasized the importance of rest, filtered air system, and other nutrients to boost the immune system.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:17 – Nasal flushing products
10:03 – Mucus and nebulizer
16:54 – Sinus anatomy
Dr. Justin Marchegiani: For today’s podcast, we’re gonna be talking about how to address sinus infections naturally with Evan today. Really excited. Good topic here. It’s a common topic that people are experiencing especially in the winter season so we’re gonna go through it. What we gotta do to heal fast from sinus infections naturally. Evan, how are we doing today?
Evan Brand: Hey, doing really well. Why don’t we start with the conventional approach? What is that? If you go to your ENT with a sinus infection, what are they doing?
Dr. Justin Marchegiani: Well, it depends, I mean, some are gonna be more antibiotic hesitant and say well you know it could be a viral infection, right? You know, almost a quarter of all antibiotics are actually prescribed for sinus infections. You know that? It’s crazy. So, most of the time, they’ll wait and see how bad it is. See if you have a fever, uh, usually like you have that punch in the face kind of feeling where your teeth are really starting to hurt, chronic headache and then you’re having a fever usually they’re waiting seven to ten days or if it’s gotten better and then gotten worse again and it’s usually seven to ten days out with a fever then they’ll start to, you know, typically prescribe antibiotics. Again, most sinus infections are viral so you know, you have to get to the root cause of that so a lot of times antibiotics won’t work. The problem with antibiotics is you’re swallowing it, it’s going 2 or 3 feet away from the actual issue so you’re basically dropping a systemic bomb to instead of hitting a localized area. Now, there are some more, I would say functional based medical doctors that may do some kind of an antibiotic in a compounded powder like an amoxicillin, something like that in a suspended solution or powder and they put it in a sinus rinse bottle like this and then you can flush your nose with that. Better, right? At least it’s more localized. We’ll talk about some strategies using saline flushes and different things that I recommend to help get that under control, naturally and not have to destroy your microflora in the gut. So, that’s a big thing out of the gates which can be very helpful. I got a sinus infection last week from a viral infection that my kids brought home. I never have been exposed to so many bugs since I have two young kids, 2- and 4-year-old boys that go to an outdoor wilderness school and they bring stuff back home from all their classmates and so I’m getting inoculated every single day and so we’ll talk about some of the strategies that I take so I can recover fast.
Evan Brand: Yeah. I still hear a little bit of you. So, what are you doing? You mentioned you got some kind of tools on your desk there.
Dr. Justin Marchegiani: Yeah. So, couple of things out of the gate, you know, to irrigate or flush that area out can be very very helpful. One, to flushing the viral particulate out. Two, we may add in some components to actually help kill what’s up in the nose as well. So, we have our saline, so you can either do NeilMed saline, which is really good. We’ll put links down below. The Neti Xlear is really great. I’ll kind of go back and forth between those. I have both. And so, we’ll take this and you’ll add eight ounces of water in one of these types of bottles. This is actually the best bottles. It’s made by Xlear. It’s Xlear’s bottle. It’s the best because of the plastic isn’t cheap so when you press it, it recoils really fast so when you’re doing good flushes, sometimes you’re pressing and then you’re having to let it reload so to speak and it’s just a really good plastic. Some of the plastics are weak so then, it kind of just stays sunken in so I also have a NeoMed bottle, definitely a cheaper plastic. And there’s another bottle by Walgreens. It’s even cheaper. So, this one is okay, you know, they give it away with like 60, 70 packets of saline so it’s pretty cheap. It’s a nice bottle. I have like three or four of them lined up in my office sink so when I’m in between patients, I’ll just give it a good flush. And so, we’ll take the saline packet. We’ll mix 8 ounces of water; we’ll add it to it and then I’ll take either food grade hydrogen peroxide. You could do regular hydrogen peroxide from the drug store. It’s not as big of a deal if you’re nebulizing it. Again, it you’re flushing it, if you’re nebulizing it, you probably wanna go more food grade just to make sure any stabilizers are out. And then, I typically just fill it up just enough to cover the bottom part of the cap. That’s it. Just about that.
Evan Brand: That’s like a dash. I mean just a tiny amount.
Dr. Justin Marchegiani: Yeah. And you know, you went too much if you put it into the water and then I would just pour it into the saline, my finger over and just shake it up and then you know you did too much if you feel any kind of irritation or burn. You can so you can always start less and kind of work your way up and then if you do too much you can just add a little bit more water to it and back off so that’s a good option right there. Another option I have is I’ll do like my GI clear 3 silver and I’ll add a cap full of that to it. You can do that. You can add just straight up betadine iodide. I’ve stopped doing that because of the orange color. It just stains. It’s really annoying so I’ll go to, like, a clear simple potassium iodine which is good. Those are a couple good options out of the gates and so we’ll basically irrigate 2 to 3 seconds of flow, clear everything out and blow your nose in between. 2 to 3 seconds of flow below your nose. That’s a good way to do it out of the gate. Now, there’s a couple of other strategies that you can do, so some of my sinus sprays that I’ll use and so I have 3 big sprays so here’s extra rescue which is really a good one because it has six different herbs in there. It has, like pau d’arco, parsley, eucalyptus, oil of oregano, tea tree, right, so it’s really good. Six different herbs and so what I’ll typically do out of the gates if you’re new to using the product. I’ll do it, about 2 sprays in each nose, about ten minutes before a sinus flush. What I find is, it starts to, like, agitate and release all the mucus. That’s kind of stuck to the inside of the sinus cavity and so like five to ten minutes before spray it, wait, and then do a sinus flush. I find that it releases things a lot better. So, that’s really good there. And once you’re better with it and you feel more comfortable, you can do it after as well. Just see how you feel. If you’re really, really inflamed too, there’s another product called Xlear max, which is a good one.
Evan Brand: I’ve never tried that one. I’m scared of that one.
Dr. Justin Marchegiani: Yeah. Well, the rescue one, I think, is like the strongest form, like a killing perspective. The Xlear max is more, like anti-inflammatory. So, the big difference is, this, the last one was grapefruit by the way and the Rescue.
Evan Brand: Okay.
Dr. Justin Marchegiani: And so in the max, the difference is it still has the same saline, still has the same xylitol. So, this has xylitol plus six herbs, okay, saline. This says xylitol saline, the difference is it has aloe so it’s a little bit more soothing, all right, for the sinus. It has the grapefruit as well, which, so it still has some killing effects in it and it has some capsicum which is like a homeopathic anti-inflammatory. So, this is like, if you’re like the tissue is really inflamed, really raw, this is a better one. This one’s really good for killing because of the different herbs that are in there. And then, there’s a regular one out there. I have it upstairs, as well, which is the regular Xlear and that’s more like people that have chronic sinus issues, you can use that more every day and it’s a little bit more gentle where it’s just the xylitol and the grapefruit extract and it has the saline and again the benefit of that, the xylitol, it really kind of knocks down some of the bacteria that could be there. It prevents biofilms from adhesions so biofilms are like the protective shields that a lot of the bacteria used to protect against the bugs. So, that’s very helpful. And so, the nice thing is if you do the saline, right? Oh, by the way, the water reverse osmosis or distilled, make sure it’s high quality filtered water. Do not use your general tap water, very bad, so make sure it’s really good. Don’t even use, like, river water, it’s gotta be really good clean filtered water. Like even now and then, I’ll use the water out of my faucet because I have a whole house activated charcoal system so it’s still good but I also have a RO system where my countertop is, so that’s where we cook in and drink out of that water so I use that 99% of the time. So, I’ll use that, I’ll add the packet, fill it up to 8 ounces, pack it and then I’ll add either hydrogen peroxide or silver. It’s good to have a couple that you rotate through just in case there’s some resistance which is, you know, meaning like there’s some bacteria or viral resistance. It’s going to have a couple of things there and then I also have just a straight grapefruit and saline solution as well. This one is okay. It’s gentle and so those are good ways to do it. I recommend, start to do it before you flush like 5-10 minutes before because a lot of times it just releases a lot of mucus and then it allows the flush to do really well and then depending on how you feel afterwards, you can also try it after a flush and then give it a sprayer. So, once everything’s really clean and see how you do afterwards. So that’s a good start out of the gates. Of course things like N-acetylcysteine are wonderful. NAC is great. That helps with the inflammation. Really helps drying up the sinuses. I’ll do glutathione, as well. I’ll do high-dose vitamin C. We’ll add in some different nutrients, zinc, those kinds of things as well. All the good immune nutrients, vitamin D decrease all the sugar consumption. A lot of that is very very helpful. I also have a red light in the office and so I’ll kind of go up against it and let the red light get in there because that’s very anti-inflammatory as well.
Evan Brand: Man, I should have paid better attention to the label on that Max. I was afraid of that one because I thought that one was more intense than the rescue. I’ve done the Rescue forever. I kind of like the berm. You will get a little burn with that Rescue one but the way you talk that Max is actually more soothing than the Rescue. The Rescue is more hardcore so I need to try the Max, I’ve never experimented with it.
Dr. Justin Marchegiani: Yeah. I think the big thing in the Max is just people are already, like more inflamed because there’s less killers in there, it’s grapefruit. It’s got the same sodium chloride, it’s got the aloe which is soothing and that has the Capsicum. I’ll do that right now actually.
Evan Brand: That’s very cool and the question came in about colloidal silver so in some of the rinses you could do a little bit of silver. We, also, have talked about it.
Dr. Justin Marchegiani: I already talked about that so I said you can do the hydrogen peroxide, add it or like I’ll do my nano silver like my GI Clear 3 or some kind of a silver so you’d add like a dropper or 2 worth of silver in there which is what I have for there. So, you can do silver, you can do hydrogen peroxide and you can also do some iodine. Those are your three good ones that you could do. You could also throw in like someone in the chat wrote about like oil of oregano or tea tree or something of that. Maybe overkill if you’re already using the Rescue afterwards or before because you’re already adding that to it.
Evan Brand: Yeah. And so, we could do that in a nebulizer protocol too, so if we’re doing a hydrogen peroxide or a glutathione or a silver nebulizer that could be another sinus support.
Dr. Justin Marchegiani: Yeah. The problem with the nebulizer, I find it’s just, it’s deeper, it’s better for, like lower respiratory stuff. The problem with, like the mucus that comes out of the nose, it’s very tarry. It’s very sticky, right? And so, what is the mucus? Well, you have one just mucus which is clear which is like your body trying to flush bacteria or virus out and then you have the immune system interacting with the infection and then the dead soldiers, right, of that fight, that battle are essentially all the green and yellow and so the more dead soldiers, right, the more battle we go from like light yellow to yellow to darker yellow to green, right? So, the darker, right, and the, the more chunky the mucus is, the more there’s an immune fight happening up there and so what happens is, you have, you know not that, this is the best analogy I can think of is you have all these dead soldiers from the immune reaction just like sitting up there and sticking all to the sinus cavity preventing breathing oxygen exchange and also some of that can eventually go down the eustachian tubes which connects to the back which can go to your ears then you can start to get an ear infection and all that dead debris can also become like fertilizer for like a bacterial infection down the road. So, you got to get it out. So the problem with nebulizer, it’s in a vapor form so it doesn’t have the ability to push the junk out and so with a nice bottle like this pressurized, you can come in there and you can really pull all that stuff out and push it out where you’re not gonna get that with a nebulizer so your nebulizer is gonna be, you can still do it, I still did it daily but it’s gonna be better for lower respiratory issues and this have all the same stuff in it a nebulizer will, the difference you’ll have the pressurized force behind it to really get it out. Push it out. That’s the difference. And there’s some like I mean there’s sometimes, I mean I won’t get graphic but like I’ll blow my nose I’m good right? I’m good, go flush it out and then there’s twice the amount of junk left behind after the flush that was that what I couldn’t get out through blowing and so you get a much deeper cleanse of the sinus cavity with this because a lot of times you’re getting stuff out literally in this upper forehead area in here and so you’re just getting a lot better release.
Evan Brand: Yeah, you mentioned NAC already, which NAC got banned from amazon so if you need access to it, Justin seems on your store, I believe I’ve got a glutathione NAC combo. I do not have an NAC by itself. What do you do, do you have something to offer there?
Dr. Justin Marchegiani: Yeah. We have different products like in my line have a detox amino product that has more other stuff in it. I just have a straight NAC here. I’ll go, there’s a couple of brands that I’ll go back to before, in between 90% are out so a lot of times I just have to get brands right now. That I typically wouldn’t get if we had a better supply chain with NAC right now but yeah we’ll put a link down below anyone needs NAC, they can reach out to the office but to highlight back on what you’re saying there, NAC is super helpful and then also there’s a Nasaline you can get which is like a pressurized syringe which is great. So, you suck up the saline from the bottle, it’s like a syringe, you put it up against your nose and you press it, that’s helpful. Also, I find too if things are really stuck, sometimes you need to go like pulsations so you need to like squeeze hard, relax, squeeze hard, relax, squeeze hard, relax because I find that the pulsation sometimes will free up some of these mucus that’s really tarry and sticky so that can be very very helpful.
Evan Brand: Knock on wood, I never ever get sinus infections.
Dr. Justin Marchegiani: I don’t either. It’s my first time.
Evan Brand: I don’t know what to, what to attribute them to like you said is it an exposure, is it a weak immune system, is there a gut connection to it?
Dr. Justin Marchegiani: It’s just part of the viral infection so viruses tend to go in two major areas. They go upper respiratory or lower respiratory, right? So, a viral infection that goes too deep can eventually become pneumonia. A viral infection here can become a major sinus infection and so by being on top of this, you have your tools, your sinus flush is your best for your upper respiratory, your nebulizer is best for your lower respiratory and so you can prevent those things once you have viral infection, it’s replicating it creating inflammation. You could prevent these things from going too far with those tools.
Evan Brand: Well, that’s a great point you just made which is the possibility of it turning into pneumonia so people listening are like well why should I care, why should I try to do this and speed the process up, why should I try to intervene? Well, because you don’t want to create more systemic inflammation or lead to something more serious especially in a person who’s 80 years old or above, you know, that could create much more problems if they didn’t treat it while it was just up here and it went further south.
Dr. Justin Marchegiani: Yeah and if someone’s sick and they’re trying to prevent it, I think two to three flushes a day is good for, like, prevention especially while you’re sick. I think it can’t hurt just doing straight saline rinse once a day in general. I wouldn’t add any killers or anything to it. Just a straight saline. I think it is fine, just to kind of keep your nose clean at the end of the day. You wanna do that, I think it’s fine. If you’re sick, I’m going like every hour or two, I’m flushing my nose out just because at one it feels really good. It’s really clean and just as long as you’re not irritating the mucus, you know, its isotonic solution, so you have like the sodium, the chloride, it has the bicarbonate in here. Those are the two major compounds, right? Like sodium chloride is basically your sea salt, right? And then, you have your bicarbonate in there. So those are the two major ingredients and then of course this is like USP grade so it’s just really really clean.
Evan Brand: And what do you mean by that? For people listening, what you’re saying is that pH balance so it’s not gonna irritate your sinus cavity.
Dr. Justin Marchegiani: Yeah. You can’t just take regular, like, clean water and put it in your nose. If you will absolutely burn it and irritate it. It would feel like someone punched you in the face because the mucous membranes need a certain pH and a certain level of sensitivity so it’s kind of like using eye drops, right? Same thing. You need to have, like, saline-based eye drops. This is, you’re using sodium chloride. Pharmaceutical grade plus the bicarbonate which is baking soda. That’s everything nice and balanced for the tissues. So, when you flush it, it shouldn’t irritate the sinuses and it should have allow it too feel nice and smooth and gentle afterwards and then if you have some kind of infection brewing even preventative for a bug just add a little bit of silver or hydrogen peroxide in there or a couple of drops, you know, some iodine that’ll give you enough killing capacity to knock down any bugs that could be multiplying but I’m going every hour or two, for me it just feels really good very soothing. It feels like plus if you blow your nose too much, you just keep your nose all raw around the side so it’s nice to have a nice clean flush. I kind of call it like, it’s like a bidet for your nose. It’s kind of how I look at it.
Evan Brand: That’s hilarious. You know, this would be a good strategy for travel too. So, if you need something portable like the excellent Rescue. If you’re on a plane or after you get off a plane it’d be a good idea to boom boom do a couple of sprays that’ll be great.
Dr. Justin Marchegiani: Oh, also, amazing for kids. Kids cannot honk their nose, blow their nose or the damn right. They just cannot get a good blow in there and you get these things on the market like a nose Frida which you know we have one you get like that deep in the cavity. We’ll do the whole nose Frida for you to think about the nose and then we’ll do this with my kids, flush it out and you’ll see so much junk come out. This is how kids get ear infections right? If you look at sinus anatomy, once you go up this far, there’s this canal, right here that goes straight to the ears and it’s called the eustachian tube and with kids it’s a little bit flatter a delta kind of angles up a little bit so it’s harder to get things uphill with kids because it’s a little bit flatter so it’s easy for the mucus and the junk to go into the ear and then you have an ear infection and of course like if your kids are getting ear issues to the food, sugar and of course high dairy products are gonna create more mucus, more mucus in the sinus cavity can make their way and so if your kids are more mucusy, one make the diet changes but two get their nose cleaned out as well so it doesn’t travel to the ear and this is why you want the mucus cleared up because if you let all the mucus and all this coagulation of all the immune soldiers so to speak, stay up there, it can make its way to the nose and now you have an ear infection.
Evan Brand: Yeah. Good point about the diet. I know we got to run here in a minute or two but that’s a good point about the diet if you are looking for like preventative maintenance strategies, I mean obviously you can’t just live in a bubble and not get exposed to things but you wanna have the good foundation of your diet to reduce inflammation, I mean so many people come in and say they have quote sinus problems, really it appears that they’re food allergies because once they clean up their diet, they get rid of gluten, they get rid of dairy all of a sudden their sinus is clear.
Dr. Justin Marchegiani: Yeah. And people have, like, allergies to the environment. One, have a really good high quality air filter. We recommend the Austin air because it has the activated charcoal, the Zeolite plus the Hepa. Hepa is, like, usually standard in most if you’re on a budget. You know, go with the Hepa to start but definitely get one that has an activated charcoal, Zeolite, the Austin air, the filter lasts five years per replacement so you don’t have to spend as much money replacing it every six months and the activated charcoal and the zeolite filters out more toxins but I’ll tell patients like you know, do a flush you know in the morning when you get up, do one after you’re outside working and then do one before bed. Just the saline’s fine. You could do a little bit of spray, you know, before or after. Try before that’s helpful but just try to get the allergen out especially before bed because if you have all these allergens way up here and they’re creating inflammation that could be a stress response during sleep that’s preventing you from deeper restorative sleep and so the sinus can be flush really helpful along with some of the uh some of the remedies that we have here.
Evan Brand: It’s a good call. Well, if people need help, they can reach out. You can book a consultation with Dr. J at justinhealth.com. So, if you have sinus issues or other health symptoms, you wanna talk, see what’s going on, see if we can help that would be justinhealth.com for Dr. J, or if you need help from me, that’s Evan, evanbrand.com. We’re available worldwide. So, most of these products we can get and we can ship to you. I know a lot of people internationally have trouble getting some of this stuff, silver and NAC. Some countries are just weird and it’s hard to import stuff but usually we have. Our team is great with logistics. So, I think it’s good to just have a stash of this stuff if you don’t already, don’t wait till you get the sinus infection then try to order, get it. Get it now. Get it, get prepped.
Dr. Justin Marchegiani: They have a bottle of it there. Someone said, can you do too much of it. I would say it depends, right. I would say, if you have an active infection, I think you’re gonna be fine just make sure the water is clean, RO high quality water. Make sure you’re using a good quality sodium bicarb, I think if the killers are making you more sensitive, right? You could always do your spray or killers before and then do the just the saline without anything in it after so then everything’s clean and flushed out so then you don’t have anything overly abrasive in your sinus after the fact, that’s a good way to do it and if that’s still a problem you could even, you could even just do a saline flush and not anything else after that. It’s still better than nothing just to get everything out of the sinus cavity but worst case do your spray before and then afterwards just the flush. And they have spray that are just silver too, so you have, I have a silver spray too. You can just do that, I’ll do that for my kids sometimes because they’ll complain about it like just the feeling it’s a tiny tinge of a burn for like 10 seconds and so I’ll do the silver sometimes with them. Oh by the way, my kid had a pink eye issue, used to silver spray, opened his eye up, I just like this, I went, gone in two days. So, silver is excellent for some of the pink eye stuff, I would never do it with this. That would burn but the silver is good. I hope that makes sense. Any other questions about that so far?
Evan Brand: I think we got most of the questions answered here, there was one question about getting mucus after food and these were things like yogurts, ice cream, soy sauce, wheat products, well yeah, I mean it sounds like food allergy so obviously I would clean up your diet. I don’t recommend any of those foods, maybe if it’s like a coconut cream ice cream with low sugar maybe but beyond that all of those foods to me sound like potential irritants.
Dr. Justin Marchegiani: Sugar and inflammatory foods, especially excess sugar and inflammatory foods will cause mucus, that’s part of the inflammatory response, that’s just part of it. Yep. That’s part of the reason why people have sinus infections outside of just getting upper respiratory tract viral issues.
Evan Brand: Yeah. Absolutely. How many people are going to the ENT and getting a paleo diet prescription, probably not many.
Dr. Justin Marchegiani: No, and there just gonna recommend steroids, Flonase, steroids, antihistamine, they’re not really ever get to the root cause that’s the problem and so It’s really good that people are bringing these things to the light, you know, this guy Dr. Mehta, I think it’s Dr. the NeilMed guy, he’s really been on top of it, which is great. I mean this is an MD that’s talking about using really good options to clean out your nose and then you know having more of these sprays together is really good and having things that can add to them, I mean, just amazing and a lot of these viruses live in your nose so preventatively we can be on top of it, you’re out with a bunch of people, you know, instead of being overly worried about washing your hands which you know, that’s fine, wash your hands but flush your nose, easiest thing, flush your nose.
Evan Brand: Totally more valuable in my opinion for sure.
Dr. Justin Marchegiani: Yeah. So guys, to reach out to Evan, evanbrand.com. Evan is available worldwide for health consultation support. I am as well, Dr. J, justinhealth.com, we are here to help you out. We’ll put some links here. Give us a little bit of time. I’ll put the links down below very soon so you can see some of the products that we use. Also, we’ll put some of the products that we recommend from our own store so you guys can get an idea of what we like. All right, any questions feel free to put them in the chat. We appreciate it. Share with family and friends, they could benefit and have a phenomenal day. Take care.
Evan Brand: Take care. See you next week.
The Gut Connection With Urinary Tract infections (UTI) and Yeast Infections | Podcast #367
Urinary tract infections (UTIs) are a common medical problem affecting millions of people worldwide. The primary source for UTIs is presumed to be the gut. That’s why in this video, Dr. J and Evan talk about how gut bacteria can contaminate the urethral opening, eventually propagate themselves in the bladder, and cause symptoms of a UTI and possible yeast infection.
They also added that women are significantly more likely to get UTIs than men. It is due to anatomical differences that make it easier for disease-causing bacteria to travel to the urinary bladder after accidental transfer from the bowels. They also discuss the other clinical and evidence-based factors with helpful tests to find the root cause of these issues.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:53 – Urinary System
10:54 – Antimicrobials and probiotics
18:55 – UTI and Yeast Infection
Dr. Justin Marchegiani: Excited to be here with Evan Brand. Today, we are gonna be chatting all about the gut connection with urinary tract issues, UTIs and yeast infections. Really excited to dive into this topic. This is the common female topic that we deal with. I mean, men deal with UTIs as well but men have a longer urethra area so it’s harder for men to have UTIs with them. Women have a much shorter urethra so bacteria can make its way up to the urinary tract and blood much faster and easier and so probably more of a female issue but we’re gonna dive in. The physiology is similar between the two so men listening will still get something of it as well. Evan, how are we doing today?
Evan Brand: Hey, doing really well. And so, looks like about 90% of infection in the bladder, 90% of these cases of these infections of bladder, urethra and kidneys, it’s all related to E. coli, which of course E. coli are in your poop and can generally just take route up that way and they can migrate and populate within the urinary tract and so women obviously know these symptoms if they’ve had it but it’s you have to urinate more frequently, it’s painful urination. It could be pressure in the pubic area. It could be fatigue. It could go more severe into kidney injury but most women are usually so miserable before they get to that point that they end up doing some sort of conventional treatment. So, why don’t we just talk about the conventional approach because I think it’s great to highlight what people are doing and then what we’re doing differently that we may argue is a far more sustainable solution without the side effects. Antibiotics are gonna be huge and we’ve got some statistics on this. Antibiotics are prescribed for 33% of women to combat a UTI before the age of 24 but of course these synthetic antimicrobials are not without short- and long-term consequences.
Dr. Justin Marchegiani: I’m gonna just share one thing here on screen just so everyone can see. So, you can see the female anatomy, right here is the urethra, here’s the bladder so you can see a very short distance from the urethra to the bladder. You can see here in the male anatomy, right at a much longer distance to get up here. Obviously in the urinary tract, you’re just typically with the UTI, it’s the bacteria that’s making its way up here, okay, into the urinary tract that’s causing the infection like Evan already mentioned that’s mostly gonna be bacteria, right? Usually on the UTI side, it’s gonna be E. coli there, can be some Pseudomonas, it’s mostly E. coli. And so, it’s really easy for women to get bladder infection because you can see it goes up faster. Again, things like birth control pills we’ll talk about and antibiotics really shift the urinary pH and the intestinal pH which has a major effect on the bladder and the urinary tract and it makes it easier for bacteria to grow that tends to be why women are a little bit more susceptible than that for bladder infection obviously but in general you’re gonna see that with birth control pills because how estrogen affects the pH and then also women when they menstruate, right, just that whole vaginal area right there, sloughing off that endometrial lining. All that blood flow does shift that whole entire are to be way more alkaline because bloods around 7.3 pH so it does shift that whole vaginal tract to be more pH higher on the pH side which can increase other bacterial infections more on the vaginal side but hopefully that helps. Any comments on that, Evan?
Evan Brand: Yeah. It’s totally interesting and this is stuff that maybe you didn’t pay attention to in school and biology class but now in adulthood it’s a lot more important and I think people just don’t even understand the anatomy of it and this is something that according to the research here, 25% of people treated for UTI, they will experience a recurrence 6 – 12 months later. So, I mean, that’s a quarter of these people that now have another UTI and they just go on this merry-go-round. And of course, every time you go on these antibiotics, you’re damaging the mitochondria, you’re damaging your gut microbiome in total, so it’s not just this one thing that you’re doing, it’s the sum to your system and it can really add up.
Dr. Justin Marchegiani: Yeah, when we deal with urinary tract issues, I kind of look at, okay, you have yeast issues over here. They’re kind of, they intermingle right and how the different things happen. You have bacterial issues over here, right? So, your UTI issues are primarily bacterial, right, affecting the urinary tract. You can have BV, bacterial vaginosis, that’s another bacterial issue. Usually, Gardnerella bacteria is one that’s affecting the vaginal canal. So, a little bit different, right? Different, you know, same general area, different anatomy per se. You’re gonna have similar sequelae of tissues affecting it, right? The big difference with the BV issue is you’re gonna get the potassium hydroxide odor which is, that’s kind of the fish smell. That’s what the bacteria in the vaginal canal does, it creates that potassium hydroxide that’s the fish odor. You’re not gonna quite get the odor with the UTI but you will have the burning during peeing. So, that’s gonna be the big differentiating factor. Sometimes, more odor on the BV but sometimes you can have none and then of course more pain during urination on the urinary tract issue and then if that continues to be left up that bacteria will eventually continue to go north and eventually hit the bladder as you can see that anatomy pretty short on video here. But, one of the big common issues is I would say like the big three, anytime I look at this problem, they tend to be the same. It’s gonna be a combination of antibiotic use so we’re wiping out a lot of the good flora in our intestinal tract which also affects the vaginal or urinary microbiome and then that affects the beneficial probiotics that actually make hydrogen peroxide like probiotics usually make hydrogen peroxide which is antibacterial. They’ll make different acids, glucuronic acid, they’ll make acidic acid. Different acid acids that actually help keep the microbes in check. They make hydrogen peroxide H202 and it keeps a lot of the bad bugs down. So, the first thing is we have a wiping out of the beneficial flora that also drive yeast overgrowth too so the same thing where it wipes out the good stuff, the beneficial probioflora, the probiotics the Bifidobacter, the Lactobacillus. The different species within the Bifidobacter and Lactobacillus, right? There’s Rudaea, casei, plantarum, lactis, these are all beneficial species, okay, that keeps the bacteria in check but also when you knock down a lot of the good stuff that can also causes this rebound overgrowth and yeast and that’s a lot of doctors today even on the conventional side tend to give an antifungal after an antibiotic in a lot of these female patients because they see a lot of these symptoms happen frequently.
Evan Brand: Wow. And, you’re mentioning the antibiotic that starts this whole cascade and that’s not necessarily the antibiotic to treat an existing UTI and then we’re talking about these recurring UTIs. We’re talking antibiotics for something simple like, I’ve heard of some women going in for a dental cleaning or something just that seems benign and then boom the antibiotic just really had forced them to take another fork in the road with their gut health and of course the vaginal health is affected.
Dr. Justin Marchegiani: Exactly. Now, with urinary tract issues, I mean they’re simple things, right? Sometimes, just after intercourse, after sex, just not peeing. Sometimes that sperm and the semen being up there can kind of create some issues with bacteria so urinating after sex can be very helpful. You’ll see it with younger kids just wiping the wrong direction, right, essentially wiping back to front bringing some of the bacteria in the stool into that urinary vaginal area can be a problem. Sometimes different contraceptive methods like that involve, like a spermicidal intravaginally can sometimes mess up the milieu of flora in the vaginal tract. Having bladder stones or kidney issues can sometimes have problems, going in for a surgical procedure where they put in some of a catheter, you know, those are, you know, gonna be way unlikely but you know just kind of given the gamut of those across the board. And then of course, you know, the antibiotic exposure and I would even say just too much sugar, too much carbohydrate, a lot of bacteria like acellular easy to digest refined processed carbs. So, more carbohydrates, more sugar, more grains, more flours are definitely gonna work, you know, increase those microbes’ kind of having a feeding frenzy if you will.
Evan Brand: And, how can you find this out? Well, there’s an easy to do at home test that you can buy for less than 10 bucks. You can do these test strips at home. These urinary test strips and if generally, you see a dark purple, you’ve got a big issue and so it’s something that people should have on hand if you’ve suffered for a while. I know a lot of women; they just hate having to go to the doctor’s office and get tested and then they leave with another antibiotic and then they’re on this merry-go-round. So, we talked about the conventional approach, they really as far as it goes antibiotics
Dr. Justin Marchegiani: So, with the test strips, I think most of them are primarily looking at either immune cell in the urinary tract. I think, a lot of times with yeast or bacteria. They’re looking for, like leukocytes or leukocyte esterase, they’re looking for bacteria or I’m sorry immune cells in there. I know, some of the yeast ones are looking at pH so they’re looking at a more alkaline type of pH. The more alkaline the pH moves from six to seven to neutral, right, neutral is around 7. Into the 7-ish range, that tends to say that okay we have more yeast issues or we’re starting to move back in the direction of bacteria if we’re starting to see some of these leukocytes moving into the urinary tract.
Evan Brand: Yes. It’s kind of an indirect marker, right? You’re looking at those leukocytes and that’s what you would be seeing in terms of like, the light purple, dark purple, extreme purple on the test strips.
Dr. Justin Marchegiani: Yeah. So, they’re looking at the immune system starting to come in there and obviously with a BV issue, bacterial vaginosis. They probably need a swab to see what’s going on there, see if it’s like a Gardnerella or a Pseudomonas or Klebsiella, you know, what the bacterial species is. Now, typically with yeast issues in the urinary tract, I’m sorry with, uh, yeast infections primarily gonna be Candida or Candida subspecies. With BV, it’s primarily Gardnerella and with UTI’s it’s gonna be E. coli, typically.
Evan Brand: Now here is the cool part. Are you ready to talk about some of the transitions you hit on the diet piece of a bit of sugar process things? Maybe we should hit this first and then we’ll talk about, like, the functional strategies that kind of thing. You and I were talking about this before we hit the record that so many people, they want the solution to an issue like this but they haven’t even got the foundation styled in, in regards to their sleep, in regards to stress, proper hydration, nutrient density, lack of antibiotics if possible. Just those foundational pieces, a lot of times, are gonna keep women in a place where they’re not gonna end up with this problem so if you’re just tuning in, somehow you found us and you’ve not been listening for a while and you’re just now hearing us and you’re looking for this magic remedy, you got to make sure you get the foundations in order first because in theory, this should not happen if you’ve got the foundation style then.
Dr. Justin Marchegiani: Correct and so first thing out of the gates is just foundational things like hydrating enough because if you have a UTI issue just having constant good water flow and also you know with some electrolytes in the water that can be very helpful kind of having an antibacterial effect. And just keeping that good water flowing, the solution to pollution is dilution so that can really kind of keeping things flushed down. Obviously, being very careful if you’re having antibiotics. Why did you have the antibiotics? Was it for routine preventative things? Was your diet off and your immune system’s weak and you got sick and you needed it? Why, right? So, you want to look at that and if you had chronic antibiotic use, you know, what does the bacteria in your gut look like because odds are, if your bacteria or yeast imbalances are present in the vaginal tract or the urinary tract, you probably, also have issues in the digestive tract. You may have SIBO, you may have bloating, you may have gas, you may have poor digestion, low enzymes, low acids, H. pylori, parasite infection, you may have to look deeper in the intestinal tract and actually work on knocking down some of those microbes fixing the gut and then really work on repopulating some of the good bacteria after the fact to really work on fixing the gut because you start to fix the gut pH and the gut bacterial milieu that does help improve IgA levels and that does help with the immune system in the vaginal area as well.
Evan Brand: Yeah. Well said. So, if you’re coming in with the UTI, most of the time, there’s gonna be more than just a UTI present. There could be as you mentioned a number of, we have someone coming in and UTI or recurrent UTI is one of their complaints, I can tell you, you and I are gonna wanna run the stool panel and we’re gonna run organic acids because we’re gonna want to look at the whole microbiome and certain things may get missed on the stool and the urine should feel in the gaps like we might find Candida in the urine and it got missed in the stool. So, stool and urine, there are things that your typical doctor and your lab locally is not gonna run. They might run a urine panel but this is not the same urine panel as an organic acid, we’re talking something far more advanced, far more comprehensive whereas the urine panel, locally, is primarily just gonna look for bacteria or maybe leukocytes as you mentioned you might get a positive or a trace or something like that but it’s not a detailed description of what’s going on you mentioned several bacteria too, like Klebsiella and Prevotella, we can identify this on a stool panel. So, that’s why it’s so important to get the data and could we just throw a woman on an herbal UT formula, we could but you know, we want to do our due diligence, we want to do a good work-up on these people too to make sure that we’re not just cut straight to the chase and we skip something huge that we would find on these tests.
Dr. Justin Marchegiani: Right. I mean a lot of the antibiotics they’re gonna be using are gonna be like Bactrim or any of these kinds of, um, Mors, Augmentin’s a big one. Bactrim and Augmentin, those are a couple definitely be very wary of any of the fluoroquinolone families because they have significant side effects regarding tensing tendons and ligaments and mitochondria so be really careful of using fluoroquinolones. Of course, when we work these patients up, we’re doing a really good history so we understand how everything came to fruition regarding the UTI, yeast infection or bacterial vaginosis. We’re trying to understand it, right? Obviously, with certain things like yeast infections, BV, like making sure things are dry in that area. If you’re in a very moist environment keeping things dry helps because yeast and mold love a very moist environment. So, keeping things dry tends to be very helpful. Soaping up some of those areas you’d be very helpful too that you can use a really nice, um, as long as the mucosa is not like really, um, irritable, you can really use a really nice sulfur soap especially in the outside air if there’s anything yeasty on the outside are, anything internally. There are definitely internal things that we can do. So, on the internal side, just getting water in there, maybe helpful using raw cranberry juice, not anything with added sugar but raw organic cranberries, you know, 4 ounces at a time diluted some water is pretty good. You can drink that. That’s gonna have a nice low pH in it, which helps prevent the bacteria from growing. It also helps with some D-mannose in the cranberries. Can also internally do things like different berberines, can be very helpful, that’s excellent boric acids, another excellent compound. You gotta be careful with these by, enlarged by itself because they can be a little bit irritating so you want some nice things that provide some moisture whether it’s aloe or shea butter. There’s different, like moisture compounds that can provide the moisture so you don’t dry out that tissue as well.
Evan Brand: You know, how about some of the suppositories. Have you used those before? I’ve seen some of these like pH suppositories, those have been helpful, also I think it’s integrative, I know Aviva Romm did a talk or an article on it one time. There was a specific probiotic that we had used, I think, it was called pro-flora that we had used, uh, that was supposed to be inserted vaginally and that was like a game changer for BV and some other related issues. So, not only taking oral probiotics but vaginal probiotics as well. That has been a game changer for many women. It’s not something we have to go to a lot but it is a good tool if someone just in bad shape and the conventional strategies failed them or made them worse then something like these vaginal probiotics are helpful. So just to be clear, there’s some strains specifically for vaginal health that are taken orally but then there’s also other blends that you can insert vaginally and the women have reported great success with those.
Dr. Justin Marchegiani: Yeah. You want to make sure the hydration is there, whether it’s aloe or beeswax or shea butter or coconut oil, some of those can be helpful. Again, the antimicrobials that we may use would be the boric acid, some of the neem, some of the different berberines. And again, we may want to also add probiotics in and around there that can be very helpful. In regards to, like yeast issues or, um, UTI issues, you got to be very careful because when you women menstruate, well more with yeast and more bacterial vaginosis because that’s affecting the vaginal canal more. When women menstruate, that blood is like 7.3, right? So, that’s very neutral to alkaline. So, when you’re menstruating, you’re taking that acidic pH in the vaginal tract and you’re moving it backup to a more neutral pH when you menstruate so that’s gonna actually make it easier for bacteria and potential yeast to grow and you could have a BV issue or yeast issue that can happen due to your menstruation. So, when you’re already more susceptible in that vaginal area, you know, you gotta, you may actually wanna do a suppository in and around your period too, because that pH is gonna move up and that can start to cause microbes to grow. Some women have to be more careful with that, you know, if they have a chronic yeast or bacterial issue just to make sure it doesn’t come back.
Evan Brand: I want to hit a few more herbs and then I want you to riff on the birth control conversation because I think that’s huge. So, you mentioned berberine and some of the other related herbs. Also, we’ll use the antifungals at the same time. So, you and I have our own custom blends that we use and so we may use something like Pau D’arco, French tarragon, horse tail, olive leaf, things that have antifungal and antimicrobial properties. So, that’s the cool thing about what we do is as you mentioned Backstrom or some of these other conventional strategies. It’s just a big sledgehammer, right? It’s not a targeted tool. It’s one sledgehammer. We don’t know exactly what we’re gonna kill but it’s an antibiotic, were just gonna drop the nuclear bomb into your gut and we’re gonna disturb not only your gut microbiome, we’re gonna negatively affect the production of your nutrients in your gut. We’re gonna negatively affect your mitochondria. We may knock out the UTI but as you saw in the papers, 25% of those UTIs are gonna come back within 6 months to a year and so when we’re coming in with these antimicrobial herbs, also, throwing in antifungal herbs, that’s where the magic really happens because there could be a combination as we talked about. It’s rare to see just UTI, it could be a combination issue meaning there’s some Candida, there’s some bacterial problems, maybe there’s parasites in the gut too. Maybe there’s H. pylori like you mentioned. And so, that’s the fun part is when you take a blend and you’re working people through this protocol. You’re now knocking 4,5,6 issues out all at once in one fell swoop when they originally just came in with the complaint of UTI. When you do the labs, you wanna uncover so much more and that’s where the beauty is.
Dr. Justin Marchegiani: 100%. Here’s one study here looking at the perceptions using contraception birth control pills. So, usually this is like a synthetic estrogen mostly, right, an ethanol, estradiol. I’m looking at the influence on the vaginal microbiota and so really the take home here inside of the gate, the vaginal state was significantly modified hormone administration apparently corrected the alterations uh, but has the potential of being an accurate tool. Where is it? Right here, um, there it is, I’m sorry. Statistically significant association between, this is, um, this is contraception and normal microbiota was observed after three months when the vaginal microbiome was modified at 6 months inflammatory reaction was detected in almost half of the women. So, only seven women but you can, it created an inflammatory state in the vaginal microbiota and then also yeast colonization was increased and it created an inflammatory reaction in three out of seven women and it altered some of the beneficial bacteria in the vaginal area. Now, small study but you can see, you know, three out of seven, it affected this and this is what we see clinically with a lot of our female patients is some of these things can be affected because it’s affecting: one, it’s creation; two, it’s causing yeast to grow impacting some of the good bacteria and how does it do this, it does it mostly via LDH. If you alter someone’s digestive pH, right, let’s say you give them a proton pump inhibitor, you’re gonna have all kinds of digestive issues and maybe even nutrient deficiencies that can affect things long term. Obviously, with birth control pills, there’s other things they do, they can create issues with nutrient absorption or they can cause nutrient deficiencies in areas of B vitamins, folate and also calcium and magnesium. So, we see a lot of women that do birth control pills have a lot of those nutrient problems. So, if you’re on a birth control pill, ideally, it’s better to use something that’s more barrier based or if you want to set it and forget it method, you know, potentially looking at the ParaGard which is a copper IUD, you just have to make sure you can handle the copper. I find if you want to set it or forget that the copper tends to be better than the hormones but ideally, you know, a barrier method it’s not internal all the time. It’s probably better so that just kind of gives you a couple options there.
Evan Brand: Yeah. I’ve heard some stories, some horror stories about the copper ones too. So, like you said it cold be a problem but
Dr. Justin Marchegiani: Not everyone has problems with it. I mean, women that like tend to cramp a lot, they could have, because that cramping, IUD being in that uterus sometimes that can cause pain but it just depends kind of where women are, you know. Some parents may be pushing kids to have a method because they don’t want their kid getting pregnant and maybe they feel like they aren’t responsible enough at maybe 18 or 19 and they set it and forget it method. If you want that, I would recommend doing the ParaGard before you go to a hormonal method.
Evan Brand: Yeah, for sure. And, not to mention too we’re already in a society of so much estrogen dominance and you and I have done podcasts about the impact of gut imbalances in issues with the glucuronidation pathway which is then causing further issues. So, we could see this estrogen problem in a woman who’s not on birth control. You could still see that manifest in this way and so that’s why you’re getting off of the xenoestrogen, you’re cleaning up your makeup. You’re getting rid of plastics. You’re fixing your gut. You’re improving detoxification. All these other functional medicine strategies are directly impacting your ability to beat this situation. So, we know, we always want people to look at the big picture. Don’t just look for the magic, uh, like, berberine, Pau D’ Arco remedy. And there’s a question here in the chat, ‘how many Pau d’ Arco capsules is needed for someone who has Candida in their gut?’. I have no clue because we rarely use it in isolation. We’re always gonna use it in a blend. And I doubt you have just Candida. You’ve probably got other issues too.
Dr. Justin Marchegiani: Yeah. Somewhere when they come in, they could have a combination of a little bit of a bacterial, a yeast issue, UTI thing. That could be a kind of combination of 2 or 3 different things happening. This one may be more predominant. So, we never wanna just go all in on one thing. Again, if someone’s having vaginal issues specifically, there’s gonna be things that we insert intravaginally like some of the boric acid, like some of the neem or the berberines and we’ll probably interchange in some probiotics because part of the big problem is you have to get the bacteria flora in the vaginal area, back up to where it should be because it’s the good bacteria that will help keep the other bad bugs in check through their natural acid and hydrogen peroxide production.
Evan Brand: Well said.
And so, the point I was making is that I don’t want people listening and going okay just give me the freaking remedy. What’s the natural urinary tract remedy? That’s what I’m here for. And we’ve talked about some of those, you know, the mannose, the cranberry, the berberines, the Pau d’ Arcos, the French Tarragon, this whole blend, you know, that may be the solution but what got you here is important. Have you fixed the other issues that have gotten you here. And so, I hope people see the big picture. Sometimes, you and I are happy to just go boom, hit the oregano oil and were happy to just throw out just this natural solution but like you said before we hit the record, you don’t want people skipping out on the low hanging fruit.
Dr. Justin Marchegiani: Exactly. And so, it’s always good to do history. I find the big issue is antibiotics can be a big factor. I also find just some of the low-hanging fruit like the intercourse and hydration can also be a big factor as well. You’ll be surprised. And so, my wife comes to me, she’s like, ‘my friend has this issue, what should I recommend?’. Well, it’s hard, I can’t really recommend a lot of things because I don’t know much about them if eating like crap and they’re not hydrating and they’re drinking lots of soda and they’ve been on lots of antibiotics, you know, I may say, hey, all right, do this [24:34] but that’s gonna be palliative and not fix the whole lead up and how everything went down. And so, the lead up and I call it the timeline history of how we get to this point matters so much because, you know, if not, you were just becoming naturopathic doctors that are using nutrients and herbs like MDs use drugs. Now, again, I think that’s better because a lot of these things are natural, have less side effects but still we want to be holistic and still root cause.
Evan Brand: Yeah. Well said. That’s the problem. There’s a difference between naturopathic approach to this issue and functional medicine approach to this issue. So, I think you made that clear, which is, you go to the naturopath, it’s hey, here’s the oversee, functional medicine is gonna come in and say, ‘okay, well, how did you get to the UTI?’. Oh, you took antibiotics, you’re on birth control for 20 years, you had a sexual partner who had extremely poor microbiome health, maybe there was some issue there, maybe you had multiple partners, maybe one of them had H. pylori. You have low stomach acid. You ended up with dysbiosis, then you got Candida overgrowth, then you drank too much alcohol, you loved to do wine in the evenings. You ate a little too much chocolate, you know, it’s like, that’s the more investigative route and that’s where people need to be thinking. We’ve got friends that are naturopaths, good people, but you just got to go deeper most of the time.
Dr. Justin Marchegiani: Yeah, and a lot of times too, if I’m, if someone has chronic issues, I wanna know more about their gut because the microbiome has such an impact especially with IgA and with the overall immune system. So, if there’s chronic issues in the vaginal area, you have to look up to the intestinal tract. Very important.
Evan Brand: Yeah, and you would say there’s gotta be some link between the low secretory IgA that you and I are seeing on the stool test and what’s going on with the vaginal microbiome too, right? You would assume that’s a system-wide defense shield that’s gonna be affected.
Dr. Justin Marchegiani: Yeah. It’s part of the mucous membrane barrier. So, mucous membranes in the eyes, the mouth, the intestinal tract, the urinary tract, the vaginal canal. So, if we see low IgA issues in the intestinal tract, that barrier is a little bit weaker. Think of the force field, you know, you see star trek, they put, like their force field up, right, so they, so when the Klingons go to shoot them, it kind of bounces off, right? Think of the force field we have in our intestinal tract and our vaginal canal and our urinary canal that kind of protects and so probiotics can help, obviously getting rid of the dysbiotic microbes can help, avoiding a lot of things that create the imbalances to begin with, which would be a lot of the antibiotics or maybe pesticides or GMO foods that produce a lot of antimicrobial compounds too. All those help avoiding those things too.
Evan Brand: You know, what’s happening even in the functional medicine world, is that everything’s becoming isolated. Are you noticing that? Like people are focusing on just the gut. So, it’s like this leaky gut formula, this leaky gut protocol and they’re ignoring the fact that you just mentioned this IgA, this mucosal barrier is kind of a system-wide problem. So, there could be oral, vaginal, gut all at the same time, all related to the same dysfunction of these force fields being down. I think it’s just marketing, right? People just want to market that they’re the gut guy, they’re the parasite guy, they’re the Candida guy. I think that’s just a marketing probe but hopefully people are seeing this and of course if they’ve been listening to us for months or years, they’re seeing that this is a system-wide problem, it’s just manifesting in this way.
Dr. Justin Marchegiani: Yeah. In the functional medicine world, a lot of people market to niche areas and symptoms which is fine because a lot of people when they get focused on something, they think they have these issues, they’re going into google or they’re typing that issue. So, for you to be relevant and for that person that has health issues to find you, you do kind of have to market to a symptom but then when you find that person and you talk to them, you wanna make sure that their approach is globally where they look at things holistically and you’re not seeing the gut person that only deals with the gut and they’re not looking at your thyroid or your anemia or your low glutathione. They’re not connecting the dots. So, you got to make sure they’re still able to connect the dots but multiple systems and they’re not just focused on one issue. So, it’s okay for doctors to market to that, you just have to make sure that their philosophy is a holistic philosophy that encompasses everything in there.
Evan Brand: Yeah and holistic spelled w-h-o-l-e a wholistic, the whole thing, the whole body, the whole person, not just holistic as in natural, it’s gonna be the whole piece and I think that’s where I suffered for a long time because I focused on my gut for so long but I was ignoring toxicity issues, I was ignoring dental issues, I was ignoring tick bite infections. So now, oh crap, I see the whole picture and I would miss that if I just dialed in the gut so and that’s what you and I do. We’ve done this over with clients worldwide, we look at the whole picture. If you’re suffering, if you’ve been through the conventional rabbit hole or maybe you’ve been fortunate to avoid the conventional rabbit hole, you don’t want to go down it but you need help, feel free to reach out. Dr. J and I work with people around the world. We can send these labs that we’re talking about stool and urine. These are at home, these are non-invasive. It’s rare that we need to do invasive testing but most of the time it’s at home functional medicine tests can be sent to your door, you do them, you send them back to the lab. We get the results. We jump on a call. We run you through them. We interpret those. We make a protocol for you and get you better and get you off the merry-go-round. So, if you need help, feel free to reach out, Dr. J is at justinhealth.com and me, evanbrand.com and you can reach out, book a call with us, we’d love to talk with you, help you, find and fix the root causes if you just have UTIs and you think that’s all it is, maybe you’re right but maybe not, either way, we’re gonna help you get to the bottom of it.
Dr. Justin Marchegiani: Very good. Excellent. So, for women that are listening and kind of want to recap here, first thing, make sure your diet is right, keep in the process refined sugar, grains, flours out, makes a huge difference. Omega-6, seed oils, in general, should be reduced as well. Hydration, make sure hydration is good, clean and filtered water, um, you know, good mineral water, especially if you have more health issues, more minerals in there is gonna be better. Next thing out of the gate, you know, urinate after intercourse, those kinds of foundational things. If you have chronic gut issues, definitely, get your gut looked at. If you’re on hormone, if you’re on birth control pills, definitely get your hormones looked at and figure out why you’re on them. Most women aren’t even on hormone or birth control pills for birth prevention. They’re on it for off-label issues like acne or headaches or lots of PMS and so most women could totally get off it because they’re not even using birth control pills for the original intention. They’re for off-label use and so that would require looking deeper at the hormones. Next, you can get tested, you can do either a, um, a MONISTAT test to look for yeast, you can get those at the drugstore, you can do one of the strip tests to look for leukocyte esterase or I think it’s nitrites in the urine for more of the UTI issues and of course, if you have a lot more of the odor-like, uh, issues, you can get a vaginal swab from your OB or your primary to rule out any of the BV issues as well, again, similar solutions, you know, some maybe more internal in regards to what we recommend, some maybe more internal like with swallowing pills so maybe internally, intravaginally and of course the more chronic the issue is, the more we have to really support the vaginal microbiome with the right beneficial bacteria getting in there internally as well. And then, of course, just keeping up with a lot of the menstruation because that can really affect a lot of the, um, the bacterial issues and yeast issues in the vaginal canal because it’s gonna shift that pH from very acidic to more neutral to alkaline at that time of the month when you menstruate. So, hopefully, that’s a good kind of crash course, out of the gates and kind of you guys understand kind of our spitball kind of philosophy and how we look at the whole history and really connect the dots and we have our little toolbox of all these things but we just got to make sure it’s catered to the history.
Evan Brand: And alcohol too, I think, we briefly mentioned it but alcohols got to go. It’s just, it’s not gonna help you. It’s going to promote all sorts of issues. It’s gonna aggravate the immune system. It’s gonna affect your IgA levels. It may promote dysbiosis and it may promote more yeast problems and so I’ve heard many stories where a woman’s like, oh yeah we went to Napa Valley and we drank wine and ate chocolate and salami and cheese all weekend and now I had a flare up. It’s like, well, yeah, duh, I mean, that’s incredibly damaging. Everything that you’ve done, you binged on wine all weekend so I think wine kind of gets like this people think that they’re not drinking alcohol. Somehow, they think they’re getting off the hook. Oh, it’s just wine, like, it’s so socially cool, it’s like coffee. It’s like coffee and wine, like wine is so accepted into the culture but it can be a big problem, I tell you. Some of those California women, the ones in San Francisco, like, it’s part of the culture here. I had one woman argue with me that she didn’t want to get off alcohol. I said, well, what if it’s gonna help your gut. She’s like, well maybe I’ll consider it. So, sometimes as practitioners, we’re having to bargain with people and try to make trades and make healthy swaps, we’ll swap it for this and try this and what if you do a binder afterwards. So, sometimes, you gotta work with people, they’re not just in a vacuum. We got to work with them and help educate them so that they’re more dedicated to the lifestyle changes but I just want to mention alcohol because I think a lot of people, don’t even consider the impact it has on the gut but then on this flora.
Dr. Justin Marchegiani: Yeah. A couple things with alcohol, number one it’s diuretic so it will increase the frequent urination and kind of make you more dehydrated so good hydration helps prevent a lot of that bacteria from growing. Number two, out of the gates, you know, it may be necessary out of the gates for the first month so as you get things under wrap. There’re also healthier versions of alcohol. I mean, you can always get, like a Cosmo martini that has the fresh lime juice in there and cranberry juice. Just make sure it’s, like not the cranberry with sugar or the lime with sugar. Make sure, it’s fresh lime or actual juice cranberries with, like a nice Tito’s vodka, I mean, Tito’s vodka is, um, it is charcoal filter, right? So, it’s gonna be really clean and you can get some nice cranberry and lime in there that should be almost be beneficial in a way, obviously, you know, keep it, you know, a drink or two maybe once or twice a week max but once you better that maybe a good option to add things back in and just stay away from a lot of the sugary stuff and of course the glutinous drinks and you’ll be in a lot better position.
Evan Brand: Yeah. It’s a funny thing you have to mention. There’s got to be real cranberries because most of the time you go to a bar, it’s like that. It’s garbage. The heart or it’s the high fructose corn syrup concentrate.
Dr. Justin Marchegiani: Yeah. So, worst case, you can always just do a fresh lime squeezed in there and see if they have anything that’s just a pure, you know, extract and that’s a much way to do it. Of course, dry or white wines and you know just a good Tito’s vodka is always great with just the lime in and of itself. That’s an easy way to do it and keep the sugar and junk down but also keep a nice acidic pH there which is helpful for the vaginal area.
Evan Brand: Yeah. We’ll hope, as you mentioned, no I think we covered It so if you need help, we mentioned the links here Dr. J, that’s Justin at justinhealth.com. You can reach out for consult worldwide. Me at evanbrand.com, either way, we’re here to help you guys. We love what we do. We have a blast and it’s fun to educate people. It’s fun to empower people and take back your health and it’s possible. Whatever you’re dealing with it’s possible to make progress so just keep your head up. Stay motivated. Don’t always run straight to that antibiotic if there’s another way. You may try another solution. If you’ve been doing this for a decade now and you’re still battling it, you’re not out of the woods yet, it’s time to look deeper.
Dr. Justin Marchegiani: Excellent. Great chat, Evan. Everyone, have an awesome week. We’ll talk soon. Take care of you all.
Evan Brand: Take care, now.
Dr. Justin Marchegiani: Bye now. Peace.
Evan Brand: Bye-bye
How to Investigate The Root Cause of Your Gut Issues | Podcast #366
In functional medicine, it has long been familiar that gut health is paramount to the rest of the body. We didn’t fully understand why for years, although we knew the gut was the seat of the chronic inflammation and immune system. With the gut microbiome renaissance, we also need to understand how integral gut bacteria are to our health.
Dr. J and Evan discuss that screening for more serious underlying issues is essential. These may include gastric ulcers from an h.pylori infection, leaky gut, and other digestive system problems. Finding out whether these conditions are an issue also impacts how you manage gut health.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
3:34 – The Signs and symptoms of digestive disorders
7:35 – What tests are effective to find the root cause of gut issues
13:58 – The downside of ordering lab tests on your own
26:21 – Food template modifications that will fit for your gut health
Dr. Justin Marchegiani: Here, Dr. J, with Evan Brand. Really excited to have an excellent podcast today. We’re gonna be chatting about how to investigate the root cause of your gut issues. We see lots of patients come in and they’ve gone to see the SIBO doc or the Candida doc or the parasite doc or the thyroid doc and whatever the symptoms that they’re dealing with, magically that issue, that doc only focuses on is the problem, how coincidental right? And so, we want to talk today about having a holistic mindset not being necessarily attached to what the diagnosis or what we think is the root issue but really be focused on the outcome and the different tools we use and have to investigate and support healing. Evan, how you doing man?
Evan Brand: Doing good. And not to mention too, the conventional approaches, right, maybe they get to the SIBO guy or to the parasite guy or to the worm guy, maybe they went to the endocrinologist first for their hormone symptoms and then they got referred to the gastro doc and then the gastro doc did an endoscopy or a colonoscopy or a barium x-ray scan like you did to me and then they say oh you’ve got gastritis and that’s the only thing they can pull out of you is hey there’s some inflammation and then it ends there so whether you’re coming, listening from the conventional approach whether you have tried to go more natural holistic approach. As you and I’ve talked many times, people over-specialize and that’s the problem. You and I are what I would consider very good specialists but we also have a generalist undertone to us, meaning, we’re not gonna get caught up in just the SIBO, we’re not gonna get caught up in just the parasite, it’s rarely that simple.
Dr. Justin Marchegiani: Absolutely. It’s like, imagine, like you hired a handyman to come over and fix something in your home and the handyman just takes this Phillips flat head screwdriver and it’s like, or, I’m sorry, not, but let’s say a regular Philipps screwdriver and just say hey I’m gonna use this Philipps screwdriver even if it requires a nail, even if it requires a wrench or a drill, I’m married or attached to this Philipps head screwdriver and we don’t want to be attached to the tool, we want to go in, know that we have a myriad of tools in our tool belt and pick the right tool for the right job. There’s a nail, I’m going to pick a hammer. Hey, there’s a, you know, a wrench, you know, we’re gonna use something that is good for a wrench etc. So, we’re picking the right tool for the job and we are focused on the outcome, getting the results and we’re not focused on how we get that outcome, right? The vegan diet people, they’re gonna make it so everything is solved by a vegan diet and that’s it, right? And so, we are independent of the tools that we use to get the success that we need.
Evan Brand: Yeah. Yeah. That’s a great point and a lot of this comes from just experience but also our own personal journey too, I mean, you know, my story, you helped me through my story of having digestive issues and skin issues for decades of my life and we looked at the H. pylori, worked on that then it was parasites then it was bacterial overgrowth then it was Candida then it was mold, I mean, so, I went through the ringer personally and I think personal suffering but of course clinical experience really gives you the non-biased approach and I think that’s what you need because if you’re trying to just sell book or you’re just trying to just get clients in from a book you wrote on SIBO, as you said, everything’s gonna be SIBO and if somebody is not in that box, you’re gonna still give them the same treatment, you’re not gonna get them better and then they’re gonna move on and the average person who comes to us has already been to 5, sometimes 10 or 15 practitioners, so it’s not surprising when we look what they’ve done and they’ve still missed some of the pieces. So, why don’t we talk now about some of the pieces, like when we’re looking at someone with gut issues, what are the pieces we’re trying to lay out on the table in front of us to gather enough information to find what’s truly going on and then of course how to fix it.
Dr. Justin Marchegiani: 100%. So, the first thing that I think is essential is you got to do a good history, you have to understand how everything unwound, right? And so, when you look at most people’s history, a lot of times there’s poor diet, there’s usually some stress issues, a lot of inflammation compounded by junky fats, um, poor digestion, in general, not being able to break down proteins and fats, lots of refined sugar usually processed grains, excess omega-6 or trans fats and these things just continue to put the body in a pro-inflammatory state and what that means is, when you become overall inflamed at a higher level, your body starts to break down faster than it can heal and so the goal of being anti-inflammatory, right, is restricting a lot of the foods that drive inflammation, so your body can heal faster than you break down. So, there’s always this net buildup versus net breakdown and so when you’re breaking down over time what starts to happen is just as you know from a joint standpoint, you’re starting to feel a little bit inflamed, stiff from a mood standpoint, you may have anxiety, depression, obviously fatigue starting to creep in. Because, the more inflamed you are, your body’s having to deal and allocate adrenal resources to deal with the inflammation, to deal with the stress where normally those adrenal resources would help with energy and good mood and good circadian rhythm and so of course then that starts putting stress on the thyroid then you start having mood issues, temperature, hair loose and then of course the more stressed you are, the more that starts to suppress your body’s ability to digest optimally. So, HCl levels, enzymes levels, maybe bile salt levels start dropping. You start to have a harder time breaking down protein, breaking down fat. You may start getting burpee or gassy or more flatulence, now, your motility starts to go south typically more on the constipated side but you can still have more diarrhea too. And then, your absorption starts to go south and when that starts to go south, now you start to have, um, a bottleneck and all the nutrients, whether it’s B vitamins, flat soluble vitamins like A, D, E, K, whether it’s minerals or amino acids to help your brain chemicals or cholesterol to help your hormones. Those building blocks start dropping and then those pathways start getting shorted and they don’t have the resources to run optimally. And, when we don’t have the resources, more symptoms start to happen. And of course, this kind of compound in this whole journey is the immune system starts to drop and then when the immune system starts to get weaker, now, bugs start coming into the situation, whether it’s parasites or yeast overgrowth or SIBO or bacterial overgrowth or H. pylori. And again, we don’t have to be married to which one or which system is the one, right? But we have to look at things objectively and, um, I think it was Dr. Kaler said this to me over a decade ago, it was kind of a good line, he said, ‘patients have the right to have more than one issue, more than one infection, more than one hormonal imbalance going on at the same time, so don’t get married to one thing because you have the right to have lots of things going on.
Evan Brand: Yeah. Yeah. And you illustrated beautifully, just the constellation of symptoms that can happen. So, if someone is coming in with gut symptoms that’s usually the tip of the iceberg. Underneath that iceberg, just like your poster, you got right there. If we put the tip of the iceberg is gut under the water there, it could be the anxiety, the depression, the fatigue, the low sex drive, the cold hands the cold feet, the brain fog, the concentration issues, the memory problems, the skin issues. And so, once you do a good history, you’re also gonna be talking about pharmaceuticals too, what kind of like proton pump inhibitors were you on. That’s a big thing, like were you on acid blocking medications, were you on other things disrupting your gut. So, of course, figuring out, if you’re still on those medications, you’re not fully gonna get better, if you have a ton of drugs that are causing these side effects and then you get into the testing. Now, this is where you and I differ from other people. Some people, they’re married to the SIBO test and I don’t want to speak for you, I’ll ask you about this but me personally, I think a SIBO test is a waste of time because when we look at a GI map stool test, we’re gonna see a more detailed breakdown of specific pathogens like Strep and Staph and Pseudomonas. And the way I look at it is your mouth to your but is one long tube, so, if there’s dysbiosis in there identified on the stool or the urine organic acids, we can assume it’s probably in the small intestine but the protocol, the herbs that you’re gonna use, are gonna treat the whole thing. So, to me, I want to hear your thoughts on this too, but to me, if I see positive hydrogen or methane, all I’m going to go and do and say is gonna to be, ‘yep that makes sense’, but beyond that those breath tests are not really that helpful.
Dr. Justin Marchegiani: Yeah. I mean, a SIBO breath test is just looking, it’s an indirect measurement, looking at the gas created by the bugs, so methane or hydrogen gases that are created. So, if we can find bugs that typically produce those gases or an imbalance in but bugs that shouldn’t be there, then we know more than likely, there’s something going on in that SIBO realm. It doesn’t change the treatment that much because a lot of the herbs we use to knock down those bugs that they’re gonna be similar if not the same on the SIBO side. Now, my philosophy may be a tiny bit different than yours but I find anyone with these type of bug issues we’re running a comprehensive stool test and usually an organic acid test and on one or two of these tests, we’re gonna see either the bugs, the bacteria imbalances, whether it’s Citrobacter, Prevotella, Morganella, Pseudomonas, Klebsiella, or H. pylori or parasites. We’ll see these bugs elevated if we don’t almost always, we catch it on the organic acid side when we’re looking at 2,3 phenol acetate or benzoate or Hippurate or D’arabinitol for yeast, usually we’ll catch it there. If I don’t catch it on any of those tests on the stool test or the organic acid test then I’ll pull out a lactulose breath test but I’d say 99% of the time we never have to go that far.
Evan Brand: Okay. Okay. Good point. Maybe it’s a 1% of the time test for you and I guess what I would do if let’s say we missed it, we felt like we missed it on stool and urine, I might just come in or if sometimes if someone just has no budget to do anything, we may just look at symptoms scan history and just come in with some herbs and see how they do. And, a lot times, a lot of these antimicrobials, antifungals, anti-parasitic herbs, a lot of times it clears up the issue anyway so we don’t like to come in blind but in a few rare cases we have come in blind and we’ve still had good benefits. A lady just chimed in on the live chat here, my gut is not happy, chronic constipation after using pain meds for pain and recovery from five back surgeries. Yeah, that’s a common issue with the opiates, right? Because that’s gonna slow everything down so yeah, I guess the answer is eventually this person’s gonna have to try to get off those opiates, right? But there are some, maybe some brain-gut motility activators we can use, right?
Dr. Justin Marchegiani: Of course, you know, if you’re on those opiates, you probably had some surgeries and surgeries man, meaning typically anesthesia, maybe a lot of antibiotics along the way so that’s probably really screwed up the gut microflora. So, first off, you have to get to the root cause of the pain. Second thing is you have to have a good, uh, doctor to work with to taper you off those medications while providing anti-inflammatory support because you need whether it’s systemic enzymes or anti-inflammatory herbs plus that brain takes time to get rewired from the opiates because you’re processing pain totally differently. Remember, opiates don’t have an anti-inflammatory mechanism, they just block pain at the brain level which isn’t good because pain is a good indication like if I have pain in my ankle and it’s there then I can know okay I shouldn’t walk on it because I’m causing more damage, right? So, even if I were to take Ibuprofen and my pain went away, I would still want to be very careful, I don’t do too much on it because I’m gonna cause damage, right? So, most people that are chronically inflamed by these opiates, they’re just causing more and more damage because just because they can’t perceive the pain, they’re still causing this inflammatory breakdown.
Evan Brand: Yep. That’s true. Someone else has chimed in, my gut has been destroyed by many rounds of antibiotics. And, that’s super common, I mean how many times have you and I see that where someone comes in after a round of antibiotics, I mean that’s probably one of the top five things we see, right?
Dr. Justin Marchegiani: 100%
Evan Brand: They said they’re dealing with IBS-D so that would be diarrhea and eating a limited vegan diet. So, my first thought is, uh, oh vegan diet, raw leafy greens, if you’re dealing with diarrhea, vegetables are gonna irritate the gut, I would push you more towards getting some good animal proteins in even if you could only handle like a carnivore collagen like a beef peptide protein powder or you know collagen shake maybe with some organic berries that’ll be my first thought. How would you think about this one?
Dr. Justin Marchegiani: Yeah. I mean, you could definitely look at reducing some of the fermentable carbohydrates and really look at cooking and steaming a lot of those things so it’s easier to break down but you really got to reach out to a good functional medicine doctor that can kind of help navigate you through it because if you don’t have all the digestive enzymes and acids there, it may be hard to break these things down. Also, someone chimed in, what about Vagus nerve issues. So, this is kind of a classic area in functional medicine where people try to talk about things differently in a nuanced way and they’re just talking about the same thing in a different way but people think it’s a new thing, right? So, when we talked about like inflammation and adrenal stress, when the more stressed you are and the more you activate the sympathetic and the more inflamed you are, right? Guess what happens when inflammation goes up and the sympathetic nervous system goes up, the vagus nerve or the parasympathetic nervous system always goes down, does that make sense? So, when we talk about these things it’s implied that the vagus nerve or the parasympathetic branch of the nervous system that would helps with healing and recovery is always going to be impaired and so people talk about things kind of as a way to nuance themselves make them seem different kind of market themselves in a different way which is fine but, you know, the average person may get a little confused about it and so just know that, that’s kind of under same umbrella that we’re talking about. We talk about the vagus nerve or the parasympathetic, it’s being factored into this whole adrenal stress inflammation umbrella, I think, yeah, inflammation is the bigger umbrella then you can put adrenals and parasympathetic and sympathetic all under that umbrella.
Evan Brand: Yeah. Very true. Very well said. Teri chimed in, I’ve been experiencing constant belching, a new symptom for me. So, once again, you got to get the labs run, I want to look at your organic acid, see what’s going on there. Get a GI map stool test run. Are you on proton pump inhibitors? Are you taking supplemental acids and enzymes? How old are you? If you’re above the age 40, you probably have low acid, low enzymes, maybe gut infections too. So, with stool, urine sample and good workup, you could probably resolve belching. I mean, that’s a pretty easy one.
Dr. Justin Marchegiani: And, I strongly recommend, do not get these labs on your own because, just because you get a lab, you’re not gonna have any ability to know what to do next and that’s everything, right? You gotta know what the plan is next, uh, and then typically you wanna look at like when I order a lab, it’s in conjunction with we’ve done a b c d e f and then not the lab is gonna plug in at g. Does that make sense? So, it’s never just this is a or this is it. There’s a whole bunch of, sequence of things that we’re doing before we get to all the data from the lab. And so, when you work with someone, most people are gonna have that plug in at some level in the clinical chain downstream. So, most people think, oh this is just it, this is a, this is the whole piece of the puzzle and it’s not. So, just kind of keep that in the back of your head. I know that can be a little bit confusing when you’re a lay person coming in there but it’s important information. I think, just start off with a lot of the foundational things first, just kind of wrap your head around it. Don’t get kind of myopic in this tunnel vision. Oh, it has to be Candida, it has to be this, be very open minded that it could be many different stressors and just have that really good differential kind of diagnosis list of all the things that we’re gonna go and hit and not get overly focused on one thing.
Evan Brand: Yeah. Good point. I’ll also say too, I’m not saying go to your doctor who’s failed here for the last 10 years and try to ask them for organic acids test or stool test because even if they were able to run it which most of the time, they don’t have accounts set-up with the lab so they’re not going to. But even if they were able to and they run it, they’re not gonna know how to interpret it, they’re not gonna know how to make a protocol based on it. So, this is a shameless plug for you and I and what we do as functional medicine practitioners, we work clinically around the world with people. So, uh, Teri’s asking where she can get the labs from. It depends, uh, we use a couple different companies. It depends on where you live and what you got.
Dr. Justin Marchegiani: We’ll do this, we’ll put some links on the videos below so for you and on your site and mine. So, if you want to get it from us, I recommend getting it from us and then work with Evan or work with myself. We’re here to help you. We’ll put the links below or you can go to evanbrand.com for Evan or Dr. J here, justinhealth.com for me. And then, just to kind of highlight what you’re saying, I see so many people that have some of these tests sometimes and the first question is walk me through what your doctor ordered this test, said about it. Did they give you a real thorough review? How much time, oh, hey they just spent a minute, they just said x y z and it really was, I’m like wow, you know, you have all this information here and yet it really isn’t thoroughly addressed, I would say 90 plus percent of the time. So, it’s really important when you get these tests ordered. You really want to come through it thoroughly, so you can extract as much actionable information as possible. And, if your doctor doesn’t have that level of, uh, skill set of information on it, that’s fine, just find someone else.
Evan Brand: Yeah. You make a great point. I mean, so many times, I know, you and I have a section on our intake form where you can, like attach previous labs. I’ll see 5, 10, 15, 20 labs and I’ll be from a medical doctor or a chiropractic or some other type of practitioner. I’m like wow, they did a really good work-up on you. Like, how did this go, why are you coming to me, what was the protocol? Oh, they didn’t have a protocol. Like, well, why’d they run the labs? ‘Because I wanted them to’. Okay, then what did they say about the labs? ‘Oh, well, that was not bad but I could use a little improvement and so they gave me an enzyme’. And it’s like, they give you an enzyme, you’ve got 20 pathogens, you’ve got parasites, you’ve got H. pylori, you’ve got major gut inflammation and the sequencing of this is important too. So, even if they read a cookie cutter protocol where it says like take oregano oil, you might not be a good candidate for that if you’ve got a bunch of inflammation. Your gut’s irritated, you go throw a, you know, a nuclear bomb in there, you’re gonna irritate your gut more. So, the sequencing is important. So, I guess, just to highlight here what we’re talking about, it’s the sequencing. As you mentioned, when does the lab come in? That’s not just the end all BL tool, there’s other strategies you’ve implemented up until that point. And then, when you work in the killers, is it right out of the gate? Do you got to settle the gut first?
Dr. Justin Marchegiani: Yeah. It’s never. The problem is people have done, the patients come in and they’ve done a lot of different things. So, like maybe, they’ve tweaked their diet and so they think, okay I’ve made these diet changes, right, whether it’s enough or not is besides the point but they think, okay I’ve done these diet changes, check. Diet isn’t part of the equation, so in their mind they kind of check that off. So, when they see another practitioner, they kind of have this list of things in their mind they’ve checked off. And then, they’re like okay, I’ve already worked on the diet stuff. Yep, I’ve already done some digestive support. So when I lay out my plan, there’s kind of like, we’ll I’m not gonna do this because I’ve already done some of this or I’m not gonna do that. No. it’s like, if I give you a safe and the combination is 6 or 7 numbers. You don’t say we’ll spin number 33 on my other state therefore I don’t have to do it this time around. The combination has to be done in sequence together. The other analogy is cooking. If you want to crack the eggs after you bake the flour, well that cake’s gonna be pretty nasty, okay. So, it’s kind of the same thing as a sequence and just because someone has done something before in the past. One, it may not have been all the way there but we still have to plug that sequence back into the overall flow of things. Does that make sense?
Evan Brand: Yeah. It does. And I know
Dr. Justin Marchegiani: You’re smiling, so it sounds like that’s something that you deal with and hear a lot.
Evan Brand: Oh yeah. Yeah. Well, it’s just, you know, once
Dr. Justin Marchegiani: It’s so much easier dealing with patients that have done nothing that have no, um, no predisposition to like what’s next, they’re like a blank state because then you can kind of come in and there’s zero resistance and you can work through your flow. When people have done a lot of things and they think they’ve done everything in that area, it’s always hard, you kind of have to convince them to redo these things over again. That could be tough.
Evan Brand: Now, well, I’m just smiling because of the safe analogy, you know, you always kill it with the analogies and I’m also smiling because I don’t know if it was your kids or my kids screaming, I’m like, I’m pulling my headphone out like is that my kids is that Justin’s kids. And, one of the things that I hope you guys love and appreciate about us is that we’re dads, we’re family men at the end of the day. And so, we’re working, we’re hustling, we’re grinding with our clients but we’re implementing this stuff into our family we’re helping kids, our own personal kids, we’re working with kids clinically. I’ve got kids that are 1 year old, 6 months old, 3 years old that are clinically working with us to get help. And so, we’re practicing what we’re preaching with our family too and I just want to highlight that because there’s so many people out there, so many practitioners that they were so focused on medical school or their practice that they never have the chance to even start a family, you’ve got these mid 40s late 40s upper 50s practitioners out there. They have no family experience and I think that’s where you and I are different because we know when you’re working on a gut protocol. Let’s talk about that for a minute. When you’re working on a gut protocol with a kid and you’re like okay, we’ve got terrible tasting tinctures that we can try, we’ve got some capsules that maybe mom or dad can open up and put into apple sauce. You know, you and I have personally and clinically dealt with the logistics of implementing this stuff so even if you’re gonna get this perfect gut protocol put together, the logistics of following it and getting your kids to take it, 3-year-old Johnny who doesn’t want to take the Artemisia, you know, it’s like, well how do you get that in. That’s the important thing because the proper labs is a step, the proper nutrition is a proper step, the protocol is a step, but the implementation of it and then what do you do after step one and then you if they react to that herb, how do you go to step 2, this is where the hand-holding is necessary. So, you know, when we talk about labs, I think, it kind of devalues the art of medicine a little bit because you and I have so much artist, you know, artistry to what we do and it’s hard to translate that just with a lab test because, you know, anybody could start running labs and like you said we’ve seen 5, 10, 15 labs come in from previous practitioners but they did nothing with it. So, the real art is when you take the protocol, you take it with, you and I are injecting confidence and we’re injecting motivation. I talked with the client this morning who said that she came to me because she was so afraid of her gut symptoms and she came out of fear but now we have basically transformed that fear into empowerment and education and the labs were a tool to help change that. So, don’t put all your eggs in this lab basket, they’re still amazing, you and I still run them on everyone but there’s other stuff that’s injected into that lab that really makes the magic happen.
Dr. Justin Marchegiani: Yeah. 100%. I think, the hardest part too is you work on dealing with the stressors, with patients. You fix their stress. You get your digestion better. You fix a lot of the microbiome. You knock down a lot of the bugs. Again, in the realm of Candida or dysbiotic bacteria, it’s still going to be there. You’re never ever gonna knock it out 100%. So, there’ll always be a small residual bit, maybe lingering in the background, way beneath threshold but if the stress starts to come back or if people start to add too much of food that’s questionable into their diet, sometimes these things can come back and the amount of flexibility, some kind of can follow the 80-20 principle. If they’re right 80% of the time on things 20% they have a little bit of flexibility. Some got to do 95.5 or some got to be 100 but just really try to make sure if they cheat, they still keep grain free anti-inflammatory etc., like last night, I went to True Food Kitchen for my birthday, and I had some of the, um, their chocolate cookies which inside the cookie, it’s like cassava and banana based. So, that’s great. If I’m gonna cheat, I’m gonna try to do it in a way that’s not gonna cause me to get bloated or gassy or have any skin issues or you know, digestive problems.
Evan Brand: Uh, a lady commented and Dr. J seems super energetic today. Yeah. He’s a birthday boy. That’s why he’s feeling better.
Dr. Justin Marchegiani: Oh, yeah. No problem there.
Evan Brand: So that’s good. Another comment here, I wonder which lab test should I run, uh.
Dr. Justin Marchegiani: I would say just here, out of the gates, regarding labs, I don’t wanna name specific companies on these videos because if we change it in the future and someone just watches the video, um, that they may just go to the old one. So, we’ll put links down below. That way, if we decide to change things in the future then you could just go look at the links down below and so my staff typically will update this in the next 12 hours or so. Just check back at the end of the day or tomorrow, we’ll have everything in there so just keep an eye on that. In that way, if something changes, um, it’ll be reflected in the description below.
Evan Brand: But here’s what we can say, we’re still gonna run a stool sample, now, maybe that type or whatever.
Dr. Justin Marchegiani: Cutting edges, some kind of stool testing is gonna be great, right? Organic acid is gonna be excellent. I love that because of the, I mean, every now and then I’ll get a stool test coming back and the gut issues look pretty good like not too bad nothing crazy but then you’ll see a lot of yeast because sometimes you miss the yeast on the stool test, that’s common or you’ll see 3 or 4 markers like Hippurate, benzoate or 2,3-phenylacetate right or D-lactate really hides. Okay, good, I’m glad I had this extra net to catch it because the stool test missed it.
Evan Brand: I had that last week actually. You know, I had a lady and I kind of got freaked out at first, you know, I was looking at the stool and I’m like, oh my God, this lady has every gut symptom in the book and normally on page 3, page 4 you’ll start to see some crazy stuff going on. In this lady, it was clean, oh man, like, is she crazy, I didn’t really think that but you know partly it is like, uh-oh, where’s it coming from, is this really her stool test. Then we get to the organic acids and holy smokes, as you mentioned, oxoglutarate, D-arabinose, tartaric acid, tricarbolic acid, everything was off the charts and I go, oh, thank you Jesus we have the answers on the organic acid. So, that’s why we love to run both urine and stool because certain things get missed and it’s the synergy of the information from the labs. You may find a parasite on stool and then you may find the Candida on urine then you really go, oh holy crap, that’s where it’s coming from. So, um, let’s hit this other one here. There was a person
Dr. Justin Marchegiani: I want to hit one of the questions. Anthony wrote to me there, thanks Anthony for the great feedback, and again guys, we’re trying to interact with you guys live and I want to answer questions live, so this is like I call it, uh, functional medicine improv, right? You know, you get your comedy shows, this is our functional medicine show so I appreciate that. Thanks for the feedback Anthony. Isabella writes in waking up distended, right in the morning. So, with that, a lot of times, you got to calm down a lot of the fermentables in the diet. If you’re waking up distended in the morning, almost always there’s a lot of fermentation happening in the gut and these gases are being produced. Now, there’s a couple of variables that you can do to help that. One, you starve it out by reducing all the foods that feed that. Two, you have to be able to break down your food because even if it’s good food, if you’re not breaking it down well, it’s gonna essentially have the ability to rot and rancidify and putrefy. So, you got to make sure enzymes, acids, and potential bile salts are addressed because HCl, hydrochloric acid, and bile salts, if you have low levels of that, those things in and off themselves are actually antimicrobial. They have a mild antimicrobial effect, not like oil of Oregano, but they have a mild antimicrobial effect. So, if you have, like, digestive distress and you have poor levels of these things, guess what, these bugs are more likely to grow and of course we have to come in there and do some killing, you know, making assumptions that like if you have a lot of distention like there’s no fiber, there’s no raw vegetables even though you read all these things have this big salad, you know, you could steam some of these things, you may want to look at low fermentable things that’s great. You may want to make sure your stress is good and you’re chewing your food up really well and you’re you know avoiding hydrating outside of an ounce or two of, you know, water to swallow and some supplements so that’s kind of your starting point. And if you wanna reach out, Isabella, you feel free to use the link down below, you can reach to Evan and I.
Evan Brand: Let’s read the rest of her comment here because I think it’s helpful for people. So, she said that she tested negative for SIBO, I’m guessing that might have been a breath test and she said she’s 21 years old and it affects her daily life. So, when I hear 21-year-old female, a lot of bloating as you mentioned, I think the veggies, I think cutting out leafy greens, no salads, maybe or
Dr. Justin Marchegiani: If you do it, keep them low FODMAP and steam it or sauté it like I’m pretty sure Bok Choy and Kale. That’s low FODMAP, if you sauteed that in some coconut oil or some ghee or some kind of good animal fat, you’d probably be okay but test it, right. I’m all about testing not guessing.
Evan Brand: True. True. So, I think about hormones, I think okay, she’s 21, right? This is a healthy fertility age. Is there some sort of issue with hormone imbalances? Are there estrogen dominance type issues as well? What about breast tenderness? What about PMS, irritability? Are there mood issues as well or is it just an extremely distended belly?
Dr. Justin Marchegiani: Now, in the history that’s gonna come out with a good history because you’re gonna see it cyclically happen typically premenstrual or typically ovulation. So, a good history will fret that out. Let’s assume it’s every day, hormones are probably not the root cause but of course we know we’ve already talked about it, chronic digestive issues will eventually cause hormone problems because of the inability to digest the nutrients to make the hormones overtime.
Evan Brand: Good point. And, the bacterial overgrowth which will crank up beta glucuronidase. That creates the recirculation of toxins. So maybe that. What about birth control too? Is that in the equation? I start thinking about that so
Dr. Justin Marchegiani: Birth control pill will, it definitely has an effect on, um, alkalizing some of that tissue in the intestinal tract and the vaginal tract. That’s why one of the big effects that you see with, like birth control pills is yeast infections, right? Because it’s shifting the pH. It’s also creating a lot of nutrient deficiencies. So, if you have birth control pill issues, they can definitely put you in that microbiome, um, area where it kind of goes the wrong way there.
Evan Brand: Yeah. So, hopefully that helps and as you mentioned if you wanna reach out, you can. Dr. J at justinhealth.com and me at evanbrand.com. With a stool and a urine and a good workout, we could probably get to the bottom of that. I would say that digestive issues are something you and I have the most experience of out of anybody that I know because all the people that have failed others then they come to us.
Dr. Justin Marchegiani: Absolutely. The hardest part too is once you kind of get on that straight and narrow, finding out how much latitude you have, right? Some people, they may not be able to do dairy afterwards. Some may still have to be grain free, they can’t even do rice or, um, oatmeal, right? So, some people they got to be a little bit tighter on their diet. Some can be a little bit looser. And it’s hard. The hardest thing I think is with kids because kids, I mean, I have two, a two- and four-year-old boys, right? And most kids in their age eat like crap. It is just like absolutely mortifying to see how most kids eat. And, normal and typical are two different things, right? So, people say, I wanna be a normal kid, I wanna eat like a normal kid. It’s like no, you wanna eat like a typical kid, like normal 60 years ago was a totally different diet than normal today, right? 60 years ago, everything was mostly organic. Kids ate relatively, you know, whole foods and there wasn’t all the GMOs and all the crap and all the excess omega-6 fats and trans fats and people were eating good proteins in every meal and we had actually home-cooked meals and home-cooked dinners. That’s totally different today, right? And so, typical and normal are two different things.
Evan Brand: Yeah. Not many seed oils or non-existent seed oils or go back a little further, go back 5000, 15-20000 years in United States, even just a few hundred, you read the native American stories, I mean those kids were eating Bison, breakfast, lunch, dinner, you know, what were having, they were having Bison. If it was a time where they maybe didn’t get a kill, they had pemmican which is gonna be like a dried meat product, maybe some tribes, they would integrate berries into it. But if your food has a brand to it, now there are some exceptions like there are some really good companies that make Bison meat and all that but in general
Dr. Justin Marchegiani: The jerky, yeah, there’s some good stuff, there’s some decent paleo granola. If you can handle nuts and seeds then that stuff’s okay as well.
Evan Brand: But in general, my point is if your food has a brand to it, it probably has some level of processed. Now, if you say a farm, like a farm name, I don’t consider that a brand. I’m talking about, like Kellogg, that’s a brand. If your food has a brand to it, it’s probably not something good. I’m not looking at the brand of my wild blueberries, I guess technically they have a name or a store but they’re blueberries. So, you just got to think simply and as you mentioned long term, there may be dietary changes but overall, I think a lot of people can get back to foods that they previously avoided or were previously afraid of, not to mention, people that are afraid of meat, so many people are afraid of red meat. We interview people all the time and they say, oh, I eat red meat a couple times a month, I eat red meat every day, like why, and oh well you know, my cholesterol or my heart or my doctor said this and so there’s still so much programming. I think you and I forget, now, I know you have TVs and you probably have some exposure to this but in general I don’t have any exposure to pharmaceutical ads and so I forget just how much indoctrination and programming of dietary information people have and so part of the art of what we’re doing too is just removing any of the historical programming, they’ve had about certain foods. I think some people freak themselves out so much, they’ve been told a certain food is so bad for them, they go into it, thinking if I eat this steak, I’m gonna have problems and they literally will put so much stress and emotion into the worry of food. That then drives further symptoms.
Dr. Justin Marchegiani: Yeah. I always start with you gotta have a framework on how you analyze any data or any concept, right? So, my first framework that I look at anything with is old foods don’t cause new diseases, right? When you look at most of the diseases we have today, the regular there routinely Neolithic, right? They weren’t at the same level that we saw a hundred years ago, right? Obviously, we had different problems back then because we didn’t have the same level of water sanitation, indoor plumbing, antibiotics which you know for like, you get a major cut, you had an infection, you don’t have antibiotics, you could die, right? So, we have that, that’s different. So, Neolithic foods cause most diseases. And so, when you look at good proteins and animal fats and these kinds of things, they have been eaten for as long as you can go back. So, those typically aren’t going to be the problem, right? It’s mostly gonna be the processed foods, the excess omega-6. And also, you know, the whole vegan bent that’s something that’s not really supported by anthropological data. You look at the works of western price so you look at people that studied indigenous societies, almost always meat was consumed when it was available. The only societies that typically didn’t consume meat were societies that didn’t have access to it. And if you look at the works of Western price when meat was accessible, it was typically consumed. It wasn’t like, oh let’s just not consume it. It’s typically, they didn’t have access to it and when they did eat it. And so, people that tend to do really good on a non-vegan diet are your ectomorphs, these are people that can handle lots of carbohydrates. It’s impossible to do a vegan vegetarian diet for the most part and not be very, very high carbohydrate and also, typically, you also got to plug in a lot of protein powders to do it well, whether it’s free form amino acids, whether it’s collagen or pea protein or rice protein or hemp protein, mostly having to plug in a lot of amino acids to get enough especially if they’re trying to put on muscle and be, you know, on the fit side.
Evan Brand: It’s hard to be Vegan, it’s easy to be an animal-based person, I’ll tell you that. There’s just a lot of hacking, have to do. So, Isabella chimed back in, she was a little bit behind on the live stream so she chimed in here. So, here we go, we got some more evidence guys. I hope you’re having as much fun as we are because this is like a, you know, on the fly functional medicine, uh, workup here. So, she said, loss of period for six months as well, mood issues like anxiety and racing heart upon waking irritability which is what I was thinking some kind of hormone stuff. I’m a bit behind wanted to input that so.
Dr. Justin Marchegiani: The problem with a lot of those symptoms, it requires me having to ask a very important question, I won’t ask that question but we’ll just say the meat of that question begins with a letter v and we’ll just let people linger on that and Isabelle, if you want to reach out feel free. I think we chatted in the part, so feel free to reach out, I’m happy to help you.
Evan Brand: Yeah. Yeah. That’s a very, very good point and would make perfect sense especially with the timeline here. I would be wanting to look at some blood work. You know, actually, I had a woman last week, 33 years old, loss of period, other issues, we ran her blood, elevated D-dimer that indicates breakdown of clotting so we’ll leave it at that for today but mid-30s women should not be having elevated D-dimer.
Dr. Justin Marchegiani: Yeah, and we’re speaking kind of like we are in a very, uh, discrete type of manner because we want to keep this information flowing to you, okay, so people out there hopefully you most, you mostly get that and you want to continue to see us on the air. That’s our goal.
Evan Brand: Here’s another question then you and I can wrap this up here in a minute. So, can gut health issues cause high resting pulse and arrhythmias. Let me tell you my personal experience and maybe we could chime in on the clinical side too but when I had gut issues when I had H. pylori, I was anxious, I had issues with my blood pressure. I had heart palpitations. I had panic attacks. I had all sorts of mood issues. I had heart issues. I had sleep issues. I had skin issues. So, 100%, gut issues can cause this.
Dr. Justin Marchegiani: Yeah. The bugs in and of themselves definitely can cause anxiety so you can go type in their scientific studies, type SIBO or H. pylori and anxiety, there’s definitely mental health association, connection with the two. Also, if you have digestive issues, you tend to have hydrochloric acid issues. When you have hydrochloric acid issues, you tend to not ionize minerals and absorb minerals optimally. The two big minerals that are intimately connected with your heart and heart rate and heart rhythm are potassium and magnesium and a lot of times people aren’t getting sodium and chloride as well. So, the electrolytes have to be looked at and potassium and magnesium have to be looked at and most don’t get enough, you need 4 7 00 of potassium a day, most get half that and so I have a product called potassium synergy that does about 13 00 per 150 in magnesium or so side by side. It’s really hard to get enough. Most supplements for potassium stink, they’re like 50 or 100 milligram capsules so you got to take like 15 or 20 capsules a day so sometimes, you need to plug in a supplement if you’re having issues, I mean you can go look at the most potassium-rich foods, salmon, avocadoes, sweet potato. Those are really good options of course, um, some animal products as well, are going to be right up there as well. And again, avocados have twice the amount of potassium as bananas, I know we’re kind of o a carb-centric society. If I say potassium, you’re gonna say bananas, right? But avocados have twice the amount.
Evan Brand: Yep. Good call. Good call. So, long story short, gut issues definitely cause other issues, mood issues are very common. Fatigue is also very common and so that’s gonna affect neurotransmitters so we would be looking at all that. We’d be looking at neurotransmitters, gut inflammation, um, secretory IgA. You can look at fecal fat. There’s a lot of stuff that goes into that, that may affect the high resting pulse. Also, seeing a lot of things right now with viruses and high resting pulse rate. So, if there was a current infection, previous infection, pulse rate could be there. You mentioned potassium.
Dr. Justin Marchegiani: Hydration, sodium chloride and then your potassium, magnesium. Those are gonna be your big ones out of the gates. And then also, blood sugar, you know, some people, they really get into a stressed-out state if they wait more than an hour or so to eat. And if you have digestions, a little wonky, you may want to start with something really simple like some gentle ginger tea or some collagen amino acids or something really light and simple in the morning and some electrolytes even before that.
Evan Brand: Yeah. Yeah. Good call. Sometimes, you know, herbals, I might come in with like motherwort or passion flower, valerian, some kind of like calming ginger.
Dr. Justin Marchegiani: Yeah. I was looking at the nutrients first because the nutrients could be actually root cause and the herbals will never be root cause but they are a palliative supporting mechanism, right? You know, it’s like, you can do passion flower or lemon balm or you can do a benzo on the pharmaceutical side. It’s like obviously the herbs are better and then even before the herbs the actual nutrients that may be deficient that are driving it.
Evan Brand: Very good at all. I’m ready to wrap this up, if you are
Dr. Justin Marchegiani: Herbs aren’t going to have the, you know, the side effects so I’m always down with supporting something palliatively if they aren’t going to have the side effects or you know any of the negative consequences like some of the meds may.
Evan Brand: Yeah. Well said. Are you ready to wrap this up?
Dr. Justin Marchegiani: Yeah. Great chat with everyone here today. I’m glad everyone’s on the chat interacting. We really appreciate it. Functional medicine improv is our flow here, uh, you guys wanna reach out to evanbrand.com for Evan, Dr. J here, myself at justinhealth.com. We’ll put links down below. If you’re seeing it on youtube, you know, great, excellent. If you’re listening to this on itunes or any of the podcast places, there will be a video link below. If you wanna see us interacting as well, there’s that as well. And phenomenal chatting. Anything else, Evan?
Evan Brand: Yeah. If people wanna chime in and they want to watch, if you guys are listening or if they’re on my podcast because we’ll upload these on my show as well. If you want to check us out here on video, give or take somewhere around 11 to 12 eastern on Mondays on Dr. J, justinhealth YouTube channel. So, if you wanna look for us, join the party. Look up Justin on YouTube justinhealth, Justin Marchegiani, Dr. J something like that. You’ll find him on there and, uh, we’ll put the link in the show notes too. So, if you wanna join the YouTube community, you can. There’s what 60 something thousand on there. So, that’s pretty
Dr. Justin Marchegiani: Also on Rumble, also on Betshoot, also on a couple other places. So, we’ll put the links on the websites so you can get the banners, get the links but Rumble’s our new one that we’re going to just get more exposure, people.
Evan Brand: And you’re reuploading the YouTube videos too there, right?
Dr. Justin Marchegiani: Yep. You got it.
Evan Brand: No live function on there or anything yet?
Dr. Justin Marchegiani: Not yet. Not yet.
Evan Brand: Okay. Okay. All right, well, you guys take it easy, we look forward to helping you get your gut health back, just stay patient and don’t give up. And so, we’ll see you next week.
Dr. Justin Marchegiani: Take care of you all. Bye now.
How to Get Your Energy Back Post-Infection | Podcast #365
When people start to feel better after an infection, it is often tempting to return to previous levels of work, leisure, and social activities. However, too soon, trying to do too much can often be counter-productive. It is easy to get caught up in a ‘boom and bust cycle of activity that can prolong your recovery.
Dr. J and Evan discuss that if fatigue and other symptoms persist, it’s important to remember to allow yourself time to recuperate by finding the right balance of rest, relaxation, and activity for your circumstances. It is essential to listen to your body and gradually build a physical and emotional recovery plan that can help you get back to your life and stay on track without experiencing too many setbacks.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
5:11 – The essential vitamins to boost your immune system
10:12 – What is the goal of the Krebs Cycle?
14:06 – Mitochondria and microbiota dysfunction in viral pathogens;
17:12 – The role of mitochondria, oxidative stress, and the response to antioxidants in chronic fatigue
20:08 – The neurotransmitters from amino acids and tryptophan pathways in B6 deficiency
Dr. Justin Marchegiani: With Evan Brand, really excited today. We’re gonna have a nice conversation on how to get your energy back post-infection. This is the topic that we’ve been getting a lot from our patients and again a lot of our inspired podcasts and videos come from real life clinical work with patients. So, we’re excited to bring you the real-life actionable information here to improve your health. Evan, how you doing today man? What’s cooking?
Evan Brand: Hey. Doing pretty well, uh, cooked some bacon this morning and that was about it with some organic blueberries and so I’m feeling good. my brain is clear and I look forward to helping people on this energy conversation, you know, so many people have chronic fatigue post-infection and they’re not fully bouncing back and so, I think that there are some easy low hanging fruit strategies that we can talk about but I’m just gonna jump straight to the big smoking gun which is looking at your mitochondria. We’re seeing a lot of issues with mitochondrial dysfunction or mitochondrial damage. I’m also seeing issues with neurotransmitters. So, I think, if you are to pick one and only one functional medicine test to look at to investigate yourself after this infection and fatigue, it would be the organic acids because you can get a great window into not only your gut health. We know that with infections, it does damage the gut, we know that there are ACE2 receptors in the gut so people that are ending up with irritable bowel or diarrhea or other problems during and post infection, we can look at that. A stool might be smart too but if you had to start with only one thing maybe the window into your gut via urine organic acids would be good enough. But more importantly, I want to see what the heck is going on with mitochondria and what kind of damage do we have because once you have the data then you can put together a protocol to fix it.
Dr. Justin Marchegiani: 100% agree. So, we know with chronic inflammation, especially like, post-viral inflammation. We know one of the biggest drivers is gonna be oxidative stress, right? So, oxidation is nothing more than your body losing electrons, right? And one of the big things that helps oxidation within any type of infection pre, ideally, we’re doing these things pre to mitigate al of the oxidative stress that’s happening at the mitochondrial level but simple low hanging fruit, out of the gates, is gonna be glutathione, vitamin C, these are really powerful antioxidants. Vitamin D even kind of fits in that category, right? Your big antioxidants are ADEK, um, I’m sorry, no, those are your fat-soluble vitamins but E is gonna be an antioxidant A is gonna be an antioxidant, right? I would even say E and K would for sure but your B and C are gonna be your water-soluble kind of more antioxidants for sure but the big are gonna plug in, you know, post-viral oxidative stress and/or pre is glutathione and vitamin C, out of the gates. And we can also look at low-hanging fruit on the mitochondrial side, which plugs into the Krebs cycle and the electron transport chain is gonna be B1, which is thiamine. I would say B vitamins as a whole was great but B1 has a major, major role and I’d even say B5, as well, pantothenic acid. So, you have thiamine, B1, right? You have Riboflavin, B2. You have niacin, B3; Pantothenic acid, B5; Pyridoxine, B6; biotin, B7; folate, B9; B12 is your methylcobalamin or hydroxyl or adenosine. And so, we’re talking B1 and B5 are gonna be big when it comes to post-viral fatigue. Those are really, really important nutrients that we can add in out of the gates and, why it’s all of this oxidative stress that’s happening when this infection is present. And so, the more you can do things like hydrate, keep inflammatory foods down like the excess Omega-6 fatty acids, um, keep the carbohydrate and the sugar in check, right? That’s gonna play a major, major role in not adding fuel to the fire if you will as well.
Evan Brand: Yeah, and you can do oral glutathione. So, we have a combination product, which is an acetylated glutathione along with an acetylcysteine. So, you can give your body the nutrients to make more. You can give the precursors but then you can also take just straight glutathione. There are some liposomal versions. There’s reduced glutathione. There’s a nebulizer version that you can take so you can inhale glutathione if you feel that there was some lung involvement. You may consider doing both. I personally did both. I did oral and I continued to do oral glutathione daily and then, also, during the acute situation, nebulized glutathione with silver. And then, you mentioned B vitamins and you can measure all this, right? So that’s the important thing is, you know, you’re shouting out all these different names but people can look at this, right? We can look at this on organic acids. We can look at the various B6, B12. You can’t look at every single nutrient in the body but you can look at a ton of nutrients from one urine sample. So, it’s pretty awesome. And then, vitamin C, believe it or not, we’re seeing a lot of issues with viral infection and acute scurvy, which is pretty interesting. If you just put it some of this data and scurvy into the research, I guess, it’s due to the oxidative stress. It’s happening quickly and every single person I’m seeing post-infection is showing low vitamin C. So, we’re just keeping people on 2 to 3 grams every day. We’re doing a powdered version with a mixed ascorbate. So, you probably don’t want to do just straight ascorbic acid and you probably wanna do like a sodium ascorbate, magnesium ascorbate, if you can get some citrus bioflavonoids in there too and just take it ongoing. Don’t wait until you’re sick. We, as a family, we just take vitamin C ongoing because we know it’s important for the health of your capillaries and all that. Can you speak on that for a minute? Like vitamin C and skin and collagen, I mean there’s a role in other things. People think vitamin C, immune, but there’s other benefits to see, right?
Dr. Justin Marchegiani: Yeah. Vitamin C plugs into making collagen, which is all of the connective tissue for your skin, uh, hair, you know, cartilage, vitamin C is really important for that. Vitamin C is a very similar molecular structure as glucose, right? Don’t quote me but it’s similar to I think C6H12O6 or O8, it’s right in that molecular area, looks very similar. So, what does that mean? That means, vitamin C has a docking site on the macrophage that actually goes and gobbles up bacteria and potential viruses and it’s gonna use that vitamin C that docks onto that macrophage to deal with the oxidation. So, I kind of think of it as like a firefighter going into a house and the vitamin C is like that fire fighter bringing that hose to squelch that fire, to squelch it, right? That’s kind of what I see vitamin C as, right? And, it’s almost like with the macrophage, it has a docking site and that glucose can actually come in there because it looks very molecularly similar to vitamin C and it can almost dock on that receptor site on that macrophage and take that vitamin C where to be used. It’s almost like giving the fire fighter a water hose, taking the water hose out and giving him a gas hose and he doesn’t even know. It’s almost like that and that’s why glucose and high levels of glucose and when it comes to a lot of these post-viral illnesses, you’re gonna see people that have very high levels of blood sugar, insulin resistance and even the extreme on the diabetes side are gonna have most of the side effects of most of the issues partly because of the oxidative stress, partly because of poor levels, you know, when you have insulin resistance that’s gonna affect oxygenation, right? Because, you’re not gonna have good blood flow and when you have poor blood flow and poor oxygenation, we need oxygen to plug into that mitochondria as well. It’s part of, you know, the key nutrients, right? We talked about B vitamins, B1, B5, very important to plug into the Krebs cycle. Well, guess what, when you have a high level of blood glucose and you’re on that pre-diabetic to diabetic side, right, 110 to 126mg/dl on the blood glucose side, your body has to process that and if you just go pull up, you know mitochondria, Krebs cycle and nutrients, right, you’re gonna see all the nutrients that are involved in that Krebs cycle to process that glucose because how it works in the Krebs cycle, everything gets funneled down to acetyl CoA, right? So, you have glucose comes to acetyl CoA, fatty acids come to acetyl CoA, they can also go this way into ketones and then you have protein coming down to acetyl CoA. Acetyl CoA pumps around the Krebs cycle twice and if you look, there’s gonna be nutrients that have to come in there to help that acetyl CoA to come around and a lot of those nutrients are gonna be B vitamins, magnesium, amino acids and so, if you’re coming in with lots of glucose and you’re not bringing in a lot of nutrients to funnel down to the acetyl CoA side, you’re gonna run that Krebs cycle twice and you’re gonna be using more B vitamins than you’re coming in. So, you can actually create a lot of nutrient deficiencies and oxidative stress when you consume a lot more glucose because it’s a transaction fee for your body to process energetically.
Evan Brand: Nice. Nice. That’s a great way to put it. And, the truth is people are coming into this infection with nutrient deficiencies already due to bacterial overgrowth problems, Candida problems, maybe post-antibiotic therapy, you know, they have issues with the gut now and they’re not making enough of their nutrients in their gut. And so, a lot of people will just depend on diet and they’ll simply, well, can I just get enough on diet, can I just eat liver and grass-fed steak and all that and get enough nutrients from that and I’ll say, look I’ve tested and I know, you have too. Over a thousand people and many of those people were already dialed in with their diet for years before they got to us. Paleo, carnivore, autoimmune, paleo, we’ve had people that have been doing an incredibly job with nutrient density and they still show up with nutrient deficiencies and so I would love if everyone could just eat their way out of this situation but I just think with the modern stress that we’re under we’re dumping a lot of those Bs. You’re mentioning all these that are fueling this cycle. We’re so depleted and burned out emotionally, physically, chemically, we’re exposed to toxins. We’re just not living in Paleo time, so Paleo, you can’t just like paleo your way out of this and you know, that’s why I used to call my podcast years ago ‘Not just Paleo’ and then I got rid of it, just call it Evan Brand now but, um, that was my whole thought at the beginning. It was like, man, if everybody could just eat their way out this and get enough Bs in the diet then you and I wouldn’t be needed.
Dr. Justin Marchegiani: 100%. Let me just kind of break this down for people just so they can get a better understanding of what’s happening here. So, when we have oxidative stress, oxidative stresses, we’re losing electrons. What’s the whole goal of the Krebs Cycle? The whole goal of the Krebs cycle is essentially gathering up electrons. Okay, so, you have fats like I mentioned before, they’re all funneling down to Acetyl-CoA. Proteins all funneling down to acetyl-CoA, right? Then you can see on the carbohydrate side like I mentioned, look at a lot of the nutrients that are involved in funneling the carbohydrates down to acetyl-CoA, different B vitamins, okay?
Evan Brand: Zoom in so,
Dr. Justin Marchegiani: B1, B2, B3, magnesium, all play really important roles and then look at the carbohydrates, look at the amino acids that are involved. Cysteine, that’s a major precursor of glutathione, serine, really important for stress. Glycine, that’s your major amino acid in collagen, right? This is why, when you’re stressed and you’re sick, it’s why your grandma tells you to have chicken soup, right, especially with the whole bone in there because you’re getting a lot of these amino acids in a liquid form. So, if your tummy doesn’t feel good and you’re nauseous, right, because the infections tend to really cause nausea because your energy is going to fight an infection versus digestion. So, it’s trying to shut that down. That’s why your grandma said chicken soup, right? Ideally, we keep the noodles out now. Now, look at the fats, right, look at where the fats can go so the fats go down to acetyl-CoA but it can also go and create these ketones, right. This is beta-hydroxybutyrate. This is a ketone, okay? Now, really important here. So, we have this acetyl-CoA, right, this is kind of our energy currency that everything gets converted from our three major macronutrients, fats, carbs and proteins. And again, if you’re listening at home, there’s a video version of this of me going through it. I know, it’s a little confusing but I’m going to try to make, break it down. Acetyl-CoA comes around this citric acid cycle or Krebs cycle. It’s the same thing. It goes around twice, okay? And you can see GSH that stands for glutathione. Fe stands for Iron. So, if you’re a female and you’re very low iron or you’re anemic or vegetarian vegan, that could be a problem.
Evan Brand: So, let me pause there, really quick, because I want to point out something. You’re showing here on this cycle that you’ve got to have not only glutathione but you’ve got to have iron so you gave a shout out to the anemic women and what I want to point out is that the women that came into this infection, anemic, which is extremely common. Women have hormonal imbalances. It’s an epidemic problem so many women have heavy periods or maybe post childbirth, their period was screwed up and they’re having heavy menstruation. So, they’re coming into this anemic or they’re coming into this with low ferritin and then that’s compounded by maybe a mold exposure where now they have low glutathione levels. The way you’re showing this cycle here, if you come in with low iron and low glutathione, you’re in big trouble.
Dr. Justin Marchegiani: You’re in big trouble. And, women are more predisposed because if they have hormonal imbalances, guess what happens to their period, they get heavier. Heavier period, they’re just gonna lose that iron. Now, men on the other side, men have it, you know, they can have increased iron. They can cause oxidative stress because iron is like, you know can be like gasoline on the fire if it does get too high, right? But you can see glutathione, iron, you can see B vitamins, you can see magnesium, you can even see manganese here and you can see different B vitamins. And, what they do is you’re creating NAD and FADH and they’re grabbing hydrogen, they’re grabbing electrons, okay? So, typically comes around here twice and you get usually two NADHs and one FADH2 per cycle and then essentially all of these things will jump into the electron transport chain next. If I could find that section here, but the electron transport chain is the next big step for that kind of gathers nutrients but for really, for today’s talk, this is the really most important thing and then just kind of highlight, you can see some of these toxins over here that come in, right? You can see fluoride, Hg is Mercury, As is gonna be, uh, arsenic, Al is gonna be aluminum. So, you can see some of these toxins, how they can kind of come in there and sabotage some of these things. And, to kind of highlight one thing, this is an article we saw here. Mitochondria and Microbiota dysfunction with post-viral issues, you can see how the gut microbiome also plays a certain role and why is that? Well, I think, because 80% of the immune is in the gut so if you have a pathogenic or dysbiotic microbiome, it’s gonna affect toxins being produced, right? It’s gonna put you right here in a hyperinflammatory state, right? We already have a lot more cytokines being produced if we have an illness and so we have to be able to calm down our immune system’s inflammation to what’s happening from an immune stress standpoint. And so, the microbiome plays a big role, iron dysregulation, reactive oxygen species, right? Vitamin C plays a major role here. Vitamin, uh, glutathione plays a major role there as well.
Evan Brand: Yeah, right there, look at that one, the mitochondrial, the heightened inflammatory oxidative state may lead to mitochondrial dysfunction and so this is what we’re seeing on paper. We’re seeing this in the stool test. We’re seeing this in the organic acid test, this issue with the gut with the mitochondria.
Dr. Justin Marchegiani: Yeah. It talks about platelet damage too which is important because what do platelets do, those are your clotting factors. And so, if we can have increased coagulation cascades, that means more clotting, right? And, you can see more clotting events, more thrombosis is that’s a blood clot, right? And so, you can see furthermore, mitochondrial oxidative just make, may contribute to microbiota dysbiosis altering coagulation and fueling inflammatory oxidative response leading to vicious cycles of events. So, this is really important and so things that we can do to be on top of the fatigue is gonna be the same things that we can do to help mitigate a lot of the inflammation. That’s gonna be keeping blood sugar in check, adding in some of these additional B vitamins, um, adding in anti-inflammatory anticoagulants. What do those look like? That could be ginger. That could be curcumin, which has anti-inflammatory and anticoagulation effects. That could be adding some extra Cod liver oil that has more vitamin A in it, which is a really powerful antioxidant but it also has natural blood thinning aspects because of the extra omega-3s in there. So, there’s different things we can do to really help reduce a lot of that inflammation. Any comments on that, Evan?
Evan Brand: Yeah. On the more intense side of supporting hypercoagulability, lumbrokinase is gonna be your most powerful. That’s your earthworm-based enzyme, which is just a cool, cool thing. Natto, there’s also serratiopeptidase, so there are other enzymes that you can use and I personally take those. I take lumbrokinase, one per day just ongoing and it’s been very helpful. I also did a podcast with Dr. Thomas Levy, all about vitamin C IV and he’s got some dark field microscopy photos of people that we’re having blood clotting issues and the vitamin C along with ozone and IV was like a game changer and vitamin C can help energy too, so I don’t want to get too deep in the rabbit hole of blood clots but we’ll just say that the vitamin C is helpful for energy also.
Dr. Justin Marchegiani: 100%. I want to show you guys one other journal article here, role of mitochondrial oxidative stress and antioxidants when it comes to chronic fatigue and so one kind of thing here, it talks about the known role of oxidative stress and how it can relate to essentially fatigue, as well as, potential, uh, specific therapeutic treatments for the mitochondria so that’s really powerful. And, you know, here are some of the big things, they’re gonna talk about vitamin C, talk about B vitamins, talk about glutathione and then also some of the more natural anti-inflammatory things but you know, each study is going to find out focus on a couple of their major things but, people in the literature are looking at these things. It is real and, um, we’re seeing it in our patients and we’re trying to apply some of these things to get people’s health back.
Evan Brand: Yeah. So, the way you look at this is what you can do to protect against oxidative stress, we covered that glutathione. What can we do to help support the Krebs cycle? We talked about B vitamins. You’ve also got just things that are gonna help the mitochondria in general, like CoQ10 and then also you can do things like PQQ and there’s other nutrients that actually create what’s called mitochondrial biogenesis where you can literally make new mitochondria. And so, I don’t think it’s in that paper, it does mention CoQ10 there but
Dr. Justin Marchegiani: Right here in the mitochondria, there are enzymes and coenzymes such as vitamin E, CoQ10 to remove ROS, that’s reactive oxygen species to prevent DNA damage. So, these are really powerful things that we can add in. For example, low CoQ10, they’ll see an increase in damage, so Coq10, PQQ, you know pyro quinolone, right? Vitamin E, and then, you know, we try to give Coq10 with vitamin E together for that same reason to prevent a lot of the oxidative stress while fueling the mitochondria. Any comments on that?
Evan Brand: Yeah. Look at the next part there too, talking about exercise. People that come in with chronic fatigue and how they’re having an increased oxidative stress after exercise and that’s a problem that we’re seeing a lot too is people that now are having, uh, post-exertional fatigue, people that are crashing. Even athletes that were really high performing people that now their performance is just in the tank and a lot of that is just this ongoing oxidative stress and mitochondrial damage that’s not, that’s not been supported and you can’t just exercise your way out of this and I get kind of annoyed when I see like those motivational videos of people that are really sweaty like you just nee to suck it up, you know, pain is weakness leaving the body. It’s like, no, you’re wrong, you got to fix the mitochondrial damage. I hate those like raw-raw videos because it’s ignoring all the nutrients. That video really needs to be talking about, hey get your glutathione up, get your ribose up, get your CoQ10 up, come on people, like that’s what he used to say.
Dr. Justin Marchegiani: And this is a similar marker that we use on the organic acid test, the one that we use 8-hydroxy-2-deoxyguanosine, this is very, very similar to that. But this is a marker for oxidative stress so we’ll actually use the same marker on a, um, on a mitochondrial test on the organic acid. So, we’ll look at some of these things to get a window of how stress these pathways are so that’s very powerful.
Evan Brand: Yeah. Ribose is amazing. Carnitine is amazing. Acetyl-L-carnitine is amazing. Also, you know, let’s hit the, let’s go up a little bit like that picture there was a like a neurotransmitter picture there that you had. Maybe, we should talk about that a little bit because it’s not directly gonna be a mitochondrial support, yeah, right there, but I think, that’s cool to point out too, which is that, if we’re coming in with nutrients like phenylalanine or tyrosine, eventually some of that may convert over to your neurotransmitters but then also your adrenal hormones like epinephrine and I think a lot of people and I know you see this too, a lot of people are showing up with just low brain chemistry across the board. And so, I’m thinking out loud with you that like, the real magic remedy is the mitochondrial support plus throwing in some of these neurotransmitter supports as well.
Dr. Justin Marchegiani: Well, that’s why we talked about B vitamins and I kind of went to the gamut, look how important B6 is in regarding the synthesis of tryptophan to serotonin, really important so you can see how B6 deficiency is really important in this process to convert this inflammatory product here, quinolinic acid, uh, back to tryptophan, it needs B6 or to avoid that whole thing it needs B6 so that’s really important. So, B6 is really important in the synthesis of amino acid tryptophan to serotonin, very important.
Evan Brand: And so, vegetarians, vegans, obviously, you’re gonna be at increased risk of issues and your recovery is not gonna be as good as someone who’s getting these good animal proteins because you’re gonna be getting adequate tryptophan and other nutrients from your animal-based products. So, even if we could get these people on eggs, if we could get these people on organ capsules, if we could get these people on even like a protein like, I’ve got one we call carnivore collagen, which is a like a beef peptide, I mean something you gotta supplement at some level if you’re not eating those foods. So, please, if you’re a vegetarian vegan and you’re exhausted then look at some of this and hopefully we can convince you to change and improve your diet a bit.
Dr. Justin Marchegiani: Yeah. No, I totally agree. I think that’s really important. I want to see if there’s anything else here, I want to highlight now because that’s enough, that’s powerful enough. Anything else, you wanted to highlight there?
Evan Brand: Well, we hit the urine, we hit the stool. Looking at the gut, you showed the study about the gut changing, we’ve seen that, I mean, you and I were talking about that march of 2020, I mean that was 2 years ago. We were talking about being affected. And so, obviously, our message is the same that it’s always been is get your stool looked at so we can see what kind of dysbiosis do you have going on because if you’re taking all these supplements, you’re doing all these foods but you’ve got malabsorption or you’ve got gut inflammation. You’re not gonna, you know, people say you are what you eat but you really what you digest from what you eat. So, if you have all these other issues in your gut, the grass-fed steak is not gonna be as valuable to you. Now, I’m not saying stop eating it, I’m saying still eat it but we’ve got to improve the digestion and assimilation of that.
Dr. Justin Marchegiani: 110%. And one thing here, I just want to highlight here, just to kind of this article, it’s talking about mitochondrial function in infections in the gut because we’re trying to talk about mitochondrial and energy post-illness, that could be a viral illness, it could also be a gut illness, right? Because, it’s talking right here, even virus dedicated virulence factors and talks about downstream of an infection. It’s fascinating that a plethora of immune responses but, uh, be it against viruses, bacteria or LPS. LPS is lipopolysaccharides or endotoxin, this can come from H. pylori, this can come from SIBO, or dysbiotic bacteria and they strongly impact tht mitochondria which is really, really important because they’re toxic, they kind of throw a monkey wrench in how the FADH and the NAD is kind of moving around the Krebs cycle, collecting hydrogens and then bringing into electron transport chain. It talks about, um, governed by the mitochondria can be translated into active therapeutics to boost immunity against pathogens to over immune responses under control in the case of inflammatory disorders. So, essentially, the more you have these infections there, the more inflammation your immune system creates that can actually impact your mitochondria. Again, when you have a lot of these illnesses, it’s not just the stress from the illness, it’s the immune response from your own immune system that creates inflammation that can actually disrupt your energy pathway. So, sometimes, you’re just fighting against yourself. And so, using nutrients to help modulate the immune response i.e., glutathione, Vitamin D, vitamin C, right, really important nutrients there. I’d also say, you can do things like curcumin, or resveratrol as well. You can have immune modulating effects. These are powerful. So, it’s good to kind of get your immune system in check. Most people that are having longer term, we call it kind of long haulers type issue. It’s typically their immune system has over responded and it’s just creating so much inflammation. So here, this illness, they’re no longer testing positive for whatever this illness is and they’re prolonged 2 to 3 months out and they’re feeling like crap still, it’s because they really didn’t get their immune system’s inflammatory cascade in check afterwards.
Evan Brand: Yeah. Well said. So, a couple comments. Number one, you can improve your energy by simply fixing your gut and that’s exactly what that data is showing and that’s exactly what you and I have seen and done clinically, hundreds and hundreds of times. People that were exhausted coming in, we give them a gut protocol, sometimes, not even giving them energy supplements because on paper they look good and all of a sudden, their energy level doubles and all we did is fix their gut so that’s the number one comment. And then number two comment is that, people need to stop waiting for some illness like this to take them down before they take this stuff serious. I mean, you and I are all about preventative approaches meaning getting your mitochondria, you gut, your brain chemistry getting all that stuff optimized now so that you’re a warrior on a daily basis so that when you do come across something like this and there probably will be more things like this that you do to get exposed to, you’re ready and you’re able to handle it and you’re not coming in so sick and looking for this emergency therapy at the end stage, it’s, in some cases, it’s too late. I think, a lot of times you can turn it around but you should have been working on your health years ago before you got this stage.
Dr. Justin Marchegiani: Yeah. And a lot of it is, you know, anytime you have some type of illness coming up, the more you can be on top of a lot of these key immune modulating anti-inflammatory nutrients ahead of time and or during versus coming in at the end when the inflammation is super high. It’s like coming in when the fire is a little baby fire and knocking it out versus having a full five alarm and trying to stop it, right? That’s kind of the analogy. So, I always recommend telling people have a couple of nutrients. You may not be taking it everyday but they may in your medicine cabinet is kind of like a, um, you know, last ditch kind of effort to kind of come in there if you start to feel a little bit ill so on my line, we have Immune Supreme, which is nice because you have some green tea in there, you have some echinacea, you have some medicinal mushrooms, you have some antioxidants and some immune modulators, that’s kind of cool. Have that in your medicine cabinet. You start to feel the tiniest thing, start taking that to get that immune system, obviously, you can ratchet up, vitamin D, vitamin C. These are easy first line things, if you have any NAC or glutathione, we can ratchet that up. These are easy things that we can do to kind of take charge of our health and prevent our immune system from throwing us off.
Evan Brand: Yeah. Well said. And, if you need help clinically, we do offer one-on-one consults around the world with people so we’re very blessed to be able to help so many people by getting the proper testing done, making the proper protocol to get you better. So, if you don’t test, you guess, you got to see what you’re up against first, look at your Bs, look at your gut, you know, once we get the data, we can help you more accurately and you’re gonna save a lot more money, a lot more time and a lot more suffering and you’re gonna get out of the dumps out of the trenches, out of the depths of hell, depression, whatever you’re dealing with. You’re gonna get out of that faster if you’re using clinical data and you have a tour guide to your body. So, if you need help clinically, you can reach out to Dr. J at justinhealth.com for consults worldwide or me, Evan Brand at evanbrand.com and we’re here for you guys. So, we look forward to helping you out.
Dr. Justin Marchegiani: 100%. I appreciate it. Yeah. Anyone that wants to reach out, Evan already gave you the links, really appreciate it. Comments down below, I really appreciate your feedback on that and also, we’ll put links down below with some products that we chatted about. We have different ones that we recommend in our line. Just wherever you go, make sure you get them from a professional grade company because raw material does matter in the supplement world. You can buy, you know, the equivalent of the grass-fed steak from the local farmer or you can get it from McDonald’s, right? And so, we want to get the high-quality raw material that’s tested to make sure there’s no impurities and just building blocks are excellent. Evan, excellent chatting with you man, really appreciate it. Guys, um, have an awesome week and we’ll talk soon. Take care you all.
Evan Brand: Take care, now. Bye-Bye.
Dr. Justin Marchegiani: Bye.
The Top 5 Causes of Bloating | Podcast #364
Abdominal bloating occurs when the gastrointestinal (GI) tract is filled with air or gas. Most people describe bloating as feeling full, tight, or swollen abdomen. Your abdomen may also be swollen (distended), hard, and painful.
Dr. J and Evan describe that gas is the most common cause of bloating, especially after eating. Gas builds up in the digestive tract when undigested food gets broken down or when you swallow air. Everyone swallows air when they eat or drink.
On the other hand, they also talk about different components of why you may be having to bloat that you may not notice. Plus, available testing and lifestyle modifications you need.
Dr. Justin Marchegiani
In this episode, we cover:
1:57 – The role of acid-pH level in the digestive system
5:01 – The link of depression and anxiety to bloating
10:02 – The benefits of probiotics and effects of stress to digestive health
18:17 – Functional medicine strategies and testing to find the root cause of bloating
Dr. Justin Marchegiani: Really excited to have a podcast today. We’re gonna be diving into a couple of different topics. The big one here is gonna be bloating – one of the big root causes of bloating. We’re gonna talk about it from a biochemical functional medicine perspective. Evan, how are you doing man? What’s going on brother?
Evan Brand: Doing pretty well, excited to dive in and talk about gut infections. I think that’s probably the first place to start because you and I have run thousands of urinary organic acids and genetic stool tests over the years. And years ago, you know, we used to use a three-day stool test. Now, with technology improvements, we could do a one-day one sample stool test and we can uncover so much. So, I’ll just kind of riff on things. I know we like to title things just for marketing purposes and call it top five but we may go into 15 by the time we’re done because just right off the top of my head here, high gut inflammation like how calprotectin may be an issue, low pancreatic enzyme function, bacterial overgrowth, where we’re gonna measure the dysbiosis, H. pylori infections, parasites, worms, specifically Clostridia and Candida can cause a lot of issues with bloating. So, in general, I would just say any gut infection but we can break that down as much as you want to. It could be a huge cause of bloating. And, the problem is this, when you go to a conventional medical doctor or a gastroenterologist and you get some sort of bloating remedy or some sort of digestive aid, maybe an acid blocker, antispasmodic medication. Obviously, these are not addressing these infections. You could take acid blockers for the rest of your life and never clear the H. pylori that’s driving the low stomach acid which then drives the fermentation in the gut which then drives the bloating. So, I just want people to have in their heads a clear mindset of what are you taking, is it actually fixing the problem, are you just masking your symptoms. And in the case of an acid blocker, you’re actually putting yourself deeper in the hole because you’re taking low stomach acid that’s driving heartburn or an infection and you’re making it worse.
Dr. Justin Marchegiani: 100%. So, you know, the first catalyst for good digestion is a nice low pH. That good acid pH, we need good hydrochloric acid to make that happen. So, we need essentially hydrogen ions to bind to chloride in our gut and so we need chloride from minerals. So, we need good minerals, good quality sea salt that helps make stomach acid on our own. Now, if we’re under a lot of stress and our adrenal glands are in stress overdrive, it could be cortisol high or low imbalances, as well as adrenaline issues, right? It could be high or low cortisol stress issues that could put us in a fight or flight state and that sympathetic nervous system stimulus is gonna negatively impact our body’s ability to start with making stomach acid and digestive secretions and of course that stomach acid is almost like an antimicrobial. Think of like using lemon or apple cider vinegar is a natural cleaner right. They recommend these online. You can make natural cleaners usually some kind of acid as the foundation of the formula because acids are antimicrobial and so think of acids in your intestinal tract as being antimicrobial. They also, some kind of help tighten the sphincter, the esophageal sphincter from the stomach into the esophagus. It gets tightened with good acidity and so part of the reason why we get bloating and a lot of these gases rise up to the esophagus is inadequate levels of acidity and that keeps the esophagus open and then what happens when that esophagus is open over time, the fermentation acids that occur can actually, eventually irritate the bottom of the esophagus because we didn’t have enough acids to trigger that good closure in the beginning.
Evan Brand: Yeah. Yeah. So, then you’ll get these, what are called silent reflux issues sometimes it’s called GERD. And once again, prescription drugs are what’s the common remedy but once again it’s not the root cause. It may reduce the symptoms because if you have that backwash it’s gonna help slow the backwash down but it’s not gonna fix the sphincter so we might come in with extra betaine hydrochloric acid or if you’re extremely inflamed which is that someone can’t tolerate a low dose of it but then we could do something like apple cider vinegar with a meal sometimes bitters. I personally don’t do bitters, I just do HCl and enzymes.
Dr. Justin Marchegiani: Yeah. We can always test it with ginger. We can always test it with an acid like lemon, lime, or apple cider vinegar, start with a teaspoon of that and mix in a couple ounces of water and then kind of work our way up from there. So, acidity is a really important first step. Of course, if we have inefficient, um, inefficient acidity levels we can almost guarantee, we’re probably gonna have poor enzyme levels and probably gonna have poor bile acid levels, right? Bile acids are important because they help break down fat and bile acids are also slightly acidic, right, in the name of bile acid and it’s also antimicrobial. So, just like we talked about the acids having an antimicrobial benefit on the HCl side, also, bile acids have an antimicrobial benefit. We see in SIBO, a hallmark of SIBO is bile aids insufficiency and so with SIBO we don’t have enough acids there on the bile side so then we have a hard time breaking down fat and then a lot of times that fat will create indigestion, petrification because it’s not being broken down. Now, when we run certain stool tests, we’ll see increases in a metabolite called steatocrit, which is a breakdown of the fat that means it’s not being broken down in the stomach. It’s coming out at higher levels which means we’re not breaking it down. So, steatocrit is a big deal because steatocrit, if we don’t have good fat digestion, we probably have some protein digestion issues, we probably have some enzyme and acid issues and we probably have, um, some gas issues, bloating issues because these things require good digestion and if they’re not being broken down well, we’re probably getting some methane or hydrogen gases kind of rising up from that.
Evan Brand: And you know, we’re taking on the subject of bloating but it’s very common that someone with these issues you’re describing, they’re also gonna have issues with energy and probably mood like anxiety and depression because you’re mentioning this issue with fat digestion, protein digestion. Now, you’re not gonna get the aminos that you need to fuel your neurotransmitter so it’s very rare that somebody’s gonna come to us and say, hey I’m just bloated and I have nothing else. Usually, along with that bloating, you’re gonna have these tangential symptoms too like anxiety, depression, fatigue, and so I encourage people, you can focus on one smoking gun like bloating as your big thing you’re coming in for but you gonna make sure you understand there’s a bigger, deeper connection to your mood issues too. So, this is the person who’s on break, uh, someone just commented about severe brain fog. We could hit that too, uh, but somebody might come in and say, hey I’m bloated and then you tease apart their case and you go, oh so you’re actually anxious too. You’re on antidepressant and an acid blocker and this happens every day, all day. So, just to clarify, number one, we hit a low stomach or we hit infections first. Number 2, low stomach acidity, you mentioned low bile in the gallbladder. Also, let’s give a shout out to people that don’t have a gallbladder, what about these poor people, they’re gonna need a lot of supplemental help for the rest of their life. And so, unfortunately, this is a very very common procedure done in the U.S., where the gallbladders are removed and so these people are gonna need some purified bile salts forever in my opinion. Well, what’s your…?
Dr. Justin Marchegiani: Absolutely! They’re definitely gonna need bile salts and some extra enzymes like lipase but again, you gotta get to the reason why that gallbladder issue even happened. Now, most people, it’s women in their 40s who have an overweight issue and so what tends to be driving, that is usually food allergens whether it’s grains or inflammatory foods but also estrogen dominance. So, if you have an imbalance in estrogen, estrogen is gonna help promote more fat storage so you obviously have more estrogen more fat storage. A lot of times you’re gonna have PMS issues too so you may be moody, irritable, um, sleep issues, uh, you could have fibrocystic issues, uh, tenderness, a lot of pain around PMS time. So, you gotta get to the root cause of that as well. So, we started out with just bloating but you can see how then this estrogen issue can affect bile levels and good bile flow because estrogen causes everything to get really stagnant and not flow well and then you’ll start having mood issues and PMS issues and maybe even fertility issues. So, you can see how you start at one point which is bloating, which is the topic of the video but then it can spiral down this other kind of tangential pathway.
Evan Brand: Yeah. Not to mention two, let’s just say it started out with heartburn, I just want people to kind of visualize this. So, let’s say it starts out with heartburn. You go to the target and you buy Prilosec, which is over the counter acid blocker medication, you reduce your stomach acid even more but you feel some relief from the heartburn and let’s say your spouse had H. pylori, you guys pass that between each other, so now you’ve got even more reduction of stomach acid levels, you’re on the acid blocking medication. Now, you’re anxious, you’re starting to get depressed, you’re getting a bit of fatigue. As you mentioned, now, you’re getting some hormonal issues, some hormonal issues like breast tenderness or PMS or ill ability, you’ve got this dysbiosis growing in your gut so you have this bacterial infection. It could be multiple things, Strep, Staph, Klebsiella, Pseudomonas, Bordetella. And now, you’ve got beta-glucuronidase issues. Now, you’re recirculating all this estrogen. You’re creating more problems with the gallbladder. Maybe, you get the gallbladder removed. Now, you’re in really big trouble then that leads to the diet so then you read some guy on the internet who says, you need to be doing 70 – 80% vegetables. So now, you’re doing all these veggies and you’re even more bloated and you’re even more gassy and you don’t know why. So, you’re eating broccoli, you’re trying to force all these leafy greens down, a lot of vegetables. Maybe, you’re doing a lot of avocados, these higher FODMAP foods that are fermenting in the gut. This is the case where you’ve got a really, to me, the best, most beneficial thing I’ve seen for these cases, get the diet very simple, focus on good quality animal proteins and for a time being minimize your vegetables so that you can let the gut rest.
Dr. Justin Marchegiani: Yeah. Absolutely. From a solution standpoint, yeah, good proteins, good fats and then if we’re gonna do vegetables, make sure they’re cooked steamed, sauteed, maybe use an instant pot and try to make sure they’re on the lower fermentable side. Now, that being said, next, what’s another driving factor of bloating? increase in fermentable vegetables. Now, people are hearing all kinds of things about probiotics being helpful. Well, they are. There’s a lot of good benefits to probiotics and the microbiome and the endogenous nutrients they produce. They, um, whether it’s vitamin K2, whether it’s different B vitamins, really helpful. It also produces acidity which helps keep a lot of bugs and bacteria from growing in the gut, totally helpful. Now, if you already have a lot of bacterial overgrowth and bad bugs growing, sometimes, these extra good bacteria can actually cause more bloating, more gas. And then, of course, because they’re fermentable they can also create histamine too. So, the histamine may create more brain fog or headaches, more destruction there. So, you may have more histamine symptoms, you may have motility issues because they’re producing hydrogen methane gases maybe and that may cause either diarrhea on one side or maybe more constipation on the other side, definitely possible.
Evan Brand: Yeah. Yeah. Good call on the histamine. And so, some of these bacteria on your gut, they’re gonna be releasing histamine too. So, if you’re combining high histamine foods, you’re doing leftovers, let’s say, last night, you made a steak, you’re cooking that leftover protein. That’s gonna be higher in histamine. Combined with the histamine being produced from this bacterial overgrowth problem, yeah, you mentioned brain fog, skin flushing, rashes. So, once again, here we are talking about bloating but we’re trying to elucidate this big spider web of other symptoms that may be going on.
Dr. Justin Marchegiani: Correct.
Evan Brand: Um, also, what about a stress component meaning someone just simply not chewing enough, they’re rushing through their meals. I think this from a mechanical perspective. If you look at your average person, I mean I saw somebody on the highway the other day, I don’t know if it was a donut, a piece of pizza, it was some kind of junk. I couldn’t tell exactly what it was but either way there’s still people trying to do makeup, scrolling on their smartphone, eating a piece of pizza, all while driving on the highway at the same time and we wonder why they have digestive problems. So, maybe we talk about the impact of not being settled when you are eating and this sort of like, this parasympathetic process that digestion is supposed to be our ancestors, they didn’t have that level of stimulation while they were trying to eat. I mean, maybe there was a wolf trying to come, get their bison killed but beyond that there wasn’t this big sympathetic stress underneath all of our meal times.
Dr. Justin Marchegiani: Yeah. We kind of started out the video talking about the parasympathetic-sympathetic balance and how important that is because the parasympathetic is part of that rest and digest that gets the digestive secretion going. It stimulates all the blood flow into the organs, the intestines. So, of course, setting really good boundaries for your meal, you know, I recommend kind of kind of go into a meal five times or ten minutes, just kind of relax, do some deep breathing, have some appreciate, appreciation about your day, the food in front of you, you know, just whatever blessings you have in your life, just try to really get to that parasympathetic state with just good breathing in the nose, right, four to five nasal breaths in and out. Focus on whatever’s good in your life, appreciation. Whatever you have to do, whatever kind of resonating prayer to put you in that state when you just feel better and then go into that meal keep it quiet or if you want to listen to something that kind of allows you to feel good and feel rested or relaxed, that’s fine. And then, go into that meal and make sure you chew your food really well. Try to avoid a lot of hydration with the food, you know, a couple of ounces of water for swallowing some pills or digestive support is fine but try to get into that meal, like, I just had to have a good routine. Get some good hydration ahead of time, try to go into some kind of meditation or prayer for five or ten minutes ahead of time to really get that parasympathetics going and then go into your meal and really just try to chew things up pretty well too, you know, about 30 chews per bite of food on the average, kind of get your food chewed up to about an oatmeal like consistency so it’s really broken down well that’s allow the enzymes and the acids to work a lot better too.
Evan Brand: Yeah. You know, what’s interesting is a lot of people are kind of pressure into these business meetings like with their boss or with their co-workers, there’s this like work-meeting-lunch deal where people are going out with people they probably wouldn’t associate with outside of the workplace and they’re going and eating with those people. And so, I would just tell you, if you don’t like it and that’s not your vibe, don’t do it. If you feel more comfortable, more relaxed eating by yourself, don’t do it. I mean, I remember, l had some stressful conversations over lunch and dinner tables before with people over the years and I leave feeling like I didn’t eat anything and that my mind was so focused on even if it wasn’t a negative conversation. If it was on some sort of business deal or the state of the world or something and then I’m eating. I would get up from the table. I’m like, oh crap, did I eat and I didn’t process that and it would sound maybe like unnecessary advice but I think a lot of people need to be picky of what they talk about it at the dinner table.
Dr. Justin Marchegiani: Yeah. I think anything that’s gonna keep you in that parasympathetic state is great, you know, save the more stressful things before or after and I think, also, just have good boundaries. Try to make sure you get at least 20 minutes for a meal, um, to yourself, you know, I mean, if you don’t have 20, if you can’t put 20 minutes in your schedule for you to consume some good food and put yourself in that parasympathetic state then you got some boundary issues and you got to really work on roping in your schedule and getting some control over it, at least so you have that 15-20 minute to yourself and you can really process that food well. And again, I’m not saying there won’t be some exceptions or some stressful days here or there but on average try to make sure 80 to 90% of the time, you really have control over your schedule to that degree.
Evan Brand: One of my favorite things to do even in the wintertime here, if I’ve got blue skies. I’m taking my shirt off, I’m going to sit on my front porch where I’ve got a nice comfy front porch patio chair and that chai is warmed up by the sun so I just take my shirt off sit there barefoot and in the chair and eat my bison burger for lunch and the sunlight is a mast cell stabilizer so I noticed the sun helps me if I have any kind of food reactions, the sun will stabilize that, obviously there’s nitric oxide benefits. There’s likely some nervous system benefits circadian rhythm benefits. So, for me, if you can get fresh air on your lunch that’s great and what the heck does sunshine have to do with bloating, well, I mean there’s even some studies on sunlight improving the diversity of your gut and we’re outside all the time now. So, if you just type in like sunlight microbiome, you can read the papers on this, it’s in a microbiology journal about how exposure to the UV rays can improve the gut diversity so it’s no surprise that all these people in offices buildings all day, they got poor diversity. Obviously from other things but lack of sunshine is a negative factor for your gut health.
Dr. Justin Marchegiani: Yep. Yeah. Absolutely. I mean, also, there’s other bugs that are out there I think we already kind of talked about H. pylori because that can affect the stomach and that can decrease, um, acid production and thus when acid production is down, we know enzyme production is also down and then that can also affect biliary function, biofunction, so we know H. pylori is a big thing. Other bugs can be problematic, right? We already mentioned SIBO, which could be a whole bunch of different bacteria that are overgrown in the small intestine that could be Citrobacter, Prevotella, Klebsiella, Pseudomonas, Morganella, right? It doesn’t really matter the actual bugs but if there’s an overgrowth there, they can definitely disrupt digestion creating different gases on the methane and hydrogen side and that can create obviously more bloat. Other parasites can cause problems too. So, we see things like Blasto, Blastocystis hominis, right? E. histo, D. fragilis, Giardia, Cryptosporidia, these are all other bugs that could be problematic. Then even things like fungal overgrowth like Candida overgrowth, whether it’s a Rhodotorula species, Albican species, these types of imbalances can cause problems. So, it’s good to test and really make sure that we look at the whole microbiome and see what’s out of balance or not and then from there food wise, I mean, of course, general refined sugar, refined grains, right? These processed foods, excess fiber, lots of raw vegetables, uh, fermentable carbohydrates, right? These things are gonna be on the list, as well. And so, we’ll kind of add those. There are a lot of different things that we have to look at so I kind of gave you the top five or six on this list. Anything else, um, Evan, you wanna add to it?
Evan Brand: Well, I would just say that if you’re coming into this conversation, you’re listening, maybe you don’t have much background and listening to people like you and I talk about functional medicine strategy. Some of this may just go right over your head. You may just tune out because you’re hearing these things which sound exotic and they sound rare, like H. pylori. I don’t have that. Giardia, what the heck is that? Blasto, though I don’t have that. You know, I just have bloating. The reality is these are very common things. The problem is the testing that’s used in the conventional gastroenterology world is very outdated and very insensitive, meaning there’s a lot of infections that go missed and even if these infections are tested for, it’s not likely that you’re gonna find an accurate result. And so, what we’re talking about, these are not rare situations, you and I, between us both, we’ve seen several thousand clients and patients across the world over the last decade and we can tell you that these issues are something we see every day, all day. So much so that in fact when I see a whole big list of infections on the stool test, I don’t get shocked by it. Yep. Uh-huh. That’s it. That’s what we’ve got. So, if you’re listening to this, you’re like, ‘man, that’s not me. I’m just bloated and tired.’ Well, there’s a reason for that. And so, I highly recommend you get tested, figure out what the heck you got, going on because if you’re not testing, you’re guessing and if you’re going and taking probiotics or random enzymes and you don’t feel better or you’re confused about what you should actually taking and not taking and you’re building up a supplement graveyard. It’s time for you to get tested and figure out what the heck you’re up against. And so, if you need help, you can reach out clinically, Dr. J is at justinhealth.com. you can reach out and do consults worldwide. So, we jump on a video call just like we’re doing here, Zoom, facetime, skype, we can look at your labs that you run at home and we can figure out what’s going on and make you – a game plan to get better. And if you need help for me, it’s Evan, evanbrand.com and either one of us, Dr. J, justinhealth.com, evanbrand.com, we’re here to help you and the cool thing is you can reverse these issues and you can get to a point where you don’t even recognize your gut health. I mean, if I look back at myself even 10 years ago, I had such severe IBS. I did every diet under the sun and I made some progress but it wasn’t until I looked at my gut that I really made the magic happen.
Dr. Justin Marchegiani: 100%. And so, just to kind of highlight a couple of things out of the gates, um, we’ll put some links below as well to some of the lab tests that we recommend, whether it’s the stool testing, whether it’s the organic acid testing which does look at bacterial and yeast metabolites. I love the organic acid because it’s very good at picking up Candida and yeast overgrowth, where a lot of times those tool testing will miss that and of course the, um, breath test will not touch any yeast overgrowth. So, it’s nice to have whether it’s stool test, whether it’s the GI map, whether it’s an organic acid, whether it’s a conventional lactulose, breath test, these are all good tests. We’ll put links down below. So, if you guys want to look at getting some of those to start out at the gates, you feel free, you can. Also, I like to compare and contrast like what we do versus the conventional gastroenterologist. So, most gastro docs, they’re just trying to rule out significant pathology, significant disease and so they may cross off the list by doing some kind of an endoscopy, which is camera down the mouth to look at inflammation in the stomach or esophagus and if they see esophagitis or gastritis, you know, what they’re going to do, they’re gonna recommend some type of PPI or Gaviscon or some type of a coding agent to kind of help reduce the inflammation but they’re not gonna really fix the root cause. Most of the time, they pull you off acids, which may be helpful in the short run but it’s forever altering your ability to break down protein or fat and it also can shift your bugs in a negative direction because now you don’t have the good acidity to keep the microbes down. You need the acidity to activate enzymes, you need the acidity to activate your bile salts. So, someone’s jumping in on the questions here saying that hey they feel better on keto but now they’re feeling more constipated. Yeah, super common because what’s happening is you’re cutting out a lot of the foods that are causing problems but you haven’t fixed your digestion, you don’t have enough acidity, enzymes, bile, there may be some bugs that are still impacting digestion and this is why being on good proteins and fats can be helpful but they also reveal weak links in your digestive chain if you’re not breaking down food well. So, just kind of getting back on the gastro doc kind of bandwagon, they’re gonna be looking at pathology inflammation in the stomach, you know, ruling out the big things like blood, um, in the ulceration in the stomach, you know, usually you’re gonna know that because you’re coughing it up but you’re seeing it in your stool. If you have irritable bowel disease symptoms like Crohn’s or ulcerative colitis, usually, you’re gonna have significant inflammation in the stomach, usually significant diarrhea, blood in the stool, they’re gonna rule that out and then what and then for the most part, once the big pathology things, ulcerations, cancer, massive amounts of inflammation are ruled out, they’re gonna typically give you like IBS diagnosis, whether it’s IBS-D for diarrhea or IBS-C for constipation and they’re gonna just manage whatever symptoms whether those symptoms are with different drugs. So, if it’s constipation, they’ll use laxatives. If it’s diarrhea, they’ll use things like Imodium or Pepto Bismol or anti-inflammatories. They’ll just modulate the symptoms with drugs and that’s it and they’re not gonna really get to the root cause. They’re gonna just try to spot the treat and then that’s where people come to us because overtime, those drugs will become less and less effective, you have more and more side effects, you’re not fixing digestion, you’re creating more nutritional deficiencies, maybe more gut permeability issues, maybe more autoimmune stuff and so these patients then come to us because they’re just tired of putting band-aids over band-aids.
Evan Brand: Yeah. Well said. I forgot to mention the endoscopic procedure that is super common, uh, they wanted to do that on me, years ago, when I had IBS and I denied that because I even back then I had read about these infections that people were acquiring from getting scoped meaning the last person that they put the tube down, they didn’t properly clean or sanitize that so then they stick it down your throat and then you leave the hospital just to investigate and as you said, the only thing that’s gonna come out to that is they may say gastritis which is super generic. It doesn’t tell you anything about these infections and they’re not gonna give you an herbal protocol to address the infection causing the gastritis. But now, you’ve left the hospital with Clostridia or some other possibly antibiotic resistant infection that’s involved to evade the sterilizing and cleaning procedures. So, I’m all about non-invasive, accurate, functional medicine testing and that’s why we love what we do because there’s a very rare, maybe one every five years, yeah, is there a case where I’m like yeah, you need an endoscopy because there’s something crazy here.
Dr. Justin Marchegiani: Yeah. Usually, with an endoscopy or colonoscopy which is gonna be going up the rectum to look in the colon. Usually, there’s gonna be blood in the stool, some type of significant inflammation, whether it’s excessive diarrhea, excessive inflammation, excessive blood in the stool, excessive weight loss. It has to be at the extreme ends for that to make sense. Most people just have inflammation and a lot of times the tests won’t kind of tell you enough about the root cause, they’re just gonna put you on medications to manage the symptoms and that’s where you’re kind of stuck in between. Now, a lot of my ulcerative colitis, IBD patients, they’ve already done that. Yeah, so then, it’s like all right, they’ve kind of already crossed that off their list any weird cancers, ulcers, it’s already done, they know, they’re just being managed with Lialda, Prednisone, a biologic and then it’s like, now what, right? And so, we still have to get to the root cause of that and get the immune system chilled out and figure out what stressors are there so we can get on top of that too.
Evan Brand: Yeah. I mean, I know you and I have seen countless emails being sent to us with pictures of colons and you know different things from these scopes like hey there’s my scope results, you know, what do you have to say about it and the answer is always the same. Okay, there’s something there, let’s work on the infections. And so, uh, yeah, someone in the chat, uh, shelly said, yes that they all recommended me, every time, I go to the doctor. So, yeah, that, I mean that’s all they’ve got, they don’t have the stuff that we’re using maybe in 20 years from now you can go right down the street and get done what we’re talking about but for now you’ve got to seek out somebody like us that’s gonna be able to help you, uh, there’s one person in the chat too asking about a viral impact on the gut, it’s real. I did a whole section of that in my better belly course about that virus in the gut and so it’s definitely a big factor.
Dr. Justin Marchegiani: Yeah, and just to kind of, uh, speak, kind of on the line here, so, um, we can, we don’t get censored, there’s certain viruses that are out there, right? There’s an ACE2 receptor site that gets impacted in these different viruses and the ACE2 receptor site, there are a lot of them in the gut and these receptor sites are really important for absorbing amino acids and so if you have any of these maybe chronic viral issues, one of the good things that you can do is actually extra free form amino acids to allow these receptor sites to absorb these amino acids easier, right? I think the free-form amino acids are already broken down. So, if you have this chronic immune stress and you’re having a hard time recovering from the immune stress adding in some additional free form amino acids can be very, very helpful on the healing side.
Evan Brand: Yeah. I’ve seen a lot and there’s papers on this too but I’ve seen it clinically too. People post viruses that will look at their stool, there’s gut inflammation, there’s low secretory IgA, so we can see there’s been some damage and so we have been able to resolve it. So, yeah, we’ll wrap this thing up but if you al need help, please reach out clinically, we mention the websites one more time, Dr. J, that’s justinhealth.com, me evanbrand.com and we’re here to help you guys, so you can reach out and we’ll get to the bottom of this.
Dr. Justin Marchegiani: And sometimes, we’ll even use some kind of an elemental diet with people that have chronic digestive issues just because it can be hard, breaking protein and fat down and these are really good, important nutrients but sometimes we just got to break it down for them and using some kind of an elemental or a modified elemental, where maybe you make the first four to six hours of the day, really easy to process in some kind of smoothie or shake that has most of the amino acids in free form, maybe the fats more easy to process like in an MCT oil or something like that and then we use a lot of the vitamins and minerals all broken down. That could be very helpful and give the digestive system a chance to rest and some people they notice this because they just feel really good when they fast and so if you fast and you feel really good that’s excellent but you’re still not fixing the problem of getting nutrients in the system so that’s where using some kind of an elemental type of shake can be really helpful.
Evan Brand: Yeah. Well said. Well, I’m done. I feel like we’ve covered a lot of good stuff here.
Dr. Justin Marchegiani: Excellent. Yeah. I mean someone asked one question about flour substitutes. It just depends on where someone’s at, so flour, it’s a processed food so out of the gates, if someone wants, um, like a starch, um, I recommend maybe a greener banana, maybe yucca, cassava, maybe a Kabocha, spaghetti squash. Just look at some of the fibers, uh, non-starch, I should say, more starchy carbohydrates that are gonna be grain-free, see how you do with that. And then, if you want an actual flour, you can look at it like an arrowroot or you can look at it like a cassava is pretty good because it’s still grain-free but it’s still gonna be on the processed side. So, ideally, try to keep it grain-free so you don’t have extra gluten sensitivity connection with those.
Evan Brand: Yeah. Definitely. That’s what I was gonna say too. Potatoes, rice, a lot of these things can still create problems for people. I’ve had many people feel like crap on some of these gluten-free breads. So, yeah, it’s still processed garbage in my opinion.
Dr. Justin Marchegiani: Yeah. And then, someone wrote in about the, um, the onions there. Onions are very high in FODMAPs and that can be a problem and so if you head, your gut feeling a lot better and you can come back in and you’re noticing FODMAPs are creeping into your diet and causing a lot more bleeding definitely kind of, you know, rain that back in and see how much that back in and see how much that kind of brings you back to homeostasis.
Evan Brand: Yeah. This person told, uh, they said that they’ve had similar issues with cabbage, brussels sprouts, and other similar veggies. So, yeah, I mean I would go more animal-based. See how you feel with just some meat and some berries for a little while. Maybe if you tolerate a little bit of some organic pecans, if you want to do a little bit of nuts but do like a bison burger and a handful of blueberries for lunch and see if you feel better. I suspect you will.
Dr. Justin Marchegiani: Yeah. At least, just try, you know, cutting out the higher FODMAP foods because when you address microbes, right? You starve it on one side with restricting certain foods that can feed it, you can kill it with certain herbals and then you crowd it out with probiotics. And so, sometimes, we have to go back to the killing side and kill the microbes out a little bit more but I always just see how much the starving kind of works. Get the starving going again and then if you have to kind of return to a protocol, where we knock down the microbes with herbs, we can always do that too.
Evan Brand: Yeah, and we’ve made these protocols a lot. It’s really fun to combine and mix and match and get the synergistic effect of this herb plus that herb. I mean, that’s where the magic really happens and there is an art to this too like you said when to cycle things on when to cycle them off, so there’s not just this one cookie cutter thing that you have to do. You really got to just work with the person. Certain herbs are used for certain parasites, certain ones we use for bacteria, certain ones we use for fungus. It depends on what you got, most of the time it’s a combination of all these bugs.
Dr. Justin Marchegiani: Awesome. Hey, Evan, great podcast today. Hope everyone at home listening enjoyed it. Feel free to share with friends or family. Put your comments down below. Let me know what things that you guys have tried at home that have worked well or haven’t. Really appreciate the conversation. Evan, have an awesome day man.
Evan Brand: You too, take it easy.
Dr. Justin Marchegiani: Take care. Bye.
Evan Brand: See you. Bye-bye.
Post Viral Immune Support To Improve Energy | Podcast #363
What you eat after a viral infection, when symptoms of fatigue persist, can have a marked impact on your speed of recovery. Dr. J and Evan discuss that specific foods need to be avoided or included in your diet to improve your immune system. So what are the truth and the evidence about diet and post-viral immune support?
The good news is that most people will benefit from some considerations when recovering from illness or infection. Having post-viral fatigue means that you will not have your usual energy to think, shop, prepare or eat as before. Be very practical and kind to yourself. Dr. J and Evan added that diet modification is vital in your recovery.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:57 – The role of acid-pH level in the digestive system
5:01 – The link of depression and anxiety to bloating
10:02 – The benefits of probiotics and effects of stress to digestive health
18:17 – Functional medicine strategies and testing to find the root cause of bloating
Dr. Justin Marchegiani: And we are live. It’s Dr. J in the house with Evan Brand. Evan, how you doing man? How are your holidays? How’s everything going brother?
Evan Brand: Everything’s going pretty good. I’m trying to start 2022 off with a bang. I suspect it’s gonna be a better year than 2021. People are becoming smarter. They’re becoming more educated. They’re becoming more resourceful. People are waking up. There’s a lot of, we’re in the great awakening and so I think, this is an important time to be alive and an important time if you’re a parent, if you’re a husband, a wife, if you’ve got kids, if you’re a teacher. It’s important time to keep your eyes open and keep your ears to the ground because stuff changes quickly and you got to be like a little speedboot. You got to be able to take turns quick, you don’t want to be the titanic right now, you don’t wanna be slow in taking big turns, you gotta be nimble in these times and so what I’m alluding to is just you got to be able to navigate the world of health which is quickly evolving and that’s true. What we’re trying to talk about today is post viral fatigue and really that’s just the title but this really could apply to bacterial infections and parasites and mold exposure but we just wanted to try to zoom in a little bit specifically on post viral fatigue and things like Epstein Barr virus, many people are familiar with and there’s a lot of people that report their chronic fatigue, picking up after something like EBV, we’ve seen it a lot with the virus going around now which would probably get flagged and censored so we won’t say it but you know what it is and there’s a lot of post, uh, viral fatigue going on from that and so you and I have dealt with some of that, you’re still going through the thick of it right now but I think you’re coming through pretty well, you’re still working and obviously you’re on your feet right now literally standing so that’s exciting and yeah.
Dr. Justin Marchegiani: For the listeners, I had COVID last week, actually symptoms started on Wednesday. Really two hard days of symptoms, I was able to work the whole time though, I mean I think that the symptoms for my COVID that were, um, tough was I would say achiness and then like sensitivity to cold like it was like 45 degrees out and it felt like it was minus 10. So, I would say sensitivity to cold and then also getting really hot at some points, getting out where I would sweat through my shirt. So hot and cold, achiness/ headaches and then like easily out of breath but I mean for me I mean, it was still fine where I could work and still do the things I had to do. So it wasn’t that bad, I mean, I had a flu in 2013 where I was literally laid up for over two days and I couldn’t do anything so I know laid up feels like it wasn’t even close to the flu of 2013 for me, that was really hard. So, definitely, um, not as bad, I actually was my own worst enemy because on Friday I was feeling like really good like 80-90% better and did like 2-3 hours of housework like cleaning my house like doing all this different stuff because it was a beautiful day and I’m like all right let me get on top of some work, work 3 hours probably walk like 15,000 steps and that next day there was a major relapse in how I felt. It was probably like I went backwards 30-40%. Here I was at 80% probably going backwards to 50. I was like whoa what happened and so then I just kind of got in the straight and narrow and just said okay I gotta really make sure I kind of make sure I kind of keep it easy until I get back to 100% because, you know, um, it just you didn’t realize how much, uh, things could go backwards so fast so you really gotta wait till you get a 100% on things and so overall I mean the only thing lingering for me right now is a slight bit of um out of breathiness and, uh, this little lingering deep tickle cough like right now you can feel it like someone’s tickling the back of your throat with your finger and you want to cough to scratch it, kind of like that and so that’s where I’m at now. That’s like kind of makes it feel like I scratch it right there, right. So, I’m doing some ginger tea, I’m doing with the Manuka honey that soothes it like that helps with the irritation. It’s not knocking the cough down. Doing some, Elderberry, um, doing some thieves, uh, natural cough drops with essential oils, um, also doing some nebulizer so I’m doing some glutathione nebulization so those are couple of things I’m doing and then obviously sinus flushes, the amount of mucus that is coming out of me is out of control so sinus flushes are really, really important because if you do not flush your sinuses, the amount of stuff that stays inside of you, oh my God. So, flushing my sinuses out 3-4 times a day, you know, really good saline reverse osmosis with a little bit of silver in there to kind of keep things flushed out is helping a lot. So, that’s kind of where I’m at but honestly feeling pretty good, um, the whole family got it purposefully, my wife had it and I’m like come over here honey gave her a big kiss and then I kissed all my kids, I’m like we’re done. We’re gonna get this thing all together, be done with it all that way we’re not, you know, I get it next month and then I’m isolating for two weeks and then my kids get no we’re gonna get it all at the same time and surprisingly my kids’ symptoms were 80% less than the adults, super, super minor. I couldn’t believe how minor it was for the kids, so very interesting. So, that was kind of my experience with, uh, with the big C, uh, so to speak. And also, the big correlation I was listening to someone talk about this, the, a lot of the post C symptoms that we see after, right, people that have dysglycemia, and blood sugar issues tend to be a big driving factor of a lot of these post viral symptoms afterwards. Talking about post-viral fatigue, one of the big things is make sure you manage your glycemia, meaning you’re having good protein, you’re having good fats, you’re not eating a bunch of refined sugar, grains, those kinds of things. Make sure you put good metaphorical logs on the fire, good proteins, good fats to really work on blood sugar stability.
Evan Brand: Yeah. Yeah. We’ll I’m glad that you’re coming through it. Regarding the shortness of breath, I would kind of put that in the same category as the post viral fatigue because that shortness of breath can create fatigue and the best thing that’s helped me and has helped many clients is doing the color oxygen. So, ChlorOxygen, you can get that on amazon, it’s readily available. And it’s just a, it’s a liquid chlorophyll extract. So, when you do that within probably 5-10 minutes, you can feel a difference, so it’s like C-h-l-o-r-Oxygen, ChlorOxygen. I would probably do 10-20 drops up to 3 times per day. That thing is absolutely incredible. You can go as high as one tablespoon in 20 ounces of water and just sip on that throughout the day. I had one guy in New York, major, major issues with shortness of breath in the acute and the long term and that ChlorOxygen literally just turned his situation around. So, I’d get some of that stuff.
Dr. Justin Marchegiani: So, it’s C-h-l-o-r Oxygen?
Evan Brand: Yeah, ChlorOxygen. Yeah, and it comes in a little bottle tincture and it’s incredible. Also, something I’ve used personally, I’ve used with several clients too is Ailanthus. Ailanthus is three of heaven which is an invasive tree. I see a lot of it in Kentucky but you can buy Ailanthus tincture and that one is also really, really good.
Dr. Justin Marchegiani: Interesting. Is this the one, right here, Is the ChlorOxygen?
Evan Brand: Yeah. That’s the one. Yep.
Dr. Justin Marchegiani: Okay. Cool.
Evan Brand: Get you some of that but should help because that’s the problem is, you know, the shortness of breath was pretty bad for me and I felt better, you know, I got infected a long time ago. It was like August 2020 and then six months later that’s when I started to have some shortness of breath which I was like, holy crap and so luckily, I was able to knock it out, uh, with Demectin and uh, yeah, Demectin really helped me and then the nebulizer and the ChlorOxygen, I would say that combination was an absolute game changer, luckily, I haven’t had any issues since then. But what we are seeing is that the mitochondria have a role in this and some of this post-viral fatigue we’re seeing is due to mitochondrial damage so I’ve been fortunate enough to see a few dozen people now. And in terms of organic acids testing after the virus, and we are seeing that the mitochondria definitely showed dysfunction. You and I talked about this many times on other podcast about the mitochondria. We can measure the dysfunction and so what we’re doing is we’re coming in with mitochondrial support nutrients so CoQ10, we’re coming in with carnitine, ribose, a lot of these amino acids and B vitamins like riboflavin which can help fuel the krebs cycle and then also we can use things like PQQ to help get the mitochondrial biogenesis going, meaning we’re literally making new mitochondria so we can measure this on paper. So, if you guys are suffering, you know, one of us can reach out or you reach out to us rather and then we can get the urine looked at because we can measure this. You don’t have to guess where is this fatigue coming from. If it’s a mitochondrial induced problem, we can measure that. Now, you have permission to have multiple things wrong with you so there could be a dopamine problem, there could be a mitochondrial problem, there could be toxin problem. So, rarely is there one issue causing this fatigue but the goal is for us to try to get as many puzzle pieces laid out in front of us and then make an appropriate protocol.
Dr. Justin Marchegiani: 100%. I’d say, the worst thing about COVID for me right now, coffee tastes bitter like it tastes bitter, almost a little bit sour, does not taste like coffee. I’ve almost been like I’m not even gonna drink it right now until this thing gets better because it does not taste that good but for me I’m just alright, I got, you know, 20 grams of collagen in there, I got some good fats, I kind of look at it as like a meal replacement for me. So, that’s probably the worst thing the whole time. For me, it kind of felt like a cold. I’d say a mild, mild to middle of the road cold. The only thing that really surprised me was that, that back swing where I was like 80% better and then went backwards that was the hardest thing.
Evan Brand: And, it could have been you overdoing it for sure, I mean,
Dr. Justin Marchegiani: oh, you totally did.
Evan Brand: Yeah. I mean I did have a little bit of that too where I kind of felt like I was better, overdid it and then I heard it again, so.
Dr. Justin Marchegiani: Yeah. 100%. So, excuse me, anything else you wanted to highlight on that so far? I would say post-viral stuff, the things that I’m doing right now and I recommend people do, in general, are gonna be Adaptogens and I like medicinal mushrooms. So, Shiitake, Maitake, Reishi. Reishi is great. I love it because it does deactivate viruses. It does build up and support the natural killer immune cells so I do like that, uh, any type of ginseng, Ashwagandha, these are things that help support energy production, support the adrenals, help buffer the HPA excess. So, any of these types of things are gonna be, uh, helpful too.
Evan Brand: You need to get on some Lion’s Mane too for your taste because what I’m finding is that the nerves are damaged and that’s affecting the sinus. So, the sense of smell, sense of taste, some of that is related to nerve damage. So, I would probably hit Lion’s Mane, maybe like two caps twice a day. That’s been helpful to restore the sense of smell and taste in some people.
Dr. Justin Marchegiani: It’s probably not damaged. It’s probably just more inflammation, right?
Evan Brand: Well, the long-term stuff, I’m talking to people just long-term. I’m talking to people that you know 6-8 months later say, I still can’t taste or smell. Bringing in Lion’s Mane, like 2 caps twice a day. It takes a few months but you know it does increase nerve growth factor and so I think that’s the mechanism.
Dr. Justin Marchegiani: That’s interesting. Yeah. I do have some Lion’s Mane. I’ll definitely add that in. I mean, I think medicinal mushrooms are gonna be really good to, um, be on top of, uh, just supporting your immune system and like helping with, um, the body regenerate and heal better.
Evan Brand: Yeah. Gabe was asking a question in the live chat on YouTube. How did you guys catch it? I don’t know, I mean I work from home. You know, I’ve got a home office, uh, Justin has a home office as well, you know, I do go out, uh.
Dr. Justin Marchegiani: Personally, it’s the new variant. The new variant has an R-naught of seven, which is that’s equal to, uh, measles so the delta variant had an R-naught of 2 or 3 so that means for every one person that gets it, it can be passed to 2-3 on average, right. The new omicron variant, it’s seven, so you can literally pass it to seven people so I think my wife was in a yoga class with three people and they were like spread out across that broom like they were like way you know spaced apart, you know, for just all the safety reasons and it was still able to get it so my whole take on omicron, it’s very, um, I think the symptoms are milder than delta for sure. That’s what everything’s been reported but, um, it’s way more contagious. Everyone’s gonna get it at this point, you just gotta have your plan and, um, be ready ahead of time, right? People don’t have a plan and then when they get it then they get stuck and they feel like they have to go to the hospital and you don’t have as many options there so try to have a, um, outpatient plan ready to rock and roll but yeah, you’re gonna get it because the, um, our knot on this thing, right, is that seven which is at a level close to measles so it’s right there. So, if you haven’t got it yet, you will. Anything else you wanna highlight on the immune side, on the post-viral stuff obviously I’m a big fan of ginger, I think ginger is nice because it’s anti-inflammatory, anti-viral, uh, helps with lymphatic. So, if your kind of like have a lot of like stagnant lymph in the chest area or in the neck I really keeps the lymph moving all that’s very helpful.
Evan Brand: Yeah. There was, uh, one person that commented if you’ve had delta you should have some memory T cells that will help if you get infected. Yes supposedly. Supposedly, um.
Dr. Justin Marchegiani: Yeah. You definitely should have memory T cells as well as memory B cells, right? So, even if you were to get sick again, um, you’re gonna be able to recruit antibodies way faster, right? Normally when you get sick if you’re first time getting exposed to an infection it takes about a week or so to really get those antibodies ramped up and so even if you were to get sick twice, you’re gonna be able to make those antibodies inside of, you know, 24 hours or so. So, you’re gonna be able to bring those antibodies to the table a lot faster and so that’s, um, that’s pretty cool. That’s pretty helpful.
Evan Brand: Yeah. Other strategies, uh, post-viral fatigue hyperbaric oxygen has been helpful. I’ve seen several clients that luckily have lived in a city where they’ve had access to do hyperbaric oxygen. Essentially, what it is, is it’s replicating being under water under water about 10 to 12 feet so that pressure is helping to get oxygen deeper inside of you. So, some of these tissues may have been starved of oxygen. This sort of mild hypoxia or hypoxemia, you know, you can basically reverse that by getting the hyperbaric oxygen. There are some people that can do there’s oxygen cans, little portable oxygen shots, if you will but it’s nothing compared to an oxygen concentrator with the hyperbaric oxygen so that’s good ongoing, I mean, I’ve had clients with Lyme that have done hyperbaric we know that’s incredible for traumatic brain injuries and concussions and that sort of thing. So, even if this is just a long-term fatigue problem, not related to viral issues at all, you know, hyperbaric is another good tool, you’re looking at probably around 100 a session but, you know, what, what’s your health? What is your health worth? So.
Dr. Justin Marchegiani: Exactly. One thing I did was very helpful was use my infrared sauna the last couple of days. That was helpful, just getting a really good sweat in felt very good, you know, raising that body temperature up can be very helpful just at um at your body knocking down viruses. That’s part of the reason why you get, um, chill while you get the nutshells but, uh, why you get a fever right. It’s part of the reason your immune system is actually knocking down some of that bacteria and or viruses by doing it that way so using an infrared sauna can be helpful too.
Evan Brand: So, look at your mitochondria, get your organic acids test done, we can measure that and look at mitochondrial function come in with specific support whether it’s B vitamins, adaptogenic herbs like Rhodiola, you mentioned, Siberian ginseng or Eleuthero. There’s medicinal mushrooms like cordyceps which there is some benefits. There are some papers on cordyceps and athletes and improving blood flow. There may be some level of oxygenation that happens with cordyceps too. So, cordyceps, reishi mushroom, I think the Lion’s mane for the brain and for the nerves would be beneficial, the ChlorOxygen for any of the shortness of breath along with the fatigue, rest, I mean just getting good quality sleep, making sure you got to do whatever you can to get good quality sleep. So, all the same sleep hygiene habits we’ve talked about for a decade together apply in regards to candling down at night if you need some passion flower. Even melatonin, there’s some really cool studies on melatonin. We know, it’s a very powerful antioxidant and we are seeing higher doses of melatonin be beneficial. So, in general, somewhere around 5 milligrams but there are some papers going wat up 30 – 40 – 50 milligrams and beyond. I don’t know a ton about the high dose so I’ll just tell you that the regular dose standard dosing is better than nothing.
Dr. Justin Marchegiani: It was that melatonin?
Evan Brand: Melatonin. Yes.
Dr. Justin Marchegiani: Yeah. Usually, it’s like the higher dose is like 10 milligrams and that’s gonna help with the oxygenation and then 30 – 500 milligrams for the arginine that’s to really increase the oxygenation.
Evan Brand: Yeah. The arginine for like nitric oxide production. Beet powder, you know, beet powder would be good too. So, anything you could do to create some vasodilation is gonna be smart.
Dr. Justin Marchegiani: Very cool. Anything else you wanna add, Evan?
Evan Brand: I think that’s it. If you need help, reach out, get tested, hopefully you get back on the full mend here so, keep, keep rolling. You’re doing a great job and hope everybody is doing well and we’ll be in touch next week. If you need help clinically, please reach out. You can reach out to Dr. J at justinhealth.com or me, Evan Brand, at evanbrand.com. We’re happy to help you guys. Keep your head up. keep moving forward.
Dr. Justin Marchegiani: I think the big thing out of the gates is to make sure you have time to sleep, rest. Don’t overdo it. Just know your body still needs more time even when you, when you’ve gotten through the whole thing to recover. Don’t overdo it. That’s really important. Keep the foundational nutrients dialed in so that would be like zinc, vitamin C, vitamin D, you know, you can keep those things in there. You may not have to use them at such a high level that you did with the infection but keep some of those nutrients. Don’t go from something to nothing. Keep something in there the whole time, find a medicinal mushroom that you like, find an adaptogen that you like. Maybe keep a little bit of ginger tea going. Something that has some antiviral support and um, you know, try to get a little bit of movement but if it’s making you feel winded then just try to do just enough where you can feel like you’re doing something but not where it’s overly taxing you. I think it’s really important to kind of meet that right in the middle.
Evan Brand: Last thing, two last things, a low histamine diet is generally pretty helpful because there are a lot of issues with mast cell activation being triggered from this. So, a lower histamine diet, fresh meat, and no leftovers is very important. And then, histamine support. I’ve got a product called histamine support but essentially it’s quercetin plus some other nutrients so anything, you can do to stabilize your mast cells that’s gonna be helpful because muscle activation can cause fatigue, meaning, after the viral issue was over, the immune system can sort of have PTSD for lack of a better terminology and the immune system will go into this crazy state where it will shut you down so that fatigue trying to rebuild that energy back up is re-regulating the immune system so like the quercetin, other mast cell stabilizers are very helpful.
Dr. Justin Marchegiani: Love it. Love it. Love it. Makes total sense and again not everyone’s gonna have that issue but you know, it’s kind of good to know if you fit into that camp. Those are a couple of strategies out of the gates. Anything else, Evan?
Evan Brand: No, that’s it. Take it easy. If people need help, reach out justinhealth.com and evanbrand.com will be available.
Dr. Justin Marchegiani: Yeah. We’re here to help you guys. I’ll probably be back later on today here. So, keep a lookout, comments down below. Let us know your thoughts on the topic, we appreciate a review. We appreciate shares to friends and family. Really helps us get the word out. You guys have a phenomenal day. We’ll talk soon.
Evan Brand: Take it easy. Bye-bye
Dr. Justin Marchegiani: Bye you all.